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Biomedical subjects

Takeo Nakayama

Publications and source records attributed to Takeo Nakayama.

32 records · Page 2Linked to original sources
PubMed2005

Karojisatsu in Japan: characteristics of 22 cases of work-related suicide.

With the rapidly increasing number of work-related suicides in Japan (Karojisatsu, in Japanese), both applications for worker's compensation insurance and civil suits are proliferating. The phenomenon of work-related suicide is examined along with the process and related factors. With informed consent from bereaved families, two certified psychiatrists independently reviewed and summarized 22 insurance and legal reports filed by psychiatrists on employee suicides that were related to heavy workloads. A clinical epidemiologist participated in discussions with psychiatrists to reach a consensus concerning the cause of the suicides. Only one case involved a female. Seventeen had experienced personnel changes, such as a promotion or transfer. Low social support was recognized in 18, high psychological demand in 18, low decision latitude in 17, and long working hours in 19 cases (more than 11 hours per day for 3 months or more, and without a day off in 9). The subjects had depressive episodes by the ICD-10 criteria and showed suicidal signs. Ten of them saw a general practitioner because of unspecified somatic complaints, but no effective measures were taken. None of them had a history of psychiatric consultation or had received mental health education dealing with job stress management. Although causality cannot be made from this case series report, we hypothesize that long working hours, heavy workloads, and low social support may cause depression, which can lead to suicide. Appropriate countermeasures are urgently needed and the present findings suggest some of them are possible.

Adult↗
PubMed2005

Japan's ethical guidelines for epidemiologic research: a history of their development.

During the latter half of the 1990s, Japanese healthcare professionals and policy-makers recognized the value of an "evidence-based" approach. At the same time, an increased social awareness of the need to protect research participants and personal information began to appear. Recognition of an evidence-based approach further promoted epidemiologic research while regulations on personal information protection imposed certain limitations on this same research. In April 2000, as a solution to this conflict, a working group funded by Japan's Ministry of Health and Welfare (MHW; currently the Ministry of Health, Labour and Welfare: MHLW) proposed a first draft of ethical guidelines for epidemiologic research. Over the next two years, the collection of domestic and foreign data by working groups and governmental ad hoc committees, questions raised by the mass media, and public statements made by organizations, such as the Science Council of Japan and the Japan Epidemiologic Association (JEA), led to a collaborative effort between the Ministry of Education, Culture, Sports, Science and Technology and the MHLW. This effort led to the creation of the Ethical Guidelines for Epidemiologic Research in June 2002, which was revised in 2004. Furthermore, JEA also announced the Ethical Guidelines for Conducting of Epidemiologic Research in October 2002. While the development of these ethical guidelines has been a challenge for Japanese epidemiologists, it has also allowed the epidemiologic community to understand their role in society. This review aims to provide insight into the interaction between the epidemiologic community and society by assessing historically the developmental process of these ethical guidelines.

Epidemiology↗
PubMed2005

Energy expenditure in males with mental retardation.

Previously, we reported that males with mental retardation (MR) (MR group) expended more energy than males without MR (control group) at a given work load. The precise physiological mechanisms for this difference remain unclear. Using the same set of subjects (23 age-, height-, and weight-matched male pairs, mean age: 36.3 y), we examined possible causes for the observed metabolic difference by monitoring physical movements and evaluating the metabolic capability of the skeletal muscles. In the supine position when no body movements were detected for any subjects, oxygen consumption (VO2) and heart rate (HR) were not markedly different between the MR and the control groups. By contrast, in the sitting and standing positions and during walking at 30 and 50 m/min, when significantly larger body movements were monitored in the MR group, VO2 and HR were significantly higher in this group than in the control group. Linear regression analyses, performed separately in the MR and control groups, revealed that the slope of the regression line of HR on relative exercise intensity (%VO2max) during walking, that of VO2 on walking speeds, and that of VO2 on the number of steps in the MR group were almost identical with those in the control group. These results suggest that the capability of skeletal muscles was not so different between the two groups. Thus, the high energy expenditure in the MR group was suggested to be a result of excessive body movements rather than an intrinsic incapability of skeletal muscles.

Adult↗
PubMed2005

[An estimation of the prevalence of excessive daytime sleepiness based on age and sex distribution of epworth sleepiness scale scores: a population based survey].

OBJECTIVES: To describe the distribution of subjective daytime sleepiness among local residents using the Epworth Sleepiness Scale (ESS) and estimate the prevalence of excessive daytime sleepiness (EDS) in a general Japanese adult population. METHODS: Subjects consisted of all residents aged 20 years and over from a self-governing body of approximately 10,000 people located in the Hokkaido region. Questionnaires, which included a Japanese version of the ESS, were distributed and later collected by a health promoter who visited subjects' residences between October and December 2000. Subjects of the analysis were restricted to those who answered five items or more out of a total of eight items. Means and standard deviations of the ESS global score were calculated for each age group by gender. And differences with reference to sex and age were examined by ANOVA. The prevalence of EDS in the Japanese general population was estimated from this study's results by direct age adjustment using the Japanese census figures for 2000. Factors related to EDS were also examined. RESULTS: A total of 5,327 residents responded to the survey (86.0%). Of these, 4,412 (71.2%) were entered for analysis. The average (+/- standard deviation) ESS global score were with 5.18 +/- 3.75 (males 5.25 +/- 3.89, females 5.12 +/- 3.75). Differing significantly age, regardless of sex (P<0001). From the overall prevalence of EDS of 9.2% (males 9.6%, females 8.8%), the estimated prevalence in the Japanese general population was to be 8.9% (males 9.3%, females 8.4%). EDS was found to be related to age, sleep duration under six hours and to snoring (P=0.002, P=0.008 and P<0.001). CONCLUSION: This study provided baseline data for the distribution by sex and age group of subjective daytime sleepiness in a community using the ESS and was used to generate the first ever estimated prevalence of EDS in the general Japanese adult population. The finding should prove useful for clinicians and researchers interested in (1) screening for daytime sleepiness, (2) evaluating changes between pre and post-interventions, (3) comparing epidemiological findings across studies, and lastly, (4) making of health policy. Daytime sleepiness estimated by ESS differs with the sex and age, possibly related to bio-medical and socio-medical factors. Further research is need to detail this problem.

Activities of Daily Living↗
PubMed2005

Adoption of structured abstracts by general medical journals and format for a structured abstract.

BACKGROUND: The use of a structured abstract has been recommended in reporting medical literature to quickly convey necessary information to editors and readers. The use of structured abstracts increased during the mid-1990s; however, recent practice has yet to be analyzed. OBJECTIVES: This article explored actual reporting patterns of abstracts recently published in selected medical journals and examined what these journals required of abstracts (structured or otherwise and, if structured, which format). METHODS: The top thirty journals according to impact factors noted in the "Medicine, General and Internal" category of the ISI Journal Citation Reports (2000) were sampled. Articles of original contributions published by each journal in January 2001 were examined. Cluster analysis was performed to classify the patterns of structured abstracts objectively. Journals' instructions to authors for writing an article abstract were also examined. RESULTS: Among 304 original articles that included abstracts, 188 (61.8%) had structured and 116 (38.2%) had unstructured abstracts. One hundred twenty-five (66.5%) of the abstracts used the introduction, methods, results, and discussion (IMRAD) format, and 63 (33.5%) used the 8-heading format proposed by Haynes et al. Twenty-one journals requested structured abstracts in their instructions to authors; 8 journals requested the 8-heading format; and 1 journal requested it only for intervention studies. CONCLUSIONS: Even in recent years, not all abstracts of original articles are structured. The eight-heading format was neither commonly used in actual reporting patterns nor noted in journal instructions to authors.

Abstracting and Indexing↗
PubMed2004

Quality of life assessment and reporting in randomized controlled trials: a study of literature published from Japan.

BACKGROUND: Standardization of quality of life (QOL) assessment and reporting in clinical trials is an imperative issue. While English-speaking countries have led this movement in standardization, there persists to be a limited amount of information from non-English-speaking including Japan. In this study, we bibliographically analyze the reporting of randomized controlled trials (RCT) conducted in Japan that used a QOL instrument. METHODS: A PubMed search of reports published between 1970-2003 followed by an examination of QOL reporting and its frequency of use in RCTs published from Japan. RESULTS: Percentages of QOL reporting in RCTs have increased between 1970-2003 both worldwide (0% for 1970-1974 to 4.4% for 2000-2003) and in Japan (0% to 1.8% for the identical periods). We found and evaluated 46 RCT reports published from Japan (32 in English, 14 in Japanese). The most commonly studied clinical condition was cancer (26, 56.5%) and the most common intervention was drug therapy (29, 63.0%). QOL was used as the primary endpoint in 10 studies (21.7%). Authors used established QOL instruments in 12 studies (26.1%), developed original instruments in 8 studies (17.5%) and assessed the symptoms or performance status in 10 studies (21.7%). Authors conceptually defined QOL in only 6 studies (13.0%). Neither response rate nor number of respondents for questionnaire surveys was specified in 16 studies (34.8%); furthermore, 11 studies (23.9%) did not describe respondents' attributes. CONCLUSIONS: Findings on relative frequency suggested that Japanese authors of RCT reports have less interest in QOL instruments than other international researchers in Western Europe and North America. Examination of RCT reports published from Japan revealed that there were several points to be improved in reporting QOL instruments. This study highlights the need to define QOL measures specific to clinical specialty and to examine methodology for assessing and reporting QOL.

Bibliometrics↗
PubMed2004

Special reference to employee knowledge about depression and suicide: baseline results of a workplace-based mental health support program.

With the sustained economic recession, suicide has been increasing in Japan (more than 300000 victims annually since 1998), particularly among middle-aged employees. Development of preventive measures is needed; however, employees have limited knowledge of the basic information about depression and suicide. One office in Saitama Prefecture, Japan, has been provided with a mental health support program. An initial questionnaire survey was conducted in December 1999. It contained demographic data and information about working styles and daily habits, including alcohol and tobacco use, quality of sleep, social support, the general well-being schedule, and knowledge/attitude toward depression and suicide. Of 225 eligible people, 216 men and women participated. Most of them had stressful schedules and demanding jobs. Their subjective well-being was generally poorer relative to the reference. The mean score of knowledge was 10.5 (SD = 2.02) for 14 items. The accuracy rates ranged from 97.6% incorrect (false) for such items as 'Most suicide victims consult psychiatrists before their deaths' to 42.1% correct (true) for 'A suicidal individual tends to be accident-prone for traffic accidents and injuries.' One-fourth of them had unfavorable attitudes toward depressive colleagues. Neither age nor gender was related to knowledge level and attitude. Variations were observed in the knowledge that employees had toward depression and suicide. A program that provides employees with appropriate information related to mental health is needed.

Adult↗
PubMed2004

The utility of anthropometric assessment at institutions and schools for individuals with intellectual disabilities and/or motor disabilities: a nation-wide survey in Japan.

OBJECTIVES: To obtain information regarding the actual methods used for nutritional assessment at institutions and schools in order to establish a nutritional assessment method for individuals with disabilities. METHODS: Questionnaires were sent to 1,080 selected institutions and schools for individuals with intellectual disabilities (ID) and/or motor disabilities (MD). The response rate was 76.5%. RESULTS: The implementation rates for height and weight measurements were generally very high at both institutions and schools for individuals with ID and/or MD (85.5-100%), but those for other items were very low and varied among different disability types. The implementation rate for BMI was 17.9-71.9%, demonstrating that BMI was not widely used among institutions and schools for individuals with ID and/or MD. As for the methods for calculating percent body fat, a high percentage of institutions and schools for individuals with ID and/or MD indicated the use of bioelectrical impedance analysis for most disability types (60 - 77.9%). CONCLUSIONS: The percentages of institutions for individuals with ID and/or MD and of schools for individuals with ID and/or MD that implement nutritional assessment are very low, with variations among different disability types.

Adipose Tissue↗
PubMed2003

Assessment of exposure to magnetic fields in occupational settings.

OBJECTIVE: It is important to have data about occupational magnetic field intensity to consider the contribution of occupational magnetic field exposure on the human body. We conducted research on exposure to occupational magnetic fields and tried to qualify data on the distribution of magnetic field' intensity in certain general working environments with individual measurements. SUBJECTS AND METHODS: We performed sample research on the exposure to low-frequency magnetic fields of workers in certain occupations and in the working environment. We also assessed the relationship between working environmental magnetic field distribution and individual exposure. RESULTS: Some occupations were found to be exposed to high magnetic fields. We observed that some workspaces, such as the transformer substation, generally had a uniform and high magnetic field measurement but employees were exposed to a lower intensity. We also found that welders were exposed to high magnetic fields at about 600 microT in a very short time but with a geometrical value of 0.08 microT. CONCLUSION: The determination of administrative levels and control levels, not only of the time weighted average of threshold limits or short term exposure limits, but also ceiling limits should be considered. More systematic research is necessary to determine variables such as operating conditions, measuring position, and frequency bands. Also, further studies will be needed to make a job-exposure matrix for the magnetic fields for each occupation type and to combine it with exposure in non-occupational settings such as commuting and ordinary life situations to explore the causal relationship between exposure to magnetic fields and disease.

Electromagnetic Fields↗
PubMed2003

Smoking patterns of university woman students in Miyagi, Japan: the Miyagaku Study.

BACKGROUND: The increase in the smoking rate among young women is a worldwide problem. However, few reports have focused on female students, in particular, with detailed accounts of their smoking behavior. The aim of this study was to clarify the smoking patterns of Japanese women of approximately 20 years of age. METHODS: Smoking behavior, age at initiation, favorite brand and related attitudes were examined using a cross-sectional anonymous questionnaire administered to students at a women's university in Miyagi, Japan in 2000. RESULTS: Of 2,984 subjects (response rate: 96%), 16% said that they smoke (95% confidence interval 15-18%): 7% of freshmen, 16% of sophomores, 22% of juniors and 20% of seniors. While music majors were most likely to smoke (21%), domestic science majors had the lowest rate of smoking (10%). Among the smokers, 27% started the habit at age 20 years, the legal age in Japan, and 25% started at age 18. The favorite brand was Marlboro (39%), followed by Mild Seven (16%), a domestic brand. One-third of the smokers had no plans to quit. CONCLUSIONS: Reaching the legal age and entering university may prompt young women to start smoking habitually. In contrast to its overall market share in Japan, a US brand is now favored by current young female smokers.

Adolescent↗
PubMed2003

[Clinical practice guidelines in Japan: toward their appropriate use and diffusion].

In Japan, the governmental report on health technology assessment in 1999 referred to the need to develop evidence-based clinical practice guidelines. The Ministry of Health and Welfare established priorities for the development of clinical practice guidelines, and started several projects. About 20 clinical practice guidelines are to be developed by 2004. However, what "guideline" means and how "guidelines" work are unclear because the word "guideline" is ambiguous in Japan. Although it is generally accepted that "directives are stronger than recommendations, which are stronger than guidelines" in the western countries, Japanese people do not usually recognize these distinctions and tend to regard guidelines as mandatory directives even in individual cases. Patients, consumers and legal professionals may overestimate the authority of clinical practice guidelines when they see them. What clinical practice guidelines are, or are not should be clarified appropriately. Autumn 2003, the Japan Council for Quality Health Care will open the information service that provides practice guidelines and related literature. This will be accessible to both healthcare professionals and the general public. Much remains to be done to bring other stakeholders to the table. All of Japanese society can, and needs to, participate in the process of developing a consensus on clinical practice guidelines.

Community Participation↗