Current Status and Issues of Ethical Review for Surgical Research in Japanese University Hospitals

BackgroundIn Korea, anesthesiologists are expected to be mainstream pain medicine (PM) practitioners. However, anesthesiology and pain medicine (APM) residency programs mostly emphasize anesthesia learning, leading to insufficient PM learning. Therefore, this study evaluated the current status of PM training in APM residency programs in 10 Korean university hospitals.MethodsOverall, 156 residents undergoing APM training participated anonymously in our survey, focusing on PM training. We assessed the aim, satisfaction status, duration, opinion on duration, desired duration, weaknesses of the training programs and plans of residents after graduating. We divided the residents into junior (first and second year) and senior (third and fourth year). Survey data were compared between groups.ResultsSenior showed significantly different level of satisfaction grade than did junior (p=0.026). Fifty-seven (81.4%) residents in junior and forty (46.5%) residents in senior underwent PM training for ≤2 months. Most (108; 69.2%) residents felt that the training period was too short for PM learning and 95 (60.9%) residents desired a training period of ≥6 months. The most commonly expressed weakness of the training was low interventional opportunity (29.7%), followed by short duration (26.6%). After residency, 80 (49.1%) residents planned to pursue a fellowship.ConclusionsDissatisfaction with PM training was probably due to a structural tendency of the current program towards anesthesia training and insufficient clinical experience, which needs to be rectified, with a change in PM curriculum.

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Problematic clinical isolates of Pseudomonas aeruginosa from the university hospitals in Sofia, Bulgaria: current status of antimicrobial resistance and prevailing resistance mechanisms

Journal of Medical Microbiology ◽

10.1099/jmm.0.46986-0 ◽

2007 ◽

Vol 56 (7) ◽

pp. 956-963 ◽

Cited By ~ 17

Author(s):

Tanya Strateva ◽

Vessela Ouzounova-Raykova ◽

Boyka Markova ◽

Albena Todorova ◽

Yulia Marteva-Proevska ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Antimicrobial Agents ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Resistance Mechanisms ◽

Clinical Isolates ◽

Current Status ◽

University Hospitals ◽

Active Efflux ◽

Genes Encoding

A total of 203 clinical isolates of Pseudomonas aeruginosa was collected during 2001–2006 from five university hospitals in Sofia, Bulgaria, to assess the current levels of antimicrobial susceptibility and to evaluate resistance mechanisms to antipseudomonal antimicrobial agents. The antibiotic resistance rates against the following antimicrobials were: carbenicillin 93.1 %, azlocillin 91.6 %, piperacillin 86.2 %, piperacillin/tazobactam 56.8 %, ceftazidime 45.8 %, cefepime 48.9 %, cefpirome 58.2 %, aztreonam 49.8 %, imipenem 42.3 %, meropenem 45.5 %, amikacin 59.1 %, gentamicin 79.7 %, tobramycin 89.6 %, netilmicin 69.6 % and ciprofloxacin 80.3 %. A total of 101 of the studied P. aeruginosa isolates (49.8 %) were multidrug resistant. Structural genes encoding class A and class D β-lactamases showed the following frequencies: bla VEB-1 33.1 %, bla PSE-1 22.5 %, bla PER-1 0 %, bla OXA-groupI 41.3 % and bla OXA-groupII 8.8 %. IMP- and VIM-type carbapenemases were not detected. In conclusion, the studied clinical strains of P. aeruginosa were problematic nosocomial pathogens. VEB-1 extended-spectrum β-lactamases appear to have a significant presence among clinical P. aeruginosa isolates from Sofia. Carbapenem resistance was related to non-enzymic mechanisms such as a deficiency of OprD proteins and active efflux.

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Status of Institutional Review Board Meetings Conducted Through Web Conference Systems in Japanese National University Hospitals During the COVID-19 Pandemic: Questionnaire Study

Journal of Medical Internet Research ◽

10.2196/22302 ◽

2020 ◽

Vol 22 (11) ◽

pp. e22302

Author(s):

Kenta Yagi ◽

Kazuki Maeda ◽

Satoshi Sakaguchi ◽

Masayuki Chuma ◽

Yasutaka Sato ◽

...

Keyword(s):

Financial Burden ◽

Controlled Trial ◽

Institutional Review Board ◽

Current Status ◽

University Hospitals ◽

State Of Emergency ◽

Face To Face ◽

Institutional Review ◽

National University ◽

The Cost

Background With the global proliferation of the novel COVID-19 disease, conventionally conducting institutional review board (IRB) meetings has become a difficult task. Amid concerns about the suspension of drug development due to delays within IRBs, it has been suggested that IRB meetings should be temporarily conducted via the internet. Objective This study aimed to elucidate the current status of IRB meetings conducted through web conference systems. Methods A survey on conducting IRB meetings through web conference systems was administered to Japanese national university hospitals. Respondents were in charge of operating IRB offices at different universities. This study was not a randomized controlled trial. Results The survey was performed at 42 facilities between the end of May and early June, 2020, immediately after the state of emergency was lifted in Japan. The survey yielded a response rate of 74% (31/42). Additionally, while 68% (21/31) of facilities introduced web conference systems for IRB meetings, 13% (4/31) of the surveyed facilities postponed IRB meetings. Therefore, we conducted a further survey of 21 facilities that implemented web conference systems for IRB meetings. According to 71% (15/21) of the respondents, there was no financial burden for implementing these systems, as they were free of charge. In 90% (19/21) of the facilities, IRB meetings through web conference systems were already being conducted with personal electronic devices. Furthermore, in 48% (10/21) of facilities, a web conference system was used in conjunction with face-to-face meetings. Conclusions Due to the COVID-19 pandemic, the number of reviews in clinical trial core hospitals has decreased. This suggests that the development of pharmaceuticals has stagnated because of COVID-19. According to 71% (15/21) of the respondents who conducted IRB meetings through web conference systems, the cost of introducing such meetings was US $0, showing a negligible financial burden. Moreover, it was shown that online deliberations could be carried out in the same manner as face-to-face meetings, as 86% (18/21) of facilities stated that the number of comments made by board members did not change. To improve the quality of IRB meetings conducted through web conference systems, it is necessary to further examine camera use and the content displayed on members’ screens during meetings. Further examination of all members who use web conference systems is required. Our measures for addressing the requests and problems identified in our study could potentially be considered protocols for future IRB meetings, when the COVID-19 pandemic has passed and face-to-face meetings are possible again. This study also highlights the importance of developing web conference systems for IRB meetings to respond to future unforeseen pandemics.

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Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

Experimental and Therapeutic Medicine ◽

10.3892/etm_00000075 ◽

2010 ◽

Vol 1 (3) ◽

pp. 481-483 ◽

Cited By ~ 1

Author(s):

HIROAKI YANAGAWA ◽

JUNJI TERAO ◽

EIJI TAKEDA ◽

YOSHIHISA TAKAISHI ◽

YOSHIKI KASHIWADA ◽

...

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

University Hospital ◽

University Hospitals ◽

Japanese University ◽

Complementary And Alternative

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Antimicrobial susceptibility profile ofAcinetobacterspecies isolated from blood cultures in two Japanese university hospitals

Microbiology and Immunology ◽

10.1111/1348-0421.12117 ◽

2014 ◽

Vol 58 (2) ◽

pp. 142-146 ◽

Cited By ~ 2

Author(s):

Kozue Kishii ◽

Ken Kikuchi ◽

Atsushi Yoshida ◽

Katsuko Okuzumi ◽

Yushi Uetera ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Blood Cultures ◽

University Hospitals ◽

Japanese University ◽

Antimicrobial Susceptibility Profile

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Technology and Staffing in Japanese University Hospitals: Government Versus Private

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300009429 ◽

1996 ◽

Vol 12 (1) ◽

pp. 93-103 ◽

Cited By ~ 1

Author(s):

William B. Vogt ◽

Layanta Bhattacharya ◽

Scott Kupor ◽

Aki Yoshikawa ◽

Toshitaka Nakahara

Keyword(s):

Technology Use ◽

Teaching Hospitals ◽

Case Mix ◽

University Hospitals ◽

Private Hospitals ◽

Japanese University ◽

Staffing Levels ◽

Medical Technologies ◽

Government Hospitals ◽

Skilled Staff

AbstractWe examined staffing levels, acquisition of medical technologies, and utilization of those technologies in private and government teaching hospitals in Japan. Adjusting for size and case mix, we found that government hospitals acquire more technology, use that technology less, and employ a more highly skilled staff than do private hospitals.

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Respecting the Wishes of Patients in Intensive Care Units

Nursing Ethics ◽

10.1177/0969733007075890 ◽

2007 ◽

Vol 14 (5) ◽

pp. 651-664 ◽

Cited By ~ 15

Author(s):

Satomi Kinoshita

Keyword(s):

Intensive Care ◽

End Of Life ◽

End Of Life Care ◽

Ethical Dilemmas ◽

Time Constraints ◽

Life Care ◽

University Hospitals ◽

Japanese University ◽

Dying Patients ◽

Patients Wishes

This study examined why intensive care unit (ICU) nurses experience difficulties in respecting the wishes of patients in end-of-life care in Japan. A questionnaire survey was conducted with ICU nurses working in Japanese university hospitals. The content of their narratives was analyzed concerning the reasons why the nurses believed that patients' wishes were not respected. The most commonly stated reason was that patients' wishes were impossible to realize, followed by the fact that decision making was performed by others, regardless of whether the patients' wishes were known, if the death was sudden, and time constraints. Many nurses wanted to respect the wishes of dying patients, but they questioned how patients die in ICUs and were therefore faced with ethical dilemmas. However, at the same time, many of the nurses realized that respecting patients' wishes about end-of-life care in an ICU would be difficult and that being unable to respect these wishes would often be unavoidable. The results thus suggest that there has been insufficient discussion about respecting the wishes of patients undergoing intensive care.

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