著者

BITO Seiji FUKUHARA Shunichi SHAPIRO Martin F HASHIMOTO Hideki KUROKAWA Kiyoshi

出版者

日本疫学会

雑誌

Journal of epidemiology (ISSN:09175040)

巻号頁・発行日

vol.11, no.4, pp.160-169, 2001-07

参考文献数

34

被引用文献数

2

---

While universal insurance coverage should eliminate or substantially reduce financial and certain structural barriers to medical care, inequity in utilization of care may continue to exist. We conducted a questionnaire survey of a national random sample of 4500 Japanese age16 or over in October, 1995. Separate analyses were conducted to predict the physician visit rates for the entire respondents (N=3395) and for those with chronic conditions (N=777). Forty-three percent of the total subjects reported an ambulatory physician visit within the past three months. About 17% of subjects with one chronic condition and 14% of those with two or more chronic conditions did not have any physician visits within recent three months. The regression model demonstrated that having a home doctor, as well as comorbidity and perceived health status, is significantly associated with outpatient visit both among all subjects (p< 0.0001) and among those with chronic conditions (p< 0.01). The Japanese health system still has unevenness in outpatient resource utilization. This mainly pertains to whether they have their own regular physician. The failure of some persons with chronic diseases to be seen requires further investigation. J Epidemiol, 2001 ; 11 : 160-169

著者

Xing-Gang Zhuo Shaw Watanabe

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.9, no.4, pp.275-284, 1999 (Released:2007-11-30)

参考文献数

28

被引用文献数

12 31

---

Dietary factors were analyzed for the regional difference of GI tract cancer mortality rates in China. Sixty-five rural counties were selected among a total of 2, 392 counties to represent a range of rates for seven most prevalent cancers. The dietary data in the selected 65 counties were obtained by three-day dietary record of households in 1983. The four digestive cancer mortality rates (annual cases per 100, 000 standardized truncated rates for ages 35-64) and per capita food consumption were analyzed by the principal components factor analysis. Esophageal cancer associated with poor area, dietary pattern rich in starchy tubers, and salt, lack of consumption of meat, eggs, vegetables and rice. Stomach cancer seemed to be less associated with diet in this study because of its small model Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy, suggesting some other carcinogenic factors would play more important role in the development of this cancer in China. The colon and rectal cancer showed close relation to diet; rich in sea vegetables, eggs, soy sauce, meat and fish, while lack in consumption of milk and dairy products. Rapeseed oil was more important risk factor for colon cancer than that of rectum. Rice, processed starch and sugar were closely associated with colon cancer, supporting the insulin/colon cancer hypothesis. J Epidemiol, 1999 ; 9 : 275-284.

著者

Chushi Kuroiwa Phengta Vongphrachanh Phoxay Xayyavong Kongmany Southalack Masahiro Hashizume Satoshi Nakamura

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.11, no.6, pp.255-262, 2001 (Released:2007-11-30)

参考文献数

22

被引用文献数

5 5

---

Following the Pan American Health Organization (PAHO) recommendation on measles elimination, the Western Pacific Region of WHO (WPR) is emphasizing accelerated measles control programme especially since the achievement of polio eradication in WPR in 2000. This includes upgraded surveillance and mass measles vaccination campaign for children aged 9 months to 4 years. However, there are limited scientific evidences supporting the feasibility of this programme in Laos. To examine measles elimination feasibility in the country, we conducted measles outbreak investigation using immunoglobulin M (IgM). From March 1999 to March 2000, we conducted 7 outbreak investigations. At the outbreak sites, we examined clinical manifestations of cases and collected individual data. About five blood samples were drawn from each outbreak, and lgM antibodies to measles were tested. Of 7 investigated outbreaks, 5 were confirmed as measles, one was chickenpox, and one occurred in the inaccessible area due to flooding. In a village of high land Lao, blood drawn was refused. Of 185 cases, 64 (34.6%) cases were immunized, and 110 (59.5%) were unimunized. The estimated vaccine efficacy is 67.9%. The number of measles cases among school-aged children was 74 (40.0%), which represented 2.5% of the total population in investigated villages. Our findings showed various difficulties of the surveillance and the limited outcomes of mass measles vaccination campaign under the accelerated measles control programme by WPR. Efforts to improve cold chain as well as increasing routine immunization coverage must be the priority of measles control. J Epidemiol, 2001 ; 11 : 255-262

著者

Ryoma Michishita Takuro Matsuda Shotaro Kawakami Akira Kiyonaga Hiroaki Tanaka Natsumi Morito Yasuki Higaki

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.7, pp.378-385, 2016-07-05 (Released:2016-07-05)

参考文献数

36

被引用文献数

1 30

---

Background: This cross-sectional study evaluated the association between unhealthy lifestyle behaviors and the prevalence of chronic kidney disease (CKD) in middle-aged and older men.Methods: The subjects included 445 men without a history of cardiovascular disease, stroke, or dialysis treatment, who were not taking medications. Unhealthy lifestyle behaviors were evaluated using a standardized self-administered questionnaire and were defined as follows: 1) lack of habitual moderate exercise, 2) lack of daily physical activity, 3) slow walking speed, 4) fast eating speed, 5) late-night dinner, 6) bedtime snacking, and 7) skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions based on the number of unhealthy lifestyle behaviors (0–1, 2, 3, and ≥4 unhealthy behaviors).Results: According to a multivariate analysis, the odds ratio (OR) for CKD (defined as estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 and/or proteinuria) was found to be significantly higher in the ≥4 group than in the 0–1 group (OR 4.67; 95% confidence interval [CI], 1.51–14.40). Moreover, subjects’ lack of habitual moderate exercise (OR 3.06; 95% CI, 1.13–8.32) and presence of late-night dinner (OR 2.84; 95% CI, 1.40–5.75) and bedtime snacking behaviors (OR 2.87; 95% CI, 1.27–6.45) were found to be significantly associated with the prevalence of CKD.Conclusions: These results suggest that an accumulation of unhealthy lifestyle behaviors, especially those related to lack of habitual moderate exercise and presence of late-night dinner and bedtime snacking may be associated with the prevalence of CKD.

著者

Toshiaki Kawachi Keiko Wada Kozue Nakamura Michiko Tsuji Takashi Tamura Kie Konishi Chisato Nagata

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.3, pp.123-130, 2016-03-05 (Released:2016-03-05)

参考文献数

39

被引用文献数

2 18

---

Background: Few studies have assessed the associations between sleep duration and stroke subtypes. We examined whether sleep duration is associated with mortality from total stroke, ischemic stroke, and hemorrhagic stroke in a population-based cohort of Japanese men and women.Methods: Subjects included 12 875 men and 15 021 women aged 35 years or older in 1992, who were followed until 2008. The outcome variable was stroke death (ischemic stroke, hemorrhagic stroke, and total stroke).Results: During follow-up, 611 stroke deaths (354 from ischemic stroke, 217 from hemorrhagic stroke, and 40 from undetermined stroke) were identified. Compared with 7 h of sleep, ≥9 h of sleep was significantly associated with an increased risk of total stroke and ischemic stroke mortality after controlling for covariates. Hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.51 (95% CI, 1.16–1.97) and 1.65 (95% CI, 1.16–2.35) for total stroke mortality and ischemic stroke mortality, respectively. Short sleep duration (≤6 h of sleep) was associated with a decreased risk of mortality from total stroke (HR 0.77; 95% CI, 0.59–1.01), although this association was of borderline significance (P = 0.06). The trends for total stroke and ischemic stroke mortality were also significant (P < 0.0001 and P = 0.0002, respectively). There was a significant risk reduction of hemorrhagic stroke mortality for ≤6 h of sleep as compared with 7 h of sleep (HR 0.64; 95% CI, 0.42–0.98; P for trend = 0.08). The risk reduction was pronounced for men (HR 0.31; 95% CI, 0.16–0.64).Conclusions: Data suggest that longer sleep duration is associated with increased mortality from total and ischemic stroke. Short sleep duration may be associated with a decreased risk of mortality from hemorrhagic stroke in men.

著者

Ryota Sakurai Hisashi Kawai Hideyo Yoshida Taro Fukaya Hiroyuki Suzuki Hunkyung Kim Hirohiko Hirano Kazushige Ihara Shuichi Obuchi Yoshinori Fujiwara

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20150017, (Released:2016-02-20)

参考文献数

28

被引用文献数

19

---

Background: The health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function.Methods: On the basis of interviews, 614 community-dwelling older adults (after excluding 63 participants who never cycled) were classified as cyclists with ML, cyclists without ML, non-cyclists with ML (who ceased bicycling due to physical difficulties), or non-cyclists without ML (who ceased bicycling for other reasons). A cyclist was defined as a person who cycled at least a few times per month, and ML was defined as difficulty walking 1 km or climbing stairs without using a handrail. Functional capacity and physical ability were evaluated by standardized tests.Results: Regular cycling was documented in 399 participants, and 74 of them (18.5%) had ML; among non-cyclists, 49 had ML, and 166 did not. Logistic regression analysis for evaluating the relationship between bicycling and functional capacity revealed that non-cyclists with ML were more likely to have reduced IADL and social function compared to cyclists with ML. However, logistic regression analysis also revealed that the risk of bicycle-related falls was significantly associated with ML among older cyclists.Conclusions: The ability and opportunity to bicycle may prevent reduced IADL and social function in older adults with ML, although older adults with ML have a higher risk of falls during bicycling. It is important to develop a safe environment for bicycling for older adults.

著者

Akira Sakai Tetsuya Ohira Mitsuaki Hosoya Akira Ohtsuru Hiroaki Satoh Yukihiko Kawasaki Hitoshi Suzuki Atsushi Takahashi Gen Kobashi Kotaro Ozasa Seiji Yasumura Shunichi Yamashita Kenji Kamiya Masafumi Abe

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.25, no.1, pp.80-87, 2015-01-05 (Released:2015-01-05)

参考文献数

8

被引用文献数

3 14 2

---

Background: Lymphocytes are susceptible to damage from radiation, and the white blood cell (WBC) count, including counts of neutrophils and lymphocytes, is a useful method of dosimetry. According to the basic survey of the Fukushima Health Management Survey (FHMS), among 13 localities where evacuation was recommended, Iitate and Namie had more individuals with external radiation exposure of more than 5 mSv than the other evacuation areas. We analyzed whether or not WBC, neutrophil, and lymphocyte counts decreased after the disaster.Methods: The subjects of this study were 45 278 men and women aged 20 to 99 years (18 953 men and 26 325 women; mean age 56 years) in the evacuation zone who participated in the Comprehensive Health Check (CHC) from June 2011 to the end of March 2012.Results: Significant differences were detected in the mean values of WBC, neutrophil, and lymphocyte counts, and for the proportion of individuals under the minimum standard for WBC and neutrophil counts, among the 13 localities. However, the distribution of individuals at each 200-cell/µL increment in lymphocyte count were similar in these areas, and the WBC, neutrophil, and lymphocyte counts did not decrease in Iitate or Namie specifically.Conclusions: No marked effects of radiation exposure on the distribution of WBC counts, including neutrophil and lymphocyte counts were detected within one year after the disaster in the evacuation zone.

著者

Chadwick John Green Palina de Dauwe Terry Boyle Seyed Mehdi Tabatabaei Lin Fritschi Jane Shirley Heyworth

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.24, no.2, pp.146-153, 2014-03-05 (Released:2014-03-05)

参考文献数

55

被引用文献数

7 32

---

Background: Data regarding the effects of tea, coffee, and milk on the risk of colorectal cancer are inconsistent. We investigated associations of tea, coffee, and milk consumption with colorectal cancer risk and attempted to determine if these exposures were differentially associated with the risks of proximal colon, distal colon, and rectal cancers.Methods: Data from 854 incident cases and 948 controls were analyzed in a case-control study of colorectal cancer in Western Australia during 2005–07. Multivariable logistic regression was used to analyze the associations of black tea (with and without milk), green tea, herbal tea, hot coffee, iced coffee, and milk with colorectal cancer.Results: Consumption of 1 or more cups of herbal tea per week was associated with a significantly decreased risk of distal colon cancer (adjusted odds ratio, 0.37; 95% CI, 0.16–0.82; PTrend = 0.044), and consumption of 1 or more cups of iced coffee per week was associated with increased risk of rectal cancer (adjusted odds ratio, 1.52; 95% CI, 0.91–2.54; PTrend = 0.004). Neither herbal tea nor iced coffee was associated with the risk of proximal colon cancer. Hot coffee was associated with a possible increased risk of distal colon cancer. Black tea (with or without milk), green tea, decaffeinated coffee, and milk were not significantly associated with colorectal cancer risk.Conclusions: Consumption of herbal tea was associated with reduced risk of distal colon cancer, and consumption of iced coffee was associated with increased rectal cancer risk.

著者

Mahbubur Rahman Satoshi Morita Tsuguya Fukui Junichi Sakamoto

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.15, no.2, pp.38-40, 2005 (Released:2005-05-10)

参考文献数

4

被引用文献数

4 5

---

BACKGROUND: Physicians' perception and attitudes towards a research topic and trial management could influence their participation in a randomized controlled trial. The objectives of this study were to determine the reasons for physicians' participation in and attitudes towards the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial.METHODS: CASE-J's main objective is to compare the effectiveness of an angiotensin II receptor antagonist (candesartan cilexetil) with that of a calcium channel blocker (amlodipine besilate) in terms of the incidence of cardiovascular events among high-risk hypertensive patients. We conducted a questionnaire survey among the physicians (n=512) participating in that trial to determine the reasons behind their participation and to elicit their reactions to the trial management.RESULTS: Eighty-eight percent of the 512 participating physicians responded to our survey. The main reasons for participation were clear objectives of the trial (85.1%), a simple protocol (61.1%), interest in finding out the inhibiting effects of the drugs on cardiac events (80.2%), and a well-organized support system (59.8%). As for negative factors, case registration and follow-up were considered cumbersome by 28.6% and 10.8%, respectively while 44.2% stated that support by the clinical research coordinators provided by the trial management authority was necessary for case screening, recruitment process, patient registration, and follow-up. Multivariate logistic regression analysis showed that participants who did not use a computer very regularly (odds ratio = 1.9, 95% confidence interval = 1.1-3.6) were more likely to consider the case registration and follow-up procedures as a cumbersome.CONCLUSION: The information generated by this study could be useful in designing future randomized controlled trials in Japan and abroad.J Epidemiol2005;15:38-40.

著者

Shizuka Sasazuki Manami Inoue Ichiro Tsuji Yumi Sugawara Akiko Tamakoshi Keitaro Matsuo Kenji Wakai Chisato Nagata Keitaro Tanaka Tetsuya Mizoue Shoichiro Tsugane

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.21, no.6, pp.417-430, 2011-11-05 (Released:2011-11-05)

参考文献数

50

被引用文献数

26 88 16

---

Background: We pooled data from 7 ongoing cohorts in Japan involving 353 422 adults (162 092 men and 191 330 women) to quantify the effect of body mass index (BMI) on total and cause-specific (cancer, heart disease, and cerebrovascular disease) mortality and identify optimal BMI ranges for middle-aged and elderly Japanese.Methods: During a mean follow-up of 12.5 years, 41 260 deaths occurred. The Cox proportional hazards model was used to estimate hazard ratios (HRs) for each BMI category, after controlling for age, area of residence, smoking, drinking, history of hypertension, diabetes, and physical activity in each study. A random-effects model was used to obtain summary measures.Results: A reverse-J pattern was seen for all-cause and cancer mortality (elevated risk only for high BMI in women) and a U- or J-shaped association was seen for heart disease and cerebrovascular disease mortality. For total mortality, as compared with a BMI of 23 to 25, the HR was 1.78 for 14 to 19, 1.27 for 19 to 21, 1.11 for 21 to 23, and 1.36 for 30 to 40 in men, and 1.61 for 14 to 19, 1.17 for 19 to 21, 1.08 for 27 to 30, and 1.37 for 30 to 40 in women. High BMI (≥27) accounted for 0.9% and 1.5% of total mortality in men and women, respectively.Conclusions: The lowest risk of total mortality and mortality from major causes of disease was observed for a BMI of 21 to 27 kg/m2 in middle-aged and elderly Japanese.

著者

Wang Chao Jiang Heng Zhu Yi Guo Yingying Gan Yong Tian Qingfeng Lou Yiling Cao Shiyi Lu Zuxun

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

2021

被引用文献数

2

---

<p><b>Background:</b> Increasing number of studies has suggested the time to first cigarette after waking (TTFC) have significant positive effect on respiratory diseases. However, few of them are focused on Chinese population. This study aims to estimate the impact of TTFC on the prevalence of chronic respiratory diseases (CRD) in Chinese elderly and explore the association in different sub-populations.</p><p><b>Methods:</b> Cross-sectional data of demographic characteristics, living environment, smoking-related variables, and CRD were drawn from the Chinese Longitudinal Healthy Longevity Survey in 2018. Multivariate stepwise logistic regression analyses were conducted to examine the association of the TTFC with the prevalence of CRD.</p><p><b>Results:</b> This study includes 13208 subjects aged 52 years and older, with a mean age of 85.3 years. Of them, 3779 participants are ex- or current smokers (44.9% had the TTFC ≤30 minutes, 55.1% >30 minutes) and 1503 have suffered from CRD. Compared with non-smokers, participants with TTFC ≤30 minutes seemed to have higher prevalence of CRD (OR 1.97; 95% CI, 1.65-2.35) than those with TTFC >30 minutes (OR 1.70; 95% CI, 1.44-2.00), although the difference was statistically insignificant (<i>P_interaction</i>=0.12). Compared with TTFC >30 minutes, TTFC ≤30 minutes could drive a higher prevalence of CRD among female participants, those aged 90 years and older, urban residents, and those ex-smokers (<i>P_interaction</i><0.05).</p><p><b>Conclusions:</b> Shorter TTFC relates to higher prevalences of CRD in Chinese older females, those aged 90 years and older, urban residents, and ex-smokers. Delaying TTFC might particially reduce its detrimental impact on respiratory disease in these specific subpopulations.</p>

著者

TOHYAMA Eiichi

出版者

日本疫学会

雑誌

Journal of epidemiology (ISSN:09175040)

巻号頁・発行日

vol.6, no.4, pp.184-191, 1996-12

参考文献数

46

被引用文献数

16

---

The Okinawa Islands located in the southern-most part of Japan were under U.S.administration from 1945 to 1972. During that time, fluoride was added to the drinking water supplies in most regions. The relationship between fluoride concentration in drinking water and uterine cancer mortality rate was studied in 20 municipalities of Okinawa and the data were analyzed using correlation and multivariate statistics. The main findings were as follows.<br>(1) A significant positive correlation was found between fluoride concentration in drinking water and uterine cancer mortality in 20 municipalities (r=0.626, p<0.005).<br>(2) Even after adjusting for the potential confounding variables, such as tap water diffusion rate, primary industry population ratio, income gap, stillbirth rate, divorce rate, this association was considerably significant.<br>(3) Furthermore, the time trends in the uterine cancer mortality rate appear to be related to changes in water fluoridation practices. <i>J Epidemiol</i>, 1996 ; 6 : 184-191.

著者

WAKAI Kenji NAITO Mariko NAITO Toru NAKAGAKI Haruo UMEMURA Osami YOKOTA Makoto HANADA Nobuhiro KAWAMURA Takashi

出版者

日本疫学会

雑誌

Journal of epidemiology (ISSN:09175040)

巻号頁・発行日

vol.19, no.2, pp.72-80, 2009-03-01

参考文献数

31

被引用文献数

3 9

---

<b>Background: </b>To examine the association between oral health and general well-being, we are currently conducting a nationwide cohort study comprising members of the Japan Dental Association (JDA). Herein, we describe the study design and the profile of the participants at baseline.<BR><b>Methods: </b>From 2001 through 2006, the participants completed a baseline questionnaire that surveyed factors related to lifestyle, general health, and oral health. Morbidity and mortality have been monitored by using information from fraternal insurance programs operated by prefectural dental associations. All respondents provided written, informed consent for participation and the use of their insurance data.<BR><b>Results: </b>A total of 21 272 JDA members participated in the baseline survey (response rate, 36.2%). Their mean age &plusmn; SD was 52.3 &plusmn; 12.3 years; 8.0% were women. Among the respondents, 30.2% of men and 10.7% of women were current smokers; 73.5% of men and 44.8% of women were current drinkers. The cohort scored higher on oral health indices than did the general Japanese population: dentists were more likely to brush their teeth &ge;3 times/day, to have &ge;20 teeth, to have fewer lost teeth, to be free from periodontal diseases, and to have higher General Oral Health Assessment Index scores. There was, however, considerable inter-individual variation in scores on the indices.<BR><b>Conclusions: </b>More than one-third of JDA members participated in the study. Their oral average health status was better than that of the general population. Nevertheless, it will be possible to compare morbidity and mortality between those with better and worse scores on oral health indices.

著者

Saiepour Nargess Ware Robert Najman Jake Baker Peter Clavarino Alexandra Williams Gail

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.1, pp.45-49, 2016

被引用文献数

12

---

<b>Background: </b>To identify patterns of loss to follow-up and baseline predictors of each pattern.<BR><b>Methods: </b>The Mater-University Study of Pregnancy collected baseline information for 7718 pregnant women who attended Mater Hospital in Brisbane, Australia, from 1981 through 1983. Follow-up data for 6753 eligible participants were collected at 6 months, 5 years, 14 years, 21 years, and 27 years after giving birth. Participants were partitioned into groups of &lsquo;Always Responders&rsquo;, &lsquo;Returners&rsquo;, &lsquo;Leavers&rsquo;, &lsquo;Intermittents&rsquo;, and &lsquo;Never Responders&rsquo;. Multinomial logistic regression was used to simultaneously compare baseline characteristics of the last four groups with &lsquo;Always Responders&rsquo;.<BR><b>Results: </b>Being younger, less educated, having no partner, and living in rented housing were associated with being a &lsquo;Returner&rsquo;. Not owning housing, receiving welfare benefits, and being younger, less educated, not married, a smoker, an Aboriginal/Islander, and born in a non-English-speaking country were associated with being a &lsquo;Leaver&rsquo;, an &lsquo;Intermittent&rsquo;, or a &lsquo;Never-responder&rsquo;. Having higher mental health score and drinking before pregnancy were associated with being a &lsquo;Leaver&rsquo; or an &lsquo;Intermittent&rsquo;. Being unemployed and not physically active were associated with being a &lsquo;Leaver&rsquo; or &lsquo;Never Responder&rsquo;. The groups &lsquo;Leavers&rsquo; and &lsquo;Never Responders&rsquo; were the most different from the &lsquo;Always Responders&rsquo;. The group that was most similar to &lsquo;Always Responders&rsquo; was the &lsquo;Returners&rsquo;.<BR><b>Conclusions: </b>Patterns of loss to follow-up should be considered in the application of missing data techniques, where researchers make assumptions about the characteristics of those subjects who do not respond to assess the type of missing data. This information can be used to prevent individuals who are at high risk of dropping out of a study from doing so.

著者

Megumi Koizumi Hiroshi Ito Yoshihiro Kaneko Yutaka Motohashi

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.18, no.5, pp.191-196, 2008 (Released:2008-10-01)

参考文献数

22

被引用文献数

14 53

---

Background: Many studies have focused on disease causality, but few of them deal with health-promoting factors. Thus, we examined the effect of having a sense of purpose in life (ikigai) on mortality from cardiovascular disease (CVD). Methods: In 1988, we conducted a prospective cohort study of 2,959 Japanese subjects, ranging in age from 40 to 74 years, and followed them till the end of 2003. The level of their sense of purpose in life was evaluated by a self-administered questionnaire. After excluding those with a history of heart disease, stroke, or malignant tumor, 1,618 subjects (832 men and 786 women) who had completed the questionnaire were used in the analyses with Cox's proportional hazards model. Results: During the average 13.3 years of follow up, 249 deaths (172 men and 77 women) occurred as a result of all causes: 32 from heart disease, 31 from stroke, 63 from CVD, and 104 from malignant tumors. The adjusted hazard ratios for death in men with a strong sense of purpose in life, as compared with those with a low sense of purpose, were 0.28 (95% confidence interval: 0.10-0.84) for stroke, 0.56 (0.28-1.10) for CVD, and 0.62 (0.45-0.86) as a result of all causes. In women, no significant relationship was found between having a sense of purpose in life and mortality; this was possibly because the smaller number of deaths reduced the statistical significance. Conclusion: We found that in men, having a sense of purpose in life affected the risk of death as a result of all causes, stroke, and CVD.

著者

Jung Hun Lee Young Sun Park Joong Sub Choi

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.20, no.2, pp.97-105, 2010-03-05 (Released:2010-03-05)

参考文献数

20

被引用文献数

38 121

---

Background: Appendicitis is one of the most frequent acute surgical conditions of the abdomen, and appendectomy is one of the most commonly performed operations in the world. However, epidemiological data on appendicitis have not been reported for South Korean or East Asian populations.Methods: We analyzed the epidemiological features and lifetime risk of appendicitis and appendectomy in South Korea using data collected for the national health insurance database from 2005 through 2007.Results: Appendectomy was performed in 59.70% of inpatients diagnosed with appendicitis. The overall incidences of appendicitis, total appendectomy, and perforated appendectomy were 22.71, 13.56, and 2.91 per 10 000 population per year, respectively. The incidence of appendicitis and appendectomy showed clear seasonality, with a peak in summer. The standardized lifetime risks of appendicitis and appendectomy were constant from 2005 through 2007. A life table model suggests that the lifetime risk of appendicitis is 16.33% for males and 16.34% for females, and that the lifetime risk of appendectomy is 9.89% for males and 9.61% for females.Conclusions: As compared to results obtained in research on Western populations, appendicitis and appendectomy had a similar perforation rate and seasonality, but a higher overall incidence, in South Koreans. Between 2005 and 2007, the incidence of appendicitis and appendectomy was constant. Overall, an estimated 15 incidental appendectomies are performed to prevent 1 inpatient with suspected appendicitis, and 26 incidental appendectomies are performed to prevent 1 appendectomy. Incidental appendectomy may have greater preventive value in Koreans.

著者

Hiroharu Kamioka Kiichiro Tsutani Hiroyasu Okuizumi Yoshiteru Mutoh Miho Ohta Shuichi Handa Shinpei Okada Jun Kitayuguchi Masamitsu Kamada Nobuyoshi Shiozawa Takuya Honda

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.20, no.1, pp.2-12, 2010-01-05 (Released:2010-01-05)

参考文献数

19

被引用文献数

32 87

---

Background: The objective of this review was to summarize findings on aquatic exercise and balneotherapy and to assess the quality of systematic reviews based on randomized controlled trials.Methods: Studies were eligible if they were systematic reviews based on randomized clinical trials (with or without a meta-analysis) that included at least 1 treatment group that received aquatic exercise or balneotherapy. We searched the following databases: Cochrane Database Systematic Review, MEDLINE, CINAHL, Web of Science, JDream II, and Ichushi-Web for articles published from the year 1990 to August 17, 2008.Results: We found evidence that aquatic exercise had small but statistically significant effects on pain relief and related outcome measures of locomotor diseases (eg, arthritis, rheumatoid diseases, and low back pain). However, long-term effectiveness was unclear. Because evidence was lacking due to the poor methodological quality of balneotherapy studies, we were unable to make any conclusions on the effects of intervention. There were frequent flaws regarding the description of excluded RCTs and the assessment of publication bias in several trials. Two of the present authors independently assessed the quality of articles using the AMSTAR checklist.Conclusions: Aquatic exercise had a small but statistically significant short-term effect on locomotor diseases. However, the effectiveness of balneotherapy in curing disease or improving health remains unclear.

著者

Ryota Sakurai Hisashi Kawai Hideyo Yoshida Taro Fukaya Hiroyuki Suzuki Hunkyung Kim Hirohiko Hirano Kazushige Ihara Shuichi Obuchi Yoshinori Fujiwara

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.26, no.6, pp.307-314, 2016-06-05 (Released:2016-06-05)

参考文献数

28

被引用文献数

19

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Background: The health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function.Methods: On the basis of interviews, 614 community-dwelling older adults (after excluding 63 participants who never cycled) were classified as cyclists with ML, cyclists without ML, non-cyclists with ML (who ceased bicycling due to physical difficulties), or non-cyclists without ML (who ceased bicycling for other reasons). A cyclist was defined as a person who cycled at least a few times per month, and ML was defined as difficulty walking 1 km or climbing stairs without using a handrail. Functional capacity and physical ability were evaluated by standardized tests.Results: Regular cycling was documented in 399 participants, and 74 of them (18.5%) had ML; among non-cyclists, 49 had ML, and 166 did not. Logistic regression analysis for evaluating the relationship between bicycling and functional capacity revealed that non-cyclists with ML were more likely to have reduced IADL and social function compared to cyclists with ML. However, logistic regression analysis also revealed that the risk of bicycle-related falls was significantly associated with ML among older cyclists.Conclusions: The ability and opportunity to bicycle may prevent reduced IADL and social function in older adults with ML, although older adults with ML have a higher risk of falls during bicycling. It is important to develop a safe environment for bicycling for older adults.

著者

Etsuji Okamoto

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.24, no.1, pp.77-83, 2014-01-05 (Released:2014-01-05)

参考文献数

10

被引用文献数

4 18

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Background: Japan’s National Database (NDB) includes data on health checks and health insurance claims, is linkable using hash functions, and is available for research use. However, the linkage rate between health check and health insurance claims data has not been investigated.Methods: Linkage rate was evaluated by comparing observed medical and pharmaceutical charges among health check recipients in fiscal year (FY) 2009 (N = 21 588 883) with expected charges from the same population when record linkage was complete. Using the NDB, observed charges were estimated from the first published result of linking health check recipients in FY2009 and their health insurance claims in FY2010. Expected charges were estimated by combining 3 publicly available datasets, including data from the Medical Care Benefit Survey and an ad-hoc report by the Japan Health Insurance Association.Results: Only 14.9% of expected charges were linked by the NDB. The linkage rate was higher for women than for men (18.2% vs 12.4%) and for elderly adults as compared with younger adults (>25% vs <10%).Conclusions: The linkage rate in the NDB was so low that any research linking health check and health insurance claims will not be reliable. Causes for the low linkage rate include differences between health check and health insurance claims data in name format (eg, insertion of a space between family and given names) and date of birth (Japanese vs Gregorian calendar). Investigation of the causes for the low linkage rate and measures for improvement are urgently needed.

著者

Yasuhiko Kubota Hiroyasu Iso Akiko Tamakoshi

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20150123, (Released:2015-12-26)

参考文献数

33

被引用文献数

2 33

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Background: The associations of bowel movement frequency and laxative use with cardiovascular disease (CVD) are unclear.Methods: A total of 72 014 subjects (29 668 men and 42 346 women) aged 40 to 79 years, without a history of CVD or cancer, completed a lifestyle questionnaire at baseline between 1988 and 1990 that included information on bowel movement frequency (daily, every 2–3 days, or once every 4 or more days) and laxative use (yes or no), and were followed-up until 2009.Results: During the subjects’ 1 165 569 person-years of follow-up, we documented 977 deaths from coronary heart disease (561 men and 416 women), 2024 from total stroke (1028 men and 996 women), 1127 from ischemic stroke (606 men and 521 women), and 828 from hemorrhagic stroke (388 men and 440 women). The prevalence of CVD risk factors, such as diabetes, stress, depression, and physical inactivity, was higher in laxative users and in those with a lower frequency of bowel movements. The multivariable HRs (95% confidence intervals [CIs]) of laxative users were as follows: 1.56 (95% CI, 1.21–2.03) for coronary heart disease and 1.37 (95% CI, 1.07–1.76) for ischemic stroke in men, and 1.27 (95% CI, 1.08–1.49) for total stroke, and 1.45 (95% CI, 1.17–1.79) for ischemic stroke in women. Similar results were observed even after the exclusion of deaths that occurred early in the follow-up period. A significant association between bowel movement frequency and mortality from CVD was not observed.Conclusions: Constipation could be a marker of exposure to CVD risk factors, and laxative use could be a risk factor for mortality from coronary heart disease and ischemic stroke.