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1.
BMC Med Educ ; 21(1): 415, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344354

RESUMO

BACKGROUND: Patient care ownership (PCO) is an essential component in medical professionalism and is crucial for delivering high-quality care. The 15-item PCO Scale (PCOS) is a validated questionnaire for quantifying PCO in residents; however, no corresponding tool for assessing PCO in Japan exists. This study aimed to develop a Japanese version of the PCOS (J-PCOS) and validate it among Japanese medical trainees. METHODS: We performed a multicenter cross-sectional survey to test the validity and reliability of the J-PCOS. The study sample was trainees of postgraduate years 1-5 in Japan. The participants completed the J-PCOS questionnaire. Construct validity was assessed through exploratory and confirmatory factor analyses. Internal consistency reliability was examined by calculating Cronbach's alpha coefficients and inter-item correlations. RESULTS: During the survey period, 437 trainees at 48 hospitals completed the questionnaire. Exploratory factor analysis of the J-PCOS extracted four factors: assertiveness, sense of ownership, diligence, and being the "go-to" person. The second factor had not been identified in the original PCOS, which may be related to a unique cultural feature of Japan, namely, a historical code of personal conduct. Confirmatory factor analysis supported this four-factor model, revealing good model fit indices. The analysis results of Cronbach's alpha coefficients and inter-item correlations indicated adequate internal consistency reliability. CONCLUSIONS: We developed the J-PCOS and examined its validity and reliability. This tool can be used in studies on postgraduate medical education. Further studies should confirm its robustness and usefulness for improving PCO.


Assuntos
Propriedade , Tradução , Estudos Transversais , Humanos , Japão , Assistência ao Paciente , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
10.
Clin J Gastroenterol ; 14(1): 336-340, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33070262

RESUMO

Bile duct schwannomas are rare benign tumors that frequently mimic more life-threatening tumors. Till date, only a few of these tumors have been diagnosed preoperatively. Herein, we report the case of a 68-year-old man who presented with a 1-day history of epigastralgia. The patient was preoperatively diagnosed with bile duct schwannoma using transpapillary biliary forceps biopsy and underwent local resection without major complications. The findings of our study indicate that endoscopic tumor biopsy may be helpful in diagnosing bile duct schwannoma before surgery; thus, enabling surgeons to plan an appropriate surgery while avoiding overtreatment.


Assuntos
Neoplasias dos Ductos Biliares , Neurilemoma , Idoso , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares , Biópsia , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Instrumentos Cirúrgicos
11.
J Infect Chemother ; 26(12): 1301-1304, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32747211

RESUMO

Corticosteroids have been used for the treatment of a great variety of diseases. Therefore, the relationship between high doses of cortisol and infections has been widely known and prophylactic therapy has been established. Adrenocortical carcinoma is a rare malignancy with poor prognosis, so little is known about how to deal with the complications resulting from hormone excess such as Cushing's syndrome. Here we report a case of an 82-year-old woman who presented with a 1-day history of dyspnea and was finally diagnosed as disseminated cryptococcosis at autopsy. The patient had received a diagnosis of metastatic adrenocortical carcinoma and Cushing's syndrome three months earlier. The findings of this study indicate the relation between severe hypercortisolemia due to adrenocortical carcinoma and opportunistic infections. In the setting of adrenocortical carcinoma with Cushing's syndrome, clinicians should maintain a high index of suspicion for opportunistic infections including cryptococcosis, which are potentially treatable by early detection and prompt intervention.


Assuntos
Neoplasias do Córtex Suprarrenal , Carcinoma Adrenocortical , Criptococose , Síndrome de Cushing , Neoplasias do Córtex Suprarrenal/complicações , Carcinoma Adrenocortical/complicações , Carcinoma Adrenocortical/diagnóstico , Idoso de 80 Anos ou mais , Criptococose/complicações , Criptococose/diagnóstico , Criptococose/tratamento farmacológico , Síndrome de Cushing/diagnóstico , Feminino , Humanos
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Clin Teach ; 12(1): 46-9, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25603708

RESUMO

BACKGROUND: Medical student involvement in curriculum development is important; however, little is known about why medical students become engaged in this activity. The aim of this study was to understand what motivates medical students at one university to participate in the process of curriculum development and gain a wider perspective on student engagement in medical education. METHODS: Grounded theory methodology was the foundation of this study. We conducted semi-structured interviews with seven medical students from the University of Tokyo who developed and participated in a group whose aim was to actively contribute towards improving their medical education. The data from the interviews were analysed by thematic synthesis, with triangulation. RESULTS: Three themes emerged as potential explanations for motivating student behaviour: (1) extracurricular interaction with faculty members; (2) engaging with highly motivated peers; and (3) student values for serving the public. CONCLUSIONS: Students working to improve educational processes at their medical schools had the opportunity to communicate more with faculty members, enjoyed opportunities for networking with other highly motivated peers and enhanced aspects of their developing professionalism.


Assuntos
Participação da Comunidade/psicologia , Currículo/normas , Educação Médica/organização & administração , Melhoria de Qualidade/organização & administração , Estudantes de Medicina/psicologia , Comunicação , Educação Médica/normas , Docentes de Medicina/organização & administração , Humanos , Entrevistas como Assunto , Motivação , Melhoria de Qualidade/normas
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