Contributions of the Medical Affairs Department to Healthcare Professionals and the Effects of the New Coronavirus Disease 2019 Pandemic on the Contributions / 医薬品情報学

Objective: The purpose of this study was to assess the opinions of healthcare professional regarding the contributions of the Medical Affairs department. Furthermore, we aimed to identify factors influencing and reasons for the contributions in the new coronavirus disease 2019 (COVID-19) pandemic situation.Design/Methods: A web-based survey was conducted among healthcare professionals (Key Opinion Leader/Key Thought Leader, KOL/KTL) who had multiple contacts with the Medical Affairs department, Japan.Results: The responses of 141 KOL/KTLs in Japan were collected; 77.3% of the respondents indicated that the contributions of the Medical Affairs department exceeded their expectations (achieved the expected level of contribution). The most common responses were “the identification of unmet medical needs” and “the dissemination of medical and scientific information, providing advanced medical and scientific information;” other responses included “promoting sales of the company's drugs.” The requests from KOL/KTLs regarding quality were “knowledge about biological and clinical statistics” and “proposal and quick response ability from the perspective of medical staff and patients,” but these responses were partially different between physicians and pharmacists. COVID-19 has resulted in substantial changes, for example, “face-to-face” interactions have significantly decreased from 91.5 to 50.4% and “Online” interactions have significantly increased from 20.6 to 70.9%. However, the effects of the declaration of emergency state could not be identified. The KOL/KTLs requested to make the meeting times more appropriate, conduct in-depth two-way discussions, provide latest information, and discuss about professional manners and behaviors.Conclusion: In summary, regardless of the changes in the types of activities caused by COVID-19, the Medical Affairs department has made substantial contributions to healthcare professionals, who highly appreciated them. Furthermore, depending on responses of individuals whose expectations could not be met, areas of improvements have been suggested.

Factors associated with adults' actions to confirm their own rubella immune status in Japan's drive toward rubella elimination: Cross-sectional online survey of non-healthcare workers in their 20s to 40s

BACKGROUND@#Rubella outbreaks occurred among adults in Japan in 2013-2014 and 2018-2019 due to immunity gaps. In response and aiming at rubella elimination by 2020, the government introduced countermeasures comprising supplementary immunization activities for voluntary testing of adult non-healthcare-related workers and vaccination of susceptible individuals. However, as of October 2020, rubella immunity testing and vaccination rates remained low. This study was conducted to identify factors associated with adults voluntarily confirming their rubella immune status, to help develop effective promotion activities for hard-to-reach and left-behind populations.@*METHODS@#In this cross-sectional study, a general population sample of non-healthcare workers aged 20-49 years in Japan completed an online survey in November 2020. Univariate analysis was performed to examine associations of specific actions taken to confirm rubella immune status with social background characteristics, knowledge of rubella, and attitude to testing and vaccination. Log binomial regression analysis was performed to explore the associations following adjustment for social background characteristics.@*RESULTS@#Among 1,854 respondents (927 men, 927 women), only 23.4% of men and 39.4% of women in their 20s to 40s have taken some action related to rubella prevention. Three major factors were associated with the targeted population having taken voluntary action: (1) knowing about testing for confirmation of immunity status (adjusted odds ratio [AOR] 4.29 men, 2.89 women), the rubella outbreak in 2013 among men in their 20s to 40s (AOR 2.79 men, 1.64 women), and congenital rubella syndrome (AOR 1.89 men, 3.10 women); (2) having acquaintances who were vaccinated against or tested for rubella (AOR 2.98 men, 1.95 women); and (3) having a positive attitude toward influenza vaccination (AOR 2.48 men, 1.83 women). Marriage, desire for pregnancy, and having children were weakly associated with taking action.@*CONCLUSIONS@#Currently, insufficient voluntary action is being taken by high-risk adult populations to close the identified immunity gaps. In this last mile to rubella elimination, our findings and suggested potential interventions via annual health check-ups and occupational health and public health initiatives could prove helpful in developing further countermeasures that actively promote and implement supplementary immunization activities targeting all adult generations.

Mortality by occupation and industry among Japanese men in the 2015 fiscal year

BACKGROUND@#Although previous studies have underscored some unique inequalities in occupational mortality in Japan, many of these trends have been dramatically altered during recent decades. We analyzed mortality data by occupation and industry in Japan, to determine whether differences remained by the mid-2010s for men in working-age population.@*METHODS@#We calculated age-standardized all-cause and cause-specific mortality, according to occupation and industry, among men aged 25-64 years in the 2015 fiscal year (1 April 2015 to 31 March 2016). Occupational and industry-specific categories were defined using the Japan Standard Occupational Classification and Japan Standard Industrial Classification, respectively. Age-standardized mortality rates were computed using 5-year age intervals. Mortality rate ratios adjusted for age and 95% confidence intervals (CIs) were estimated using Poisson regression. Cause-specific deaths were classified into four broad groups (cancers [C00-D48], cardiovascular diseases [I00-I99], external causes [V01-Y98], and all other diseases) based on the International Statistical Classification of Diseases 10th Revision (ICD-10).@*RESULTS@#Clear mortality differences were identified by both occupation and industry among Japanese males. All-cause mortality ranged from 53.7 (clerical workers) to 240.3 (service workers) per 100,000 population for occupation and from 54.3 (workers in education) to 1169.4 (workers in mining) for industry. In relative terms, service workers and agriculture, forestry, and fishing workers had 2.89 and 2.50 times higher all-cause mortality than sales workers. Administrative and managerial workers displayed higher mortality risk (1.86; 95% CI 1.76-1.97) than sales workers. Similar patterns of broad cause-specific mortality inequality were identified in terms of both absolute and relative measures, and all broad cause-specific deaths contributed to the differences in mortality by occupation and industry.@*CONCLUSIONS@#Substantial differences in mortality among Japanese male workers, according to occupation and industry, were still present in 2015.

“Ten Minimum Requirement”: A management tool to improve quality of healthcare services in Lao People Democratic Republic (Lao PDR)

In Lao People's Democratic Republic (PDR), the mortality rate forchildren under 5 years of age is high (131 per 1000 live births in 2003),partly as a consequence of poor basic services provided by district hospitals.A simplified management tool, “Ten MR (Minimum Requirement)”, was developed inLao PDR. The tool assured the quality of health services including theprocesses of planning, implementing, self-monitoring, supervision, reportingand evaluation. The tool focused on ten basic services, integratingstakeholders from district hospitals and governing agencies. Each districthospital develops feasible annual activities, designating responsible peoplebased on a consensus between hospital staff and local governing agencies.Hospitals can self-monitor their activities on a monthly basis. Supervisoryvisits to district hospitals by local governing agencies improved activitiesand communication between staff. Visualization of progress promoted the sharingof achievements between staff and highlighted activities in need of more work.In 2004, district hospitals in Vientiane andOudomxay province initiated the introduction of the tool. These districthospitals included primary care hospitals for outpatients, emergency care andin-patients, with a capacity of 10-20 beds, providing care for a population ofbetween 30,000 and 80,000 people. The Ministry of Health recognized theeffectiveness of Ten MR and implemented the expansion of the tool to alldistrict hospitals in Lao PDR from 2011. Ten MR benefits district hospitals andgoverning agencies. Ten MR focuses on the daily routine work, enhancing teamwork and communication between all stakeholders.

“Ten Minimum Requirement”: A Management Tool to Improve Quality of Healthcare Services in Lao People Democratic Republic (Lao PDR)

In Lao People’s Democratic Republic (PDR), the mortality rate among children under 5 years of age is high (131 per 1000 live births in 2003), partly as a consequence of poor basic services provided by district hospitals. A simplified management tool, “Ten MR (Minimum Requirement)”, was developed in Lao PDR. The tool assured the quality of health services including the processes of planning, implementing, self-monitoring, supervision, reporting and evaluation. The tool focused on ten basic services, integrating stakeholders from district hospitals and governing agencies. Each district hospital develops feasible annual activities, assigning responsibility to people based on a consensus between hospital staff and local governing agencies. Hospitals can self-monitor their activities on a monthly basis. Supervisory visits to district hospitals by local governing agencies improved activities and communication between staff. Visualization of progress promoted the sharing of achievements between staff and highlighted activities in need of more work. In 2004, district hospitals in Vientiane and Oudomxay provinces initiated the application of the tool. These district hospitals included primary care hospitals for outpatients, emergency care and in-patients, with a capacity of 10–20 beds, providing care for a population of between 30,000 and 80,000 people. The Ministry of Health recognized the effectiveness of Ten MR and implemented the expansion of the tool to all district hospitals in Lao PDR from 2011. Ten MR benefits district hospitals and governing agencies. Ten MR focuses on the daily routine work, enhancing team work and communication among all stakeholders.

Incidence of Medical Errors by Interns in Japan / 医学教育

Recently, patient safety has become a social concern in Japan. Even though cases of “incidents” and “accidents” by interns have been collected and analyzed in each hospital, few published reports have concerned teaching hospitals. The purpose of this study was to identify the incidence of “incidents” and “accidents” by first-year and second-year interns in Japan.<BR>1) In August 2005, a questionnaire was mailed to 231 interns at 14 teaching hospitals. A total of 192 interns participated in this study, with a response rate of 83.1%.<BR>2) The number of cases of “incidents” and “accidents” involving interns since the start of their training was collected.An “incident” was defined as an error that was prevented before occurrence, whereas an “accident” was defined as an unplanned, unexpected, and undesired event with adverse consequences.<BR>3) Among first-year interns, “incidents” occurred at a rate of 0.79 per resident-month (95% confidence interval [CI]: 0.30-1.28), while “accidents” were observed at a rate of 0.13 per resident-month (95% CI: 0.06-0.20).<BR>4) Among second-year interns, “incidents” occurred at a rate of 0.24 per resident-month (95% CI: 0.14-1.34), and “accidents” were observed at a rate of 0.06 per resident-month (95% CI: 0.01-0.11).<BR>5) There was no significant difference in the number of cases of “incidents” and “accidents” in regards to sex, age, or the number of beds of teaching hospitals.

Factors associated with turnover interntion among nurses in small and medium-sized medical institutions

<p><b>OBJECTIVES</b>The objective of this study was to evaluate factors associated with turnover intention among nurses in small and medium-sized medical institutions.</p><p><b>METHODS</b>A self-administered questionaire survey was performed in 293 registered nurses, licensed practical nurses, and assistant nurses working full-time in various medical institutions. Multiple linear regression analysis was conducted, with turnover intention as the dependent variable, and nurses' basic attributes and job satisfaction as independent variables.</p><p><b>RESULTS</b>As for nurses' basic attributes, turnover intention was significantly associated with registered nurses, younger nurses and those with low satisfaction with sleep. As for nurses' job satisfaction, the number of nurses with turnover intention was significantly higher for those with low satisfaction with salary, low satisfaction with welfare, poor implementation of fair salary raise and poor cooperation among nurses.</p><p><b>CONCLUSION</b>Turnover intention may be reduced by the enhancement of trust in the organization, giving appropriate advice to young nurses and registered nurses, and developing measures for addressing sleep disorders.</p>

Factors Associated with Turnover Intention among Nurses in Small and Medium-Sized Medical Institutions

Objectives: The objective of this study was to evaluate factors associated with turnover intention among nurses in small and medium-sized medical institutions. Methods: A self-administered questionnaire survey was performed in 293 registered nurses, licensed practical nurses, and assistant nurses working full-time in various medical institutions. Multiple linear regression analysis was conducted, with turnover intention as the dependent variable, and nurses’ basic attributes and job satisfaction as independent variables. Results: As for nurses’ basic attributes, turnover intention was significantly associated with registered nurses, younger nurses and those with low satisfaction with sleep. As for nurses’ job satisfaction, the number of nurses with turnover intention was significantly higher for those with low satisfaction with salary, low satisfaction with welfare, poor implementation of fair salary raise and poor cooperation among nurses. Conclusion: Turnover intention may be reduced by the enhancement of trust in the organization, giving appropriate advice to young nurses and registered nurses, and developing measures for addressing sleep disorders.