Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Internet addiction (IA) has been drawing attention to mental health. However, few reports have been found on the related factors of at-risk IA among regular workers by a nationwide survey. The study aimed to evaluate the characteristics of at-risk IA and identify related factors among senior high school teachers in Japan. METHODS: This survey was a cross-sectional survey of high schools across Japan in 2017. There were 3189 teachers (2088 males and 1098 female) who participated in this survey. The questionnaire asked about their devices, both the time and the activities of using their internet, and sociodemographic factors. IA was measured by the internet addiction test (IAT) by which 40-79 points were classified as at-risk IA, and more as IA. We compared the related factors of at-risk IA and non-IA using descriptive analysis and multivariable regression analysis. RESULTS: The rates of IA and at-risk IA were 0.09% (n = 3) and 6.91% (n = 220), respectively. At-risk IA was positively associated with activities on the internet for gaming, entertainment, net-surfing, and younger ages. In addition, the at-risk IA group had a longer time spent on the internet than the non-IA group. CONCLUSIONS: Around 7% of high school teachers are at-risk IA in this survey, though they have regular work. Our results suggest that at-risk IA may be reinforced not only by the active internet use such as gaming, but also by purposeless behaviors, such as net-surfing. Managing time on the internet may support preventing at-risk IA among senior high school teachers.

DOI： 10.1002/npr2.12350

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

Rapid eating has been demonstrated to be associated with obesity and overweight. However, few studies have characterized the separate relationships of eating speed with visceral and subcutaneous fat mass or circulating adiponectin concentration. We hypothesized that rapid eating is associated with the larger visceral fat tissue (VFT) area and lower adiponectin concentration, but not with the subcutaneous fat tissue (SFT) area in men and women. We performed a cross-sectional study of 712 adults aged 20-86 years (528 men and 184 women; mean ± SD age 59.36 ± 13.61 years). The participants completed a self-reported questionnaire, and underwent anthropometric and laboratory measurements and computed tomographic imaging of the abdomen as a part of annual medical check-ups. Multivariate linear regression analyses revealed that rapid eating was associated with larger visceral (B = 24.74; 95% CI 8.87-40.61, p = 0.002) and subcutaneous fat areas (B = 31.31; 95% CI 12.23-50.38, p = 0.001), lower adiponectin concentration (B =  - 2.92; 95% CI - 4.39- - 1.46, p < 0.001), higher body mass index (BMI) (B = 2.13; 95% CI 1.02-3.25, p < 0.001), and larger waist circumference (B = 5.23; 95% CI 2.16-8.30, p < 0.001) in men, which is partially consistent with the hypothesis. In contrast, rapid eating was found to be associated only with BMI, and not with abdominal adipose area or adiponectin concentration in women, which is a result that is not consistent with the hypothesis. These results suggest that there is no difference in the association of rapid eating with VFT and SFT areas.

DOI： 10.1038/s41598-023-38623-7

PubMed

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Publishing type：Research paper (scientific journal)   Publisher：Japanese Society for Hygiene  

DOI： 10.1265/ehpm.23-00127

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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Authorship：Last author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1038/s41440-022-01059-z

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Other Link： https://www.nature.com/articles/s41440-022-01059-z

Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Excessive alcohol use is a leading cause of global morbidity and premature mortality. This study aimed to evaluate the effectiveness of two types of nurse-delivered interventions to reduce excessive alcohol consumption among screened participants using the alcohol use disorder identification test (AUDIT) in the workplace. METHODS: A randomized controlled trial involving AUDIT-positive employees of five Japan-based companies was conducted. Participants were randomized into the patient information leaflet (PIL), 15-minute brief advice and counseling, and five-minute brief advice groups. Outcomes (weekly alcohol consumption, drinking, and binge drinking frequency in the previous 30 days) were evaluated at 6 and 12 months. A total of 351 participants were randomly divided into three groups. RESULTS: The follow-up rates were 96.3% (n = 338) and 94.9% (n = 333) at 6 and 12 months, respectively. At six months, the weekly alcohol consumption significantly decreased in the brief advice and counseling group. The mean change in alcohol consumption was -38.1 g/week (-1.64 US fl.oz./week) in the 15-minute brief advice and counseling group, and the reduction significantly differed relative to the PIL group. However, a significant change in alcohol consumption was not observed in the five-minute brief advice group. Improvement in drinking and binge drinking frequency was observed in all three groups. CONCLUSIONS: The nurse-delivered 15-minute brief advice and counseling was effective in reducing alcohol consumption in a workplace setting. This evidence can contribute to facilitating the implementation of workplace screening and brief intervention, which plays a crucial role in preventing the burden of harmful alcohol use.

DOI： 10.1111/acer.14909

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Center for Open Science  

<p>Studies have demonstrated that addiction leads to blunted responses of cortisol and sympathetic nervous system (SNS) to acute stressors; however, limited studies have examined the neuroendocrine and SNS stress responses in Internet addiction (IA). To examine acute stress responses in IA, the current study recruited a total of 76 Japanese university students and staff members (51 females and 25 males, mean age = 22.4 years, SD = 4.7), and measured the salivary cortisol, salivary alpha-amylase (sAA), and blood pressure (BP) responses to an acute stressor under stress or a nonstress placebo conditions in IA and non-IA groups. The results revealed that patients with IA showed a blunted cortisol response to a stressor. In contrast, no differences were found in the sAA and BP responses between the IA and non-IA groups. These results suggest that IA may be characterized by blunted cortisol responses in acute stress settings.</p>

DOI： 10.31234/osf.io/qjav2

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Language：Japanese   Publisher：(公社)日本栄養・食糧学会  

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

This cross-sectional study aimed to clarify how cognitive biases and situational factors related to diagnostic errors among physicians. A self-reflection questionnaire survey on physicians’ most memorable diagnostic error cases was conducted at seven conferences: one each in Okayama, Hiroshima, Matsue, Izumo City, and Osaka, and two in Tokyo. Among the 147 recruited participants, 130 completed and returned the questionnaires. We recruited primary care physicians working in various specialty areas and settings (e.g., clinics and hospitals). Results indicated that the emergency department was the most common setting (47.7%), and the highest frequency of errors occurred during night-time work. An average of 3.08 cognitive biases was attributed to each error. The participants reported anchoring bias (60.0%), premature closure (58.5%), availability bias (46.2%), and hassle bias (33.1%), with the first three being most frequent. Further, multivariate logistic regression analysis for cognitive bias showed that emergency room care can easily induce cognitive bias (adjusted odds ratio 3.96, 95% CI 1.16−13.6, p-value = 0.028). Although limited to a certain extent by its sample collection, due to the sensitive nature of information regarding physicians’ diagnostic errors, this study nonetheless shows correlations with environmental factors (emergency room care situations) that induce cognitive biases which, in turn, cause diagnostic errors.

DOI： 10.3390/ijerph19084645

Scopus

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ  

<sec><title>Objectives</title>This study aimed to assess trends in the prevalence of alcohol use depending on smoking behaviours and that of smoking depending on drinking behaviours among Japanese adolescents.

</sec><sec><title>Design</title>This was a retrospective study using Japanese school-based nationwide surveys conducted between 1996 and 2017.

</sec><sec><title>Setting</title>Surveyed schools, both junior and senior high schools, considered representative of the entire Japanese population, were sampled randomly.

</sec><sec><title>Participants</title>We enrolled 11 584–64 152 students from 179 to 103 schools yearly. They completed a self-reported and anonymous questionnaire on smoking and drinking behaviour.

</sec><sec><title>Results</title>Since 1996, the prevalence of alcohol use and smoking among adolescents decreased in each survey (p&lt;0.01). The prevalence of alcohol use in the non-smokers group was 29.0% in 1996 and 4.0% in 2017, and in the smokers group, it was 73.3% in 1996 and 57.4% in 2017. The reduction rate (the difference in prevalence between 1996 and 2017 divided by the prevalence in 1996) was 0.86 in the non-smokers group and 0.22 in the smokers group. The prevalence of smoking in the non-drinkers group was 6.7% in 1996 and 0.7% in 2017, while that in the drinkers group was 32.5% in 1996 and 18.9% in 2017. The reduction rate was 0.90 in the non-drinkers group and 0.42 in the drinkers group. Therefore, downward trends differed among the groups. In a subanalysis of senior high school students, we divided students into three groups according to their intention to pursue further education. Between 1996 and 2017, there was a consistent difference in the prevalence of alcohol use and smoking among these groups.

</sec><sec><title>Conclusions</title>Alcohol use and smoking among Japanese adolescents seem to have reduced. However, certain groups showed poor improvements, and health risk behaviour disparity exists, which may widen further. We need to focus on high-risk groups and implement appropriate measures or interventions accordingly.

</sec>

DOI： 10.1136/bmjopen-2020-045063

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

<title>Abstract</title>
<sec>
<title>Study Objectives</title>
Sleep problems and problematic Internet use have important implications for adolescent health; however, there have been no large-scale surveys using comprehensive measures. We examined the association between Internet use duration and sleep problems among Japanese adolescents.


</sec>
<sec>
<title>Methods</title>
We used data from the Lifestyle Survey of Adolescents collected in 2012, 2014, and 2017. We calculated the change in sleep status (insomnia, sleep duration, bedtime, and sleep quality) and Internet usage (screen time and services such as Internet surfing, social media use, streaming such as YouTube, and online gaming). A binary logistic model was estimated for insomnia. Generalized ordered logit models were employed for the ordinal outcomes (sleep duration, bedtime, sleep quality, and multidimensional sleep health). Sampling weights were constructed based on participation rate on survey years and selection rates from population statistics.


</sec>
<sec>
<title>Results</title>
We analyzed data from 248 983 adolescents. Sleep status was unchanged; however, many adolescents used more Internet services and for longer durations. The odds ratio of Internet screen time for all sleep problems (insomnia, shorter sleep duration, later bedtime, and worse sleep quality) gradually declined. Longer Internet screen time (&amp;gt;5 hours) was strongly associated with all sleep problems. Internet services were also associated with sleep problems; particularly, social media use and online gaming were linked to later bedtimes.


</sec>
<sec>
<title>Conclusions</title>
Despite the decreased strength in the association between Internet usage and sleep problems, longer Internet time was strongly associated with sleep problems. Public health interventions should consider Internet use as an intervention target to improve adolescents’ health.


</sec>

DOI： 10.1093/sleep/zsab175

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

Purpose This study aimed to assess the success of the Japanese government's "Early to bed, early to rise, and don't forget your breakfast" (EB, ER, and DFB) health promotion program for adolescents, which has been ongoing since 2006. Methods We randomly selected 264 junior and senior high schools and conducted a survey of their habits related to EB, ER, and DFB. We defined EB, ER, and DFB as follows: bedtime before 10 p.m. (junior high school) or 11 p.m. (senior high school) and waking-up before 7 a.m., at which point the student should eat breakfast every day. Multivariate analysis was performed on the students' lifestyles, and school-related factors were set as independent variables. Results Data from 84,988 participants (31,474 from junior and 53,514 from senior high school) were analyzed. The effective response rates were 47.9% for junior high schools and 53.7% for senior high schools (overall rate: 51.4%). The data showed that 70-80% of students complied with ER and DFB, while less than 10% complied with EB. For almost all adolescents, "using the Internet >= 2 h/day" was the most negative factor influencing EB, ER, and DFB, and "family rules for using the Internet" was the most positive factor. Conclusions For Japanese adolescents, it is especially important to promote the achievement of EB, and limits on the amount of time and rules for using the Internet were significantly related factors. Further study is required to clarify these causal relationships for an improved implementation of EB, ER, and DFB.

DOI： 10.1007/s41105-021-00321-0

Web of Science

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

<title>Abstract</title>
<sec>
<title>Study Objectives</title>
To determine the prevalence of and risk-factors for difficulty waking up for school among adolescents.


</sec>
<sec>
<title>Methods</title>
We used a self-administered questionnaire (140 junior high schools [JHSs]; 124 senior high schools [SHSs]) selected randomly in 2012 from throughout Japan.


</sec>
<sec>
<title>Results</title>
Total response rate: 60.7%. Data from 38 494 JHS and 61 556 SHS students were analyzed. The prevalence of at least one instance of school tardiness/absence due to difficulty waking up over a 30-day period was 10.9 (95% confidence-interval:10.5–11.3)%/2.9(2.7–3.1)% for JHS-boys and 7.7(7.3–8.1)%/2.0(1.8–2.2)% for JHS-girls. The prevalence was 15.5(15.1–15.9)%/5.6(5.3–5.9)% for SHS-boys and 14.4(14.0–14.8)%/5.9(5.6–6.2)% for SHS-girls. We used ordinal regression to identify the risk factors associated with the experience of school tardiness/absence. Factors significantly associated with school tardiness in all four groups (JHS boys/girls, SHS boys/girls) were “no-participation-in-club-activities,” “early-morning-awakening,” “feeling bad throughout a morning,” “drinking,” and “smoking.” Among associated factors, the highest odds ratio was found for monthly smoking-days (none vs. at least one-day or more) for JHS-girls at 5.30(3.57–7.85). Factors significantly associated with school absence in all four groups were “no wishing to go to university,” “no participation in club activities,” “disorders of initiating and maintaining sleep,” “long internet use,” “drinking,” “smoking,” “poor-mental-health” and “feeling bad throughout a morning.” Among associated factors, the highest odds ratio was found for monthly smoking-days (none vs. at least one-day or more) for JHS-girls at 4.60(3.45–6.15).


</sec>
<sec>
<title>Conclusions</title>
These results suggest that the risk factors for difficulty waking up among adolescents are sleep status, lifestyle, and mental health, which can indicate the presence of an underlying disease.


</sec>

DOI： 10.1093/sleep/zsab157

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.alcohol.2020.11.005

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Cureus, Inc.  

Recently, the "Choosing Wisely" initiative has gained traction and high-value care has garnered attention. However, the actual situation of high-value care is different between developed and developing countries. To elucidate this, we highlight the differences between the high-value care provided by healthcare systems in Japan and Myanmar, as representations of developed and developing countries, respectively. Despite the total numbers of magnetic resonance imaging (MRI) equipment in Japan being 400 times higher than in Myanmar, and gross domestic product per capita being 32 times higher in Japan, the individual costs (out of pocket expenditures) per MRI scan are the same (USD 60). However, the total cost per MRI scan is different, implying that differing healthcare costs indicate the existence of over- and under-diagnosis problems among different countries. This study suggests that detailed patient histories and physical examinations are important for selecting relevant diagnostic imaging and reducing unnecessary imaging.

DOI： 10.7759/cureus.14342

Web of Science

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

Background: Sleep problems in adolescence, such as insomnia and short sleep duration, are associated with physical and mental health problems. However, little is known about the recent trends in sleep problems among adolescents. Therefore, this study examined trends in sleep problems among Japanese adolescents. Methods: Using data from the Lifestyle Survey of Adolescents collected in 2004 (n = 102,451), 2008 (n = 95,680), 2010 (n = 98,867), 2012 (n = 101,134), 2014 (n = 85,931), and 2017 (n = 64,417), we calculated the trends of insomnia, shorter sleep duration, late bedtimes, and poor sleep quality. Multivariable logistic regression analysis models were used to examine the association of each sleep problem and survey years. Findings: We analyzed data from 545,285 Japanese adolescents. Results indicated that, since 2004, the odds ratio for insomnia have decreased (Adjusted odds ratio [AOR] 0•85, 95% CI 0•82-0•87), as have the odds ratio for poor sleep quality (AOR 0•92, 95% CI 0•88-0•95). However, the odds ratio for shorter sleep duration (AOR 1•13, 95% CI 1•10-1•17) and late bedtimes tended to increase (AOR 1•06, 95% CI 1•03-1•08) during this period. Interpretation: The prevalence of insomnia symptoms and poor sleep quality among adolescents decreased from 2004 to 2017. However, there were increasing trends toward shorter sleep duration and late bedtimes. These changes are both relieving and concerning. Teachers, parents, and health professionals should consider educating adolescents regarding sleep hygiene, adjusting schedules of extracurricular activities, and enhancing time management to improve their sleep quantity. Funding: This study received funding from Japan's Ministry of Health, Labour and Welfare.

DOI： 10.1016/j.lanwpc.2021.100107

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiological Association  

DOI： 10.2188/jea.je20200598

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本職業・災害医学会  

【目的】トラックドライバーの健康支援のため、運行管理者によるドライバーへの健康支援に繋がる関わりや健康支援上の困難感の調査を行った。【対象・方法】運送業の事業主・運行管理者向けのセミナー参加者へ無記名自記式調査票を配布・回収(482人、回収率62.2%)した。分析対象はそのうちの現任運行管理者163人を選んだ。調査内容は、(1)基本属性(11項目)(2)会社の方針や体制(8項目)(3)マニュアルや相談窓口の活用(4項目)(4)健康支援に繋がる関わりの程度(16項目)(5)健康支援上の困難感(9項目)だった。分析では、まず(4)(5)の項目毎の平均得点を算出した。次に従業員規模と健康診断等担当の兼務の有無等でKruskal-Wallis、Mann-WhitneyのU検定(P<.05)で項目別回答分布の違いを確認した。また従業員規模50人未満かつ、産業保健スタッフなし群を抽出し健康相談窓口の活用度と困難感の関連を確認した。【結果】"健康支援に繋がる関わり"はいずれも平均点が高めで、「日頃から雑談をし、ねぎらいの言葉をかけるなど運転者と様々なコミュニケーションをとっている」(3.4±0.5)が最も高値だった。"健康支援上の困難感"もいずれも平均得点が高めで、最も高値は「運転者の体調確認や健康支援を、極め細やかに行う時間や人手が不足している」(3.2±0.9)だった。健診等の担当の兼務あり群では"健康支援に繋がる関わり"で有意に高い項目が6項目あった。従業員規模50人未満かつ、産業保健スタッフなし群では公的健康相談窓口を3割が「知らない」と答え、「知らない」群では人手不足とメンタルヘルスに関する項目で困難感が有意に高かった。【結論】運行管理者は健康支援に繋がる関わりを多くもち、ドライバーの健康支援のキーパーソンといえる。また健診等の担当の兼務者は、非兼務者より健康支援がやり易いことも示唆された。今後さらなる専門家や社外資源の活用にむけ教育・支援が重要と考えられた。(著者抄録)

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

OBJECTIVES: Problematic internet use (PIU) has been suggested in relation to psychological symptoms among schoolteachers, but the relationship with physical symptoms remains unclear. We examined whether PIU or longer Internet usage time is associated with neck pain in schoolteachers. METHODS: We conducted a cross-sectional study among 2582 teachers aged 20 years or older (35.6% women) in Shimane and Tottori, Japan in 2018. Neck pain was defined as ≥5 points on the Neck Disability Index. The Compulsive Internet Use Scale (CIUS) was used to assess PIU. Internet usage time on weekdays and weekends was divided into five groups: 0, 1-29, 30-59, 60-119, and ≥120 min/day. Logistic regression analysis was conducted to examine the association of the CIUS score and Internet usage time on weekdays or weekends with neck pain, adjusting for sex, age, position at school, insomnia, and psychological distress. RESULTS: We observed 800 (31.0%) teachers with neck pain. The median (interquartile range) of their CIUS scores was 7 (2, 14). A higher CIUS score was independently associated with a higher prevalence of neck pain (odds ratio of 4th vs. 1st quartiles, 1.41; 95% confidence interval, 1.06-1.87; trend P = .006). Compared with non-Internet users, Internet users on weekdays had almost double the odds of neck pain although the difference did not reach the customary level for designating statistical significance. CONCLUSIONS: In conclusion, teachers with higher scores in CIUS were associated with a higher prevalence of neck pain in Japan, suggesting adults with PIU being at risk of physical disorders.

DOI： 10.1002/1348-9585.12298

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/1348-9585.12298

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Tottori University Faculty of Medicine  

DOI： 10.33160/yam.2021.11.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Telomere length (TL) influences the development of lifestyle-related diseases, and neonatal TL may influence their prevalence. Various factors have been reported to affect neonatal TL. Although the fetus is exposed to multiple conditions in utero, the main factors affecting the shortening of neonatal TL are still not known. In this study, we sought to identify factors that influence fetal TL. A total of 578 mother-newborn pairs were included for TL analysis. TL was measured in genomic DNA extracted from cord blood samples using quantitative PCR. The clinical factors examined at enrollment included the following intrauterine environmental factors: maternal age, assisted reproductive technology (ART) used, body mass index (BMI), gestational diabetes mellitus (GDM), maternal stress, smoking, alcohol consumption, preterm delivery, small-for-gestational-age, neonatal sex, and placental weight. Univariate and multivariate regression analyses were used to verify the relationship between neonatal TL and these clinical factors. The median neonatal TL to single-copy gene ratio was 1.0. Pregnancy with ART was among the 11 factors associated with shorter neonatal TL. From multiple regression analysis, we determined that neonatal TL was significantly shorter for pregnancies in the ART group than in the other groups. We conclude that pregnancy with ART is associated with shorter neonatal TL.

DOI： 10.3390/ijms21249688

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)  

Unhealthy dietary behaviors in adolescence are an important public health problem. Gender differences in dietary behaviors have already appeared during adolescence. However, few studies have assessed a variety of adolescent dietary behaviors in Japan. We aimed to clarify gender differences in unhealthy dietary behaviors among Japanese adolescents. The participants consisted of 84,988 participants from seventh to 12th grades. Unhealthy dietary behaviors were defined according to the National Health and Nutrition Survey. Multivariable logistic regression was used to analyze a nationally representative sample of Japanese adolescents from the 2014 to 2015 Lifestyle Survey. The effective response rate was 51.4%. The prevalence of unhealthy dietary behaviors (skipping breakfast, snacking, eating out, skipping meals, eating alone at dinner, and subjectively poor diet quality) among boys and girls was 14.2% versus 12.4%, 19.6% versus 14.1%, 10.6% versus 7.0%, 7.9% versus 5.6%, 13.3% versus 12.1%, and 12.3% versus 15.8%, respectively. Compared with boys, girls were more negatively associated with skipping breakfast [OR = 0.76 (95% CI 0.73-0.79)], snacking [OR = 0.67 (95% CI 0.65-0.70)], eating out [OR = 0.62 (95% CI 0.59-0.66)], skipping meals [OR = 0.61 (95% CI 0.58-0.65)], and eating alone at dinner [OR = 0.79 (95% CI 0.76-0.83)]. However, girls were more positively associated with subjectively poor diet quality [OR = 1.19 (95% CI 1.14.1.24)]. The findings suggest that gender differences existed in dietary behaviors. Gender differences in dietary behaviors suggest opportunities for tailoring interventions related to dietary education in schools.

DOI： 10.1016/j.pmedr.2020.101203

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: The prognostic implication of isolated systolic hypertension (ISH), defined as SBP at least 140 mmHg and DBP less than 90 mmHg, among young-to-middle-aged adults remains controversial. We examined the association of ISH with cardiovascular disease (CVD) risk in adults aged 30-49 years. METHODS: In a prospective cohort of representative Japanese general populations from the NIPPON DATA80 (1980-2009), we studied 4776 participants (mean age, 39.4 years; 55.4% women) without clinical CVD or antihypertensive medication. Participants were classified as follows: normal blood pressure (BP) (SBP/DBP, <120/<80 mmHg), high-normal BP (120-129/<80 mmHg), elevated BP (130-139/80-89 mmHg), ISH, isolated diastolic hypertension (IDH) (<140/≥90 mmHg), and systolic--diastolic hypertension (SDH) (≥140/≥90 mmHg). RESULTS: ISH was observed in 389 (8.1%) participants. During the 29-year follow-up, 115 participants died of CVD, 28 of coronary heart disease, and 49 of stroke. Cox proportional hazards models adjusted for demographics and CVD risk factors showed that participants with ISH had higher risk of CVD mortality than those with normal BP [hazard ratio (confidence interval), 4.10 (1.87-9.03)]. The magnitude of CVD mortality risk related to ISH was comparable with that related to IDH [3.38 (1.31-8.72)] and not as great as that related to SDH [5.41 (2.63-11.14)]. We found significant associations of ISH with coronary and stroke mortality. The association of ISH with CVD mortality was consistent across men and women and those aged 30-39 and 40-49 years. CONCLUSION: ISH among young-to-middle-aged Japanese adults was independently associated with higher risk of CVD mortality later in life.

DOI： 10.1097/HJH.0000000000002533

PubMed

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Evidence regarding the effect of psychological factors and evacuation on cardiovascular disease occurrence after large-scale disasters is limited. This prospective study followed up a total of 37,810 Japanese men and women aged 30–89 years from the Fukushima Prefecture with no history of stroke or heart disease at baseline (2012), until 2017. This period included 3000 cardiovascular events recorded through questionnaires and death certificates. The participants’ psychological distress, trauma reaction, and evacuation status were defined, and divided into four groups based on combinations of psychological factors and evacuation status. We calculated the hazard ratios and 95% confidence intervals for only psychological, only evacuation, or both of them compared with neither using Cox proportional hazard models. Psychological factors along with evacuation resulted in approximately 5% to 25% higher magnitude of stroke and heart disease risk than psychological factors only among men. Compared to neither, the multivariable hazard ratios of those with both psychological distress and evacuation were 1.75 for stroke and 1.49 for heart disease, and those of both trauma reaction and evacuation were 2.01 and 1.57, respectively, among men. Evacuation combined with psychological factors increased the risk of stroke and heart disease risks especially in men after the Great East Japan Earthquake.

DOI： 10.3390/ijerph17217832

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: From among the global public health concerns, smoking remains one of the most crucial challenges. Especially for adolescents, the increase in the use of electronic cigarettes is controversial, as its use may lead to established smoking. In Japan, where a unique tobacco regulation system exists, the heat-not-burn tobacco market has been growing. However, the prevalence and association of combustible cigarettes and new tobacco-related products have not yet been closely investigated among Japanese adolescents. This study aimed to clarify the prevalence of smoking among adolescents, including new types of tobacco-related products, and to compare the characteristics of their users. METHODS: The 2017 Lifestyle Survey of Adolescents is a nationally-representative survey collected in Japan. From the national school directory, 98 junior high schools and 86 high schools were randomly sampled throughout Japan. The students completed an anonymous questionnaire at school. We calculated the prevalence of use for each type of tobacco product. Then, the use of a combination of products and the characteristics of different types of products were examined. RESULTS: In total, 64,152 students from 48 junior high schools and 55 high schools were included the analysis (school response rate = 56%, Mage = 15.7 years, 53.9% boys). The age-adjusted rate of ever (current) use of electronic cigarettes was 2.1% (0.7%) in junior high school and 3.5% (1.0%) in high school; that of combustible cigarettes was 2.6% (0.6%) in junior high school and 5.1% (1.5%) in high school. The rate of heat-not-burn tobacco use was lower relative to other products: 1.1% (0.5%) in junior high school and 2.2% (0.9%) in high school. An examination of the combined use of the three products identified a high number of dual users. Comparisons between different types of users indicated different backgrounds for combustible cigarette users and new product users. CONCLUSIONS: The prevalence of new tobacco-alternative products is growing in popularity among Japanese adolescents. Dual use is common, and many adolescents use new products only. Moreover, e-cigarettes might attract a broader range of groups to smoking. Continuous monitoring and research are needed to investigate their influence as a possible gateway to tobacco smoking.

DOI： 10.1186/s12889-020-08916-x

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Low sleep quality in adolescents is an important public health concern, as it relates to both their current and future physical and mental health. Furthermore, subjective happiness is also often regarded as a major life goal. Although Japan is an economically powerful country, the reported levels of subjective happiness among Japanese adolescents is low. Thus, this study aims to examine the relationship between subjective happiness and sleep problems in Japanese adolescents. METHODS: We conducted a nationally representative cross-sectional study of adolescents enrolled in junior and senior high schools in Japan. We used a questionnaire to determine the prevalence of sleep problems (eg, insomnia, short sleep duration (SSD) and poor sleep quality) and to evaluate the participants' reported levels of subjective happiness. Multivariable logistic regression analyses were used to examine the associations between subjective happiness and sleep problems. Adjusted variables were basic demographic characteristics (eg, gender and school grade), lifestyle behaviors, and mental health status. RESULTS: Data from 64,329 students were analyzed (age range 12-18 years, mean age 15.7 years, 53.9% male). The results indicated that reported levels of subjective happiness were strongly associated with the prevalence of sleep problems. Linear relationships can be observed between sleep problems and subjective happiness scores. The multivariable logistic regression analysis showed that dose-response association of subjective happiness score was observed with all three sleep problems. CONCLUSIONS: Due to these findings, we recommend that policy makers and school officials educate adolescents on the importance of both subjective happiness and good sleep hygiene.

DOI： 10.1016/j.sleep.2020.01.008

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Subjective happiness is often regarded as a major life goal. Although Japan is an economically powerful country, the level of subjective well-being reported among Japanese adolescents is lower than in other countries. We aimed to investigate the lifestyle factors related to unhappiness in Japanese adolescents. We collected data through the 2017-2018 Lifestyle Survey of Adolescents, a nationally representative cross-sectional study enrolled in randomly selected junior and senior high schools throughout Japan. We assessed the prevalence of subjective unhappiness in junior and senior high school students according to school life factors and daily lifestyle habits. A multivariable logistic regression analysis was used to examine the associations between these factors and unhappiness. A total of 64,329 students were included in the sample (mean age 15.7 years, 53.9% boys). The average prevalence of unhappiness was 10.2%. The logistic regression analyses indicated that unhappiness was strongly associated with being male and with engaging in unhealthy lifestyle behaviors such as not having breakfast, poor sleep quality, and some problematic Internet usage. Although the prevalence of unhappiness was significantly higher among current smokers and alcohol drinkers, these behaviors were not associated with unhappiness in the multivariable logistic regression analysis. Unhappiness among Japanese adolescents appears to be strongly related to how they spend their daily life. We therefore consider it desirable for school officials to educate students on the importance of happiness and lifestyle factors conducive to happiness.

DOI： 10.1371/journal.pone.0235252

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BACKGROUND: Diagnostic errors are prevalent and associated with increased economic burden; however, little is known about their characteristics at the national level in Japan. This study aimed to investigate clinical outcomes and indemnity payment in cases of diagnostic errors using Japan's largest database of national claims. METHODS: We analyzed characteristics of diagnostic error cases closed between 1961 and 2017, accessed through the national Japanese malpractice claims database. We compared diagnostic error-related claims (DERC) with non-diagnostic error-related claims (non-DERC) in terms of indemnity, clinical outcomes, and factors underlying physicians' diagnostic errors. RESULTS: All 1,802 malpractice claims were included in the analysis. The median patient age was 33 years (interquartile range = 10-54), and 54.2% were men. Deaths were the most common outcome of claims (939/1747; 53.8%). In total, 709 (39.3%, 95% CI: 37.0%-41.6%) DERC cases were observed. The adjusted total billing amount, acceptance rate, adjusted median claims payments, and proportion of deaths were significantly higher in DERC than non-DERC cases. Departments of internal medicine and surgery were 1.42 and 1.55 times more likely, respectively, to have DERC cases than others. Claims involving the emergency room (adjusted odds ratio [OR] = 5.88) and outpatient office (adjusted OR = 2.87) were more likely to be DERC than other cases. The initial diagnoses most likely to lead to diagnostic error were upper respiratory tract infection, non-bleeding digestive tract disease, and "no abnormality." CONCLUSIONS: Cases of diagnostic errors produced severe patient outcomes and were associated with high indemnity. These cases were frequently noted in general exam and emergency rooms as well as internal medicine and surgery departments and were initially considered to be common, mild diseases.

DOI： 10.1371/journal.pone.0237145

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(NPO)日本高血圧学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Background and purpose: The association between an increased supraventricular ectopic beat (SVEB) and subclinical cerebrovascular disease remains unclear. Given the emerging concept that an increased SVEB is a marker of atrial cardiomyopathy or atherosclerosis burden, we sought to determine whether excessive supraventricular ectopic activity (ESVEA) is associated with a higher burden of subclinical cerebrovascular disease in the middle-aged to older cohort with neither apparent stroke nor atrial fibrillation. Methods: We conducted a cross-sectional population-based study of 462 men (mean age, 68.1 years) who underwent 24-h Holter electrocardiography and brain magnetic resonance imaging. ESVEA was defined as the presence of >10 SVEBs/h. Subclinical cerebrovascular diseases were defined as silent brain infarct (SBI), white matter hyperintensity (WMH) and intracranial atherosclerotic stenosis (ICAS). The association of ESVEA with the presence of subclinical cerebrovascular diseases was adjusted for potential confounding covariates. Results: A total of 88 (19.0%) participants had ESVEA and 81 (17.5%), 91 (19.7%) and 109 (23.6%) had SBI, WMH and ICAS, respectively. In multivariable-adjusted Poisson regression with robust error variance, ESVEA was associated with the presence of WMH (relative risk, 1.58; 95% confidence interval, 1.06–2.36) and ICAS (relative risk, 1.49; 95% confidence interval, 1.02–2.18), but not with that of SBI (relative risk, 1.32; 95% confidence interval, 0.86–2.01). These associations were consistent when the graded distributions of subclinical cerebrovascular diseases were applied as outcomes in ordinal logistic regression. Conclusions: The ESVEA was independently associated with higher burdens of WMH and ICAS. This suggests that increased SVEBs might improve risk stratification of individuals at high risk of subclinical cerebrovascular disease and consequently apparent ischaemic stroke.

DOI： 10.1111/ene.13970

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Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ene.13970

Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (bulletin of university, research institution)  

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (bulletin of university, research institution)   Publisher：島根大学医学部  

本研究の目的は、中山間地域在住の家族介護者の介護負担感とソーシャルサポート(social support:以下SS)との関連、および要介護者の問題行動の有無別にこれらの関連を明らかにすることを目的とした。島根県の中山間地域在住の家族介護者246名を対象に、質問紙調査法にて研究を行った。回答不備を除く134名の結果を分析対象として介護負担感の高、低群について二群間比較を行った。結果、介護負担感高群は低群に比べ、SSの合計得点、家族内情緒的・手段的サポート得点、家族外手段的サポート得点が有意に低かった。要介護者が問題行動を有する場合は、介護負担感高群は低群に比べ、SSの合計得点、家族内情緒的・手段的サポート得点が有意に低かった。家族介護者以外の家族から提供されるSSを促進するための具体的な支援策が、介護負担感の軽減に有効であると考えられた。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J04309&link_issn=&doc_id=20190416590004&doc_link_id=%2Fdl0bulle%2F2018%2F004100%2F004%2F0023-0028%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdl0bulle%2F2018%2F004100%2F004%2F0023-0028%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: School teachers have a possibility toward at-risk Internet addiction (IA) due to increased opportunities to use the Internet, along with the spread of the Internet in recent years. Burnout syndrome (BOS) is found to be one of the symptoms related to unhealthy mental health, especially among teachers. This study aims to research the relationship between at-risk IA and the Internet usage or BOS by conducting a nationwide cross-sectional survey and examining the factors associated with IA. METHOD: This study was a cross-sectional survey by anonymous questionnaire. This survey was a random sampling survey of junior high schools across Japan in 2016. The participants were 1696 teachers at 73 schools (response rate in teachers 51.0%). We asked participants for details of their backgrounds, Internet usage, the Internet Addiction Test (IAT) by Young, and the Japanese Burnout Scale (JBS). We divided the participants into either the at-risk IA group (IAT score ≧ 40, n = 96) or the non-IA group (IAT score < 40, n = 1600). To compare the difference between at-risk IA and non-IA, we used nonparametric tests and t test according to variables. To analyze the relationship between the IAT score and the scores of three factors of the JBS (emotional exhaustion, depersonalization, and personal accomplishment), we used both ANOVA and ANCOVA, adjusted by relevant confounding factors. To clarify the contribution of each independent variable to IAT scores, we used multiple logistic regression analysis. RESULTS: In our study, at-risk IA was associated with using the internet many hours privately, being on the Internet both on weekdays and weekends, playing games, and surfing the Internet. In the relationship between IAT score and BOS factor score, a higher score for "depersonalization" had a positive relationship with at-risk IA, and the highest quartile for "decline of personal accomplishment" had a lower odds ratio with at-risk IA by multiple logistic regression analysis. CONCLUSION: We clarified there is a significant relationship between at-risk IA and BOS among junior high school teachers in a nationwide survey. Our results suggest that finding depersonalization at the early stage may lead to the prevention of at-risk IA among teachers. Those who are at-risk of IA may feel personal accomplishment through use of the Internet.

DOI： 10.1186/s12199-018-0759-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

PurposeDietary behaviors and sleep are important lifestyle factors to protect adolescent health. However, little is known about how dietary behaviors are related to sleep disturbances. The purpose of this study was to conduct a large-scale survey among Japanese adolescents to verify the association between unhealthy dietary behaviors and sleep disturbances.MethodsThis study included 65,688 and 99,581 students enrolled in 140 and 120 randomly selected junior and senior high schools, respectively. A total of 85,931 self-administered questionnaires were collected from 79 junior and 77 senior high schools from 2014 to 2015. The survey included questions on sleep patterns, dietary behaviors, alcohol consumption, and smoking, as well as questions on mental health. For dietary behaviors, we adopted the items on meal habits in the National Health and Nutrition Survey including, the frequency of eating breakfast, the frequency of family meals, and subjective diet quality. We performed a multivariate analysis on the relationship between the dietary behaviors and sleep disturbance.ResultsData from 84,988 questionnaires were analyzed. Boys and girls with less healthy dietary behaviors had a significantly higher prevalence for each sleep disturbance. Subjective sleep quality and insomnia were significantly associated with breakfast frequency, family meal frequency, and diet quality. Short sleep duration was significantly associated with breakfast frequency and family meal frequency, but not with subjective diet quality.ConclusionsOur study suggested that sleep and dietary behaviors affect one another. Those involved in public health education should encourage adolescents to establish healthy sleep patterns as well as healthy dietary behaviors.

DOI： 10.1007/s41105-018-0193-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

In 2018, a new training program for primary care physicians was launched in Japan. As physicians responsible for the training of new primary care physicians, we have faced many problems, particularly in rural areas. The influence of this new program on primary care physicians in rural areas of Japan has not been sufficiently investigated. The aim of this research was to improve training for primary care physicians in Japan by examining training programs in Sweden, where the population challenges are similar to those seen in Japan. In this paper, we will express our opinions and describe the differences in the primary care fostering systems and clinical research training for generalist in Japan and Sweden.

DOI： 10.1002/jgf2.211

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Previous large-scale studies suggest that internet gaming disorder (IGD) among children and adolescents has become an important public concern. Minors are known to be particularly susceptible to problematic internet gaming use owing to age-related underdevelopment of cognitive control. It has been shown that precursors of addictions appear during adolescence; therefore, prevention efforts must be established targeting minors who have their first experience with addictive substances and behaviors during pubescence. Since the DSM-5 classification of IGD in 2013, studies on IGD have drastically increased in number. Thus, we performed an updated review of studies of IGD in children and adolescents to assess the clinical implications of IGD. The search included all publication years, using PubMed, MEDLINE, and PsycINFO. Across studies, the presence of IGD had a negative effect on sleep and schoolwork in minors. Additionally, family factors, including the quality of parent-child relationships, were important social factors in minors with IGD. Brain imaging studies indicate that impaired cognitive control in minors with IGD is associated with abnormal function in the prefrontal cortex and striatum. Persistent pathological online game use from childhood may aggravate abnormal brain function; therefore, preventive care and early intervention are increasingly important. Although extant research supports the effectiveness of cognitive behavioral therapy for minors with IGD, effective psychological intervention for minors with IGD is an urgent issue that requires further research. This review, which presents updated findings of IGD in minors, is expected to contribute to the development of future research and be useful in clinical practice in the field of child and adolescent psychiatry.

DOI： 10.1186/s13030-019-0144-5

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Hazardous drinking (HD) and heavy episodic drinking (HED) constitute different types of alcohol-related harm. The socioeconomic status (SES) background of various alcohol consumption behaviors is not clear. The purpose of this study was to clarify existing SES differences between HD and HED. METHODS: The 2013 national survey regarding alcohol use among Japanese adults was utilized. The results from 1193 men and 1503 women aged 20-64 years were included in the analysis. Education attainment, household income, marital status, working status, and occupation were adopted as SES determinants. Binomial logistic regression analysis was conducted to estimate the odds ratios (ORs) of HD and HED for each SES group. RESULTS: ORs (95% confidence intervals) of HD were higher among persons with less education among both men [1.61 (1.18-2.20)] and women [1.78 (1.19-2.67)]. The OR of HED in men was significantly higher among those who belonged to high household income, were married, and managers or professionals. The OR of HED among women was higher in persons who were employed, as compared with those who engaged in housework. There were no correlations between HED and educational background. CONCLUSIONS: This study showed that in Japan, a lower educational background for both men and women was associated with a higher risk for HD, while higher current SES for men and working women were associated with a higher risk for HED. It is necessary to recognize the SES differences between HD and HED to achieve a policy to reduce alcohol-related harm.

DOI： 10.1016/j.drugalcdep.2018.08.015

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MARY ANN LIEBERT, INC  

Because schoolteachers are subject to suffer from mental health problems, this study aimed to examine the relationship between problematic Internet use (PIU) and psychological distress, insomnia, and alcoholism among schoolteachers. The cross-sectional study surveyed junior and senior high school teachers in Shimane prefecture, a rural area in Japan. A total of 2,663 junior and senior high school teachers (1,702 men and 961 women) completed the self-rated questionnaire measuring PIU, psychological distress, insomnia, and alcoholism. The results of hierarchical multiple regression analyses showed that psychological distress, insomnia, and alcoholism were associated with PIU among schoolteachers. The results indicate that schoolteachers with more severe psychological distress, insomnia, or alcoholism, regardless of gender, would use the Internet in a more problematic way. The study suggests that PIU could be an important condition related to multiple health problems in schoolteachers.

DOI： 10.1089/cyber.2018.0233

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: This study investigated the association between secondhand-smoke (SHS) exposure and sleep disturbance symptoms. METHODS: This study was a cross-sectional survey of junior and senior high school students throughout Japan. A total of 85,931 adolescents responded, and 84,988 questionnaires were included in the analysis. RESULTS: Adolescents who had never smoked accounted for 88.0% of respondents; among that group 39.1% reported having been exposed to SHS over the previous week. The results of multiple logistic regression analyses indicated that the adjusted odds ratios for insomnia symptoms such as difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) and early morning awakening (EMA), as well as sleep disturbance symptoms such as subjectively insufficient sleep and short sleep duration (<6 h), tended to be higher both among never-smoking adolescents with SHS exposure and among smoking adolescents, as compared with never-smoking adolescents without SHS exposure. When adolescents with one or more of DIS, DMS, and EMA were defined as having insomnia, the adjusted odds ratio for insomnia was highest for adolescents who smoked, followed in descending order by those exposed to SHS both inside and outside the home, those exposed to SHS only inside the home, those exposed to SHS only outside the home, and never-smoking adolescents without SHS exposure (p < 0.001). CONCLUSIONS: The present study has revealed that SHS exposure is associated with sleep disturbance. Thus, in addition to smoking cessation programs, it is also necessary to endorse measures to protect adolescents from SHS exposure in order to promote good sleep in this population.

DOI： 10.1016/j.sleep.2018.04.014

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本循環器病予防学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The prevalence of Internet addiction (IA) among employed adults has not been reported using a large sample. To clarify the actual status of addictive Internet use among employed adults, this study aimed to evaluate the prevalence and the risk factors of IA and at-risk IA among employed adults in Japan. METHODS: This cross-sectional study surveyed all junior and senior high school personnel in Shimane Prefecture, a rural area in Japan. Eligible participants included 3,211 junior and senior high school personnel (1,259 men and 1,952 women). Participants completed a questionnaire on their activities and factors related to Internet use. RESULTS: The prevalence of IA and at-risk IA was 0.03% and 4.82%, respectively. Furthermore, game playing was shown to be the Internet activity most closely associated with at-risk IA. CONCLUSIONS: This study showed that around 5% of school personnel in a rural area in Japan are at risk for developing addiction to the Internet and that using the Internet for game playing is related to at-risk IA. Our results suggest that employed adults should be instructed to use the Internet properly.

DOI： 10.2188/jea.JE20160185

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Language：English   Publishing type：Research paper (scientific journal)  

Previous studies demonstrated independent contributions of plasma free amino acids (PFAAs) and high uric acid (UA) concentrations to increased risks of lifestyle-related diseases (LSRDs), but the important associations between these factors and LSRDs remain unknown. We quantified PFAAs and UA amongst Japanese subjects without LSRDs (no-LSRD, n = 2805), and with diabetes mellitus (DM, n = 415), dyslipidemia (n = 3207), hypertension (n = 2736) and metabolic syndrome (MetS, n = 717). The concentrations of most amino acids differed significantly between the subjects with and without hyperuricemia (HU) and also between the no-LSRD and LSRD groups (p < 0.05 to 0.001). After adjustment, the logistic regression analyses revealed that lysine in DM, alanine, proline and tyrosine in dyslipidemia, histidine, lysine and ornithine in hypertension, and lysine and tyrosine in MetS demonstrated significant positive associations with HU among the patients with LSRDs only (p < 0.05 to 0.005). By contrast, arginine, asparagine and threonine showed significant inverse associations with HU in the no-LSRD group only (p < 0.05 to 0.01). For the first time, we provide evidence for distinct patterns of association between PFAAs and HU in LSRDs, and postulate the possibility of interplay between PFAAs and UA in their pathophysiology.

DOI： 10.1038/s41598-017-17710-6

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.4236/health.2017.99095

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Objective: Google+ is one of the most actively used Social Networking Sites in the world. The aim of our study is to characterize the Google+ communities related to diabetes and identify the factors associated with the activity level of these communities. Methods: We conducted a systematic search for diabetes-related Google+ communities. We categorized the principal objective of eligible communities into six themes: (1) awareness creation, (2) providing support and sharing experience, (3) product or service promotion, (4) diet-related topics, (5) exercise-related topics, and (6) others. The themes for the posts were: (1) asking for information, (2) providing information, (3) expressing emotion, and (4) advertisement. Results: We included 145 Google+ communities and 378 posts for analysis. Majority (80.0%) of the communities were focused on "General Diabetics", 11.8% were focused on "Type 1 diabetes", 6.2% were focused on "Type 2 diabetes", and 2.1% were focused on "Gestational diabetes". Majority of the communities (35.2%) had the principal objective "Provide support and share experience". Regarding the user-generated posts, 29.6% posts had at least one "+" ("+" is similar to "like" in Facebook), 17.7% posts had comments, and 89.2% posts had external links. Majority of the posts (69.6%) were focused on "General diabetes", 16.9% were focused on "Type 1 diabetes", 12.4% were focused on "Type 2 diabetes" and 1.15 were focused on "gestational diabetes". The top two themes of the posts were "Providing information" (72.8%) and "Advertisement" (31.5%). Conclusion: Our study revealed that major activity of diabetes-related Google+ communities was related to providing support and information. However, the accuracy and effectiveness of the information in the communities need to be scrutinized further from clinical perspective.

DOI： 10.1007/s13340-017-0311-5

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Nicotine concentration in hair is a useful marker of tobacco exposure. Detection of nicotine in the hair of non-smokers indicates passive smoking. Accurate measurement of nicotine among active and passive smokers can help in smoking cessation programs or programs designed to prevent secondhand smoke exposure. OBJECTIVE: To establish, using high-performance liquid chromatography-ultraviolet detection (HPLC/UV), a hair nicotine cut-off value to distinguish active from passive smokers. METHODS: Hair samples were collected from randomly chosen Japanese men (n= 192) between 2009 and 2011. Nicotine and cotinine levels in hair were measured using HPLC/UV with column-switching. T-tests and chi-square tests were performed to compare active and passive smokers, while receiver operating characteristic curves were used to evaluate the effectiveness of the cut-off value. RESULTS: There were 69 active smokers and 123 passive smokers. The nicotine and cotinine concentrations in hair were significantly higher in active than in passive smokers (p< 0.01). The area under the curve for nicotine was 0.92. A hair nicotine cut-off value of 5.68 ng/mg, with a sensitivity of 94.2% and specificity of 87.0%, was identified as the optimal cut-off value for separating active from passive smokers. CONCLUSION: Nicotine and cotinine concentrations in hair clearly distinguished active from passive smokers.

DOI： 10.3233/CBM-170004

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INTRODUCTION Japan is a developed country with high use of Internet and online platforms for health information. 'Yahoo! Answer Japan' is the most commonly used question-and-answer service in Japan. AIM To explore the information users seek regarding breast cancer from the 'Yahoo! Answer Japan' web portal. METHODS The 'Yahoo! Answer Japan' portal was searched for the key word 'breast cancer' and all questions searched for the period of 1 January to 31 December 2014 were obtained. The selected questions related to human breast cancer and were not advertisements or promotional material. The questions were categorized using a coding schema. High and low access of the questions were defined by the number of view-counts. RESULTS Among the 2392 selected questions, six major categories were identified; (1) suspected breast cancer, (2) breast cancer screening, (3) treatment of breast cancer, (4) life with breast cancer, (5) prevention of breast cancer and (6) others. The highest number of questions were treatment related (28.8%) followed by suspected breast cancer-related questions (23.4%) and screening-related questions (20%). Statistical analysis revealed that the treatment-related questions were more likely to be highly accessed. CONCLUSION Content analysis of Internet question-answer communities is important, as questions posted on these sites would serve as a rich source of direct reflection regarding the health-related information needs of the general population.

DOI： 10.1071/HC16048

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Language：English   Publishing type：Research paper (scientific journal)  

Aims: There are no legal regulations in Japan governing minors' consumption of alcohol-flavoured non-alcoholic beverages (AFNAB); therefore, we examined if their consumption could lead to increased alcohol use among adolescents in Japan. Methods: This cross-sectional study used a nonclinical, nationally representative sample of 38,494 junior (19,662 boys) and 61,556 senior (31,925 boys) high school students recruited in 2012. We measured AFNAB consumption rates and the order that adolescents first consumed AFNAB and alcohol. Results: The AFNAB consumption was strongly associated with alcohol use in high school students. Among all age groups, alcohol was more commonly consumed before AFNAB for both males and females. Conclusions: Consumption of AFNAB is more prevalent among minors than alcohol consumption and it has a strong association with alcohol consumption. However, concerns that AFNAB use would lead to increased alcohol use were not supported because AFNAB consumption usually started after adolescents began consuming alcohol. Short Summary: Consumption of AFNAB is more prevalent among high school students than alcohol consumption and it has a strong association with alcohol consumption. However, concerns that AFNAB use would lead to increased alcohol use were not supported because AFNAB consumption usually started after adolescents began consuming alcohol.

DOI： 10.1093/alcalc/agw081

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BACKGROUND: Recently, the association of plasma free amino acid (PFAA) profile and lifestyle-related diseases has been reported. However, few studies have been reported in large Asian populations, about the usefulness of PFAAs for evaluating disease risks. We examined the ability of PFAA profiles to evaluate lifestyle-related diseases in so far the largest Asian population. METHODS: We examined plasma concentrations of 19 amino acids in 8589 Japanese subjects, and determined the association with variables associated with obesity, blood glucose, lipid, and blood pressure. We also evaluated the PFAA indexes that reflect visceral fat obesity and insulin resistance. The contribution of single PFAA level and relevant PFAA indexes was also examined in the risk assessment of lifestyle-related diseases. RESULTS: Of the 19 amino acids, branched-chain amino acids and aromatic amino acids showed association with obesity and lipid variables. The PFAA index related to visceral fat obesity showed relatively higher correlation with variables than that of any PFAA. In the evaluation of lifestyle-related disease risks, the odds ratios of the PFAA index related to visceral fat obesity or insulin resistance with the diseases were higher than most of those of individual amino acid levels even after adjusting for potential confounding factors. The association pattern of the indexes and PFAA with each lifestyle-related disease was distinct. CONCLUSIONS: We confirmed the usefulness of PFAA profiles and indexes as markers for evaluating the risks of lifestyle-related diseases, including diabetes mellitus, metabolic syndrome, dyslipidemia, and hypertension in a large Asian population.

DOI： 10.1186/s12199-017-0642-7

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BACKGROUND: Studies on the association of plasma-free amino acids with gout are very limited and produced conflicting results. Therefore, we sought to explore and characterize the plasma-free amino acid (PFAA) profile in patients with gout and evaluate its association with the latter. METHODS: Data from a total of 819 subjects (including 34 patients with gout) undergoing an annual health examination program in Shimane, Japan were considered for this study. Venous blood samples were collected from the subjects and concentrations of 19 plasma amino acids were determined by high-performance liquid chromatography-electrospray ionization-mass spectrometry. Student's t-test was applied for comparison of variables between patient and control groups. The relationships between the presence or absence of gout and individual amino acids were investigated by logistic regression analysis controlling for the effects of potential demographic confounders. RESULTS: Among 19 amino acids, the levels of 10 amino acids (alanine, glycine, isoleucine, leucine, methionine, phenylalanine, proline, serine, tryptophan, valine) differed significantly (P < .001 to .05) between the patient and control groups. Univariate logistic regression analysis revealed that plasma levels of alanine, isoleucine, leucine, phenylalanine, tryptophan and valine had significant positive associations (P < .005 to .05) whereas glycine and serine had significant inverse association (P < .05) with gout. CONCLUSIONS: The observed significant changes in PFAA profiles may have important implications for improving our understanding of pathophysiology, diagnosis and prevention of gout. The findings of this study need further confirmation in future large-scale studies involving a larger number of patients with gout.

DOI： 10.1186/s12199-017-0609-8

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BACKGROUND: This study aimed to clarify the associations between the frequency and amount of alcohol consumption and problematic Internet use, such as Internet addiction and excessive Internet use. METHODS: A self-administered questionnaire survey was administered to students enrolled in randomly selected junior and senior high schools throughout Japan, and responses from 100,050 students (51,587 males and 48,463 females) were obtained. Multiple logistic regression analyses were performed in order to examine the associations between alcohol use and problematic Internet, use such as Internet addiction (Young Diagnostic Questionnaire for Internet Addiction ≥5) and excessive Internet use (≥5 h/day). RESULTS: The results of multiple logistic regression analyses indicated that the adjusted odds ratios for Internet addiction (YDQ ≥5) and excessive Internet use (≥5 h/day) became higher as the number of days in which alcohol had been consumed during the previous 30 days increased. In addition, the adjusted odds ratio for excessive Internet use (≥5 h/day) indicated a dose-dependent association with the amount of alcohol consumed per session. CONCLUSIONS: This study revealed that adolescents showing problematic Internet use consumed alcohol more frequently and consumed a greater amount of alcohol than those without problematic Internet use. These findings suggest a close association between drinking and problematic Internet use among Japanese adolescents.

DOI： 10.1016/j.je.2016.10.004

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Language：Japanese   Publisher：The Society of Physical Therapy Science  

[Purpose] The circumstances of falls in a residential care facility for the aged were investigated and analyzed according to the time of day, to clarify the characteristics of individual factors of falls. [Subjects and Methods] The first falls of 94 residents of a care facility in Fukushima City were investigated. Age, gender, height, weight, care level, activity category, dementia category, ADL assessment, grip strength, Hasegawa Scale, 10-meter gait, BPSD of the subjects, and the place of the fall were assessed and compared according to the time of the fall. [Result] There were 39 falls in the day (09:01~17:00), 32 falls in the evening (17:01~01:00), and 23 falls in the morning (01:01~09:00). Fallers in the morning period had significantly shorter height and BPSD nighttime insomnia, and a larger number of corridor falls. [Conclusion] Short subjects with nighttime insomnia using corridors in the small hours and early morning have a high risk of fall, and therefore require attention.

DOI： 10.1589/rika.32.133

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Other Link： http://search.jamas.or.jp/link/ui/2017216714

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Introduction: Japan is assumed to have serious health and social problems due to Internet overuse, but little is known about the actual conditions. This study was conducted to investigate the prevalence of problematic Internet use (PIU) and associated Internet use in adolescents in Japan. Methods: A nationwide survey of adolescent Internet use was conducted in 2012 and 2013. The participants were 100,050 students from randomly selected junior and senior high schools nationwide who gave valid responses to a self-reported questionnaire. The questionnaire included questions on Internet use and the Japanese version of the Young's Diagnostic Questionnaire (YDQ) as well as other questions related to lifestyle habits. Internet users were classified by gender according to three categories on the basis of their YDQ scores: adaptive use, maladaptive use, and PIU. Results: The estimated prevalence of PIU was 6.2% in males, 9.8% in females, and 7.9% in total; it closely correlated with female gender, school grades, and number of Internet hours. The following common and gender-specific applications that conferred a risk of PIU were identified: downloading (both genders), online gaming (males), social networking services, blogs, and bulletin boards (females). Conclusions: A cross-sectional survey using YDQ of a large number of high school students yielded a PIU prevalence of 7.9% in Japan. This study showed that problems associated with Internet overuse have already become serious; therefore, planning and implementation of prevention and control measures is urgently required.

DOI： 10.1016/j.abrep.2016.10.001

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Language：Japanese   Publisher：日本公衆衛生学会  

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The aim of this study was to clarify the association between smoking and problematic Internet use (PIU), such as Internet addiction (IA) and excessive Internet use (EIU), among Japanese adolescents. A self-administered questionnaire was administered to students enrolled in randomly selected junior and senior high schools throughout Japan. Responses were obtained from 100,050 students (0.94:1 ratio of boys to girls). The prevalence of IA (as indicated by a Young Diagnostic Questionnaire for Internet Addiction score ≥5) in all participants, boys, and girls was 8.1%, 6.4%, and 9.9%, respectively. The prevalence of EIU (≥5 hours/day) in all participants, boys, and girls was 12.6%, 12.3%, and 13.0%, respectively. The results of multiple logistic regression analyses indicated that the adjusted odds ratios (AORs) for IA and EIU were significantly higher among students who smoked (including those who previously smoked) than among those who never smoked (p < 0.01 for all comparisons). In addition, the AORs were the highest for students who smoked ≥21 cigarettes per day. The prevalence and AORs of IA and EIU tended to increase with smoking frequency and number of cigarettes smoked per day, indicating a dose-dependent relationship. Thus, IA and EIU have strong associations with smoking. This study revealed that adolescents who routinely smoked or those who smoked more cigarettes per day had a higher risk of PIU than adolescents who did not. These findings suggest that there is a close association between smoking and PIU among Japanese adolescents.

DOI： 10.1089/cyber.2016.0182

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

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AIMS: Nationwide surveys to clarify the characteristics and trends of the drinking behavior of Japanese adults were carried out in 2003, 2008, and 2013. METHODS: These were periodical cross-sectional surveys. Subjects were chosen through a stratified two-stage random sampling method. The surveys included drinking frequency and amount, ICD-10 alcoholism diagnostic standards, questionnaire for the determination of harmful alcohol use ( AUDIT: Alcohol Use Disorders Identification Test). In 2003, the surveys obtained responses from 2547 people (73% response rate); in 2008, 4123 people (55% response rate); and in 2013, 4153 people (59% response rate). RESULTS: The proportion of lifetime experience of alcohol dependence diagnosed by ICD-10 was 1.9% for male and 0.2% for female, and the estimated number of patients was 1.07 million. The declining trends were observed in the percentage of daily drinkers and the amount of alcohol consumed per week for male. The lowering of the age for consuming their first alcoholic drink and their first drunken experience was observed among female. The gender difference of prevalence of problem drinking is getting smaller. The binge drinking and heavy episodic drinking were observed especially younger generation. The only small proportion of patients with alcohol dependence had received specialized medical care, whereas the many of these visited medical institutions and health screening. CONCLUSIONS: The survey observed many hidden alcoholic patients, and showed the possibility that the healthcare facilities and health screening became the place of screening and intervention for alcohol dependence.

DOI： 10.1093/alcalc/agw002

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OBJECTIVE: This study aimed to clarify the prevalence of anger and impulsivity and its associated factors through a nationwide survey of junior and senior high school adolescent students in Japan. METHODS: A self-administered questionnaire covering (1) personal data, (2) lifestyle, (3) mental health status, and (4) feelings of anger and impulsivity was distributed to junior and senior high school students in Japan. Among the total of 10,955 junior high schools and 5,115 senior high schools nationwide, 130 and 110 were randomly selected, respectively. Of those, 92 junior and 80 senior high schools participated in the survey. The survey period was from December 2008 to the end of January 2009. A total of 95,680 questionnaires were collected. After excluding invalid responses, the remaining 94,777 responses (response rate: 62.3%) were analyzed. RESULTS: From the questions regarding anger and impulsivity, 8.7% (95% CI, 8.5%-8.9%) and 7.5% (95% CI, 7.3%-7.7%) of the participants were considered to have experienced intense anger and impulsivity, respectively. Logistic regression analysis indicated that the odds ratios for experiencing intense feelings of anger were significantly higher (all P values < .05) among students who smoked, consumed alcohol, skipped breakfast, did not wish to go to university, had short sleep duration, had decreased positive feelings, had increased depressive feelings, or used mobile phones for longer hours. The odds ratios for experiencing intense impulsivity were significantly higher among students who smoked, consumed alcohol, skipped breakfast, did not participate in club activities, had short sleep duration, had decreased positive feelings, had increased depressive feelings, or used mobile phones for longer hours. CONCLUSIONS: The results suggest that healthy lifestyle habits, good sleep habits, and improved mental health are important for preventing intense feelings of anger and impulsivity among adolescents.

DOI： 10.4088/JCP.15m10044

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BACKGROUND AND AIM: No nationally representative survey of irritable bowel syndrome (IBS) among adolescents has ever been performed in Japan. In the present study, we aimed to clarify the prevalence of IBS among Japanese adolescents and the factors associated with it. METHODS: The items related to the diagnostic criteria for IBS based on the Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders were included in a cross-sectional nationwide survey of "alcohol consumption and smoking habits among junior and senior high school students." The participating schools were sampled from among all junior and senior high schools in Japan using the cluster-sampling method, and self-administered questionnaires were sent to the selected schools by mail. Among 99 416 questionnaires that were collected, data from 98 411 valid responses were analyzed. RESULTS: The results showed that the prevalence of IBS was 18.6%. Although no sex difference was observed in the overall prevalence of IBS, the prevalence of diarrhea-predominant IBS was higher among boys than among girls, and the prevalence of constipation-predominant IBS was higher among girls than among boys. The prevalence of IBS increased with progression of the school grade, and there were the significant relationships between IBS and sleep-phase delay and insomnia symptoms. IBS was also significantly associated with poor mental health status. CONCLUSION: These results indicate that IBS is common among junior and senior high school students, and associated with lifestyle and mental health.

DOI： 10.1111/jgh.12974

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Language：Japanese   Publisher：(株)日本医事新報社  

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OBJECTIVES: The objective was to study the relationship between mental health and lifestyles of adolescents using samples representative of Japanese adolescents nationwide. METHOD: The survey was conducted between December 2004 and January 2005 among students enrolled in randomly selected junior and senior high schools. Self-administered questionnaires addressed lifestyles, sleeping habits, and mental health status. Of 103 650 questionnaires collected, 85 158 were analyzed. RESULTS: Population characteristics associated with poor mental health were being female, being a senior high school student, skipping breakfast, not participating in extracurricular activities, not consulting parents about personal matters, parental smoking, students' smoking or alcohol use, poor subjective sleep assessment, and short or long sleeping duration. CONCLUSION: Smoking and anxiety disorders are associated with an elevation in acculturative stress in adolescents. Prepossessing adolescents are in subclinical depression. Results suggest that lifestyles approaches in preventions that target students can be effective in reaching high-risk populations.

DOI： 10.1177/1010539512452753

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OBJECTIVES: Nicotine in cigarettes is metabolized primarily by CYP2A6-catalyzed oxidation. The CYP2A6*4 allele, in which CYP2A6 is a homozygous whole-deletion variant, completely lacks enzyme activity. The aim of this study was to examine the effects of CYP2A6*4 genetic polymorphism on smoking behavior and nicotine dependence in a general population of Japanese men. METHODS: The subjects were 124 healthy Japanese men who gave informed consent to give saliva samples. The survey items included general information, smoking behaviors and nicotine dependence. The polymerase chain reaction restriction fragment length polymorphism method was used to analyze the genetic polymorphisms of CYP2A6. The subjects were classified into two groups: Group W (CYP2A6*4 absence: *1A/*1A, *1A/*1B and *1B/*1B) and Group D (CYP2A6*4 presence: *1B/*4A, *4A/*4A, *1A/*4A or *1B/*4D, and *1A/*4D). We analyzed the differences in the survey items between the two groups. RESULTS: There were no significant differences in smoking behaviors between the two groups. However, Group D tended to have less difficulty in refraining from smoking after waking in the morning compared to Group W (p=0.051). CONCLUSIONS: CYP2A6*4 genetic polymorphisms may not strongly affect smoking behavior but may possibly have an effect on nicotine dependence.

DOI： 10.5387/fms.2015-14

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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BACKGROUND: The Fukushima Daiichi nuclear power plant accident (FDNPPA) was the world's second largest nuclear power plant accident. At the time that it occurred, internet usage prevalence in Japan was as high as 80%. OBJECTIVES: To compare health knowledge on radiation and preventive behaviour between internet users and non-users among adults employed in industries in Fukushima after the nuclear disaster. METHODS: We conducted a cross-sectional questionnaire study among adults employed in industries in Fukushima 3-5 months after the FDNPPA. Targets were 1394 regular workers who took part in health seminars provided by the Fukushima Occupational Health Promotion Center. After applying the selection criteria, there were 1119 eligible participants. The questionnaire asked for personal characteristics and main sources of information about the FDNPPA, as well as health knowledge on radiation and preventive behaviours following the nuclear accident. We assessed the contribution of each variable using logistic regression analysis. RESULTS: Among the eligible respondents, 637 workers (56.9%) were internet users and 482 (43.1%) were non-users. Internet users had more health knowledge than non-users (average 4.6 radiation-related health conditions in internet users vs 3.6 conditions in non-users) and more preventive behaviours (average 2.6 behaviours in internet users vs 1.9 in non-users). According to logistic regression analyses, internet usage was positively associated with greater health knowledge on radiation (OR 1.13; 95% CI 1.08 to 1.20) and more preventive behaviours (OR 1.14; 95% CI 1.07 to 1.23). CONCLUSIONS: Internet usage was significantly and positively associated with greater health knowledge and more preventive behaviours. The internet is a useful method of distributing information to the general public in emergency situations such as a nuclear disaster.

DOI： 10.1136/emermed-2013-202955

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At the end of 2013, a Japanese newspaper reported that 4,173 children were unidentified or missing in Japan. The article concluded that child abuse was a matter of national concern. In examining the strengths and weaknesses of Japan's welfare system in regard to child abuse, it would seem that a weakness exists with regard to its ambiguity on the roles of different officers who contact suspected cases. Although three types of officer (health, welfare, and police officers) can take charge, child abuse cases might be missed because the division of labor varies between the different types of officer. However, a strength exists in the periodical pediatric health check system that is in place in each of Japan's 1,742 municipalities. To efficiently implement early intervention for child abuse, it is necessary to rearrange the division of labor among the three types of officers to clarify who should intervene in suspected cases.

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

We conducted an epidemiological study to examine the associations between sleep environments and sleep habits in Japanese adolescents. The targets were students attending junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were then sent to the schools for all students to complete. A total of 99416 adolescents responded, with an overall response rate of 64.0%. A total of 96861 questionnaires were subjected to analysis. Associations between sleep environments (type of bed, lighting during sleep, sharing a bedroom) and sleep duration, bedtimes, wake-up times, sleep quality, or symptoms of insomnia were examined. In total, 65.5% of the adolescents surveyed slept on a bed, and 33.0% slept on a futon laid on the floor or tatami. In total, 66.6% slept with the light off, 31.0% slept with a dim light on, and 2.0% slept with the light on. Of those surveyed, 69.3% had their own bedrooms, 17.1% shared a bedroom with one other person, 8.0% shared a bedroom with three people, and 5.0% shared a bedroom with four people or more. The factors with high odds ratios with regard to insomnia were use of a futon laid on the floor or tatami, sleeping with the light on, and not sharing a bedroom. Sleep environments are associated with insomnia. Type of bed, lighting, and sharing a bedroom should be considered as factors that affect the sleep of adolescents.

DOI： 10.1111/sbr.12050

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OBJECTIVES: To clarify the risk factors for falls in hospital settings and to propose the use of such factors to identify high-risk persons at admission. DESIGN: Prospective cohort study. SETTING: Fukushima Medical University Hospital, Japan, from August 2008 and September 2009. PARTICIPANTS: 9957 adult consecutive inpatients admitted to our hospital. METHODS: Information was collected at admission from clinical records obtained from a structured questionnaire conducted in face-to-face interviews with subjects by nurses and doctors and fall events were collected from clinical records. RESULTS: The proportion of patients who fell during follow-up was 2.5% and the incidence of falls was 3.28 per 100 person-days. There were significant differences in age, history of falling, cognitive dysfunction, planned surgery, wheelchair use, need for help to move, use of a remote caring system, rehabilitation, use of laxative, hypnotic or psychotropic medications and need for help with activities of daily living (ADL) between patients who did and did not fall. Multivariable adjusted ORs for falls showed that age, history of falls and need for help with ADL were common risk factors in both men and women. Using psychotropic medication also increased the risk of falling in men while cognitive dysfunction and use of hypnotic medication increased the risk of falling in women. Planned surgery was associated with a low risk of falls in women. CONCLUSIONS: To prevent falls in inpatients it is important to identify high-risk persons. Age, history of falling and the need for help with ADL are the most important pieces of information to be obtained at admission. Care plans for patients including fall prevention should be clear and considered.

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BACKGROUND: Unhappiness at school is one of the main reasons for truancy among adolescents. In order to assess this problem more thoroughly in the context of Japanese adolescents, the present study examined the associations between feelings of unhappiness at school and lifestyle habits, school life realities, and mental health status. METHOD: This study was designed as a cross-sectional survey. A self-administered questionnaire was provided to students enrolled in randomly selected junior and senior high schools throughout Japan. We calculated the percentages of both junior and senior high school students who felt unhappy at school based on factors related to school life, lifestyle habits, and mental health status. Multiple logistic regression analyses were performed in order to examine the associations between those factors and students' feelings of unhappiness at school. RESULTS: A total of 98,867 valid responses were analysed, 7.9% (Boys: 8.4%, Girls: 7.4%) of which came from students who responded that they felt unhappy at school. For both junior and senior high school students, the percentages of those who felt unhappy at school were significantly higher among those who had not yet decided on their future life course, who did not participate in extracurricular activities, did not eat breakfast every day, went to bed late, had used tobacco or alcohol in the previous 30 days, and had poor mental health compared with others. The results of multiple logistic regression analyses indicated that the adjusted odds ratios for feeling unhappy at school with regard to the above-mentioned factors were significantly high for both junior and senior high school students. CONCLUSIONS: The present results suggest that school employees and administrators must provide health guidance to students, considering that irregular lifestyle habits, lower school engagement, smoking, drinking alcohol, and poor mental health status are all associated with maladaptation to school among adolescents.

DOI： 10.1371/journal.pone.0111844

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OBJECTIVES: From our previous results, manganese (Mn) and iron (Fe) in the blood of Parkinson's disease (PD) patients without depression were higher than those of both the PD patients with depression and controls, the hypothesis that "two types of PD exist-PD without depression and affected by Mn and Fe, and PD with depression and unaffected by Mn or Fe" was induced. To investigate the hypothesis, correlations among blood and urine metals were compared in the subjects. METHODS: Subjects comprised PD patients with depression, PD patients without depression and controls recruited from an outpatient clinic in China. Morning blood and urine samples were used to measure concentrations of metals. RESULTS: In the controls, Mn, Fe and zinc (Zn) levels in blood strongly correlated with each other. The correlation coefficient between Mn and Zn in blood was significant in the PD patients with depression and the controls, but not in the PD patients without depression. Correlations of Fe between blood and urine in the PD patients without depression were significant, but not in the PD patients with depression and the controls. CONCLUSIONS: A common route of simultaneous intake of Mn, Fe and Zn could exist in our subjects, however in PD patients without depression, a large intake of Mn may have been from another route. Some results of the PD patients without depression were different from those of the PD patients with depression and the controls. Thus, two types of PD may exist.

DOI： 10.5387/fms.2014-8

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In this study, we attempted to clarify the associations between various sleep disturbance symptoms and the frequency and amount of alcohol use among Japanese adolescents. This study was designed as a cross-sectional sampling survey. A self-administered questionnaire survey was administered to students enrolled in randomly selected junior and senior high schools throughout Japan. A total of 99,416 adolescents responded, and 98,867 questionnaires were subjected to analysis. The prevalence rates of sleep disturbance in the 30 days preceding the day of the survey were as follows: subjectively insufficient sleep (SIS) (boys: 37.6%, girls: 38.7%); short sleep duration (SSD) with less than 6 h of sleep (boys: 28.0%, girls: 33.0%); difficulty initiating sleep (DIS) (boys: 12.5%, girls: 14.1%); difficulty maintaining sleep (DMS) (boys: 10.1%, girls: 10.9%); and early morning awakening (EMA) (boys: 5.1%, girls: 5.0%). Adolescents reporting one or more symptoms of DIS, DMS, and EMA were classified as having insomnia, and its prevalence was 21.5%. The prevalence of each symptom of sleep disturbance increased significantly with the number of days on which alcohol was consumed in the previous 30 days and the amount of alcohol consumed per drinking session (p < 0.01). Multiple logistic regression analyses showed that the adjusted odds ratio (AOR) for each symptom of sleep disturbance, except SIS and EMA, tended to increase with the number of days on which alcohol was consumed and the amount of alcohol consumed per drinking session. The prevalence of sleep disturbance is particularly high among adolescents drinking alcohol. The risk of having each symptom of sleep disturbance, except SIS and EMA, increases with the number of days on which alcohol was consumed and the amount of alcohol consumed per drinking session. These findings reconfirm the need to eliminate underage drinking to ensure good sleep among adolescents.

DOI： 10.1016/j.alcohol.2013.09.041

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After the Great East Japan Earthquake on March 11th, 2011, a journalist visited the disaster area with febrile symptoms and was diagnosed with measles of the D genotype, which is not indigenous to Japan. After continuing activities in disaster areas and Tokyo, 11 measles cases were reported, some of which were identified as genotype D. Meanwhile non-profit activities directed towards volunteers were offered including interviews to screen for subjective symptoms, check body temperature and advise volunteers to refrain from working in shelter areas during the period of sickness. As a consequence, disease transmission was controlled among volunteers. In disaster areas, anyone can be an infection vector. In order to prevent transmission of infectious diseases, a field action plan, which includes body temperature checks and standard precautions should be formulated and put into place. If the action plans are shared among local governments and non-governmental organizations (NGOs), they can become a norm and be expected to control infectious disease transmission.

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Language：Japanese   Publisher：日本公衆衛生学会  

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DOI： 10.1017/dmp.2013.73

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OBJECTIVE: The main objective of our study was to clarify the prevalence of disorders of arousal (confusional arousals, sleepwalking, sleep terrors) and sleep-related bruxism (teeth grinding) and their associated factors among Japanese adolescents. METHODS: Our study was designed as a cross-sectional sampling survey. The targets were students attending junior and senior high schools throughout Japan. The questionnaire asked for personal data and information on lifestyle, depressive state, and sleep status including the frequency of experiencing disorders of arousal and sleep-related bruxism. RESULTS: A total of 99,416 adolescents responded. The overall response rate was 63.7%, and 98,411 questionnaires were subjected to analysis. The prevalence of disorders of arousal was 7.1% (95% confidence interval [CI], 6.9-7.3%) among boys and 7.7% (95% CI, 7.5-7.9%) among girls. The prevalence of sleep-related bruxism was 2.3% (95% CI, 2.2-2.4%) among boys and 3.0% (95% CI, 2.8-3.2%) among girls. The factors associated with disorders of arousal were the grade in school, smoking habit, alcohol consumption, naptime (min), breakfast habit, participation in club activities, sleep duration, difficulty initiating sleep, nocturnal awakening, early morning awakening, subjective sleep assessment, snoring, decrease in positive feelings, and depression (all p<.001). The factors associated with sleep-related bruxism were gender, smoking habit, nocturnal awakening, snoring, early morning awakening, decrease in positive feelings, and depressive feelings (all p<.001). CONCLUSIONS: If disorders of arousal or sleep-related bruxism are observed in an adolescent, his or her smoking habit, alcohol consumption, sleep status, and depressive state should be considered.

DOI： 10.1016/j.sleep.2013.03.005

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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In 2012, several kinds of electronic books (e-books) became available in Japan. Since several major book retailers launched e-book businesses, it is expected that e-books will become a popular source of information in the country. However, we are concerned that e-books may also be a source of misinformation. In examining 24 available materials published by anti-vaccinists, "atopy businesses", and "wellness maintenance" authors, each was found to contain inaccuracies or misinformation. Thus far, such information is only available in printed books. If these books are scanned and circulated, or published in e-book format, this misinformation may circulate rapidly as e-book devices are becoming popular, and, consequently, harm people's health. We think that it is important for the government to formulate ethical guidelines for the publishing e-books with due consideration to freedom of expression.

DOI： 10.2196/ijmr.2541

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Language：Japanese   Publisher：(一社)日本循環器病予防学会  

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BACKGROUND: The nuclear power plant accidents in Fukushima resulted in a widespread release of radioactive substances in the Fukushima prefecture. AIM: To clarify what factors led to precautions among general workers who displayed preventive behaviours against radiation following the nuclear disasters in Fukushima. METHODS: Descriptive study of preventive behaviours among general workers 3-5 months following the nuclear disasters. The subjects were 1394 regular workers who took part in radiation seminars conducted by the Fukushima Occupational Health Promotion Center between July and August 2011. Of 1217 responses, 1110 eligible responses were included in this study. This anonymous questionnaire survey was asking for characteristics and questions on preventive behaviours following the nuclear disasters. The authors assessed the contribution of each variable by a logistic regression analysis. RESULTS: Keeping track of environmental radiation levels and washing hands and gargling were significantly more frequent among female subjects, older age and workers residing up to approximately 80 km away from the power plants. Washing hands and gargling were also related with living with children. Wearing a mask when leaving home and buying bottled water were significantly more often observed with female subjects and workers residing up to 80 km. Refraining from going outdoors was positively associated with workers residing up to 80 km and workers living with children. CONCLUSIONS: These results provide information that may help with the targeting of health information after a nuclear disaster. This may contribute to determining an order of priority when distributing information after a nuclear disaster.

DOI： 10.1136/emermed-2011-201000

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.4236/health.2013.54100

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After the Great East Japan Earthquake on 11 March 2011, the environmental radiation dose in Fukushima City increased. On 11 April, 1 mo after the earthquake, the environmental radiation dose rate at various surfaces in the same area differed greatly by surface property. Environmental radiation measurements continue in order to determine the estimated time to 50% reduction in environmental radiation dose rates by surface property in order to make suggestions for decontamination in Fukushima. The measurements were carried out from 11 April to 11 November 2011. Forty-eight (48) measurement points were selected, including four kinds of ground surface properties: grass (13), soil (5), artificial turf (7), and asphalt (23). Environmental radiation dose rate was measured at heights of 100 cm above the ground surface. Time to 50% reduction of environmental radiation dose rates was estimated for each ground surface property. Radiation dose rates on 11 November had decreased significantly compared with those on 11 April for all surface properties. Artificial turf showed the longest time to 50% reduction (544.32 d, standard error: 96.86), and soil showed the shortest (213.20 d, standard error: 35.88). The authors found the environmental radiation dose rate on artificial materials to have a longer 50% reduction time than that on natural materials. These results contribute to determining an order of priority for decontamination after nuclear disasters.

DOI： 10.1097/HP.0b013e31826ab94c

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Some heavy metals are suspected to be pathogenic to both Parkinson's disease (PD) and depression. Common background may exist in them. METHODS: Subjects comprised PD patients with depression, PD patients without depression and controls recruited from the outpatient clinic in China. Morning blood and urine samples were used to measure concentrations of metals and vitamins. RESULTS: Whole-blood manganese was significantly higher in the PD patients without depression than in both the PD patients with depression and the controls. Serum iron was significantly higher in the PD patients without depression than in the controls. Urine iron was also significantly higher in the PD patients without depression than in the controls. Serum copper was significantly lower in the PD patients with depression than in both the PD patients without depression and the controls. CONCLUSIONS: Excessive intake of iron and accumulation of manganese seemed to be involved in the etiology of non-depressive PD.

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BACKGROUND: During and after the Fukushima nuclear disaster (FND), many parents were concerned about the effects of radiation on the health of their children. PURPOSE: To clarify the factors that influenced general workers living with children and the effect of child age groups in implementing preventive behaviorsagainst radiation following the FND. MATERIALS AND METHODS: A descriptive study of preventive behaviors among general workers was carried out 3-5 months after the nuclear disaster. The subjects were 1,394 regular workers, who took part in radiation seminars run by the Fukushima Occupational Health Promotion Center between July and September, 2011. In total, 1,217 responses were submitted, of which 1,110 were eligible for the present study. This anonymous questionnaire survey inquired about the presence and age of children in the household and about radiation preventive behavior implemented after the FND. The contribution of each variable was assessed by logistic regression analysis. RESULTS: General workers in Fukushima who lived with younger children performed more preventive behavior against radiation during and after the FND. In particular, both location-related and daily routines were practiced significantly more frequently (p<0.01) by workers living with a child in the age ranges of 0-6 (8 of 10 items) and 7-12 (5 of 10 items). CONCLUSIONS: This is the first study to assess the positive association between living with children by age group and increased preventive behavior against radiation implemented by general workers after the FND.

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Language：Japanese   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Ever since the Fukushima Daiichi nuclear power plant (NPP) accident, every day about 3,000 workers have been working to repair the situation. The frequent occurrence of heat disorders has been a concern for the workers wearing protective clothing with poor ventilation. We have been analyzing the heat disorder problem since the accident in order to come up with a solution to prevent future heat disorder incidents among Fukushima Daiichi NPP accident clean-up workers. METHODS: From March 22 to September 16, 2011, the Fukushima Labor Bureau assessed 43 cases of nuclear power plant workers with heat disorders. Age of subject, month and time of occurrence, temperature, and humidity were examined for each case, as well as the severity of heat disorders. The grade of severity was divided into Grade I and Grade II or higher. Then, age, temperature, and humidity were analyzed using the Mann-Whitney Utest, and age, temperature, humidity, and presence or absence of a cool-vest were analyzed using the χ(2) test and logistic regression analysis. SPSS version 17.0 statistical software was used with a level of significance of p< 0.05. RESULTS: Heat disorders occurred most frequently in subjects in their 40s (30.2%), followed by those in their 30s (25.6%), mostly in July (46.5%) between 7 am and 12 pm (69.8%). Heat disorders occurred most frequently in environments with temperatures more than 25°C (76.7%) and humidity of 70-80% (39.5%). Heat disorders of Grade II or higher occurred in 10 cases, 5 of which were in June. According to statistical analysis, there were no significant differences in difference of severity for all factors. CONCLUSIONS: Heat disorders usually occur in workers aged 45-60; however, cases of heat disorders at the Fukushima Daiichi NPP occurred in clean-up workers at the relatively younger ages of 30-40, suggesting the need for heat disorder prevention measures for these younger workers. Heat disorder cases primarily occurred in the morning, necessitating preventive measures for the early hours of the day. In addition, because heat disorders of Grade II or higher occurred in June in 5 of 10 cases, we believe heat disorder precautions should be implemented from June. The lack of significant difference in severity difference may be attributable to the small number of cases or other factors. We think Fukushima Daiichi NPP accident clean-up workers need heat disorder prevention measures for their safety, based on the results of this study.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：University of the West Indies  

DOI： 10.7727/wimj.2013.119

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Language：English   Publishing type：Research paper (scientific journal)  

During the measles epidemic periods in 1999-2003, a research group elaborated a method of estimating vaccination coverage. The objective of cumulative vaccination coverage (CVC) was to estimate the age of vaccine completion for vaccine targets in an age cohort. From randomly selected children of an age cohort, vaccine records including the date of birth and date of vaccine administration were retrieved, allowing for the calculation of the age of vaccine targets. By acquiring this information, it is possible to derive vaccination trends by age. According to the literature, CVC is now more widely applied and is used for monitoring delays of vaccination due to changes of the vaccine administration schedule and schedule interaction when newly-introduced vaccines are implemented. Although CVC is rather costly because it requires random sampling, we conclude that it is a useful method for estimating herd immunity. © 2013 Takahashi K, et al.

DOI： 10.4172/jaa.1000080

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Language：Japanese   Publisher：日本大学医学会  

全国約10万人の中高生を対象とした大規模疫学調査データを用いて喫煙行動と不眠の関連性について検討を行った。調査デザインは断面標本調査とした。2004年から2005年にかけて全国学校総覧より無作為抽出した中学高校の在校生を対象に自記式質問調査票による調査を行い、回答に不備のなかった102,451人分の調査票を解析した。入眠障害、中途覚醒、早朝覚醒の有訴者率は、喫煙日数、喫煙本数が多いあるいはニコチン依存度が高いほど有意に高値を示した。多重ロジスティック回帰分析により非喫煙者に対する調整オッズ比を算出した結果、毎日喫煙する、1日21本以上喫煙する、朝起きていつもすぐに吸いたくなるという群が最も高値を示し、いずれも有意な関連が認められた。これら体内のニコチン摂取量と不眠症状の関係から、喫煙行動と不眠の間に密接な関連があることが示唆された。今後、学校において喫煙防止と睡眠衛生を含めた包括的な対策が必要である。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J01010&link_issn=&doc_id=20130125470014&doc_link_id=10.4264%2Fnuma.71.428&url=https%3A%2F%2Fdoi.org%2F10.4264%2Fnuma.71.428&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：神奈川県公衆衛生協会  

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Objective: It is well known that manganese (Mn) exposure is involved in parkinsonism. The aim of our study was to test the hypotheses that Mn affects nicotinamide N-methyltransferase (NNMT) activity, increases the metabolism of nicotinamide (NA) to 1-methylnicotinamide (MNA), and leads to neurocytotoxicity. Methods: Following demonstration of the effects of Mn concentrations on the survival rate of Mouse CD1 brain striatum neuronal cells (MS cells), the effect of Mn on NNMT activity was investigated by comparing the difference in the amount of MNA produced after various Mn concentrations were added to mouse brain cytosol fractions as an enzyme solution. Toxicity induced by MNA and its precursor NA on MS cells was measured. Results: The survival rate of MS cells decreased significantly with increasing concentrations of Mn in the culture medium. With respect to the influence of Mn on NNMT activity, NNMT activity increased significantly at Mn concentrations of 1 lmol/mg protein. MNA and NA neurotoxicity were compared by comparing cell survival rate. Cell survival rate dropped significantly when the cells were cultivated with 10 mM of MNA. There was also a tendency for the survival rate to fall following the addition of 10 mM NA
however, the difference with the control was not significant. Conclusions: Our study suggests the possibility that Mn causes increased NNMT activity, thereby increasing MNA levels in the brain and bringing about neuron death. Daily absorption of Mn and NA may thus contribute to idiopathic Parkinson's disease. © The Japanese Society for Hygiene 2012.

DOI： 10.1007/s12199-011-0262-6

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Language：English   Publishing type：Research paper (other academic)   Publisher：WILEY-BLACKWELL  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Language：Japanese   Publisher：(一社)日本睡眠学会  

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Background &amp
aims: Factors associated with depression in Parkinson's disease, especially lifestyle and nutrition, have been poorly studied. Our study was conducted to investigate nutritional factors associated with depression in Parkinson's disease. Methods: The subjects were 82 Parkinson's disease patients and the same number of sex and age-matched controls recruited from the outpatient clinic of Xiangfan No. 1 People's Hospital in Hubei, China between 2006 and 2008. The Parkinson's disease patients were divided into two groups, 24 Parkinson's disease with depression and 58 Parkinson's disease without depression. DSM-IV criteria was used for the primary diagnosis of depressive disorders. The severity of depression in patients was assessed by the criteria of the Hamilton Depression Rating Scale (HAMD-17), and a score ≥14 was defined as "depression". Information about eating habits and other factors was obtained by subject recall of state prior to diagnosis of Parkinson's disease and depression. Results: Compared with the Parkinson's disease patients without depression and the controls, the Parkinson's disease patients with depression had relatively low levels of income and education. Fat and vitamin B1 intake was significantly higher in the Parkinson's disease patients with depression than in both the Parkinson's disease patients without depression and the controls. Bean product intake was significantly lower in the Parkinson's disease patients with depression than in both the Parkinson's disease patients without depression and the controls. Conclusions: Less fat and vitamin B1 but more bean product intake might be associated with a lower risk for depression in Parkinson's disease patients from a higher income bracket with better educational background. © 2012 European Society for Clinical Nutrition and Metabolism.

DOI： 10.1016/j.clnme.2012.02.002

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J01030&link_issn=&doc_id=20120220430004&doc_link_id=10030212171&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F10030212171&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Language：Japanese   Publishing type：Research paper (scientific journal)  

A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.

DOI： 10.1265/jjh.67.38

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OBJECTIVE: The possibility that smoking prevalence among junior and senior high school students may decrease with increasing mobile phone bill was reported by the mass media in Japan. We conducted a nationwide survey on adolescent smoking and mobile phone use in Japan in order to assess the hypothesis that mobile phone use has replaced smoking. METHODS: A total of 70 junior high schools (response rate; 71%), and 69 high schools (90%) from all over Japan responded to 2005 survey. Students in the responding schools were asked to fill out an anonymous questionnaire about smoking behavior, mobile phone bill, and pocket money. Questionnaires were collected from 32,615 junior high school students and 48,707 senior high school students. RESULTS: The smoking prevalence of students with high mobile phone bill was more likely to be high, and that of students who used mobile phones costing 10,000 yen and over per month was especially high. When "quitters" were defined as students who had tried smoking but were not smoking at the time of survey, the proportion of quitters decreased as the mobile phone bill increased. The proportion of students who had smoking friends increased with the increase in the mobile phone bill per month. CONCLUSION: The hypothesis that the decrease in smoking prevalence among Japanese adolescents that has been observed in recent years is due to a mobile phone use can be rejected.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS INC  

Study Objective: The objective of this study was to examine the association between the use of mobile phones after lights out and sleep disturbances among Japanese adolescents.Design and Setting: This study was designed as a cross-sectional survey. The targets were students attending junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were sent to schools for all students to fill out.Participants: A total of 95,680 adolescents responded. The overall response rate was 62.9%, and 94,777 questionnaires were subjected to analysis.Intervention: N/AMeasurements and Results: Daily mobile phone use, even if only for a brief moment everyday, was reported by 84.4%. Moreover, as for use of mobile phones after lights out, 8.3% reported using their mobile phone for calling every day and 17.6% reported using it for sending text messages every day. Multiple logistic regression analysis showed that mobile phone use for calling and for sending text messages after lights out was associated with sleep disturbances (short sleep duration, subjective poor sleep quality, excessive daytime sleepiness, and insomnia symptoms) independent of covariates and independent of each other.Conclusion: This study showed that the use of mobile phones for calling and for sending text messages after lights out is associated with sleep disturbances among Japanese adolescents. However, there were some limitations, such as small effect sizes, in this study. More studies that examine the details of this association are necessary to establish strategies for sleep hygine in the future.

DOI： 10.5665/SLEEP.1152

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER JOURNAL HEALTH PROMOTION INC  

Purpose. To describe differences in physical activity in the context of clustering patterns of health-promoting behaviors.
Design. A cross-sectional study with 1 724 participants (response rate, 91.1%).
Setting. Tadami Town, in a rural area of Fukushima Prefecture, japan.
Subjects. Part of the general population who participated in annual health checkups (age range, 30-93 years).
Measures. The Health-Promoting Lifestyle Profile II was used to assess frequency of health-promoting behaviors (physical activity, health responsibility, spiritual growth, interpersonal relationships, nutrition, and stress management). Smoking status, alcohol consumption, and disease status were self reported. Public health nurses measured the weight and height of participants.
Analysis. Cluster analysis was conducted to identify clustering patterns of health-promoting behaviors other than physical activity. Differences in. physical activity between identified clusters were examined by multiple logistic regression analysis.
Results. Four clusters were identified and labeled as "Most challenged" (20.4%), "Adherence to norms" (30.3 %), "Well in mentality" (20.9%), and "Health-promoting" (28.4%). "Health-promoting" was the most physically active cluster, followed by "Adherence to norms" and "Well in mentality."
Conclusions. Although the survey methodology was subject to selection, self-report, and recall biases, we have described physical activity in the context of clustering patterns of health-promoting behaviors. Laying the groundwork for physical activity in the lifestyle is important for establishing health-promotion strategies to increase physical activity. (Am J Health Promot 2011;25 [6]:410-416.)

DOI： 10.4278/ajhp.090720-QUAN-232

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：B M J PUBLISHING GROUP  

Background Proper age verification can prevent minors from accessing tobacco products. For this reason, electronic locking devices based on a proof-of age system utilising cards were installed in almost every tobacco vending machine across Japan and Germany to restrict sales to minors.Objective We aimed to clarify the associations between amount smoked by high school students and the usage of age verification cards by conducting a nationwide cross-sectional survey of students in Japan.Methods This survey was conducted in 2008. We asked high school students, aged 13-18 years, in Japan about their smoking behaviour, where they purchase cigarettes, if or if not they have used age verification cards, and if yes, how they obtained this card.Results As the amount smoked increased, the prevalence of purchasing cigarettes from vending machines also rose for both males and females. The percentage of those with experience of using an age verification card was also higher among those who smoked more. Somebody outside of family was the top source of obtaining cards. Surprisingly, around 5% of males and females belonging to the group with highest smoking levels applied for cards themselves.Conclusions Age verification cards cannot fully prevent minors from accessing tobacco products. These findings suggest that a total ban of tobacco vending machines, not an age verification system, is needed to prevent sales to minors.

DOI： 10.1136/tc.2010.036947

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Objective: The objective of this study was to clarify the prevalence of nightmares and sleep paralysis and associated factors among Japanese adolescents.Methods: This study was designed as a cross-sectional sampling survey. The targets were junior and senior high schools throughout Japan. Self-reported anonymous questionnaires were sent to schools for all students to complete.Results: A total of 90,081 questionnaires were analyzed. The overall response rate was 62.6%, and the prevalence of nightmares and sleep paralysis was 35.2% and 8.3%, respectively. Multiple logistic analyses revealed that female sex, drinking alcohol, poor mental health, difficulty initiating sleep, low subjective sleep assessment, presence of excessive daytime sleepiness, and presence of sleep paralysis had higher odds ratios than others for nightmares. Male sex, poor mental health, drinking alcohol, taking a long daytime nap, early or late bedtime, difficulty initiating sleep, low subjective sleep assessment, presence of excessive daytime sleepiness, and presence of nightmares had higher odds ratios than other factors for sleep paralysis.Conclusions: This study has revealed the prevalence of nightmares and sleep paralysis among Japanese adolescents. Furthermore, the results of this study suggest that it is important to maintain regular sleep habits for preventing these symptoms. We propose that health education about regular sleep habits should be promoted among Japanese adolescents. (C) 2010 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.sleep.2010.04.015

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DOI： 10.1016/j.psychres.2010.10.025

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN ATHEROSCLEROSIS SOC  

Aim: The World Health Organization (WHO) includes insulin resistance among its criteria for diagnosing metabolic syndrome (MetS); however, previous epidemiologic studies have limited their research to settled populations only. This study aims to clarify the relationship between plasma insulin and metabolic factors on a broader scale by studying data obtained from nomadic and settled Mongolian populations.
Methods: A cross-sectional epidemiologic study of 200 nomads and 256 farmers was performed in Inner Mongolia, Republic of China. Plasma insulin levels and other metabolic factors, such as blood pressure, serum lipids and obesity, were measured. Participants were classified into 3 categories according to their plasma insulin levels.
Results: Cut-off values grouped into tertiles of fasting insulin for all participants were 6.73 nmol/L and 10.33 nmol/L. The mean number of metabolic risk factors, waist circumference, fasting plasma glucose and triglyceride were higher, and the mean HDL cholesterol was lower in the higher fasting insulin tertile among farmers after adjusting for age, gender, smoking, alcohol drinking and total cholesterol. However, no MetS factors were statistically related with fasting insulin tertile levels among nomads.
Conclusions: In nomads, hyperinsulinemia may not be an indicator of MetS due to their specific lifestyle.

DOI： 10.5551/jat.5843

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Although a number of previous studies have examined the prevalence of excessive daytime sleepiness (EDS) among adolescents, there have been very few nationwide studies. Therefore, we conducted a cross-sectional nationwide study to clarify the prevalence of EDS and associated factors among Japanese adolescents. The survey was performed from December 2007 to March 2008 on students enrolled in randomly selected junior and senior high schools throughout Japan, using self-administered questionnaires. Of 90 361 questionnaires collected, 87 233 were analyzed. The Japanese version of the Epworth Sleepiness Scale (JESS) was used to measure EDS, which was defined as a JESS score of > 10. The prevalence (and 95% confidence interval) of EDS among males was 28.1% (27.7-28.5%), and that among females was 38.4% (37.9-38.9%). Multivariate analysis revealed that female sex, higher school grade, poor assessment of subjective sleep, late bedtime, parasomnia symptoms, long commuting time, poor mental health, drinking alcohol, smoking, and participating in extracurricular activities had significantly higher odds ratios for EDS. In conclusion, EDS in Japanese adolescents is common and associated with multiple factors.

DOI： 10.1111/j.1479-8425.2010.00474.x

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Hypertension and smoking are major causes of disability and death, especially in the Asia-Pacific region, where there is a high prevalence of a combination of these two risk factors. We attempted to measure the medical expenditures of a Japanese male population with hypertension and/or a smoking habit over a 10-year period of follow-up. A cohort study was conducted that investigated the medical expenditures due to a smoking habit and/or hypertension during the decade of the 1990s using existing data on physical status and medical expenditures. The participants included 1708 community-dwelling Japanese men, aged 40-69 years, who were classified into the following four categories: 'neither smoking habit nor hypertension', 'smoking habit alone', 'hypertension alone' or 'both smoking habit and hypertension.' Hypertension was defined as a systolic blood pressure of > or =140 mm Hg, a diastolic blood pressure of > or =90 mm Hg or taking antihypertensive medications. In the study cohort, 24.9% had both a smoking habit and hypertension. During the 10-year follow-up period, participants with a smoking habit alone (18,444 Japanese yen per month), those with hypertension alone (21,252 yen per month) and those with both a smoking habit and hypertension (31,037 yen per month) had increased personal medical expenditures compared with those without a smoking habit and hypertension (17,418 yen per month). Similar differences were observed even after adjustment for other confounding factors (P<0.01). Japanese men with both a smoking habit and hypertension incurred higher medical expenditures compared with those without a smoking habit, hypertension or their combination.

DOI： 10.1038/hr.2010.81

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background: The aim of the present study was to determine the prevalence of and factors associated with smoking among Japanese medical students, to help promote effective antismoking measures in this population.Methods: From the 80 university medical schools in Japan, 20 were randomly selected and invited to participate in our survey. The survey focused on medical students and employed an anonymous self-administered questionnaire. Information on each university's antismoking measures was obtained using a separate questionnaire administered to teaching stall The survey was conducted from December 2006 through March 2007. Factors associated with smoking were identified by using the chi-square test and multiple logistic regression analysis.Results: A total of 1619 valid surveys were returned. The overall prevalence of smoking was 13.7% (18.1% among men and 5.1% among women). Factors associated with smoking among medical students were male sex, enrollment at a private medical university, smoking by siblings, alcohol consumption, coffee consumption, insomnia, and less than 6 hours of sleep per night.Conclusions: Antismoking education must be further promoted to Japanese medical students, with consideration given to the factors associated with smoking behavior found in the present study.

DOI： 10.2188/jea.JE20090127

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DOI： 10.5551/jat.1727

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DOI： 10.1618/jhes.13.1

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DOI： 10.1007/s12199-009-0099-4

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Language：English   Publisher：ELSEVIER IRELAND LTD  

We examined whether the A1166C polymorphism of the angiotensin II type I receptor gene (AGTR1) affects cardiovascular event occurrence in a Japanese prospective cohort study. The 2212 participants who gave informed consent for genetic analysis were enrolled in this study (the Shigaraki Study). The average observation period was 1954 days. Cardiovascular events occurred in 37 individuals (1.7%). The independent factors which specified cardiovascular events were age (hazard ratio (HR)=1.13; 95% confidence interval (CI): 1.10-1.16; p&lt;0.0001) and sex (HR=2.18; 95% CI: 1.23-3.85; p=0.007). However, the A1166C polymorphism of AGTR1 was not a predictive factor for cardiovascular events (HR=1.11; 95% CI: 0.61-2.02; p=0.731). (C) 2008 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ijcard.2008.04.079

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Language：English   Publisher：Okayama University Medical School  

DOI： 10.18926/AMO/31856

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Trends in alcohol drinking prevalence were assessed among Japanese adolescents, and possible reasons for a decrease in drinking prevalence observed in 2004.Cross-sectional nationwide surveys were conducted periodically. High schools were randomly sampled from throughout Japan in 1996, 2000, and 2004. All enrolled students in sampled schools were subjects of the surveys. Self-reporting anonymous questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. Questions about drinking prevalence of students and family members, proportion of students who have no friends, and sources of alcohol were included. Students who drunk at least one day of the 30 days preceding the survey were defined as the current drinkers.The drinking prevalence in 2004 was decreased in comparison to that in 1996 and 2000 in both sexes and in all school grades. The current drinking rate (monthly drinker) among junior high school boys was 29.4% in 1996, 29.0% in 2000, and 20.5% in 2004, while that among senior high school boys was 49.7%, 48.7%, and 36.2%, respectively. The respective prevalence among junior and senior girls was 24.0%, 25.5%, and 20.0% and 40.8%, 42.1%, and 34.1%. The prevalent sources of alcohol beverages were searching in home, stores (convenience store, supermarket, or gas-stand), liquor shops, and bars. An analysis of the reasons for this decrease identified a decrease in drinking prevalence in students' families, especially by fathers and older brothers, and an increase in the proportion of students who had no friends.A decrease in drinking prevalence of male family members and a limitation of sources of alcoholic beverages may contribute to the decrease in adolescent drinking prevalence.

DOI： 10.1111/j.1530-0277.2008.00822.x

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Language：English   Publisher：Acoustical Society of Japan  

A questionnaire survey and interviews were conducted among victims of the Mid-Niigata Earthquake from Yamakoshi village to elucidate the problems related to the living environment and the stressful experiences encountered by them in the temporary shelters. In this study we aim to clarify the relationships between environmental problems, including acoustic environment problems, and stressful experiences encountered in the temporary shelters, and we examine the impact of the acoustic environment of the temporary shelters on evacuee stress. Among the environmental problems (living space, temperature, illumination, acoustic environment, odor, and problems related to the shelter facilities and to maintaining privacy), the acoustic environment was the fifth most frequently cited environmental problem. However, a higher proportion of the participants who complained about the acoustic environment of the temporary shelters had stressful experiences than those who did not complain about the acoustic environment. These relationships were shown to be statistically significant by chi-square tests. It was found by logistic regression analyses that among the living environment problems, the acoustic environment was the most important factor in determining whether refugees found living conditions unpleasant and/or experienced stress. These results suggest that improvements to the acoustic environment of temporary shelters should lead to the mitigation of some evacuee stress.

DOI： 10.1250/ast.30.110

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Other Link： http://dl.ndl.go.jp/info:ndljp/pid/10573192

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: For the Japanese population, a body mass index (BMI) of 25.0-29.9 is classified as obesity and is a risk factor for cardiovascular disorders such as hypertension. METHODS: A cohort study to clarify obesity costs for a Japanese population was conducted utilizing baseline BMI and medical costs over a 10-year follow-up period. The participants were 4502 community dwelling Japanese National Health Insurance (NHI) beneficiaries aged 40-69 years. According to their baseline BMI values (kg/m(2)), participants were classified into the following three categories: BMI < 18.5, 18.5 < or = BMI < 25.0 and 25.0 < or = BMI. Medical costs per person per month were compared among the three categories. Excess medical costs attributable to the 25.0 < or = BMI category compared to the 18.5 < or = BMI < 25.0 category were estimated. RESULTS: Approximately 20% of the Japanese population studied had a BMI of 25.0 or over. A J-shaped relationship between BMI and personal total medical costs was observed. Personal total medical costs per month determined from the 10-year follow-up in each category were 189 Euros (BMI < 18.5), 134 Euros (18.5 < or = BMI < 25.0) and 155 Euros (25.0 < or = BMI). A J-shaped pattern was observed after adjusting for age, sex, smoking and drinking habits, and excluding early deceased participants. Furthermore, smoking habit did not modify the J-shaped pattern of total medical costs. The estimated excess medical costs for the 25.0 < or = BMI category represented 3.1% of the total medical costs for the entire study population (634 105 Euros). CONCLUSION: The Japanese NHI beneficiaries with a BMI of 25.0 or over showed increased medical costs compared to those with a BMI of 18.5-24.9.

DOI： 10.1093/eurpub/ckl271

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS INC  

Study Objective: Pregnant women suffer from sleep disturbance, which may be aggravated by passive smoking. In this study we investigated the effects of passive smoking on sleep disturbance during pregnancy.Design: Two cross-sectional questionnaire surveys conducted in 2002 and 2006.Setting: Clinical institutions specializing in obstetrics and gynecology that participated in the nationwide surveys: 260 in the 2002 survey and 344 in the 2006 survey.Participants: 16,396 and 19,386 pregnant women in Japan surveyed in 2002 and 2006, respectively.Intervention: N/A.Measurements and Results: Pregnant women exposed to passive smoking were likely to have sleep disturbances, such as subjective insufficient sleep, difficulty in initiating sleep, short sleep duration, and snoring loudly/breathing uncomfortably. Smoking pregnant women had the same sleep disturbances and also experienced excessive daytime sleepiness and early morning awakening, The prevalence of 5 types of sleep disturbance (insufficient sleep, difficulty in initiating sleep, short sleep duration, excessive daytime sleepiness, and snoring loudly/breathing uncomfortably) among nonsmokers with environmental tobacco smoke showed a mean value intermediate between that of active smokers and that of nonsmokers without environmental tobacco smoke.Conclusion: Passive smoking is independently associated with increased sleep disturbance during pregnancy.

DOI： 10.1093/sleep/30.9.1155

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

1996、2000、2004年と3回実施された中学生5万人、高校生7万人を対象とした飲酒問題の全国調査の結果を検討した。その結果、中・高生の飲酒経験者は中学生で60%から40%に、高校生で75%から60%に減少し、中・高校生の1回あたりの飲酒量も減少し、飲酒による失敗経験も減少し、未成年飲酒禁止法への理解も高まっていた。中高生自身の酒の購入も減少し、アルコール濃度の低い甘い酒が多く飲まれるようになり、親から飲酒を勧められる経験も減少するなど、飲酒行動の変化が認められた。しかし、高リスクの問題飲酒群は男子はやや減少しているものの女子では減少していなかった。これらの減少傾向は、未成年者飲酒法の改正を中心とするこの10年間における未成年者飲酒に対する様々な政策や業界や世論の変化と、日本社会全体のアルコール消費量の減少傾向によるものと思われた。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J02993&link_issn=&doc_id=20070711040004&doc_link_id=10019738127&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F10019738127&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.puhe.2006.07.024

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OBJECTIVE: The purpose of this study is to determine whether the statistics from three published reports on Parkinson's disease (PD) are mutually interrelated and to clarify the relationship between the prevalence statistics and mortality statistics of PD. These statistics included data on "number of patients with PD (PD Patients)", "number of patients with PD receiving financial aid for treatment (PD Recipients)" as an indicator showing the prevalence of PD, and "number of deaths from PD (PD Deaths, i.e., mortality)". METHODS: The data on PD Patients, PD Recipients and PD Deaths were cited from "Patient Survey" by Ministry of Health, Labour and Welfare, a report by the Research Committee on Epidemiology of Intractable Diseases and "Vital Statistics of Japan" by Ministry of Health, Labour and Welfare, respectively. The expected PD Patients, PD Recipients and PD Deaths were calculated as products of their respective rates for the entire country and prefecture population, adjusting for a difference in population composition. Observed/expected number ratios (O/E ratio) of PD Patients, PD Recipients and PD Patients were calculated by prefecture. The correlation between the O/E ratios was examined. In addition, the relationships of the O/E ratios with the number of hospitals or physicians per person were examined. RESULTS: There were no significant correlations between the O/E ratios of PD Patients, PD Recipients or PD Deaths. The O/E ratio of PD Recipients significantly correlated with the numbers of hospitals and physicians per person. CONCLUSION: PD Patients and PD Recipients were included in number of people with PD and PD Deaths was derived from people with PD. However, these statistics do not necessarily reflect the prevalence of PD in each prefecture. When using these published statistics as an indicator of the prevalence of PD, it is necessary to clarify the purpose of their use and to comprehend their characteristics.

DOI： 10.1265/jjh.62.64

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Language：Japanese   Publishing type：Research paper (other academic)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PHYSICIANS POSTGRADUATE PRESS  

Objective: Previous epidemiological studies on relationships between mental health status and sleep status of adolescents have not been sufficiently representative. In the present study, using samples representative of Japanese adolescents associations between mental health nationwide, status and various sleep statuses were examined. Method: The survey was conducted in December 2004 and January 2005 among students enrolled in randomly selected junior and senior high schools throughout Japan using self-administered, questionnaires that addressed lifestyle, sleep status. mental health status, and personal data. Of 103.650 questionnaires collected, 99,668 were analyzed. Sleep status was assessed according to sleep duration, subjective sleep assessment, bedtime. and insomnia symptoms. The Japanese version of the 12-item General Health Questionnaire was employed for assessment of mental health status. Results: Mental health status of subjects whose sleep duration was less than 7 hours, and those who slept 9 hours or more, was poorer than that of subjects who slept for 7 hours or more but less than 9 hours. A U-shaped association was observed between mental health status and sleep duration. Furthermore, a linear association was observed between Subjective sleep assessment and mental health status; the worse the subjective sleep assessment. the poorer the mental health status. Mental health status was also inversely proportional to the frequency of insomnia symptoms. Conclusion: The fact that sleep duration and subjective sleep assessment showed different patterns of association with mental health status indicates that these 2 sleep parameters have independent significance. Considering these associations. it is important to promote mental health care and sleep hygiene education for adolescents.

DOI： 10.4088/JCP.v68n0916

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BACKGROUND AND METHODS: A cohort study investigating medical costs associated with the combination of hypertension and diabetes was conducted. The participants included 4535 community-dwelling Japanese individuals, aged 40-69 years, who were classified into the following four categories: 'Neither hypertension nor diabetes', 'Hypertension alone', 'Diabetes alone' or 'Both hypertension and diabetes'. Medical costs per person per month were compared among the four categories. RESULTS AND CONCLUSION: Of the study population, 1.3% had both hypertension and diabetes. During the 10-year follow-up period, participants with both hypertension and diabetes incurred higher medical costs, as compared with those without hypertension, diabetes or their combination, even after adjustment for other confounding factors.

DOI： 10.1097/01.hjh.0000249711.28769.80

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：EXCERPTA MEDICA INC  

Epidemiologic studies have investigated the relation between alcohol intake and coronary calcification, with controversial results. Furthermore, the influence of heavy drinking has not been well elucidated. In the present study, a random sample of community-based Japanese men aged 40 to 49 years without a history of cardiovascular disease (n = 245) were examined for coronary artery calcium (CAQ determined by electron-beam computed tomography and drinking status. There was a J-shaped association between alcohol intake and CAC. There was an increase of CAC in heavy drinkers (&gt;= 46 g/day), and participants who were drinking &gt;= 69 g/day showed a significant increase in CAC compared with never drinkers after adjusting for other cardiovascular risk factors. (c) 2006 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.amjcard.2006.01.095

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DOI： 10.1093/heapro/dal007

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS INC  

Objectives: Although a number of previous studies have examined the prevalence of insomnia among adolescents, there have been very few nationwide studies. The objectives of this nationwide study were to clarify the prevalence of insomnia, its symptoms, and associated factors among Japanese adolescents.Design and Setting: This study was designed as a cross-sectional sampling survey. The targets were junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were sent to schools for all students to fill out.Participants: A total of 103,650 adolescents responded, and 102,451 questionnaires were subjected to analysis.Intervention: N/AMeasurements and Results: The prevalence of difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening was 14.8%, 11.3%, and 5.5%, respectively. Insomnia was defined as the presence of one or more of these three symptoms. The prevalence of insomnia was 23.5%. Multivariate analyses revealed that, among junior high school students, male sex, poor mental health, skipping breakfast, drinking alcohol, smoking, not participating in extracurricular activities, and late bedtime had significantly higher odds ratios for insomnia. Among senior high school students, the same characteristics were associated with a significantly higher odds ratio for insomnia, as was the additional factor of having no intent to study at university.Conclusion: Insomnia in Japanese adolescents is common and associated with multiple factors. The results of this study suggest the need for comprehensive program to prevent insomnia in Japanese adolescents.

DOI： 10.1093/sleep/29.12.1543

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Language：Japanese   Publishing type：Research paper (other academic)   Publisher：Fukushima Medical University  

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Other Link： http://search.jamas.or.jp/link/ui/2006160380

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DOI： 10.1136/tc.2005.011569

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BACKGROUND: Evidence suggests that the predictive value of serum alanine aminotransferase (ALT) levels for prognosis, measured by indices such as all-cause mortality and medical costs, may be modified by body mass index (BMI). However, the relationship between serum ALT and BMI has not been satisfactorily elucidated. METHODS: Four thousand, five hundred and twenty-four community dwelling Japanese National Health Insurance beneficiaries, 40-69 years old, were classified into five categories according to their serum ALT levels (IU/L) (ALT<20, 20< or =ALT<30, 30< or =ALT<40, 40< or =ALT<50 and 50< or =ALT) and followed for 10 years. Hazard ratios for all-cause mortality, with reference to the lowest serum ALT category, and medical costs per person were evaluated for each serum ALT category after analyzing interactions between serum ALT levels and BMI for all-cause mortality and for medical costs. RESULTS: A significant interaction between serum ALT levels and BMI was observed. In participants below the median BMI, positive, graded relationships were identified between serum ALT levels and all-cause mortality as well as between serum ALT levels and personal medical costs. The multivariate-adjusted hazard ratio in the "50< or =ALT" category showed an approximately 8-fold increase. However, in the participants at or above the median BMI, no significant relationships between serum ALT levels and all-cause mortality or personal medical costs were identified. CONCLUSIONS: In these Japanese participants, the predictive value of serum ALT levels for prognosis was more evident if BMI was taken into account. A combination of high serum ALT levels and below median BMI was associated with excess mortality and medical costs.

DOI： 10.2188/jea.16.15

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Language：Japanese   Publisher：国立保健医療科学院  

根拠に基づいた予防や治療の世界的動向を知ることができるデータベース"Cochrane Database of Systematic Reviews 3rd Quarter 2005"を用いて文献検索し,未成年者の喫煙防止に効果的な対策はなにか検討した.結果,最も有効な対策は「タバコ広告や販売促進事業への介入」で,「マスメディアへの介入」も効果があると考えられた.一方,「小売業者への介入」「学校における防煙プログラム」「地域介入」は効果に乏しいと思われた

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2005&ichushi_jid=J03876&link_issn=&doc_id=20060420470002&doc_link_id=0506426&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F0506426&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：English   Publishing type：Research paper (scientific journal)  

Hypertension and related cardiovascular diseases may lead to an increase in medical costs for patients. We attempted to clarify the relationship between hypertension and long-term medical costs by a cohort study utilizing existing data as well as baseline blood pressures and medical costs over a 10-year period. The participants included 4191 Japanese National Health Insurance beneficiaries aged 40-69 years, living in one area, who were not taking anti-hypertensive medication and did not have a history of major cardiovascular disease. They were classified into four categories according to their blood pressure. We evaluated the mean medical costs per month, cumulative hospitalization, and all-cause mortality for each blood pressure category. Hypertension-related medical costs attributable to hypertensive individuals, as compared to normotensive individuals, were estimated. There was a positively graded correlation between blood pressure and personal total medical costs, especially for men. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensive men were also higher than those in normotensive men. However, the hypertension-related medical costs for mild to moderate hypertensives were higher than those for severe hypertensives. The hypertension-related medical costs for all hypertensives accounted for 23.7% of the total medical costs for the Japanese population. In conclusion, high blood pressure was a useful predictor for excess medical costs; moreover, concomitant hypertension, regardless of the grade, increased the medical costs of Japanese National Health Insurance beneficiaries.

DOI： 10.1291/hypres.28.859

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Language：Japanese   Publisher：(一社)日本アルコール・アディクション医学会  

平成元年または2年度に滋賀県の7町1村で基本健康診査を受診した4496名(40〜69歳)のうち,飲酒習慣を有する2039名(男1520名,女519名)の国民健康保険被保険者を対象に,飲酒習慣と長期的な医療費の関連について検討した.平均9.0±2.9年間の追跡調査の結果,男性において毎日日本酒換算で3合以上の多量飲酒群は,他群に比べ1ヵ月で約2000〜3000円の医療費が高く,この傾向はベースラインから5年以内では統計学的に有意であった.健康日本21の現状(成人男性の4.1%が多量飲酒者)と目標(多量飲酒者の2割減少)に当てはめると,目標達成により年間約84億円の総医療費減少が期待された.また多量飲酒者への対策により,過剰医療費削減にもつながると考えられた

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&lt;p&gt;There are few community-based epidemiologic studies that have dealt with risk factors for heart failure in non-Western populations. It has been reported that the measurement of plasma B-type natriuretic peptide (BNP) is useful for detecting patients with asymptomatic heart failure. To clarify the determinants of high plasma BNP level, the association of BNP with cardiovascular risk factors in community dwelling residents was examined. The plasma BNP levels were measured in 686 residents aged 35-69 years who received annual health check-up. The relationship of BNP to blood pressure, blood haemoglobin, serum cholesterol (total and high-density lipoprotein cholesterol), plasma glucose, electrocardiographic (ECG) findings, urinary salt excretion, and lifestyle factors (smoking and alcohol consumption) were cross-sectionally analysed. The plasma BNP geometric mean was 13.7 pg/ml. Both linear and logistic regression analyses indicated that the plasma BNP levels were positively associated with age, urinary salt excretion, higher blood pressure, high R-wave voltage in the 12-lead ECG (Minnesota Code 3-1 or 3-3), and female gender. Plasma BNP levels were inversely associated with blood h

DOI： 10.1038/sj.jhh.1001792

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS  

Background Since World War II (WWII), exposures to westernized lifestyle have occurred in many non-Western countries, including Japan. National surveys showed that risk factor profiles for atherosclerosis around 1990 were similar in men in the post WWII birth cohorts in the US and Japan. We compared the degree of coronary calcium and other factors in men in the post WWII birth cohort: men aged 40-49 in the US and Japan.
Methods We conducted a cross-sectional study examining randomly selected 100 men from Kusatsu, Japan, and 100 men from Allegheny County, US. Coronary calcium was assessed using electron-beam computed tomography.
Results Systolic blood pressure, total cholesterol, low density lipoprotein (LDL)-cholesterol, and smoking rates were higher among the Japanese (122.6 +/- 14.1 versus 113.7 +/- 9.6 mmHg, P &lt; 0.01; 5.72 +/- 0.90 versus 4.99 +/- 0.81 mmol/l (220.9 +/- 34.6 versus 192.8 +/- 31.3 mg/dl), P &lt; 0.01; 3.52 +/- 1.01 versus 3.10 +/- 0.78 mmol/l (136.0 +/- 39.0 versus 119.7 +/- 30.0 mg/dl), P &lt; 0.01; and 48 versus 15%, P &lt; 0.01, respectively). Triglycerides and fibrinogen were similar. High density lipoprotein (HDL)-cholesterol was higher among the Japanese. Body mass index, fasting insulin, and C-reactive protein were higher among the Americans. Prevalence of coronary artery calcium score &gt;0 was strikingly lower among the Japanese than the Americans (13% versus 47%, P &lt; 0.01).
Conclusions Much lower prevalence of coronary calcium despite a less favourable profile of many major independent risk factors in the Japanese might imply that there are strong protective factors against atherosclerosis in the Japanese. Further investigation is of critical importance.

DOI： 10.1093/ije/dyh285

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OBJECTIVE: To examine the effectiveness of a small-scale smoking cessation intervention program conducted annually for ten years in an occupational setting in Japan. METHODS: We conducted an annual intervention program promoting smoking cessation in male smokers from 1993 to 2002 in an occupational setting in Hyogo, Japan. Trends in smoking prevalence in this worksite were compared with a control group from two similar worksites of the same company. The intervention program was carried out by medical students (the fourth year of a six-year course) who received training on the protocol prior to the intervention. This protocol consisted of one initial group session, followed by periodical correspondence for two months. Successful cessation of smoking was determined by self-declaration of abstinence for longer than four weeks after intervention, confirmed by an expiratory carbon monoxide concentration of less than nine ppm. Smoking prevalence was determined by a self-administered questionnaire provided at the annual health checkup. RESULTS: The proportion of smokers who participated in the program was 3.47% on average. Abstinence rates following each intervention ranged from 13.3% to 60.0%, with the prevalence of male smokers at the intervention worksite decreasing from 56.2% in 1993 to 47.0% in 2002. In contrast, the smoking prevalence of the control worksites remained largely unchanged, being 60.2% in 1995 and 57.6% in 2002. At the end of the study, the intervention worksite had a significantly lower prevalence of smokers in either the crude or age-adjusted rate. CONCLUSION: A small-scale but repeated smoking cessation intervention program at a worksite can reduce smoking prevalence more efficiently than the natural trends.

DOI： 10.1007/BF02898095

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Language：English   Publisher：The Japanese Society of Hypertension  

Pulse wave velocity (PWV) is an indicator of arterial stiffness, especially in the aorta, and a marker for vascular damage. We examined the association of brachial-ankle PWV (baPWV) with serum α-tocopherol and C-reactive protein (CRP) levels in addition to the traditional risk factors. Study subjects were 178 Japanese male workers aged 50-59 without past histories of cardiovascular diseases. The relation of baPWV with serum α-tocopherol and CRP levels was cross-sectionally analyzed after adjusting for other cardiovascular risk factors. The arithmetic mean of serum α-tocopherol was 38.9μmol/l, and the geometric mean of serum CRP was 0.47 mg/l. Multiple linear regression analysis indicated that serum CRP levels were associated with an elevation of baPWV, in addition to age, systolic blood pressure and heart rate. However, serum α-tocopherol, serum lipids (triglyceride, low and high density lipoprotein cholesterol), fasting plasma glucose, body mass index, smoking and alcohol drinking did not significantly correlate to baPWV. Multivariate-adjusted means of baPWV according to serum CRP quartile were 1,431, 1,436, 1,507 and 1,508 cm/s (p =0.033). The serum CRP level might be an important marker for arterial stiffness in Japanese middle-aged males. However, no relation was observed between α-tocopherol and baPWV. (Hypertens Res 2004; 27: 173-180)

DOI： 10.1291/hypres.27.173

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Language：Japanese   Publisher：Japanese Society of Public Health  

Background Exposure to smoking scenes in movies and TV dramas has been known to be a trigger for young people starting habitual smoking, but it has not been clarified to what extent youth is routinely exposed to smoking scenes in television programs in Japan.<br/>Objective To clarify the status quo of smoking scenes and smoking-related items in serial TV dramas targeting young audience in Japan.<br/>Method Seven TV dramas targeting a young audience broadcast between July and September, 2001 were analyzed. A total of 63 hours of TV programs were divided into units of three minutes (a total of 1,264 units). All the units were reviewed for smoking scenes, description of social contexts related to smoking behavior, existence of smoking and smoking-related items.<br/>Findings Among the 1,264 three-minute units, 129 (10.2%) contained smoking behavior, and 258 (20.4%) depicted smoking environment with presence of smoking-related items. Smokers were male actors (126 units, 97.7%), aged 20-40 years (118 units, 91.5%), leading actors (72 units, 55.8%), and were smoking alone (80 units, 62.0%). Smoking places mainly took place in indoor settings (56 units, 43.4%). Ashtrays were the most frequently observed smoking-related items (8.1% of the total units).<br/> The smoking scenes with actions other than smoking itself accounted for 70 units (54.3% of the smoking scenes).<br/> As for the actions other than smoking, working (28 units, 21.7%) and eating (17 units, 13.2%) were commonly observed. Regarding smoking scenes without any other actions, 32 units (24.8%) were observed in the beginning or ending telops, and 27 units (20.9%) showed a person smoking without doing anything else. There were only 3 units (0.2%) which were against smoking behavior.<br/> Approximately 30% of the Japanese serial television drama scenes featured tobacco use in story plots. As the general features of the smoking scenes, most of them do not necessarily require smoking in the story. Furthermore, there was little consideration about separation of designated smoking areas.

DOI： 10.11236/jph.50.1_62

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Coronary heart disease (CHD) is the leading cause of death in the United States (US). Approximately half of deaths from CHD occur out of hospital, most being sudden. The majority of sudden cardiac deaths occur in asymptomatic subjects. Recent lipid-lowering trials in asymptomatic subjects have demonstrated the potential for risk reduction for CHD events by primary prevention. It is, however, generally acknowledged that risk will be underestimated in asymptomatic subjects who fall into the category of intermediate risk by the traditional risk factors. Non-invasive measurements of subclinical atherosclerosis, which is the end result of risk-factor exposure, have the possibility of improving the risk stratification of asymptomatic subjects in intermediate-risk.<br/> Electron-beam computed tomography (EBCT) is a non-invasive and highly sensitive means to detect calcification within coronary arterial wall. Coronary artery calcification (CAC) is a recognized marker of atherosclerosis. Atherosclerotic burden of coronary arteries correlates strongly with the amount of CAC measured by EBCT. Studies examining the predictive value of CAC among asymptomatic subjects consistently reported that CAC is a risk for CHD. Two studies reported that unadjusted odds ratios of CAC for CHD were over 20. Incremental value of EBCT over the traditional risk assessment models, however, has not been established.<br/> Although CHD mortality in Japan remains uniquely low in industrialized countries, among men aged 30-49, risk factor profiles for CHD are similar between men in the US and Japan, except higher prevalence of cigarette smoking in Japan and higher prevalence of obesity in the US. It is reported that the declining trend in CHD mortality in Japan has recently slowed down in metropolitan areas, especially in men aged 30-49, and that the incidence has increased in middle-aged workers in a metropolitan area. A mortality validation study reported that the differences in CHD mortality between the US and Japan were not as large as suggested by vital statistics. It is, therefore, important to evaluate subclinical atherosclerosis measured by EBCT in men in recent birth cohorts in Japan and compare it to that in men in the US in order to predict future trend in CHD in Japan.

DOI： 10.11236/jph.50.3_183

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Total pages：xxi, 411p   Language：Japanese

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

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DOI： 10.1161/circ.141.suppl_1.P547

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J-GLOBAL

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Language：Japanese   Publisher：(一社)日本病院総合診療医学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：国立保健医療科学院  

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Other Link： http://search.jamas.or.jp/link/ui/2013222445

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Rapid communication, short report, research note, etc. (scientific journal)   Publisher：JOURNAL SPORTS SCIENCE & MEDICINE  

Web of Science

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Language：Japanese   Publisher：(公社)日本産業衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：東北公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本循環器病予防学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：Japanese   Publisher：(一社)日本衛生学会  

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Language：English   Publisher：W B SAUNDERS CO LTD  

DOI： 10.1016/j.puhe.2007.12.004

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Language：Japanese   Publisher：中央調査社  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English  

Objectives: To assess trends in smoking prevalence among Japanese adolescents and to analyze possible causal factors for the decrease in smoking prevalence observed in a 2004 survey. Methods: Nationwide cross-sectional surveys were conducted in 1996, 2000 and 2004. Survey schools, both junior and senior high schools, considered to be representative of the whole of Japan were sampled randomly. Enrolled students were asked to complete a self-reporting anonymous questionnaire on smoking behavior. The questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. School principals were asked about the policy of their respective school on smoking restrictions. Results: Cigarette smoking prevalence (lifetime, current, and daily smoking) in 2004, based on the completed questionaires, had decreased relative to previous years in both sexes and in all school grades. The most important trends were: a decrease in smoking prevalence among the fathers and older brothers of the students
an increase in the proportion of students who did not have friends
a decrease in the proportion of current smokers who usually bought cigarettes in stores decreased in 2004, in particular for the oldest boys. An association was found between a lower smoking rate at a school and a smoke-free school policy. Conclusions: Japan has experienced a decrease in the prevalence of smoking among adolescents. A decrease in smoking prevalence among the fathers and older brothers, limitations to minors' access to tobacco, an increase in the proportion of students without friends, and a school policy restricting smoking may have contributed to this decreasing trend. © 2008 The Japanese Society for Hygiene.

DOI： 10.1007/s12199-008-0033-1

Scopus

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Language：Japanese   Publisher：東北公衆衛生学会  

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Language：Japanese   Publisher：(一社)日本循環器病予防学会  

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Language：Japanese   Publisher：公益社団法人日本産業衛生学会  

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Language：Japanese   Publisher：中央調査社  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese  

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Other Link： http://search.jamas.or.jp/link/ui/2007308972

Language：English   Publisher：JAPANESE CIRCULATION SOCIETY  

Background Although obesity is required for some criteria defining metabolic syndrome, clustering of other risk factors also indicates an increased risk of cardiovascular disease. Whether the relationship between cardiovascular risk factor clustering and medical expenditures differs with body mass index (BMI) requires investigation, especially in a population with a low prevalence of obesity such as that in Japan.
Methods and Results A 10-year cohort study of 4,478 Japanese National Health Insurance beneficiaries aged 40-69 years in a community between 1990 and 2001 was carried out in the present study. The clustering of cardiovascular risk factors showed a positive and graded relationship to personal medical expenditures in participants who are overweight (BMI &gt;= 25.0) and normal weight (BMI &lt;25.0). The individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and overweight than for those without these factors (26,782 vs 15,377 Japanese yen). Differences in the geometric means were similarly significant after adjustment for other confounding factors. However, the excess medical expenditures by risk clustering of normal weight categories within the total medical expenditures were higher than those of overweight categories because more participants were of normal weight.
Conclusions Cardiovascular risk factor clustering and being overweight can be a useful predictor of medical expenditures in a Japanese population.

DOI： 10.1253/circj.71.807

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Language：Japanese  

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Language：Japanese   Publisher：杏林書院  

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Other Link： http://search.jamas.or.jp/link/ui/2007292260

Language：Japanese   Publisher：公益社団法人日本産業衛生学会  

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Language：Japanese  

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Language：English  

DOI： 10.2188/jea.16.90

PubMed

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Language：Japanese   Publisher：(公財)明治安田厚生事業団  

早期心不全予防を目的として,某地域の35〜69歳の一般住民686名を対象に,性別,BNPを含む血液検査,血圧,生活習慣に関して統計学的に検討を行い,地域スクリーニングを行った.BNP濃度とBMI,DBP,総コレステロール,HDLコレステロール,血糖値,喫煙状況とは関連性がなかった.尿中1日塩分排泄量とBNP濃度,心電図のR波高電位とは正相関がみられ,ヘモグロビン濃度とBNP濃度は負の相関を示した.女性は男性よりもBNP濃度は有意に高い傾向を示し,SBPとgrade2以上の高血圧および年齢もBNP濃度と正の相関を示した.このような血漿BNP濃度を用いたスクリーニングによって,無症候性心不全の規定要因が明らかとなった

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Language：Japanese   Publisher：(一社)日本循環器病予防学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

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Event date： 2023.7.21 - 2023.7.22

Language：Japanese   Presentation type：Oral presentation (invited, special)  

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Event date： 2023.7.8 - 2023.7.9

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2023.2.1 - 2023.2.3

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2022.10.14 - 2022.10.16

Language：English   Presentation type：Poster presentation  

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Event date： 2022.10.8

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：山梨県  

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Event date： 2022.10.7 - 2022.10.9

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Venue：山梨県  

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Event date： 2022.10.7 - 2022.10.9

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Event date： 2022.10.7 - 2022.10.9

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Venue：山梨県  

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Event date： 2022.10.7 - 2022.10.9

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Venue：山梨県  

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Event date： 2022.10.7 - 2022.10.9

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Venue：山梨県  

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Event date： 2022.9.8 - 2022.9.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：宮城県仙台市  

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Event date： 2022.9.8 - 2022.9.10

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Venue：宮城県仙台市  

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Event date： 2022.6.10 - 2022.6.12

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：武庫川女子大学  

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Event date： 2022.5.25 - 2022.5.28

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：ザ クラウンパレス新阪急高知  

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Event date： 2022.1.26 - 2022.3.13

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：千葉県  

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Event date： 2022.1.26 - 2022.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：千葉県  

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Event date： 2022.1.23 - 2022.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：千葉県  

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Event date： 2021.12.21 - 2021.12.23

Language：Japanese   Presentation type：Poster presentation  

Venue：東京  

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Event date： 2021.12.21 - 2021.12.23

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Venue：東京  

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Event date： 2021.12.17 - 2021.12.19

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Venue：三重県津市  

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Event date： 2021.12.17 - 2021.12.19

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：三重県津市