Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
最新号
選択された号の論文の7件中1~7を表示しています
Original Article
  • Takashi Yamauchi, Machi Suka, Hiroyuki Yanagisawa
    2020 年 30 巻 6 号 p. 237-243
    発行日: 2020/06/05
    公開日: 2020/06/05
    [早期公開] 公開日: 2019/05/18
    ジャーナル オープンアクセス

    Background: The present study aimed to examine the association between the presence/absence of help-seeking behavior (ie, behavior aimed at obtaining assistance from others to improve a situation or problem) and psychological distress among private and public employees by age group using a nationally representative sample of the Japanese population.

    Methods: The present study analyzed data obtained from the 2016 Comprehensive Survey of Living Conditions, a nationwide cross-sectional survey. Of 568,426 participants, 78,284 private and public employees aged 20 to 59 years, who were receiving no mental health services at the time of the survey and reported at least one stressor in daily life, were eligible. The primary outcome measure was self-rated psychological distress as measured by the Kessler Psychological Distress Scale. Multiple logistic regression analyses were carried out separately by age group, adjusting for sociodemographic and job/life-related factors.

    Results: The proportion of participants not showing help-seeking behavior was significantly higher among those aged 40–59 years compared to those aged 20–39 (30.5% and 22.7%, respectively; P < 0.001). Participants without help-seeking behavior had significantly higher odds ratios (ORs) for psychological distress, regardless of age group (OR = 1.9 [95% confidence interval (CI), 1.6–2.0] and OR = 1.6 [95% CI, 1.4–1.7] for the age 20–39 years and 40–59 years groups, respectively), compared to those showing help-seeking behavior.

    Conclusions: Participants not showing help-seeking behavior were more likely to have severe psychological distress, and this trend appeared to be slightly stronger among those aged 20–39 years. These findings suggest that promoting help-seeking behavior is important for improving mental health among workers.

  • Akira Fujiyoshi, Katsuyuki Miura, Takayoshi Ohkubo, Naoko Miyagawa, Yo ...
    2020 年 30 巻 6 号 p. 244-252
    発行日: 2020/06/05
    公開日: 2020/06/05
    [早期公開] 公開日: 2019/05/25
    ジャーナル オープンアクセス
    電子付録

    Background: The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men.

    Methods: Our cohort initially comprised 1,094 men aged 40–79 years from a random sample from Shiga, Japan in 2006–2008. Of 853 men who returned for the follow-up examination (2009–2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up (higher CASI scores [range 0 to 100] indicate better cognition). Proteinuria was assessed via dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59–40, and <40 mL/min/1.73 m2) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score, with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders.

    Results: Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (Ptrend = 0.029), and 90.0, 88.5, and 88.5 for eGFR (Ptrend = 0.015) in mutual-adjustment model.

    Conclusions: Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline.

  • Kumi Tenjin, Michikazu Sekine, Masaaki Yamada, Takashi Tatsuse
    2020 年 30 巻 6 号 p. 253-259
    発行日: 2020/06/05
    公開日: 2020/06/05
    [早期公開] 公開日: 2019/06/01
    ジャーナル オープンアクセス

    Background: Although parents seek the best for their children, nutrition education for parents has attracted little attention to improve their children’s dietary habits. To address this gap, this study aimed to examine the relationship between parental lifestyle factors and children’s dietary habits.

    Methods: We used data from the questionnaire survey of the Super Shokuiku School Project conducted in January 2016. The participants consisted of 1,632 elementary school children who answered questions about their lifestyle, while their parents answered parental lifestyle questions, including Breslow’s seven health practice score (BHPS). Logistic regression analysis was performed to evaluate the strength of the relationship between parental lifestyle factors and parental dietary attitudes or children’s dietary habits.

    Results: Compared with good maternal BHPS (scores of 6–7), poor maternal BHPS (scores of 0–3) was significantly associated with less parental interest in Shokuiku, less parental consideration of nutrient balance, and an increased rate of children eating breakfast alone (adjusted odds ratio [aOR] 2.95; 95% confidence interval [CI], 1.82–4.78, aOR 3.86; 95% CI, 2.50–5.96, and aOR 2.42; 95% CI, 1.34–4.35, respectively). There was no significant difference between parental BHPS and the following children’s dietary habits: frequency of eating breakfast, vegetable intake, and snacking. These habits of children were associated with their personal lifestyle factors.

    Conclusion: Two types of dietary habits among children were associated with lifestyle factors of both parents and children. Nutrition education might be especially important for parents to improve their dietary attitude and children’s dietary habits. However, different nutrition education interventions would be needed to appropriately address each dietary habit.

  • Takuya Osaki, Mamoru Satoh, Fumitaka Tanaka, Kozo Tanno, Yuji Takahash ...
    2020 年 30 巻 6 号 p. 260-267
    発行日: 2020/06/05
    公開日: 2020/06/05
    [早期公開] 公開日: 2019/05/25
    ジャーナル オープンアクセス

    Background: Epidemiological studies have shown that high circulating cystatin C is associated with a risk of cardiovascular disease (CVD) independent of creatinine-based renal function measurements. The present study investigated the comparison between the cystatin C-based estimated glomerular filtration rate (GFRcys) and creatinine-based GFR (GFRcr) to determine whether these measurements are associated with CV biomarkers and elevated CVD risk in a general Japanese population.

    Methods: The Iwate Tohoku Medical Megabank Organization pooled individual participant data from a general population-based cohort study in Iwate prefecture (n = 29,375). Chronic kidney disease (CKD) was estimated using the GFRcys, GFRcr and the urine albumin-to-creatinine ratio (UACR).

    Results: The prevalence of CKD in the participants was found to be higher based on the GFRcr than the GFRcys. Multiple variable analyses after adjusting for baseline characteristics showed that high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were associated with the GFRcys. The area under the receiver operating characteristic (AUROC) curve for identifying individuals with a high Suita score was higher for the GFRcys (AUROC = 0.68) than it was for the GFRcr (AUROC = 0.64, P < 0.001). The GFRcys provided reclassification improvement for the CVD risk prediction model by the GFRcr (net reclassification improvement = 0.341; integrated discrimination improvement = 0.018, respectively, P < 0.001).

    Conclusions: The GFRcys is more closely associated with CV biomarkers, including hs-cTnT and NT-proBNP levels, and a high Suita score than the GFRcr, and it provides additional value in the assessment of CVD risk using GFRcr.

Statistical Data
  • Kosuke Kiyohara, Junya Sado, Tasuku Matsuyama, Yusuke Katayama, Sumito ...
    2020 年 30 巻 6 号 p. 268-275
    発行日: 2020/06/05
    公開日: 2020/06/05
    [早期公開] 公開日: 2019/05/18
    ジャーナル オープンアクセス
    電子付録

    Background: Little is known about the characteristics of emergency patients transported to hospital while participating in sports activity. Hence, we identified characteristics of emergency patients transported to hospital by emergency medical service (EMS) while participating in sports activity in Osaka City.

    Methods: Population-based ambulance records of Osaka Municipal Fire Department were reviewed. All sports-related emergency transport cases (ie, patients experiencing external injury or illness during/immediately after participation in sports activity and then transported to hospital by the EMS) were enrolled, including both athletes and recreational sports participants. The study was performed from January 1, 2013 to December 31, 2015. Data of patient characteristics were described according to the type of sports.

    Results: During the study, 661,190 patients required emergency transport in Osaka city; 2,642 (0.4%) were sports-related emergency transport, including 2,453 external injuries and 298 illnesses. Overall, 79.0% of patients were men and 44.4% were less than 18 years. Emergency transport during ball games accounts for the majority of cases (71.5%, 1,888/2,642), including baseball (n = 380), soccer (n = 368), and futsal (n = 209). The leading diagnosis/symptom of external injury was fracture/bone contusion (n = 701) and that of illness was heatstroke/dehydration (n = 184). Serious acute illness, such as sudden cardiac arrest, accounted for 0.6% (16/2,751) of all accidents, with half of them (n = 8) related to long-distance running.

    Conclusion: Characteristics of sports-related accidents widely varied by type of sports. Measures to prevent serious accidents during sports activities should be established based on the information on patient characteristics of each type of sports.

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