Yoshihiro Kaneko

Increasing Prevalence of Japanese Cedar Pollinosis: A Meta-Regression Analysis

Background: Japanese cedar pollinosis, caused by the pollen of the Japanese cedar tree (Cryptomeria japonica), is the commonest seasonal allergic disease in Japan. A number of epidemiological surveys have been reported on Japanese cedar pollinosis, but it has never been assessed systematically or quantitatively. To confirm the increasing prevalence of Japanese cedar pollinosis and related factors, we conducted a meta-regression analysis on population-based surveys in Japan. Methods: We searched for data from population-based surveys in which serological methods were used to test all participants. Weighted regression of logit-transformed prevalence and sensitization rates were used to evaluate the effects of the year of survey, age, and degree of urbanization. We also analyzed the relationship between prevalence and sensitization rate. Results: Thirty-eight reports with 27 subgroups for prevalence and 134 subgroups for sensitization rate were selected from the literature published in the years between 1986 and 2000. The Japanese cedar pollen sensitization rate was found to be significantly correlated with the year of survey, age, and degree of urbanization (adjusted R2 = 0.55). The coefficient for the correlation between the prevalence and the sensitization rate revealed a statistically significant correlation (Pearson’s r = 0.70, p < 0.001). Conclusions: The prevalence of Japanese cedar pollinosis among adolescents was predicted to be 28.7% in metropolitan areas and 24.5% in the general population in urban areas in the year 2004, derived from the estimated sensitization rate and the relationship between sensitization rate and prevalence. The prevalence of Japanese cedar pollinosis increased 2.6-fold between 1980 and 2000, and the prevalence differed considerably according to age and degree of urbanization.

Prevalence of Depressive Symptoms and Related Risk Factors for Depressive Symptoms among Elderly Persons Living in a Rural Japanese Community: a Cross-Sectional Study

To clarify the prevalence of depression in a rural community in Japan and to evaluate the social and familial risk factors for depression, with the goal of suicide prevention, a questionnaire survey was conducted on a total of 2,763 elderly persons. The determined prevalence of depressive symptoms (Zung’s self-rated depression scale score of 50 points or more) was 10.4%. Logistic regression analysis showed associations between depressive symptoms and age, absence of a friendly companion, irritation with one’s family, frequent loneliness, the opinion that stress has a large impact on one’s life, suicide ideation, and poor subjective physical and mental health.

Effect of Having a Sense of Purpose in Life on the Risk of Death from Cardiovascular Diseases

Background Many studies have focused on disease causality, but few of them deal with health-promoting factors. Thus, we examined the effect of having a sense of purpose in life (ikigai) on mortality from cardiovascular disease (CVD). Methods In 1988, we conducted a prospective cohort study of 2,959 Japanese subjects, ranging in age from 40 to 74 years, and followed them till the end of 2003. The level of their sense of purpose in life was evaluated by a self-administered questionnaire. After excluding those with a history of heart disease, stroke, or malignant tumor, 1,618 subjects (832 men and 786 women) who had completed the questionnaire were used in the analyses with Cox’s proportional hazards model. Results During the average 13.3 years of follow up, 249 deaths (172 men and 77 women) occurred as a result of all causes: 32 from heart disease, 31 from stroke, 63 from CVD, and 104 from malignant tumors. The adjusted hazard ratios for death in men with a strong sense of purpose in life, as compared with those with a low sense of purpose, were 0.28 (95% confidence interval: 0.10-0.84) for stroke, 0.56 (0.28-1.10) for CVD, and 0.62 (0.45-0.86) as a result of all causes. In women, no significant relationship was found between having a sense of purpose in life and mortality; this was possibly because the smaller number of deaths reduced the statistical significance. Conclusion We found that in men, having a sense of purpose in life affected the risk of death as a result of all causes, stroke, and CVD.

Male gender and low education with poor mental health literacy : A population-based study

BACKGROUND Both male gender and low socioeconomic status have been related to depression and suicide, but their possible relationship to mental health literacy remains uncertain. The objectives of this study were to assess the level of mental health literacy in rural communities in Japan and to examine related factors. METHODS A population-based cross-sectional study using a questionnaire was conducted. Response rate was 88.2% from 8163 residents aged 30-69 years. The relationships between mental health literacy (including cognition of depression, attitude toward depression, and acceptance of suicide) and demographics, socioeconomic status, and the severity of depression were assessed by logistic regression analysis. RESULTS Of the respondents, 25.2% showed an inadequate cognition of depression, 12.5% showed an inadequate attitude toward depression, and 13.1% showed an acceptance of suicide. Of the complete respondents (65.5%), an inadequate cognition of depression was associated with being male (adjusted odds ratio=1.93, 95% confidence interval: 1.68-2.22), advanced age (2.18, 1.58-3.00), and a lower level of education (1.95, 1.34-2.86); an inadequate attitude toward depression was associated with being male (2.18, 1.82-2.61),a lower education (2.34, 1.38-3.97), and the severity of depression (2.26, 1.54-3.32); and an acceptance of suicide was associated with being male (1.33, 1.13-1.58) and the severity of depression (5.77, 4.20-7.93). CONCLUSIONS Poor mental health literacy related strongly to male gender and a low level of education. According to our results, poor mental health literacy may possibly be a factor contributing to male vulnerability to suicide.

Impact of obesity on plasma B-type natriuretic peptide levels in Japanese community-based subjects

The plasma B-type natriuretic peptide (BNP) concentration was recently shown to be inversely correlated with body mass index (BMI). However, very few attempts have been made to associate abdominal obesity and BNP in the Japanese general population. Here, we conducted a cross-sectional study, and examined 339 male and 429 female residents without heart disease in a rural Japanese community who received an annual health checkup in 2006. BNP was inversely associated with both BMI and abdominal circumference (AC) in the age-adjusted regression analysis (pxa0<xa00.05). Following adjustment for traditional risk factors, multiple regression analysis revealed that BNP was negatively correlated with AC (pxa0<xa00.05), but not BMI. Although metabolic syndrome was not associated with BNP levels, AC had an influence on low BNP levels in the multiple regression analysis using both AC and BMI concurrently (pxa0<xa00.05 for AC and pxa0>xa00.60 for BMI). These effects were more prominent in men than in women. Collectively, plasma BNP levels are inversely related with obesity, as measured by AC, in Japanese community-based subjects.

Community-based suicide prevention program in Japan using a health promotion approach.

Suicide prevention programs at a national level in developed countries were briefly reviewed, and the community-based suicide prevention programs in Akita Prefecture, in the Tohoku Region of Japan, were also outlined. Suicide prevention programs were proposed in Western countries in the 1980s. A famous example is the national prevention program in Finland that was started in 1986. The national suicide prevention programs in Western countries share some common features such as their comprehensiveness and diversity. Typical policies of suicide prevention programs were categorized according to primary, secondary and tertiary prevention. Regarding community-based suicide prevention programs using a health promotion approach, the Akita prefectural government incorporated a suicide prevention program into the local health promotion strategy “Health Akita 21” in 2001. An outline of the four action programs was as follows: to raise awareness of suicide prevention, to increase opportunities for mental health consultation, to promote both primary and secondary prevention of depression, and to create a supportive environment for mental health promotion. Community-based suicide prevention programs were started in some communities of model projects that are financially supported by Akita Prefectural government. Efforts to evaluate the effectiveness of community-based suicide prevention programs are needed in the future.

Physician's Perceptions of Interprofessional Collaboration in Clinical Training Hospitals in Northeastern Japan.

Background Effective and efficient interprofessional collaboration (IPC) is needed between departments in a healthcare setting. Although Japanese physicians are expected to provide leadership in IPC, it has been suggested that their perception of IPC is more negative than among other healthcare professionals. The purpose of this study was to clarify Japanese physician’s perceptions of IPC and what factors influenced their views. Methods This cross-sectional study surveyed 732 medical doctors at a university hospital and six foundation hospitals in a prefecture located in Tohoku district, northeastern Japan. Those hospitals were approved for delivery of postgraduate clinical training. Physician’s perceptions of IPC were investigated for three items, namely providing patient-centered care, preventing medical accidents, and improving the quality of medical care. A total of 409 doctors who were engaged in clinical practice, responded adequately to the survey. Factors associated with negative perceptions towards IPC among physicians were analyzed using a logistic regression model. Results The proportion of negative perceptions of IPC for providing patient-centered care, preventing medical accidents, and improving the quality of medical care were 41.1%, 34.0% and 33.7%, respectively. Negative perceptions of IPC for providing patient-centered care were associated with older age (50 + years; odds ratio (OR): 2.73; 95% confidence interval (CI): 1.11 - 6.68) and a lower frequency of interprofessional meetings (no meetings; OR: 2.95; 95%CI: 1.43 - 6.08). Negative perceptions of IPC for preventing medical accidents were associated with a lower frequency of interprofessional meetings (no meetings, OR: 3.23; 95%CI: 1.58 - 6.62). Negative perceptions of IPC for improving the quality of medical care were associated with middle age (40 - 49 years, OR: 2.93; 95%CI: 1.20 - 7.12) and a lower frequency of interprofessional meetings (no meetings; OR: 2.75; 95%CI: 1.34 - 5.66). Conclusions Physician’s negative perceptions of IPC in our study were associated with age and a lower frequency of interprofessional meetings. Our findings suggest that effective regular interprofessional meetings serve to share information about patients, and to allow physicians to understand each other better, which should have a positive impact on the quality of patient-centered care.

Attitudes towards those bereaved by a suicide: a population-based, cross-sectional study in rural Japan.

BackgroundFamily or friends bereaved by suicide are at risk of experiencing complications because of attitudes regarding suicide. It is important that individuals close to those grieving after a death by suicide demonstrate adequate knowledge and compassionate attitudes. To this end, we examined the factors that contribute to attitudes toward persons bereaved by the suicide of a family member or friend, and perceptions of suicide prevention and the promotion of mental health.MethodsA total of 5154 residents of a rural town in northern Japan aged 30–69 years completed a cross-sectional questionnaire. The questionnaire gathered data about demographic variables, depressive symptoms, and issues related to suicide including personal experience of an acquaintances suicide, attitudes towards those bereaved by suicide, and perceptions regarding suicide prevention. Factors related to these attitudes and perceptions were analysed using logistic regression models.ResultsOverall, 67.5% of respondents demonstrated appropriate attitudes towards those bereaved by suicide; 30.4% of responses were undetermined, and 2.1% were inappropriate. Undetermined attitudes were associated with male gender (adjusted OR 1.42, 95%CI = 1.26–1.61), younger age (2.64, 2.12–3.29), lower education level (1.32, 1.07–1.62), greater severity of depression (3.81, 2.80–5.20), and lack of personal experience of an acquaintances suicide (1.39, 1.22–1.57). Inappropriate attitudes were associated with male gender (adjusted OR 1.98, 95%CI = 1.33–2.94), lower education level (2.55 1.34–4.83), and greater severity of depression (6.93, 3.52–13.67). Overall, 16.0% demonstrated passive thoughts regarding suicide prevention and the promotion of mental health in the community, and were associated with male gender (1.22, 1.04–1.42), younger age (2.72, 2.03–3.65), lower education level (1.32, 1.02–1.71), and greater severity of depression (4.94, 3.58–6.82).ConclusionFactors that contributed to undetermined attitudes included male gender, younger age, lower education level, greater severity of depression, and lack of personal experience of an acquaintances suicide. Passive thoughts regarding suicide prevention and the promotion of mental health were associated with male gender, younger age, lower education level, and greater severity of depression.

Association between psychological distress and a sense of contribution to society in the workplace

BackgroundGlobally, mental health promotion related to psychological distress in the workplace has become a great concern, and a focus of much research attention. However, a sense of contribution to society and sense of bonding with the workplace have not been examined in relation to psychological distress. Thus, the purpose of this study is to examine whether these two factors are associated with psychological distress.MethodsWe conducted a cross-sectional survey of 1137 full-time employees who worked in systems engineering, sales, or administration at a Japanese company. Participants sense of contribution to society, sense of bonding with the workplace, psychological distress, and qualitative job stress (quantitative and qualitative workloads, job-control latitude, and support from supervisors, co-workers and family) were assessed with a questionnaire. We performed multiple logistic regression analyses to examine associations between psychological distress and sense of contribution to society and of bonding with the workplace.ResultsA high sense of contribution to society was significantly associated with a high sense of bonding with the workplace (Spearmans ρ = 0.47, p < 0.01). A sense of contribution to society was negatively associated with psychological distress after adjusting for job stress factors (OR = 2.05, 95% CI 0.99-4.23) or sociodemographic characteristics of participants (OR = 2.92, 1.53-5.59). After adjusting for job stress factors as well as sociodemographic characteristics, the association became weaker. A sense of bonding with the workplace was negatively associated with psychological distress after adjusting for sociodemographic characteristics (OR = 2.49, 1.29-4.79). However, this association was not observed after adjusting for job stress factors.ConclusionsPsychological distress in the workplace was associated with sense of contribution to society. Therefore, workplace mental health promotion should consider the workers sense of contribution to society.

Leisure-time activities and psychological distress in a suburban community in Japan

Objective There is a wide range of leisure-time activities and previous research indicates that some of these are associated with lower psychological distress. The aim of this study was to assess whether leisure-time activities were associated with psychological distress. Methods A population-based questionnaire survey was conducted in 2009 in a suburban area of northern Japan using complete enumeration. Of 16,996 residents aged 30–79 years who received the questionnaire, 14,261 (83.9%) responded and 9908 (58.3%) responses were eligible for analysis. The relationship between psychological distress and physical, artistic, outdoor, and volunteer leisure-time activities was assessed separately and simultaneously by sex. Results The percentage of reported psychological distress was 2.8% for men and 3.9% for women. Each category of leisure-time activity was related to psychological distress separately. The simultaneous analyses revealed that engaging in regular outdoor leisure activity was associated with less psychological distress in both men (odds ratio [OR] = 0.38; 95% confidence intervals [CI]: 0.23, 0.63, p < 0.001) and women (OR = 0.39; 95% CI: 0.25, 0.59, p < 0.001). Engaging in regular physical activity was associated with less psychological distress in women (OR = 0.09; 95% CI: 0.01, 0.68, p = 0.019). Volunteer work and art activities were not associated with psychological distress in either men or women. Conclusion Greater engagement in outdoor leisure activity and physical activity was significantly associated with a lower likelihood of psychological distress. The results from the present study indicate that engaging in leisure-time activities, especially in outdoor leisure and physical activities, may be an effective means of promoting public health.