1.Current Challenges and Future Opportunities for Child and Adolescent Psychiatry in Japan.
Masaru TATENO ; Takahiko INAGAKI ; Takuya SAITO ; Anthony P S GUERRERO ; Norbert SKOKAUSKAS
Psychiatry Investigation 2017;14(5):525-531
Japan has been facing a serious shortfall of child and adolescent psychiatric workforce relative to increasing service needs. Likely because of a combination of limited workforce supply and limited trust or perception of effectiveness, mental health services are under-utilized by the educational and child welfare systems. Child and adolescent psychiatry (CAP) has not been a formally established specialty in Japan. The lack of basic structure in the specialty most likely contributes to a lack of training facilities, limited exposure to and interest in the specialty, and hence an inadequate workforce. To date, there exists no standardized training program for CAP in Japan and each training hospital determines its own teaching curriculum and training content. Clinical experience in CAP varies greatly among hospitals. To solve current problems in child and adolescent psychiatry in Japan, we advocate for the development and establishment of a more standardized child and adolescent psychiatry training system that is akin to what exists in the US and that teaches and evaluates according to specific competencies. Through standardizing care and education and ultimately improving workforce, the quality of mental health services can be raised. The tragic and costly consequences of unidentified and untreated mental illness in youth can be avoided by taking timely evidence based actions in partnership with others.
Adolescent
;
Adolescent Psychiatry*
;
Adolescent*
;
Child Welfare
;
Child*
;
Curriculum
;
Education
;
Humans
;
Japan*
;
Mental Health Services
2.Current Challenges and Future Opportunities for Child and Adolescent Psychiatry in Japan.
Masaru TATENO ; Takahiko INAGAKI ; Takuya SAITO ; Anthony P S GUERRERO ; Norbert SKOKAUSKAS
Psychiatry Investigation 2017;14(5):525-531
Japan has been facing a serious shortfall of child and adolescent psychiatric workforce relative to increasing service needs. Likely because of a combination of limited workforce supply and limited trust or perception of effectiveness, mental health services are under-utilized by the educational and child welfare systems. Child and adolescent psychiatry (CAP) has not been a formally established specialty in Japan. The lack of basic structure in the specialty most likely contributes to a lack of training facilities, limited exposure to and interest in the specialty, and hence an inadequate workforce. To date, there exists no standardized training program for CAP in Japan and each training hospital determines its own teaching curriculum and training content. Clinical experience in CAP varies greatly among hospitals. To solve current problems in child and adolescent psychiatry in Japan, we advocate for the development and establishment of a more standardized child and adolescent psychiatry training system that is akin to what exists in the US and that teaches and evaluates according to specific competencies. Through standardizing care and education and ultimately improving workforce, the quality of mental health services can be raised. The tragic and costly consequences of unidentified and untreated mental illness in youth can be avoided by taking timely evidence based actions in partnership with others.
Adolescent
;
Adolescent Psychiatry*
;
Adolescent*
;
Child Welfare
;
Child*
;
Curriculum
;
Education
;
Humans
;
Japan*
;
Mental Health Services
3.A Case of Progressive Respiratory Failure Resulting from Chronic Bird Fancier's Disease after Postoperative Chemotherapy
Yoko SHINOHARA ; Yusuke KIYOKI ; Keita ANDO ; Tyuta OKAWA ; Takashi YAMANA ; Naoki NISHIYAMA ; Naoki KAWAKAMI ; Yoko WAKAI ; Takaaki YAMASHITA ; Kazuhito SAITO ; Takuya ONUKI ; Masaharu INAGAKI
Journal of the Japanese Association of Rural Medicine 2016;65(1):62-69
75-year-old man had the right lower lobe resected because of pulmonary adenocarcinoma (stage IIB) and received 4 courses of postoperative chemotherapy 4 years earlier. Thereafter, he continued to complain of cough, sputum, and progressive exertional breathlessness. The preoperative chest CT showed ground glass opacity (GGO) at the bottom of both lung fields, and over time the GGO changed to honeycombing with traction bronchiectasis. He was administered prednisolone, clarithromycin, and pirfenidone but with little improvement. He exhibited hypoxemia (PaO2 56 mmHg) and was admitted. An interview revealed that he had worked in the poultry farming business for 45 years having had contact with and breeding 3,000 game fowl at the time of hospitalization. We suspected bird-related hypersensitivity pneumonitis. Results of the reaction to pigeon dropping extracts (PDE) were high, with PDE IgG 0.697 and PDE IgA 0.445. He was diagnosed with chronic bird-related hypersensitivity pneumonitis. Although the chest CT appearance was difficult to distinguish from that of idiopathic interstitial pneumonia, the test for PDE and the interview were useful for reaching a diagnosis.
4.Internet Addiction and Attention-Deficit/Hyperactivity Disorder Traits among Female College Students in Japan.
Masaru TATENO ; Yukie TATENO ; Chikara KAMIKOBE ; Ryunosuke MONDEN ; Oji SAKAOKA ; Junichiro KANAZAWA ; Takahiro A KATO ; Takuya SAITO
Journal of the Korean Academy of Child and Adolescent Psychiatry 2018;29(3):144-148
OBJECTIVES: Previous studies have reported that internet addiction (IA) is associated with attention-deficit/hyperactivity disorder (ADHD) consistently. However, in terms of gender, there are controversial findings. We aimed to investigate the relation between IA and self-acknowledged ADHD traits among female college students in Japan. METHODS: The study questionnaire consisted of questions about demographics, Adult ADHD Self-Report Scale-V1.1 Part A (ADHD screener) and Young's Internet Addiction Test (IAT). When four or more items are more frequent than the cut-off on ADHD screener, the subject was categorized into students with a positive ADHD screen. We defined students with total IAT score of 70 and higher as IA. RESULTS: A total number of respondents was 369 (mean age: 19.0±0.7 years). Seventy-seven subjects were screened positive on ADHD screener (20.9%). Students with a positive ADHD screen scored significantly higher on the IAT (54.2±14.2 vs. 42.5±11.3). The rates of IA in students with and without a positive ADHD screen were 18.2% and 1.0%, respectively. CONCLUSION: Results of this study demonstrated the relation between IA and self-evaluated ADHD traits among female college students in Japan. Appropriate education for students on how to use the internet properly will be necessary to prevent IA.
Adult
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Demography
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Education
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Female*
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Humans
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Internet*
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Japan*
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Surveys and Questionnaires
5.A Case of Cryptococcosis with a Large Lung Mass
Tomohiro MORIYA ; Takuya SHINMURA ; Naoki KAWAKAMI ; Yoko WAKAI ; Kazuhito SAITO
Journal of the Japanese Association of Rural Medicine 2019;67(5):591-
In many patients with pulmonary cryptococcosis, chest radiographs show solitary or multiple nodular shadows, but pulmonary cryptococcosis with a large mass is rare. A previously healthy 45-year-old man presented to the hospital complaining of fever and cough. Contrast-enhanced computed tomography showed a tumor shadow with a long diameter of 64 mm in the lower lobe of the right lung. We considered the possibility of a lung abscess, but because it was refractory to antibiotics, we suspected the possibility of a malignant tumor. Transbronchial biopsy was performed, and Cryptococcus neoformans was detected. There were no complications of meningitis or immune deficiency, including acquired immune deficiency syndrome. He was administered antifungal drugs, and shrinkage of the shadow was achieved. Pulmonary cryptococcosis should also be considered when a large lung mass is observed.
6.A Practical Grading Scale for Predicting Outcomes of Radiosurgery for Dural Arteriovenous Fistulas: JLGK 1802 Study
Hirotaka HASEGAWA ; Masahiro SHIN ; Jun KAWAGISHI ; Hidefumi JOKURA ; Toshinori HASEGAWA ; Takenori KATO ; Mariko KAWASHIMA ; Yuki SHINYA ; Hiroyuki KENAI ; Takuya KAWABE ; Manabu SATO ; Toru SERIZAWA ; Osamu NAGANO ; Kyoko AOYAGI ; Takeshi KONDOH ; Masaaki YAMAMOTO ; Shinji ONOUE ; Kiyoshi NAKAZAKI ; Yoshiyasu IWAI ; Kazuhiro YAMANAKA ; Seiko HASEGAWA ; Kosuke KASHIWABARA ; Nobuhito SAITO ;
Journal of Stroke 2022;24(2):278-287
Background:
and Purpose To assess the long-term outcomes of intracranial dural arteriovenous fistula (DAVF) treated with stereotactic radiosurgery (SRS) alone or embolization and SRS (Emb-SRS) and to develop a grading system for predicting DAVF obliteration.
Methods:
This multi-institutional retrospective study included 200 patients with DAVF treated with SRS or Emb-SRS. We investigated the long-term obliteration rate and obliteration-associated factors. We developed a new grading system to estimate the obliteration rate. Additionally, we compared the outcomes of SRS and Emb-SRS by using propensity score matching.
Results:
The 3- and 4-year obliteration rates were 66.3% and 78.8%, respectively. The post-SRS hemorrhage rate was 2%. In the matched cohort, the SRS and Emb-SRS groups did not differ in the rates of obliteration (P=0.54) or post-SRS hemorrhage (P=0.50). In multivariable analysis, DAVF location and cortical venous reflux (CVR) were independently associated with obliteration. The new grading system assigned 2, 1, and 0 points to DAVFs in the anterior skull base or middle fossa, DAVFs with CVR or DAVFs in the superior sagittal sinus or tentorium, and DAVFs without these factors, respectively. Using the total points, patients were stratified into the highest (0 points), intermediate (1 point), or lowest (≥2 points) obliteration rate groups that exhibited 4-year obliteration rates of 94.4%, 71.3%, and 60.4%, respectively (P<0.01).
Conclusions
SRS-based therapy achieved DAVF obliteration in more than three-quarters of the patients at 4 years of age. Our grading system can stratify the obliteration rate and may guide physicians in treatment selection.
7.Influence of the stage of emergency declaration due to the coronavirus disease 2019 outbreak on plasma glucose control of patients with diabetes mellitus in the Saku region of Japan
Takuya WATANABE ; Yuichi TEMMA ; Junichi OKADA ; Eijiro YAMADA ; Tsugumichi SAITO ; Kazuya OKADA ; Yasuyo NAKAJIMA ; Atsushi OZAWA ; Tetsuya TAKAMIZAWA ; Mitsuaki HORIGOME ; Shuichi OKADA ; Masanobu YAMADA
Journal of Rural Medicine 2021;16(2):98-101
Objective: Because patients with diabetes mellitus (DM) were forced to stay indoors during the state of emergency, resulting in stress and a lack of physical activity, concerns about their glycemic control were raised.Patients and Methods: The 165 patients’ glycated hemoglobin (HbA1c) levels were compared during the following periods: the 4 months that were selected as a representative condition 1 year before the COVID-19 pandemic (May 2018, March 2019, June 2019, and July 2019) and the latter 3 months as a 1-year follow-up during the COVID-19 pandemic (May 2019, March 2020, June 2020, and July 2020).Results: The patients’ HbA1c levels were 7.32 ± 1.23, 7.44 ± 1.20, 7.16 ± 1.06, 7.01 ± 1.05, 7.23 ± 1.06, 7.45 ± 1.18, 7.15 ± 10.7, and 7.11 ± 1.17 in May 2018, March 2019, June 2019, July 2019, May 2019, March 2020, June 2020, and July 2020, respectively (expressed as mean ± standard deviation).Conclusion: The analysis showed that HbA1c levels did not worsen during the self-restraint period.
8.Enhanced event-based surveillance for imported diseases during the Tokyo 2020 Olympic and Paralympic Games
Ayu Kasamatsu ; Masayuki Ota ; Tomoe Shimada ; Munehisa Fukusumi ; Takuya Yamagishi ; Anita Samuel ; Manami Nakashita ; Tomohiko Ukai ; Katsuki Kurosawa ; Miho Urakawa ; Kensuke Takahashi ; Keiko Tsukada ; Akane Futami ; Hideya Inoue ; Shun Omori ; Miho Kobayashi ; Takahisa Shimada ; Sakiko Tabata ; Yuichiro Yahata ; Hajime Kamiya ; Fumi Yoshimatsu ; Tomimasa Sunagawa ; Tomoya Saito
Western Pacific Surveillance and Response 2021;12(4):13-19
In 2021, the National Institute of Infectious Diseases, Japan, undertook enhanced event-based surveillance (EBS) for infectious diseases occurring overseas that have potential for importation (excluding coronavirus disease 2019 [COVID-19]) for the Tokyo 2020 Olympic and Paralympic Summer Games (the Games). The pre-existing EBS system was enhanced using the World Health Organization Epidemic Intelligence from Open Sources system and the BlueDot Epidemic Intelligence platform. The enhanced EBS before and during the Games did not detect any major public health event that would warrant action for the Games. However, information from multiple sources helped us identify events, characterize risk and improve confidence in risk assessment. The collaboration also reduced the surveillance workload of the host country, while ensuring the quality of surveillance, even during the COVID-19 pandemic.
9.Use of Epidemic Intelligence from Open Sources for global event-based surveillance of infectious diseases for the Tokyo 2020 Olympic and Paralympic Games
Manami Yanagawa ; John Carlo Lorenzo ; Munehisa Fukusumi ; Tomoe Shimada ; Ayu Kasamatsu ; Masayuki Ota ; Manami Nakashita ; Miho Kobayashi ; Takuya Yamagishi ; Anita Samuel ; Tomohiko Ukai ; Katsuki Kurosawa ; Miho Urakawa ; Kensuke Takahashi ; Keiko Tsukada ; Akane Futami ; Hideya Inoue ; Shun Omori ; Hiroko Komiya ; Takahisa Shimada ; Sakiko Tabata ; Yuichiro Yahata ; Hajime Kamiya ; Tomimasa Sunagawa ; Tomoya Saito ; Viema Biaukula ; Tatiana Metcalf ; Dina Saulo ; Tamano Matsui ; Babatunde Olowokure
Western Pacific Surveillance and Response 2022;13(3):18-24
The establishment of enhanced surveillance systems for mass gatherings to detect infectious diseases that may be imported during an event is recommended. The World Health Organization Regional Office for the Western Pacific contributed to enhanced event-based surveillance for the Tokyo 2020 Olympic and Paralympic Games (the Games) by using Epidemic Intelligence from Open Sources (EIOS) to detect potential imported diseases and report them to the National Institute of Infectious Diseases (NIID), Japan. Daily screening of media articles on global infectious diseases was conducted using EIOS, which were systematically assessed to determine the likelihood of disease importation, spread and significant impact to Japan during the Games. Over 81 days of surveillance, 103 830 articles were screened by EIOS, of which 5441 (5.2%) met the selection criteria for initial assessment, with 587 (0.6%) assessed as signals and reported to NIID. None of the signals were considered to pose a significant risk to the Games based on three risk assessment criteria. While EIOS successfully captured media articles on infectious diseases with a likelihood of importation to and spread in Japan, a significant manual effort was required to assess the articles for duplicates and against the risk assessment criteria. Continued improvement of artificial intelligence is recommended to reduce this effort.