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Yutaka Yasui

Publications and source records attributed to Yutaka Yasui.

105 records · Page 6Linked to original sources
PubMed2002

Hepatitis B knowledge and practices among Cambodian American women in Seattle, Washington.

Southeast Asians have higher liver cancer rates than any other racial/ethnic group in the US. Approximately 80 percent of liver cancers are etiologically associated with hepatitis B virus (HBV) infection which is endemic in Southeast Asia. An in-person survey of Cambodian women (n = 320) was conducted in Seattle, Washington, during 1999. The questionnaire included items about HBV knowledge, beliefs, and practices. Prior to being provided with a description of the disease, only about one-half (56 percent) of our respondents had heard of HBV infection. Less than one-quarter (23 percent) of the study group thought that asymptomatic individuals can transmit the disease to others. Most thought that HBV infection can cause liver cancer (54 percent) and death (72 percent). However, a minority thought that infection can be lifelong (24 percent) and incurable (15 percent). Only 38 percent reported they had been serologically tested for HBV. Finally, of those who had been tested and thought they were susceptible, two-thirds (67 percent) had not been vaccinated. Lower levels of education were associated with lower levels of HBV knowledge and serologic testing. Our findings suggest that Cambodian immigrants have low levels of HBV knowledge, serologic testing, and vaccination; and demonstrate a need for targeted educational interventions aimed at reducing HBV-related liver cancer mortality among Southeast Asian communities.

Adult↗
PubMed2002

Information women receive about heart attacks and how it affects their knowledge, beliefs, and intentions to act in a cardiac emergency.

In this study we investigate (a) what information women receive on acute myocardial infarction (AMI) from different information sources, (b) how women evaluate this information, and (c) how information acquisition is related to women's knowledge of AMI, personal risk perceptions, and behavioral intentions regarding a cardiac emergency. A random sample of 844 women 50 years and over were telephoned in the state of Washington. Repeated measures regression analyses showed that women receive most of their information on AMI from the mass media, even though they evaluated the media as less believable, less useful, less clear, and making less of an impression than information received from health care providers. Logistic regression analyses showed that the total number of information sources from which heart attack information was received in the past year was positively related to knowledge of AMI symptoms, beliefs about AMI, and personal risk perceptions. The results are discussed in terms of their pragmatic implications.

Adaptation, Psychological↗
PubMed2002

Hepatitis B knowledge and practices among Chinese American women in Seattle, Washington.

BACKGROUND: Chinese Americans have higher rates of chronic hepatitis B virus (HBV) infection, resulting in higher incidences of liver cancer, compared with the general population. METHODS: The authors conducted a community-based survey of HBV knowledge and preventive practices among Chinese American women in Seattle, Washington, during 1999. RESULTS: Less than half (46%) of the respondents knew that HBV could cause liver cancer. Only 35% reported that they had been serologically tested for HBV, and most of those who knew they were susceptible (61%) had not been vaccinated. CONCLUSIONS: The findings indicate low levels of HBV knowledge, screening, and vaccination among Chinese immigrants. Targeted interventions are needed to reduce the burden of HBV infection and liver cancer in this community.

Adult↗
PubMed2002

A statistical method for the estimation of window-period risk of transfusion-transmitted HIV in donor screening under non-steady state.

Human immunodeficiency virus (HIV) can be transmitted by transfusion of blood even if the blood unit is test-negative for HIV. This is largely due to a time period following an infection, called the window period, during which antibodies against HIV are not detectable. Window-period risk refers to the probability for a test-negative blood unit to be infectious because of its donation during the window period. Estimation of window-period risk is important in public health for evaluating the safety of donated blood. The standard method for this estimation problem has been based on so-called incidence/window-period (IWP) models in which blood-donation and HIV-infection processes are assumed to be stochastically stationary and independent. Here we propose a new approach in which we relax this key assumption of the IWP models. We estimate window-period risk for each unit of donated blood using a given distribution of window-period risk. The proposed method utilizes the actual observed donation intervals including those of seroconversions, thereby relaxing the assumption that may not be met in practice. Bootstrap is used to compute confidence intervals without specifying the complex dynamics of the donation and infection processes. A simulation study illustrates the usefulness of the proposed method over the IWP method in scenarios where the IWP assumptions do not hold. A real application of the proposed method is presented using blood bank data from a province of northern Thailand. Advantages and limitations of the proposed method are discussed and compared with the IWP models.

Journal Article↗
PubMed2002

Risk of disease recurrence and second neoplasms in survivors of childhood cancer treated with growth hormone: a report from the Childhood Cancer Survivor Study.

GH deficiency is common in survivors of childhood cancer, especially in those treated with radiation to the brain. The impact of GH therapy on disease recurrence has been studied in survivors of pediatric brain tumors, but few data are available on the risk of disease recurrence in survivors of other tumor types who are treated with GH. Likewise, the risk of second neoplasms (SN) associated with GH use has not been systematically evaluated. We studied 361 GH-treated cancer survivors (including 172 brain tumor survivors) from among 13,539 survivors enrolled in the Childhood Cancer Survivor Study, a cohort of 5-yr survivors of childhood cancer. Using a time-dependent Cox model, we compared risk of recurrence, risk of SN, and risk of death between survivors who did and did not receive treatment with GH. The relative risk of disease recurrence was 0.83 (95% confidence interval, 0.37-1.86; P = 0.65) for GH-treated survivors. The relative risk of recurrence was not increased for any of the major cancer diagnoses. GH-treated subjects were diagnosed with 15 SN, all solid tumors and no secondary leukemias, for an overall relative risk of 3.21 (95% confidence interval, 1.88-5.46; P < 0.0001). This was mainly due to a small excess number of SN observed in GH-treated survivors of acute leukemia. The risk of death was not associated with GH use (P = 0.43). We conclude that GH therapy does not appear to increase the risk of disease recurrence or death in survivors of childhood cancer. The increased number of SN, particularly in survivors of acute leukemia, is of concern, but the data need to be interpreted with caution given the small number of events.

Adolescent↗
PubMed2002

Mailing strategies and recruitment into an intervention trial of the exercise effect on breast cancer biomarkers.

Recruitment into public health intervention trials can be costly and time-consuming. We examined two components of recruitment for an exercise trial: (a) a randomized pilot study of mailing strategies; and (b) the results from the entire recruitment process. In the pilot study, 4,999 women were randomized into one of four groups using a factorial design. The first factor was the inclusion or exclusion of a personal invitation letter, and the second was the use of first-class stamps versus bulk mail. We received 580 (11.6%) responses. Responses from interested women were nonsignificantly higher (odds ratio, 1.19; P = 0.10) for first-class versus bulk-rate postage. However, the cost to randomize one participant using first-class mail was $56.14 (in 1998 dollars) more than for bulk mail. We found no difference in response when including the invitation letter (odds ratio, 1.00; P > 0.50). The general recruitment process identified potentially eligible women primarily through mass mailings but also through media and other sources. We mailed recruitment materials, via bulk mail and including an invitation letter, to 103,577 women in the Seattle area over 2 years. Response rates were different (P < 0.001) between age groups: 6.2% for 50-59-year-old women; 7.9% for 60-69-year-old women; and 7.4% for 70-75-year-old women. The proportion of respondents eventually randomized did not differ by recruitment strategy (mail, media, other). Our study indicates that bulk mail may be more cost-effective than first-class mail for recruitment into intervention trials and that older women are willing to participate in such studies.

Age Factors↗
PubMed2002

Boosted decision tree analysis of surface-enhanced laser desorption/ionization mass spectral serum profiles discriminates prostate cancer from noncancer patients.

BACKGROUND: The low specificity of the prostate-specific antigen (PSA) test makes it a poor biomarker for early detection of prostate cancer (PCA). Because single biomarkers most likely will not be found that are expressed by all genetic forms of PCA, we evaluated and developed a proteomic approach for the simultaneous detection and analysis of multiple proteins for the differentiation of PCA from noncancer patients. METHODS: Serum samples from 386 men [197 with PCA, 92 with benign prostatic hyperplasia (BPH), and 96 healthy individuals], randomly divided into training (n = 326) and test (n = 60) sets, were analyzed by surface-enhanced laser desorption/ionization (SELDI) mass spectrometry. The 124 peaks detected by computer analyses were analyzed in the training set by a boosting tree algorithm to develop a classifier for separating PCA from the noncancer groups. The classifier was then challenged with the test set (30 PCA samples, 15 BPH samples, 15 samples from healthy men) to determine the validity and accuracy of the classification system. RESULTS: Two classifiers were developed. The AdaBoost classifier completely separated the PCA from the noncancer samples, achieving 100% sensitivity and specificity. The second classifier, the Boosted Decision Stump Feature Selection classifier, was easier to interpret and used only 21 (compared with 74) peaks and a combination of 21 (vs 500) base classifiers to achieve a sensitivity and specificity of 97% for the test set. CONCLUSIONS: The high sensitivity and specificity achieved in this study provides support of the potential for SELDI, coupled with a bioinformatics learning algorithm, to improve the early detection/diagnosis of PCA.

Algorithms↗
PubMedDate not supplied

An alternate method of radiofrequency neurotomy of the sacroiliac joint: a pilot study of the effect on pain, function, and satisfaction.

BACKGROUND AND OBJECTIVES: The sacroiliac joint (SIJ) can be a source of chronic refractory mechanical spine pain. Few previous studies have described radiofrequency (RF) sensory denervation of the SIJ; results have been inconsistent and technically demanding. This uncontrolled, prospective, cohort study evaluates the effects of an innovative method of RF ablation of the posterior sensory nerves of the SIJ on pain, analgesic use, disability, and satisfaction of patients suffering with chronic mechanical SIJ pain. METHODS: Nine subjects with SIJ pain, confirmed by a local anesthetic joint block, were studied. Subjects were treated with a series of RF strip lesions performed adjacent to the lateral dorsal foraminal aperture plus conventional monopolar lesioning at the L5 dorsal ramus. Each subject completed a questionnaire twice before and at 1, 3, 6, 9, and 12 months after the procedure. The questionnaire evaluated pain intensity and frequency, analgesic intake, disability, satisfaction (with current pain level and the RF procedure), and procedure complications. Data were analyzed by using linear mixed model analysis. RESULTS: After the procedure, significant reductions of back and leg pain frequency and severity, analgesic intake, and dissatisfaction with their current level of pain occurred. Complications were minimal. Overall, 8 of 9 subjects were satisfied with the procedure. CONCLUSIONS: RF sensory ablation of the SIJ using bipolar strip lesions is a technically uncomplicated and low-risk procedure. The resulting effects on pain, disability, and satisfaction are promising. Further evaluation of this technique, including randomized controlled trials, is recommended.

Adult↗
PubMedDate not supplied

Effects of risk counseling on interest in breast cancer genetic testing for lower risk women.

PURPOSE: A randomized trial was conducted to test the effects of two counseling methods (genetic counseling and group counseling) against a control no-intervention condition on interest in genetic testing in lower risk women. METHODS: After completing baseline surveys, women (N = 357) were randomized to one of three conditions: to receive individual genetic risk counseling, to receive a group psychosocial group counseling, or to serve as a control group. Participants completed follow-up questionnaires 6 months after randomization. RESULTS: All participants had some familial history of breast cancer, but none had a family history indicative of autosomal dominant genetic mutation. At baseline over three fourths of the sample judged themselves to be appropriate candidates for testing. By the end of the survey, two thirds (70%) of the women in the counseling group still judged themselves to be appropriate candidates for testing. Findings were similar for interest in genetic testing. Changes in beliefs about genetic testing (e.g., beliefs about potential stigma associated with testing) altered the effects of counseling. CONCLUSION: These results indicate that counseling can change interest in genetic testing only slightly and that changing women's beliefs about the properties of testing might be one mechanism of doing so.

Adolescent↗
PubMedDate not supplied

Effect of a yearlong, moderate-intensity exercise intervention on the occurrence and severity of menopause symptoms in postmenopausal women.

OBJECTIVE: To evaluate the effect of moderate-intensity exercise on the occurrence and severity of menopause symptoms. DESIGN: A yearlong, randomized, clinical trial, conducted in Seattle, WA, with 173 overweight, postmenopausal women not taking hormone therapy in the previous 6 months. The intervention was a moderate-intensity exercise intervention (n = 87) versus stretching control group (n = 86). Using logistic regression, odds ratios comparing exercise with controls were calculated at 3, 6, 9, and 12 months for menopause symptoms and their severity. RESULTS: There was a significant increase in hot flash severity and decreased risk of memory problems in exercisers versus controls over 12 months, although the numbers affected were small. No other significant changes in symptoms were observed. CONCLUSIONS: Exercise does not seem to decrease the risk of having menopause symptoms in overweight, postmenopausal women not taking hormone therapy and may increase the severity of some symptoms in a small number of women.

Adipose Tissue↗
PubMedDate not supplied

Health care of young adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

BACKGROUND: We wanted to determine the type of outpatient medical care reported by young adult survivors of childhood cancer and to examine factors associated with limited medical care. METHODS: We analyzed data from 9,434 adult childhood cancer survivors enrolled in a retrospective cohort study who completed a baseline questionnaire. They had a mean age of 26.8 years (range 18 to 48 years), 47% were female, 12% were minorities, and 16% were uninsured. Four self-reported outcome measures were used to determine outpatient medical care in a 2-year period: general contact with the health care system, general physical examination, cancer-related medical visit, and medical visit at a cancer center. RESULTS: Eighty-seven percent reported general medical contact, 71.4% a general physical examination, 41.9% a cancer-related visit, and 19.2%, a visit at a cancer center. Factors associated with not reporting a general physical examination, a cancer-related visit, or a cancer center visit included no health insurance (odds ratio [OR] = 2.34; 95% confidence interval [CI], 1.97-2.77), male sex (OR = 1.65; 95% CI, 1.44-1.88), lack of concern for future health (OR = 1.57; 95% CI, 1.36-1.82), and age 30 years or older in comparison with those 18 to 29 years (OR = 1.56; 95% CI, 1.35-1.81). The likelihood of reporting a cancer-related visit or a general physical examination decreased significantly as the survivor aged or the time from cancer diagnosis increased. This trend was also significant for those treated with therapies associated with substantial risk for cardiovascular disease or breast cancer. CONCLUSIONS: Primary care physicians provide health care for most of this growing high-risk population. To optimize risk-based care, it is critical that cancer centers and primary care physicians develop methods to communicate effectively and longitudinally.

Adolescent↗
PubMedDate not supplied

Screening mammography among Chinese Canadian women.

BACKGROUND: Though breast cancer is the most common malignancy among Chinese women, screening mammography is underutilized. This study examined barriers and facilitators of screening mammography among Chinese Canadian women. METHODS: Using community-based sampling, Chinese women in British Columbia were interviewed in 1999 about multiple preventive health behaviours. We included 213 women in the mammography analysis; main outcome measures were ever having a mammogram and routine mammography. RESULTS: Seventy-five percent of women 50 to 79 years old reported ever having had a mammogram, and 53% had two or more mammograms within the last five years. Receiving a recommendation for a mammogram from medical personnel or from a family member, and believing that cancer cannot be prevented by faith were independently associated with both screening outcomes. CONCLUSIONS: A multifaceted approach to screening mammography promotion in Chinese Canadian women is suggested. Interventions that include education of and by medical providers and family members should be considered.

Aged↗
PubMedDate not supplied

Hepatitis B knowledge and practices among Chinese Canadian women in Vancouver, British Columbia.

INTRODUCTION: Liver cancer rates are higher in North American Chinese than non-Asian ethnic/racial groups, largely due to chronic hepatitis B virus (HBV) infection. METHODS: A community-based survey of Chinese women (n = 147) was completed during 1999 to examine HBV knowledge and practices in Vancouver, British Columbia. RESULTS: Most women had heard of HBV (85%) but smaller proportions knew about some routes of transmission (e.g., sexual intercourse) and sequelae of infection. Knowledge about HBV was significantly associated with education level (p = 0.005), English fluency (p < 0.001) and household income (p = 0.007). Previous serologic testing for HBV infection was significantly associated with education level (p = 0.04), English fluency (p = 0.01), and level of knowledge about HBV (p < 0.001). CONCLUSIONS: Efforts to increase knowledge about HBV infection in this community should consider targeting less educated and less acculturated individuals.

Acculturation↗
PubMedDate not supplied

Hepatitis B knowledge and practices among Chinese immigrants to the United States.

INTRODUCTION: Chinese immigrants to the United States experience high rates of liver cancer. Chronic carriage of hepatitis B virus (HBV) is the most common underlying cause of liver cancer among Chinese Americans. Our objective was to describe Chinese immigrants' hepatitis B knowledge, testing, and vaccination levels. METHODS: A community-based, in-person survey of Chinese men and women was conducted in Seattle during 2005. Our study sample included 395 individuals. RESULTS: Less than one-half (48%) of our study group indicated they had received a hepatitis B blood test, and about one-third (31%) indicated they had been vaccinated against hepatitis B. The proportions of respondents who knew HBV can be spread during childbirth, during sexual intercourse, and by sharing razors were 70%, 54%, and 55%, respectively. Less than one-quarter of the study group knew that HBV cannot be spread by eating food that was prepared by an infected person (23%) and by sharing eating utensils with an infected person (16%). DISCUSSION: Over 50% of our respondents did not recall being tested for HBV. Important knowledge deficits about routes of hepatitis B transmission were identified. Continued efforts should be made to develop and implement hepatitis B educational campaigns for Chinese immigrant communities.

Adult↗