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Biomedical subjects

Shinji Nakahara

Publications and source records attributed to Shinji Nakahara.

At least 19 recordsLinked to original sources
PubMed2006

AIDS health beliefs and intention for sexual abstinence among male adolescent students in Kathmandu, Nepal: a test of perceived severity and susceptibility.

OBJECTIVES: In Nepal, male adolescent students are at high risk for infection with human immunodeficiency virus (HIV) because of their risky sexual behaviours. This study examined whether two subscales of the Health Belief Model (HBM), perceived severity and perceived susceptibility, are associated with abstinence intention among Nepalese male adolescent students for HIV/acquired immunodeficiency syndrome (AIDS) prevention. STUDY DESIGN AND METHODS: A school-based study was conducted at a single school located in central Kathmandu from July to August 2002. Participants included 183 male students in Grades 9-12 aged 14-19 years. Anonymous self-reported questionnaires were used, and Zagumny's AIDS Health Belief Scale was adopted as a measure of perceived severity and perceived susceptibility. RESULTS: Over half of the students (53%) strongly agreed with abstinence intention. Students with higher levels of perceived severity strongly agreed with abstinence intention [crude odds ratio 1.86, 95% confidence interval (CI) 1.02-3.38; adjusted odds ratio 1.94, 95% CI 1.05-3.58], but those with higher levels of perceived susceptibility did not. Moreover, age-stratified analysis showed that a high level of perceived susceptibility tended to decrease strong abstinence intention among students aged 16-19 years. CONCLUSIONS: Perceived severity enhanced abstinence intention. The interpretations of perceived susceptibility need further examination through a longitudinal study among students aged 16-19 years. Furthermore, future research is needed to assess the effect of HIV/AIDS education on HIV/AIDS prevention strategies using perceived severity as a motivational tool to help persuade Nepalese male students to abstain from sexual intercourse.

Acquired Immunodeficiency Syndrome↗
PubMed2006

School regulations governing bicycle helmet use and head injuries among Japanese junior high school students.

We examined the effectiveness of school regulations concerning bicycle helmet use in reducing head injuries among student bicycle commuters to junior high schools in the Japanese prefecture of Saitama. This was done by comparing the rates of head injuries and the ratios of head injuries to non-head injuries between junior high schools with and without school regulations concerning helmet use. Bicycle injury data were derived from school insurance records. Information relating to numbers of bicycle commuters and demographics was collected for each school. We identified that the head injury rate was significantly higher in schools that had no regulations governing the use of bicycle helmets (rate ratio 2.97, 95% confidence interval (CI) 1.03-8.56; odds ratio 2.46, 95% CI 0.80-7.60). The observed trend was more prominent in male students than in female students. The actual rate of bicycle injuries did not significantly differ between the schools with and without regulations concerning helmet use. This suggests that students at schools with regulations were no more cautious in riding their bicycles than their counterparts in schools with no regulations, and that there was no significant difference in the traffic environments surrounding each school. Thus implicating that the observed difference in the head injury rate was most accounted for by the presence of school regulations governing helmet use.

Adolescent↗
PubMed2006

Relationship between mechanisms and activities at the time of pedestrian injury and activity limitation among school adolescents in Kathmandu, Nepal.

This study assessed the relationship between pedestrian activity at the time of injury, the type of vehicle involved and resulting activity limitation among school adolescents in the Kathmandu and Lalitpur districts of Nepal. A cross-sectional study of 1557 students in grades 6-8 across 14 schools was conducted using a self-administered questionnaire from August to September 2003. Twenty-three percent of adolescents reported pedestrian injuries, 38% were from urban and 21% from semi-urban areas. Adolescents were commonly injured by motorcycles and motor vehicles while crossing the road; however, while walking and playing, they were commonly injured by bicycles and motorcycles. Bicycles and motor vehicles were less likely to be involved in injury while crossing the roads and playing, respectively (p < 0.001). Activity was more likely to be limited for a longer period of time (> 7 days) with injuries endured while crossing the road (p < 0.001). In urban areas, boys and girls were more likely to be injured while crossing the road and walking, respectively (p < 0.05), and both were commonly injured by motorcycles. In semi-urban areas, boys and girls were commonly injured while walking and were more likely to be injured by motorcycles and bicycles, respectively (p < 0.05). In both areas, more boys than girls were injured while playing. These findings have important implications for pedestrian safety interventions in poor countries.

Accidents, Traffic↗
PubMed2006

Cross-cultural use of the predetermined scale cutoff points in refugee mental health research.

BACKGROUND: Cross-cultural use of the cutoff points determined in Indo-Chinese refugees of the Hopkins Symptom Checklist-25 (HSCL-25) and the Harvard Trauma Questionnaire (HTQ) is common in refugee mental health research but it might have caused misclassifications. METHODS: We assessed the validity of the predetermined cutoff points in identifying depression and post-traumatic stress disorder (PTSD) cases among Afghan refugees, with the algorithm method as a gold standard. We estimated the prevalence of depression and PTSD, using the HSCL-25 and the HTQ with the cutoff points and the algorithm method, and calculated sensitivity, specificity, positive and negative predictive values of the cutoff points. RESULTS: Nine in ten PTSD cases/non-cases were correctly identified as cases/non-cases, and nine in ten respondents classified as PTSD cases/non-cases were actually cases/non-cases. In contrast, only one in three non-depression cases was correctly identified as a non-case, and three in five respondents who were classified as depression cases was actually a case. The prevalence of depression was estimated to be 86% with the cutoff points and 53% with the algorithm method, and that of PTSD 46% and 44%, respectively. CONCLUSIONS: The cutoff point approach might have low specificity and positive predictive value particularly for depression in our study. Cross-cultural use of the scale cutoff points determined in one cultural group to another needs to be reconsidered.

Afghanistan↗
PubMed2006

Effect of post-migration detention on mental health among Afghan asylum seekers in Japan.

OBJECTIVES: Afghan asylum seekers in Japan were increasingly subject to detention following the terrorist attack in New York in September 2001, yet little is reported about the net impact of the detention on their mental health. We examined this by comparing asylum seekers who had once been detained in post-migration and their non-detained counterparts. METHOD: We conducted a cross-sectional survey in 2002/03 among asylum seekers from Afghanistan who were in the process of refugee application in Japan. We contacted them through their lawyers or non-governmental organizations. Of 73 contacted, 55 agreed to participate. Anxiety and depression were measured using the Hopkins Symptom Checklist 25, and posttraumatic stress disorders (PTSD) and past traumatic experiences were studied with the Harvard Trauma Questionnaire. These mental disorders were scored on a 4-point scale; the average symptom score of 4 indicates the worst mental health status. RESULTS: Respondents reported a mean (SD) of 10 (4.0) pre-migration traumas. Since their arrival in Japan, 18 (33%) had once been detained. Trauma exposures and other characteristics of those detained were not significantly different from those not detained, whereas the symptom scores of anxiety (2.91), depression (2.75) and PTSD (2.90) among those detained were higher than among those not detained (2.30, 2.41, 2.34 respectively). Multiple regression analyses revealed independent adverse effects of post-migration detention, alongside exposure to greater trauma and living alone, and the effects were comparable between these variables. CONCLUSION: The post-migration detention of Afghan asylum seekers in Japan was independently related to their worsened mental health.

Adolescent↗
PubMed2005

Mathematical models assuming selective recruitment fitted to data for driver mortality and seat belt use in Japan.

Previous research has indicated that unbelted drivers are at higher risk of involvement in fatal crashes than belted drivers, suggesting selective recruitment that high-risk drivers are unlikely to become belt users. However, how the risk of involvement in fatal crashes among unbelted drivers varies according to the level of seat belt use among general drivers has yet to be clearly quantified. We, therefore, developed mathematical models describing the risk of fatal crashes in relation to seat belt use among the general public, and explored how these models fitted to changes in driver mortality and changes in observed seat belt use using Japanese data. Mortality data between 1979 and 1994 were obtained from vital statistics, and mortality data in the daytime and nighttime between 1980 and 2001 and belt use data between 1979 and 2001 were obtained from the National Police Agency. Regardless of the data set analyzed, exponential models, assuming that high-risk drivers would gradually become belt users in order of increasing risk as seat belt use among general motorists reached high levels, showed the best fit. Our models provide an insight into behavioral changes among high-risk drivers and support the selective recruitment hypothesis.

Accidents, Traffic↗
PubMed2005

Temporal distribution of motorcyclist injuries and risk of fatalities in relation to age, helmet use, and riding while intoxicated in Khon Kaen, Thailand.

This study investigated the temporal distribution of risky behaviors among injured motorcyclists, that is, riding unhelmeted or while intoxicated, and showed how they are associated with risk of fatal injuries. Data of motorcyclists injured in Khon Kaen municipality in northeastern Thailand and transferred to Khon Kaen Regional Hospital were obtained from the trauma registry system of the hospital. Case fatalities were compared by time of day, age group, helmet use, and alcohol intoxication. Unhelmeted riding peaked late in the evening and riding while intoxicated peaked around midnight. Both were associated with increased fatality risk after stratification by time of day; the odds ratios were 3.49 (95% confidence interval (CI) = 1.48-9.36) and 3.01 (CI = 1.71-5.19), respectively. Nighttime injuries were not significantly associated with increased fatality risk after stratification by helmet use or alcohol intoxication. Unhelmeted driving was prevalent and associated with higher fatality risk among younger drivers, whereas intoxicated driving was less prevalent among teens but associated with increased risk among those aged 20-39 years. This study shows that riding unhelmeted or while intoxicated can explain the increased fatality risk at night, suggesting that safety education or enforcements should be targeted at specific age groups and appropriate times.

Accidents, Traffic↗
PubMed2004

Day-care centre supplementary feeding effects on child nutrition in urban slum areas of Nepal.

We compared the nutritional status of children aged 1-5 years from slums attending two day-care centres (DCCs) in Nepal (one in an urban slum area) with that of non-attendees to evaluate the impact of supplementary feeding. We measured the anthropometrics of 23 children attending two DCCs and 23 matched controls from the same neighbourhood and interviewed their mothers. We found a better nutritional status, particularly the height-for-age Z-score, among the attendees of the DCC with children's longer attendance, but no difference at the other, although attendees who had been fed for longer tended to show better nutrition. Our study indicates that in the least developed countries good quality day-care of sufficient duration has the potential to improve child nutrition.

Anthropometry↗
PubMed2004

Relation between increased numbers of safe playing areas and decreased vehicle related child mortality rates in Japan from 1970 to 1985: a trend analysis.

OBJECTIVES: To examine vehicle related mortality trends of children in Japan; and to investigate how environmental modifications such as the installation of public parks and pavements are associated with these trends. DESIGN: Poisson regression was used for trend analysis, and multiple regression modelling was used to investigate the associations between trends in environmental modifications and trends in motor vehicle related child mortality rates. SETTING: Mortality data of Japan from 1970 to 1994, defined as E-code 810-23 from 1970 to 1978 and E810-25 from 1979 to 1994, were obtained from vital statistics. Multiple regression modelling was confined to the 1970-1985 data. Data concerning public parks and other facilities were obtained from the Ministry of Land, Infrastructure, and Transport. SUBJECTS: Children aged 0-14 years old were examined in this study and divided into two groups: 0-4 and 5-14 years. MAIN RESULTS: An increased number of public parks was associated with decreased vehicle related mortality rates among children aged 0-4 years, but not among children aged 5-14. In contrast, there was no association between trends in pavements and mortality rates. CONCLUSIONS: An increased number of public parks might reduce vehicle related preschooler deaths, in particular those involving pedestrians. Safe play areas in residential areas might reduce the risk of vehicle related child death by lessening the journey both to and from such areas as well as reducing the number of children playing on the street. However, such measures might not be effective in reducing the vehicle related mortalities of school age children who have an expanded range of activities and walk longer distances.

Accidents, Traffic↗
PubMed2004

Depressive status of leprosy patients in Bangladesh: association with self-perception of stigma.

Stigmatization by the general population and their negative attitudes towards leprosy negatively impacts on patients' mental health, and so too does patients' perception of that stigma. The objective of this present study is to assess the depressive status of leprosy patients, the patient perception of that stigma, and its association with their depressive status in Dhaka, Bangladesh. Subjects were 140 patients, and a selected comparison group of 135 local people without any chronic diseases. To evaluate depressive status, the Center for Epidemiologic Studies Depression scale (CES-D) Bengali version was applied. The patient group's depressive status was significantly more severe than that of the comparison group. Depressive status of those who answered affirmatively was significantly more severe than that of those who answered negatively for three responses to questions: 1) 'I have been physically attacked by people', 2) 'I feel people regard me as strange' and 3) 'I have been refused the purchase of something by a shopkeeper'. The results showed that the depressive status in leprosy patients was greater than that of the general public. Further, actual experiences of discrimination based on stigma associated with the depressive status of leprosy patients. Mental health care for patients, regulation of discriminatory action and education that would decrease social stigma among the general population, especially people who might often have contact with patients, seem necessary to improve the mental health of Bangladeshi leprosy patients.

Adolescent↗
PubMed2002

Mortality of front-seat occupants attributable to unbelted rear-seat passengers in car crashes.

The risk of death of unbelted rear-seat occupants is obviously increased in car crashes. However, there is little epidemiological evidence that unbelted rear-seat occupants will also increase the risk of death of front-seat passengers. We compared risk of death and severe injury of front-seat occupants in car crashes with belted or unbelted rear-seat passengers. The risk of death of belted front-seat occupants with unbelted rear-seat passengers was raised nearly five-fold. If rear seatbelts had been used, almost 80% of deaths of belted front-seat occupants could have been avoided. Rear seatbelt use should be encouraged for the safety of all car occupants.

Accidents, Traffic↗