Yoshitaka Kaneita

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.

The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey.

STUDY OBJECTIVE The objective of this study was to examine the association between the use of mobile phones after lights out and sleep disturbances among Japanese adolescents. DESIGN AND SETTING This study was designed as a cross-sectional survey. The targets were students attending junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were sent to schools for all students to fill out. PARTICIPANTS A total of 95,680 adolescents responded. The overall response rate was 62.9%, and 94,777 questionnaires were subjected to analysis. INTERVENTION N/A. MEASUREMENTS AND RESULTS Daily mobile phone use, even if only for a brief moment every day, was reported by 84.4%. Moreover, as for use of mobile phones after lights out, 8.3% reported using their mobile phone for calling every day and 17.6% reported using it for sending text messages every day. Multiple logistic regression analysis showed that mobile phone use for calling and for sending text messages after lights out was associated with sleep disturbances (short sleep duration, subjective poor sleep quality, excessive daytime sleepiness, and insomnia symptoms) independent of covariates and independent of each other. CONCLUSION This study showed that the use of mobile phones for calling and for sending text messages after lights out is associated with sleep disturbances among Japanese adolescents. However, there were some limitations, such as small effect sizes, in this study. More studies that examine the details of this association are necessary to establish strategies for sleep hygiene in the future.

HEPATITIS C VIRUS IS FREQUENTLY COINFECTED WITH SERUM MARKER-NEGATIVE HEPATITIS B VIRUS: PROBABLE REPLICATION PROMOTION OF THE FORMER BY THE LATTER AS DEMONSTRATED BY IN VITRO COTRANSFECTION

Patients with hepatitis C have been reported occasionally to be coinfected with serum marker‐negative (silent) hepatitis B virus (HBV). The frequency and significance of such coinfection were investigated. Thirty patients with hepatitis C virus (HCV) infections (10 acute, 10 chronic, 10 cirrhotic) were selected randomly; the acute cases were without serum hepatitis B surface antigen (HBsAg) and anti‐hepatitis B core IgM, and the chronic cases were without HBsAg. A nested polymerase chain reaction for the X open reading frame was used to amplify HBV DNA in serum, and immunoperoxidase staining was carried out on liver biopsy specimens. Nucleotide sequencing was carried out to characterize the amplified HBV DNAs. In order to clarify the possibility that the silent HBV mutant promotes HCV replication in the liver, the full‐length HCV RNA and the cloned silent HBV DNA dimer were cotransfected into an established cell line, HuH‐7, and the amount of secreted HCV RNA was quantified serially. The target HBV DNA was amplified in 26 (86.7%) of the 30 patients. Subsequent direct nucleotide sequencing in 9 selected patients revealed an 8‐nucleotide deletion, characteristic of a silent HBV mutant. Immunostaining revealed hepatitis B surface antigen in 15 (50.0%). Cotransfected silent HBV DNA augmented the secretion of HCV RNA by up to 5‐fold in comparison with HCV RNA transfection alone. In conclusion, HCV is coinfected frequently with the silent HBV mutant and the latter probably promotes the replication of the former in the liver. J. Med. Virol. 52:399–405, 1997.

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.

Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression.

OBJECTIVE The dose-response of short sleep duration in mortality has been studied, in addition to the incidences of notable health complications and diseases such as diabetes mellitus, hypertension, cardiovascular diseases, stroke, coronary heart diseases, obesity, depression, and dyslipidemia. METHODS We collected data from prospective cohort studies with follow-ups of one year or more on associations between short sleep duration and the outcomes. For the independent variable, we divided participants at baseline into short sleepers and normal sleepers. The primary outcomes were defined as mortality and an incident of each health outcome in the long-term follow-up. Risk ratios (RRs) for each outcome were calculated through meta-analyses of adjusted data from individual studies. Sub-group and meta-regression analyses were performed to investigate the association between each outcome and the duration of short sleep. RESULTS Data from a cumulative total of 5,172,710 participants were collected from 153 studies. Short sleep was significantly associated with the mortality outcome (RR, 1.12; 95% CI, 1.08-1.16). Similar significant results were observed in diabetes mellitus (1.37, 1.22-1.53), hypertension (1.17, 1.09-1.26), cardiovascular diseases (1.16, 1.10-1.23), coronary heart diseases (1.26, 1.15-1.38), and obesity (1.38, 1.25-1.53). There was no sufficient usable evidence for meta-analyses in depression and dyslipidemia. Meta-regression analyses found a linear association between a statistically significant increase in mortality and sleep duration at less than six hours. No dose-response was identified in the other outcomes. CONCLUSIONS Based on our findings, future studies should examine the effectiveness of psychosocial interventions to improve sleep on reducing these health outcomes in general community settings.

Coping strategies and their correlates with depression in the Japanese general population

This studys aim was to examine the relation between depression and stress-coping strategy among the general population. The survey was conducted in June 2000, using a large sample representative of the Japanese general population. A total of 24,551 responses from individuals aged 20 years or older were analyzed. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess the prevalence of depression with two different cut-off points; 16 and 26. Stress-coping strategies were asked based on given examples of actual behaviors covering problem-focused, emotion-focused, and avoidant ones. There was no marked gender difference in the prevalence of a problem-solving strategy, while various types of gender differences were found with respect to the prevalence of emotion-focused and avoidant strategies. In relation to depression, multivariate logistic regression analyses revealed the significantly highest odds ratios (OR) for avoidant coping strategies and the lowest OR for problem-focused ones in both genders. The fact that depression was associated positively with avoidant strategies but negatively with problem-solving strategies indicates that individual stress-coping strategies have their own significance with respect to depression, and may be utilized in establishing an evidence-based cognitive behavioral approach to depressive patients.

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.

Long sleep duration and health outcomes: A systematic review, meta-analysis and meta-regression

We examined the dose-response relationship between long sleep duration and health outcomes including mortality and the incidence of diabetes mellitus, hypertension, cardiovascular diseases, stroke, coronary heart diseases, obesity, depression and dyslipidemia. We collected data from 5,134,036 participants from 137 prospective cohort studies. For the independent variable, we categorized participants at baseline as having long sleep duration or normal sleep duration. Risk ratios (RRs) for mortality and incident health conditions during follow-up were calculated through meta-analyses of adjusted data from individual studies. Meta-regression analyses were performed to investigate the association between each outcome and specific thresholds of long sleep. Long sleep was significantly associated with mortality (RR, 1.39; 95% CI, 1.31-1.47), incident diabetes mellitus (1.26, 1.11-1.43), cardiovascular disease (1.25, 1.14-1.37), stroke (1.46, 1.26-1.69), coronary heart disease (1.24, 1.13-1.37), and obesity (1.08, 1.02-1.15). Long sleep was not significantly related to incident hypertension (1.01, 0.95-1.07). Insufficient data were available for depression and dyslipidemia. Meta-regression analyses found statistically significant linear associations between longer sleep duration and increased mortality and incident cardiovascular disease. Future studies should address whether the relationship between long sleep and health outcomes is causal and modifiable.

The association between sleep problems and perceived health status: A Japanese nationwide general population survey

OBJECTIVE Sleep problems in humans have been reported to impact seriously on daily function and to have a close association with well-being. To examine the effects of individual sleep problems on physical and mental health, we conducted a nationwide epidemiological survey and examined the associations between sleep problems and perceived health status. METHODS Cross-sectional surveys with a face-to-face interview were conducted in August and September, 2009, as part of the Nihon University Sleep and Mental Health Epidemiology Project (NUSMEP). Data from 2559 people aged 20 years or older were analyzed (response rate 54.0%). Participants completed a questionnaire on perceived physical and mental health statuses, and sleep problems including the presence or absence of insomnia symptoms (i.e., difficulty initiating sleep [DIS], difficulty maintaining sleep [DMS], and early morning awakening [EMA]), excessive daytime sleepiness (EDS), poor sleep quality (PSQ), short sleep duration (SSD), and long sleep duration (LSD). RESULTS The prevalence of DIS, DMS, and EMA was 14.9%, 26.6%, and 11.7%, respectively, and 32.7% of the sample reported at least one of them. At the complaint level, the prevalence of EDS, PSQ, SSD, and LSD was 1.4%, 21.7%, 4.0%, and 3.2%, respectively. Multiple logistic regression analyses revealed that DMS, PSQ, SSD, and LSD were independently associated with poor perceived physical health status; DIS, EDS, and PSQ were independently associated with poor perceived mental health status. CONCLUSIONS This study has demonstrated that sleep problems have individual significance with regard to perceived physical or mental health status.