Hiroki Mishina

Screening for maternal depression in primary care pediatrics.

Purpose of review An estimated 10–20% of mothers suffer from postpartum depression. Given its profound impact on both mother and infant and the availability of effective interventions, pediatricians can improve identification and referral of mothers with postpartum depression by screening regularly during well child visits. The purpose of this paper is to review and assess recently developed screening tools. Recent findings Since the development of the Edinburgh Postnatal Depression Scale in 1987, several shorter screening tools have been introduced. Although further innovation to optimize appropriate identification of postpartum depression is critical, these brief tools have been shown to be useful in improving pediatrician recognition of depression in mothers and referral to psychiatric specialists. Summary Recently developed brief screening tools are recommended for routine use by pediatricians during well child visits to identify mothers who need additional evaluation for depression. Screening should be conducted repeatedly during the first year of child rearing as symptoms of postpartum depression may appear at any time and its progression may help differentiate between mild and more severe forms of depression. Pediatricians can also provide appropriate follow-up of the family.

Test performance of two-question screening for postpartum depressive symptoms

Background:  The Edinburgh Postnatal Depression Scale (EPDS) is commonly used to screen for postpartum depression, but it is difficult to consistently administer it to all mothers during busy well‐child visits owing to the fact that it is time‐consuming. The purpose of the present paper was to evaluate the performance of a concise, two‐question screening tool in the detection of mothers with postpartum depressive symptoms who had a high EPDS score.

Mentoring the next generation of physician-scientists in Japan: a cross-sectional survey of mentees in six academic medical centers

BackgroundPhysician-scientists play key roles in biomedical research across the globe, yet prior studies have found that it is increasingly difficult to recruit and retain physician-scientists in research careers. Access to quality research mentorship may help to ameliorate this problem in the U.S., but there is virtually no information on mentoring in academic medicine in Japan. We conducted a survey to determine the availability and quality of mentoring relationships for trainee physician-scientists in Japan.MethodsWe surveyed 1700 physician-scientists in post-graduate research training programs in 6 academic medical centers in Japan about mentorship characteristics, mentee perceptions of the mentoring relationship, and attitudes about career development.ResultsA total of 683 potential physician-scientist mentees completed the survey. Most reported that they had a departmental mentor (91%) with whom they met at least once a month; 48% reported that they were very satisfied with the mentoring available to them. Mentoring pairs were usually initiated by the mentor (85% of the time); respondents identified translational research skills (55%) and grant writing (50%) as unmet needs. Mentoring concerning long-term career planning was significantly associated with the intention to pursue research careers, however this was also identified by some mentees as an unmet need (35% desired assistance; 15% reported receiving it).ConclusionsMore emphasis and formal training in career mentorship may help to support Japanese physician-scientist mentees to develop a sense of self-efficacy to pursue and stay in research careers.

A novel Internet-based blended learning programme providing core competency in clinical research.

RATIONALE, AIMS AND OBJECTIVES We developed a novel Internet-based blended learning programme that allows busy health care professionals to attain core competency in clinical research. This study details the educational strategies and learning outcomes of the programme. METHOD This study was conducted at Kyoto University and seven satellite campuses from September 2009 to March 2010. A total of 176 health care professionals who had never attempted to attain core competency in clinical research were enrolled. The participants were supplied with a novel programme comprising the following four strategies: online live lectures at seven satellite campuses, short examinations after each lecture, an Internet-based feedback system and an end-of-course examination. We assessed the proportion of attendance at the lectures as the main outcome. In addition, we evaluated interaction via the feedback system and scores for end-of-course examination. RESULTS Of the 176 participants, 134 (76%) reported working more than 40 hours per week. The mean proportion of attendance over all 23 lectures was 82%. A total of 156 (89%) participants attended more than 60% of all lectures and were eligible for the end-of-course examination. A total of the participants accessed the feedback system 3564 times and asked 284 questions. No statistically significant differences were noted in the end-of-course scores among medical doctors, pharmacists, registered nurses and other occupations. CONCLUSIONS We developed an Internet-based blended learning programme providing core competency in clinical research. Most busy health care professionals completed the programme successfully. In addition, the participants could attain the core competency effectively, regardless of their occupation.

Can pediatricians accurately identify maternal depression at well-child visits?

Background:  The feasibility of a two‐item screening tool for maternal depression in a pediatric setting was recently reported. We assessed whether the accuracy of pediatrician recognition of maternal depression during the one‐month well‐child visit could be improved by an educational intervention using the two‐item screening tool.

Maternal childrearing anxiety reflects childrearing burden and quality of life.

Background:  The government of Japan has recently initiated public programs to allay maternal childrearing anxiety. The aim of the present study was to determine the prevalence of childrearing anxiety and describe its relationships with perceived childrearing burden and maternal quality of life (QOL).

Application of a two-question screening instrument to detect depressive symptoms in patients with vitiligo: A pilot study

To the Editor: Several studies have investigated the relationship between skin diseases and mental health, revealing that patients with psoriasis or vitiligo had a higher prevalence of depressive symptoms than the general population. However, few dermatologists are familiar with detecting depression, which remains undertreated. A useful method for detecting depression is a two-question screening instrument (ie, ‘‘During thepastmonth,haveyouoftenbeenbothered by feeling down, depressed, or hopeless?’’ and ‘‘During thepastmonth,haveyouoftenbeenbothered by little interest or pleasure in doing things?’’), which has been shown tohave high sensitivity for diagnosing depressioncomparedwith semistructured interviews. Patients answeredeachquestionwith yes (1) or no (0); a total score

Pediatric resident perceptions of shift work in ward rotations

1 is regarded as a positive screen. The use of this two-question screening instrument todetect depressive symptomshasnot beenevaluated in patients with skin diseases. We therefore assessed the use of this instrument in screening for depressive symptoms in vitiligo patients comparedwith the short version of the Center for Epidemiological Studies Depression Screening Index (CES-D, in which a score of

Trends and variations in infant mortality among 47 prefectures in Japan

10 suggests a diagnosis of depression). A total of 54 patients with vitiligo vulgaris were recruited from the Department of Dermatology in Kyoto University and Fukui Red Cross Hospital between May 2008 and May 2009. The study was approved by the Research Ethics Committee of Kyoto University. All statistical analyses were performed using STATA (v 9.2; StataCorp, TX). Out of the 54 patients, 15 (27.8%) had depressive symptoms as assessed using CES-D. When the twoquestion screening instrument was administered, a total score of

Regional variations in prevalence of postpartum depressive symptoms: Population‐based survey

1 was reported in 93.3% and 33.3% of patients with or without depressive symptoms, respectively. When the cut-off was defined as a total