1.Lessons from the Field Count more than Ever: The New Era of Global Health
Kenzo Takahashi ; Jun Kobayashi
Tropical Medicine and Health 2015;advpub(0):-
For many years, Japan has been silent on theachievements of Japan's Overseas Development Assistance program including thehealth improvement of foreign countries. Japan’s contribution to global healthcommunities through G8 process including Hashimoto Initiative is steadfast. Onthe other hand, in the field activity level, experts involved in ODA have not disclosedtheir achievements. However, the article by Wada et al.,which describes the contents of TEN MR (Minimum Requirement), shed light onJapan’s silent ODA community by disclosing Japan’s achievements in globalhealth by drawing lessons that may be applicable to othercountries. Our future challenge in the global health will be how to synthesizeactions that reflect the lessons learnt from the field and which show scientificevidence using established methods.
2.Lessons from the Field Count more than Ever: The New Era of Global Health
Kenzo Takahashi ; Jun Kobayashi
Tropical Medicine and Health 2015;43(4):243-245
For many years, Japan has been silent on the achievements of Japan’s Overseas Development Assistance program including the health improvement of foreign countries. Japan’s contribution to global health communities through G8 process including Hashimoto Initiative is steadfast. On the other hand, in the field activity level, experts involved in ODA have not disclosed their achievements. However, the article by Wada et al., which describes the contents of TEN MR (Minimum Requirement), shed light on Japan’s silent ODA community by disclosing Japan’s achievements in global health by drawing lessons that may be applicable to other countries. Our future challenge in the global health will be how to synthesize actions that reflect the lessons learnt from the field and which show scientific evidence using established methods.
3.A Retrospective Study of the Factors Influencing the Necessity of Holding Death Conferences for Patients Who Died in a Palliative Care Unit of Cancer Specialist Hospital
Jun Kako ; Masamitsu Kobayashi ; Asuko Sekimoto
Palliative Care Research 2017;12(4):929-935
Objective: To determine the factors influencing the necessity of holding death conferences. Methods: Data of 416 cancer patients who died in the palliative care unit of the National Cancer Center Hospital East between August 2013 and February 2015 were reviewed. Patients’ medical charts and data sheets of conferences held after their deaths were analyzed. Results: A total of 25.7% of participants saw the necessity of holding death conferences. Multiple logistical regression analyses revealed four independent factors that influenced the holding of death conferences: age <50 years; length of stay in the palliative care unit ≥20 days; epidural analgesia; aphonia; and abdominal distention. Conclusion: These factors might explain nurses’ difficulty in providing end-of-life care for cancer patients.
4.What Do Medical Students Think of Telling the Truth From Interviews With Patients?
Shinya KOBAYASHI ; Jun AMANO ; Seiji OHSHIMA
Medical Education 1999;30(3):161-164
For medical students, death education is essential. As a part of death education in medical courses, a lecture was given about telling the truth to patients with cancer. Patients with recurrent cancer took part in this lecture and talked about their operations, informed consent, and telling the truth. From the questions of medical students to both patients and teachers (surgeons), student's opinions about telling the truth were examined. Medical students approve of telling the truth to patients with cancer and support the rights of patients to know the truth about their disease. If they have cancer, they want to be told the truth. However, they are wary of telling the truth to all patients. They think that the truth should not be told without understanding the patient's personality. Students recognized that they are not sensitive enough and want to learn sensitivity by telling the truth.
5.EFFECTS OF PROLONGED VOLUNTARY WHEEL-RUNNING ON TIBIAL BONE-MASS IN GROWING MALE RATS USING pQCT
FUMIHIKO KARIYA ; JUN KITAGAWA ; KEIZO KOBAYASHI ; MITSUO NARUSAWA ; YOSHIBUMI NAKAHARA
Japanese Journal of Physical Fitness and Sports Medicine 2004;53(1):107-114
In this study, we investigated the effects of prolonged voluntary running training on bone mass in the tiba of growing male SD rats. At 5 weeks old, the rats were divided into 4 groups : group 15 VE (n=7) exercised voluntarily on a running wheel for 10 weeks from 5- to 15-weeks old ; group 35 VE (n=7) exercised voluntarily on a running wheel for 30 weeks from 5- to 35-weeks old ; in groups 15SC (n=6) and 35 SC (n=5), rats were housed individually in normal plastic cages for the same periods as groups 15 VE and 35 VE, respectively. At the end of each experimental period, the right tibia from each rat was used for bone- mass analysis using peripheral quantitative cumputed tomography (pQCT) . The evaluated portions were the proximal methaphysis and the diaphysis, with total, cortical, and trabecular data from these portions being obtained as volumetric bone mineral content (vBMC) and volumetric bone mineral density (vBMD) . The results indicated that 1) although voluntary running distance tended to decline during the later period (1635 wk old) in 35 VE rats, some mean values obtained for bone mass parameters using pQCT were significant greater in 35 VE than in 35SC ; 2) the mean values from those parameters in 15 VE were not significantly different from those in 15 SC. These results suggest that the continuation of voluntary exercise may be important for bone- mass enhancement in rat tibia.
6.Behavior of Adult Influenza Patients during the 2009 Pandemic after Outpatient Clinic Presentations at a Hospital in Tokyo, Japan
Daisuke Nonaka ; Hirohisa Morikawa ; Hiroko Arioka ; Jun Kobayashi ; Ryosuke Shoda ; Tetsuya Mizoue
Tropical Medicine and Health 2011;39(3):83-85
The 2009 pandemic of novel swine-origin influenza A (H1N1) highlighted the importance of community mitigation measures such as voluntary isolation. During the pandemic, we investigated the voluntary isolation behavior of patients with influenza during the 7-day period after they visited an outpatient clinic at a hospital in Tokyo, Japan. A questionnaire-based survey was conducted on patients diagnosed with influenza. Of a total of 14 patients, 13 (93%) visited a workplace, school or other potentially crowded setting at least once in the 7-day period after presentation. Five patients (36%) visited a potentially crowded setting either with a fever or on the day after having a fever. The voluntary isolation behavior of Japanese people with influenza did not necessarily adhere to the Japanese government recommendation that people with influenza-like illness stay home for 7 days following the onset of symptoms.
7.Can Japan Contribute to the Post Millennium Development Goals? Making Human Security Mainstream through the TICAD Process
Kenzo Takahashi ; Jun Kobayashi ; Marika Nomura-Baba ; Kazuhiro Kakimoto ; Yasuhide Nakamura
Tropical Medicine and Health 2013;41(3):135-142
In 2013, the fifth Tokyo International Conference on African Development (TICAD V) will be hosted by the Japanese government. TICAD, which has been held every five years, has played a catalytic role in African policy dialogue and a leading role in promoting the human security approach (HSA). We review the development of the HSA in the TICAD dialogue on health agendas and recommend TICAD’s role in the integration of the HSA beyond the 2015 agenda. While health was not the main agenda in TICAD I and II, the importance of primary health care, and the development of regional health systems was noted in TICAD III. In 2008, when Japan hosted both the G8 summit and TICAD IV, the Takemi Working Group developed strong momentum for health in Africa. Their policy dialogues on global health in Sub-Saharan Africa incubated several recommendations highlighting HSA and health system strengthening (HSS). HSA is relevant to HSS because it focuses on individuals and communities. It has two mutually reinforcing strategies, a top-down approach by central or local governments (protection) and a bottom-up approach by individuals and communities (empowerment). The “Yokohama Action Plan,” which promotes HSA was welcomed by the TICAD IV member countries. Universal health coverage (UHC) is a major candidate for the post-2015 agenda recommended by the World Health Organization. We expect UHC to provide a more balanced approach between specific disease focus and system-based solutions. Japan’s global health policy is coherent with HSA because human security can be the basis of UHC-compatible HSS.
8.A case of CPT-11-induced diarrhea showing a remarkable improvement using octreotide
Tomoe Miyasaka ; Hideyuki Kushihara ; Hiroko Kobayashi ; Masumi Miwa ; Takeo Yamaguchi ; Jun-ichi Haruta ; Kiyoshi Fujiyoshi
Palliative Care Research 2010;5(2):338-341
Introduction: CPT-11 induced diarrhea reduces patient compliance, lowers quality of life, and can be potentially life threatening. Loperamide is effective in the majority of cases of CPT-11-induced diarrhea. However, the case of advanced gastrointestinal cancer where oral administration is difficult. We adapted octreotide for use in a case of CPT-11-induced diarrhea where oral administration was difficult due to digestive tract stenosis. Case Report: A 61-year old man was diagnosed with advanced gastric cancer. He was treated with CPT-11 100mg/m² weekly for three weeks followed by a 1-week rest. CPT-11-induced diarrhea developed after 10 days of treatment. At the same time, his digestive tract stenosis worsened, making Loperamide unusable. We administered octreotide 200μg continuous intravenous drip infusion. One day after octreotide administration, the number of diarrhea has decreased from 20 times to four times. Conclusions: Octreotide is one of the effective treatments for CPT-11-induced diarrhea. Palliat Care Res 2010; 5(2): 338-341
9.Three Cases of Abdominal Aortic Aneurysm (AAA) Associated with Horseshoe Kidney
Noriyuki Sasaki ; Jun Kiyosawa ; Junichi Tanaka ; Masayoshi Kobayashi ; Kenji Hida ; Hiroo Shikata ; Shigeru Sakamoto ; Junichi Matsubara
Japanese Journal of Cardiovascular Surgery 2004;33(4):259-262
Horseshoe kidney is an unusual abnormality occurring in 0.25% of the population. In surgery for AAA with horseshoe kidney, reconstruction of aberrant renal and preservation of renal isthmus is important. We report 3 cases of AAA with horseshoe kidney treated successfully without division of the isthmus.
10.Households with insufficient bednets in a village with sufficient bednets: evaluation of household bednet coverage using bednet distribution index in Xepon district, Lao PDR
Daisuke Nonaka ; Tiengkham Pongvongsa ; Futoshi Nishimoto ; Phetsomphon Nansounthavong ; Yu Sato ; Hongwei Jiang ; Rie Takeuchi ; Kazuhiko Moji ; Panom Phongmany ; Jun Kobayashi
Tropical Medicine and Health 2015;advpub(0):-
InLao PDR, the National Malaria Control Program (NMCP) evaluates bednet coverage,often at the village level, using a coverage target of one net per 2.5 (or fewer)persons in a given population. However, in villages that meet the target, notall households necessarily meet the target or utilize all available bednets. Thisstudy explored households that fell short of the target and household utilizationof bednets in villages that met the target of bednet coverage set by the NMCP. Thepersons per net ratio (PPNR), which is defined as the population divided by thenumber of available bednets in a household/village, was used to determine whethera household/village met the NMCP target. Using a household survey, we collectedand analyzed the data of 635 households in 17 villages in Xepon district in2012. Households that fell short of the target (households with a PPNR of >2.5 or no bednet) existed in every village. The proportion of these households differedgreatly among the villages, ranging from 3.4–50%, with some households fallingfar short. Of the 635 households, 275 (43.5%) had at least one bednet that wasnot being used on the night preceding the survey and 131 (20.6%) had at leasttwo. In conclusion, in villages that met the NMCP target, a considerable numberof households fell short of the target. Available bednets were not fullyutilized in many of the surveyed households.