General Consumer Awareness of Warnings Regarding the Consumption of Alcoholic Beverages

Over the past two decades, the liquor industry in Japan has strived to address alcohol-related problems through initiatives such as warnings in the various media. In this study, we conducted an Internet-based questionnaire survey to examine general consumer awareness of such warnings, and the media by which they are conveyed, on the consumption of alcoholic beverages. A total of 985 subjects (males:487, females:498) in age groups ranging from 20s to 70s responded (response rate:22.4%). The awareness rates for warnings regarding underage drinking, drunk driving, and drinking during pregnancy, and those for messages encouraging moderation in drinking, were 96.4%, 83.7%, 59.6%, and 45.5%, respectively. Logistic regression analysis adjusted for habitual alcohol consumption demonstrated significant gender- and/or age-based differences in the rates of awareness of warnings and the media publicizing them. For example, the odds ratio of awareness among women of warnings against underage drinking was significantly higher than that of awareness among men. Issues that must be addressed in the future include:(1) increasing public awareness about messages regarding drinking during pregnancy and drinking in moderation;(2) reviewing the wording of warnings to make them more effective;and (3) devising and employing, on a regular basis, more effective means of transmitting messages in consideration of gender and age

Sleep Duration and Overweight among Elementary Schoolchildren:A Population-based Study in Japan

Although a number of studies have investigated the relationship of sleep duration to overweight and obesity, studies conducted among population-based elementary schoolchildren have been limited in Japan. The aim of the present study was to investigate the relationship between sleep duration and overweight among elementary schoolchildren in Japan. The study subjects were all fourth-grade schoolchildren (9 or 10 years of age) in Ina-town, Saitama Prefecture, Japan from 1999 to 2008. Information concerning each subjectʼs sex, age, and lifestyle was obtained using a self-administered questionnaire, while measurements of his or her height and weight were carried out. Childhood overweight was determined according to the definition established by the International Obesity Task Force. Data from 3,433 children were analyzed. In logistic regression analysis, a statistically significant dose-response relationship was observed between sleep duration and overweight among boys (p for trend＝0.014) but not among girls (p for trend＝0.149). Short sleep duration was associated with childhood overweight, and the sex difference in the association was observed. These findings suggested that it is important to consider sleep duration as part of any program to prevent overweight among elementary schoolchildren, especially among boys

Relationship between Eating Quickly and Overweight : A Cohort Study of Schoolchildren in Japan

Several cross-sectional studies have shown that eating quickly is associated with overweight in children and adolescents. However, few cohort studies have examined this relationship. Here we investigated the relationship between eating quickly and overweight in a cohort study of fourth-grade schoolchildren (aged 9 or 10 years) who attended elementary schools in Ina-town, Japan. The children were followed for 3 years from 2001-2004 (at baseline) to 2004-2007. A questionnaire survey including information about eating speed (fast, medium, or slow) was administered, and height and weight measurements were obtained at baseline and follow-up. Overweight was defined according to the body mass index cutoff points proposed by the International Obesity Task Force. We used a Poisson regression model to examine the association between eating quickly at baseline and being overweight 3 years later. Data from 934 non-overweight children (465 boys, 469 girls) were analyzed. Eating quickly was not significantly associated with being overweight in the boys, whereas it was significantly associated with being overweight in the girls. Our analysis indicates that among girls, eating quickly leads to overweight, and that the modification of eating quickly could help prevent overweight in adolescents

Attitudes of Japanese Medical Students towards Disclosure of a Diagnosis of Life-threatening Illness

In this study we investigated the attitudes of Japanese medical students toward being informed of a diagnosis of life-threatening illness. Fourth-year medical students from 20 randomly sampled universities were administered questionnaires that examined their opinion about whether they would welcome disclosure of medical information if they were diagnosed as having an ultimately fatal disease. Data from 1,619 students (male 1,074, female 545, effective collection rate 90.6%) were analyzed. With regard to attitudes about disclosure of a diagnosis of life-threatening illness, 87.7% of the students stated that they would wish to be informed even if there was little chance of recovery, and 11.6% expressed a wish to be informed of their condition only if there was a chance of recovery. Students who did not wish to be informed even if there was a chance of recovery accounted for 0.7% of those surveyed. Our study reveals that medical students are more positive than are members of the general population with regard to being informed of the truth. The proportion of those who wished to be informed even if there was little chance of recovery was higher among students from national and public universities than among those from private universities, and the inter-group difference was statistically significant. Among male students, answers to the survey were significantly correlated with 12-item General Health Questionnaire scores and mental health status, suggesting that mental health status may have affected how this study population viewed being informed of their diagnosis.</p

Usage of the .9 Codes of the ICD-10 for Japanese Mortality Statistics

The structural deficits and problems associated with application of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) were investigated. For this purpose, mortality statistics in Japan were examined for bias in the proportions of death causes classified using the ICD-10 four-character subcategory system, particularly the large distribution of cases classified under the .9 (unspecified) codes. The results showed that most deaths due to the 3 major causes were coded into the .9 subcategories. For example, 97.6% of the 607,065 deaths between 1995 and 2007 classified as I21 (acute myocardial infarction) were coded as I21.9 (acute myocardial infarction, unspecified). This suggests that the quality of the data recorded on many death certificates is poor. Thus, to ensure that the fourth-digit-level subcategories of the ICD-10 code system are effectively used to represent mortality data and actual causes of death in Japan, future studies should address the following objectives:(1) to minimize the discrepancy between the ICD classification terms and the names of diseases actually used in clinical practice, and (2) to actively raise awareness among physicians about the need to accurately record death causes on death certificates, since these records form the basis for determining mortality statistics in Japan.</p

Mental Health Status among Japanese Medical Students: A Cross-Sectional Survey of 20 Universities

The purposes of this study were to evaluate the mental health status of Japanese medical students and to examine differences based on gender, as well as on university type and location, using the results of a nationwide survey. Between December 2006 and March 2007, we conducted a questionnaire survey among fourth-year medical students at 20 randomly selected medical schools in Japan. The data from 1,619 students (response rate:90.6%;male:1,074;female:545) were analyzed. We used the Japanese version of the 12-item General Health Questionnaire (GHQ-12) to measure mental health status. Poor mental health status (GHQ-12 score of 4 points or higher) was observed in 36.6% and 48.8% of the male and female medical students, respectively. The ratio of the age-adjusted prevalence of poor mental health status in female versus male medical students was 1.33 (95% confidence interval:1.10-1.62). The universities were categorized into two groups based on the university type (national/public:15 vs. private:5) or location (in a large city:7 vs. in a local city:13 cities). The prevalence of poor mental health status in both men and women differed between these groups, although not significantly. The GHQ-12 scores in men significantly differed between the categorized groups of universities. These results suggest that adequate attention must be paid to the mental health of medical students, especially females, and that a system for providing mental health care for medical students must be established in the context of actual conditions at each university

Changes in body mass index, leptin and adiponectin in Japanese children during a three-year follow-up period: a population-based cohort study

<p>Abstract</p> <p>Objective</p> <p>The study examined changes in and relationship between body mass index (BMI), leptin and adiponectin levels over a 3-year period in a pediatric population-based cohort.</p> <p>Study design</p> <p>A 3-year prospective cohort study of 268 boys and 251 girls aged 9–10 in Ina, Saitama, Japan.</p> <p>Results</p> <p>Median body mass index (BMI) significantly increased from baseline (age 9–10) to follow up (age 12–13) in boys from 17.1 to 18.3 kg/m²(<it>P </it>< 0.001) and in girls from 16.5 to 18.5 kg/m²(<it>P </it>< 0.001), respectively. Adiponectin values significantly decreased from baseline to follow up in boys (13.5 to 8.9 μg/ml, respectively) (<it>P </it>< 0.001) and in girls (12.4 to 9.5 μg/ml, respectively) (<it>P </it>< 0.001). Leptin values at follow up significantly decreased from baseline in boys (4.9 to 2.3 ng/dl, respectively) (<it>P </it>< 0.001) and also in girls (5.3 to 5.1 ng/dl, respectively) (<it>P </it>= 0.049).</p> <p>A relatively strong correlation was seen in BMI (Spearman's correlation coefficient, <it>r </it>= 0.864, <it>P </it>< 0.001 in boys; <it>r </it>= 0.873, <it>P </it>< 0.001 in girls), adiponectin (<it>r </it>= 0.705, <it>P </it>< 0.001 in boys; <it>r </it>= 0.695, <it>P </it>< 0.001 in girls), and leptin (<it>r </it>= 0.449, <it>P </it>< 0.001 in boys; <it>r </it>= 0.610, <it>P </it>< 0.001 in girls) before and after the three-year period.</p> <p>The ratio of follow up to baseline BMI was negatively correlated with that for adiponectin (<it>r </it>= -0.224, <it>P </it>< 0.001 in boys; <it>r </it>= -0.165, <it>P </it>= 0.001 in girls) and positively correlated with that for leptin (<it>r </it>= 0.518, <it>P </it>< 0.001 in boys; <it>r </it>= 0.609, <it>P </it>< 0.001 in girls).</p> <p>Conclusion</p> <p>This study demonstrated that baseline adiponectin, leptin and BMI values measured at ages 9–10 correlated with those measured three years later. However, adiponectin values decreased and leptin values increased in those subjects whose BMI increased during over this period.</p

Blue Monday Phenomenon among Men:Suicide Deaths in Japan

The number of suicide deaths in Japan has continued to be high, and is a pressing social problem. Although the weekly distribution of suicide deaths has been documented, no nationwide analysis has yet been conducted. In the present study, the ratios of the number of suicide deaths per day, by day of the week, and on weekdays relative to holidays were calculated using the data for all suicide deaths recorded in 2003. The suicide deaths recorded on holidays were treated as the reference, and a confidence interval of 95% (95% CI) was used. We calculated the suicide death ratios among men and women of all ages (men:23,396, women:8,713, total:32,109) and also among those of productive age (age:15-64 years, men:18,552, women:5,481, total:24,033). Among men of all ages, the suicide death ratio on Mondays was found to be significantly high at 1.49 (95% CI:1.04-2.14), and the ratios were found to decrease over the course of the week from Monday to Friday. On each weekday, the suicide death ratios among men of productive age were found to be higher than those among men of all ages. Among women, the suicide death ratios on any weekday were found to be higher than 1, but there was no significant difference between the days. Among both men and women, the number of suicide deaths on holidays was lower than that on weekdays. This study revealed that the number of suicide deaths recorded per day on Mondays is 1.5 times higher than that on holidays among men. This suggests that the structure of the work week may possibly influence suicide deaths among men. Future discussions regarding the arrangement and distribution of weekly holidays should be conducted in order to reduce the number of suicide deaths.</p

Association between Public Assistance and Frequent Emergency Department Visits in Urban Areas of Japan: A Case-Control Study

Emergency department（ED）crowding due to frequent visitors increases medical costs and endangers the safety of patients who need prompt treatment. Although some studies have examined the social background of frequent visitors to the ED, there are few comprehensive studies of factors related to frequent ED visits in Japan. The present study examined whether public assistance status, age, and underlying conditions are associated with frequent visits to the ED. Subjects in this study were patients over 20 years of age who visited the ED of General Medicine in Showa University Hospital in Tokyo, Japan, from April 1, 2014, to March 31, 2015（n＝6,182）. Information regarding sex, age, public insurance, hypertension, diabetes mellitus, dyslipidemia, chronic obstructive pulmonary disease, cancer, dysuria, bronchial asthma, and chronic kidney disease was collected using a patient database created from medical and hospital records. Based on a previous study, subjects who visited the ED four or more times were defined as frequent visitors, while those who visited the ED less than four times were considered infrequent visitors. Logistic regression analysis was performed to calculate odds ratios（ORs）and 95％ confidence intervals（CIs）for frequent ED visits. Receipt of public assistance significantly increased the OR for frequent visits（4.26, 95％ CI: 1.90-9.56）, even after adjusting for sex, age, and potential confounding factors（OR: 3.89, 95％ CI: 1.62-9.35）. The current study found a significant association between frequent ED visits and the receipt of public assistance. Emergency physicians and medical practitioners need to share information with outpatient physicians and welfare officers and work together with patients to address their specific medical and social vulnerabilities