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Article ; Online: Long working hours, depression and suicidality among OB/GYNs in Japan.

Ishikawa, M

2022 Volume 72, Issue 3, Page(s) 200–206

Abstract: Background: There is abundant evidence linking long working hours among physicians with adverse health effects; however, most studies have focused on medical residents. In Japan, obstetrician/gynaecologists (OB/GYNs) work the longest hours, yet no ... ...

Abstract	Background: There is abundant evidence linking long working hours among physicians with adverse health effects; however, most studies have focused on medical residents. In Japan, obstetrician/gynaecologists (OB/GYNs) work the longest hours, yet no studies have investigated potential relationships between excessive overtime and depression and suicidal ideation within this population. Aims: To investigate the relationship between long working hours and depression and suicidal ideation among OB/GYNs in Japan. Methods: We administered a survey questionnaire to OB/GYNs and received 919 valid responses. Multivariate logistic regression was performed with depression and suicidal ideation as the outcome variables and number of working hours per week, gender, age, marital status, hospital type and geographical area type as the explanatory variables. Results: Sixteen per cent of the participants were depressed, and 3% reported suicidal ideation. Working 100 or more hours per week increased the odds for both depression and suicidal ideation [odds ratio (OR): 2.08 (95% confidence interval {CI}: 1.07-4.05, P = 0.03); and OR: 7.03 (95% CI: 1.95-25.38, P < 0.001), respectively]. Conclusions: The results suggest that the Japanese Government should vigorously promote physicians' work-style reform, so that a lowered upper limit of overtime hours will be enforced from 2024 to improve physicians' health and patients' safety.
MeSH term(s)	Depression/epidemiology ; Depression/etiology ; Humans ; Japan/epidemiology ; Physicians ; Risk Factors ; Suicidal Ideation ; Suicide
Language	English
Publishing date	2022-02-03
Publishing country	England
Document type	Journal Article
ZDB-ID	1103950-4
ISSN	1471-8405 ; 0962-7480
ISSN (online)	1471-8405
ISSN	0962-7480
DOI	10.1093/occmed/kqab191
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Article ; Online: Internalization of negative societal views on old age into self-perceptions of aging: exploring factors associated with self-directed ageism.

Ishikawa, Motoko

Frontiers in sociology

2023 Volume 8, Page(s) 1291325

Abstract: Introduction: A growing number of research has provided evidence for the negative impact of ageism on older people's health and well-being. Among the three different manifestations of ageism, namely institutional, interpersonal and self-directed ageism, ...

Abstract	Introduction: A growing number of research has provided evidence for the negative impact of ageism on older people's health and well-being. Among the three different manifestations of ageism, namely institutional, interpersonal and self-directed ageism, significant ageism-health associations have been proved to be strongest for self-directed ageism. This supports stereotype embodiment theory, which maintains that lifetime exposure to negative age stereotypes leads to the internalization of ageism as a form of negative attitudes towards own aging and it adversely affects health and well-being in old age. However, little is known about how people internalize negative age stereotypes held in the society into self-perceptions of aging. Methods: This study aimed to explore how socially shared beliefs about old age are internalized into self-perceptions of aging focusing on uncovering factors related to self-directed ageism. Data were derived from the survey that had examined citizen's attitudes towards old age and aging in Finland. Multinominal logistic regression models were performed to examine the association of sociodemographic and contextual factors with different combinations of societal age stereotypes and two indicators of self-perceptions of aging: subjective views on old age and personal feelings of own old age. Results: The analyses showed that being female, attaining tertiary education, evaluating poor quality of life and awareness of institutional old age discrimination were related to holding negative views on aging towards both society and oneself. Discussion: The findings from univariate and multivariate models suggest that it is not age
Language	English
Publishing date	2023-11-17
Publishing country	Switzerland
Document type	Journal Article
ISSN	2297-7775
ISSN (online)	2297-7775
DOI	10.3389/fsoc.2023.1291325
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Article ; Online: Overwork among resident physicians: national questionnaire survey results.

Ishikawa, Masatoshi

BMC medical education

2022 Volume 22, Issue 1, Page(s) 729

Abstract: Background: Residents experience the longest working hours among physicians. Thus, it would be beneficial to perform a nationwide survey in Japan on residents' long work hours and the background factors promoting upper limits on working hours of ... ...

Abstract	Background: Residents experience the longest working hours among physicians. Thus, it would be beneficial to perform a nationwide survey in Japan on residents' long work hours and the background factors promoting upper limits on working hours of Japanese residents. The aim of this study was to study or assess the state of physicians' excessive work hours and its background factors using a questionnaire survey. Methods: The survey was sent to 924 hospitals. The physicians' general attributes, work hours and conditions, and employers' foundational entities were explored. Multiple logistic regression analysis was performed to elucidate the background factors for long work hours. Results: Of the 4306 resident physicians who responded, 67% had ≥ 60 in-hospital hours/week and 27% had ≥ 80 h/week; 51% were on-call ≥ four times/month. Many of them hoped for increased remuneration. Additionally, female (reference: male, OR: 0.65, 95% CI: 0.55-0.76), 35-40 years old (reference: 25-30 years old, OR: 1.83, 95% CI: 1.32-2.54), childlessness (reference: child, OR: 1.41, 95% CI: 1.12-1.75), surgical specialization (reference: internal medicine, OR: 2.51, 95% CI: 1.96-3.23), neurosurgical specialization (reference: internal medicine, OR: 4.38, 95% CI: 2.92-6.59) and hospitals with 200-400 physicians (reference: <100 physicians, OR: 1.82, 95% CI: 1.12-2.96) exhibited significant correlations with ≥ 80 in-hospital hours/week. Conclusion: Understanding the factors that increase the likelihood of residents working very long hours could aid in making targeted changes to address the specific concerns. Moreover, reducing working hours to a reasonable limit can improve resident physicians' health and the quality of care they provide in their community.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Internal Medicine ; Internship and Residency ; Japan ; Physicians ; Surveys and Questionnaires ; Workload
Language	English
Publishing date	2022-10-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-022-03789-7
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Article ; Online: Relationships between overwork, burnout and suicidal ideation among resident physicians in hospitals in Japan with medical residency programmes: a nationwide questionnaire-based survey.

Ishikawa, Masatoshi

BMJ open

2022 Volume 12, Issue 3, Page(s) e056283

Abstract: Objectives: This study examined the relationships between overwork, burnout and suicidal ideation among resident physicians working in hospitals throughout Japan.: Design: A nationwide, questionnaire-based survey.: Setting: Participating hospitals ...

Abstract	Objectives: This study examined the relationships between overwork, burnout and suicidal ideation among resident physicians working in hospitals throughout Japan. Design: A nationwide, questionnaire-based survey. Setting: Participating hospitals (n=416) were accredited by the Japanese Medical Specialty Board to offer medical residency programmes in 19 core specialties. Surveys were conducted in October 2020. Participants: Valid responses were obtained from 4306 physicians (response rate: 49%). Outcome measures: Items pertaining to the Japanese Burnout Scale, depressive tendencies and suicidal ideation were included in questionnaires. Multiple regression analyses were performed: suicidal ideation was the response variable; sex, age, core specialty, marital status, income, weekly working hours and workplace (ownership, number of beds, number of full-time physicians and regional classification) were explanatory variables. Results: Regarding the Japanese Burnout Scale, the highest score was recorded for 'sense of personal accomplishment', followed by 'emotional exhaustion' and 'depersonalization'. Increased emotional exhaustion and depersonalisation were associated with longer working hours, but there was no such trend for sense of personal accomplishment. Depressive tendencies and suicidal ideation were noted in 24.1% and 5.6% of respondents, respectively. These percentages tended to increase when respondents worked longer hours. Several factors were significantly associated with suicidal ideation: female sex (reference: male, OR: 2.08, 95% CI: 1.56 to 2.77), ≥12 million yen income (reference: <2 million yen, OR: 0.21, 95% CI: 0.05 to 0.79), ≥100 working hours/week (reference:<40 hours/week, OR: 3.64, 95% CI: 1.88 to 7.04) and 600-799 hospital beds (reference: <200 beds, OR: 0.23, 95% CI: 0.07 to 0.82). Conclusions: Many Japanese residents demonstrated a tendency to experience burnout and suicidal ideation. Female sex, low income, long working hours and insufficient hospital beds were associated with suicidal ideation. To ensure physicians' health and patients' safety, it is necessary to advance workstyle reform for physicians.
MeSH term(s)	Burnout, Professional/epidemiology ; Burnout, Professional/psychology ; Female ; Hospitals ; Humans ; Internship and Residency ; Japan ; Male ; Physicians/psychology ; Suicidal Ideation ; Surveys and Questionnaires
Language	English
Publishing date	2022-03-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-056283
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Article: Clinical Physicians and Factors Associated With Opening Clinics: An Analysis of National Physician Census Surveys in Japan.

Ishikawa, Masatoshi

Cureus

2022 Volume 14, Issue 1, Page(s) e21321

Abstract: Background and objective In Japan, clinics play a key role in providing primary medical care. Data on temporal trends in the number, proportion, and characteristics of clinical physicians, as well as factors associated with the opening of clinics in ... ...

Abstract	Background and objective In Japan, clinics play a key role in providing primary medical care. Data on temporal trends in the number, proportion, and characteristics of clinical physicians, as well as factors associated with the opening of clinics in Japan, have not been adequately explored. This study aimed to analyze the temporal trends as well as factors associated with the opening of clinics in Japan. Methodology This study employed a longitudinal study design. Data from the biennial national physician census surveys from 1996 to 2016 were analyzed. It involved all physicians in Japan. As the primary and secondary outcome measures, temporal trends in the number and percentages of physicians were estimated and logistic regression was used to analyze physicians opening clinics. Results Recently, the rate of increase in the number of clinical physicians in Japan has been decelerating, and the proportion of older clinical physicians has been increasing. Specifically, the number of clinical physicians increased in the first decade, from 81,888 in 1996 to 95,213 in 2006, but decreased in the second decade to 102,453 in 2016. Apparently, clinical physicians were aging: the number of clinical physicians aged 39 years or younger decreased by 48%, while those aged between 55 and 69 years increased by 91%. The physician-related factors associated with opening clinics include belonging to the age group of 40-54 years, being male, and having an urban area to practice. As of 2016, 39.1% held no board-certified qualifications, whereas 17.1% held board-certified qualifications in areas other than their specialization. Conclusion This study based on national surveys revealed that the rate of increase in doctors in Japanese clinics is slowing down and that the proportion of elderly doctors is increasing. The physician-related factors associated with opening clinics include being middle-aged, male gender, and the availability of an urban area for practice.
Language	English
Publishing date	2022-01-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.21321
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Article ; Online: Current state and future direction of task shifting in obstetric and gynecological care: A survey of obstetrician-gynecologists across Japan.

Ishikawa, Masatoshi

Medicine

2022 Volume 101, Issue 2, Page(s) e28467

Abstract: Abstract: To conduct a survey about task shifting in obstetric and gynecological care.A multivariate logistic regression analysis was conducted in Japanese hospitals using obstetrician-gynecologists (OB/GYNs) who answered that task shifting was rarely ... ...

Abstract	Abstract: To conduct a survey about task shifting in obstetric and gynecological care.A multivariate logistic regression analysis was conducted in Japanese hospitals using obstetrician-gynecologists (OB/GYNs) who answered that task shifting was rarely used at their working environment as the outcome variable and using their personal attributes (sex, age, type of medical institution employed at, and regional characteristics) as predictor variables. Opinions were gathered regarding promoting task shifting impact on individual work duties.Responses were collected from 919 OB/GYNs (49.9% women, 50.8% <40 years). Characteristics' analysis of 34.6% of OB/GYNs who thought that task shifting was hardly used indicated that it was used significantly more at private university hospitals (odds ratio 5.33, 95% confidence interval: 2.33-12.18) than at national university hospitals (odds ratio 3.54, 95% confidence interval: 1.67-7.51). "Transfer of patients (from operating rooms to the ward)" and "securing the contrast agent line" were the only items related to the task shifting status for individual work duties that were identified by most respondents, revealing that task shifting is not progressing. More than half and 9% of the OB/GYNs said that task shifting progression would improve and decline medical care quality, respectively. Overall, 46% and 24% of the respondents thought that task shifting could reduce working hours by ">1 hour, but <2 hours"/day and "<1 hour"/day, respectively.The current study confirmed that OB/GYNs working at university hospitals believe that task shifting is not progressing in university hospitals and that the working environment is poor. Even if task shifting reduces the number of working hours per day by 2 hours, the working hours of these physicians still exceed the criteria for death by overwork. Thus, further working hour reduction measures are needed in addition to task shifting, such as consolidation of medical institutions dealing with deliveries.To promote task shifting in obstetrical and gynecological care in Japan, it is necessary to continue promoting policy-based, institutional, and educational guidance.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Female ; Gynecology/trends ; Humans ; Japan ; Male ; Obstetrics/trends ; Physicians ; Practice Patterns, Physicians' ; Pregnancy ; Surveys and Questionnaires
Language	English
Publishing date	2022-01-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000028467
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Article ; Online: The role of task shifting in reforming the working styles of pediatricians in Japan: A questionnaire survey.

Ishikawa, Masatoshi

Medicine

2022 Volume 101, Issue 35, Page(s) e30167

Abstract: We aimed to shorten the working hours of pediatricians who are regularly experiencing overwork in Japan, recommended tasks for task shifting must be identified, and the impact of promoting task shifting on both the quality of medical care and working ... ...

Abstract	We aimed to shorten the working hours of pediatricians who are regularly experiencing overwork in Japan, recommended tasks for task shifting must be identified, and the impact of promoting task shifting on both the quality of medical care and working hours must be examined. Characteristics of the pediatric department must also be considered. A questionnaire survey was conducted with pediatricians working in hospitals across Japan. A multiple logistic regression analysis was performed with pediatricians who did not recommend task shifting in the workplace as the explained variable and the attributes of the responding pediatricians (gender, age, primary workplace, number of pediatricians, pediatric medical management fee) as the explanatory variables. Details about the tasks recommended for task shifting and the impact of recommending task shifting on the quality of medical care and working hours were described. Questionnaires were sent nationwide to 848 hospitals that calculated pediatric inpatient medical management fees and received responses from 1539 pediatricians in 416 hospitals (response rate: 49%). As a characteristic of 231 (15%) doctors who thought that the task shift had not progressed at all at their place of employment, significant positive associations were found in men, working at national and public university hospitals, private university hospitals, and private hospitals and pediatric inpatient medical care management fee 1 hospitals. Task shifting was not recommended overall, as the task items that a majority of pediatricians marked as "transferred" were limited to "medication instructions" and "intravenous injection of antibiotics, etc" More than half of the respondents (60%, a total of 921 doctors) reported that the quality of medical care improved slightly or significantly when task shifting was promoted. The most frequent response to survey items querying the number of work hours that could be shortened through task shifting was "1 to 2 hours." The tasks suitable for task shifting were identified based on the characteristics of participants' pediatric departments. Results suggest that task shifting was not recommended in university hospitals and that promotion of task shifting could improve the quality of medical care and reduce the working hours of pediatricians.
MeSH term(s)	Child ; Employment ; Humans ; Japan ; Male ; Pediatricians ; Physicians ; Surveys and Questionnaires
Language	English
Publishing date	2022-09-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000030167
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Article ; Online: [Improvement in Aqueous Solubility of Bioactive Molecules by Decreasing Intermolecular Interaction].

Ishikawa, Minoru

Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan

2022 Volume 142, Issue 4, Page(s) 365–379

Abstract: Sufficient aqueous solubility is a key requirement for small molecular drug candidates, and improvement of the aqueous solubility of bioactive compounds is often a major issue for medicinal chemists. Decreasing the partition coefficient (Log P) by the ... ...

Abstract	Sufficient aqueous solubility is a key requirement for small molecular drug candidates, and improvement of the aqueous solubility of bioactive compounds is often a major issue for medicinal chemists. Decreasing the partition coefficient (Log P) by the introduction of a hydrophilic group is the conventional approach for improving the aqueous solubility of drug candidates, but is not always effective. On the other hand, the solubility of a solid solute in water is also dependent on the crystal packing of the solute suggesting the existence of another principle of solvation. We have developed alternative strategies to improve solubility by means of chemical modification to weaken intermolecular interaction in the solid state, thereby lowering the melting point and increasing the solubility. In this review, we summarize the strategies for improving solubility, that is, modification of molecules in ways that would disrupt molecular planarity by increasing the dihedral angle, that would bend the molecular structure, that would disrupt molecular symmetry, or that introduce a non-flat substituent at the meta position of a benzene substructure. We showed that these strategies can increase the aqueous solubility of molecules even if their hydrophobicity is concomitantly increased. Furthermore, we found that disruption of intermolecular interaction resulted in better aqueous solubility than a decrease of hydrophobicity in some cases.
MeSH term(s)	Hydrophobic and Hydrophilic Interactions ; Molecular Structure ; Solubility ; Water/chemistry
Chemical Substances	Water (059QF0KO0R)
Language	Japanese
Publishing date	2022-03-31
Publishing country	Japan
Document type	Journal Article ; Review
ZDB-ID	200514-1
ISSN	1347-5231 ; 0031-6903 ; 0372-7750 ; 0919-2085 ; 0919-2131
ISSN (online)	1347-5231
ISSN	0031-6903 ; 0372-7750 ; 0919-2085 ; 0919-2131
DOI	10.1248/yakushi.21-00185-3
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Article ; Online: Factors associated with overwork among pediatricians at Japanese hospitals.

Ishikawa, Masatoshi

Pediatrics international : official journal of the Japan Pediatric Society

2022 Volume 64, Issue 1, Page(s) e15173

Abstract: Background: Given the global health issue of doctors working excessive hours, working practices for doctors in Japan are currently undergoing reform. We aimed to ascertain the actual situation of excessive working hours among pediatricians and factors ... ...

Abstract	Background: Given the global health issue of doctors working excessive hours, working practices for doctors in Japan are currently undergoing reform. We aimed to ascertain the actual situation of excessive working hours among pediatricians and factors influencing these conditions in Japan. Methods: Pediatricians employed at hospitals throughout Japan completed a questionnaire regarding their current working situation, including the time spent at the hospital and whether their working environment had improved since 2018, when the reform of doctors' working practices began. Multiple logistic regression analysis was performed to identify background factors associated with excessive working hours. Results: Questionnaires were sent to 848 Japanese hospitals that submitted insurance reimbursement claims for pediatric inpatient treatment. Valid responses were received from 1,539 pediatricians at 416 hospitals (49% response rate). Of these pediatricians, 51.7% spent ≥60 h/week at their hospital, 14.4% spent ≥80 h/week, and 47.4% worked nights at least four times a month. Compared with 2018, 8.8% and 35.4% responded that their working environment had greatly or somewhat improved, respectively. Working for ≤60 h/week was considered appropriate by 81.9% of pediatricians. Background factors associated with spending ≥80 h/week at the hospital were male sex, age <30 years, lack of children, specialty of pediatric cardiology, annual income exceeding ¥16 million, employment at a private university hospital, and employment at a hospital with a comparatively large number of pediatricians. Conclusions: This study clarified the background factors and the actual situation of the long working hours among pediatricians working in Japanese hospitals.
MeSH term(s)	Adult ; Child ; Female ; Hospitals ; Humans ; Japan ; Male ; Pediatricians ; Physicians ; Surveys and Questionnaires
Language	English
Publishing date	2022-06-21
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1470376-2
ISSN	1442-200X ; 1328-8067
ISSN (online)	1442-200X
ISSN	1328-8067
DOI	10.1111/ped.15173
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Article ; Online: Media portrayals of transitions from work to retirement in two ageing societies: the case of ageing baby boomers in Japan and Finland.

Ishikawa, Motoko

Journal of aging studies

2022 Volume 62, Page(s) 101062

Abstract: This article explores media portrayals of the transition from work to retirement under the circumstances of demographic change through a focus on newspaper discussions about ageing baby boomers in Japan and Finland. Due to their shared characteristics as ...

Abstract	This article explores media portrayals of the transition from work to retirement under the circumstances of demographic change through a focus on newspaper discussions about ageing baby boomers in Japan and Finland. Due to their shared characteristics as a distinct population group that advances the rapid ageing of the population, media representations of Japanese and Finnish baby boomers during the transitional period to retirement give insight into the social perceptions of retirement and their implications on later life. Manifest content analysis and subsequent thematic analysis identify that the topic of "work, retirement and pension" dominates media discussions in both countries. Analysis also conveys that this topic involves specific themes on three levels: macro level, attitudinal level and behavioural level regarding working, subjective and social perceptions of retirement. Social and cultural differences between Japan and Finland are well accounted for in shaping each theme, which is characterised by even contrasting expressions regarding the extension of working life and attitudes toward work and retirement. However, deeper analysis suggests that the idea that values an active, productive and engaged lifestyle beyond retirement underlies both Japanese and Finnish media discourses. Media discussions in both countries risk creating a discriminatory dichotomy among older people: the Finnish media marginalises those who are out of work and without work-like activities, while the Japanese media tend to exclude those without socially desirable competence.
MeSH term(s)	Aged ; Aging ; Finland ; Humans ; Japan ; Pensions ; Retirement
Language	English
Publishing date	2022-08-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2006012-9
ISSN	1879-193X ; 0890-4065
ISSN (online)	1879-193X
ISSN	0890-4065
DOI	10.1016/j.jaging.2022.101062
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