著者

Hiroki Shimura Satoru Suzuki Susumu Yokoya Manabu Iwadate Satoshi Suzuki Takashi Matsuzuka Noriko Setou Tetsuya Ohira Seiji Yasumura Shinichi Suzuki Hitoshi Ohto Kenji Kamiya Thyroid Ultrasound Examination Group

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.S23-S35, 2022-12-05 (Released:2022-12-05)

参考文献数

71

被引用文献数

3 10

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The Great East Japan Earthquake on March 11, 2011, and the subsequent tsunami caused an accident at the Fukushima Daiichi Nuclear Power Plant, in which extensive damage to the nuclear power reactors resulted in massive radioactive contamination. Fukushima Prefecture implemented the Thyroid Ultrasound Examination (TUE) program as part of the Fukushima Health Management Survey project in response to residents’ anxieties about health risks due to radiation exposure for residents aged 0–18 years at the time of the nuclear accident. This program consisted of the primary examination and the confirmatory examination. In the primary examination, thyroid nodules and cysts were examined using portable ultrasound apparatuses. The confirmatory examination was performed to have clinical or cytological diagnosis. As of June 30, 2021, 116, 71, 31, 36, and 9 examinees in the first, second, third, and fourth round of surveys, and the survey at age 25 years, respectively, were determined to have nodules cytologically diagnosed as malignant or suspicious for malignancy. The confirmatory examination of the fourth-round survey and the primary and confirmatory examination of fifth-round survey are currently in progress. Together with the low thyroid absorbed radiation dose estimated in the United Nations Scientific Committee on the Effects of Atomic Radiation 2020 report, our results suggested that the increased incidence of childhood thyroid cancer in Fukushima Prefecture was not caused by radiation exposure, but rather by the highly sensitive detection method. As detailed in this review, there were ongoing challenges in our program, such as actions against the risk of overdiagnosis and psychological support for participants and their families.

著者

Aya Goto Yusuke Tsugawa Keiya Fujimori

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180015, (Released:2018-12-15)

参考文献数

25

被引用文献数

7

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Background: Little is known about the association between the anxiety toward the effects of radiation on reproduction caused by the Fukushima nuclear accident and the birth rate of people in Fukushima. Therefore, we examined changes and associated factors of future pregnancy intention among mothers in Fukushima Prefecture.Methods: Using data from three postal surveys among women who registered their pregnancies in the prefecture (N = 6,751 in 2012, N = 6,871 in 2013, and N = 6,725 in 2014), we analyzed the factors associated with women’s intention of future pregnancy using multivariable logistic regression models.Results: The proportion of mothers with pregnancy intention increased from 53.5% in 2012 to 57.9% in 2014, especially among multiparas (P for trend <0.001). Factors inversely associated with pregnancy intention of both groups were older maternal age (adjusted odds ratio [aOR] 0.92 for primipara and 0.87 for multipara), poor subjective health (aOR 0.75 and 0.81, respectively), and presence of depressive symptoms (aOR 0.71 and 0.79, respectively) (P < 0.01 for all items). In addition, not living with husband (aOR 0.24), dissatisfaction with obstetrical care (aOR 0.89) and child abnormalities (aOR 0.72) were inversely associated with pregnancy intention among primiparas, while receiving infertility treatment (aOR 2.05) was positively associated among multiparas (P < 0.01 for all items). A separate analysis of 2012 and 2013 data showed that concern about radiation contamination of breast milk was associated with pregnancy intention among primiparas (aOR 0.61, P < 0.001).Conclusions: Mothers’ concern about radiation was associated with lower pregnancy intention, especially among primiparas. Providing quality obstetrical and mental health care and parenting support may be the keys to maintaining the temporal increase in fertility.

著者

Masahiko Gosho Tomohiro Ohigashi Kengo Nagashima Yuri Ito Kazushi Maruo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20210089, (Released:2021-09-25)

参考文献数

46

被引用文献数

8

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Background: Logistic regression models are widely used to evaluate the association between a binary outcome and a set of covariates. However, when there are few study participants at the outcome and covariate levels, the models lead to bias of the odds ratio (OR) estimated using the maximum likelihood (ML) method. This bias is known as sparse data bias, and the estimated OR can yield impossibly large values because of data sparsity. However, this bias has been ignored in most epidemiological studies.Methods: We review several methods for reducing sparse data bias in logistic regression. The primary aim is to evaluate the Bayesian methods in comparison with the classical methods, such as the ML, Firth’s, and exact methods using a simulation study. We also apply these methods to a real data set.Results: Our simulation results indicate that the bias of the OR from the ML, Firth’s, and exact methods is considerable. Furthermore, the Bayesian methods with hyper-g prior modeling of the prior covariance matrix for regression coefficients reduced the bias under the null hypothesis, whereas the Bayesian methods with log F-type priors reduced the bias under the alternative hypothesis.Conclusion: The Bayesian methods using log F-type priors and hyper-g prior are superior to the ML, Firth’s, and exact methods when fitting logistic models to sparse data sets. The choice of a preferable method depends on the null and alternative hypothesis. Sensitivity analysis is important to understand the robustness of the results in sparse data analysis.

著者

Takakiyo Nishikawa Nobuo Sakata Takehiro Sugiyama Nanako Tamiya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220165, (Released:2022-12-10)

参考文献数

22

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BACKGROUND: No studies in Japan have examined whether dispensing by family pharmacists, who are incentivized by reimbursement to provide continuous and exclusive medication management, results in prescription changes. Our primary objective was to identify the variables affecting prescription changes, particularly to investigate dispensing by family pharmacists as a possible factor.METHODS: We identified 333,503 records of pharmacy claims data from patients aged 65 years or older who received medication instructions at outpatient pharmacies at Tsukuba, a medium-sized city near Tokyo, between April 2018 and March 2019. We extracted data on dispensing by family pharmacists, number of medicines, patient sex, patient age, and pharmacy category. A multilevel modified Poisson regression analysis was performed to analyze the correlation between dispensing by family pharmacists and pharmacist-initiated prescription change.RESULTS: Dispensing by family pharmacists was 1.37 times more likely to involve a record of prescription change than dispensing by non-family pharmacists. Older age, female sex, polypharmacy, and small-scale pharmacies were also found to be factors.CONCLUSION: This study indicated that dispensing by family pharmacists was a potential factor for pharmacist-initiated prescription changes that may prevent excessive medication and limit pharmacological interactions. Since the likelihood of inappropriate prescriptions being issued varies from hospital to hospital, subsequent studies should take into account the quality of each institution.

著者

Takashi Oshio Satoshi Shimizutani

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20210030, (Released:2021-05-15)

参考文献数

34

被引用文献数

3

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Background: Encouraging older adults to continue working longer would be a realistic solution to the shrinking labor force, which is a result of the aging population. This study examined whether working longer improves the health of older adults.Methods: We used repeated cross-sectional data from 1,483,591 individuals aged 55–69 years collected from 11 waves of a nationwide population-based survey conducted in Japan from 1986 to 2016. We estimated pooled regression models to explain health outcomes by work status, controlling for potential endogeneity biases. Based on the estimation results, we conducted simulations to predict the health impact of policy measures that encourage older adults to participate in the labor force.Results: The regression analysis showed that work status had a mixed health impact. For example, work reduced the probability of poor self-rated health by 6.7 (95% confidence interval [CI]: 6.2–7.2) percentage points and increased that of psychological distress by 12.2 (95% CI: 11.3–13.1) percentage points. The simulation results showed that raising both the mandatory retirement age and eligibility age for claiming public pension benefits to 70 years would increase the employment rate by 27.8 (standard deviation [SD]: 4.2) percentage points among those aged 65–69 years, which would reduce their probability of poor self-rated health by 1.8 (SD: 0.4) percentage points and raise that of psychological distress by 4.1 (SD: 0.8) percentage points for that age group.Conclusions: The results suggest the need to pay attention to the health outcomes of policy measures that encourage older adults to work longer.

著者

Ryosuke Fujii

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20230052, (Released:2023-06-03)

参考文献数

4

著者

Naoki Nago Shizukiyo Ishikawa Tadao Goto Kazunori Kayaba

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.21, no.1, pp.67-74, 2011-01-05 (Released:2011-01-05)

参考文献数

17

被引用文献数

66 66 23

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Background: We investigated the relationship between low cholesterol and mortality and examined whether that relationship differs with respect to cause of death.Methods: A community-based prospective cohort study was conducted in 12 rural areas in Japan. The study subjects were 12 334 healthy adults aged 40 to 69 years who underwent a mass screening examination. Serum total cholesterol was measured by an enzymatic method. The outcome was total mortality, by sex and cause of death. Information regarding cause of death was obtained from death certificates, and the average follow-up period was 11.9 years.Results: As compared with a moderate cholesterol level (4.14–5.17 mmol/L), the age-adjusted hazard ratio (HR) of low cholesterol (<4.14 mmol/L) for mortality was 1.49 (95% confidence interval [CI]: 1.23–1.79) in men and 1.50 (1.10–2.04) in women. High cholesterol (≥6.21 mmol/L) was not a risk factor. This association was unchanged in analyses that excluded deaths due to liver disease, which yielded age-adjusted HRs of 1.38 (95% CI, 1.13–1.67) in men and 1.49 (1.09–2.04) in women. The multivariate-adjusted HRs and 95% CIs of the lowest cholesterol group for hemorrhagic stroke, heart failure (excluding myocardial infarction), and cancer mortality significantly higher than those of the moderate cholesterol group, for each cause of death.Conclusions: Low cholesterol was related to high mortality even after excluding deaths due to liver disease from the analysis. High cholesterol was not a risk factor for mortality.

著者

Ryota Sakurai Hisashi Kawai Hiroyuki Suzuki Susumu Ogawa Hunkyung Kim Yutaka Watanabe Hirohiko Hirano Kazushige Ihara Shuichi Obuchi Yoshinori Fujiwara

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180162, (Released:2018-12-08)

参考文献数

12

被引用文献数

2 2

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Background: Considering the rate of growth of the older population in several countries, accidental falls in older cyclists are expected to increase. However, the prevalence and correlates of bicycle-related falls (BR-falls) are unknown. The aim of the present study was to explore the characteristics of BR-falls, focusing on the risk factors.Methods: Seven-hundred and ninety-one older adults participated in a comprehensive baseline assessment that included questions on bicycle use, BR-falls, lifestyle, and physical and cognitive evaluations. A cyclist was defined as a person who cycled at least a few times per month. The incidence of BR-falls in participants who did not report BR-falls at baseline was again ascertained 3 years later. Logistic regression analyses examined the predictors of BR-falls incidence.Results: At baseline, 395 older adults were cyclists and 45 (11.4%) of them had experienced BR-falls. Adjusted regression analysis showed that slower gait velocity, shorter one-leg standing time, and experience of falls (ie, non-BR-falls) were associated with BR-falls. Among the 214 cyclists who did not report BR-falls at baseline and who participated in both baseline and follow-up assessments, 35 (16.4%) cyclists experienced BR-falls during the 3-year follow-up. Adjusted regression analysis revealed that higher body mass index and non-BR-falls were predictors of future incidence of BR-falls, independent of physical function.Conclusions: Our results showed that experience of falls, irrespective of bicycling, is an independent correlate and risk factor of BR-falls. This suggests that experience of falls and BR-falls may share the same risk factors.

著者

Kenichi Mori Keiko Wada Kie Konishi Yuko Goto Fumi Mizuta Sachi Koda Takahiro Uji Yatsuji Ito Chisato Nagata

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.29, no.2, pp.61-64, 2019-02-05 (Released:2019-02-05)

参考文献数

21

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Background: Cedar pollinosis is one of the most prevalent forms of seasonal allergic reaction in Japan. Only one prospective study has examined the association between cedar pollinosis and mortality. Using a symptom-based questionnaire on cedar pollinosis, we investigated the association of cedar pollinosis with all-cause and cause-specific mortality.Methods: Data came from the Takayama Study, which recruited residents aged ≥35 years in 1992 from Takayama city in Gifu Prefecture, Japan. The current study used information on cedar pollinosis that was obtained from the second survey in 2002. A total of 12,471 persons who were 45–80 years old and had no history of cancer, coronary heart disease, or stroke responded to a questionnaire asking about four symptoms related to cedar pollinosis. Mortality and migration data were obtained throughout the follow-up period up to March 2013. Cox proportional hazard models were used to examine the relation between cedar pollinosis and mortality.Results: A total of 1,276 persons died during follow-up period. Among these, there were 504 neoplasm, 278 cardiovascular, and 181 respiratory deaths. After adjusting for potential confounders, cedar pollinosis was associated with significantly lower all-cause mortality (hazard ratio [HR] 0.79; 95% confidence interval [CI], 0.65–0.95) and respiratory mortality (HR 0.38; 95% CI, 0.18–0.82). There was no significant association between cedar pollinosis and mortality due to neoplasm or cardiovascular disease.Conclusions: We found an inverse association between cedar pollinosis and the risk of all-cause and respiratory mortality. Further research is needed to elucidate the association between cedar pollinosis and mortality.

著者

Shiho Amagasa Shigeru Inoue Shigekazu Ukawa Sachiko Sasaki Koshi Nakamura Aya Yoshimura Aya Tanaka Takashi Kimura Takafumi Nakagawa Akihiro Imae Ding Ding Hiroyuki Kikuchi Akiko Tamakoshi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200185, (Released:2020-08-08)

参考文献数

51

被引用文献数

9

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BackgroundPrevious research has established that women accumulate less moderate-to-vigorous physical activity (MVPA) than men. To date, however, little is known about the gender differences in device-based activity patterns of sedentary behavior (SB) and light-intensity physical activity (LPA). We aimed to compare time spent in SB and different intensities of physical activity taking into account of co-dependence of time use domains.MethodsThis cross-sectional study was conducted in Suttu town, Hokkaido, Japan. Data were analyzed from 634 Japanese adults (278 men, aged 19-92 years) who provided valid accelerometer (HJA-750C) data. Gender differences in activity behavior patterns were tested by multivariate analysis of covariance (MANCOVA) based on isometric log-ratio transformations of time use, adjusting for age. We also developed bootstrap percentile confidence intervals (CI) to support the interpretation of which behavior differed between genders.ResultsOverall, participants had percent time spent in SB, LPA, MVPA during wearing time (mean 14.8 hours) corresponding to 53.9%, 41.7%, and 4.4%, respectively. Activity behavior patterns differed significantly between genders after controlling for time spent in all activities. Women spent relatively 13.3% (CI: 9.9, 15.9) less time in SB and 19.8% (CI: 14.9, 24.6) more time in LPA compared to men. The difference of time spent in MVPA was not statistically significant.ConclusionsIn contrast with previous studies, our findings suggest that Japanese women are more physically active than men when all intensities of activities are considered. Given the health benefits of LPA, evaluating only MVPA may disproportionately underestimate the level of physical activity of women.

著者

Yuta Taniguchi Masao Iwagami Nobuo Sakata Taeko Watanabe Kazuhiro Abe Nanako Tamiya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.5, pp.356-360, 2021-05-05 (Released:2021-05-05)

参考文献数

22

被引用文献数

10

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Background: With increasing age globally, more people may become vulnerable to food choking. We investigated the nationwide epidemiology of food choking deaths in Japan.Methods: Using Japanese Vital Statistics death data between 2006 and 2016, we identified food choking deaths based on the 10th revision of the International Statistical Classification of Diseases code W79 (Inhalation and ingestion of food causing obstruction of respiratory tract) as a primary diagnosis. We assessed the demographics of people with food choking deaths; temporal trends of food choking deaths by the year (overall and by age group), the day of year; and prefecture variations.Results: Overall, 52,366 people experienced food choking deaths (median age, 82 years, 53% were male, and 57% occurred at home). The highest numbers occurred January 1–3, and were lowest in June. Despite a stable total number of cases at around 4,000 yearly, from 2006 to 2016 the incidence proportion declined from 16.2 to 12.1 per 100,000 population among people aged 75–84 years. Among people ≥85 years, the incidence proportion peaked at 53.5 in 2008 and decreased to 43.6 in 2016. The number of food choking deaths varied by prefecture.Conclusions: There are temporal and regional variations of food choking deaths in Japan, possibly due to the consumption of Japanese rice cake (mochi), particularly over the New Year’s holiday.

著者

Eiichi Tohyama

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.6, no.4, pp.184-191, 1996 (Released:2007-11-30)

参考文献数

46

被引用文献数

13 16

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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.(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).(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.(3) Furthermore, the time trends in the uterine cancer mortality rate appear to be related to changes in water fluoridation practices. J Epidemiol, 1996 ; 6 : 184-191.

著者

Yudai Tamada Kenji Takeuchi Chikae Yamaguchi Masashige Saito Tetsuya Ohira Kokoro Shirai Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200051, (Released:2020-05-16)

参考文献数

34

被引用文献数

19

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Background: While laughter is broadly recognized as a good medicine, a potential preventive effect of laughter on disability and death is still being debated. Accordingly, we investigated the association between the frequency of laughter and onset of functional disability and all-cause mortality among the older adults in Japan.Methods: The data for a 3-year follow-up cohort including 14,233 individuals (50.3% men) aged ≥ 65 years who could independently perform the activities of daily living and participated in the Japan Gerontological Evaluation Study were analyzed. The participants were classified into four categories according to their frequency of laughter (almost every day, 1–5 days/week, 1–3 days/month, and never or almost never). We estimated the risks of functional disability and all-cause mortality in each category using a Cox proportional hazards model.Results: During follow-up, 605 (4.3%) individuals developed functional disability, identified by new certification for the requirement of Long-Term Care Insurance, and 659 (4.6%) deaths were noted. After adjusting for the potential confounders, the multivariate-adjusted hazard ratio of functional disability increased with a decrease in the frequency of laughter (p for trend = 0.04). The risk of functional disability was 1.42 times higher for individuals who laughed never or almost never than for those who laughed almost every day. No such association was observed with the risk of all-cause mortality (p for trend = 0.39).Conclusions: Low frequency of laughter is associated with increased risks of functional disability. Laughter may be an early predictor of functional disability later on in life.

著者

Kaori Sakurada Tsuneo Konta Masafumi Watanabe Kenichi Ishizawa Yoshiyuki Ueno Hidetoshi Yamashita Takamasa Kayama

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180249, (Released:2019-04-06)

参考文献数

23

被引用文献数

30

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Background: Positive and negative psychological factors are associated with mortality and cardiovascular disease. This study prospectively investigated associations between daily frequency of laughter, and mortality and cardiovascular disease in a community-based population.Methods: This study included 17,152 subjects ≥40 years old who participated in an annual health check in Yamagata Prefecture. Self-reported daily frequency of laughter was grouped into 3 categories (≥1/week; ≥1/month but <1/week; <1/month). Associations between daily frequency of laughter and increase in all-cause mortality and cardiovascular disease incidence were determined using Cox proportional hazards modeling.Results: During follow-up (median, 5.4 years), 257 subjects died and 138 subjects experienced cardiovascular events. Kaplan-Meier analysis revealed that all-cause mortality and cardiovascular disease incidence were significantly higher among subjects with a low frequency of laughter (log-rank P<0.01). Cox proportional hazard model analysis adjusted for age, gender, hypertension, smoking, and alcohol drinking status showed that risk of all-cause mortality was significantly higher in subjects who laughed <1/month than in subjects who laughed ≥1/week (hazard ratio (HR) 1.95, 95% confidence interval (CI), 1.16-3.09). Similarly, risk of cardiovascular events was higher in subjects who laughed ≥1/month but < 1/week than in subjects who laughed ≥1/week (HR 1.62, 95% CI, 1.07-2.40).Conclusion: Daily frequency of laughter represents an independent risk factor for all-cause mortality and cardiovascular disease in a Japanese general population.

著者

Atsushi Goto Kota Katanoda

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20230078, (Released:2023-04-08)

参考文献数

11

被引用文献数

12

著者

Kohtaro Kikuchi Tatsuhiko Anzai Kunihiko Takahashi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220186, (Released:2022-10-15)

参考文献数

27

被引用文献数

5

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Background: Japan has witnessed an unusual increase in the number of suicides among women during the coronavirus disease 2019 pandemic. An analysis is required to identify the influencing factors during the pandemic and develop new measures for preventing suicides.Methods: Data on the number of monthly suicides were collected from the National Police Agency of Japan. The expected number of suicides among women during the pandemic was estimated using a time-series model based on pre-pandemic data, considering year-to-year trends. The observation-to-expectation (O/E) ratio of suicides was estimated from March 2020 to October 2021 using job status, suicide motive, and age.Results: The number of suicides among women in Japan increased beyond the expected number until October 2021. The O/E ratio based on job status, suicide motive, and age (except self-employed, unknown job status, and women ≥80 years) was significantly above 1.0 from March–December 2020, and the increase in suicides continued in almost all categories in 2021.Conclusion: Although several reasons were reported for increased suicides among women in Japan during the pandemic (e.g., economic downturn, financial instability, and loneliness), suicides increased irrespective of job status, suicide motive, or age. The preventive measures for suicide without omission might have been important during the pandemic, as opposed to limiting interventions to the reported specific aspects.

著者

Toshiyuki Ojima Yosikazu Nakamura Roger Detels

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.14, no.6, pp.187-192, 2004 (Released:2005-03-18)

参考文献数

30

被引用文献数

33 41

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BACKGROUND: Suicide is one of the most important public health issues in both Japan and the United States. This study is to clarify the differences in methods of suicide between the two countries, among various races within the United States, and between genders and age-groups.METHODS: Vital statistics mortality data and the estimated population in 1999 in Japan and in the United States were used. Age-adjusted mortality rates were calculated using the age-specific total population of Japan and the United States as a standard population. In addition, the proportionate distribution of suicide methods was calculated.RESULTS: Age-adjusted mortality rates from suicide in Japan were about 2 times higher for males and 3 times higher for females compared with the United States. The most common method among both genders in Japan was hanging, followed by jumping from a high place. In the United States, it was firearms among both genders, followed by hanging among males and drugs among females. For Asians in the United States, hanging was the method of choice for about half among both genders; hanging was the most common method for the age group of 40 years or more among males and for all age groups among females. Firearms were the method of choice for the 20-39 age group among males.CONCLUSIONS: Although the overall suicide rates among Asians in the United States were lower than Japan, the methods were similar to those in Japan.

著者

Tomohiro Shinozaki Etsuji Suzuki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200226, (Released:2020-07-18)

参考文献数

84

被引用文献数

20

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Epidemiologists are increasingly encountering complex longitudinal data, in which exposures and their confounders vary during follow-up. When a prior exposure affects the confounders of the subsequent exposures, estimating the effects of the time-varying exposures requires special statistical techniques, possibly with structural (i.e., counterfactual) models for targeted effects, even if all confounders are accurately measured. Among the methods used to estimate such effects, which can be cast as a marginal structural model in a straightforward way, one popular approach is inverse probability weighting. Despite the seemingly intuitive theory and easy-to-implement software, misunderstandings (or “pitfalls”) remain. For example, one may mistakenly equate marginal structural models with inverse probability weighting, failing to distinguish a marginal structural model encoding the causal parameters of interest from a nuisance model for exposure probability, and thereby failing to separate the problems of variable selection and model specification for these distinct models. Assuming the causal parameters of interest are identified given the study design and measurements, we provide a step-by-step illustration of generalized computation of standardization (called the g-formula) and inverse probability weighting, as well as the specification of marginal structural models, particularly for time-varying exposures. We use a novel hypothetical example, which allows us access to typically hidden potential outcomes. This illustration provides steppingstones (or “tips”) to understand more concretely the estimation of the effects of complex time-varying exposures.

著者

Keisuke Kuwahara Toru Honda Tohru Nakagawa Shuichiro Yamamoto Takeshi Hayashi Tetsuya Mizoue

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.28, no.2, pp.94-98, 2018-02-05 (Released:2018-02-05)

参考文献数

24

被引用文献数

6 11

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Background: Data on the effect of physical activity intensity on depression is scarce. We investigated the prospective association between intensity of leisure-time exercise and risk of depressive symptoms among Japanese workers.Methods: The participants were 29,052 employees (24,653 men and 4,399 women) aged 20 to 64 years without psychiatric disease including depressive symptoms at health checkup in 2006–2007 and were followed up until 2014–2015. Details of leisure-time exercise were ascertained via a questionnaire. Depressive states were assessed using a 13-item questionnaire. Multivariable-adjusted hazard ratio of depressive symptoms was estimated using Cox regression analysis.Results: During a mean follow-up of 5.8 years with 168,203 person-years, 6,847 workers developed depressive symptoms. Compared with workers who engaged in no exercise during leisure-time (0 MET-hours per week), hazard ratios (95% confidence intervals) associated with >0 to <7.5, 7.5 to <15.0, and ≥15.0 MET-hours of leisure-time exercise were 0.88 (0.82–0.94), 0.85 (0.76–0.94), and 0.78 (0.68–0.88) among workers who engaged in moderate-intensity exercise alone; 0.93 (0.82–1.06), 0.82 (0.68–0.98), and 0.83 (0.71–0.98) among workers who engaged in vigorous-intensity exercise alone; and 0.96 (0.80–1.15), 0.80 (0.67–0.95), and 0.76 (0.66–0.87) among workers who engaged in both moderate- and vigorous-intensity exercise with adjustment for age, sex, lifestyles, work-related and socioeconomic factors, and body mass index. Additional adjustment for baseline depression score attenuated the inverse association, especially among those who engaged in moderate-intensity exercise alone.Conclusions: The results suggest that vigorous-intensity exercise alone or vigorous-intensity combined with moderate-intensity exercise would prevent depressive symptoms among Japanese workers.

著者

Wakaba Fukushima Megumi Hara Yuri Kitamura Masahiko Shibata Yoshikazu Ugawa Koichi Hirata Akira Oka Shinya Miyamoto Susumu Kusunoki Satoshi Kuwabara Shuji Hashimoto Tomotaka Sobue

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.1, pp.34-43, 2022-01-05 (Released:2022-01-05)

参考文献数

50

被引用文献数

8

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Background: Since June 2013, Japan has suspended proactive recommendation of human papillomavirus (HPV) vaccination due to self-reported diverse symptoms, including pain and motor dysfunction, as possible serious adverse events following immunization. Although these symptoms may be seen in adolescents without HPV vaccination, their frequency, taking into account disease severity, has not been examined.Methods: A two-stage, descriptive, nationwide epidemiological survey was conducted in 2016, with a 6-month target period from July 1 to December 31, 2015, to estimate the prevalence and incidence of diverse symptoms among Japanese adolescents without HPV vaccination. Participants were 11,037 medical departments in hospitals selected nationwide by stratified random sampling. Eligible patients had to satisfy four criteria: (1) aged 12–18 years upon visiting hospital; (2) having at least one of four symptoms/disorders (pain or sensory dysfunction, motor dysfunction, autonomic dysfunction, or cognitive impairment); (3) symptoms/disorders persisting for at least 3 months; and (4) both criteria (2) and (3) influence attendance at school or work. We then extracted data of patients with diverse symptoms similar to those after HPV vaccination while considering opinions of doctors in charge.Results: Estimated 6-month period prevalence of diverse symptoms among girls aged 12–18 years without HPV vaccination was 20.2 per 100,000. Annual incidence was estimated to be 7.3 per 100,000.Conclusion: Adolescent Japanese girls without HPV vaccination also visited hospitals with diverse symptoms similar to those following HPV vaccination. Our findings predict the medical demands for coincident diverse symptoms, which are temporally associated with but not caused by HPV vaccination of Japanese adolescents.