著者

Shota Hamada Hideto Takahashi Nobuo Sakata Boyoung Jeon Takahiro Mori Katsuya Iijima Satoru Yoshie Tatsuro Ishizaki Nanako Tamiya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180055, (Released:2018-09-22)

参考文献数

29

被引用文献数

30

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Background: This study aimed to determine whether there are disparities in healthcare services utilization according to household income among people aged 75 years or older in Japan.Methods: We used data on medical and long-term care (LTC) insurance claims and on LTC insurance premiums and needs levels for people aged 75 years or older in a suburban city. Data on people receiving public welfare were not available. Participants were categorized according to household income level using LTC insurance premiums data. The associations of low income with physician visit frequency, length of hospital stay (LOS), and medical and LTC expenditures were evaluated and adjusted for the five-year age group and LTC needs level.Results: The study analyzed 12,852 men and 18,020 women, among which 13.3% and 41.5% were respectively categorized as low income. Participants with low income for both genders were more likely to be functionally dependent. In the adjusted analyses, lower income was associated with fewer physician visits (incidence rate ratio: 0.90 (95% confidence interval 0.87-0.92) for men and 0.97 (0.95-0.99) for women), longer LOS (1.98 (1.54-2.56) and 1.42 (1.20-1.67)), and higher total expenditures (1.09 (1.01-1.18) and 1.09 (1.05-1.14)).Conclusions: This study suggests older people with lower income had fewer consultations with physicians but an increased use of inpatient services. The income categorization used in this study may be an appropriate proxy of socioeconomic status.

著者

Kunihiko Takahashi Hideto Takahashi Tomoki Nakaya Seiji Yasumura Tetsuya Ohira Hitoshi Ohto Akira Ohtsuru Sanae Midorikawa Shinichi Suzuki Hiroki Shimura Shunichi Yamashita Koichi Tanigawa Kenji Kamiya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180247, (Released:2019-06-15)

参考文献数

20

被引用文献数

3

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Background: After the Fukushima Daiichi Nuclear Power Plant accident, a preliminary ultrasound-based screening for thyroid cancer was conducted to establish a baseline for subsequent evaluations. In this survey, we assessed the relationship between the proportion of non-examinees and characteristics of the target populations.Methods: After summarizing a regional difference of non-examinees among the population of 359,200 (primary evaluation) and 2,246 (confirmatory testing) individuals who were living in the Fukushima prefecture on 11 March 2011, we estimated odds ratios (ORs) for each characteristic including age, sex, area of residence, and moving after the accident, based on the proportion of non-examinees for the primary examination and the confirmatory testing, using a multivariate logistic regression model.Results: The dataset included 64,117 non-examinees (primary evaluation) and 194 (confirmatory testing). The logistic regression result indicated that girls were not likely to be non-examinees compared to boys with adjusted OR of 0.80 (95% confidence interval[CI]:0.78-0.81) for the primary evaluation. OR was the lowest for children 6-10 years old (y/o) (OR=0.26, CI:0.25-0.27), and higher for those 11-15 y/o (OR=1.28, CI:1.25-1.32) and over 16 y/o (OR=5.30, CI:5.16-5.43) when compared to children 0-5 y/o. Individuals residing in the western part of the prefecture showed higher ORs. There was a higher proportion of non-examinees among those who moved after the accident compared to those who did not in the primary evaluation (OR=1.72, CI:1.64-1.79).Conclusions: In addition to the demographic characteristics, a change of residence could be a potential factor that influenced the proportion of non-examinees. Our results will help proper interpretation of reports and prospective management of the survey.

著者

Tomoki Nakaya Kunihiko Takahashi Hideto Takahashi Seiji Yasumura Tetsuya Ohira Hiroki Shimura Satoru Suzuki Satoshi Suzuki Manabu Iwadate Susumu Yokoya Hitoshi Ohto Kenji Kamiya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.Supplement_XII, pp.S76-S83, 2022-12-05 (Released:2022-12-05)

参考文献数

31

被引用文献数

2 4

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Background: After the first-round (Preliminary Baseline Survey) ultrasound-based examination for thyroid cancer in response to the accident at the Fukushima Daiichi Nuclear Power Plant in 2011, two rounds of surveys (Full-scale Survey) have been carried out in Fukushima Prefecture. Using the data from these surveys, the geographical distribution of thyroid cancer incidence over 6 or 7 years after the disaster was examined.Methods: Children and adolescents who underwent the ultrasound-based examinations in the second- and/or third-round (Full-scale) survey in addition to the first-round survey were included. With a discrete survival model, we computed age, sex, and body mass index standardized incidence ratios (SIRs) for municipalities. Then, we employed spatial statistics to assess geographic clustering tendency in SIRs and Poisson regression to assess the association of SIRs with the municipal average absorbed dose to the thyroid gland at the 59-municipality level.Results: Throughout the second- and third-round surveys, 99 thyroid cancer cases were diagnosed in the study population of 252,502 individuals. Both flexibly shaped spatial scan statistics and maximized excess events test did not detect statistically significant spatial clustering (P = 0.17 and 0.54, respectively). Poisson regression showed no significant dose-response relationship: the estimated relative risks of lowest, middle-low, middle-high, and highest areas were 1.16 (95% confidence interval [CI], 0.52–2.59), 0.55 (95% CI, 0.31–0.97), 1.05 (95% CI, 0.79–1.40), and 1.24 (95% CI, 0.89–1.74).Conclusion: There was no statistical support for geographic clustering or regional association with radiation dose measures of the thyroid cancer incidence in the cohort followed up to the third-round survey (fiscal years 2016–2017) in Fukushima Prefecture.

著者

重田 史絵 高橋 秀人 シゲタ フミエ タカハシ ヒデト Fumie Shigeta Hideto Takahashi

雑誌

立教大学コミュニティ福祉研究所紀要

巻号頁・発行日

vol.9, pp.37-49, 2021-11

著者

Shota Hamada Hideto Takahashi Nobuo Sakata Boyoung Jeon Takahiro Mori Katsuya Iijima Satoru Yoshie Tatsuro Ishizaki Nanako Tamiya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.29, no.10, pp.377-383, 2019-10-05 (Released:2019-10-05)

参考文献数

29

被引用文献数

8 30

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Background: This study aimed to determine whether there are disparities in healthcare services utilization according to household income among people aged 75 years or older in Japan.Methods: We used data on medical and long-term care (LTC) insurance claims and on LTC insurance premiums and needs levels for people aged 75 years or older in a suburban city. Data on people receiving public welfare were not available. Participants were categorized according to household income level using LTC insurance premiums data. The associations of low income with physician visit frequency, length of hospital stay (LOS), and medical and LTC expenditures were evaluated and adjusted for 5-year age groups and LTC needs level.Results: The study analyzed 12,852 men and 18,020 women, among which 13.3% and 41.5%, respectively, were categorized as low income. Participants with low income for both genders were more likely to be functionally dependent. In the adjusted analyses, lower income was associated with fewer physician visits (incidence rate ratio [IRR] 0.90; 95% confidence interval [CI], 0.87–0.92 for men and IRR 0.97; 95% CI, 0.95–0.99 for women), longer LOS (IRR 1.98; 95% CI, 1.54–2.56 and IRR 1.42; 95% CI, 1.20–1.67, respectively), and higher total expenditures (exp(β) 1.09; 95% CI, 1.01–1.18 and exp(β) 1.09; 95% CI, 1.05–1.14, respectively).Conclusions: This study suggests that older people with lower income had fewer consultations with physicians but an increased use of inpatient services. The income categorization used in this study may be an appropriate proxy of socioeconomic status.

著者

Daisuke Hazeki Masao Yoshinaga Hideto Takahashi Yuji Tanaka Yasue Haraguchi Mayumi Abe Masami Koga Toshiro Fukushige Masami Nagashima

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.74, no.8, pp.1663-1669, 2010 (Released:2010-07-23)

参考文献数

12

被引用文献数

13 33 8

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Background: The corrected QT interval (QTc) according to Bazett's formula (QTc = QT/RR1/2) has been used in clinical practice. Bazett's formula, however, overcorrects the QT interval at fast heart rates and undercorrects it at low heart rates. Guidelines and some investigators have recommended using Fridericia's formula (QTc = QT/RR1/3) in these cases, especially in tachycardic subjects. The aim of the present study was to determine cut-offs for QTc suitable for screening pediatric subjects with prolonged QT intervals, based on manually measured values corrected by Fridericia's formula in a large number of subjects. Methods and Results: Three consecutive QT and RR intervals were measured in 4,655, 4,655, and 5,273 1st, 7th, and 10th graders, aged 6, 12, and 15 years, respectively. Each QT interval was corrected by Fridericia's formula, and mean values were calculated. Determination of the cut-offs for screening was based on the prevalence of abnormal electrocardiographic phenotypes of 1:1,164 and on the upper 0.025 percentile in the QTc distribution derived from previous studies. The tentative cut-offs suitable for screening subjects with prolonged QT intervals were 430 ms for 1st graders, 445 ms for 7th graders, and 440 and 455 ms for 10th grade boys and girls, respectively. Conclusions: These tentative cut-offs can be used to screen subjects with prolonged QT intervals in the clinical setting. Further studies are needed to confirm their validity.  (Circ J 2010; 74: 1663 - 1669)

著者

Masao Yoshinaga Yoshiaki Kato Yuichi Nomura Daisuke Hazeki Toshiaki Yasuda Kazuhiro Takahashi Takashi Higaki Yuji Tanaka Akihiro Wada Hitoshi Horigome Hideto Takahashi Kentaro Ueno Hiroshi Suzuki Masami Nagashima

出版者

日本不整脈学会

雑誌

Journal of Arrhythmia (ISSN:18804276)

巻号頁・発行日

vol.27, no.3, pp.193-201, 2011-07-25 (Released:2011-08-26)

参考文献数

27

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Background: Electrocardiographic and molecular studies have clarified an association between sudden infant death syndrome (SIDS) and long QT syndrome (LQTS), and few data are available for the QT interval in infancy from birth to 1 year of age. Appropriate time of electrocardiographic screening is not clarified. Medical examinations during infancy are mandatory in Japan.Methods and Results: The study population included 1,058 infants. Electrocardiograms were collected with information of infants at birth and at examination. The QT intervals of three consecutive beats were measured in lead V5. Statistical analysis revealed that the following formula was appropriate to minimize the effect of heart rate for infants: corrected QT interval; QTc = QT interval/RR interval0.43. Subjects were divided into four groups as follows: 0–2, 3–6, 6–11, and 12–52 weeks of age. Tukey’s multiple comparison showed that the QTc intervals were longest (p<0.0001) in subjects who were 6–11 weeks of age.Conclusions: The QTc interval showed the highest peak at 6–11 weeks of age in infancy. The peak period of occurrence of SIDS is at approximately 2 months of age. An appropriate time of electrocardiographic screening for QT prolongation will be one month of age, and follow-up studies are needed.