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Biomedical subjects

Eiji Yano

Publications and source records attributed to Eiji Yano.

At least 19 recordsLinked to original sources
PubMed2006

Patients' preferences for decision making and the feeling of being understood in the medical encounter among patients with rheumatoid arthritis.

OBJECTIVE: To examine how patients' preferences for decision making in the medical encounter affect the association between their participation style and the feeling of being understood by the physician. METHODS: The study group comprised 115 patients with rheumatoid arthritis who were under continuous care by 8 rheumatologists at a university-affiliated rheumatology clinic in Tokyo, Japan. A questionnaire was distributed just after each encounter, in which patients' self-reported participation in communication during the visit, preference for decision making, and the feeling of being understood were measured. The feeling of being understood was regressed on the participation style and preference for decision making after controlling for demographic and functional variables. RESULTS: Patient participation in visit communication was positively associated with the feeling of being understood. This relationship was moderated by patients' preference for decision making. Patients with higher preference for decision making were more likely to feel understood when they more actively participated in visit communication, whereas this relationship was weaker among those with lower preference for decision making. CONCLUSION: Inviting patients to participate in visit communication may not always enhance the feeling of being understood by the physician when patients have less preference for autonomous decision making in the relationship with the physician. Exploring patients' preferences in the relationship would help physicians understand what the patient expects from visit communication and tailor their practice style to meet patients' needs.

Adult↗
PubMed2006

Regular prescriptions for benzodiazepines: a cross-sectional study of outpatients at a university hospital.

OBJECTIVE: To investigate 1) the patterns of regular prescriptions for benzodiazepines among department clinics in a university teaching hospital, 2) the effects of patient's characteristics on regular benzodiazepine prescriptions, and 3) the patterns of benzodiazepine prescriptions among department clinics from the perspective of pharmacological half-life. PATIENTS: Patients were 22,099 outpatients (51% female; mean age: 56 years) who were prescribed any drug three or more times. METHODS: Cross-sectional study of patient-based data (July 2002 to August 2003) from the database of a computer ordering system at a university hospital. The patterns of regular prescriptions for benzodiazepines were compared among the clinical departments (i.e., Internal Medicine, Psychiatry, and Others). A logistic regression model was used to assess the effects of patient gender and age, and the clinic visited on the issuing of regular prescriptions for benzodiazepines. RESULTS: Regular benzodiazepine users were 3,204 (14.5%). Benzodiazepines were more likely to be prescribed for women (61.3%) than for men and were prescribed most often by psychiatrists (31.7%), followed by internists (20.1%). Multivairate logistic regression model showed that being female and elderly, and being prescribed by a psychiatrist were significantly associated with regular benzodiazepine prescriptions. With regard to the pharmacological half-life, internists were more likely to prescribe short half-life benzodiazepines than were psychiatrists (p < 0.001). CONCLUSION: A large number of outpatients at a Japanese university hospital appeared to be maintained on a regular supply of benzodiazepine drugs. Educational programs are needed to promote the rational prescribing of benzodiazepines.

Age Distribution↗
PubMed2006

Respiratory symptoms and lung function in Bangkok school children.

BACKGROUND: Previous epidemiological studies have shown acute effects of ambient air pollutants in children with respiratory disorders. METHODS: The chronic effects of air pollution in Bangkok children were investigated. Children aged 10-15 years were examined for lung functions using spirometry tests and for respiratory symptoms by the American Thoracic Society's Division of Lung Diseases (ATS-DLD-78-C) questionnaire during May-August 2004. Effects of residential area were estimated by multiple logistic regression analysis. Of the 878 children, 722 (82%) had completed lung function test and ATS-DLD questionnaire. RESULTS: In children, who live in roadside (R) and general (G) areas with high (H) pollution, the prevalence of respiratory symptoms increased significantly [odds ratios (95% confidence interval) in HR and HG are 2.44 (1.21-4.93) and 2.60 (1.38-4.91), respectively]. Children with normal lung function were less observed in H- and M-polluted roadside and general area [HR, OR = 1.41 (95% CI 0.89-2.22); HG, 1.08 (0.71-1.64); and MR, 0.99 (0.63-1.57)]. Residential locations and family members were associated with the prevalence of respiratory symptoms, whereas factors such as the responder of ATS-DLD, gender, age, residential years, home size, parental smoking habits, use of air conditioners, and domestic pets were not associated. Age was associated with the impaired lung function, whereas others factors were not associated. CONCLUSION: The prevalence of respiratory symptoms and impaired lung function were higher among children living in areas with high pollution than those in areas with low pollution.

Adolescent↗
PubMed2006

Adverse effects of asbestos exposure and smoking on lung function.

BACKGROUND: Exposure to asbestos is a well-recognized cause of both malignant and nonmalignant diseases of lung parenchyma and pleura. This study was conducted to determine the adverse effects of exposure to asbestos and smoking on pulmonary function. METHODS: Four hundred and sixty-eight workers who were occupationally exposed to asbestos for an average of 13 years were selected from an asbestos-product factory in China. Of them, 85 workers were diagnosed with asbestosis. Additionally, 282 workers who had no experience of exposure to industrial dust were included as a control group. A questionnaire was administered during a face-to-face interview and spirometric maneuvers and single-breath CO diffusing capacity (DL(CO)) were performed. RESULTS: Multivariate regression analysis showed that exposure to asbestos was more strongly associated with decreased forced vital capacity (FVC) and DL(CO), and asbestosis more strongly associated with decreased FVC, while smoking was a major contributing factor to reduced FEV1/FVC. The results were confirmed by a further analysis where the subjects were grouped exclusively by smoking, asbestos exposure, and chest radiographic changes. No interaction or joint effect was observed between asbestos exposure and smoking. CONCLUSIONS: This analysis suggested that asbestos and smoking might play independent roles, in which asbestos caused mainly a restrictive impairment, and smoking was a major causal factor for airway obstruction in the workers who were intensively exposed to asbestos.

Adult↗
PubMed2006

Gastric electrical activity and cardiovascular risk factors in relation to autonomic nervous function, hormonal responses, and health-related lifestyles in young men.

BACKGROUND: Electrogastrography (EGG) is the noninvasive recording of gastric myoelectrical activity. The purpose of the present study was to assess associations of EGG with risk factors for cardiovascular disease (CVD), autonomic nervous function, hormonal responses, and health-related lifestyles. METHODS: EGG was measured in 435 Japanese men, aged 24-39 years, who worked at the same company. In addition to anthropometric measurements and blood examinations, power spectral analysis of heart rate variability in low-frequency (LF; 0.04-0.15 Hz) and high-frequency (HF; 0.15-0.40 Hz) bands was conducted. LF/HF and HF were used as the indicators of sympathetic and parasympathetic nervous activity, respectively. Serum cortisol and catecholamine levels were measured as well. RESULTS: In univariate analyses, the EGG frequency was associated positively with the serum high-density lipoprotein (HDL) and cholesterol level (both-P < 0.0001) and negatively with age, body mass index (BMI), serum triglyceride level, fasting blood sugar, and diastolic blood pressure (all P < 0.05). The EGG frequency tended to increase with increases in the HF band (P = 0.10) and was not significantly associated with the LF/HF ratio (P = 0.45). Neither hormonal responses nor health-related lifestyle factors such as smoking and alcohol were significant (all P > 0.05). A multivariate analysis indicated that both the HDL cholesterol level and BMI were independent predictors of EGG frequency (both P < 0.05), after adjusting for the significant effects of age, HF, and other CVD factors. CONCLUSIONS: Slowed EGG frequency appeared to be linked with various CVD risk factors, including obesity and low HDL cholesterol levels, in young men.

Adult↗
PubMed2006

Evaluating medical students' non-verbal communication during the objective structured clinical examination.

OBJECTIVES: Non-verbal communication (NVC) in medical encounters is an important method of exchanging information on emotional status and contextualising the meaning of verbal communication. This study aimed to assess the impact of medical students' NVC on interview evaluations by standardised patients (SPs). METHODS: A total of 89 medical interviews in an objective structured clinical examination (OSCE) for post-clerkship medical students were analysed. All interviews were videotaped and evaluated on 10 non-verbal behaviour items. In addition, the quality of the interview content was rated by medical faculty on 5 items and the interview was rated by SPs on 5 items. The relationships between student NVC and SP evaluation were examined by multivariate regression analyses controlling for the quality of the interview content. RESULTS: Standardised patients were likely to give higher ratings when students faced them directly, used facilitative nodding when listening to their talk, looked at them equally when talking and listening, and spoke at a similar speed and voice volume to them. These effects of NVC remained significant after controlling for the quality of the interview content. CONCLUSIONS: This study provided evidence of specific non-verbal behaviours of doctors that may have additional impacts on the patient's perception of his or her visit, independently of the interview content. Education in basic NVC should be incorporated into medical education alongside verbal communication.

Education, Medical, Undergraduate↗
PubMed2006

Somatic symptoms for predicting depression: one-year follow-up study in annual health examinations.

It has recently been noted that screening for depression can improve clinical outcomes. The purpose of the present study was to examine whether somatic symptoms reported at health examinations predicted depression in the following year. Subjects were 1066 Japanese workers (732 men, mean age 35 years) attending annual health examinations at an institute in two successive years. A self-administered questionnaire including items of 12 major somatic symptoms was given to all the subjects. Then clinical interviews of the DSM-IV were used to diagnose major depression and minor depression in both years. In addition, the 17-item Hamilton Depression Scale (HDS-17) was measured as one of the outcomes of depression in the following year. The prevalence of major (minor) depression was 3.7 (7.8)% at baseline and 3.4 (5.9)% for the following year, respectively. The following year's HDS-17 scores were higher (all P < 0.05) in those who had complained of each somatic symptom at baseline than in those who had not. Three somatic symptoms (low back pain, dizziness, and abdominal pain) at baseline were significant risk factors of major depression for the following year. Dizziness at baseline significantly predicted major and minor depression for the following year as well. Somatic symptoms may be good predictors to screen for depression at health examination.

Adult↗
PubMed2006

Clinical application of paroxetine for tapering benzodiazepine use in non-major-depressive outpatients visiting an internal medicine clinic.

Chronic benzodiazepine (BDZ) users often have difficulty with BDZ withdrawal. To examine clinical effects of selective serotonin reuptake inhibitor (SSRI) on tapering BDZ use in non-depressive patients, 97 outpatients with a history of BDZ use for at least 3 months were recruited at an internal medicine clinic of a university hospital. After the 4th edition of the Diagnostic and Statistical Manual (DSM-IV) clinical interviews for screening major depression, 66 outpatients (68%) without the DSM-IV major depression were randomly assigned to one of three groups: SSRI-assisted BDZ-reduction group (10-20 mg of paroxetine, n = 22), simple BDZ-reduction group (no paroxetine, n = 23), and reference group (no BDZ-reduction, n = 21). A standardized 8-week program involving gradual BDZ discontinuation was performed in the two BDZ-reduction groups. The Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A) and the BDZ Withdrawal Symptom Questionnaire were assessed during the intervention period. Those with major depression were excluded from the BDZ-reduction intervention and treated with a different protocol of medication. In total, 10 (45.5%) in the SSRI-assisted BDZ-reduction group (n = 22) succeeded in becoming BDZ-free after completing the program, whereas only four (17.4%) in the simple BDZ-reduction group (n = 23) succeeded. The assistance of the SSRI significantly predicted the success of becoming BDZ-free (P = 0.023), controlling for the effects of age, gender, period of BDZ use, and baseline HAM-D and HAM-A scores. The score changes on the three questionnaires were comparable (all P > 0.05) among the three groups during the intervention period. The use of SSRI may have beneficial effects on BDZ withdrawal without the worsening of mood states in cases without major depression.

Adult↗
PubMed2006

Surgery for patients with severe supratentorial intracerebral hemorrhage.

INTRODUCTION: Little information is available on the efficacy of aggressive treatment such as surgery in improving the outcome of severely affected patients after supratentorial intracerebral hemorrhage (ICH). Our objective was to assess the effect of hematoma removal and ventricular drainage on the mortality of patients with severe primary supratentorial ICH. METHODS: We studied 103 consecutive patients who were admitted to the intensive care unit and diagnosed with primary supratentorial ICH. The impacts of clinical factors on 30-day mortality were assessed, including surgery, Glasgow Coma Scale (GCS) score and pupillary abnormality at admission, hematoma volume, and other related factors. RESULTS: The 30-day mortality rate was 42%, and the median time between admission and death was 3 days (range: 1 to 27 days). Hematoma removal and ventricular drainage, within the first 24 hours of admission, were performed on 11 and 17 patients, respectively. Two patients who were treated with removal and four with drainage died. A logistic regression model for predicting 30-day mortality was performed. After controlling for GCS score, pupillary abnormality, hydrocephalus, and hematoma volume, hematoma removal was identified as an independent predictor of survival (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.02 to 0.92). Ventricular drainage also tended to decrease mortality rate greatly (OR, 0.31; 95% CI, 0.06 to 1.76). Patients with GCS scores of 3 or 4 were 4.01 times more likely to die (95% CI, 1.13 to 14.26) than those with GCS of at least 5. CONCLUSIONS: Hematoma removal may reduce the mortality rate of patients with severe supratentorial ICH.

Adult↗
PubMed2006

Controlled trial of worksite health education through face-to-face counseling vs. e-mail on drinking behavior modification.

This study examined the effectiveness of a traditional face-to-face health education and e-mail health education on alcohol usage among male workers in comparison with a control group. Male workers at a manufacturing plant (N=36) who had abnormal serum gamma-GTP were stratified by age and job types, then randomized into three groups: face-to-face education, e-mail education, and the control. The subjects were assessed on their knowledge about and attitude towards drinking, reported alcohol consumption, and serum gamma-GTP before the start of education and 2 months later after comparison of the education. Paired t-test and repeated ANOVA were conducted to test the significance of changes pre and post the intervention and across groups. In the face-to-face group, knowledge (p=0.001), attitude (p=0.026), alcohol consumption (p=0.003) and serum gamma-GTP showed significant improvement. In the e-mail group, only alcohol consumption showed marginal improvement (p=0.077). In the control group, no variables remarkably changed. These results indicate that the face-to-face health education was more effective than the e-mail program. We discuss why the face-to-face approach was superior to the e-mail approach in this study by referring to self-monitoring, goal setting processes and timely feedback. We concluded that further studies are warranted to identify the effect of health education using e-mails and other network tools in consideration of the above three factors.

Adult↗
PubMed2006

The relationship between coping with stress and employment in patients receiving maintenance hemodialysis.

The goal of this study was to assess the relationship between emotion- and task-oriented coping (EOC/TOC) with stress and employment in patients undergoing maintenance hemodialysis. Individuals aged 18 to 64 yr who had uremia and had been undergoing hemodialysis regularly for at least three months were evaluated according to sociodemographic and clinical factors. Work status was defined using the most recent International Labour Organization definitions. Patients were requested to complete the following questionnaires: the Japanese version of the Coping Inventory for Stressful Situations, the Short Form-36 Health Survey, an item on itchiness, the Self-Efficacy on Health-Related Behavior Scale, the Japanese version of the Health Locus of Control Scale, the Social Support Scale, and the Japanese version of the Hospital Anxiety and Depression Scale. A total of 317 individuals participated in this study. Among men, age, physical functioning, EOC, and depression differed significantly (p<0.05) depending on employment. Among women, marital status, household composition, EOC, depression, and anxiety differed significantly (p<0.05) depending on employment. TOC was not significantly associated with employment in either sex. Multiple logistic regression analyses, including possible confounders, indicated that when EOC increased by 10 points, the associated adjusted odds ratio of an unemployed or economically inactive status changed by 1.48 (95% confidence interval, 1.04-2.11; p=0.030) in men and by 1.88 (95% confidence interval, 1.02-3.46; p=0.042) in women. These results suggest that EOC is associated with employment in patients receiving maintenance hemodialysis.

Adaptation, Psychological↗
PubMed2006

Mental ability and psychological work performance in Chinese workers.

This study was to explore the relationship among mental ability, occupational stress, and psychological work performance in Chinese workers, and to identify relevant modifiers of mental ability and psychological work performance. Psychological Stress Intensity (PSI), psychological work performance, and mental ability (Mental Function Index, MFI) were determined among 485 Chinese workers (aged 33 to 62 yr, 65% of men) with varied work occupations. Occupational Stress Questionnaire (OSQ) and mental ability with 3 tests (including immediate memory, digit span, and cipher decoding) were used. The relationship between mental ability and psychological work performance was analyzed with multiple linear regression approach. PSI, MFI, or psychological work performance were significantly different among different work types and educational level groups (p<0.01). Multiple linear regression analysis showed that MFI was significantly related to gender, age, educational level, and work type. Higher MFI and lower PSI predicted a better psychological work performance, even after adjusted for gender, age, educational level, and work type. The study suggests that occupational stress and low mental ability are important predictors for poor psychological work performance, which is modified by both gender and educational level.

Adult↗
PubMed2006

Possible gender differences in the relationships of self-efficacy and the internal locus of control with compliance in hemodialysis patients.

In this study, the authors assessed gender differences between the relationships of self-efficacy and the internal health locus of control with compliance in hemodialysis patients. Using a self-efficacy scale for health-related behavior and the Japanese version of the Health Locus of Control Scale, the authors studied individuals who had been regularly undergoing hemodialysis for longer than 1 year. Blood urea nitrogen, serum potassium, and interdialytic weight gain were used to measure compliance. In men, self-efficacy and the internal health locus of control were negatively correlated with all compliance measures. In women, all the correlations were positive, except for that between self-efficacy and interdialytic weight gain. The authors constructed regression lines for the significant interactions. On the basis of blood urea nitrogen or serum potassium levels, the authors found that female patients who had higher self-efficacy or internal health locus of control were less compliant. The decrease of interdialytic weight gain accompanying increased self-efficacy was more significant in men than it was in women.

Female↗
PubMed2006

[An evaluation of teaching objectives for seminars and clerkship of social medicine in medical schools in Japan].

OBJECTIVES: The purpose of this study was to evaluate the curriculum of seminars and clerkship for social medicine in medical schools in Japan, with special reference to teaching objectives. METHODS: A survey was conducted in December, 2002 by sending questionnaires to all the member departments of the Conference for Hygiene and Public Health Teaching in Medical Schools in Japan. Teaching objectives for seminars and clerkship of social medicine stated in their curricula were analyzed by frequencies of key words related to learner's "Knowledge, Attitude, and Behavior". Also, five professors of public health independently rated the stated teaching objectives using nine evaluation criteria divided into three levels and mean ratings were obtained. RESULTS: Although 80% of the schools described their General Instructional Objectives (GIOs), only 63% of the universities stated Specific Behavioral Objectives (SBOs). Evaluation of the contents of the descriptions revealed that, although many courses described the GIOs with the student as subjective, only a small number of courses mentioned "Attitude and Behavior" in SBO. Also, many courses did not make any apparent distinction between GIOs and SBOs. CONCLUSIONS: Practical training is a crucial component in medical education and seminars and clerkship play an important role in teaching social medicine to medical students. However, the present study revealed that many medical schools in Japan do not have adequately defined teaching objectives. Improvement of the curricula in courses of social medicine is required with particular reference to specific behavioral objectives and goals for seminars and clerkship.

Clinical Clerkship↗
PubMed2005

Autonomic nervous activity changes in relation to the reporting of subjective symptoms among male workers in an information service company.

OBJECTIVES: The objective of the study was to clarify the relationship between major subjective symptoms and autonomic nervous system function by power spectral analysis of heart rate variability (HRV). METHODS: Short-term HRV was examined for 413 male workers in a Japanese information service company aged 19-45 years, and questionnaire survey on subjective symptoms and biochemical measurements were conducted at annual health checkup. RESULTS: The most prevalent subjective symptom (> or =10%) was dullness, followed by fatigue, backache, diarrhea, sleep disorder, and irritation. HRV in high frequency (HF 0.15-0.40 Hz) bands and the coefficient of variance in the electrocardiographic R-R interval (CVrr) were lower in the subjects with any of these six symptoms than in those without the symptoms. Both parameters were negatively associated with the reporting of any of the six symptoms by multiple regression analyses, controlling for the significant effects of age (HF and CVrr) and plasma cortisol levels (HF). CONCLUSION: It was suggested that the reporting of the subjective symptoms is one of good predictors for reduced parasympathetic tones.

Adult↗
PubMed2005

Prediction of major depression in Japanese adults: somatic manifestation of depression in annual health examinations.

BACKGROUND: The present study examined whether somatic symptoms found in annual health examinations, could be predictive of major depression in the ensuing year. METHOD: Subjects analyzed were 1027 non-major-depressive workers (706 men, mean age 35) attending annual health examinations at a research institute. All were Japanese and found not to be suffering from major depression when interviewed, according to the semi-structured interviews of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). A self-administered questionnaire containing items relating to twelve major somatic symptoms was completed by all the subjects. The same DSM-IV interviews for the diagnosis of major depression were conducted to calculate the odds ratio of baseline variables for depressive and somatic symptoms, physical examination items, and health-related life-styles for the prediction of major depression in the ensuing year. RESULTS: The prevalence of major depression in the ensuing year was 2.5%. For four somatic symptoms (fatigue, lower back pain, dizziness, and nausea), the prevalence was higher (all p < 0.05) in those who complained of each somatic symptom at baseline than in those who did not. Furthermore, the multiple logistic regression analysis indicated that lower back pain and dizziness at baseline were independent risk factors of major depression in the ensuing year [odds ratio (95% confidence intervals), 3.2 (1.1, 8.9) and 6.0 (1.8, 20.1), respectively]. LIMITATIONS: It is possible that somatic manifestations of depression are culturally bound phenomena and results might be generalizable only to Japanese workers. CONCLUSION: Somatic symptoms reported at annual health examinations may be useful indicators for predicting major depression.

Adult↗