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The Influence Of Self-Owned Home Blood Pressure Monitoring (Hbpm) On Primary Care Patients With Hypertension: A Qualitative Study, Adina Abdullah

Adina Abdullah

Background: Home blood pressure monitoring (HBPM) is gaining popularity among hypertensive patients. This study aimed to explore the influence of self-initiated HBPM on primary care patients with hypertension. Methods: Six in-depth interviews and two focus group discussions were conducted, taking into consideration the experiences of 24 primary care patients with hypertension. These patients had been using HBPM as part of their hypertension management. The overriding influences were grouped under themes which emerged from analyzing the data using the grounded theory approach. Results: There are both positive and negative influences of self-initiated HBPM. Patients used the readings of their HBPM to …

Social Support And Suicide In Japanese Men And Women E The Japan Public Health Center (Jphc)-Based Prospective Study, Kalpana Poudel-Tandukar, Akiko Nanri, Tetsuya Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Although the important role of social support in mental health is acknowledged, no prospective study has yet examined the relation of social support to suicide. Here, we investigated the associationbetween social support and suicide in a cohort of Japanese men and women. A total of 26,672 men and 29,865 women aged 40e69 years enrolled in the Japan Public Health Center-based prospective study in1993e1994 completed a self-administered questionnaire which included four items of social support, and were followed for death through December 2005. Hazard ratios (HRs) and 95% confidence intervals (95% CI) of suicidal death by social support index were estimated …

Social Support And Suicide In Japanese Men And Women E The Japan Public Health Center (Jphc)-Based Prospective Study (Journal Of Psychiatric Research), Kalpana Poudel-Tandukar, Akiko Nanri, Tetsuya Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Kalpana Poudel-Tandukar

Differences In Suicide Risk According To Living Arrangements In Japanese Men And Women – The Japan Public Health Center-Based (Jphc) Prospective Study, Kalpana Poudel-Tandukar, Akiko Nanri, Tetsyta Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Background: Living alone has been suggested as a risk factor for suicide. However, the effect on suicide risk of living together with spouse, child(ren) and parent(s) is unclear. This study aims toexamine the association between living arrangements with spouse, child(ren), and parent(s) and suicide in a Japanese men and women.Methods: Altogether 104, 528 participants aged 40–69 years, who completed baseline questionnaire (1990–1994), were followed for death through December 2005. We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for suicide according to living arrangements.Results: During an average 13.2-year follow up, …

Differences In Suicide Risk According To Living Arrangements In Japanese Men And Women – The Japan Public Health Center-Based (Jphc) Prospective Study (Journal Of Affective Disorders), Kalpana Poudel-Tandukar, Akiko Nanri, Tetsyta Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Kalpana Poudel-Tandukar

Public And Private Justice: Redressing Health Care Harm In Japan, Robert B. Leflar

Robert B Leflar

Japanese legal structures addressing health care-related deaths and injuries rely more on public law institutions and rules than do the common-law North American jurisdictions, where private law adjudication is predominant. This article explores four developments in 21st-century Japanese health care law. The first two are in the public law sphere: criminal prosecutions of health care personnel accused of medical errors, and a health ministry-sponsored “Model Project” to analyze medical-practice-associated deaths. The article addresses a private law innovation: health care divisions of trial courts in several metropolitan areas. Finally, the article introduces Japan’s new no-fault program for compensating birth-related obstetrical injuries. …

Muscular And Performance Fitness And The Incidence Of Type 2 Diabetes: Prospective Study Of Japanese Men, Susumu S. Sawada, I-Min Lee, Hisashi Naito, Koji Tsukamoto, Takashi Muto, Steven N. Blair

Faculty Publications

Background: Limited data are available on the relationship between muscular and performance fitness (MPF) and the incidence of type 2 diabetes.

Methods: A cohort of 3792 Japanese men completed a medical examination that included MPF and cardiorespiratory fitness tests. MPF index composite score was calculated using Z-scores from vertical jump, sit-ups, side step, and functional reach tests.

Results: The mean follow-up period was 187 months (15.6 years). There were 240 patients who developed type 2 diabetes during follow-up. Relative risks and 95% confidence intervals (CI) for incidence of diabetes across baseline quartiles of MPF index composite score were obtained using …

Possible Harms Of Oseltamivir—A Call For Urgent Action, Tom Jefferson, Mark Jones, Peter Doshi, Chris Del Mar

Christopher Del Mar

Extract: Oseltamivir is a successful drug: between July, 2004, and June, 2009, more than 11·5 million new prescriptions were issued in the USA, and nearly all influenza pandemic plans recommend antiviral drugs as a mainstay of containment on a population basis and treatment on an individual basis, with oseltamivir preferred because of ease of administration and storage. Because 75% of the world production of oseltamivir has been used in Japan,¹ this is where to look for any serious harms the drug might cause. ¹ See note in article.

The Regulation Of Medical Malpractice In Japan, Robert Leflar

Robert B Leflar

How Japanese legal and social institutions handle medical errors is little known outside Japan. For almost all of the 20th century, a paternalistic paradigm prevailed. Characteristics of the legal environment affecting Japanese medicine included few attorneys handling medical cases, low litigation rates, long delays, predictable damage awards, and low-cost malpractice insurance. However, transparency principles have gained traction and public concern over medical errors has intensified. Recent legal developments include courts' adoption of a less deferential standard of informed consent; increases in the numbers of malpractice claims and of practicing attorneys; more efficient claims handling by specialist judges and speedier trials; …

Is American Health Care Uniquely Inefficient?, Alan M. Garber, Jonathan Skinner

Dartmouth Scholarship

No abstract provided.

The Effects Of Price Regulation On Pharmaceutical R&D And Innovation, Heather M. O'Neill, Lena Clarissa Crain

Business and Economics Faculty Publications

As rising health care expenditures focus government attention on slowing the growth, the pharmaceutical industry comes under increasing pressure to curb prices of ethical drugs. Pharmaceutical price regulations have been implemented in many countries to control pharmaceutical expenditures. Yet, creating innovative drugs requires enormous R&D costs, which in turn require adequate expected economic returns. Since price controls reduce profits and expected returns, as countries invoke stricter price regulations, firms will either move their R&D process into less regulated markets or move out of innovative R&D. This paper assesses the impact of drug price regulations in Japan compared to market-priced drugs …

Medical Error As Reportable Event, As Tort, As Crime: A Transpacific Comparison, Robert B. Leflar, Futoshi Iwata

Robert B Leflar

All nations seek to reduce the human toll from medical error, but variations in legal and institutional structures guide those efforts into different trajectories. This article compares legal and institutional responses to patient safety problems in the United States and Japan, addressing developments in civil malpractice law (including discoverability of internal hospital documents), administrative practice (including medical accident reporting systems), and - of particular significance in Japan - criminal law. In the U.S., battles over rules of malpractice litigation are fierce; tort law occupies center stage. The hospital accreditation process plays a critical role in medical quality control, and peer …

Informed Consent And Patients' Rights In Japan: 2001 Epilogue, Robert B. Leflar

Robert B Leflar

Japan is on a steeper trajectory toward the incorporation of informed consent principles into medical practice than the “gradual transformation” observed in a 1996 article, Informed Consent and Patients’ Rights in Japan. Among the most significant recent developments from 1996 to 2001 have been these seven: (1) the 1997 enactment of the Organ Transplantation Law permitting the use of brain death criteria in limited circumstances in which informed consent is present; (2) the strengthening of patients’ rights in clinical drug trials; (3) the continued trend toward increasing disclosure to patients of cancer diagnoses; (4) initiatives by the health ministry toward …

The Effects Of Industrial Quality Management Of The Japanese And United States Health Care Systems, Mary Jo Sexton-Tosh

Theses

This thesis will focus on the effects of industrial quality management on the Japanese and United States Health Care Systems.

Research bas attributed the lack of quality management information in terms of the Japanese health care system to the closing of Japan's borders prior to the Meijing Restoration Era. Because of the isolation from the western world, Japan is behind the United States in its implementation of quality measurement standards to the provision and outcome of health care services.

Over the years the development of the health care industry in both the United States and Japan has taken different paths. …

Informed Consent And Patients' Rights In Japan, Robert B. Leflar

Robert B Leflar

This article analyzes the development of the concept of informed consent in the context of the culture and economics of Japanese medicine, and locates that development within the framework of the nation's civil law system. Part II sketches the cultural foundations of medical paternalism in Japan; explores the economic incentives (many of them administratively directed) that have sustained physicians' traditional dominant roles; and describes the judiciary's hesitancy to challenge physicians' professional discretion. Part III delineates the forces testing the paternalist model: the undermining of the physicians' personal knowledge of their patients that accompanies the shift from neighborhood clinic to high-tech …

Alumnae News, Yale School Of Nursing

Yale School of Nursing Alumni Newsletters and Magazines

No abstract provided.