In April 2020, the Japanese government declared a state of emergency due to the COVID-19 pandemic, and infection control measures, including requests to work from home and stay-at-home restrictions, ...were introduced. This study examined changes in smoking behavior during the COVID-19 state of emergency.
An online cross-sectional survey was conducted in Osaka, Japan. To assess differences in smoking behavior among 5,120 current smokers before and after the declaration of a state of emergency, prevalence ratios (PRs) for two outcomes, increased smoking and quitting smoking, were calculated using multivariable Poisson regression, adjusting for potential covariates.
We found 32.1% increased the number of cigarettes smoked and 11.9% quit smoking. After adjustment for all variables, we found risk factors for COVID-19 (men and older age group) had both significantly higher PR for quitting smoking (men: PR 1.38; 95% confidence interval CI, 1.17-1.62) and participants aged ≥65 years: PR 2.45; 95% CI, 1.92-3.12) and significantly lower PR of increased smoking (men: PR 0.85; 95% CI, 0.78-0.93 and participants ≥65 years: PR 0.38; 95% CI, 0.29-0.49). Additionally, respondents working from home or living alone had significantly higher PR for increased smoking (working from home: PR 1.29; 95% CI, 1.17-1.41 and living alone: PR 1.23; 95% CI, 1.10-1.38) and respondents who changed from cigarettes to heated tobacco products (HTPs) had significantly lower PR for quitting smoking (PR 0.150; 95% CI, 0.039-0.582).
We suggest people who have high-risk factors for COVID-19 might change their smoking behavior for the better, while people who work from home or live alone might change their smoking behavior for the worse, during the COVID-19 state of emergency. Additionally, changing from smoking cigarettes to using HTPs makes smokers less likely to quit.
COVID-19 vaccination for general population started on April 12, 2021, in Osaka, Japan. We investigated public attitudes toward vaccination and associated factors of vaccine hesitancy during the ...third state of emergency.
An internet-based, self-reported, cross-sectional survey was conducted in June 2021, using the smartphone health app for residents of Osaka aged ≥18 years. Respondents were asked about their attitudes toward COVID-19 vaccine. Responses "Don't want to receive vaccines" or "Don't know" were defined as vaccine hesitancy (vs. "Received 1st dose", "Received 2nd dose", or "Want to receive vaccines"). Multivariable Poisson regression analysis was conducted to examine the associations between hesitancy and population characteristics.
23,214 individuals (8,482 men & 14,732 women) were included in the analysis. Proportions that answered "Received (1st dose)", "Received (2nd dose)", "Want to receive vaccines", "Don't want to receive vaccines", "Don't know", and "Don't want to answer" were 14.6%, 3.8%, 70.6%, 4.3%, 6.1%, and 0.5% among men; and 11.3%, 6.0%, 64.9%, 6.2%, 11.0%, and 0.6% among women. Factors associated with vaccine hesitancy included being a woman (aPR = 1.33; 95%CI = 1.23-1.44), age 18-39 (aPR = 7.00; 95%CI = 6.01-8.17) and 40-64 years (aPR = 4.25; 95%CI = 3.71-4.88 vs. 65+ years), living alone (aPR = 1.19; 95%CI = 1.08-1.30 vs. living with 3+ members), non-full-time employment and unemployment (aPRs ranged 1.12 to 1.49 vs. full-time employment), cardiovascular diseases/hypertension (aPR = 0.72; 95%CI = 0.65-0.81), and pregnancy (women of reproductive age only) (aPR = 1.35; 95%CI = 1.03-1.76).
Most respondents expressed favorable attitudes toward COVID-19 vaccination while hesitancy was disproportionately high in certain populations. Efforts are needed to ensure accessible vaccine information resources and healthcare services.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and ...smoking status.Methods: We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.Results: After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs) were 1.06 (95% credible interval CrI, 1.05–1.08) for men and 1.08 (95% CrI, 1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs of 1.32 (95% CrI, 1.14–1.50) for men and 1.30 (95% CrI, 1.11–1.49) for women in England.Conclusions: Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.
We developed and validated an instrument to measure community-level social capital based on data derived from older community dwellers in Japan.
We used cross-sectional data from the Japan ...Gerontological Evaluation Study, a nationwide survey involving 123,760 functionally independent older people nested within 702 communities (i.e., school districts). We conducted exploratory and confirmatory factor analyses on survey items to determine the items in a multi-dimensional scale to measure community social capital. Internal consistency was checked with Cronbach's alpha. Convergent construct validity was assessed via correlating the scale with health outcomes.
From 53 candidate variables, 11 community-level variables were extracted: participation in volunteer groups, sports groups, hobby activities, study or cultural groups, and activities for teaching specific skills; trust, norms of reciprocity, and attachment to one's community; received emotional support; provided emotional support; and received instrumental support. Using factor analysis, these variables were determined to belong to three sub-scales: civic participation (eigenvalue = 3.317, α = 0.797), social cohesion (eigenvalue = 2.633, α = 0.853), and reciprocity (eigenvalue = 1.424, α = 0.732). Confirmatory factor analysis indicated the goodness of fit of this model. Multilevel Poisson regression analysis revealed that civic participation score was robustly associated with individual subjective health (Self-Rated Health: prevalence ratio PR 0.96; 95% confidence interval CI, 0.94–0.98; Geriatric Depression Scale GDS: PR 0.95; 95% CI, 0.93–0.97). Reciprocity score was also associated with individual GDS (PR 0.98; 95% CI, 0.96–1.00). Social cohesion score was not consistently associated with individual health indicators.
Our scale for measuring social capital at the community level might be useful for future studies of older community dwellers.
•Most study failed to capture multiple dimensions of community-level social capital.•We developed and validated 11-item health related community social capital scale.•The scale assessed civic participation, social cohesion, and reciprocity.
Due to increases in cancer survivability, quality assessments of cancer care must include long-term outcomes. This multicenter retrospective cohort study evaluated between-hospital variations in the ...3-year survival rates of patients with gastric, colorectal, and lung cancer irrespective of treatment modality. We linked cancer registry data and administrative data from patients aged 18-99 years who were diagnosed with gastric, colorectal, or lung cancer between 2013 and 2015 in Osaka Prefecture, Japan. The 3-year survival rates were adjusted for potential prognostic factors using multilevel logistic regression models. Between-hospital variations were visually evaluated using funnel plots. We analyzed 10,296 gastric cancer patients from 30 hospitals, 9276 colorectal cancer patients from 30 hospitals, and 7978 lung cancer patients from 28 hospitals. The 3-year survival rate was 70.2%, 75.2%, and 45.0% for gastric, colorectal, and lung cancer, respectively. In the funnel plots, the adjusted survival rates of gastric and colorectal cancer for all hospitals lay between the lower and upper control limits of two standard deviations of the average survival rates. However, the adjusted survival rates of lung cancer for four hospitals lay below the lower limit while that for two hospitals lay above the upper limit. Older age, men, advanced cancer stage, comorbidities, functional disability, emergency admission, current/ex-smokers, and underweight were independently associated with poorer survival. In conclusion, there were between-hospital variations in 3-year survival for lung cancer even after adjusting for case mix. Quality improvement initiatives may be needed to raise the consistency of care.
We examined whether pre-disaster social support functions as a disaster preparedness resource to mitigate post-disaster depressive symptoms among older survivors of the 2011 Great East Japan ...earthquake and tsunami. The participants were 3,567 individuals aged ≥65 years living in Iwanuma city who completed a baseline survey as part of the nationwide Japan Gerontological Evaluation Study seven months before the disaster. A follow-up survey was administered approximately 2.5 years after the disaster. The analysis included a total of 2,293 participants, and social support (giving and receiving emotional & instrumental help) before the disaster was measured using four items. Depressive symptoms were assessed using the GDS with a cut-off score of 4/5 (not depressed/depressed). We discovered that participants who gave and received emotional and instrumental support before the disaster were significantly less likely to develop depressive symptoms after the disaster compared to those without support (ARR = 0.70; 95% CI: 0.56-0.88). The risk of the onset of depressive symptoms was 1.34 (95% CI: 1.03-1.74) among those who experienced disaster damages but had also given and received social support, and 1.70 (95% CI: 1.03-2.76) among those who experienced damages but lacked support. Strengthening social aid may help cultivate psychological resilience to disasters.
The relationship between hospital volume and patient outcome is globally known; thus, hospital volume is widely used as a quality indicator. In Japan, however, recent studies on this topic are ...scarce. The present study examined whether hospital surgery volume is associated with postoperative 5‐year survival among cancer patients. Using the Osaka Cancer Registry, we identified a sample of 86 145 patients who were diagnosed with cancer at any of five different sites (stomach, colorectum, lung, breast and uterus) and underwent surgeries between 2007 and 2011 in Osaka. We ranked hospitals by annual surgical volume, sorted patients in descending order by hospital volume, and assigned them into quartiles (high, medium, low and very low volume). We analyzed the association between hospital volume and 5‐year survival among 80 959 patients aged between 15 and 84 years using Cox proportional hazard models. Adjustments were made for characteristics of patients, type of surgery and adjuvant treatment received. The mortality hazard of patients treated at very low‐volume hospitals was 1.36‐1.82‐fold higher than that of patients treated at high‐volume hospitals. Absolute differences in adjusted survival rates between high‐volume and very low‐volume hospitals varied with the cancer site: 14.9 in stomach, 11.5 in colorectal, 10.8 in lung, 2.4 in breast and 3.3 in uterine cancers. Hospitals with lower surgery volumes showed higher mortality risks after cancer surgery than those with higher volumes. Monitoring site‐specific surgery volumes and referring patients from low‐volume to high‐volume hospitals may be beneficial for improving the long‐term survival of cancer patients.
Postoperative 5‐year survival of 80 959 patients diagnosed with stomach, colorectal, lung, breast or uterine cancers was compared among hospitals categorized by quartiles of surgery volume, using the Osaka Cancer Registry database. Very low hospital volume was significantly associated with higher mortality hazards, whereas absolute differences in survival probability between high‐volume and very low‐volume hospitals varied with the cancer site. Monitoring site‐specific surgery volume and referring patients from low‐volume to high‐volume hospitals are recommended to improve postoperative survival of cancer patients.
The coronavirus disease 2019 (COVID-19) affected cancer care in Japan, but the detailed impact on cancer diagnosis and treatment is not well-understood. We aimed to assess the impact of COVID-19 on ...digestive cancer care in Osaka Prefecture, which has a population of 8.8 million. We conducted a multi-center cohort study, using hospital-based cancer registry (HBCR) data linked to administrative data from 66 designated cancer care hospitals in Osaka. Records of patients diagnosed with cancer of the stomach, colorectum, esophagus, liver, gallbladder or pancreas were extracted from the HBCR data. Baseline characteristics, such as the number of diagnoses, routes to diagnosis and clinical stage, were compared between patients diagnosed in 2019 and those in 2020. We also compared treatment patterns such as the number of treatments (operations, endoscopic surgeries, chemotherapies, radiotherapies), pathological stage and time to treatment for each digestive cancer. In total, 62,609 eligible records were identified. The number of diagnoses decreased in 2020, ranging from -1.9% for pancreatic cancer to -12.7% for stomach cancer. Screen-detected cases decreased in stomach and colorectal cancer. The percentage of clinical stage III slightly increased across different cancers, although it was only significant for colorectal cancer. Among 52,741 records analyzed for treatment patterns, the relative decrease in radiotherapy was larger than for other treatments. The median time from diagnosis to operation was shortened by 2-5 days, which coincided with the decrease in operations. The impact of COVID-19 on cancer care in 2020 was relatively mild compared with other countries but was apparent in Osaka. Further investigation is needed to determine the most affected populations.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
9.
E-Cigarettes Use Behaviors in Japan: An Online Survey Koyama, Shihoko; Tabuchi, Takahiro; Miyashiro, Isao
International journal of environmental research and public health,
01/2022, Letnik:
19, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Electronic cigarette (e-cigarette) use has become increasingly widespread throughout the world, including in Japan. However, little is known about how e-cigarettes are used in Japan, a country with ...heavy restrictions on nicotine-containing e-liquids and/or vaping products. This study examined e-cigarette use (e-cigarette use duration, frequency of use, device type, electrical resistance, nicotine use, favorite e-liquid flavors) among users in Japan, through an online survey using a web-based self-reported questionnaire which included questions about sex, age, combustible cigarette and heated tobacco product (HTP) use behaviors. Of 4689 e-cigarettes users analyzed, 93.5% were men and 52.9% had been using e-cigarettes for 1-3 years. Over 80% used e-cigarettes every day; 62.3% used nicotine liquid, and half of the nicotine liquid users used nicotine salt. The most popular liquid flavor was fruit (prevalence: 68.1%), followed by tobacco (prevalence: 48.4%). While 50.9% were e-cigarette single users, 35.2% were dual users (e-cigarettes and cigarettes or HTPs) and 13.8% were triple user (e-cigarettes, cigarettes and HTPs). This is the first comprehensive survey of Japanese e-cigarette users and our finding suggest more than half use nicotine liquid, although e-cigarettes containing nicotine liquid have been prohibited by the Pharmaceutical Affairs Act since 2010 in Japan. The study also showed 49.1% of participants used cigarettes and/or HTPs concurrently (dual or triple users).
The impact of hospital surgical volume on long-term mortality has not been well assessed in Japan, especially for esophageal, biliary tract, and pancreatic cancer, although these three cancers need a ...high level of medical-technical skill. The purpose of this study was to examine associations between hospital surgical volume and 3-year mortality for these severe-prognosis cancer patients.
Patients who received curative surgery for esophageal, biliary tract, and pancreatic cancers were analyzed using the Osaka Cancer Registry data from 2006-2013. Hospital surgical volume was categorized into tertiles (high/middle/low) according to the average annual number of curative surgeries per hospital for each cancer. Three-year survivals were calculated using the Kaplan-Meier method. Hazard ratios (HRs) of 3-year mortality were calculated using Cox proportional hazard models, adjusting for patient characteristics.
Three-year survival was higher with increased hospital surgical volume for all three cancers, but the relative importance of volume varied across sites. After adjustment for all confounding factors, HRs in middle- and low-volume hospitals were 1.34 (95% confidence interval CI, 1.14-1.58) and 1.57 (95% CI, 1.33-1.86) for esophageal cancer; 1.39 (95% CI, 1.15-1.67) and 1.57 (95% CI, 1.30-1.89) for biliary tract cancer; 1.38 (95% CI, 1.16-1.63) and 1.90 (95% CI, 1.60-2.25) for pancreatic cancer, respectively. In particular for localized pancreatic cancer, the impact of hospital surgical volume on 3-year mortality was strong (HR 2.66; 95% CI, 1.61-4.38).
We suggest that patients who require curative surgery for esophageal, biliary tract, and pancreatic cancer may benefit from referral to high-volume hospitals.
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