Background: Increasing video game time is a public health issue, and there is a growing trend toward restricting gameplay from childhood. Given that the relationship between video game playing time and problem behaviors remains unclear, we examined the association in children. Methods: Using a national survey that includes all infants born in Japan on January 10 and 17, and July 10 and 17, 2001, we analyzed data from 28126 participants to examine the relationship between video game playing time at 7 years old and the four types of problem behaviors at 8 years old (i.e., unsociability, fights with friends, school refusal, and poor academic performance). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for problem behaviors, adjusting for sex, friends, siblings, maternal age at delivery, maternal educational attainment, developmental disorder tendency, unsociability, fights with friends, school refusal, and poor academic performance at 7 years old. Results: Playing video games for < 1 hour/day at the age of 7 years was associated with lower odds of unsociability at 8 years old (OR 0.86; 95% CI 0.75-0.99) than playing no video games. Playing video games for >= 2 hours/day was associated with higher odds of fights with friends (OR 1.51; 95% CI 1.02-2.24) and school refusal (OR 1.90; 95% CI 1.09-3.30) than playing no video games. Conclusion: Our findings suggest that problem behaviors may differ according to the duration of game play in young children.
Background: To evaluate nationwide long-term changes in psychiatric service utilization across age groups following Japan's first COVID-19 state of emergency and to compare these changes across regions with different states of emergency intensities. Methods: This population-based interrupted time-series study used publicly available aggregated data derived from the National Database of Health Insurance Claims from April 2013 to April 2024, covering nearly all psychiatric patients in Japan. Segmented regression was used to estimate changes after the first state of emergency (April-May 2020). Outcomes were mean daily numbers of psychiatric outpatient visits and inpatient care per 100,000 population. Prefectures were categorized as high-, middle-, and low-intensity regions by the cumulative duration of subsequent declarations. Results: Slope changes in psychiatric outpatient visits varied substantially by age and region. Pre-existing upward trends accelerated after the state of emergency among patients aged 15-39 and 60-69 years, with greater acceleration in high-intensity regions than in middle-or low-intensity regions. The largest change was observed among patients aged 20-24 years in high-intensity regions (0.54 [95% CI, 0.46-0.63]), compared with middle-intensity (0.34 [95% CI, 0.27-0.41]) and low-intensity regions (0.42 [95% CI, 0.34-0.50]). In contrast, psychiatric inpatient care generally declined across most age groups and regions. Conclusion: Following the first state of emergency, psychiatric outpatient visits increased with marked heterogeneity by age group and region, with more pronounced acceleration in high-intensity regions. These findings underscore the value of age-and region-specific monitoring of psychiatric service utilization during future public health crises.
Background: On July 1, 2017, Taiwan introduced a mandatory license renewal policy for older drivers, which was gradually implemented among drivers aged >= 75 years. However, the benefits of this regulation remain uncertain. This study examined the effects of the license renewal policy on collision and case fatality rates among older drivers. Methods: We conducted a controlled interrupted time-series analysis using monthly national police-reported motor vehicle collision data from January 2013 to December 2021. Drivers aged >= 75 years comprised the age group subject to the policy, and drivers aged 65-74 years served as the comparison group. Collision rates were modeled using negative binomial regression with age-group-specific population as the offset. Case fatality rates were modeled using Poisson regression with monthly collision counts as the offset. Estimates were expressed as rate ratios and ratios of rate ratios (RRRs). Results: The immediate post-policy level change in collision rates among drivers aged >= 75 years did not differ significantly from that among drivers aged 65-74 years (RRR, 1.061; 95% CI, 0.992-1.134). However, the post-policy monthly trend was significantly greater among drivers aged >= 75 years than among drivers aged 65-74 years (RRR, 1.004; 95% CI, 1.001-1.007). For case fatality rates, neither the immediate level change nor the post-policy monthly trend differed significantly between groups. Conclusion: The introduction of the license renewal policy was not associated with clear evidence of a population-level road safety benefit among drivers aged >= 75 years.
Cancer Biobank Aichi (CBBA) was established at Aichi Cancer Center in 2017 as a hospital-based prospective biobank embedded in first-visit outpatient care. With written informed consent, up to 13 mL of blood is collected, processed within 2 hours, fractionated into serum, plasma, and buffy coat, dispensed into 2D-barcoded aliquots, and stored at-80 degrees C under continuous monitoring with distributed freezer storage. DNA is extracted from buffy coat and stored as ready-to-use aliquots. Epidemiological information is obtained using a structured questionnaire; most lifestyle exposures (physical activity, alcohol intake, smoking, and diet) refer to the year preceding the index visit. The questionnaire includes outpatient dietary assessment and separate ascertainment of electronic/heat-not-burn tobacco product use. Clinical information is updated annually through linkage with the institutional hospital-based cancer registry based on standardized registration items recommended by the National Cancer Center Japan; for approved projects, linkage to department-level clinical data is available under governance review with data minimization and pseudonymization. Among 34,574 first-visit outpatients approached or informed about CBBA, 29,470 (85.2%) provided biospecimens and/or questionnaire data and were included, including 10,075 non-cancer participants. Biospecimens were available for 25,105 participants and questionnaire data for 26,570; 22,205 provided both components. CBBA enables multiple epidemiologic and translational study designs using biospecimens collected at first presentation, one-year-referenced lifestyle data, an internal non-cancer reference group, and registry follow-up.
Background: To evaluate the relative validity of nutrient and food group intakes estimated using the brief-type self-administered Diet History Questionnaire for Japanese preschool children aged 3-6 years (BDHQ3y). Methods: This study included 500 children (253 boys and 247 girls) aged 3-6 years recruited from 32 prefectures in Japan. Guardians completed the BDHQ3y to report their child's dietary intake over the previous month and then 8-day weighed dietary records (DRs) over a year (2 days per season). From the BDHQ3y and DRs, energy-adjusted intakes of 44 nutrients and 26 food groups were estimated based on the density method. Results: Percentage differences in median intakes were within 10% for 26 nutrients (most energy-providing nutrients and several vitamins and minerals) and three food groups (cereals, fish/shellfish and milk/dairy products). The median Spearman's rank correlation coefficients were 0.31 (interquartile range [IQR], 0.23-0.40) for nutrients and 0.32 (IQR, 0.23-0.41) for food groups. Correlations exceeded 0.40 for 11 nutrients (eg, added sugar, dietary fiber and calcium) and nine food groups (eg, vegetables, fruits and milk/dairy products). Bland-Altman plots showed wide limits of agreement, with overestimation of intakes of protein, fats, carbohydrates, fruits, and milk/dairy products, as well as underestimation of intake of vegetables at higher intake levels. Similar findings were made when boys and girls were analyzed separately. Conclusion: The BDHQ3y has the potential to monitor population-level intakes of a range of nutrients. However, its utility for ranking individuals and assessing individual-level intake remains limited, requiring cautious interpretation and application.
