Eise Yokoyama

Mental Health Status, Shift Work, and Occupational Accidents among Hospital Nurses in Japan

Mental Health Status, Shift Work, and Occupational Accidents among Hospital Nurses in Japan: Kenshu Suzuki, et al. Department of Public Health, School of Medicine, Nihon University—A questionnaire survey was conducted with questions from the 12‐item General Health Questionnaire, among others, targeting 4,407 nurses in 8 general hospitals in Japan, in the hope of improving the work environment of nurses and to provide data that will allow a discussion of the measures necessary for preventing medical errors, thus improving occupational health. For each type of accident, the percentage of those who had made medical errors was significantly higher for the “mentally in poor health” group than for the “mentally in good health” group (p<0.0001). The percentage of nurses in the “mentally in good health” and “mentally in poor health” groups who had experienced occupational accidents over the past 12 months (i.e., whether they were “with errors” or “without errors”) was calculated for each of the following four types of medical accident:(1) drug‐administration errors, (2) incorrect operation of medical equipment, (3) errors in patient identification, and (4) needlestick injuries. For each type of accident, the percentage of those who had made medical errors was significantly higher for the “mentally in poor health” group than for the “mentally in good health” group (p<0.0001). Multiple logistic regression analyses revealed significant associations between experience of medical errors in the past 12 months and being mentally in poor health, with night or irregular shift work, and age.

Associations between sleep disturbance and mental health status: A longitudinal study of Japanese junior high school students

BACKGROUND A limited number of longitudinal studies have addressed the association between sleep disturbance and mental health status among adolescents. To examine whether each of these is a risk factor for the onset of the other, we conducted a prospective longitudinal study of Japanese adolescents. METHODS In 2004, we performed a baseline study of students attending three private junior high schools in Tokyo, and in 2006, a follow-up study was performed on the same population. The mean age of the subjects was 13 years. The Pittsburgh Sleep Quality Index was used to evaluate sleep disturbance, and the 12-item General Health Questionnaire was used to evaluate mental health status. RESULTS The subjects were 698 students, of whom 516 were suitable for analysis. The incidence of newly developed poor mental health status during the 2 years leading to the follow-up study was 35.1%. New onset of poor mental health status was significantly associated with new onset of sleep disturbance and lasting sleep disturbance. The incidence of sleep disturbance during the 2 years leading to the follow-up study was 33.3%. New onset of sleep disturbance was significantly associated with new onset of poor mental health status and lasting poor mental health status. CONCLUSIONS Sleep disturbance and poor mental health status increase each others onset risk.

Factors Associated with Exclusive Breast-feeding in Japan: for Activities to Support Child-rearing with Breast-feeding

BACKGROUND Benefits of breast-feeding are not only limited to nutrition and sanitation in developing countries but also extend to cost-saving health care and alleviation of anxiety related to childrearing in developed countries. This study aims to elucidate factors associated with exclusive breast-feeding in Japan and use this information to achieve child-rearing support worldwide by promoting breast-feeding. METHODS This cross-sectional study used data from a survey conducted by Ministry of Health, Labour and Welfare of the Japanese government, the First Longitudinal Survey of Babies in 21st Century. All subjects were infants (n = 53,575) born in Japan in 2001 between January 10 and 17 and between July 10 and 17. According to the data, the exclusive breast-feeding rate in Japan during the first 6 months of life was 21.0%. We examined the factors associated with exclusive breast-feeding using univariate and multivariate logistic regression analyses. RESULTS Among the factors examined, the adjusted odds ratio (OR) for exclusive breast-feeding was low for late childbearing, low birth weight infants, multiple births, smoking parents, living with grandparents, and feeling burdened by childrearing. The adjusted OR was high for factors that included sufficient childcare leave and consultation about childrearing with the spouse, a birth attendant and/or nurse, and a peer in a child-rearing circle. CONCLUSIONS Exclusive breast-feeding is associated not only with medical factors but also with social factors. This study clarifies the necessity of social support to reduce the child rearing burden and a political system to promote paternal participation in childrearing and to improve the childcare leave system.

Association of onset of obesity with sleep duration and shift work among Japanese adults

OBJECTIVE The objective of this longitudinal epidemiological study was to investigate the association of risk factors for cardiovascular illness with sleep duration and shift work. METHODS This study used data obtained at medical checkups conducted in 1999 and 2006 for the employees of a local government organization in Japan (covering 21,693 male employees and 2109 female employees). The medical checkup data included (1) body measurements, (2) blood test parameters, and (3) replies to a self-administered questionnaire (inquiring about sleep duration, with or without shift work, etc.). On the basis of these data, we conducted multiple logistic regression analyses to study the association between the risk of new-onset obesity, hypertension, hyperglycemia, hypertriglyceridemia, and hypo-high density lipoprotein (HDL) cholesterolemia and shift work as well as sleep duration. RESULTS Among the male subjects who were engaged in shift work, the relative risk of new-onset obesity for those with a sleep duration of less than 5 h was 1.30 (95% CI, 1.14-1.49) higher than for those with sleep duration of 5-7 h. Furthermore, analysis using both engagement in shift work and sleep duration as dependent variables showed that the relative risks of new-onset obesity for those with a sleep duration of less than 5 h were 1.20 (95% CI, 1.09-1.32) for men and 1.7 (95% CI, 1.11-2.87) for women. CONCLUSIONS Short sleep duration is associated with onset of obesity.

Smoking trends before, during, and after pregnancy among women and their spouses

Background: Pregnancy and childbirth can act as strong factors motivating parents to spontaneously quit smoking. The aim of the present survey was to establish smoking cessation guidelines for this group. The objectives were to clarify the smoking status of parents before, during and after pregnancy, as well as the factors associated with continuous smoking during pregnancy and post‐partum smoking relapse among women who had stopped smoking during pregnancy.

Novel Wide-Range Quantitative Nested Real-Time PCR Assay for Mycobacterium tuberculosis DNA: Clinical Application for Diagnosis of Tuberculous Meningitis

ABSTRACT Although the “gold standard” for diagnosis of tuberculous meningitis (TBM) is bacterial isolation of Mycobacterium tuberculosis, there are still several complex issues. Recently, we developed an internally controlled novel wide-range quantitative nested real-time PCR (WR-QNRT-PCR) assay for M. tuberculosis DNA in order to rapidly diagnose TBM. For use as an internal control calibrator to measure the copy number of M. tuberculosis DNA, an original new-mutation plasmid (NM-plasmid) was developed. Due to the development of the NM-plasmid, the WR-QNRT-PCR assay demonstrated statistically significant accuracy over a wide detection range (1 to 105 copies). In clinical applications, the WR-QNRT-PCR assay revealed sufficiently high sensitivity (95.8%) and specificity (100%) for 24 clinically suspected TBM patients. In conditional logistic regression analysis, a copy number of M. tuberculosis DNA (per 1 ml of cerebrospinal fluid) of >8,000 was an independent risk factor for poor prognosis for TBM (i.e., death) (odds ratio, 16.142; 95% confidence interval, 1.191 to 218.79; P value, 0.0365). In addition, the copy numbers demonstrated by analysis of variance statistically significant alterations (P < 0.01) during the clinical treatment course for 10 suspected TBM patients. In simple regression analysis, the significant correlation (R2 = 0.597; P < 0.0001) was demonstrated between copy number and clinical stage of TBM. We consider the WR-QNRT-PCR assay to be a useful and advanced assay technique for assessing the clinical treatment course of TBM.

Novel Wide-Range Quantitative Nested Real-Time PCR Assay for Mycobacterium tuberculosis DNA: Development and Methodology

ABSTRACT Previously, we designed an internally controlled quantitative nested real-time (QNRT) PCR assay for Mycobacterium tuberculosis DNA in order to rapidly diagnose tuberculous meningitis. This technique combined the high sensitivity of nested PCR with the accurate quantification of real-time PCR. In this study, we attempted to improve the original QNRT-PCR assay and newly developed the wide-range QNRT-PCR (WR-QNRT-PCR) assay, which is more accurate and has a wider detection range. For use as an internal-control “calibrator” to measure the copy number of M. tuberculosis DNA, an original new-mutation plasmid (NM-plasmid) was developed. It had artificial random nucleotides in five regions annealing specific primers and probes. The NM-plasmid demonstrated statistically uniform amplifications (F = 1.086, P = 0.774) against a range (1 to 105) of copy numbers of mimic M. tuberculosis DNA and was regarded as appropriate for use as a new internal control in the WR-QNRT-PSR assay. In addition, by the optimization of assay conditions in WR-QNRT-PCR, two-step amplification of target DNA was completely consistent with the standard curve of this assay. Due to the development of the NM-plasmid as the new internal control, significantly improved quantitative accuracy and a wider detection range were realized with the WR-QNRT-PCR assay. In the next study, we will try to use this novel assay method with actual clinical samples and examine its clinical usefulness.

The Relationship of Job Type to Burnout in Social Workers at Social Welfare Offices

The Relationship of Job Type to Burnout in Social Workers at Social Welfare Offices: Fumi Takeda, et al. Graduate School of Comprehensive Human Sciences, University of Tsukuba—This study sought to determine the relationship of job type differences to burnout level, the details of job characteristics for each job type, and the association between burnout and job factors in 189 social workers at all social welfare offices in a prefecture in Japan. Among the three job types, 32.9% of social workers involved with public assistance, 29.0% of social workers involved with public assistance, the elderly, the disabled and single mothers, and 15.2% of social workers involved with the elderly, the disabled and single mothers were scored in the “high burnout” category (p<.05). Job type differed significantly with respect to the job characteristics of percentage of time spent on home visits per typical working day, job satisfaction, aversion to the job, and social support. The job type of public assistance work had a higher percentage of time spent on home visits per typical working day, aversion to the job, lower job satisfaction, and less social support than the job type involving no public assistance work. Multiple regression analyses showed the associations between job factors and burnout for each job type. Aversion to the job had a primary positive association with burnout for all social worker job types. Social support had a negative association with burnout in social workers whose clients included public assistance cases. The number of years in social work had a negative association with burnout, while percentage of time spent doing interviews per typical working day had a positive association with burnout in social workers who were involved with public assistance, the elderly, the disabled and single mothers. These results suggest that the job type of public assistance work may carry a higher risk of burnout than job types involving no public assistance work. To ameliorate this risk, it was thought to be important to improve aversion to the job as well as having a social support network for public assistance social workers.

A Tale of Two Countries---the United States and Japan: Are Differences in Health Due to Differences in Overweight?

Background Despite similar standards of living and health care systems for older persons, there are marked differences in the relative health of the elderly populations in the United States (US) and Japan. We explore the association of overweight and obesity with these health disparities. Methods Data on older adults from the US National Health Interview Survey (1994) and the Longitudinal Study of Aging II (1994) were compared to similar data from the 1999-2001 Nihon University Japanese Longitudinal Study of Aging. Regression analyses for the 2 countries were conducted to examine the correlates of being overweight and obese, and the relationships of overweight and obesity with activities of daily living functioning, heart disease, arthritis, and diabetes. Results The prevalence of overweight and obesity is higher in the US than in Japan, as is the prevalence of heart disease, diabetes, arthritis, and functioning problems. Education level and marital status are predictors of overweight for older Americans but not for older Japanese people. Health behaviors affect weight in all groups. The prevalence of functioning problems and disease are more likely to be associated with being overweight in US men and women than in Japanese women, and are not associated with being overweight in Japanese men. Conclusion Despite similar standards of living and health care systems for older persons, the conditions associated with poor health differ in the US and Japan. Being overweight or obese appears to be related to more functioning problems and arthritis in the US than in Japan.

Alcohol Consumption and Abstention among Pregnant Japanese Women

Background In order to clarify the alcohol consumption status of pregnant women in Japan and the characteristics of pregnant women who abstained from alcohol after their pregnancy had been confirmed, a nationwide questionnaire-based study of alcohol consumption behavior was performed. We also examined the factors associated with alcohol consumption during pregnancy and abstention after the confirmation of pregnancy. Methods After random sampling, 260 institutions participated in the survey; these were selected from a list of survey points fixed by the Japan Association of Obstetricians and Gynecologists. The study was conducted on pregnant women with confirmed pregnancies by using self-administered anonymous questionnaires during the period from February 1 through 14, 2002. Results Alcohol consumption during pregnancy was reported in 11.1% of the study participants, and abstention after the confirmation of pregnancy, in 76.9%. Significant associations were recognized between higher education and both alcohol consumption during pregnancy and abstention after pregnancy confirmation. Furthermore, alcohol consumption was significantly associated with parity, smoking, and shorter sleep duration, whereas abstention was significantly associated with less frequent alcohol consumption and knowledge regarding the risk of alcohol consumption. Conclusion The results clarified the factors associated with alcohol consumption during pregnancy and abstention after the confirmation of pregnancy in Japan.