OBJECTIVES:Research funding is a limited resource that not only affects scientific progress but also significantly affects researchers' career paths and family formation. Research environments in social medicine are rapidly changing, and increasing attention is being paid to researchers' mental health. In this study, we aimed to examine the associations among research funding status, marital status, number of children, and mental health of researchers in social medicine by gender. METHODS:We conducted a web-based survey among Japanese medical researchers from December 2022 to January 2023. Among them, the present study focused on researchers in social medicine by sex; researchers who gave their consent and self-identified their primary field as social medicine were included. The primary outcome was poor mental health, defined as a score of less than 13 on the World Health Organization-5 Well-Being Index. Multivariable logistic regression analysis was used to examine associations among three factors (shortage of research funds, marital status, and number of children) adjusted for age, employment type, and research effort. RESULTS:Responses from 567 participants were analyzed. Among female researchers, the lack of research funding was associated with poor mental health. Among male researchers, being single and not having children were associated with poor mental health. CONCLUSIONS:Research funding status, marital status, and number of children may be associated with mental health among social medicine researchers, and these factors differed between men and women. Although causal relationships cannot be inferred owing to the cross-sectional design of this study, tailored interventions considering gender-specific contexts may be necessary to support researchers' mental health.
Falls among older adults are a growing public health concern and an increasingly important cause of long-term care needs. Evidence shows that exercise programs combining balance and resistance training can effectively reduce fall risk, yet participation in regular exercise remains limited among community-dwelling older adults in Japan. The Lively 100-Year-Old Exercise was developed in Kochi City in 2002 as a resident-led, community-based fall-prevention program. Despite its spread to many municipalities nationwide, regional disparities in implementation remain, and certain populations-particularly older men-are less likely to participate. To address these challenges, in this paper, implementation science frameworks are applied. The Consolidated Framework for Implementation Research was used to identify barriers and facilitators across five domains, namely, innovation, outer setting, inner setting, individual, and implementation process. Key strategies include strengthening social appeal, administrative support, interdepartmental collaboration, and resident leadership. Furthermore, the COM-B model was used to identify barriers and facilitators to individual participation in the Lively 100-Year-Old Exercise, classifying them into capability (understanding health benefits), motivation (enjoyment and sense of purpose), and opportunity (social support and accessible environments). In this paper, it is concluded that sustained dissemination of the Lively 100-Year-Old Exercise requires evidence-based implementation strategies, systematic evaluation of implementation outcomes, and close collaboration among researchers, local governments, and community stakeholders.
BACKGROUND:Japanese workers face long working hours, mental stress, and caregiving responsibilities, contributing to physical and psychological symptoms (e.g., fatigue, depressive mood, and sleep disturbances). These symptoms adversely affect the quality of life (QOL) and work productivity. Nationwide studies on symptom-QOL-work productivity associations across various occupations remain scarce. OBJECTIVE:In this study, we quantitatively assessed the associations between self-reported symptoms, QOL, and work productivity loss using a large-scale person-reported outcomes database (PRO-DB). METHODS:In this cross-sectional analysis, we used data from the first PRO-DB survey (June 2024). Among 192,572 employed respondents, demographic data, 40 self-reported symptoms, QOL (EuroQol 5-Dimension 5-Level questionnaire), and work productivity loss [overall work impairment (OWI), Work Productivity and Activity Impairment questionnaire] were analyzed. Generalized linear regression models, adjusted for demographics, were used to assess the impact of symptoms on QOL and OWI. A weighted analysis was conducted to estimate workforce burden by weighting the effect sizes of symptoms on QOL and OWI by the number of respondents reporting each symptom. RESULTS:Consciousness disturbance (-0.207 QOL, 29.3 OWI) and hallucinations/delusions/auditory hallucinations (-0.192 QOL, 29.3 OWI) were strongly associated with lower QOL and increased OWI but had a limited population impact due to their low prevalence. In contrast, weighted analysis showed that easy fatigability (-0.0199 QOL, 4.79 OWI) and depressive mood (-0.0135 QOL, 2.44 OWI) had the greatest workforce-wide effects on QOL and productivity loss. CONCLUSION:These findings highlight a dual burden of symptoms among Japanese workers. Effective interventions should address both rare severe symptoms and common mild symptoms to improve well-being and productivity.
Habitual alcohol consumption is an established risk factor for hypertension. To prevent hypertension, daily alcohol consumption is generally recommended to be less than 20-30 ml in men and 10-20 ml in women. The association between alcohol consumption and hypertension is affected by various factors, including age, sex, body weight, genetic disposition, drinking patterns, smoking habits, and medication for hypertension. The difference in blood pressure between drinkers and nondrinkers tended to be more prominent in men than in women, in the elderly than in the young, in individuals with high alcohol exposure per body weight than in those with low alcohol exposure, in smokers than in nonsmokers, and in individuals not receiving medication for hypertension than in those receiving it. Regarding the effect of polymorphisms of alcohol-metabolizing enzymes on the association between alcohol consumption and blood pressure or hypertension, the findings of previous studies were inconsistent: the associations were reported to be stronger in individuals showing facial flushing after drinking (flushers) than in nonflushers in some studies, but not in others. It remains to be clarified whether the polymorphism of aldehyde dehydrogenase 2 is involved in determining the sensitivity of blood pressure to alcohol. Drinking with a meal may be effective in suppressing the increase in blood pressure induced by alcohol consumption. According to the evidence obtained from the previous studies, differences in the types of alcohol beverage may not affect the association between alcohol consumption and blood pressure, although the anti-oxidative action of wine is expected to lower blood pressure by increasing nitric oxide activity. In conclusion, the effects of the aforementioned confounders on the relationship between alcohol consumption and blood pressure should be taken into consideration when recommending the upper limit of individual alcohol consumption for the prevention and therapy for hypertension.
OBJECTIVES:Eating attitudes represent a significant health risk for young women. According to Japan's 2019 National Health and Nutrition Survey, 20.7% of women in their 20s have a Body mass index (BMI) below 18.5 kg/m2. In this study we aimed to examine the psychological mechanisms underlying body image distortion, weight loss desire, and high Eating Attitudes Test (EAT-26) scores, with a focus on personality traits and self-efficacy, in young women without suspected eating disorders. METHODS:A self-administered questionnaire survey was conducted in December 2020 on 167 female university students in Okayama, Japan. Participants with EAT-26 scores of 20 or higher were excluded, and the final analysis was conducted on young women without suspected eating disorders. The survey assessed personality traits using the NEO Five-Factor Inventory (NEO-FFI), self-efficacy using the Trait Self-Efficacy Scale, and eating attitudes using EAT-26. Data were analyzed using multiple regression and path analysis. RESULTS:Factor analysis revealed five subscales of self-efficacy: "Patience", "Coping Skills", "Execution Ability", "Sociability", and "Challenge". Multiple regression analysis showed that both "Patience" and "Coping Skills" were negatively associated with body image distortion and weight loss desire. The NEO-FFI subscale "Extraversion" was positively associated with both weight loss desire and EAT-26 scores, whereas "Neuroticism" was positively associated with EAT-26 scores. These subscales may serve as predictive psychological factors. Furthermore, path analysis confirmed a sequential model of a process in which body image distortion leads to weight loss desire, which in turn contributes to higher EAT-26 scores. CONCLUSIONS:In this study we developed a sequential model of a process in which body image distortion leads to weight loss desire, which subsequently results in higher EAT-26 scores. This process was found to be associated with the self-efficacy subscales "Patience" and "Coping Skills" and the personality trait subscales "Neuroticism" and "Extraversion".
OBJECTIVES:In this study, we aimed to identify work environmental factors related to work engagement among nurses in a medium-sized hospital, based on levels of sense of coherence (SOC). METHODS:An anonymous, self-administered questionnaire was administered to 102 nurses working at a medium-sized hospital. The participants were divided into two groups based on the mean SOC scores, and multiple regression analysis was conducted to examine the work environmental factors related to work engagement. RESULTS:In the low SOC-score group, positive factors included "My workplace provides opportunities to learn necessary knowledge" and "Facilities such as a nap room and daycare center are provided." Positive factors in the high SOC-score group included "I have opportunities to demonstrate my abilities including my qualifications and experience." However, "Ward meetings and committee activities held during working hours" was a negative factor. CONCLUSIONS:To create a workplace that enhances work engagement, it is important to support the acquisition of necessary knowledge in a series of steps. When SOC is low, it is important to provide nap rooms and childcare facilities. When SOC is high, it is vital to provide support so that they can focus on patient care during working hours and attend meetings without difficulty.
In response to the review of my book "Minamata Disease and the Responsibility of Medicine" by Makoto Futatsuka, Komyo Eto, and Makoto Uchino, I submitted a "Reply" pointing out that the review contained many medical errors, logical inconsistencies, and ethical problems. In the "Forum" that the three authors subsequently contributed, they presented six more points of negative findings on exposure and health problems related to Minamata disease in a fragmented manner, without responding to the various issues that I had pointed out in the "Reply." In the case of environmental pollution causing diseases such as Minamata disease, the tasks of researchers in the field of medicine and public health are to (1) investigate the temporal and spatial spread of health problems, (2) investigate the pathophysiological factors for the health problems caused by environmental pollution, and (3) establish diagnostic criteria based on toxicological and epidemiological information. However, the three authors' opinions and logic clearly indicate that they lacked a standard academic or practical approach to methylmercury poisoning to pursue these three points, and that their understanding of the pathophysiology of the disease was inadequate and the premise for pursuing a diagnosis was flawed. Through discussions in this forum, the inaction of experts in the fields of public health, neurology, and pathology with regard to Minamata disease, as insisted in my book, was considered to be further confirmed.
We received Dr. Takaoka's responses. The nine major points described in these responses were reviewed from the basic perspectives of epidemiology, toxicology and neuroscience. The responses indicate important failures in our views: exposure and health hazards are misconsidered from the toxicological perspective, mass biases in epidemiological surveys, and ignorance from the pathological viewpoint. We are looking forward to scientific discussion.
OBJECTIVE:In this study, we aimed to examine the relationship between the Eating Assessment Tool-10 (EAT10) score, a screening index for dysphagia, and the Epworth Sleepiness Scale (ESS) score, which evaluates daytime sleepiness in Japanese workers. METHOD:A cross-sectional study of 496 workers (454 men and 42 women) at two business locations in Japan was conducted from November 2021 to June 2022. Dysphagia was assessed using the score of EAT10, a self-administered questionnaire. Daytime sleepiness was evaluated by calculating the score of ESS, a self-administered questionnaire. To examine the correlation between the degree of dysphagia (EAT10 score) and the degree of daytime sleepiness (ESS score), Spearman's rank correlation coefficient was calculated. Logistic regression analysis was performed with the presence or absence of daytime sleepiness as the dependent variable and the presence or absence of dysphagia and basic attributes as the independent variables, and the effect of dysphagia on daytime sleepiness was evaluated using odds ratios and 95% confidence intervals. RESULTS:EAT10 scores of 3 or higher accounted for 5.6% of the total number of participants. High ESS scores (3 or higher) were significantly more frequent in the high-EAT10score group (odds ratio, 3.92: 95% confidence interval, 1.54-10.1) when adjusting for the effects of gender, age, body mass index, alcohol consumption, and smoking. CONCLUSION:This study suggests that dysphagia may be associated with daytime sleepiness in Japanese workers. Even a method using only a simple self-administered questionnaire may enable early detection and treatment of dysphagia and excessive daytime sleepiness.
OBJECTIVES:Using the Total Health Index (THI) health check questionnaire, we aim to clarify the subjective health associated with working using visual display terminals (VDTs). METHODS:Focusing on male manufacturing workers, we analyzed data from responses to 130 THI questions in the four annual surveys from 2010 for three groups: those who worked with VDTs for four hours or more per day (4 h<), less than four hours per day (4 h>), and those who did not use VDTs (0 h). We examined the state of subjective health by assigning scores to the three-choice responses to each question (yes=3, sometimes=2, no=0 point). We then calculated the cumulative scale score for each of the 16 scales to determine the three groups' characteristics. RESULTS:The 4 h<, 4 h>, and 0 h groups consisted of 480, 440, and 80 employees, respectively. The 4 h< group had significantly more complaints of eye fatigue, lack of energy, and others than the 4 h> group. The mean percentile of the scale score was significantly higher for the two scales of "eyes/skin" and "depression" in the 4 h< group than the 4 h> group. We compared the changes in scale scores between those who increased and those who decreased their VDT work time with those in the previous year. The group increased with VDT work time showed higher scores in the questions "lack of energy recently" and others. Regular exercise reduced the severity of complaints about depression. CONCLUSIONS:THI confirmed that prolonged VDT work has negative impacts on health. To reduce these negative impacts, surveys using THI are useful for determining preventive measures.
Hygiene is a field of study that aims to "protect health" and "protect lifestyle" of people from external factors such as bacteria, poor nutrition, and toxic chemicals, as well as internal factors such as lifestyle and stress. In the early days of hygiene science in Japan, the results of nutritional epidemiology research by Dr. Kanehiro Takaki, a naval doctor who studied medicine in Kagoshima, on the prevention of beriberi, a national disease at the time, were highly regarded internationally. Since then, hygiene research on food ingredients has been vigorously pursued to expand from basic research to applied research, as exemplified by the development of the allithiamine. The symposium "Food Ingredients and Hygiene: Exploring the Functions of Food Ingredients from Hygiene" was organized by the Young Researchers Association at the 94th Annual Meeting of the Japanese Society for Hygiene (Kagoshima) to introduce recent research and examples of industry-academia collaboration. Young researchers involved in hygiene research on foods and food materials presented their recent work ranging from basic research, such as the functional evaluation of foods by animal experiments and the evaluation of the effects of polyphenols and yogurt on health, which have long been studied, to applied research leading to the commercialization of foods with useful physiological effects. This mini-review is a summary of the symposium. As the Young Researchers Association, we hope that this symposium/mini-review will encourage young researchers to become interested in various functions of food ingredients, conduct related research, and consider how to contribute their research results to society.
OBJECTIVES:In addition to an aging population, the number of single-person households is increasing in semi-mountainous areas. The nutritional status of older adults living alone has also been studied as they are prone to undernutrition. In this study, we aimed to develop a risk prediction model and a simple assessment sheet for screening undernutrition using factors related to food environment accessibility among older adults living alone in semi-mountainous areas. METHODS:This study included 181 participants (36 men, 145 women) living alone in four semi-mountainous areas (mean age, 83.6 years). Factors related to accessibility to the food environment were measured using 30 predefined items. The Mini-Nutritional Assessment Short Form was used for the nutritional status assessment. RESULTS:An exploratory factor analysis was performed using 30 items of the food environment accessibility, among which, 16 items were extracted. On the basis of the results of a logistic regression analysis using 17 items including age, 10 items were selected to be included in the logistic model to predict the risk of undernutrition. The risk prediction model showed fair discrimination (area under the curve=0.722) and calibration capabilities (Hosme-Lemeshow test, p=0.822). A simple rating sheet was developed using a model to predict undernutrition risk using factors related to food environment accessibility among older adults living alone in semi-mountainous areas. CONCLUSIONS:A simple assessment sheet was developed to evaluate the undernutrition risk using factors related to food environment accessibility among older adults living alone in semi-mountainous areas.
The relationship between alcohol consumption and incident ischemic heart disease and stroke is characterized by a J- or U-shape. This denotes that light drinking has a preventive effect on cardiovascular diseases. Effects of alcohol drinking on lipid metabolism including an increase in HDL cholesterol concentration and a decrease in LDL cholesterol concentration are the main reasons for the anti-atherosclerotic action of alcohol. The antithrombotic effect of alcohol through the inhibition of platelet function is also involved in the lower incidence of ischemic arterial disease in drinkers. Capacitative Ca2+ entry, a main mechanism for platelet aggregation, is inhibited by ethanol. Ethanol also inhibits plasmalemmal phospholipase A2 activity and consequent thromboxane A2 production. French paradox is a phenomenon showing the merit of red wine consumption for the prevention of ischemic heart disease. In addition to ethanol, red wine contains anti-oxidative polyphenol compounds, represented by resveratrol, which has an antiplatelet action. Resveratrol also inhibits the capacitative Ca2+ entry in platelets. Furthermore, ethanol and resveratrol show a synergic inhibitory action on platelet aggregation, which may be caused by the reduction in the Ca2+ sensitivity of the contractile apparatus of platelets and the attenuation of COX-1 activity. Thus, the strength of the antithrombotic action is thought to differ depending on alcohol beverage. Decreases in concentrations of coagulation factors including fibrinogen are also involved in the alcohol-induced antithrombotic action. Alcohol drinking causes hemorrhagic diathesis as well as antithrombotic tendency.
OBJECTIVES:Virtual reality (VR) and three-dimensional (3D) images have become increasingly popular. It has been reported that visually induced motion sickness (VIMS) is more frequently caused by viewing these images. We propose a method to control VIMS by controlling visually evoked postural responses (VEPRs) using galvanic vestibular stimulation (GVS). In this study, we focused on the effect of VEPRs on body sway and conducted a transfer function analysis between the GVS and body sway. On the basis of the results of this investigation of the causes of VIMS, countermeasures must be considered. METHODS:The experiment involved 15 healthy young adults, comprising six males and nine females, all aged 21 years. The subjects were asked to maintain a Romberg posture while viewing an image that included a large number of randomly positioned moving spheres with their peripheral vision. In addition, body sway during GVS as an external stimulus was measured for 120s for each task. RESULTS:The transfer function analysis of the body sway showed that the influence on the equilibrium function was significantly enhanced not only by the GVS but even more so by viewing the video clips synchronized to the GVS. CONCLUSIONS:GVS current signals induced body sway and increased the width of body sway synergistically. It was also suggested that a time delay structure occurred between the GVS current signal and body sway.
OBJECTIVES:Recent legislative changes in the wake of the novel coronavirus pandemic have placed an increased emphasis on the research activities of Local Public Health Institutes (PHIs) in Japanese municipalities. However, few studies have examined the ethical review processes of these institutes. METHODS:We analyzed information on (a) the status and year of establishment of "Ethics Review Committees" (and equivalent committees), (b) the number of review cases for each year, (c) the status of public disclosure of committee activities, and (d) the composition of committee members for 85 PHIs across Japan. Publicly available information from each PHI and the Ministry of Health, Labour and Welfare was used for the analysis. RESULTS:Out of 85 PHIs nationwide, about half of them publicly disclosed the establishment of their committees (41 committees, 48.2%). The number of review cases handled by the committees varied, with some committees having no cases or only one case. Among the committees, approximately 20% still maintained adherence to outdated national research ethics guidelines, and approximately 15% did not specify any guidelines they followed. Furthermore, we identified committees without external members (at least two committees) and those lacking public representation (four committees). CONCLUSION:There are differences in the operational performance of ethics review committees at PHIs, possibly owing to varying levels of understanding of the guidelines, the degree of proactive engagement in academic research, and the emphasis on human subject research. There is a crucial need to accumulate and share experiences that support the review functions of the committees.
OBJECTIVES:The objectives of this study were to develop a Japanese version of the Pediatric Epilepsy Medication Self-Management Questionnaire Caregiver Version (PEMSQ-J) and to examine its reliability and validity. METHODS:A quantitative cross-sectional study was conducted among primary caregivers (N=309) of children under the age of 18 taking epilepsy medication. The PEMSQ-J was the main instrument used to collect information such as basic demographics.Cronbach's α was calculated to determine internal consistency, and the intraclass correlation coefficient was calculated to assess reproducibility. In addition, confirmatory factor analysis with covariance structure analysis was performed to confirm the goodness of fit of the model. Finally, criterion-related validity was confirmed. RESULTS:Analysis of responses to items on the PEMSQ-J revealed no ceiling or floor effects, and there was no marked bias in distributions in terms of skewness or kurtosis. Internal consistency assessed with Cronbach's α ranged from 0.847 to 0.935. A test of reproducibility revealed that the intraclass correlation for the total score was 0.730. Exploratory factor analysis identified two factors, which differed from the four factors in the original version. When their details and structure were examined, however, the two were interpreted as having a similar structure. Similarly to those of the original version, the goodness-of-fit indices for the four factors according to confirmatory factor analysis were close to the standard values. CONCLUSION:The PEMSQ-J, which consists of 27 items with a four-factor structure, was statistically acceptable, and it was found to have a certain degree of reliability and validity.
Drs. Futatsuka, Eto, and Uchino expressed their opinions in the Journal of the Japanese Society for Hygiene in the form of a review of my book, "Minamata Disease and the Responsibility of Medicine." (The reviewers translated it as "Responsibility of Medical Authorities," but for my purposes in writing this book, I believe it should be translated as "Responsibility of Medicine.") The nine major comments of the three reviewers described in this book review were reviewed from the basic perspective of toxicology, epidemiology, and neuroscience. This book review is fraught with either medical, logical, or ethical problems in all the nine points as follows: (1) the inadequate way in which exposure and health hazards are considered from the toxicological perspective, (2) problems in interpreting epidemiological information, (3) the failure to consider recent achievements in methylmercury toxicosis studies, (4) presenting the reviewers' own theories without regard to the content of my book while calling it a "book review," (5) presenting and criticizing what Takaoka does not claim as if he does, and (6) making claims that are inconsistent with the three reviewers' own views. The problems with this book review will become even clearer when you read "Minamata Disease and the Responsibility of Medicine" itself.
What is health? We all have a goal that we aspire for in our life-our "reason to live". Health is a pillar necessary for achieving our goal in life and I believe that altruism is the basic principle of this pillar. In this paper, I first discuss altruism in health from biological and economic perspectives, and then review the history of the concept of health. Next, I introduce the keywords necessary for understanding health and then present the points necessary for determining good health and for the role of each individual in issues concerning health. In conclusion, I would like to define health as a state of physical, mental and social well-being necessary for people to achieve self-achievement and happiness while living in society. Health is an attitude, and the very process of striving to achieve good health is itself "good health". In addition, altruism is fundamental to good health. The spirit of respect and empathy for not only humans health but also "planetary health" is important.
OBJECTIVE:In this study, we aimed to develop a comprehensive health literacy (HL) scale for Japanese workers (CHLS-J) and to investigate the relationship between HL and health-related behaviors.METHODS:We conducted a cross-sectional study by a questionnaire survey of Japanese workers aged 18 years and older (N=313). The HL scale we previously developed was slightly modified on the basis of the pre-examination and used for developing CHLS-J. Self-reported data on demographic variables, socioeconomic status, health-related behaviors, present illness, past illness, and HL were collected. To determine the factor structure of the HL scale, an exploratory factor analysis was conducted, and the internal consistency of the scale was assessed using Cronbach's coefficient alpha. The criterion-related validity was evaluated using the Pearson product-moment correlation coefficient.RESULTS:From the results of factor analysis, 30 HL items were extracted and the structure was based on three factors (the knowledge and competencies for collecting health information, decision-making and communication, and the motivation for utilizing health information). High CHLS-J scores were significantly associated with food purchasing behaviors based on food labeling and maintaining a well-balanced diet. Furthermore, patients with present or past illness were more likely to have high CHLS-J scores.CONCLUSIONS:The results show that CHLS-J is mostly a validated and reliable scale, and that the high-HL group had a healthy eating lifestyle. This study suggests that CHLS-J can be used to measure HL and educate Japanese workers on the necessity of health behavioral changes.
