Asian Pacific Journal of Disease Management Vol. 8(2014) No. 1-2

Further urbanization in Japan has led to a new ‘kinrin souon’ problem, which means neighborhood noise issue within and among communities. The purpose of this study was to review the Japanese literatures that focused on neighborhood noise issues, and to clarify what kinds of research have already been done in this field. To conduct this systematic review, the researcher utilized three databases—namely, the Japanese Central Review of Medicine, Cinii Articles, and the National Diet Library-Online Public Catalog Access. The keyword used for this study was “kinrin souon” in the Japanese language, which literally translates to “neighborhood noise”. From the extant published work, 23 literatures were selected for this thematic analysis. Analyzing the secular change of the literature, approximately 50% were published after the 1980s. Lack of communication among neighbors negatively affected how they perceived the loudness of daily sounds. Having a tight and harmonious relationship among neighbors actually reduced the negative perception of daily noise. Considering the effects of urbanization, the neighborhood noise issue has become unavoidable for people living in many communities and local governments in urban areas. Some cases of neighborhood noise would need further assistance from the local government to resolve the issue because of weak community relations among its citizens. The issue includes not only the loudness of the noises but also the emotional conflicts between and among neighbors. The keys to solving this problem are improvement of living conditions and improvement of neighbor relations among community members.

The aim of this study was to clarify the risk factors for interruption of psychiatric treatment among mentally ill people living in the community. Three hundred seventy-two mentally ill people who received psychiatric consultation services that supported healthcare professionals who experienced difficulties in carrying out their casework on community people were analyzed. We performed logistic regression analysis to examine the relationship between a mentally ill person’s interruption of psychiatric treatment and parameters. Among 199 mentally ill people in whom usable data could be obtained, 64 people (32.2%) had no history of interruption of psychiatric treatment, while 135 (67.8%) interrupted psychiatric treatment.

The logistic regression analysis revealed that receiving welfare benefit (Odds Ratio=3.07, 95%CI=1.40−6.72) and refusing to take medicine (Odds Ratio=7.99, 95% CI=3.62−17.63) were significantly associated with interruption of psychiatric treatment among the mentally disabled. To our knowledge, this is the first study that systematically investigated the percentage of mentally ill patients living in a Japanese community with treatment interruption. Our findings indicated the necessity of developing a community health care system to prevent interruption of psychiatric treatment in mentally ill patients. Furthermore, health care professionals should share information on patients who refuse to take medicine and try to use the information on patients’ refusal to take medicine for avoiding an untreated period in mentally ill people.

It remains unclear whether longer-term use of recombinant human soluble thrombomodulin (rhs-TM) enhances outcomes in patients with disseminated intravascular coagulation (DIC). This study investigated whether longer use of rhs-TM influenced outcomes in patients with DIC based on a national administrative database. Between 2010 and 2012, 6,354 patients with DIC were treated with rhs-TM at 735 hospitals in Japan. Patients were divided into two groups according to duration of use of rhs-TM: < 7 days (n = 4,685) and ≥ 7 days (n = 1,669). The in-hospital mortality rate, length of stay (LOS) and medical costs during hospitalization in these two groups were compared. Overall mortality rates were similar in the (odds ratio 1.05; 95% confidence interval (CI): 0.93 – 1.19, p = 0.358). LOS was significantly longer and medical costs during hospitalization significantly higher in patients treated with rhs-TM for ≥ 7 than < 7 days. The unstandardized coefficient for LOS was 15.97 days (95% CI, 13.77 – 18.16 days; p < 0.001) whereas that for medical costs during hospitalization was 11650.5 US dollars (95% CI, 10350.0 – 12950.9 US dollars; p < 0.001). Longer treatment with rhs-TM did not affect the mortality rate of patients with DIC but significantly increased LOS and medical costs during hospitalization. Additional prospective studies are required to confirm the efficacy of longer treatment with rhs-TM for patients with DIC.