Journal of Epidemiology
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Volume 13 , Issue 3
Showing 1-8 articles out of 8 articles from the selected issue
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  • Mahbubur Rahman, Osamu Takahashi, Masashi Goto, Tsuguya Fukui
    Volume 13 (2003) Issue 3 Pages 127-135
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    This paper summarizes Bacillus Calmette-Guesrin (BCG) vaccination and revaccination policies in Japan, its cost-effectiveness, side effects, proposed selective vaccination strategy, and present tuberculosis situation in Japanese perspectives based on Medline database and other published reports. Universal BCG vaccination in infants and revaccination among children were not found economically justifiable. Overall tuberculosis incidence in Japan is higher than that of other developed countries. Trend of decline in tuberculosis incidence is similar to that of the countries where universal BCG vaccination has never been implemented. In the recent years, the number of tuberculosis group infection has been escalating. Since BCG revaccination program has already been discontinued, a consensus on universal BCG vaccination is also essential based on social, political, and economical factors. Side by side, more pragmatic strategies such as well-defined tuberculin test, selective vaccination policy based on tuberculosis incidence in each administrative zone, and early vaccination of high risk groups, should be formulated. J Epidemiol 2003;13:127-135.
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  • Shuji Hashimoto, Yoshitaka Murakami, Kiyosu Taniguchi, Nahoko Shindo, ...
    Volume 13 (2003) Issue 3 Pages 136-141
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    BACKGROUND: The estimation of incidence rates of infectious diseases based on the sentinel surveillance data is rather rare. We attempted to estimate these in 2000 in Japan by the surveillance data, and to evaluate their biases. METHODS: We used the incidences of influenza-like illness and 12 pediatric diseases in each of the sentinel medical institutions in Japan based on surveillance data in 2000. The incidence in all medical institutions was estimated under the assumption that the sentinel medical institutions were randomly selected. The possible bias of this estimate was evaluated in comparison with the hypothetical true incidence obtained as the total incidence in all medical institutions estimated by a regression model using the numbers of all disease outpatients per day from the National Survey of Medical Care Institutions of Japan. RESULTS: The estimated annual incidence rate was 75.6 (95% confidence interval: 72.3-78.7) per 1, 000 population in influenza-like illness, and ranged from 1.1 (95% confidence interval: 1.0-1.2) to 285.2 (95% confidence interval: 270.2-300.3) per 1, 000 population aged 0-19 years among 12 pediatric diseases. The ratio of the estimated incidence to the hypothetical true one was 1.06-1.26 among influenza-like illness and the 12 pediatric diseases. CONCLUSIONS: The incidence rates of influenza-like illness and pediatric diseases in 2000 in Japan were estimated from sentinel surveillance data. The rates obtained provide some useful but not always accurate information. Thus, further research is necessary. J Epidemiol2003;13:136-141.
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  • Toshiya Nagamatsu, Yukio Oida, Yoshinori Kitabatake, Hiroshi Kohno, Ke ...
    Volume 13 (2003) Issue 3 Pages 142-148
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    We measured functional fitness in older subjects and performed a follow-up survey for 6 years to clarify whether the level of functional fitness at a given point contributes to prediction of the subsequent occurrence of impairment of functions necessary for independent living. The longitudinal data were obtained for 391 persons aged 60 years or over, who were independently living in the community. Four items of functional fitness, i.e. the ability to perform standing/sitting movements, ability to perform traveling movements, ability to perform housekeeping movements, and ability to perform personal grooming activities, were assessed. The relationship between functional fitness and the risk of the occurrence of impairment of independence in daily living was evaluated using a binomial logistic regression model. In males, all the 4 items of functional fitness were significantly related to the risk of impairment of activities of daily living (ADL). In females, however, none of the items was significantly related to the risk of ADL impairment. In conclusion, functional fitness appears to be valid as a predictive parameter of future occurrence of ADL impairment in relatively healthy and independent elderly males. However, its validity in elderly females needs further evaluation. J Epidemiol2003;13:142-148.
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  • Dongmei Qiu, Jiamo Mei, Takoo Tanihata, Katsuhiko Kawaminami, Masumi M ...
    Volume 13 (2003) Issue 3 Pages 149-156
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    To clarify the risk factors of CVD deaths in rural areas in Jiangxi Province, China, a cohort study was carried out from September 1 through December 31, 2000 involving 50, 252 participants aged 40 years or older in 4 counties. Among the 3, 429 deaths, 671 cases (398 males and 273 females) died of CUD. In addition, excluding 183 cases with a previous history of CVD, 632 CUD deaths out of 50, 469 subjects were analyzed using Cox proportional hazard models. The multivariate hazard ratio {HR} for CUD mortality significantly increased in parallel with age, blood pressure and degree of liking far salty foods (p for trend<0.01 ). The multivariate HR for CVD mortality of ex-drinkers was 1.55 (95%CI: 1.04, 2.31) compared with non-drinkers. The multivariate HR for CVD mortality of subjects who ate meat once or twice per month was 0, 75 (95%CI: 062, 0.91) compared with those who never ate meat or sel- dom. There was no significant relationship between smoking and CVD mortality. Our results indicated that the main risk factors for CVD mortality were advancing age, high-normal blood pressure and hyper- tension. The risk in these areas was lower in subjects who disliked salty foods and those who ate meat once or twice per month, J Epidemiol 2003;13:149-156.
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  • Derek Smith, Kumeko Ohmura, Zentaro Yamagata
    Volume 13 (2003) Issue 3 Pages 157-161
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    Background: Although hand dermatitis represents a common occupational disease among hospital nurses, epidemiologic studies of this nature are comparatively rare in Japan. Methods: We recruited a complete cross-section of nurses from a teaching hospital in central Japan. Data was gathered by means of a self-reported questionnaire, with hand dermatitis symptoms and evaluation criteria drawn from previously validated research. Participants were categorised according to their hospital department during the analysis. Results: A total of 305 questionnaires were successfully completed and returned (response rate: 84%). There were statistically significant differences in hand dermatitis prevalence between the departments (p<0.05), ranging from 6% in psychiatry to 48% in the surgical unit and averaging 35% across the entire group. A history of allergic disease was shown to increase the risk of hand dermatitis (odds ratio=3.7, 95% confidence interval: 2.1 - 6.6). Washing their hands more than 15 times per work shift also increased the risk (odds ratio=2.0, 95% confidence interval: 1.2 - 3.4). Conclusion: This study has shown that hand dermatitis prevalence varies among Japanese nurses depending on their hospital department, and is generally quite high when compared to other reports. J Epidemiol 2003;13:157-161.
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  • Sang-Ah Lee, Daehee Kang, Ki Shim, Jae Choe, Weon Hong, Haymie Choi
    Volume 13 (2003) Issue 3 Pages 162-168
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    BACKGROUND: The association of dietary habits and Helicobacter pylori infection with early gastric cancer is still unclear. METHODS: A hospital-based case-control study was conducted in Korea. Sixty-nine patients were newly diagnosed as having early gastric cancer at the Division of Gastroenterology, Asan Medical Center, and 199 healthy subjects who visited the Health Promotion Center of the this same hospital for annual health examinations were selected as controls. Helicobacter pylori infection status was assayed by ELISA, and information for dietary habits was obtained by interview using a semi-quantitative food frequency questionnaires. Preference for salty taste was also evaluated using a sensitive test. RESULTS: H. pylori seropositivity was observed in 88% of cases, as compared with 75% of controls (OR=5.3, 95% confidence interval:1.7-16.5). Adaptive salt concentration was significantly and positively associated with early gastric cancer risk (p<0.01). Decreased risks of early gastric cancer were observed in association with intakes of clear broth, raw vegetables, fruits, fruit or vegetable juices, and soybean curds. On the other hand, a high intake of salt-fermented fish and kimchi were associated with an elevated risk of early gastric cancer. Subjects with positive H. pylori infection and a high salty prefer- ence had a 10-fold higher risk of early gastric cancer than subjects without H. pylori infection and with a low salty preference (p for interaction = 0.047). CONCLUSION: Some dietary factors and H. pylori infection are significantly associated with early gastric cancer. In particular, high-salty diets may enhance the effect of H. pylori infection in gastric car- cinogenesis. J Epidemiol 2003;13:162-168.
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  • Tomoyuki Watanabe, Masako Omori, Hiromi Fukuda, Hiroki Takada, Masaru ...
    Volume 13 (2003) Issue 3 Pages 169-175
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    BACKGROUND: This study aimed to examine the contribution made by the change in mortality from malignant neoplasms to the life expectancy at birth, observed during the years 1965-1995 in Japan. METHODS: We used data on the population and number of deaths by cause, age and sex in 1965, 1975, 1985 and 1995. The contribution of different ages and causes of death to the change in life expectancy were examined with the method developed by Pollard. RESULTS: We found that, among all causes, the decrease of mortality from stomach cancer led to the greatest improvement in life expectancy for both sexes. On the other hand, negative contributions were seen with cancers of many sites, such as cancer of the intestine, liver and lung for males, and cancer of the intestine, gallbladder, lung and breast for females. Recently, the contributing years of all cancers have been negative because of the increase in mortality from malignant neoplasms. In addition, increase of death from malignant neoplasms in middle-aged and elderly people negatively influenced the life expectancy at birth. CONCLUSIONS: Female cancer influenced the improvement in life expectancy at birth. Cancer for males, however, contributed little to improvement of life expectancy at birth except for a little prolongation of life expectancy at birth during the years 1965-1975. To develop a public health policy, the contributing years to life expectancy at birth can be a useful indication in evaluating the impact of death from various diseases. It is necessary to analyze the contribution made by various causes of death to the changes of life expectancy at birth. J Epidemiol 2003;13:169-175.
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  • Masahiko Ando, Nobuyuki Hamajima, Noritaka Ariyoshi, Tetsuya Kamataki, ...
    Volume 13 (2003) Issue 3 Pages 176-181
    Released: November 30, 2007
    JOURNALS FREE ACCESS
    BACKGROUND: Genetic variation of CYP2A6 is shown to alter nicotine metabolism. This study was developed to investigate the genetic influence of the whole deletion-allele of CYP2A6 on active and passive smoking behavior. METHODS: Two hundred and forty Japanese adults, who visited Aichi Cancer Center as outpatients, were genotyped for the wild-type (CYP2A6∗ 1A, CYP2A6∗ 1B) and the whole deletion-type (CYP2A6∗4C) polymorphism of CYP2A6. Information about active and passive smoking status was obtained by a self-administered questionnaire. Genetic influence of CYP2A6 polymorphism on smoking behavior was evaluated using the Mantel extension test. RESULTS: The frequency of the deletion allele was 18%. All 8 subjects carrying two deletion alleles had no smoking habit, and the homozygous deletion genotype showed a tendency to correlate with active smoking status after adjustment for sex and age (p=0.054). However, the proportion of never smokers among heterozygous subjects was almost the same as among subjects carrying no deletion allele (54% and 58%, respectively). Furthermore, CYP2A6 genotypes were correlated neither with the number of cigarettes smoked per day nor with the age at starting smoking (p=0.364 and 0.880, respectively). Among never smokers, CYP2A6 genotypes were not correlated with exposure to passive smoking at home or in the workplace (p=0.623 and 0.484, respectively). CONCLUSION: Despite the possible protection against active smoking behavior in subjects homozygous for the deletion allele, the CYP2A6 polymorphism has only a limited impact on public health because no protective effect was found in heterozygous subjects. J Epidemiol2003;13:176-181.
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