研究者詳細 - 髙橋　徳幸

その他リンク： https://link.springer.com/article/10.1007/s13340-024-00692-y/fulltext.html

Investigating the perceptions of career development as the Japanese regional quota medical students and graduates in A prefecture 査読有り国際誌

Suematsu, M; Inoue, R; Takahashi, N; Miyazaki, K; Okazaki, K; Miyata, Y; Ohashi, W; Kuzuya, M

JOURNAL OF GENERAL AND FAMILY MEDICINE 2024年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of General and Family Medicine

Background: There are few reports about the perceptions of the regional quota called Chiikiwaku medical students and graduates. Method: Eighty-four medical students and 41 graduates were enrolled in A prefecture. The questionnaire comprised 22 items scored on a 7-point Likert scale, focusing on perceptions of merit and demerit of Chiikiwaku. The data were collected online. Results: Chiikiwaku students scored higher on an item such as ‘regional quotas are a solution to the doctor shortage’. Chiikiwaku graduates felt more burdened than Chiikiwaku students. Conclusion: Our results suggested that the perception of Chiikiwaku was different between Chiikiwaku students and graduates.

DOI： 10.1002/jgf2.689

Efficient detection of somatic UBA1 variants and clinical scoring system predicting patients with variants in VEXAS syndrome 査読有り

Maeda, A; Tsuchida, N; Uchiyama, Y; Horita, N; Kobayashi, S; Kishimoto, M; Kobayashi, D; Matsumoto, H; Asano, T; Migita, K; Kato, A; Mori, I; Morita, H; Matsubara, A; Marumo, Y; Yuji, I; Machiyama, T; Shirai, T; Ishii, T; Kishibe, M; Yoshida, Y; Hirata, S; Akao, S; Higuchi, A; Rokutanda, R; Nagahata, K; Takahashi, H; Katsuo, K; Ohtani, T; Fujiwara, H; Nagano, H; Hosokawa, T; Ito, T; Haji, Y; Yamaguchi, H; Hagino, N; Shimizu, T; Koga, T; Kawakami, A; Kageyama, G; Kobayashi, H; Aoki, A; Mizokami, A; Takeuchi, Y; Motohashi, R; Hagiyama, H; Itagane, M; Teruya, H; Kato, T; Miyoshi, Y; Kise, T; Yokogawa, N; Ishida, T; Umeda, N; Isogai, S; Naniwa, T; Yamabe, T; Uchino, K; Kanasugi, J; Takami, A; Kondo, Y; Furuhashi, K; Saito, K; Ohno, S; Kishimoto, D; Yamamoto, M; Fujita, Y; Fujieda, Y; Araki, S; Tsushima, H; Misawa, K; Katagiri, A; Kobayashi, T; Hashimoto, K; Sone, T; Hidaka, Y; Ida, H; Nishikomori, R; Doi, H; Fujimaki, K; Akasaka, K; Amano, M; Matsushima, H; Kashino, K; Ohnishi, H; Miwa, Y; Takahashi, N; Takase-Minegishi, K; Yoshimi, R; Kirino, Y; Nakajima, H; Matsumoto, N

RHEUMATOLOGY 2023年8月

Myelodysplastic syndrome with trisomy 8 presenting periodic fever and multiple<i> MEFV</i> gene variants outside exon 10: a case report 査読有り国際誌

Takahashi, N; Hanajiri, R; Suzuki, M; Anan, C; Inagaki, A; Kishida, D; Ozawa, S; Kohri, S; Kamiya, N; Sato, M; Sato, J

NAGOYA JOURNAL OF MEDICAL SCIENCE 85 巻 ( 1 ) 頁： 195 - 203 2023年2月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Nagoya Journal of Medical Science

Myelodysplastic syndrome is associated with the development of autoinflammatory conditions, such as recurrent fever, polymyalgia, arthralgia, and erythema. Trisomy 8 is a common chromosomal abnormality in patients with myelodysplastic syndrome. Myelodysplastic syndrome with trisomy 8 involves autoinflammatory conditions, especially Behçet’s disease-like symptoms with intestinal mucosal damage. MEFV variants, particularly those in exon 10, are pathogenic in familial Mediterranean fever, the most common autoinflammatory disease, presenting typical symptoms such as periodic fever and pleuritis/pericarditis/ peritonitis. MEFV variants outside exon 10 are common in Japanese patients with familial Mediterranean fever and are associated with atypical symptoms, including myalgia and erythema. MEFV variants in myelodysplastic syndrome with trisomy 8 have rarely been investigated, although myelodysplastic syndrome with trisomy 8 might develop autoinflammatory conditions similar to those in familial Mediterranean fever. We encountered a 67-year-old man who had myelodysplastic syndrome with trisomy 8 and multiple MEFV variants outside exon 10. He presented with periodic fever, as well as chest/abdominal pain, myalgia, and erythema, although the symptoms did not fulfill the diagnostic criteria of familial Mediterranean fever. We discussed the possibility that these symptoms are modified by MEFV variants outside exon 10 in myelodysplastic syndrome with trisomy 8

DOI： 10.18999/nagjms.85.1.195

我が国における地域枠医学生及び卒業生の地域枠に関する認識

A 2-item version of the Japanese Consultation and Relational Empathy measure: a pilot study using secondary analysis of a cross-sectional survey in \nprimary care 査読有り国際共著国際誌

Takahashi, N; Matsuhisa, T; Takahashi, K; Aomatsu, M; Mercer, SW; Ban, N

FAMILY PRACTICE 39 巻 ( 6 ) 頁： 1169 - 1175 2022年11月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Family Practice

Background: The Consultation and Relational Empathy (CARE) measure is a patient-reported measure of physician empathy which is widely used internationally. The Japanese version of the CARE measure has very high internal reliability, suggesting that a shorter version may have adequate validity and reliability. Objective: To investigate a valid shorter version of the Japanese CARE measure. Methods: We conducted a pilot study using secondary analysis of previous data obtained from 9 general practitioners and 252 patients and used to develop the Japanese CARE measure. All 1,023 possible combinations of the Japanese CARE items (n = 1-10) were candidates for the short measure. The internal consistency (Cronbach's alpha) and the correlations between candidate short questionnaires and the original questionnaire were calculated. After selecting the most valid short questionnaire, inter-rater reliability was determined using generalizability theory, and construct validity (Spearman's rho) was determined using patient satisfaction. Results: Two items were selected for a pilot shorter version: item 6 "Showing care and compassion"and item 9 "Helping you to take control."These showed high internal consistency and correlations with the 10-item measure (Cronbach's alpha = 0.920, correlation = 0.979). Forty-five questionnaires per doctor allowed us to reliably differentiate between practitioners. The construct validity for the pilot short measure was high (Spearman's rho 0.706, P < 0.001). Conclusion: We generated a pilot 2-item version of the Japanese CARE measure. This pilot 2-item version provides a basis for future validation studies of short CARE measures in other languages.

DOI： 10.1093/fampra/cmac034

谷口拓未, 井上理香子, 末松三奈, 高橋徳幸, 岡崎研太郎, 大橋渉, 葛谷雅文, 前野哲博

医学教育 53 巻 ( Suppl. ) 頁： 131 - 131 2022年7月

Key factors for overcoming psychological insulin resistance: A qualitative study in Japanese people with type 2 diabetes 査読有り国際共著国際誌

Okazaki, K; Takahashi, N; Shingaki, T; Perez-Nieves, M; Stuckey, H

PRIMARY CARE DIABETES 16 巻 ( 3 ) 頁： 411 - 416 2022年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Primary Care Diabetes

Aims: We report the key factors that motivate reluctant Japanese people with type 2 diabetes (T2D) to initiate insulin treatment. Methods: Participants were asked questions pertaining to 2 primary areas of exploration in a concurrent mixed methods approach: (a) understanding people's thoughts and perceptions before and after insulin initiation and any related factors; and (b) exploring the reasons behind people's responses. Data were analyzed using Steps for Coding and Theorization. Results: Participant responses broadly related to 3 themes which influence insulin initiation; 1. Advice from a health care provider (HCP) that insulin is an appropriate treatment; 2. Demonstration by HCPs on how to use the insulin pen/needle and the injection process; and 3. Resignation/surrender/acceptance of insulin, where participants felt there was no other choice but to commence insulin. Conclusions: Based on the 3 identified themes, it is important for HCPs to explain the benefits of insulin and demonstrate and explain the injection procedure to reluctant Japanese people with T2D. We also identified resignation/surrender/acceptance of insulin as a reason for treatment commencement. This study provides important information to assist HCPs in helping reluctant Japanese people with T2D to initiate basal insulin therapy.

DOI： 10.1016/j.pcd.2022.02.009

Diversity of academic general medicine A cross-sectional bibliometric study of original English-language research articles in general medicine and cardiology in Japan 査読有り国際誌

Takahashi, N; Matsuhisa, T; Takahashi, K; Ban, NO

MEDICINE 101 巻 ( 11 ) 頁： e29072 2022年3月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Medicine (United States)

Although research in general medicine is diverse, it has not been compared with research in a different medical specialty. The study aim was to understand the characteristics of research produced at Japanese university departments of general medicine and published in English-language journals, via comparison with another academic specialty, cardiology. In this cross-sectional study, a nationwide survey of the official websites of 82 university-affiliated medical schools in Japan was conducted in April 2020 to identify the heads of general medicine departments. We then surveyed the research output of these individuals in terms of original article output and research field diversity for journals listed in the Web of Science Core Collection of journals from 2010 to 2019. A similar survey of cardiology department publications was also conducted to provide a reference for intergroup comparisons and analysis of covariance. The analysis included 128 researchers from 78 general medicine departments and 96 researchers from 81 cardiology departments. The dominant research field of general medicine was general and internal medicine; that of cardiology was cardiac/cardiovascular systems. Data stratification by research field showed that general medicine researchers published significantly more articles than researchers in cardiology, a field that contains relatively few researchers. Furthermore, a comparison of individual researchers with the same number of published articles showed that researchers in general medicine departments published across a significantly wider range of fields than those in cardiology. This is the first study to describe the research characteristics of general medicine university departments in Japan through comparison with research in a different academic specialty. General medicine researchers in Japan comprise a heterogeneous group that mainly publishes research on general and internal medicine. Some general medicine researchers take a multidisciplinary approach to research and publishing.

DOI： 10.1097/MD.0000000000029072

Students' perception of a hybrid interprofessional education course in a clinical diabetes setting: a qualitative study 査読有り国際誌

Suematsu, M; Okumura, K; Hida, T; Takahashi, N; Okazaki, K; Fuchita, E; Abe, K; Kamei, H; Hanya, M

INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 12 巻頁： 195 - 204 2021年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International journal of medical education

Objectives: To explore what the student participants learned and how they felt about the use of three educational settings, namely, face-to-face workshop setting, asynchronous and synchronous online learning environments and interactions with outpatients in a real-world clinical setting in a hybrid interprofessional education course. Methods: This qualitative study used semi-structured in-depth interviews with healthcare undergraduate student participants in a course comprising workshops in three educational settings. A total of 15 healthcare undergraduate students, which included four medical, three pharmacy, five nursing and three nutrition students, completed this IPE course. All students agreed to participate in the study. We conducted four focus groups selected using convenient sampling. Focus group transcripts were analysed using the 'Steps for Coding and Theorization' qualitative data analysis method. We investigated the students' perception through the experience of three educational settings in the hybrid interprofessional education course. Results: The students recognised that this course had three types of educational spaces, namely, real, semi-real and unreal. Then, the positive changes in the awareness of students are trained in recognition of the patient perspective, the recognition of the roles discharged by the other professions and the recognition of the functions of their own profession after experiencing the educational spaces designated for this course. Conclusions: The repeated experience of participants to real, semi-real and unreal educational spaces promoted changes over time in the students' awareness of interprofessional competencies with respect to patient-centred care and ameliorated their readiness to undertake interprofessional tasks.

DOI： 10.5116/ijme.6165.59e0

Clinical Images: Extensive multiple organ involvement in VEXAS syndrome 査読有り国際誌

Takahashi, N; Takeichi, T; Nishida, T; Sato, J; Takahashi, Y; Yamamura, M; Ogi, T; Akiyama, M

ARTHRITIS & RHEUMATOLOGY 73 巻 ( 10 ) 頁： 1896 - 1897 2021年10月

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Arthritis and Rheumatology

DOI： 10.1002/art.41775

病院総合診療医の診療対象になりうる新しい成人発症自己炎症性疾患 : VEXAS 症候群査読有り

その他リンク： https://nagoya.repo.nii.ac.jp/records/2000161#.YmFQ_C_3LnE

高橋徳幸, 佐藤寿一

日本病院総合診療医学会雑誌 17 巻 ( 5 ) 頁： 588 - 589 2021年9月

Effect of physician attire on patient perceptions of empathy in Japan: a quasi-randomized controlled trial in primary care 査読有り国際共著国際誌

Matsuhisa, T; Takahashi, N; Takahashi, K; Yoshikawa, Y; Aomatsu, M; Sato, J; Mercer, SW; Ban, N

BMC FAMILY PRACTICE 22 巻 ( 1 ) 頁： 59 2021年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMC Family Practice

Background: There is limited quantitative research on the effect of physician attire on patient–physician relationships. This study aimed to measure the influence of Japanese family physicians’ attire on the “human” aspects of medical care in terms of patient-perceived relational empathy. Methods: This was a multicenter, prospective, controlled trial conducted in primary clinics in Japan. We explored the effects of family physician attire (white coat vs. casual attire) on patient-perceived empathy. Family physicians were allocated to alternate weeks of wearing a white coat or casual attire during consultations. Patients’ perceptions of physician empathy were evaluated using the self-rated Japanese Consultation and Relational Empathy (CARE) Measure. We used a linear mixed model to analyze the CARE Measure scores, adjusting for cluster effects of patients nested within doctor, age, and sex of patients, and doctors’ sex and years of clinical experience. We used the same method with Bonferroni adjustment to analyze patient sex differences in perceived empathy. Results: A total of 632 patients of seven family physicians were allocated to white coat-wearing consultations (n = 328), and casual attire-wearing consultations (n = 304). There was no difference in CARE Measure scores between white coat and casual primary care consultations overall (p = 0.162). Subgroup analysis of patient sex showed that CARE Measure scores of male patients were significantly higher in the Casual group than in the White coat group (adjusted p-value = 0.044). There was no difference in female patient scores between White coat and Casual groups (adjusted p-value = 1.000). Conclusions: This study demonstrated that physician attire (white coat or casual attire) in a primary care setting did not affect patient-perceived relational empathy overall. However, male patients of physicians wearing casual attire reported higher physician empathy. Although empathy cannot be reduced to simple variables such as attire, white coats may have a negative effect on patients, depending on the context. Family physicians should choose their attire carefully. Trial registration: Japanese University Hospital Medical Information Network (UMIN-ICDR). Clinical Trial identifier number UMIN000037687 (Registered August 14, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042749). The study was prospectively registered.

DOI： 10.1186/s12875-021-01416-w

その他リンク： http://link.springer.com/article/10.1186/s12875-021-01416-w/fulltext.html

A novel online interprofessional education with standardised family members in the COVID-19 period 査読有り国際誌

Suematsu, M; Takahashi, N; Okazaki, K; Fuchita, E; Yoshimi, A; Hanya, M; Noda, Y; Abe, K; Kuzuya, M

INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 12 巻頁： 36 - 37 2021年3月

Problem-Based Learning in Child and Adolescent Psychiatry: A Perspective from Japan 査読有り

Iwatsuki, J; Kondo, T; Takahashi, N; Takami, H; Nishigori, H; Bustos-Villalobos, I; Aleksic, B; Kasuya, H; Ban, NO; Yagi, T; Skokauskas, N

ADVANCES IN MEDICAL EDUCATION AND PRACTICE 12 巻頁： 1329 - 1335 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Advances in Medical Education and Practice

Purpose: Japanese higher education institutions have long been striving for the globaliza-tion of medical education. Nagoya University (NU) adopted PBL as a means of enhancing intercultural awareness in globalizing medical education by working with the Norwegian University of Science and Technology (NTNU), Faculty of Medicine and Health Science, under the Trondheim NTNU-Nagoya (TroNa) partnership for mobility and internationaliza-tion of child and mental health studies. This study aims to assess students’ attitudes towards PBL and to suggest future developments in this form of education by introducing common PBL scenarios experienced at NTNU and NU. Methods: Two 90-minute PBL sessions were conducted at NU. Ten groups of medical students were formed, each consisting of up to 10 students, and students were asked to fill in a questionnaire developed to assess their understanding of, attitudes to and satisfaction with the classes. We investigated three different groups of questions on: NU medical students’ general impressions of PBL; their impressions of PBL in child and adolescent psychiatry (CAP); and their impressions of PBL in specific case scenarios. Correlations between each of the questions from the three groups were evaluated using multivariate analysis. Results: Overall, a majority of the NU medical students were satisfied with PBL, while a small number preferred traditional lecture-style learning (5%). More than half of the students agreed that PBL increased their understanding and interest in CAP (53%), although some male students felt that the amount of time spent was insufficient (20.3%). Correlations were seen for students who thought that PBL enhanced their understanding of and interest in CAP. Regarding case scenarios, most students (82.5%) agreed that PBL helped them to develop clinical problem-solving skills. Conclusion: The study found an overall positive attitude towards PBL, PBL in CAP and the specific PBL case scenario presented.

DOI： 10.2147/AMEP.S333958

A survey of Japanese physician preference for attire: what to wear and why 査読有り

Yoshikawa, Y; Matsuhisa, T; Takahashi, N; Sato, J; Ban, N

NAGOYA JOURNAL OF MEDICAL SCIENCE 82 巻 ( 4 ) 頁： 735 - 745 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Nagoya Journal of Medical Science

Many studies have examined the impression made on patients by physicians' attire. Regardless of practice location, many patients express most confidence in physicians who wear white coats. The number of physicians in Japan who choose not to wear white coats in practice has been increasing, particularly in primary care settings. However, very few studies have examined physician preference for attire. To clarify Japanese general practitioners' preference for attire by practice setting, we conducted a survey of physician preferences and reasons for attire selection. Subjects were 794 general practitioners certified by the Japan Primary Care Association and recruited from a mailing list. We conducted a web-based questionnaire survey. Physicians were asked to choose one of four different dress styles (semi-formal, white coat, scrubs, and casual) for different practice settings and state the reasons for selection. The response rate was 19.3% (n = 153; men 112). Most subjects chose white coats as usual attire for hospital practice (52%), mainly because of custom and professionalism. In contrast, most subjects chose non-white coats for clinics (59%) and home care (hospital-provided, 58%; clinic-provided, 71%). More subjects chose casual dress for clinic and home care practice, mainly to appear empathic. Most subjects chose white coats as the most appropriate hospital attire (54%), mainly because of patient perceptions of this attire being professional. Most subjects considered non-white coat attire more appropriate for clinic and home care practice. The findings indicate that general practitioners choose their clothes depending on practice location.

DOI： 10.18999/nagjms.82.4.735