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Zeng D, Shimosaka M, Wu X, Anagnostou D, Asakura K, Kinoshita A. Why do male nurses choose to work in foreign countries? A qualitative study on Chinese male nurses working in Japan. Heliyon 2024; 10:e23262. [PMID: 38332879 PMCID: PMC10851210 DOI: 10.1016/j.heliyon.2023.e23262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 02/10/2024] Open
Abstract
Aim This study aimed to examine foreign-educated male nurses' motivation to emigrate for work, as well as explore the contextual factors that shape their career trajectories. Background To that end, we interviewed Chinese male nurses working in Japan. No previous study has examined why male nurses seek employment abroad or the problems they face. Methods This study employed a qualitative and inductive research design. Sixteen Chinese male nurses working in Eastern and Western Japan were recruited using convenience and snowball sampling methods and were interviewed via video calls. Co-researchers of both genders from different occupational and cultural backgrounds coded the findings and identified common themes in participants' responses. We analysed our findings vis-à-vis various theoretical perspectives and developed an explanatory model. Results Participants' experience as nurses in Japan ranged from six months to eight years. The findings confirmed that factors identified in earlier reports influenced nurses' motivation and work. Two new factors emerged: influence by others and social reasons. Moreover, two factors that affected male nurses' motivation to work abroad, namely, external factors and the influence of others, were identified. Social reasons were identified as a pull factor. Conclusion Our study provides valuable insights into recruiting and retaining foreign male nurses in developed countries facing issues such as ageing populations and nursing shortages. Implications for nursing policy This study has important implications for nursing management. Our findings highlight the importance of orienting foreign-educated nurses regarding the local work culture to increase the recruitment and retention of foreign talent. Moreover, enhanced salary packages and benefits to improve motivation can lead to improved job performance, which can positively impact patient and safety outcomes.
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Affiliation(s)
- Derong Zeng
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Xiaoyu Wu
- Faculty of Health Science, Department of Nursing, Kyoto Koka Women's University, Kyoto, Japan
| | | | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Japan
| | - Ayae Kinoshita
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Yamada M, Asakura K, Sugiyama S, Takada N. Insights from defining nurses' career success: An integrative review. Nurs Open 2024; 11:e2040. [PMID: 38268298 PMCID: PMC10697118 DOI: 10.1002/nop2.2040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 10/12/2023] [Accepted: 10/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIMS To review the literature and identify factors that make sense of and influence nurses' career success. We sought to provide insights into achieving nurses' career success. DESIGN An integrative review conducted in May 2022 using Whittemore and Knafl's methodology of integrative review. METHODS The databases searched were PubMed, Web of Science, Scopus, and CINAHL. Search criteria included the keywords "nurs*" and "career success" in the title and abstract. The quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross-sectional studies and qualitative research. We extracted five types of information from quantitative studies: the definition of career success, factors of career success instruments, reliability or validity of career success instruments, and factors influencing nursing career success. Furthermore, we extracted two types of information from qualitative studies: themes that imply career success and factors that influence nurses' career success. Primary data were categorized into two perspectives: (1) what nurses' career success means and (2) what influences nurses' career success. Categorized data were unified into similar contents. Themes were developed from unified subgroups. RESULTS Fourteen studies were included in the analysis. Seven themes were integrated into the factors that make sense of nurses' career success: satisfaction, positive attitude towards work, quality work in nursing, continuation of career and professional development, positive interaction at work, person-organization fit, and enrichment of an individual's life. Three themes were integrated into the factors influencing nursing career success: personal resources, positive behavior toward nursing work and research, and job resources and environment. NO PATIENT OR PUBLIC CONTRIBUTION Patients or members of the public were not involved in this review.
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Affiliation(s)
- Masako Yamada
- Graduate School of MedicineTohoku UniversitySendaiJapan
| | - Kyoko Asakura
- Graduate School of MedicineTohoku UniversitySendaiJapan
| | | | - Nozomu Takada
- Graduate School of MedicineTohoku UniversitySendaiJapan
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Hara Y, Yamada M, Takada N, Sugiyama S, Asakura K. The moderating role of work-to-family spillover in the association between nurses' work values and work engagement: A cross-sectional study. Jpn J Nurs Sci 2023; 20:e12554. [PMID: 37470364 DOI: 10.1111/jjns.12554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/21/2023]
Abstract
AIM Although researchers have emphasized the importance of enhancing work engagement in nurses to ensure work-related well-being, the underlying mechanisms of the influencing factors of work engagement remain unclear. This study aimed to elucidate whether work-to-family spillover moderates the relationship between nurses' work values and work engagement. METHODS In total, 2600 nurses from 52 hospitals in the Tohoku region of Japan were recruited, and 1587 nurses participated. The questionnaire included items on demographic characteristics, the Nurses' Work Values Scale, the Japanese version of the Work-life Balance Scale, and the Work Engagement Scale. Data were analyzed using hierarchical multiple regression. RESULTS The interaction terms of negative work-to-family spillover with extrinsic work values and prestige work values were significantly associated with work engagement. The interaction terms of nurses' work values and positive work-to-family spillovers did not show a significant association. CONCLUSIONS Nurses who emphasized extrinsic work values and those who did not emphasize prestige work values had the lowest work engagement in settings with high negative work-to-family spillover. To ensure nurses' work-related well-being and engagement, nursing managers could provide support for nurses in tackling work-related negative events, so that these do not carry over to family settings.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Masako Yamada
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nozomu Takada
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shoko Sugiyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Hara Y, Asakura K, Yamada M, Takada N, Sugiyama S. Development and psychometric evaluation of the nurses' Work Values Scale. Nurs Open 2023; 10:6957-6971. [PMID: 37518936 PMCID: PMC10495741 DOI: 10.1002/nop2.1950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/03/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
AIM This study aimed to develop the nurses' Work Values Scale (WVS) to determine how important certain values are for nurses and to psychometrically test the scale. DESIGN Instrument development and validation study. METHOD A two-phase scale development process comprising item generation, scale improvement and psychometric property evaluation was used. In the first phase, scale items were identified. In the second phase, item and exploratory factor analyses were performed in Study 1, and confirmatory factor analysis, validity verification and reliability verification of the nurses' WVS were performed in Study 2. RESULTS As a result of the analysis, a scale of 30 items with four subdomains was developed. In convergent validity and reliability verification, it was shown that the nurses' WVS has acceptable validity and reliability. NO PATIENT OR PUBLIC CONTRIBUTION Patients or members of the public were not involved in this study.
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Affiliation(s)
- Yukari Hara
- Graduate School of MedicineTohoku UniversitySendaiJapan
| | - Kyoko Asakura
- Graduate School of MedicineTohoku UniversitySendaiJapan
| | - Masako Yamada
- Graduate School of MedicineTohoku UniversitySendaiJapan
| | - Nozomu Takada
- Graduate School of MedicineTohoku UniversitySendaiJapan
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Hara Y, Hirayama H, Takada N, Sugiyama S, Yamada M, Takahashi M, Toshi K, Asakura K. Classification by Nurses' Work Values and Their Characteristics: Latent Profile Analysis of Nurses Working in Japanese Hospitals. Nurs Rep 2023; 13:877-889. [PMID: 37368344 DOI: 10.3390/nursrep13020077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
This study aimed to classify nurses with similar work values into subgroups by examining their intrinsic, extrinsic, social, and prestige work values. Additionally, we clarified the characteristics of the obtained subgroups using personal attributes, work engagement, and life satisfaction. Using a cross-sectional observational study design, we randomly sampled 52 hospitals in the Tohoku region of Japan and conducted a self-administered questionnaire survey with 2600 nurses. Latent profile analysis was performed to identify the number of subgroups. Of the 1627 collected questionnaires, 1587 were regarded as valid. The latent profile analysis revealed the following five subgroups with strong statistical significance: (1) self-oriented, (2) low, (3) medium-low, (4) medium-high, and (5) high types. The means of work engagement and life satisfaction gradually increased from the (2) low- to (5) high-type subgroups. There were significant differences among the subgroups in terms of marital status, child status, and job title. The (5) high-type subgroup had many nurses with job titles, high work engagement, and high life satisfaction. The (2) low-type subgroup included many nurses who were young, had few years of experience, were married, had children, and had low levels of work engagement and life satisfaction. Preregistration: This study was not registered.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Hideyuki Hirayama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Nozomu Takada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Shoko Sugiyama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Masako Yamada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Miki Takahashi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
- National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Japan
| | - Keita Toshi
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
- Medical Corporation Kanno-Aiseikai Midorigaoka Hospital, 1-16 Nishitamagawa-cho, Shiogama 985-0045, Japan
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
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Nagata T, Minami Y, Muramatsu Y, Asakura K, Katamine M, Katsura A, Kinoshita D, Ako J. High thrombotic risk is associated with higher prevalence of suboptimal stent results in patients with high bleeding risk. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Shorter duration of dual antiplatelet therapy after drug-eluting stent implantation is required in patients with high bleeding risk (HBR) irrespective of the presence of concomitant high thrombotic risk (HTR). The prevalence of post-stent suboptimal findings in patients with HBR remains unclear.
Purpose
To clarify the prevalence of post-stent suboptimal findings assessed by optical coherence tomography (OCT) in patients with HBR according to the presence of HTR.
Methods
A total of 607 consecutive patients with stable coronary disease, who underwent OCT imaging of the culprit lesion were included. HBR was defined based on the Academic Research Consortium for High Bleeding Risk (ARC-HBR). HTR was defined as lesions with diffuse long (≧60 mm), treated with more than three stents, chronic total occlusion or diffuse long lesion (≧32 mm) in patients with diabetes mellitus. Post-stent suboptimal OCT criteria was defined as minimum stent area (MSA) <4.5 mm2, edge dissection and stent malapposition.
Results
The prevalence of HBR was 55.8%. The prevalence of HTR was significantly higher in patients with HBR than in those without HBR (35.0 vs. 26.6%, p=0.028) (Figure A). Among patients with HBR, the prevalence of post-stent suboptimal OCT criteria was significantly higher in patients with HTR than in those without HTR (86.2 vs. 64.7%, p<0.001), mainly due to the higher prevalence of MSA <4.5 mm2 (Figure B) in patients with HTR.
Conclusions
HTR was associated with a higher prevalence of post-stent suboptimal findings among patients with HBR. The present results may suggest the importance of optimal stenting in patients with HBR, particularly in those with concomitant HTR.
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Affiliation(s)
- T Nagata
- Kitasato University School of Medicine , Sagamihara , Japan
| | - Y Minami
- Kitasato University School of Medicine , Sagamihara , Japan
| | - Y Muramatsu
- Kitasato University School of Medicine , Sagamihara , Japan
| | - K Asakura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - M Katamine
- Kitasato University School of Medicine , Sagamihara , Japan
| | - A Katsura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - D Kinoshita
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine , Sagamihara , Japan
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Nihei Y, Asakura K, Sugiyama S, Takad N. A concept analysis of shame in the field of nursing. Nurs Forum 2022; 57:1529-1535. [PMID: 36268903 PMCID: PMC10092440 DOI: 10.1111/nuf.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 11/29/2022]
Abstract
AIM The study aimed to conceptually define "shame" within the field of nursing. BACKGROUND Many nurses sometimes experience and struggle with shame in their professional lives. It reduces their sense of self-worth and hampers emotional well-being and efficacy at work. DESIGN The conceptual analysis was performed using Walker and Avant's method. DATA SOURCES We searched using Academic Search Complete, CINAHL, PsycINFO, MEDLINE, and Psychology and Behavioral Sciences Collection databases for literature published between 1980 and 2020. REVIEW METHODS We searched for keywords "shame," "nurse," and "nursing," with the condition that the keywords must be included in the title or abstract. RESULTS Shame in the nursing field was defined as a negative emotion, an experience of self-blame and anger, an emotion accompanied by social anxiety, loneliness, and influenced by society and culture. Shame in the nursing field has three antecedents: negative evaluation, the involvement of others, and social and affiliated-group norms. Consequences of shame in nursing include decreased senses of self-esteem and self-efficacy, escape through defense mechanisms, depressive states, and alleviation of distress through reaffirmation of self-promotion and reflection leading to personal growth. CONCLUSIONS We clarified the significance of self, others, others' evaluations, and differences in socio-cultural contexts while defining shame.
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Affiliation(s)
- Yoko Nihei
- Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Faculty of Health Science, Tohoku Fukushi University, Sendai, Japan
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shoko Sugiyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nozomu Takad
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Asakura K, Minami Y, Nagata T, Katamine M, Katsura A, Kinoshita D, Ako J. Higher triglyceride level is associated with the higher prevalence of layered plaque in nonculprit coronary plaques. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The impact of the high triglyceride (TG) level on the characteristics of coronary plaque in nonculprit lesion remains to be elucidated.
Purpose
To clarify the association between the TG level and the characteristics of nonculprit coronary plaque in patients with stable coronary disease using optical coherence tomography (OCT).
Methods
A total of 531 consecutive patients who underwent OCT imaging of the nonculprit lesion were included. Patients were classified into either the higher TG group (non-fasting TG ≥150 mg/dL, n=197) or the lower TG group (non-fasting TG <150 mg/dL, n=334). The morphologies of nonculprit plaque assessed by OCT were compared between the two groups.
Results
The median (interquartile range) of TG in the two groups was 193.0 (168.0–244.0) mg/dL and 95.0 (75.0–120.0) mg/dL, respectively. The prevalence of layered plaque was significantly higher in the higher TG group than the lower TG group (40.1 vs. 27.5%, p=0.004), whereas the prevalence of other plaque components was comparable between the two groups (Figure 1). The prevalence of layered plaque was significantly higher in the higher TG group than in the lower TG group among patients with diabetes mellitus (DM) (44.2 vs. 28.7%, p=0.037) although it was comparable between the two groups among patients without DM (Figure 2).
Conclusion
A higher TG level was associated with a higher prevalence of layered plaque in nonculprit plaques in patients with stable coronary disease, particularly in patients with DM. The present results may partly explain the impact of TG on the progression of coronary plaque and the increased incidence of recurrent events in patients with coronary artery disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Asakura
- Kitasato University School of Medicine , Kanagawa , Japan
| | - Y Minami
- Kitasato University School of Medicine , Kanagawa , Japan
| | - T Nagata
- Kitasato University School of Medicine , Kanagawa , Japan
| | - M Katamine
- Kitasato University School of Medicine , Kanagawa , Japan
| | - A Katsura
- Kitasato University School of Medicine , Kanagawa , Japan
| | - D Kinoshita
- Kitasato University School of Medicine , Kanagawa , Japan
| | - J Ako
- Kitasato University School of Medicine , Kanagawa , Japan
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Yamada M, Asakura K, Takada N, Hara Y, Sugiyama S. Psychometric properties of the Japanese version of the career competencies questionnaire for nurses: a cross-sectional study. BMC Nurs 2022; 21:263. [PMID: 36162990 PMCID: PMC9512970 DOI: 10.1186/s12912-022-01035-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Career competencies, which are the knowledge, skills, and abilities essential for career development, have been shown to facilitate career success, fulfilling both work and life goals. In dynamically changing healthcare settings, nurses' career competencies are key for successfully navigating their careers and improving their nursing practice abilities. However, limited studies have examined career competencies in the nursing profession. In particular, no research has been conducted on career competencies among Japanese nurses, which remains a major challenge as voluntary effort is the main factor promoting career and professional development. Therefore, the purpose of this study was to evaluate the validity and reliability of the Japanese version of the Career Competencies Questionnaire (CCQ-J). METHODS In this cross-sectional study conducted between June 2020 and August 2021, the English CCQ was translated into Japanese using back and forward translation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted on separate samples. In the first step, item analysis and EFA were conducted with 276 nurses from one hospital. In the second step, CFA was conducted and concurrent validity and reliability were evaluated with 522 nurses from hospitals in the Tohoku region. RESULTS Content validity was confirmed by the back-translation report, an expert panel, and a pilot test. The EFA showed that the CCQ-J consisted of a three-factor structure that explained 66.69% of the variance. The CFA revealed that all the fit indices were acceptable [chi-square value (CMIN) = 432.26, degree of freedom (df) = 153, chi-square fit statistic/degree of freedom (CMIN/df) = 2.83, goodness-of-fit index (GFI) = 0.93, adjusted goodness of fit index (AGFI) = 0.89, comparative fix index (CFI) = 0.96, and root mean square error of approximation (RMSEA) = 0.06]. Cronbach's α for the 21-item CCQ-J and its subscales ranged from 0.85 to 0.95. Concurrent validity was demonstrated via the positive correlation between work engagement, life satisfaction, and the CCQ-J. CONCLUSIONS The CCQ-J is a valid and reliable instrument to assess the career competencies of Japanese nurses. We hope that the findings presented in this study will contribute to a better understanding of nurses' career competencies and their successful career and professional development in the future.
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Affiliation(s)
- Masako Yamada
- Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Kyoko Asakura
- Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Nozomu Takada
- Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Yukari Hara
- Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Shoko Sugiyama
- Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
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Suzuki T, Hishida T, Yano K, Imoto T, Oka N, Maeda C, Okubo Y, Masai K, Kaseda K, Asakura K, Emoto K, Asamura H. EP07.03-007 Clinicopathological Analyses for Predicting Recurrence After Complete Resection of Thymoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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11
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Katamine M, Minami Y, Nagata T, Asakura K, Katsura A, Kinoshita D, Hashimoto T, Ako J. High sensitivity C-reactive protein is associated with vulnerable characteristics in non-culprit plaques in patients with ST-segment elevation myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Higher level of high sensitivity C-reactive protein (hsCRP) is associated with an increased risk of recurrent cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI). However, the association between hsCRP and the characteristics of non-culprit plaques in patients with STEMI remains to be elucidated.
Purpose
To clarify the morphological characteristics of non-culprit plaque in patients with STEMI according to the hsCRP levels using optical coherence tomography (OCT).
Methods
A total of 79 non-culprit plaques in 76 consecutive patients with STEMI, who underwent OCT imaging of the non-culprit plaques in a culprit vessel were included. The characteristics of non-culprit plaques assessed by OCT were compared between the higher hsCRP group (hsCRP ≥ 0.16 mg/dL, 38 plaques in 38 patients) and the lower hsCRP group (hsCRP < 0.16 mg/dL, 41 plaques in 38 patients).
Results
The prevalence of plaque with macrophage (63.2 vs. 31.7%, p = 0.006), plaque with large lipid (maximal lipid arc > 180 °) (57.9 vs. 31.7%, p = 0.018), healed plaque (50.0 vs. 26.8%, p = 0.045) and cholesterol crystal (18.4 vs. 2.4%, p = 0.045) was significantly higher in the higher hsCRP group than in the lower hsCRP group (Figure). In a multivariate analysis, the higher hsCRP was independently associated with the presence of plaque with macrophage (Odds ratio [OR], 3.031; 95% confidence interval [CI]: 1.112-8.264, p = 0.030), plaque with large lipid (OR, 2.897; 95% CI: 1.122-7.478, p = 0.026) and healed plaque (OR, 2.666; 95% CI: 1.030-6.896, p = 0.040).
Conclusions
Higher level of hsCRP is associated with a higher prevalence of vulnerable characteristics in non-culprit plaques in patients with STEMI. The present results may partly explain the pathogenesis of an increased incidence of recurrent cardiovascular events in patients with STEMI. Abstract Figure.
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Affiliation(s)
- M Katamine
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Nagata
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - D Kinoshita
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University School of Medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Sagamihara, Japan
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Sugiura T, Uesaka K, Okamura Y, Ito T, Yamamoto Y, Ashida R, Ohgi K, Otsuka S, Nakagawa M, Aramaki T, Asakura K. Major hepatectomy with combined vascular resection for perihilar cholangiocarcinoma. BJS Open 2021; 5:6342603. [PMID: 34355240 PMCID: PMC8342931 DOI: 10.1093/bjsopen/zrab064] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022] Open
Abstract
Background Hepatectomy with vascular resection (VR) for perihilar cholangiocarcinoma (PHCC) is a challenging procedure. However, only a few reports on this procedure have been published and its clinical significance has not been fully evaluated. Methods Patients undergoing surgical resection for PHCC from 2002–2017 were studied. The surgical outcomes of VR and non-VR groups were compared. Results Some 238 patients were included. VR was performed in 85 patients. The resected vessels were hepatic artery alone (31 patients), portal vein alone (37 patients) or both (17 patients). The morbidity rates were almost the same in the VR (49.4 per cent) and non-VR (43.8 per cent) groups (P = 0.404). The mortality rates of VR (3.5 per cent) and non-VR (3.3 per cent) were also comparable (P > 0.999). The median survival time (MST) was 45 months in the non-VR group and 36 months in VR group (P = 0.124). Among patients in whom tumour involvement was suspected on preoperative imaging and whose carbohydrate antigen 19-9 (CA19-9) value was 37 U/ml or less, MST in the VR group was significantly longer than that in the non-VR group (50 versus 34 months, P = 0.017). In contrast, when the CA19-9 value was greater than 37 U/ml, MST of the VR and non-VR groups was comparable (28 versus 29 months, P = 0.520). Conclusion Hepatectomy with VR for PHCC can be performed in a highly specialized hepatobiliary centre with equivalent short- and long-term outcomes to hepatectomy without VR.
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Affiliation(s)
- T Sugiura
- Division of Hepato-Biliary-Pancreatic Surgery
| | - K Uesaka
- Division of Hepato-Biliary-Pancreatic Surgery
| | - Y Okamura
- Division of Hepato-Biliary-Pancreatic Surgery
| | - T Ito
- Division of Hepato-Biliary-Pancreatic Surgery
| | - Y Yamamoto
- Division of Hepato-Biliary-Pancreatic Surgery
| | - R Ashida
- Division of Hepato-Biliary-Pancreatic Surgery
| | - K Ohgi
- Division of Hepato-Biliary-Pancreatic Surgery
| | - S Otsuka
- Division of Hepato-Biliary-Pancreatic Surgery
| | - M Nakagawa
- Division of Plastic and Reconstructive Surgery
| | - T Aramaki
- Division of Diagnostic Radiology, Shizuoka Cancer Centre, Shizuoka, Japan
| | - K Asakura
- Division of Diagnostic Radiology, Shizuoka Cancer Centre, Shizuoka, Japan
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13
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Hara Y, Asakura K. Concept analysis of nurses' work values. Nurs Forum 2021; 56:1029-1037. [PMID: 34322885 DOI: 10.1111/nuf.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/03/2021] [Accepted: 07/17/2021] [Indexed: 11/30/2022]
Abstract
This study aimed to clarify the nature and definition of nurses' work values. To this end, we adopted Walker and Avant's (2019) concept analysis procedure. We searched PubMed, CINAHL, Scopus, and Web of Science for previous literature that sampled nurses and nursing students published before September 2020. From 104 studies, 30 were analyzed. Citation sources for the definition of work values were also included in the target literature. After clarifying all usages of the concept, important attributes were determined, and model cases, borderline cases, related cases, antecedents, consequences, and empirical referents were identified. Nurses' work values were defined as: enduring beliefs about the preferable conditions and outcomes nurses desire through their work, that place importance on their work, and that are the principles and standards that guide attitudes, judgments, and behaviors. Additionally, the antecedents for nurses' work values included basic human values, gender, and generation, and the consequences comprised attitudes, judgments, and behaviors related to work. Clarification of the concept enables the proper utilization of knowledge regarding nurses' work values and the development of a related theory.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan
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14
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Hara Y, Asakura K, Sugiyama S, Takada N, Ito Y, Nihei Y. Nurses Working in Nursing Homes: A Mediation Model for Work Engagement Based on Job Demands-Resources Theory. Healthcare (Basel) 2021; 9:316. [PMID: 33809246 PMCID: PMC7999486 DOI: 10.3390/healthcare9030316] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022] Open
Abstract
This study examined the impact that the attractiveness of working in nursing homes and autonomous clinical judgment have on affective occupational commitment, and whether work engagement mediates these relationships. This analysis was based on the job demands-resources theory. The study setting was 1200 nursing homes (including long-term care welfare facilities and long-term care health facilities) in eastern Japan. An anonymous, self-report questionnaire survey was administered to two nurses from each facility, resulting in a prospective sample of 2400 participants. Overall, 552 questionnaires were analyzed, in which structural equation modeling and mediation analysis using the bootstrap method were performed. The results showed that the attractiveness of working in nursing homes does not directly affect affective occupational commitment; work engagement fully mediates the impact of attractiveness of working in nursing homes on affective occupational commitment. Additionally, autonomous clinical judgment showed a direct impact on both work engagement and affective occupational commitment, indicating that work engagement partially mediates the impact on affective occupational commitment. To increase the affective occupational commitment of nurses working in nursing homes, managers should help nurses recognize the attractiveness of working in nursing homes, and then provide appropriate support to help such nurses work in a motivated manner.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Shoko Sugiyama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Nozomu Takada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Yoshimi Ito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
- School of Nursing, Miyagi University, 1-1 Gakuen, Taiwa-cho, Kurokawa-gun, Miyagi 981-3298, Japan
| | - Yoko Nihei
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
- Department of Nursing, Faculty of Health Sciences, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, Miyagi 981-8522, Japan
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15
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Suzuki T, Hishida T, C. M, Matsuda K, Nakagomi T, Omura S, Tanaka H, Masai K, Kaseda K, Asakura K, Asamura H. P26.07 Video-Assisted Thoracoscopic Surgery for Stage I Thymoma: Short-Term Outcomes and Appropriate Indications. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Sunohara T, Imamura H, Goto M, Fukumitsu R, Matsumoto S, Fukui N, Oomura Y, Akiyama T, Fukuda T, Go K, Kajiura S, Shigeyasu M, Asakura K, Horii R, Sakai C, Sakai N. Neck Location on the Outer Convexity is a Predictor of Incomplete Occlusion in Treatment with the Pipeline Embolization Device: Clinical and Angiographic Outcomes. AJNR Am J Neuroradiol 2021; 42:119-125. [PMID: 33184073 DOI: 10.3174/ajnr.a6859] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/11/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE With the increasing use of the Pipeline Embolization Device for the treatment of aneurysms, predictors of clinical and angiographic outcomes are needed. This study aimed to identify predictors of incomplete occlusion at last angiographic follow-up. MATERIALS AND METHODS In our retrospective, single-center cohort study, 105 ICA aneurysms in 89 subjects were treated with Pipeline Embolization Devices. Patients were followed per standardized protocol. Clinical and angiographic outcomes were analyzed. We introduced a new morphologic classification based on the included angle of the parent artery against the neck location: outer convexity type (included angle, <160°), inner convexity type (included angle, >200°), and lateral wall type (160° ≤ included angle ≤200°). This classification reflects the metal coverage rate and flow dynamics. RESULTS Imaging data were acquired in 95.3% of aneurysms persistent at 6 months. Complete occlusion was achieved in 70.5%, and incomplete occlusion, in 29.5% at last follow-up. Multivariable regression analysis revealed that 60 years of age or older (OR, 5.70; P = .001), aneurysms with the branching artery from the dome (OR, 10.56; P = .002), fusiform aneurysms (OR, 10.2; P = .009), and outer convexity-type saccular aneurysms (versus inner convexity type: OR, 30.3; P < .001; versus lateral wall type: OR, 9.71; P = .001) were independently associated with a higher rate of incomplete occlusion at the last follow-up. No permanent neurologic deficits or rupture were observed in the follow-up period. CONCLUSIONS The aneurysm neck located on the outer convexity is a new, incomplete occlusion predictor, joining older age, fusiform aneurysms, and aneurysms with the branching artery from the dome. No permanent neurologic deficits or rupture was observed in the follow-up, even with incomplete occlusion.
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Affiliation(s)
- T Sunohara
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
| | - H Imamura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Goto
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - R Fukumitsu
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - S Matsumoto
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Fukui
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Y Oomura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - T Akiyama
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - T Fukuda
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Go
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - S Kajiura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Shigeyasu
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Asakura
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - R Horii
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - C Sakai
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Sakai
- From the Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
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17
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Kato A, Minami Y, Asakura K, Katamine M, Katsura A, Muramatsu Y, Sato T, Kakizaki R, Hashimoto T, Meguro K, Shimohama T, Ako J. Plaque erosion is associated with less systemic atherosclerosis than other plaque types of acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous studies have demonstrated that plaque erosion is associated with less atheromatous plaque at both culprit and non-culprit lesion than other plaque types of acute coronary syndrome (ACS). However, the status of systemic atherosclerosis in patients with plaque erosion remains to be elucidated.
Purpose
To clarify if plaque erosion is associated with less systemic atherosclerosis than other plaque types of ACS.
Methods
A total of 239 consecutive patients with ACS who underwent optical coherence tomography (OCT) imaging of the culprit lesion were enrolled. Patients were classified into either plaque erosion (PE, n=45) or non-plaque erosion (non-PE, n=194) including plaque rupture and calcified nodule based on OCT findings of the culprit lesions. The status of systemic atherosclerosis was assessed by the findings of carotid echography, the severity of aortic arch calcification (AAC; grade 0–3) on chest X-ray, brachial-ankle pulse wave velocity (baPWV) and ankle-brachial pressure index (ABPI).
Results
The maximum intima media thickness (IMT) was significantly thinner in the PE group than in the non-PE group (1.9±0.8 vs. 2.3±0.9 mm, p=0.023) (Panel A). The prevalence of heterogeneous plaque and calcified plaque was significantly lower in the PE group than in the non-PE group (25.0 vs. 50.4%, p=0.010, 18.8 vs. 38.5%, p=0.037, respectively). The prevalence of AAC grade was significantly different between the two groups with a tendency toward lower AAC grade in the PE group than the non-PE group (Panel B). The mean baPWV (1588.1±420.6 vs. 1686.5±363.5 cm/sec, p=0.186) and ABPI (1.1±0.1 vs. 1.1±0.1, p=0.270) was comparable between the two groups.
Conclusion
Plaque erosion was associated with less atherosclerosis in carotid artery and aortic arch than non-plaque erosion. These findings may help further clarify the distinct pathophysiology of plaque erosion.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Kato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - M Katamine
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Muramatsu
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Sato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - R Kakizaki
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Shimohama
- Kitasato University School of Medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Sagamihara, Japan
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18
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Hashimoto T, Minami Y, Asakura K, Katamine M, Kato A, Katsura A, Muramatsu Y, Sato T, Kameda R, Meguro K, Shimohama T, Ako J. Lower levels of low-density lipoprotein cholesterol are associated with lower prevalence of thin-cap fibroatheroma in statin-treated patients with coronary artery disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lowering low-density lipoprotein cholesterol (LDL-C) with statins slows progression of atherosclerotic plaques and reduces cardiovascular events. The 2019 European Society of Cardiology guideline for the management of dyslipidaemias recommends the absolute LDL-C treatment target as <55mg/dL for very high-risk patients, <70 mg/dL for high-risk patients and <100 mg/dL for moderate-risk patients. However, the difference in plaque composition of coronary lesions according to these LDL-C levels remains to be elucidated.
Purpose
To investigate plaque morphologies according to LDL-C levels in statin-treated patients with coronary artery disease (CAD).
Methods
A total of 685 consecutive statin-treated patients with CAD, who underwent optical coherence tomography (OCT) imaging of culprit lesions were enrolled. The prevalence of vulnerable compositions in culprit plaques evaluated by OCT was compared among the groups of patients classified by LDL-C levels (<55, 55–70, 70–100, ≥100 mg/dL).
Results
LDL-C levels <55 mg/dL, <70 mg/dL and <100 mg/dL were observed in 6.3%, 21.8% and 63.9% of patients, respectively. The prevalence of thin-cap fibroatheroma was significantly different among the groups (P=0.014, Figure) with a trend toward lower prevalence in the lower two LDL-C groups than in the higher two LDL-C groups. A gradient with lower prevalence of thrombus in lower LDL-C groups was observed, although the statistical significance was not demonstrated (Figure). There was no significant difference in the prevalence of macrophage or cholesterol crystal among the groups.
Conclusions
Lower LDL-C level was associated with a trend toward lower prevalence of thin-cap fibroatheroma and thrombus in statin-treated patients with CAD.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Hashimoto
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - M Katamine
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - A Kato
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - Y Muramatsu
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - T Sato
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - R Kameda
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - T Shimohama
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular medicine, Sagamihara, Japan
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Katamine M, Minami Y, Asakura K, Kato A, Katsura A, Sato T, Muramatsu Y, Hashimoto T, Kameda R, Meguro K, Shimohama T, Ako J. Higher level of high sensitivity C-reactive protein is associated with more fibrocalcific plaque and longer lesion in patients with acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The association between the level of high sensitivity C-reactive protein (hsCRP) and coronary plaque characteristics in patients with acute coronary syndrome (ACS) remains to be elucidated.
Purpose
To clarify the morphological characteristics of culprit lesion in patients with ACS according to the hsCRP levels using optical coherence tomography (OCT).
Methods
A total of 215 consecutive patients with ACS, who underwent OCT imaging of culprit lesions were included. The patients were classified into either the higher hsCRP group (hsCRP ≥0.14 mg/dL, n=108) or the lower hsCRP group (hsCRP <0.14 mg/dL, n=107) according to the median preprocedural hsCRP level. The morphological characteristics of culprit lesion assessed by OCT were compared between the two groups.
Results
The higher hsCRP group had higher prevalence of insulin therapy (14 vs. 6%, p=0.037) and current smoker than the lower hsCRP group (37 vs. 18%, p=0.002). The prevalence of long lesion (≥25 mm, 67 vs. 53%, p=0.041) and fibrocalcific plaque (53 vs. 33%, p=0.003) was significantly higher in the higher hsCRP group than in the lower hsCRP group (Figure). On the other hand, the prevalence of plaque rupture (36 vs. 46%, p=0.174) and lipid-rich plaque (47 vs. 64%, p=0.011) was rather lower in the higher hsCRP group than in the lower hsCRP group (Figure). In a multivariate analysis, fibrocalcific plaque (odds ratio [OR]: 2.098, 95% confidence interval [CI]: 1.125–3.913, p=0.019), lesion length (mm, OR: 1.036, 95% CI: 1.010–1.061, p=0.004) and current smoker (OR: 2.757, 95% CI: 1.388–5.476, p=0.003) was independently associated with higher hsCRP level.
Conclusions
ACS patients with high hsCRP levels had more fibrocalcific plaque and longer lesion than those with low hsCRP levels. The association between high hsCRP levels and vulnerable characteristics of culprit plaque was not demonstrated.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Katamine
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Minami
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Asakura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Kato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - A Katsura
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Sato
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Muramatsu
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Hashimoto
- Kitasato University School of Medicine, Sagamihara, Japan
| | - R Kameda
- Kitasato University School of Medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Shimohama
- Kitasato University School of Medicine, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Sagamihara, Japan
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20
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Mauriello F, Ariga-Miwa H, Paone E, Pietropaolo R, Takakusagi S, Asakura K. Transfer hydrogenolysis of aromatic ethers promoted by the bimetallic Pd/Co catalyst. Catal Today 2020. [DOI: 10.1016/j.cattod.2019.06.071] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Takada N, Asakura K, Sugiyama S. Developing and validating the Japanese version of professional attitude scale for nurses. Int Nurs Rev 2020; 68:24-33. [PMID: 33047308 PMCID: PMC8247416 DOI: 10.1111/inr.12627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/20/2020] [Accepted: 08/23/2020] [Indexed: 11/28/2022]
Abstract
Aim We developed and psychometrically tested the Japanese version of the Professional Attitude Scale for Nurses (PASN‐J). Background Nurses must recognize the importance of their professionalism; therefore, it is critical to quantitatively measure nurses’ professional attitudes. Introduction This instrument validation study was designed to generate an itemized scale and examine its content validity/psychometric testing using a sample of Japanese nurses. Methods Based on a trait approach focusing on the characteristic traits of the nursing profession, a 59‐item draft scale was generated. During November 2017, 2657 nurses from 29 facilities in Japan were surveyed. The questionnaire included demographics, the 59‐item draft scale, and a self‐report scale of nurses’ professional behaviour and nursing practice ability. Using exploratory and confirmatory factor analyses, we evaluated the construct, criterion‐related, concurrent, and known‐groups validity, and reliability of the PASN‐J. Results Data from 1716 participants were analysed. The analyses yielded a 38‐item, 3‐factor scale that adequately fit the data. PASN‐J scores were positively correlated with nurses’ professional behaviour and nursing practice ability. Conclusion The 38‐item PASN‐J has good reliability and validity, making it useful for measuring the current condition of nursing professionalism and evaluating nursing education. Implications for Nursing and Health Policy: This scale can evaluate nursing education and promote nurses’ professionalism. The PASN‐J will help identifying the elements of undergraduate nursing education that require further emphasis. Additionally, the PASN‐J could facilitate the development of nursing policies to promote professional development in nurses. Ultimately, evaluating nursing education with the PASN‐J enhances nurses’ professional attitudes and subsequently improves their quality of nursing, nursing efficiency and patient outcomes.
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Affiliation(s)
- N Takada
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - K Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - S Sugiyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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22
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Hara Y, Asakura K, Asakura T. The Impact of Changes in Professional Autonomy and Occupational Commitment on Nurses' Intention to Leave: A Two-Wave Longitudinal Study in Japan. Int J Environ Res Public Health 2020; 17:ijerph17176120. [PMID: 32842676 PMCID: PMC7504321 DOI: 10.3390/ijerph17176120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 02/07/2023]
Abstract
This study aimed to investigate changes in nurses’ attitudes toward professional autonomy and occupational commitment over time, and their effect on nurses’ intentions to leave, using a two-wave longitudinal design. Anonymous, self-report questionnaires were distributed to all nurses working at 28 hospitals in western Japan on two separate occasions (n = 1778). Multivariate analysis using a generalized estimation equation was conducted, with the intention to leave at Time 2 as the dependent variable, and the changing secular trends in all subscales of attitudes toward professional autonomy and occupational commitment as the independent variables. Age, sex, education, and intention to leave at Time 1 were control variables. Results showed that increasing changing secular trends in control over work conditions, which is a subscale of attitudes toward professional autonomy, increased intention to leave at Time 2, while increasing changing secular trends in all subscales of occupational commitment decreased intention to leave at Time 2. Nurses with a progressive attitude toward discretion of control over work conditions may have higher intentions to leave. Therefore, increasing control over their work conditions may reduce this intention. Additionally, it is necessary to continually enhance nurses’ occupational commitment by offering professional development programs.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan;
- Correspondence: ; Tel.: +81-22-717-7932
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan;
| | - Takashi Asakura
- Faculty of Education, Tokyo Gakugei University, 4-1-1, Nukuikita, Koganei, Tokyo 184-8501, Japan;
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Sugiyama S, Asakura K, Takada N. Japanese nurse practitioners' legal liability ambiguity regarding their medical practice: a qualitative study. BMC Nurs 2020; 19:62. [PMID: 32669968 PMCID: PMC7346369 DOI: 10.1186/s12912-020-00458-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 07/02/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Nurse practitioners' role is always expanding. The Japanese Nurse Practitioner (JNP) system was initiated in 2015 to shift some aspects of doctors' work to various other healthcare professionals, including nurses. JNPs' fulfillment of their roles was shown to have a certain degree of efficacy and provide positive outcomes for patients (e.g., shortening hospitalization period). Nurse practitioners are considered legally liable for their medical practices because they are performed on doctors' behalf; however, in real life, there is ambiguity regarding such practice. It is necessary to clarify nurse practitioners' legal liability in order to ensure the safety of their medical practice and protect them in medical procedures performed on physicians' behalf. This study aimed to clarify how JNPs understand their own legal liability in medical practice. METHODS A qualitative, inductive research design was adopted to record participants' opinions. The survey was conducted from October 2017 to February 2018. Participants were nurses working as JNPs at general hospitals in eastern Japan. We recruited participants via snowball sampling. RESULTS With regard to JNPs' legal liability in their medical practice, three themes understanding were observed: "determining whether the JNP has the ability to perform the assigned medical procedure," "exercising caution when performing medical procedures on a doctor's behalf" and "an urge to follow up with appropriate medical practice until the end of care." CONCLUSIONS We demonstrated that JNPs recognized their own legal liability in medical practice. They had to protect themselves because their legal position was ambiguous. Furthermore, JNPs accepted that diagnosis and drug prescription could be performed on behalf of doctors if trusting relationships had been previously established.
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Affiliation(s)
- Shoko Sugiyama
- Tohoku University, Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Kyoko Asakura
- Tohoku University, Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Nozomu Takada
- Tohoku University, Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
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Makino H, Tanaka A, Asakura K, Koezuka R, Tochiya M, Ohata Y, Tamanaha T, Son C, Shimabara Y, Fujita T, Miyamoto Y, Kobayashi J, Hosoda K. Addition of low-dose liraglutide to insulin therapy is useful for glycaemic control during the peri-operative period: effect of glucagon-like peptide-1 receptor agonist therapy on glycaemic control in patients undergoing cardiac surgery (GLOLIA study). Diabet Med 2019; 36:1621-1628. [PMID: 31335979 DOI: 10.1111/dme.14084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 01/20/2023]
Abstract
AIM To test the hypothesis that the addition of a glucagon-like peptide-1 receptor agonist that can decrease glucose levels without increasing the hypoglycaemia risk will achieve appropriate glycaemic control during the peri-operative period. METHODS We studied 70 people with Type 2 diabetes who underwent elective cardiac surgery. Participants were randomized to either an insulin-alone or an insulin plus liraglutide 0.6 mg/day group. We evaluated average M values, which indicated the proximity index of the target glucose level from day 1 to day 10. RESULTS The average M value in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (liraglutide plus insulin 5.8 vs insulin-alone 12.3; P < 0.001). The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (odds ratio 0.19, 95% CI 0.08-0.49; P < 0.001). The frequency of hypoglycaemia in the liraglutide plus insulin group tended to be lower than that in the insulin-alone group (odds ratio 0.57, 95% CI 0.15-2.23; P = 0.21). CONCLUSIONS The results of this study showed that the addition of low-dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low-dose liraglutide may achieve better glycaemic control during the peri-operative period. (Clinical trials registry no.: UMIN 000008003).
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Affiliation(s)
- H Makino
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - A Tanaka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Asakura
- Department of, Data Science, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - R Koezuka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - M Tochiya
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Ohata
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Tamanaha
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - C Son
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Shimabara
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Fujita
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Miyamoto
- Department of, Preventive Cardiology, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - J Kobayashi
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Hosoda
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
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Masai K, Kaseda K, Asakura K, Hishida T, Asamura H. WS05.03 How to Perform a Proper Systematic Nodal Dissection in Lung Cancer Surgery. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Migita S, Simodai-Yamada S, Asakura K, Mukaiyama T, Okumura Y, Hao H. P2805Initial pathological responses of third-generation everolimus-eluting stents implantation: comparison with second-generation everolimus-eluting stents. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Third-generation drug-eluting stent (3rd DES) is commonly used now in percutaneous coronary intervention, and it has not only thinner struts, easier delivery than second-generation drug-eluting stent (2nd DES), but also abluminal biodegradable polymer. Clinical superiority of 3rd DES has been demonstrated compared to 1st and 2nd DESs. However, pathological response after 3rd DES implantation remains unclear.
Purpose
Pathological study of coronary artery after 3rd DES implantation have not been reported as far as we have referred to the previous studies. This study aimed to examine the initial tissue response after 3rd DES and 2nd DES implantation within one year.
Methods
Using specimens obtained by autopsy, we compared the histology between 3rd DES (n=3, 8 histological sections) and 2nd DES (n=6, 41 histological sections) lesions within 1 year after stent implantation to evaluate early tissue reaction. Stent segments were fixed with 10% buffered formalin and embedded in plastic, followed by hematoxylin–eosin, Masson's trichrome and elastica van Gieson. Ratio of covered stent struts by neointima was calculated. The thickness of neointima and the area of fibrin deposition were morphometrically evaluated. The degree of inflammation around struts was examined semi-quantitatively (score 0–3).
Results
The ratio of covered struts and thickness of neointima of 3rd DES were 0.84±0.04 and 68.2±10.3μm, while those of 2nd DES were 0.69±0.05 and 30.4±4.8μm respectively. The inflammation score was similar between two groups (1.00±0.14 vs. 1.02±0.16). The area of fibrin deposition around the struts was larger in 3rd DES compared with 2nd DES (1276.6±490.3μm2 vs. 658.0±173.4μm2). These results suggest that the 3rd DES may obtain prompt as well as rich covering of struts in the initial term after DES implantation. Although the biological feature of the polymers in 3rd and 2nd DESs is different, the inflammatory responses after both 3rd and 2nd DESs implantation were similar, at least within one year after deployment. The degree of inflammation was mild, less than approximately 50 inflammatory cells (score 1) around the struts.
Conclusions
Our pathological analysis showed advanced healing process in 3rd DES compared with 2nd DES lesions in the viewpoint of strut coverage by neointima. Observation of long-term pathological response may be required to evaluate the superiority of bioabsorbable polymer in 3rd DES.
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Affiliation(s)
- S Migita
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - S Simodai-Yamada
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - K Asakura
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - T Mukaiyama
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
| | - Y Okumura
- Nihon University, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - H Hao
- Nihon University, Division of Human Pathology, Department of Pathology and Microbiology, Tokyo, Japan
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Matsuda K, Kaseda K, Masai K, Asakura K, Hishida T, Asamura H. EP1.18-16 Surgery for Locally Advanced Lung Cancer Invading the Spine After Chemoradiotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Asakura K, Kadota T, Matsuzaki J, Yoshida Y, Nakagawa K, Asamura H, Watanabe S, Ochiya T. P1.11-10 Serum MicroRNA Biomarkers for Screening of Resectable Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Asakura K, Asakura T, Satoh M, Watanabe I, Hara Y. Health indicators as moderators of occupational commitment and nurses' intention to leave. Jpn J Nurs Sci 2019; 17:e12277. [PMID: 31305030 DOI: 10.1111/jjns.12277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 04/22/2019] [Accepted: 05/13/2019] [Indexed: 11/30/2022]
Abstract
AIM This study examined the hypothesis that health indicators moderate the relationship between occupational commitment and intention to leave among nurses, using a large sample in Japan. METHODS A self-administered questionnaire was distributed to all registered nurses (N = 11,171) working in group hospitals in western Japan in 2014. The questionnaire evaluated intention to leave, occupational commitment, psychological distress, cumulative fatigue, and demographic variables. After a preliminary analysis of the bivariate and multivariate associations between variables and intention to leave, we tested the interactions between occupational commitment and health indicators on intention to leave. RESULTS Of the 5,768 returned questionnaires, data from 5,505 (49.3%) participants were analyzed. Participants' mean age was 36.27 years (SD = 10.37). Most (95.14%) were women. According to a generalized estimating equation, the interaction of continuance occupational commitment and cumulative fatigue was significantly related to intention to leave (b = -0.0055). Additionally, the interaction of affective occupational commitment and psychological distress was significantly related to intention to leave (b = 0.0079). CONCLUSIONS This study clarified that the relationship between occupational commitment and intention to leave was robust for nurses in good health. Interventions aimed at reducing fatigue and improving psychological distress should be implemented to prevent the protective effects of occupational commitment on nurses' intention to leave from being compromised.
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Affiliation(s)
- Kyoko Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Takashi Asakura
- Faculty of Education, Tokyo Gakugei University, Tokyo, Japan
| | - Miho Satoh
- Faculty of Nursing, Yokohama City University, Yokohama, Japan
| | - Ikue Watanabe
- Faculty of Healthcare Science, Tohoku Fukushi University, Sendai, Japan
| | - Yukari Hara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Abstract
Intravenous immunoglobulin (IVIG) is widely used for treatment of autoimmune neurological disorders and is currently in clinical trials as a therapy for multiple sclerosis. We have previously demonstrated that certain mouse monoclonal antibodies of the IgM isotype, promote significant remyelination when administered to mice with chronic Theiler's murine encephalomyelitis virus-induced demyelinating disease. These IgM antibodies bind to antigens expressed on oligodendrocytes. We now demonstrate that polyclonal human IgG (IVIG) and polyclonal human IgM also promote remyelination in this system. Although both polyclonal human IgG and IgM promote remyelination, IgM is more potent Polyclonal human IgM also differs from human IgG in its ability to bind strongly to antigens expressed in the CNS and by oligodendrocytes. We propose that polyclonal IgG and polyclonal IgM may function to promote remyelination by different mechanisms. IVIG may function based on its immunomodulatory activity, while the activity of IgM is critically dependent upon its reactivity with CNS antigens. This possibility has clear relevance to the use of antibodies as a therapy for multiple sclerosis, suggesting that combined treatment with antibodies exerting immunomodulatory activity, in concert with antibodies that function through direct binding to CNS antigens, may synergize to enhance the efficacy of the therapy.
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Affiliation(s)
- A Bieber
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
- Department of Immunology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
| | - K Asakura
- Department of Neurology, Nagoya University, School of Medicine, Nagoya, Japan
| | - A Warrington
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
- Department of Immunology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
| | - SV Kaveri
- Institut National de la Santé et de la Recherche Medicate (INSERM) U430, Paris, France
| | - M Rodriguez
- Department of Neurology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
- Department of Immunology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
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Abstract
In order to retain nursing staff, it is crucial to have a comprehensive understanding of the factors that motivate nurses to stay at an institution. Toward this aim, we identified a variety of factors that strengthen nurses' intention to stay at their current hospital. A cross-sectional questionnaire survey was conducted at 12 hospitals in the Tohoku and Kanto regions of Japan. Of the 1,034 nurses working in those hospitals, 713 returned the questionnaire (response rate: 69.0%). Of these, we analysed the data of 485 nurses (17.42 ± 9.83 years of clinical experience, 95.3% female) (valid response rate: 46.9%) who met the inclusion criteria of planning to stay at their current hospital and completing all questionnaire items. An exploratory factor analysis indicated that variables strengthening intention to stay at the current hospital could be grouped into five factors: "comfortable workplace environment," "passive motivational factors," "convenience of hospital location," "favorable work-life balance," and "fulfilment in nursing." Nurses who were married or had children placed a higher priority on a "favorable work-life balance" in remaining at their current workplace. Regular employees or nurses working in the smaller cities tended to display higher "passive motivational factors," which comprised various extrinsic factors. Though extrinsic factors are considered to make only short-term contributions to employee retention, they could generate positive synergistic effects when combined with intrinsic motivations such as "fulfilment in nursing." Effective nurse-retention strategies should be developed by capitalizing on the interaction among the five factors that strengthen nurses to stay at their current hospital.
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Affiliation(s)
- Miho Satoh
- Department of Fundamental Nursing, School of Medicine, Yokohama City University.,Department of Nursing, Tohoku University Graduate School of Medicine
| | - Ikue Watanabe
- Department of Nursing, Tohoku University Graduate School of Medicine.,Department of Nursing, Faculty of Health Sciences, Tohoku Fukushi University
| | - Kyoko Asakura
- Department of Nursing, Tohoku University Graduate School of Medicine
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Uchida S, Yoshida Y, Asakura K, Nakagawa K, Watanabe S. P3.01-102 Potential Predictors of Unexpected Readmission After Lung Resection. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kobayashi A, Horinouchi H, Nakayama Y, Ohe Y, Yotsukura M, Uchida S, Asakura K, Yoshida Y, Nakagawa K, Watanabe S. P1.17-06 Salvage Surgery After Chemotherapy and/or Radiotherapy Including SBRT and Proton: Consecutive Analysis of 46 Patients. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tei-Tominaga M, Asakura K, Asakura T. Generation-Common and -Specific Factors in Intention to Leave among Female Hospital Nurses: A Cross-Sectional Study Using a Large Japanese Sample. Int J Environ Res Public Health 2018; 15:E1591. [PMID: 30050014 PMCID: PMC6121610 DOI: 10.3390/ijerph15081591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/16/2018] [Accepted: 07/24/2018] [Indexed: 11/21/2022]
Abstract
An understanding of the conditions that determine the factors affecting nurses' intention to leave is important for countries suffering from nurse shortage. AIM to examine factors influencing intention to leave among female hospital nurses in a large Japanese sample, classified into four generations by age and considering economic conditions. METHODS a cross-sectional survey with convenience sampling was conducted. Anonymous self-administered questionnaires were distributed to all nurses in 30 hospitals. To assess intention to leave, basic attributes, life conditions, work characteristics, and factors of psychosocial work environment were addressed. After classifying data into four generations based on age cohorts, we conducted multivariate logistic regression analysis using the completed data (N = 5074, mean age = 36.24 years). RESULTS regardless of the generational characteristics influenced by economic conditions, effort and monetary reward were generation-common factors. Over-commitment, social support, and the presence of a role model were generation-common factors in three generations. While having children increased intention to leave in the generation born in 1965⁻1979, having family members in need of caregiving other than children decreased the risk in the generation born in the 1980s. CONCLUSION generational countermeasures considering factors of psychosocial work environment and life conditions are needed to avert female nurse turnover.
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Affiliation(s)
| | - Kyoko Asakura
- Division of Nursing Education and Administration, Graduate School of Medicine, Tohoku University, Sendai 980-0872, Japan.
| | - Takashi Asakura
- Laboratory of Health and Social Behaviour, Tokyo Gakugei University, Tokyo 184-8501, Japan.
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Kobayashi A, Horinouchi H, Ito Y, Oe Y, Uchida S, Asakura K, Yoshida Y, Nakagawa K, Watanabe S. PS01.06 Feasibility of Salvage Pulmonary Resection after Definitive Chemoradiotherapy for Advanced Non-Small Cell Lung Cancer Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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36
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Suzuki S, Sakurai H, Masai K, Asakura K, Nakagawa K, Motoi N, Watanabe S. P1.05-002 Characteristics and Prognosis of Ground Glass Opacity Predominant Primary Lung Cancer Larger Than 3.0 Cm on Thin-Section Computed Tomography. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Katsuya Y, Horinouchi H, Goto Y, Kanda S, Fujiwara Y, Nokihara H, Yamamoto N, Asakura K, Nakagawa K, Sakurai H, Watanabe SI, Igaki H, Itou Y, Itami J, Ohe Y. 430P Comparison of multimodality therapy in clinical stage IIIAN2 non-small cell lung cancer: consecutive analysis of surgery, radiotherapy, chemotherapy and their combination. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zheng LM, Sone S, Itani Y, Wang Q, Hanamura K, Asakura K, Li F, Yang ZG, Wang JC, Funasaka T. Effect of CT digital image compression on detection of coronary artery calcification. Acta Radiol 2016; 41:116-21. [PMID: 10741781 DOI: 10.1080/028418500127345064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To test the effect of digital compression of CT images on the detection of small linear or spotted high attenuation lesions such as coronary artery calcification (CAC). Material and Methods: Fifty cases with and 50 without CAC were randomly selected from a population that had undergone spiral CT of the thorax for screening lung cancer. CT image data were compressed using JPEG (Joint Photographic Experts Group) or wavelet algorithms at ratios of 10:1, 20:1 or 40:1. Five radiologists reviewed the uncompressed and compressed images on a cathode-ray-tube. Observer performance was evaluated with receiver operating characteristic analysis. Results: CT images compressed at a ratio as high as 20:1 were acceptable for primary diagnosis of CAC. There was no significant difference in the detection accuracy for CAC between JPEG and wavelet algorithms at the compression ratios up to 20:1. CT images were more vulnerable to image blurring on the wavelet compression at relatively lower ratios, and "blocking" artifacts occurred on the JPEG compression at relatively higher ratios. Conclusion: JPEG and wavelet algorithms allow compression of CT images without compromising their diagnostic value at ratios up to 20:1 in detecting small linear or spotted high attenuation lesions such as CAC, and there was no difference between the two algorithms in diagnostic accuracy.
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Affiliation(s)
- L M Zheng
- Department of Radiology, Second Hospital of Hebei Medical University, Shijazhuang, China
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Li F, Sone S, Takashima S, Kiyono K, Yang ZG, Hasegawa M, Kawakami S, Saito A, Hanamura K, Asakura K. Effects of JPEG and wavelet compression of spiral low-dose CT images on detection of small lung cancers. Acta Radiol 2016; 42:156-60. [PMID: 11259942 DOI: 10.1080/028418501127346657] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To compare the effect of compression of spiral low-dose CT images by the Joint Photographic Experts Group (JPEG) and wavelet algorithms on detection of small lung cancers. Material and Methods: Low-dose spiral CT images of 104 individuals (52 with peripheral lung cancers smaller than 20 mm and 52 control subjects) were used. The original images were compressed using JPEG or wavelet algorithms at a ratio of 10:1 or 20:1. Five radiologists interpreted these images and evaluated the image quality on a high-resolution CRT monitor. Observer performance was studied by receiver operating characteristic (ROC) analysis. Results: There was no significant difference in the detection of cancers measuring 6 to 15 mm in uncompressed images and in those compressed by either of the algorithms, although the quality of images compressed at 20:1 with the wavelet algorithm was somewhat inferior. A lower diagnostic accuracy was noted using images compressed by the JPEG or wavelet algorithms at 20:1 in detecting lung cancers measuring 6 to 10 mm and cancers measuring from 6 to 15 mm with ground-glass opacity. Conclusion: Compression of low-dose CT images at a ratio of 10:1 using JPEG and wavelet algorithms does not compromise the detection rate of small lung cancers.
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Affiliation(s)
- F Li
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan
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Abstract
This study's aim was to develop and test the psychometric properties of the Attitude toward Professional Autonomy Scale for Nurses in Japan. In Study 1, the initial (26-item) version of the scale was pilot tested on 454 Japanese nurses; item analysis and exploratory factor analysis were performed. In Study 2, the revised version of the scale (19 items) was administered to 802 Japanese nurses. The scale had good internal consistency (α = .85). Correlations with the scale of the desire of self-determination supported its concurrent validity. The scale could facilitate the assessment of cognitive aspects of professional autonomy among nurses and contribute to assessment of the propensity to behave autonomously among nurses in various clinical settings.
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Affiliation(s)
- Kyoko Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Miho Satoh
- School of Nursing, Tokyo Healthcare University, Tokyo, Japan
| | - Ikue Watanabe
- School of Health Science, Tohoku Fukushi University, Sendai, Japan
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Satoh M, Watanabe I, Asakura K. Occupational commitment and job satisfaction mediate effort-reward imbalance and the intention to continue nursing. Jpn J Nurs Sci 2016; 14:49-60. [DOI: 10.1111/jjns.12135] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 02/24/2016] [Accepted: 03/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Miho Satoh
- Faculty of Nursing; Tokyo Health Care University; Tokyo Japan
| | - Ikue Watanabe
- Faculty of Health Sciences; Tohoku Fukushi University; Sendai Japan
| | - Kyoko Asakura
- Department of Nursing Education and Administration; Graduate School of Medicine, Tohoku University; Sendai Japan
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Mochizuki I, Ariga H, Fukaya Y, Wada K, Maekawa M, Kawasuso A, Shidara T, Asakura K, Hyodo T. Structure determination of the rutile-TiO2(110)-(1 × 2) surface using total-reflection high-energy positron diffraction (TRHEPD). Phys Chem Chem Phys 2016; 18:7085-92. [DOI: 10.1039/c5cp07892j] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Detailed structure of the rutile-TiO2(110)-(1 × 2) has been determined using the newly developed technique of total-reflection high-energy positron diffraction (TRHEPD).
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Affiliation(s)
- I. Mochizuki
- Institute of Materials Structure Science
- High Energy Accelerator Research Organization (KEK)
- Ibaraki 305-0801
- Japan
| | - H. Ariga
- Institute for Catalysis
- Hokkaido University
- Sapporo
- Japan
| | - Y. Fukaya
- Advanced Science Research Center
- Japan Atomic Energy Agency
- Naka
- Japan
| | - K. Wada
- Institute of Materials Structure Science
- High Energy Accelerator Research Organization (KEK)
- Ibaraki 305-0801
- Japan
| | - M. Maekawa
- Quantum Beam Science Directorate
- Japan Atomic Energy Agency
- Takasaki
- Japan
| | - A. Kawasuso
- Quantum Beam Science Directorate
- Japan Atomic Energy Agency
- Takasaki
- Japan
| | - T. Shidara
- Accelerator Laboratory
- High Energy Accelerator Research Organization (KEK)
- Tsukuba
- Japan
| | - K. Asakura
- Institute for Catalysis
- Hokkaido University
- Sapporo
- Japan
| | - T. Hyodo
- Institute of Materials Structure Science
- High Energy Accelerator Research Organization (KEK)
- Ibaraki 305-0801
- Japan
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Yoshida H, Asakura K, Fukuda J, Ozaki M. Three-dimensional positioning and control of colloidal objects utilizing engineered liquid crystalline defect networks. Nat Commun 2015; 6:7180. [PMID: 25994837 PMCID: PMC4647884 DOI: 10.1038/ncomms8180] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 04/14/2015] [Indexed: 11/29/2022] Open
Abstract
Topological defects in liquid crystals not only affect the optical and rheological properties of the host, but can also act as scaffolds in which to trap nano or micro-sized colloidal objects. The creation of complex defect shapes, however, often involves confining the liquid crystals in curved geometries or adds complex-shaped colloidal objects, which are unsuitable for device applications. Using topologically patterned substrates, here we demonstrate the controlled generation of three-dimensional defect lines with non-trivial shapes and even chirality, in a flat slab of nematic liquid crystal. By using the defect lines as templates and the electric response of the liquid crystals, colloidal superstructures are constructed, which can be reversibly reconfigured at a voltage as low as 1.3 V. Three-dimensional engineering of the defect shapes in liquid crystals is potentially useful in the fabrication of self-healing composites and in stabilizing artificial frustrated phases. Topological defects can be used not only to modify the properties of liquid crystals but also as scaffolds to build new structures by trapping particles. Here, Yoshida et al. construct three-dimensional colloidal superstructures in a nematic host, which are reconfigurable in an electric field.
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Affiliation(s)
- H Yoshida
- Division of Electrical, Electronic and Information Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - K Asakura
- Division of Electrical, Electronic and Information Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - J Fukuda
- 1] Nanosystem Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 1-1-1 Umezono, Tsukuba 305-8568, Japan [2]
| | - M Ozaki
- Division of Electrical, Electronic and Information Engineering, Osaka University, 2-1 Yamada-oka, Suita, Osaka 565-0871, Japan
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Affiliation(s)
- T Shintani
- Department of Otorhinolaryngology, Sapporo Medical College, Japan
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Uchida N, Nakamura K, Fujiwara Y, Matsusue E, Kanemitsu T, Yoshida O, Asakura K, Kimura K. EP-1148 Custom-designed oral prostheses improve accuracy of daily treatment setup for head and neck cancer radiotherapy. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41140-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kobayashi S, Asakura K, Suga H, Sasaki S. Inverse association between dietary habits with high total antioxidant capacity and prevalence of frailty among elderly Japanese women: a multicenter cross-sectional study. J Nutr Health Aging 2015; 18:827-39. [PMID: 25389961 DOI: 10.1007/s12603-014-0478-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the association of dietary habits with high total antioxidant capacity (TAC) with frailty among elderly Japanese women. DESIGN Cross-sectional multicenter study. SETTING Thirty-five of 47 prefectures in Japan. PARTICIPANTS 2121 grandmothers or acquaintances of dietetic students aged 65 and older. MEASUREMENTS Dietary TAC and food intakes were calculated using a validated brief-type self-administered diet history questionnaire. The TAC value of each food was assigned using four different assays, ferric reducing ability of plasma (FRAP), oxygen radical absorbance capacity (ORAC), Trolox equivalent antioxidant capacity (TEAC), and total radical-trapping antioxidant parameter (TRAP). Frailty was defined as the presence three or more of the following four components: slowness and weakness (two points), exhaustion, low physical activity, and unintentional weight loss. RESULTS The number of subjects with frailty was 486 (23%). Multivariate adjusted ORs (95% CI) for frailty in the highest compared to the lowest quintile were 0.35 (0.24, 0.53) for FRAP, 0.35 (0.23, 0.52) for ORAC, 0.40 (0.27, 0.60) for TEAC, and 0.41 (0.28, 0.62) for TRAP. The intakes of green tea, coffee, vegetables, and fruits which contribute to dietary TAC were also associated with lower odds of frailty (the range of multivariate adjusted OR: 0.47 for vegetables to 0.77 for green tea), although the odds ratios were less marked than those of dietary TAC. CONCLUSIONS Dietary habits with high TAC showed a stronger inverse association with frailty in elderly Japanese women than the individual foods examined.
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Affiliation(s)
- S Kobayashi
- S. Sasaki, Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; E-mail: ; Tel: +81-3-5841-7872; Fax: +81-3-5841-7873
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Tani Y, Asakura K, Sasaki S, Hirota N, Notsu A, Todoriki H, Miura A, Fukui M, Date C. The influence of season and air temperature on water intake by food groups in a sample of free-living Japanese adults. Eur J Clin Nutr 2015; 69:907-13. [DOI: 10.1038/ejcn.2014.290] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 10/31/2014] [Accepted: 12/21/2014] [Indexed: 11/09/2022]
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Kobayashi S, Asakura K, Suga H, Sasaki S. Inverse association between dietary habits with high total antioxidant capacity and prevalence of frailty among elderly Japanese women: A multicenter cross-sectional study. J Nutr Health Aging 2015. [DOI: 10.1007/s12603-014-0556-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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