In Japan, physical activity duration in junior high schools is substantially higher than that in elementary schools. Using longitudinal data, this study examined the association between changes in ...physical activity duration and depressive symptoms in 1225 adolescents without depressive symptoms at baseline (51.2% female) from a rural city in Japan. Adolescents in the group that changed from "Active" (physical activity duration ≥7 h /week) in the fifth-grade of elementary school (age 11 years) to "Inactive" in the second-grade of junior high school (age 14 years) had a higher odds ratio of being rated as having depressive tendencies at age 14 years than adolescents in the Active-Active group. Additionally, the results of the cross-lagged effects model analysis suggested that depressive symptoms may be a factor in the reduced physical activity duration.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•There is growing concern for problematic Internet use (PIU) among students.•The temporal directional relationships between PIU and depression were studied.•We studied the relationship using the ...random intercept, cross-lagged panel model.•We found that PIU preceded depressive symptoms among junior high-school students.
The results from research on the temporal directional relationship between problematic Internet use (PIU) and depressive symptoms are inconsistent. This study aimed to explore this relationship among junior high school students in Japan.
Junior high/middle school students in the seventh grade (Time 1, T1) were recruited annually for 4 years starting in 2014; each cohort was followed up at 1 year (Time 2, T2) and 2 years (Time 3, T3). Three-year longitudinal panel data were collected from self-reported questionnaires that were completed by 1192 students (586 males and 606 females). Young’s Internet Addiction Test and the Birleson Depression Self-rating Scale were used to assess participants’ PIU and depressive symptoms, respectively. The temporal directional relationship between PIU and depressive symptoms was analyzed using the random intercept, cross-lagged panel model.
The mean of the Internet Addiction Test increased as grade level increased: 28.0 at T1, 30.7 at T2 and 32.6 at T3. There was a unidirectional positive effect from PIU at T2 to depressive symptoms at T3, but not vice versa. There was no directional effect from PIU at T1 to depressive symptoms at T2, nor any in the reverse.
Our findings suggest that PIU precedes depressive symptoms. Therefore, addressing PIU is a promising preventive measure for adolescent depression.
The eligibility of COVID-19 vaccines has been expanded to children aged 12 and above in several countries including Japan, and there is a plan to further lower the age. This study aimed to assess ...factors related to parental COVID-19 vaccine hesitancy. A nationwide internet-based cross-sectional study was conducted between May 25 and June 3, 2021 in Japan. The target population was parents of children aged 3-14 years who resided in Japan, and agreed to answer the online questionnaire. Parental COVID-19 vaccine hesitancy (their intention to vaccinate their child) and related factors were analyzed using logistic regression models. Interaction effects of gender of parents and their level of social relationship satisfaction related to parental vaccine hesitancy was tested using log likelihood ratio test (LRT). Social media as the most trusted information source increased parental vaccine hesitancy compared to those who trusted official information (Adjusted Odds Ratio: aOR 2.80, 95% CI 1.53-5.12). Being a mother and low perceived risk of infection also increased parental vaccine hesitancy compared to father (aOR 2.43, 95% CI 1.57-3.74) and those with higher perceived risk of infection (aOR 1.55, 95% CI 1.04-2.32) respectively. People with lower satisfaction to social relationships tended to be more hesitant to vaccinate their child among mothers in contrast to fathers who showed constant intention to vaccinate their child regardless of the level of satisfaction to social relationship (LRT p = 0.021). Our findings suggest that dissemination of targeted information about COVID-19 vaccine by considering means of communication, gender and people who are isolated during measures of social distancing may help to increase parental vaccine acceptance.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study aims to determine the approximate number of hospitalizations of persons without family and the medical challenges they encounter in hospitals across Japan. Self-administered questionnaires ...were mailed to 4,000 randomly selected hospitals nationwide to investigate the actual conditions and problems, decision-making processes, and use of the government-recommended Guidelines for the hospitalization of, and decision-making support for, persons without family. To identify the characteristics of each region and role of hospitals, chi-square tests were used to make separate group comparisons by hospital location and type. Responses were received from 1,271 hospitals (31.2% response rate), of which 952 hospitals provided information regarding the number of admissions of persons without family. The mean (SD) and median number of hospitalizations (approximate number per year) of patients without family was 16 (79) and 5, respectively. Approximately 70% of the target hospitals had experienced the hospitalization of a person without family, and 30% of the hospitals did not. The most common difficulties encountered during the hospitalization were collecting emergency contact information, decision-making related to medical care, and discharge support. In the absence of family members and surrogates, the medical team undertook the decision-making process, which was commonly performed according to manuals and guidelines and by consulting an ethics committee. Regarding the use of the government-recommended Guidelines, approximately 70% of the hospitals that were aware of these Guidelines responded that they had never taken any action based on these Guidelines, with significant differences by region and hospital type. To solve the problems related to the hospitalization of persons without family, the public should be made aware of these Guidelines, and measures should be undertaken to make clinical ethics consultation a sustainable activity within hospitals.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To clarify the physical and mental conditions of children during the coronavirus disease 2019 pandemic and consequent social distancing in relation to the mental condition of their caregivers. This ...internet-based nationwide cross-sectional study was conducted between April 30 and May 13, 2020. The participants were 1,200 caregivers of children aged 3-14 years. Child health issues were categorized into "at least one" or "none" according to caregivers' perception. Caregivers' mental status was assessed using the Japanese version of the Kessler Psychological Distress Scale-6. The association between caregivers' mental status and child health issues was analyzed using logistic regression models. Among the participants, 289 (24.1%) had moderate and 352 (29.3%) had severe mental distress and 69.8% of children in their care had health issues. The number of caregivers with mental distress was more than double that reported during the 2016 national survey. After adjusting for covariates, child health issues increased among caregivers with moderate mental distress (odds ratio 2.24, 95% confidence interval 1.59-3.16) and severe mental distress (odds ratio 3.05, 95% confidence interval 2.17-4.29) compared with caregivers with no mental distress. The results highlight parents' psychological stress during the pandemic, suggesting the need for adequate parenting support. However, our study did not consider risk factors of caregivers' mental distress such as socioeconomic background. There is an urgent need for further research to identify vulnerable populations and children's needs to develop sustainable social support programs for those affected by the outbreak.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Major barriers exist in incorporating artificial intelligence into epidemiology, particularly in data interpretation. Thus, we examined the application of highly interpretable ...machine-learning methods— Random Forest (RF) and Sparse Logistic Regression (SLR)— to a large-scale health check-up dataset, examining the advantages of creating prediction models using these.
Methods
This study involved 392,791 participants who underwent healthcare checkups in Japan from 1999 to 2018. Participants who received diabetes treatment, or had an HbA1c level of 6.5% or higher, were excluded. The objective variable examined was type 2 diabetes onset over five years. Each prediction model was created using 26 health status items over three consecutive years. We examined three analytical methods to compare their predictive powers: RF, SLR, and a multivariate stepwise logistic regression (MSLR) as a conventional method. Variable Importance (VI) was calculated in the RF analysis, with Standard Regression Coefficients (SRC) being calculated in the SLR and MSLR analyses.
Results
Predictive accuracy is highest in the SLR model (AUC:0.955), followed by the RF model (AUC:0.949), and then the MSLR model (AUC:0.939). The RF model measures blood glucose, HbA1c, height, red blood cells, and aspartate transaminase with a higher predictive power. In the SLR model, HbA1c, blood glucose, systolic blood pressure, HDL-Cholesterol, and age have higher SRC.
Conclusions
Machine learning techniques enable more accurate diabetes risk predictions than existing methods and suggest new ways of identifying associated predictors.
Key messages
Applying machine-learning methods to health check-up data achieves a high accuracy in predicting type 2 diabetes while maintaining data interpretability.
To determine the climate conditions that affect the incidence of atopic dermatitis from infancy to 3 years old.
We analyzed 100,303 children born from 2011 to 2014 for follow-up until 3 years old ...using cohort data from the Japan Environment and Children's Study. The study included 15 Regional Centers, including 19 prefectures across Japan. We used meteorological data of the Japan Meteorological Agency. We calculated the hazard ratio (HR) of the standard deviation and low vs. high mean values of several climate conditions in children in their first 6 months of life to determine the incidence of atopic dermatitis.
The Kaplan-Meier curve showed that children born in the months of October to December had the highest incidence of atopic dermatitis. Among climate conditions, a one standard deviation increase in the temperature (HR = 0.87), minimum temperature (HR = 0.87), and vapor pressure (HR = 0.87) showed the lowest HRs for the incidence of atopic dermatitis. These results were confirmed by an analysis by strata of the birth season. A low vapor pressure (HR = 1.26, p<0.0001) and the combination of a low mean temperature or low mean minimum temperature and low vapor pressure (HR = 1.26, p<0.0001) were associated with the highest incidence of atopic dermatitis. These results were consistent when they were adjusted for a maternal and paternal history of allergy and the prefecture of birth.
Among climate conditions, a low vapor pressure is the most strongly associated with a high incidence of atopic dermatitis. Measuring vapor pressure may be useful for preventing atopic dermatitis.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Japan is facing a rapid increase in the number of reported child maltreatment cases. Child maltreatment has long-term consequences for the victims, and unemployment rate is considered a strong ...predictor of it. However, only few studies have analyzed the causal relation between child maltreatment and the unemployment rate—particularly the effects of the latter on the former—in Japan.
Using prefecture-level longitudinal data from 2005 to 2016, we employed a fixed effects instrumental variable estimation. The estimation included a weighted average of the national unemployment rate across industries by industrial structures in 2005 as an instrument to identify the causal effects.
The average local unemployment rate changed by approximately 50% from the peak to the bottom in the sample period. A 50% increase in local unemployment rates increased the number of reported child neglect cases and child deaths by 80% and 70% (statistically significant at the 5% level), respectively. Further, it increased cases of death due to external causes, unintentional injuries, and unintentional drowning by 146%, 217%, and 315% (statistically significant at the 5% level), respectively.
The local unemployment rate is a risk factor for child maltreatment, resulting in children’s death, especially as a result of unintentional drowning—the common cause of death due to child neglect. When the local unemployment rates rise, governments should allocate more financial and human resources for preventive measures to combat child deaths caused by neglect.
The BioBank Japan (BBJ) Project was launched in 2003 with the aim of providing evidence for the implementation of personalized medicine by constructing a large, patient-based biobank (BBJ). This ...report describes the study design and profile of BBJ participants who were registered during the first 5-year period of the project.
The BBJ is a registry of patients diagnosed with any of 47 target common diseases. Patients were enrolled at 12 cooperative medical institutes all over Japan from June 2003 to March 2008. Clinical information was collected annually via interviews and medical record reviews until 2013. We collected DNA from all participants at baseline and collected annual serum samples until 2013. In addition, we followed patients who reported a history of 32 of the 47 target diseases to collect survival data, including cause of death.
During the 5-year period, 200,000 participants were registered in the study. The total number of cases was 291,274 at baseline. Baseline data for 199,982 participants (53.1% male) were available for analysis. The average age at entry was 62.7 years for men and 61.5 years for women. Follow-up surveys were performed for participants with any of 32 diseases, and survival time data for 141,612 participants were available for analysis.
The BBJ Project has constructed the infrastructure for genomic research for various common diseases. This clinical information, coupled with genomic data, will provide important clues for the implementation of personalized medicine.
•The BioBank Japan Project (BBJ) enrolled 200,000 patients with 47 target diseases.•The BBJ is one of the largest patient-based biobanks in the world.•The BBJ may allow for personalized medicine in the future.
This case–control study investigated immune thrombocytopenic purpura (ITP) risk following live, inactivated, and simultaneous vaccination, with a focus on infants aged < 2 years. We matched case ...patients with ITP to one or two control patients with other diseases by institution, hospital visit timing, sex, and age. We calculated McNemar’s pairwise odds ratios (ORs 95% confidence interval) with 114 case–control pairs. The case group had 27 (44%) males and 22 (35%) infants, and the control group included 49 (43%) males and 42 (37%) infants. For all age groups, the McNemar’s OR for ITP occurrence was 1.80 (0.54–6.84,
p
= 0.64) for all vaccines. Among infants, these were 1.50 (0.17–18.0,
p
= 0.50) for all vaccines, 2.00 (0.29–22.1,
p
= 0.67) for live vaccines, and 1.00 (0.01–78.5,
p
= 0.50) for inactivated vaccines. Sex-adjusted common ORs for simultaneous vaccination were 1.52 (0.45–5.21,
p
= 0.71) for all vaccines, 1.83 (0.44–7.59,
p
= 0.40) for inactivated vaccines only, and 1.36 (0.29–6.30,
p
= 0.69) for mixed live and inactivated vaccines. In infants, these were 1.95 (0.44–8.72,
p
= 0.38), 1.41 (0.29–6.94,
p
= 0.67) and 2.85 (0.43–18.9,
p
= 0.28), respectively. These limited data suggest no significant ITP risk following vaccinations or simultaneous vaccination in any age group, including infants.