著者
Hirokazu Tanaka Johan P. Mackenbach Yasuki Kobayashi
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.33, no.5, pp.246-255, 2023-05-05 (Released:2023-05-05)
参考文献数
28
被引用文献数
4

Background: We aimed to develop census-linked longitudinal mortality data for Japan and assess their validity as a new resource for estimating socioeconomic inequalities in health.Methods: Using deterministic linkage, we identified, from national censuses for 2000 and 2010 and national death records, persons and deceased persons who had unique personal identifiers (generated using sex, birth year/month, address, and marital status). For the period 2010–2015, 1,537,337 Japanese men and women aged 30–79 years (1.9% in national census) were extracted to represent the sample population. This population was weighted to adjust for confounding factors. We estimated age-standardized mortality rates (ASMRs) by education level and occupational class. The slope index of inequality (SII) and relative index inequality (RII) by educational level were calculated as inequality measures.Results: The reweighted sample population’s mortality rates were somewhat higher than those of the complete registry, especially in younger age-groups and for external causes. All-cause ASMRs (per 100,000 person-years) for individuals aged 40–79 years with high, middle, and low education levels were 1,078 (95% confidence interval [CI], 1,051–1,105), 1,299 (95% CI, 1,279–1,320), and 1,670 (95% CI, 1,634–1,707) for men, and 561 (95% CI, 536–587), 601 (95% CI, 589–613), and 777 (95% CI, 745–808) for women, respectively, during 2010–2015. SII and RII by educational level increased among both sexes between 2000–2005 and 2010–2015, which indicates that mortality inequalities increased.Conclusion: The developed census-linked longitudinal mortality data provide new estimates of socioeconomic inequalities in Japan that can be triangulated with estimates obtained with other methods.
著者
Naho Morisaki Aurélie Piedvache Seiichi Morokuma Kazushige Nakahara Masanobu Ogawa Kiyoko Kato Masafumi Sanefuji Eiji Shibata Mayumi Tsuji Masayuki Shimono Toshihiro Kawamoto Shouichi Ohga Koichi Kusuhara the Japan Environment and Children’s Study Group
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20210049, (Released:2021-08-28)
参考文献数
16
被引用文献数
15

Background: Tracking gestational weight gain (GWG) during pregnancy makes it possible to optimize pregnancy outcomes, and GWG growth curves are well suitable for this purpose. The GWG guidelines for Japanese were revised in 2021. However, currently, there are no GWG growth curves to guide women on how to gain weight to meet these guidelines.Methods: Using data on 96,631 live births from the Japan Environment and Children’s Study (JECS), we created descriptive GWG percentile curves estimating the trajectory of GWG required to meet the GWG guidelines stratified by pre-pregnancy body mass index (BMI). For both analyses, Bayesian mixed models with restricted cubic splines adjusted for maternal characteristics were used.Results: GWG curves substantially differed by pre-pregnancy BMI and were higher among multiparas and those with lower maternal age and with no previous disease. We estimated that underweight, normal weight, overweight, and obese women who gain 8.4 to 11.1 kg, 6.4 to 9.1 kg, 3.8 to 6.5 kg, and <1.9 kg at 30 weeks of gestation are on the trajectory to reach the new guidelines at 40 weeks of gestation.Conclusions: We provide GWG percentiles curves for Japanese women, as well as GWG trajectory curves to meet the new GWG recommendations. These results may help pregnant women monitor weight during pregnancy.
著者
Chaochen Wang Hiroshi Yatsuya Koji Tamakoshi Hiroyasu Iso Akiko Tamakoshi
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.25, no.1, pp.66-73, 2015-01-05 (Released:2015-01-05)
参考文献数
52
被引用文献数
36 35

Background: Findings regarding the association between milk consumption and all-cause mortality reported by studies carried out in Western populations have been inconsistent. However, no studies have been conducted in Japan on this issue. The present study aimed to investigate the association of milk drinking with all-cause, cardiovascular, and cancer mortality in Japan.Methods: The data were obtained from the Japan Collaborative Cohort (JACC) study. A total of 94 980 Japanese adults aged 40–79 years who had no history of cancer, stroke, or chronic cardiovascular diseases were followed between 1988 and 2009. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of mortalities were assessed using a Cox proportional hazard regression model and taking the lowest milk consumption group as the reference.Results: During a median of 19 years of follow-up, there were 21 775 deaths (28.8% and 35.3% from cardiovascular diseases and cancer, respectively). Drinking milk 1–2 times a month was associated with lower all-cause mortality in men compared to those who never drank milk (multivariable-adjusted HR 0.92; 95% CI, 0.85–0.99). In women, those who drank 3–4 times a week also had a lower mortality risk compared with those who never drank milk (HR 0.91; 95% CI 0.85–0.98). Inverse associations between drinking milk and mortality from cardiovascular diseases and cancer were found only in men.Conclusions: Drinking milk at least 1–2 times a month was associated with lower all-cause mortality in men compared to never drinking milk. An inverse association was also found between drinking milk and mortality from both cardiovascular diseases and cancer. However, lower all-cause mortality in women was found only in those who drank milk 3–4 times/week.
著者
Nam-Hee Kim Hawazin W. Elani Ichiro Kawachi
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.33, no.2, pp.101-108, 2023-02-05 (Released:2023-02-05)
参考文献数
42
被引用文献数
1

Background: In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults.Methods: We compared data before and after policy implementation using double difference (DD) and triple difference (DDD) analyses. We used the nationally representative data from the Korea National Health and Nutrition Examination Survey from 2010 and 2016–2018. Individuals aged ≥65 years were included in the treatment group, and individuals aged <65 years were included in the control group.Results: Dental insurance expansion was associated with a paradoxical increase in perceived unmet dental needs among elderly individuals (8.8 percentage points increase, 95% CI: 4.7 to 13.0). However, there were improvements in dental prosthetics outcomes (denture wearing [4.0 percentage points, 95% CI: 0.2 to 7.9] and dental implants [5.0 percentage points, 95% CI: 2.1 to 7.9]; P < 0.01). Upon analyzing low-income elderly individuals using DDD analysis, we found that the insurance expansion led to a 21.6% smaller increase in unmet dental needs among low-income adults, compared to high-income adults (95% CI, −35.0 to −8.5; P < 0.01).Conclusion: Dental insurance expansion in South Korea resulted in improvements in access to dental prosthetic services overall. It also led to a smaller increase in unmet dental needs among low-income older adults, compared to high-income adults.
著者
Kenichi Katabami Takashi Kimura Takumi Hirata Akiko Tamakoshi
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20220240, (Released:2023-01-28)
参考文献数
45

Background:The neurological prognosis of asphyxia is poor and the effect of advanced airway management (AAM) in the prehospital setting remains unclear. This study aimed to evaluate the association between AAM with adrenaline injection and prognosis in adult patients with asystole asphyxia out-of-hospital cardiac arrest (OHCA).Methods:This study assessed all-Japan Utstein cohort registry data between January 1, 2013 and December 31, 2019. We used propensity score matching analyses before logistic regression analysis to evaluate the effect of AAM on favorable neurological outcome.Results:There were 879,057 OHCA cases, including 70,299 cases of asphyxia OHCAs. We extracted the data of 13,642 cases provided with adrenaline injection by emergency medical service. We divided 7,945 asphyxia OHCA cases in asystole into 5,592 and 2,353 with and without AAM, respectively. After 1:1 propensity score matching, 2,338 asphyxia OHCA cases with AAM were matched with 2,338 cases without AAM. Favorable neurological outcome was not significantly different between the AAM and no AAM groups (adjusted odds ratio: 1.1, 95% confidence interval (CI): 0.5–2.5). However, the return of spontaneous circulation (ROSC) (adjusted odds ratio: 1.7, 95% CI: 1.5–1.9) and 1-month survival were improved in the AAM groups (adjusted odds ratio: 1.5, 95% CI: 1.1–1.9).Conclusions:AAM with adrenaline injection for patients with asphyxia OHCA in asystole was associated with improved ROSC and 1-month survival rate but showed no differences in neurologically favorable outcome. Further prospective studies may comprehensively evaluate the effect of AAM for patients with asphyxia.
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

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
Akio Yagi Shinya Hayasaka Toshiyuki Ojima Yuri Sasaki Taishi Tsuji Yasuhiro Miyaguni Yuiko Nagamine Takao Namiki Katsunori Kondo
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.29, no.12, pp.451-456, 2019-12-05 (Released:2019-12-05)
参考文献数
40
被引用文献数
7 8

Background: While bathing styles vary among countries, most Japanese people prefer tub bathing to showers and saunas. However, few studies have examined the relationship between tub bathing and health outcomes. Accordingly, in this prospective cohort study, we investigated the association between tub bathing frequency and the onset of functional disability among older people in Japan.Methods: We used data from the Japan Gerontological Evaluation Study (JAGES). The baseline survey was conducted from August 2010 through January 2012 and enrolled 13,786 community-dwelling older people (6,482 men and 7,304 women) independent in activities of daily living. During a 3-year observation period, the onset of functional disability, identified by new certification for need of Long-Term Care Insurance, was recorded. Tub bathing frequencies in summer and winter at baseline were divided into three groups: low frequency (0–2 times/week), moderate frequency (3–6 times/week), and high frequency (≥7 times/week). We estimated the risks of functional disability in each group using a multivariate Cox proportional hazards model.Results: Functional disability was observed in a total of 1,203 cases (8.7%). Compared with the low-frequency group and after adjustment for 14 potential confounders, the hazard ratios of the moderate- and high-frequency groups were 0.91 (95% confidence interval [CI], 0.75–1.10) and 0.72 (95% CI, 0.60–0.85) for summer and 0.90 (95% CI, 0.76–1.07) and 0.71 (95% CI, 0.60–0.84) for winter.Conclusion: High tub bathing frequency is associated with lower onset of functional disability. Therefore, tub bathing might be beneficial for older people’s health.
著者
Shun Yasuda Kanako Okazaki Hironori Nakano Kayoko Ishii Hyo Kyozuka Tsuyoshi Murata Keiya Fujimori Aya Goto Seiji Yasumura Misao Ota Kenichi Hata Kohta Suzuki Akihito Nakai Tetsuya Ohira 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.S104-S114, 2022-12-05 (Released:2022-12-05)
参考文献数
51
被引用文献数
4

Background: This study aimed to investigate the effects of maternal exposure to external radiation on perinatal outcomes among women who experienced the Fukushima Daiichi Nuclear Disaster (FDND) using the Fukushima Health Management Survey (FHMS).Methods: Data from the Pregnancy and Birth Survey and Basic Survey in the FHMS were combined to analyze external maternal radiation exposure following the FDND, and the relationship between radiation dose and perinatal outcomes was analyzed using binomial logistic regression analysis. Missing dose data were supplemented using multiple imputation.Results: A total of 6,875 individuals responded to the survey. Congenital anomalies occurred in 2.9% of patients, low birth weight (LBW) in 7.6%, small for gestation age (SGA; <10th percentile) in 8.9%, and preterm birth in 4.1%. The median maternal external radiation dose was 0.5 mSv (maximum, 5.2 mSv). Doses were classified as follows: <1 mSv (reference), 1 to <2 mSv, and ≥2 mSv. For congenital anomalies, the crude odds ratio for 1 to <2 mSv was 0.81 (95% confidence interval [CI], 0.56–1.17) (no participants with congenital anomaly were exposed to ≥2 mSv). At 1 to <2 mSv and ≥2 mSv, the respective adjusted odds ratios were 0.91 (95% CI, 0.71–1.18) and 1.21 (95% CI, 0.53–2.79) for LBW, 1.14 (95% CI, 0.92–1.42) and 0.84 (95% CI, 0.30–2.37) for SGA, and 0.91 (95% CI, 0.65–1.29) and 1.05 (95% CI, 0.22–4.87) for preterm birth.Conclusion: External radiation dose due to the FDND was not associated with congenital anomalies, LBW, SGA, or preterm birth.
著者
Yao Yang Minlan Yuan Yu Zeng Yuanjing Xie Yueyao Xu Dengbin Liao Yongmei Chen Meiru Chen Yuanyuan Qu Yao Hu Wei Zhang Huan Song
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20220290, (Released:2022-12-24)
参考文献数
45
被引用文献数
1

PurposeTo establish a prospective hospital-based cohort, featured by detailed multidimensional data of trauma patients with active follow-ups, which can be a reliable data source for all studies focusing on the effects or underlying mechanistic pathways of environmental and biological factors on multiple interested trauma-related outcomes, particularly the incidence and trajectory of trauma-related psychopathology, in Chinese population.MethodsThe China Severe Trauma Cohort (CSTC) enrolled all traumatized individuals aged 12 to 80 years admitted to the Trauma Center of West China Hospital between 1st March 2020 and 8th July 2022. The bio-sample and detailed questionnaire data were collected at recruitment, and phone/internet follow-ups were scheduled at 1-, 3-, 6-, 12-months after the baseline. Long-term health outcomes are planned to be obtained from administrative databases through data linkage.ResultsA total of 2,500 trauma patients were enrolled (response rate=87.1%) with an average age of 46.01 years, and most of the participants were males(62.6%). The proportions of participants with blood and fecal sample collected at baseline were 93.8% and 66.3%, respectively. Upon 31st August 2022, the follow-up rate was 90.0%, 77.0%, 76.5%, and 89.0% for 1-, 3-, 6-, and 12-months follow-up, respectively. Fall/wrench (47.6%) and traffic accident (26.2%) were the top causes of current trauma. The most common psychopathology at recruitment was sleep disturbance(39.4%), followed by depression(22.6%), anxiety(18.2%), and acute stress reaction(7.8%), all of which showed recovering trajectories during the follow-up period, particularly the first 3 months after baseline.ConclusionsCSTC provides a platform with multidimensional data to study both short-term and long-term trauma-related health consequences, prompting early identification and intervention for individuals with high risk of health decline after trauma exposures.
著者
Kayoko Ishii Aya Goto Hiromi Yoshida-Komiya Tetsuya Ohira Keiya Fujimori
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.S64-S75, 2022-12-05 (Released:2022-12-05)
参考文献数
47
被引用文献数
6

With the aim of monitoring the mental and physical health of mothers and children following the Fukushima nuclear accident and providing them with necessary care, we have been conducting an annual survey of expectant and nursing mothers since 2011. The Pregnancy and Birth Survey is a mail-in survey of about 15,000 individuals, with a response rate of approximately 50.0% each year. In addition, because respondents to a survey conducted in the immediate aftermath of the disaster showed a particularly high rate of depression, follow-up surveys have been conducted at 4 years after childbirth. Reviewing the results of surveys from FY 2011 through FY 2018, we found that the prevalence of depressive symptoms among mothers was highest in the survey after childbirth and decreased over time. Data of follow-up surveys showed that the prevalence of depression was lower than immediately after childbirth and then decreased over time. The proportion of mothers with radiation anxiety was higher among respondents in the FY 2011 follow-up than in the FY 2014 follow-up, indicating the prolonged impact of the nuclear accident, especially among those who gave birth immediately after the disaster. Characteristics of mothers who received telephone parenting counseling included first delivery, caesarean section, living in evacuation zones, not being able to receive medical examinations as scheduled, and having radiation anxiety. Continuous care should be provided to mothers who gave birth immediately after the nuclear accident, including routine perinatal care and parenting support, provision of information on radiation, and long-term monitoring of their wellbeing.
著者
Susumu Yagome Takehiro Sugiyama Kosuke Inoue Ataru Igarashi Ryotaro Bouchi Mitsuru Ohsugi Kohjiro Ueki Atsushi Goto
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.32, no.10, pp.476-482, 2022-10-05 (Released:2022-10-05)
参考文献数
25
被引用文献数
11

Background: Regular visits with healthcare professionals are important for preventing serious complications in patients with diabetes. The purpose of this retrospective cohort study was to clarify whether there was any suppression of physician visits among patients with diabetes during the spread of the novel coronavirus 2019 (COVID-19) in Japan and to assess whether telemedicine contributed to continued visits.Methods: We used the JMDC Claims database, which contains the monthly claims reported from July 2018 to May 2020 and included 4,595 (type 1) and 123,686 (type 2) patients with diabetes. Using a difference-in-differences analysis, we estimated the changes in the monthly numbers of physician visits or telemedicine per 100 patients in April and May 2020 compared with the same months in 2019.Results: For patients with type 1 diabetes, the estimates for total overall physician visits were −2.53 (95% confidence interval [CI], −4.63 to 0.44) in April and −8.80 (95% CI, −10.85 to −6.74) in May; those for telemedicine visits were 0.71 (95% CI, 0.47–0.96) in April and 0.54 (95% CI, 0.32–0.76) in May. For patients with type 2 diabetes, the estimates for overall physician visits were −2.50 (95% CI, −2.95 to −2.04) in April and −3.74 (95% CI, −4.16 to −3.32) in May; those for telemedicine visits were 1.13 (95% CI, 1.07–1.20) in April and 0.73 (95% CI, 0.68–0.78) in May.Conclusion: The COVID-19 pandemic was associated with suppression of physician visits and a slight increase in the utilization of telemedicine among patients with diabetes during April and May 2020.
著者
Takashi Oshio
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.32, no.8, pp.363-369, 2022-08-05 (Released:2022-08-05)
参考文献数
43
被引用文献数
3

Background: Enhanced female labor force participation is raising the importance of grandparents’ caring for their grandchildren. However, previous studies have reported mixed results of the association between grandchild care and grandparents’ health.Methods: Longitudinal data of 33,204 individuals born between 1946 and 1955 were collected from a 14-wave nationwide panel survey conducted from 2005 to 2018. We examined how caring for at least one co-residing grandchild aged <6 years was associated with grandparents’ psychological distress (defined by five or higher Kessler 6 score) and poor self-rated health in pooled cross-sectional, fixed-effects, and 3-year follow-up logistic models.Results: While pooled cross-sectional models showed a positive association between grandchild care and grandparents’ health, the fixed-effects or follow-up logistic models did not find any significant association between them. In the case of grandmothers, the odds ratio of reporting psychological distress in response to caring for grandchildren was 0.98 (95% confidence interval [CI], 0.89–1.08) and 1.04 (95% CI, 0.85–1.27) observed from fixed-effects and 3-year follow-up models, respectively, compared to 0.86 (95% CI, 0.81–0.91) in the pooled cross-sectional model. Similar patterns were observed for self-rated health for grandmothers, while grandfathers’ health outcomes were not sensitive to grandchild care. These results contrasted with those of caring for parents, which had almost consistently a negative association with grandparents’ health.Conclusion: The results suggest that caring for grandchildren does not have a beneficial or detrimental effect on grandparents’ health.
著者
Sakura Kiuchi Taro Kusama Kemmyo Sugiyama Takafumi Yamamoto Upul Cooray Tatsuo Yamamoto Katsunori Kondo Ken Osaka Jun Aida
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.32, no.7, pp.330-336, 2022-07-05 (Released:2022-07-05)
参考文献数
50
被引用文献数
2 13

Background: Although the feasibility of randomized trials for investigating the long-term association between oral health and cognitive decline is low, deriving causal inferences from observational data is challenging. We aimed to investigate the association between poor oral status and subjective cognitive complaints (SCC) using fixed-effects model to eliminate the confounding effect of unobserved time-invariant factors.Methods: We used data from Japan Gerontological Evaluation Study (JAGES) which was conducted in 2010, 2013, and 2016. β regression coefficients and 95% confidence intervals [CIs] were calculated using fixed-effects models to determine the effect of deteriorating oral status on developing SCC. Onset of SCC was evaluated using the Kihon Checklist-Cognitive function score. Four oral status variables were used: awareness of swallowing difficulty, decline in masticatory function, dry mouth, and number of teeth.Results: We included 13,594 participants (55.8% women) without SCC at baseline. The mean age was 72.4 (standard deviation [SD], 5.1) years for men and 72.4 (SD, 4.9) years for women. Within the 6-year follow-up, 26.6% of men and 24.9% of women developed SCC. The probability of developing SCC was significantly higher when participants acquired swallowing difficulty (β = 0.088; 95% CI, 0.065–0.111 for men and β = 0.077; 95% CI, 0.057–0.097 for women), decline in masticatory function (β = 0.039; 95% CI, 0.021–0.057 for men and β = 0.030; 95% CI, 0.013–0.046 for women), dry mouth (β = 0.026; 95% CI, 0.005–0.048 for men and β = 0.064; 95% CI, 0.045–0.083 for women), and tooth loss (β = 0.043; 95% CI, 0.001–0.085 for men and β = 0.058; 95% CI, 0.015–0.102 for women).Conclusion: The findings suggest that good oral health needs to be maintained to prevent the development of SCC, which increases the risk for future dementia.
著者
Taiji Noguchi Fumi Kondo Takeshi Nishiyama Takahiro Otani Hiroko Nakagawa-Senda Miki Watanabe Nahomi Imaeda Chiho Goto Akihiro Hosono Kiyoshi Shibata Hiroyuki Kamishima Akane Nogimura Kenji Nagaya Tamaki Yamada Sadao Suzuki
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.32, no.2, pp.89-95, 2022-02-05 (Released:2022-02-05)
参考文献数
37
被引用文献数
1

Background: Marital transitions are associated with adverse health events, such as mortality and cardiovascular disease. Since marital transitions (eg, becoming widowed) are unavoidable life events, it is necessary to identify modifiable intermediate outcomes. Thus, we examined the association between marital transitions and vegetable intake among middle-aged and older Japanese adults.Methods: This longitudinal study included Japanese adults aged 40–79 years who received an annual health checkup between 2007 and 2011 (baseline) and 5 years later (follow-up). Marital transitions were classified as whether and what type of transition occurred during the 5-year period and comprised five groups: consistently married, married to widowed, married to divorced, not married to married, and remained not married. Changes in total vegetable, green and yellow vegetable, and light-colored vegetable intake from baseline to follow-up were calculated using the Food Frequency Questionnaire.Results: Data from 4,813 participants were analyzed (mean age, 59.4 years; 44.1% women). Regarding marital transitions, 3,960 participants were classified as “consistently married,” 135 as “married to widowed,” 40 as “married to divorced,” 60 as “not married to married,” and 529 as “remained not married.” Multivariable linear regression analysis revealed that compared to consistently married, married to widowed was inversely associated with the change in total vegetable intake (β = −16.64, SE = 7.68, P = 0.030) and light-colored vegetable intake (β = −11.46, SE = 4.33, P = 0.008).Conclusion: Our findings suggest that being widowed could result in a reduced intake of vegetables. Hence, dietary counseling according to marital situation is necessary.
著者
Ikuyo Tsutsumi Yusuke Tsutsumi Chikashi Yoshida Takuya Komeno Yuichi Imanaka
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.32, no.1, pp.27-33, 2022-01-05 (Released:2022-01-05)
参考文献数
24
被引用文献数
5

Background: The number of new noncommercial clinical studies conducted in Japan declined within the first year of the implementation of the Clinical Trials Act (CTA) on April 1, 2018. This study aimed to examine the impact of the CTA’s enforcement on the number of new noncommercial clinical studies registered in the Japanese Clinical Trial Registry.Methods: An interrupted time-series design was used in the analysis, which was conducted from April 2015 to March 2019. We collected data for studies registered in the Clinical Trial Registry, managed by the University Hospital Medical Information Network.Results: In total, 35,811 studies were registered; of these, 16,455 fulfilled the eligibility criteria. The difference in the trend of monthly number of new studies after CTA enforcement decreased significantly by 15.0 (95% confidence interval [CI], −18.7 to −11.3), and the level decreased by 40.8 (95% CI, −68.2 to −13.3) studies from the pre-enforcement to the post-enforcement period. Multigroup analyses indicated that the act exerted a significant effect on the trend of new clinical studies, particularly those with smaller sample sizes, interventional study designs, and nonprofit funding sponsors.Conclusions: The number of Japanese noncommercial clinical studies declined significantly following implementation of the CTA. It is necessary to establish a system to promote clinical studies in Japan while ensuring transparency and safety.