Burden of Cardiovascular Risk Factors on the Frequency of Medical Consultations Among Japanese National Health Insurance Beneficiaries

Background:Data from the Organization for Economic Co-operation and Development (OECD) showthat Japan among OECD countries has the highest average number of medical consultations. The presentstudy estimates the burden of cardiovascular risk factors on the frequency of medical consultations amongJapanese National Health Insurance beneficiaries.Methods and Results:We analyzed data from 3,648 individuals aged 40-74 years who had participatedin health checks that were linked to monthly medical expenditure records with billing dates. The odds ratios(ORs) of factors for the prevalence of frequent medical consultations were calculated using a multivariablelogistic regression analysis. The population attributable fractions( PAF) of each factor for such prevalencedefined as over 12 medical consultations per year were also calculated as days. The odds ratios ofhypertension, dyslipidemia and diabetes were 2.5 (95% confidence interval (CI) :2.1, 2.9), 2.3 (95% CI:1.9, 2.7) and 2.3( 95% CI:1.7, 3.1), respectively and the PAF were 29.0%, 20.5%, and 5.8%, respectively.The odds ratios of hypertension in men and women were 2.6( 95% CI:2.2, 3.3) and 2.6( 95% CI:2.1, 3.2),respectively with PAF of 33.4% and 27.4%, respectively.Conclusions:Hypertension imposes the largest burden on the frequency of medical consultations amongexamined factors. Therefore, preventing incident hypertension might be the most important factor influencingmedical expenditures

Association between smoking, exercise habits and dental checkups among community residents in Japan

Background:Poor lifestyle is a risk factor for oral diseases, and dental checkups are very useful for preventingoral disease. But association between lifestyle and dental checkups is unclear. The aim of this studywas to examine the association between lifestyle and participation in dental checkups.Methods:A cross-sectional questionnaire-based survey was conducted in a city of Japan, from where wewere asked to evaluate the health promotion program conducted in the city. Three thousand subjects aged20 years or over were randomly selected from about 35,000 inhabitants. Completed questionnaires were obtainedfrom 1,670 persons (741 men and 929 women). The odds ratio (OR) with 95% confidence intervalfor having dental checkups was calculated using age-adjusted logistic regression models.Results:Of 1,670 subjects, 57.4% of men and 53.7% of women had dental checkups. The current smokerand ex-smoker rate were 30.2% and 29.2% for men and 9.6% and 10.7% for women, respectively. The proportionof subjects who did not perform 30 minutes of moderate-intensity exercise twice or more a weekwas 60.6% in men and 70.2% in women. Compared with non-smokers, the OR of having dental checkupswas significantly lower among current smokers:0.59 for men and 0.53 for women. There were no significantdifferences among ex-smokers compared with non-smokers. The OR of having dental checkups wassignificantly lower for women who never performed exercise:0.55.Conclusions:We conclude that people who have poor lifestyle, especially smokers and women who neverperform exercise, should be advised to have dental checkups

Association Between Dental Health Behavior and Incidence of Dental Caries in Women Nurses in Japan

Background:The relationship between dental health behavior and incidence of dental caries among women nurses remains unclear.Methods:A cross-sectional questionnaire-based survey was conducted on 6 9 3 women nurses who worked at Dokkyo Medical University Hospital. The survey questionnaire consisted of demographic characteristics, dental health behavior, visits to dentists during working hours in the previous year, and further details about dental problems. The odds ratio( OR) with 95% confidence interval( CI) for experience with dental problems due to dental caries in the previous year was calculated using single logistic regression models.Results:Among 693 subjects, 178( 25.7%) had experienced dental problems due to dental caries in the previous year. Compared with subjects who never brushed their teeth after snacking between meals, the OR of experience with dental problems due to dental caries was significantly lower among subjects who always brushed their teeth after snacking between meals (OR:0.55, 95% CI:0.32-0.94). Compared with subjects who never had dental checkups, the OR of experience with dental problems due to dental caries was significantly lower among subjects who had dental checkups once a year (OR:0.46, 95% CI:0.26-0.81) and less than once a year( OR:0.57, 95% CI:0.39-0.83).Conclusions:Women nurses who always brushed their teeth after snacking between meals had less experience with dental problems due to dental caries than those who did not. Women nurses who had dental checkups were at lower risk of dental problems due to dental caries than those who did not

Skipping Breakfast is Associated with Poor Vegetable Intake Among College Students in Japan

Background:Recently young adults in Japan frequently show several dietary lifestyle problems such asskipping breakfast and poor vegetable intake. The present study investigated whether skipping breakfast isassociated with dietary intake, especially vegetable consumption, in college students.Methods:A total of 151 Japanese college students aged 18-21 participated in this cross-sectional study.Of these, we selected 125 (57 males and 68 females) participants who provided complete responses to thequestionnaire, the brief-type self-administered diet history questionnaire( BDHQ), for assessment of dietaryintake during the past 1 month. The frequency of eating breakfast, weight and height were confirmed in thequestionnaire. Breakfast in this study was defined as a meal in the morning that included grain dishes suchas rice and bread. Subjects who frequently skipped breakfast were defined as those who skipped breakfasttwice or more weekly, based on the median frequency of skipping breakfast among all data from 125 participants.Results:The proportion of respondents who skipped breakfast was significantly higher among males(64.9 %) than among females (44.1 %) (p=0.020). The multiple logistic regression analysis adjusted forgender, BMI category, drinking status and energy intake showed that the proportion of those with a vegetableintake of 350 g or more daily in the group that skipped breakfast was significantly lower than that in thegroup that ate breakfast( Odds ratio 0.22, 95% confidence interval 0.07-0.67).Conclusions:The present findings suggest that Japanese college students who habitually skip breakfastalso tend to have a poor vegetable intake

Preliminary Report of Body Mass Index Among People with and Without Schizophrenia in Japan

This cross-sectional study was designed to estimate body mass index (BMI, kg/m^2) of individuals with and without schizophrenia and to examine factors contributing to excessive weight. There were a total of 208 patients (138 men, 70 women) with schizophrenia under hospitalization in a psychiatric hospital and 1,054 controls (797 men, 257 women) without schizophrenia, who underwent overnight medical screening at another university-affiliated hospital in the same area of Japan in 1998. The mean BMI among the 208 patients with schizophrenia was 24.44±4.0 compared with a mean BMI of 23.64±2.7 in healthy controls. There were no significant differences between male patients and male controls ; however, mean BMI was higher in female patients than in female controls, especially among patients under 60 years of age. As weight gain (with increase in BMI) after initiation of medication for schizophrenia is associated more with female gender and younger age, education and support to prevent obesity is particularly important for younger female patients

The Combination of Smoking and Overweight is Associated with Dyslipidemia Among Inpatients and Hypertension Among Outpatients with Schizophrenia

SUMMARYObjective:As the physical health of patients with schizophrenia is relatively poor and their risk of prematuredeath is considerably increased compared with the general population, we examined the associationbetween lifestyle-related diseases and smoking, drinking, and overweight in inpatients and outpatients withschizophrenia.Methods:The study design was cross-sectional. Subjects were 138 inpatients and 135 outpatients withschizophrenia from a psychiatric hospital in Japan. They were asked for information concerning smokingand alcohol use, and height and weight were measured to calculate body mass index. Data on hypertension,dyslipidemia, type 2 diabetes, cardiovascular diseases, and use of atypical antipsychotics were acquired frommedical records.Results:Inpatients were more likely to receive atypical antipsychotic medication and less likely to drinkalcohol. The smoking prevalence was 38.4% (53.8% in men, 17.2% in women) in inpatients and 39.3%(56.3% in men, 20.3% in women) in outpatients. Multivariate odds ratio( OR) for hypertension was significantlyhigher among outpatients than inpatients. After adjustment for age, sex, and use of atypical antipsychoticmedication, overweight smokers showed a significantly higher OR for dyslipidemia (3.17, 95% CI:1.07-9.37) among inpatients, and a significantly higher OR for hypertension (3.15, 95% CI:1.14-8.74)among outpatients. When the reference group is non-smokers with BMI below 25, smokers with BMI of 25or more had a significant higher OR( 3.38, 95% CI:1.36-8.38) for dyslipidemia among patients with schizophrenia.Conclusion:After adjustment for atypical antipsychotic medication use, the combination of smoking andoverweight was significantly associated with the prevalence of dyslipidemia among inpatients and hypertensionamong outpatients with schizophrenia

イガクセイ トシテ テキセツ ナ コウドウ ヤ タイド オ ジコ ヒョウカ スル トキニ エイキョウ スル セイカツ シュウカン カンレン インシ ノ ケントウ : ダイ1ガクネン カラ ダイ2ガクネン エノ ジコ ヒョウカ テン ノ ヘンカ オ チュウシン ニ

目的:プロフェッショナリズムの育成を医学教育に導入することを前提に医学生の低学年時の行動に対する自己評価の変化とそれに影響する因子を検討した.調査対象:2010 年の獨協医科大学医学部第1 学年の学生92 名(男子57 名,女子35 名)調査方法:2010 年7 月の1 年次と2011 年8 月に2 年次の2 回にわたって行動規範に関する自己評価表および国民健康・栄養調査に基づき作成した生活習慣調査アンケート調査を施行したその得点に影響する生活習慣関連因子を検討した.結果:1 年次から2 年次で自己評価が有意に向上したのは,「他者の人権や人格を尊重し,積極的かつ友好的にコミュニケーションをとり,分かりやすく説明する技術や態度の習得」「常に予習・復習を欠かさないなど学習習慣」「積極的に新しい知識や技能を吸収しようとする能動的な学習態度」であった.一方,2 年次で有意に自己評価が低下していたのは「講義や実習を欠席しない」「他人のものを盗用したり,データをねつ造したりしてレポートを作成しない」「与えられた課題や宿題等の提出期限を守っている」などであった.1 年次の低い自己評価に影響した項目は,男子,喫煙経験,朝食欠食,睡眠で休養がとれていないこと,睡眠補助剤の使用であった.さらに,1 年次の喫煙経験は2 年次の低い自己評価にも影響した.結論:不健康なライフスタイルが行動や態度の自己評価に影響することが判明したことより,生活習慣の変容は,行動の自己評価を向上させる可能性が示唆された.ObjectiveThe purpose of this study was to investigate factors associatedwith the professionalism of medical students, andspecifically their fitness to practice.SubjectsSubjects were 92 first-year students (57 men, 35 women)at Dokkyo Medical University School of Medicine.MethodsA 26-item self-report questionnaire on fitness to practiceand a 12-item self-report questionnaire on lifestyle werecompleted by the medical students at Dokkyo Medical University,once in their first year in July 2010 and again intheir second year in August 2011.ResultsFitness to practice scores were significantly higheramong second-year than first-year students regarding"friendly and positive communication with others while respectingtheir individual differences and human rights","learning earnestly through preparation and review beforeand after lectures", and "willingness to learn". Conversely,fitness to practice scores were significantly lower amongthe second-year than first-year students regarding "unexcusedabsence from lectures or clinical practice"," submissionof plagiarized or falsified reports", and" missed submissiondeadlines". The factors associated with lower selfassessmentscores among first-year students were beingmale, smoking experience, skipping breakfast, poor qualityof sleeping and sleeping pill usage. Furthermore, smokingexperience among first-year students was associated withlower self-assessment scores of fitness to practice in thesecond year.ConclusionThe results suggest that the early adoption of healthybehaviors had a positive influence on fostering educationalprofessionalism among medical student

イリョウケイ ダイガク ニオケル シュウカンテキ キツエンシャ ト ヒ キツエンシャ ノ ライフ スタイル ト タバコ ニ タイスル イシキ チョウサ ノ ケントウ

わが国では,「健康日本21」や健康増進法の施行にともない,タバコの害に関する教育がますます必要となってきている.そこで本研究は医療工学部で学ぶ大学生を対象に喫煙状況,生活習慣及びタバコに対する意識を調査し,喫煙の問題点を検討することを目的とした.平成18年4月に「喫煙行動とタバコに対する意識」に関する調査票を配布し,学生295名(男子244名,女子51名)の回答が得られた.その結果,習慣的喫煙率は,男子26.6%,女子9.8%と男子が有意に高かった.喫煙率は,学年が上がると増加し, 1年は11.6%であったが, 4年では35.7%であった.また喫煙者群は,健康状態が良くないと感じているもの,睡眠で十分な休養がとれていないもの,毎日に1食以上の欠食をするもの,間食が多いもの,外食が多いもの,飲酒頻度が高いものの割合が高かった.タバコの意識調査結果では,タバコの害についての教育は非喫煙者と喫煙者ともに受けているが,習慣的喫煙者は,禁煙の必要性に対する意識が低いという結果となった.特に,「医療系大学は全面禁煙すべき」,「医療従事者は喫煙するべきではない」の2提言の評価が低かった.本研究は,ある一つの医療系大学のみの調査であるが,医学部の学生と同様に,コメディカルを養成する大学においても,禁煙教育に取り組む必要性を示唆する結果となった.Like medical students, students who become co-medical workers are educated to be good advisers to help people stop smoking. The aim of this study was to evaluate the smoking-related unhealthy behaviors in smokers and nonsmokers among Japanese co-medical university students. A cross-sectional survey that queried smoking habits, attitudes toward smoking and lifestyle behaviors was delivered to students in April on 2006 and collected. We received 295 completed questionnaires from 244 men and 51 women. From the results of this survey, there were significantly more smokers among the men than women, and significantly more smokers in the higher than lower grades. Smokers were more likely to feel unhealthy, not derive relaxation from sleep, skip meals, eat snacks, eat away from home, and drink alcohol than non-smokers. From the results of this survey of attitudes toward smoking, there were no significant differences between smokers and non-smokers in the education they received on the harm of smoking, but current smokers underestimated the importance of tobacco cessation, especially, in the two statements that "it was important to have a tobacco-free campus at a university for co-medical workers" and "co-medical workers should not be smokers." Although the scale of this study was limited to only one university in Japan, the significant preliminary results make it clear that there are serious smoking issues in co-medical students as well as medical students

イリョウケイ ダイガクセイ ニオケル チョウショク ケッショク ト ライフ スタイル トノ ケントウ

平成17年国民健康・栄養調査報告によると, 20歳代, 30歳代の朝食欠食率が増加しており,毎日の朝食摂取は,健康的習慣を構築するための課題となっている.そこで本研究は,医療系大学生を対象にライフスタイルの横断アンケート調査を行い,朝食欠食に関与する因子を検討した.その結果,有効回答290名(男子241名,女子49名)から以下の結果を得た.週2日以上朝食を欠食する者は,男子で62.2%,女子で51.0%であった.学年別では,第1学年では,過2日以上朝食を欠食する者は27.3%であったが,第2学年以上になると増加し, 70%以上となった.また健康状態が不良と感じているものに朝食欠食者が多かった.次に,過2回以上朝食を欠食する者を朝食欠食者とし,ライフスタイルを検討した.その結果,喫煙者と家族と別居している者に朝食欠食者が多く,逆に6～8時間の睡眠をとっている者に少なかった.According to the National Health and Nutrition Survey in Japan, the rate of breakfast-skipping by people in their twenties and thirties has increased and become a public health concern. The aim of this study was to evaluate the association factors of skipping breakfast among Japanese co-medical university students. A cross-sectional survey that queried lifestyle behaviors was delivered to students and collected in April of 2007. We received 290 completed questionnaires from 241 men and 49 women. From the results of this survey, the rate of breakfast-skipping two or more times in a week was 62.2% for men, and 51.0% in women. The rate among the first year students was only 27.3%, but the rates among second year students and those of higher-year students were over 70%. Students who felt their health was poor were significantly more likely to skip breakfast frequently. After breakfast skippers were defined as students who skipped breakfast two or more times a week, lifestyles among breakfast skippers were examined by comparison with breakfast eaters. Breakfast skippers were significantly more likely to smoke and live away from home. Moreover, students who slept for 6 to 8 hours were significantly less likely to skip breakfast. Either sleeping less than 6 hours or more than 8 hours puts students at higher risk for breakfast-skipping