Toshiko Yoshida

Reliability and cross-cultural validity of a Japanese version of the Dental Fear Survey

BackgroundThis study established the reliability and cross-cultural validity of a Japanese version of the Dental Fear Survey (DFS).MethodsTwo studies were carried out in separate populations. The first involved 166 Japanese dental and nursing students and assessed internal consistency and test-retest reliability. The second involved 2,095 Japanese parents or guardians of school children and tested the hypothesis that the conceptual structure of the Japanese translation was consistent with the U.S. version using Structural Equation Modeling (SEM).ResultsIn the first study Cronbach alpha ranged from .94 to .96 and test-retest reliability (Spearman correlation) ranged from .89 to .92. The intra-class correlation coefficients (ICC) was 0.919 (95%CI: 0.892 – 0.940). In the second study SEM was used on the covariance matrix of the 20 questions in a random sample of 600 questionnaires to evaluate the goodness of fit of the theoretical model; and then, in an exploratory manner corrected for specification errors until a model that fit the data well was achieved.ConclusionThe Japanese version of the DFS appears reliable and demonstrates cross-cultural validity. The modeling confirms the three factors on which the English language version was based.

Effect of cigarette smoke on pharmacokinetics of oral, intrarectal, or intravenous indomethacin in rats

SummaryThe effect of cigarette smoke exposure on the pharmacokinetics of indomethacin administered orally, intravenously or intrarectally was investigated in rats. When cirgarette smoke exposure was performed for 10 min using a Hamburg II smoking machine immediately after the oral administration of indomethacin (5 mg/kg), the plasma indomethacin concentration was significantly lowered during the first 2 h after administration. However, there was no significant difference in plasma indomethacin concentration between the cigarette smoke-exposed and nonexposed control rats thereafter. Cigarette smoke exposure caused a significant decrease in the area under the concentration-time curve from 0 to 4 h (AUC0–4) and a prolongation of the time to reach the maximum concentration (tmax). The plasma level of O-desmethyl-indomethacin (a major metabolite) was not significantly changed by cigarette smoke. When indomethacin (5 mg/kg) was administered to rats intravenously or intrarectally, cigarette smoke exposure did not have any influence on the pharmacokinetics of indomethacin or 0-desmethyl-indomethacin. The pharmacokinetic effect of cigarette smoke on orally administered indomethacin was mimicked by the subcutaneous injection of nicotine at 0.3 mg/kg but not at 0.1 mg/kg. These results suggest that acute exposure to cigarette smoke decreases the plasma concentration of indomethacin when it is administered orally but not intrarectally or intravenously.

A proposed core curriculum for dental English education in Japan

BackgroundGlobalization of the professions has become a necessity among schools and universities across the world. It has affected the medical and dental professions in terms of curriculum design and student and patient needs. In Japan, where medicine and dentistry are taught mainly in the Japanese language, profession-based courses in English, known as Medical English and Dental English, have been integrated into the existing curriculum among its 83 medical and 29 dental schools. Unfortunately, there is neither a core curriculum nor a model syllabus for these courses.MethodsThis report is based on a survey, two discussion forums, a workshop, and finally, the drafting of a proposed core curriculum for dental English approved by consensus of the participants from each university.ResultsThe core curriculum covers the theoretical aspects, including dental English terms and oral pathologies; and practical aspects, including blended learning and dentist-patient communication. It is divided into modules and is recommended to be offered for at least two semesters.ConclusionsThe core curriculum is expected to guide curriculum developers in schools where dental English courses are yet to be offered or are still in their early development. It may also serve as a model curriculum to medical and dental schools in countries in Asia, Europe, Africa, and Central and South America, where English is not the medium of instruction.

新教育技法「チーム基盤型学習（TBL）」の臨床薬学教育における有用性

The concept of Team-Based Learning (TBL) was developed in the late 1970s by Larry Michaelsen, who wanted students to enjoy the benefits of small group learning within large classes in the business school environment. In contrast to problem-based learning (PBL), which is student centered, TBL is typically instructor centered. Recently, TBL is being used as a teaching method in over 60 health science professional schools in the US and other countries. In the present study, the impact of adopting TBL in teaching pharmaceutical care practices to students was evaluated. Students were required to answer a set of multiple-choice questions individually in individual readiness assessment test (IRAT) before the TBL sessions to assess their level of preparation. The same set of questions was then reattempted by the group readiness assessment test (GRAT) during TBL. Comparing the scores obtained in the GRAT and IRAT before the first TBL session, the scores from the GRAT were always higher than those of the IRAT, indicating that TBL has encouraged active learning. In addition, students were surveyed about their level of satisfaction with TBL and written comments about TBL were solicited. The results of the questionnaire showed that 87.3±9.3% of the students were satisfied. Moreover, no student commented that TBL was in any way inferior to the PBL. Implementation of a TBL approach was successfully integrated into the pharmaceutical care education course. In order to further improve the usefulness of TBL in teaching pharmaceutical care, a hybrid teaching approach that also comprises PBL and a lecture-based course is desirable.

Evaluation of the Total Design Method in a survey of Japanese dentists

BackgroundThis study assessed the application of the Total Design Method (TDM) in a mail survey of Japanese dentists. The TDM was chosen because survey response rates in Japan are unacceptably low and the TDM had previously been used in a general population survey.MethodsFour hundred and seventy eight dentist members of the Okayama Medical and Dental Practitioners Association were surveyed. The nine-page, 27-item questionnaire covered dentist job satisfaction, physical practice, and dentist and patient characteristics. Respondents to the first mailing or the one-week follow-up postcard were defined as early responders; others who responded were late responders. Responder bias was assessed by examining age, gender and training.ResultsThe overall response rate was 46.7% (223/478). The response rates by follow-up mailing were, 18% after the first mailing, 35.4% after the follow-up postcard, 42.3% after the second mailing, and 46.7% after the third mailing. Respondents did not differ from non-respondents in age or gender, nor were there differences between early and late responders.ConclusionThe application of TDM in this survey of Japanese dentists produced lower rates of response than expected from previous Japanese and US studies.

Relationships of trainee dentists\' empathy and communication characteristics with simulated patients\' assessment in medical interviews

Objectives We aimed to clarify the characteristics of communication between trainee dentists and simulated patients (SPs) and to examine how the level of trainee dentists’ self-reported empathy influences assessment by SPs in medical interviews. Materials and methods The study involved 100 trainee dentists at Okayama University Hospital and eight SPs. The trainee dentists conducted initial interviews with the SPs after completing the Japanese version of the Jefferson Scale of Empathy. Their interviews were recorded and analyzed using the Roter Interaction Analysis System. The SPs assessed the trainees’ communication immediately after each interview. The trainee dentists were classified into two groups (more positive and less positive groups) according to SP assessment scores. Results Compared with the less positive trainees, the more positive trainees scored higher on the [Emotional expression] and lower on the [Medical data gathering] Roter Interaction Analysis System categories. There was no difference in [Dental data gathering] between the two groups. The SPs of more positive trainees had higher rates of [Positive talk] and [Emotional expression] and lower rates of [Medical information giving] and [Dental information giving]. The trainees with more positive ratings from SPs had significantly higher Jefferson Scale of Empathy total scores. Conclusion The results of this study suggest that responding to the SPs’ emotions is a relevant characteristic of dentist–SP communication to SPs’ positive assessment in medical interviews. Further, trainees’ self-reported empathy was related with the SPs’ assessment of trainees’ communication, which indicated that patient satisfaction can be improved by increasing the dentist’s empathy. Thus, an empathic attitude among dentists is a significant determinant of patient satisfaction.

Permeability of artificial membranes to tegaful suppositories.

Permeability of artificial membranes to tegaful in suppositories was investigated by using the dissolution apparatus in the paddle method of JP X, Sartorius absorption simulator and a suppository release apparatus. Pemeability was evaluated on the basis of the release of tegaful from suppositories through cellophane and lipid membranes. Five products (A-1, A-2, B-1, B-2 and C) of tegaful suppositories from 3 manufacturers were used.The release of tegaful from product A-2 and B-2 in the method using the dissolution apparatus and the suppository release apparatus was significantly more rapid than that from the remaining products. The release of tegaful from product B-2 with Sartorium absorption simulator was also significantly more rapid than that from product A-1 and C. The similar results were obtained in 3 methods. Therefore, this study suggests that the dissolution apparatus in the paddle method of JP X be applicable for evaluation of the release of tegaful from suppositories.