- 著者
- Kiyoshi Shikino Tsutomu Mito Yoshiyuki Ohira Daiki Yokokawa Yota Katsuyama Takahiro Ota Eri Sato Yuta Hirose Shiho Yamashita Shingo Suzuki Kazutaka Noda Takanori Uehara Masatomi Ikusaka
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.0085-22, (Released:2022-07-05)
- 参考文献数
- 39
- 被引用文献数
- 6
Objective Difficult patient encounters (DPEs) are defined as encounters with patients causing strong negative feelings in physicians. In primary care settings, DPEs account for approximately 15% of visits among outpatients. To our knowledge, this is the first epidemiological study of DPEs in Japan. Methods We conducted a survey of 8 physicians (5.0±2 years of clinical experience) who examined first-visit patients ≥15 years old with clinical symptoms at the Department of General Medicine in Chiba University Hospital and 4 community hospitals over a 2-month period since December 2015. Materials We evaluated 10-Item Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10) scores (DPE ≥31 points; non-DPE ≤30 points) and patient age, sex, and presence of psychological or social problems. Results The valid response rate was 98.9% (94/95) and 98.4% (189/192) in the university and community hospitals, respectively. The percentage of DPEs was 39.8% (37/93) and 15.0% (26/173) in the university and community hospitals, respectively; the percentage of DPEs was significantly higher at the university hospital than at the community hospitals (p<0.001). The proportion of patients with psychosocial problems was significantly higher in the DPE group than in the non-DPE group (93.7% vs. 40.4%, p<0.001). Conclusion Our findings were similar to those reported in primary care settings in other countries in community hospital outpatient and general internal medicine departments, where patients are mostly non-referrals, although the values were higher in university hospital general medicine departments, where patients were mostly referrals. Patients involved in DPEs have a high rate of psychological and social problems.
- 著者
- Shingo Suzuki Akihiro Kaidow Takuma Meya Anri Masuya Takashi Shiina
- 出版者
- 公益財団法人 応用微生物学・分子細胞生物学研究奨励会
- 雑誌
- The Journal of General and Applied Microbiology (ISSN:00221260)
- 巻号頁・発行日
- vol.63, no.1, pp.22-27, 2017 (Released:2017-03-17)
- 参考文献数
- 38
- 被引用文献数
- 2
Many significant gene mutations in E. coli have contributed to the development of genetics. Among these, a commonly used recA mutation, Δ(srl–recA)306 has been sequenced by a next-generation sequencer combined with a long PCR. An original report described that Δ(srl–recA)306 cells were deleted from srlR to recA genes in their genome. The next-generation sequencer enables more accurate details to be determined. We ask whether both surrounding genes from hypF to norV for srlR and alaS for recA is there first. The long PCR was carried out with primers, norR and alaS, and amplified DNA fragments differed in length from wild to Δ(srl–recA)306 cells, suggesting that an entire Δ(srl–recA)306 mutation was included. Sequences of those DNA fragments indicated that 9147 bp, from srlR to recA including 10 genes, were replaced by a Tn10 DNA sequence. Junction points at both srlR-Tn10 and Tn10-recA were determined precisely. The results indicate that the first 97% of recA gene sequences were lost with a downstream recX gene remaining intact. The phenotypic difference between Δ(srl–recA)306 and ΔrecA::Km is discussed.