著者

Fumie Nishizaki Mai Shimbo Noriko Fukue Chisa Matsumoto Satsuki Noma Satoko Ohno-Urabe Chizuko A. Kamiya Sachiko Kanki Tomomi Ide Hideo Izawa Tatsunori Taniguchi Atsuko Nakayama Yoshio Kobayashi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0063, (Released:2023-06-28)

参考文献数

23

被引用文献数

2

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Background: Equality in training opportunities, studying abroad, and satisfaction with work are not well investigated among Japanese cardiologists.Methods and Results: We studied cardiologists’ career development using a questionnaire that was emailed to 14,798 cardiologists belonging to the Japanese Circulation Society (JCS) in September 2022. Feelings regarding equality in training opportunities, preferences for studying abroad, and satisfaction with work were evaluated with regard to cardiologists’ age, sex, and other confounding factors. Survey responses were obtained from 2,566 cardiologists (17.3%). The mean (±SD) age of female (n=624) and male (n=1,942) cardiologists who responded to the survey was 45.6±9.5 and 50.0±10.6 years, respectively. Inequality in training opportunities was felt more by female than male cardiologists (44.1% vs. 33.9%) and by younger (<45 years old) than older (≥45 years old) (42.0% vs. 32.8%). Female cardiologists were less likely to prefer studying abroad (53.7% vs. 59.9%) and less satisfied with their work (71.3% vs. 80.8%) than male cardiologists. Increased feelings of inequality and lower work satisfaction were investigated among cardiologists who were young, had family care duties, and had no mentors. In the subanalysis, significant regional differences were found in cardiologists’ career development in Japan.Conclusions: Female and younger cardiologists felt greater inequality in career development than male and older cardiologists. A diverse workplace may prompt equality in training opportunities and work satisfaction for both female and male cardiologists.

著者

Mai Shimbo Atsuko Nakayama

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.62, no.3, pp.465-469, 2021-05-29 (Released:2021-05-29)

参考文献数

42

被引用文献数

4

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The coronavirus disease 2019 (COVID-19) pandemic has changed the lives of healthcare professionals, especially vulnerable physicians such as young or female cardiologists. In Japan, they are facing the fear of not only infection but also weak and unstable employment, difficulties in medical practice and training anxiety, implications for research and studying abroad, as well as worsened mental health issues due to social isolation. Conversely, some positive aspects are seen through the holding of remote meetings and conferences. Here, we suggest a new working style for cardiologists, as well as offer solutions to the medical employment problems that have been taken place in Japan.

著者

Atsuko Nakayama Hiroyuki Morita Issei Komuro

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.11, pp.474-480, 2019-11-08 (Released:2019-11-08)

参考文献数

55

被引用文献数

2

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Abdominal aortic aneurysms (AAA) are referred to as “time bombs”. The only way to prevent AAA rupture is elective repair beforehand using surgical replacement or an endovascular procedure. Non-surgical strategies to prevent AAA expansion are under intense investigation. At each AAA stage, that is, occurrence, expansion, and rupture, the mechanisms and risk factors are different, as discussed in this review. Based on the mechanism and risk factors for AAA expansion, the most effective strategy against AAA expansion need to be identified, but so far none has. Exercise is known to be essential for preventing atherosclerosis related to the coexistence of AAA and CAD, but some doctors are hesitant to prescribe exercise programs to AAA patients given that BP elevation during exercise can cause AAA expansion or rupture. In our retrospective study and prospective study on the safety and effectiveness of exercise for AAA patients, the protective role of mild-moderate exercise against expansion of small AAA was clearly shown. The stability of AAA on exercise might be related to reduced inflammatory activity in the aortic wall, stabilized elevation in BP during exercise, increased aortic blood flow, upregulation of transforming growth factor-β1, moderated BMI and/or fat, or improved endothelial function. Until a revolutionary drug emerges that can regress AAA, cardiac rehabilitation remains the best strategy for preventing AAA expansion and rupture.

著者

Kentaro Hori Atsuko Nakayama Daichi Kobayashi Yuichi Adachi Kotaro Hirakawa Tomoki Shimokawa Mitsuaki Isobe

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0102, (Released:2023-05-02)

参考文献数

36

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Background: We investigated the components of frailty associated with hospitalization-associated disability (HAD) after cardiac surgery.Methods and Results: This retrospective, observational study evaluated 1,446 older patients after elective cardiac surgery at the Sakakibara Heart Institute. We examined the association between HAD and 7 domains of frailty assessed by the Kihon Checklist. HAD was defined as a decline in the ability to perform activities of daily living (ADL) between admission and discharge, as assessed by the Barthel Index. Logistic regression and decision tree analysis were used to identify associations between the number and type of frailty components and HAD. Of the 1,446 patients, 190 were excluded, and 90 (7%) developed HAD. An increase in the number of frailty components was a risk factor for HAD (odds ratio: 1.88, 95% confidence interval: 1.62–2.17). Decision tree analysis identified physical functional decline, depression, and cognitive dysfunction as factors associated with HAD. The incidence of HAD was highest in cases of physical functional decline (21%) and lowest for cases in which the 3 aforementioned factors were absent (2.8%).Conclusions: An increased number of frailty factors increased the risk of HAD and the findings also reaffirmed the importance of a comprehensive assessment to evaluate the risk of HAD, including evaluation of physical function, cognitive function, and depression.

著者

Kentaro Hori Koyo Usuba Akihiro Sakuyama Yuichi Adachi Kotaro Hirakawa Atsuko Nakayama Masatoshi Nagayama Tomoki Shimokawa Shuichiro Takanashi Mitsuaki Isobe

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.3, no.8, pp.423-430, 2021-08-10 (Released:2021-08-10)

参考文献数

36

被引用文献数

7

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Background:Hospitalization-associated disability (HAD) is associated with prolonged functional decline and increased mortality after discharge. Therefore, we examined the incidence and risk factors associated with HAD in elderly patients undergoing cardiac surgery in Japan.Methods and Results:We retrospectively examined 2,262 elderly patients who underwent elective cardiac surgery at Sakakibara Heart Institute. HAD was defined as a functional decline between time of admission and discharge measured by the Barthel Index. We analyzed clinical characteristics using machine learning algorithms to identify the risk factors associated with HAD. After excluding 203 patients, 2,059 patients remained, of whom 108 (5.2%) developed HAD after cardiac surgery. The risk factors identified were age, serum albumin concentration, estimated glomerular filtration rate, Revised Hasegawa’s Dementia Scale, N-terminal pro B-type natriuretic peptide, vital capacity, preoperative Short Physical Performance Battery (SPPB) score, operation times, cardiopulmonary bypass times, ventilator times, length of postoperative intensive care unit stay, and postoperative ambulation start day. The highest incidence of HAD was found in patients with an SPPB score ≤9 and in those who started ambulation >6 days after surgery (76.9%).Conclusions:Several risk factors for HAD are components of frailty, suggesting that preoperative rehabilitation to reduce the risk of HAD is feasible. Furthermore, the association between HAD and a delayed start of ambulation reaffirms the importance of early mobilization and rehabilitation.