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1.
Medicine (Baltimore) ; 100(41): e27533, 2021 Oct 15.
Article in English | MEDLINE | ID: covidwho-2191084

ABSTRACT

ABSTRACT: Understanding the relationship between pain and physical activity (PA) levels is beneficial for maintaining good health status. However, the impact of pain on changes in PA during the coronavirus disease 2019 (COVID-19) pandemic is unknown. The purpose of this study was to examine whether PA levels pre-, during, and post-COVID-19 state of emergency differ between Japanese adults who had pain after the COVID-19 state of emergency and those who did not.Data were collected from a cross-sectional online survey conducted between October 19 and 28, 2020. The analytic sample consisted of 1967 Japanese adults aged ≥40 years who completed the online survey. Participants completed questionnaires on the presence of pain and duration of PA, defined as the total PA time per week based on activity frequency and time. Participants were asked to report their PA at 3 time points: October 2019 (before the COVID-19 pandemic), April 2020 (during the COVID-19 state of emergency), and October 2020 (after the COVID-19 state of emergency).Among participants aged ≥60 years who reported pain in October 2020, the total PA time was significantly lower than participants who did not report having pain. Furthermore, the total PA time in April 2020 was significantly lower than that in October 2019; however, no significant difference in total PA time was observed between April and October 2020. Among participants aged 40 to 59 years, no significant differences were observed in total PA times at the 3 time points between those with and without pain. In addition, the total PA time in October 2020 significantly increased compared to that in April 2020, although it significantly decreased in April 2020 compared to October 2019.This study suggests that older adults with pain have lower PA levels after the COVID-19 state of emergency.


Subject(s)
Exercise , Pain/epidemiology , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Japan/epidemiology , Male , Middle Aged , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
2.
Medicine (Baltimore) ; 100(36): e27105, 2021 Sep 10.
Article in English | MEDLINE | ID: covidwho-2191064

ABSTRACT

ABSTRACT: To assess the general Japanese population's thoughts on coronavirus disease of 2019 related discrimination by Tweets.Tweets were retrieved from search queries using the keywords "health care providers and discrimination (no hashtags)" and "corona and rural area (no hashtags)" via the Twitter application programming interface. Subsequently, a text-mining analysis was conducted on tokenized text data. R version 4.0.2 was used for the analysis.In total, 51,906 tweets for "corona and health care providers", 59,560 tweets for "corona and rural" were obtained between the search period of July 29, 2020 and September 30, 2020. The most common 20 words from the tokenized text data were translated to English. Word clouds with the original Japanese words are presented.Tweets for corona and health care providers did not suggest significant evidence of discrimination toward health care providers on Twitter. Results for corona and rural area, however, showed the unexpected word "murahachibu" (an outmoded word meaning ostracism), suggesting persistent strong social pressure to prevent bringing the disease to the community. This kind of pressure may not be supported by scientific facts. These results demonstrate the need for continued educational efforts to disseminate factual information to the public.


Subject(s)
COVID-19/epidemiology , Data Mining , Health Personnel , SARS-CoV-2 , Social Isolation , COVID-19/psychology , Humans , Japan/epidemiology , Pandemics
4.
BMJ Open ; 12(11): e064716, 2022 Nov 24.
Article in English | MEDLINE | ID: covidwho-2137773

ABSTRACT

OBJECTIVES: To examine the prevalence and the associated factors of burnout among both healthcare workers (HCWs) and the general working population, which has not yet been unknown, using large-scale, nationwide data. DESIGN: Cross-sectional internet-based study. SETTING: Nationwide internet survey conducted between 8 and 26 February 2021 in Japan. PARTICIPANTS: Workers aged 20-64 years. We classified the workers as HCWs and the general working population. EXPOSURES: Demographic characteristics (age, sex and marital status), socioeconomic status (education, employment and income), health-related, work-related and industry-related factors (smoking, alcohol use, physical and psychiatric comorbidities, working hours, types of healthcare professionals, experience on the COVID-19 frontline and working industries). MAIN OUTCOME MEASURES: Burnout defined as a score of ≥3 points on the Mini-Z Single-Item Burnout Scale. RESULTS: Of the included 12 650 workers, 1087 were HCWs. After inverse probability weighting on data from the 2016 Comprehensive Survey of Living Conditions, burnout in HCWs and the general working population was 33.5% (95% CI 29.2% to 38.0%) and 31.0% (95% CI 29.7% to 32.4%), respectively. In the weighted multivariable modified Poisson regression models, working 60 hours or more was associated with burnout in all workers (HCWs: prevalence ratio (PR) 2.52, 95% CI 1.68 to 3.76; general population: PR 1.26, 95% CI 1.07 to 1.48). Widowed/separated compared with married was associated with burnout only among HCWs (PR 1.69, 95% CI 1.16 to 2.47), whereas presence of physical or psychiatric comorbidities was associated with burnout among the general working population (PR 1.14, 95% CI 1.03 to 1.28; and PR 1.65, 95% CI 1.45 to 1.87, respectively). CONCLUSIONS: Burnout was prevalent in both HCWs and the general working population in Japan. Both common and specific risk factors were observed. Our findings highlight the need for the general workplace policy and targeted interventions for burnout prevention.


Subject(s)
Burnout, Professional , COVID-19 , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Japan/epidemiology , Pandemics , Burnout, Professional/epidemiology , Burnout, Professional/etiology , Health Personnel/psychology , Internet
6.
Front Public Health ; 10: 1008348, 2022.
Article in English | MEDLINE | ID: covidwho-2142342

ABSTRACT

Examining stock market interactions between China (mainland China and Hong Kong), Japan, and South Korea, this study employs a framework that includes 239 economic variables to identify the spillover effects among these three countries, and empirically simulates the dynamic time-varying non-linear relationship between the stock markets of different countries. The findings are that in recent decades, China's stock market relied on Hong Kong's as a window to the exchange of price information with Japan and South Korea. More recently, the China stock market's spillover effect on East Asia has expanded. The spread of the crisis has strengthened co-movement between the stock markets of China, Japan, and South Korea.


Subject(s)
COVID-19 , Humans , Japan , COVID-19/epidemiology , Republic of Korea , China , Far East
7.
Emerg Infect Dis ; 28(12): 2500-2503, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2141582

ABSTRACT

Surveillance of bat betacoronaviruses is crucial for understanding their spillover potential. We isolated bat sarbecoviruses from Rhinolophus cornutus bats in multiple locations in Japan. These viruses grew efficiently in cells expressing R. cornutus angiotensin converting enzyme-2, but not in cells expressing human angiotensin converting enzyme-2, suggesting a narrow host range.


Subject(s)
Chiroptera , Animals , Humans , Peptidyl-Dipeptidase A , Japan/epidemiology , Betacoronavirus , Host Specificity
8.
J Nutr Sci Vitaminol (Tokyo) ; 68(Supplement): S81-S83, 2022.
Article in English | MEDLINE | ID: covidwho-2141568

ABSTRACT

Cumulative evidence shows that people with lower socioeconomic status (SES) have higher risk of mortality and non-communicable diseases, which are strongly related to diet. A low diet quality may be related to a rise in chronic non-communicable diseases from childhood onward. This literature review summarizes the food assistance for reducing health disparities among children in Japan. The school lunch program in Japan is important for achieving adequate nutrient intakes in schoolchildren and reducing disparities of adequate nutrient intake by household income levels. Additionally, the number of children's cafeterias, contributing to the support of children suffering from poverty by providing free or low-cost meals in a comfortable environment, as well as being bases for multi-generational community communication, and where local children and adults eat together, has rapidly increased. Those who with lower SES tended to use food supports, such as the children's cafeteria, as well as food pantries and emergency home food deliveries, during the COVID-19 pandemic. It will be necessary to establish a public-private system that can provide information on local food assistance to people whose socioeconomic status has changed rapidly.


Subject(s)
COVID-19 , Food Assistance , Noncommunicable Diseases , Child , Adult , Humans , Japan , Pandemics , Lunch
9.
Sangyo Eiseigaku Zasshi ; 64(6): 345-353, 2022 Nov 25.
Article in Japanese | MEDLINE | ID: covidwho-2140865

ABSTRACT

OBJECTIVES: COVID-19 has led to an increased use of online consultations in occupational health. We examined experience, satisfaction, and difficulties with online consultations during the first year after the COVID-19 pandemic by surveying a sample of workers. METHODS: An online survey was conducted in March 2021 among full-time employees of an online panel survey (E-COCO-J: The Employee Cohort Study on the COVID-19 Pandemic in Japan). Respondents were asked to report whether they had online or face-to-face consultations with occupational health professionals in the past year, their level of satisfaction, and their difficulties and problems related to the online consultations. RESULTS: Of the 1,153 respondents, 1,102 (excluding those who were unemployed or on leave) were included in the analysis. Fifty respondents had had online consultations in the past year and 57 had face-to-face consultations. The proportion of respondents who reported satisfaction with online consultations was high (more than 70%) for general health, follow-ups, and guidance consultations, among others. However, the proportion of satisfaction with online occupational consultations was low (less than 40%) for employees who worked long hours, or took leave or returned to work. Over 30% of the respondents indicated that the difficulties with online consultations were due to incongruence with their expectations ("I preferred a face-to-face consultation instead of an online one"), quality of communication ("I did not feel like I was able to consult sufficiently"), and concerns about confidentiality ("I was worried that someone could hear our conversation"). CONCLUSION: The experience of online consultations was similar to that of face-to-face consultations. Satisfaction with online occupational consultations for those who worked long hours and those who took leave or returned to work was low. In the online consultation for occupational health, the occupational health professional may be required to judge its suitability depending on type of the consultation and take necessary consideration and measures to maintain the quality of the online consultation.


Subject(s)
COVID-19 , Occupational Health , Humans , Pandemics , Japan/epidemiology , Cross-Sectional Studies , Personal Satisfaction , Cohort Studies , Referral and Consultation
10.
BMC Public Health ; 22(1): 2147, 2022 11 22.
Article in English | MEDLINE | ID: covidwho-2139232

ABSTRACT

BACKGROUND: Low-income is one of the well-established determinants of people's health and health-related behavior, including susceptibility to the coronavirus disease 2019 (COVID-19) infection. Two social welfare services are available in Japan to support financial and medical care among low-income patients: Public Assistance (PA), which provide both minimum income and medical costs; and Free/Low-Cost Medical Care (FLCMC), wherein only medical costs were covered. In this study, changes in Health-Related Quality of Life (HRQOL) scores of low-income patients on PA and FLCMC, before and after COVID-19 pandemic, were described and compared against those that are not utilizing the said services (comparison group) to evaluate the contribution of social welfare services in protecting the HRQOL of the beneficiaries during the pandemic. METHODS: We used repeated cross-sectional data of adult beneficiaries of FLCMC and PA, as well as those without social welfare services, who regularly visit the Kamigyo clinic in Kyoto, Japan. We collected the data from 2018 and 2021 using a questionnaire on patients' socioeconomic attributes and the Japanese version of Medical Outcomes Study 12-Item Short Form Health Survey (SF-12). The Japanese version of SF-12 can calculate the three components scores: physical health component summary (PCS), the mental health component summary (MCS), and the role-social component summary (RCS), which can be transformed to a 0-100 range scale with a mean of 50 and standard deviation of 10. RESULTS: Data of 200 and 174 beneficiaries in 2018 and 2021, respectively, were analyzed. Low-income patients on social welfare services had lower PCS, and RCS than the comparison group in both years. Multiple linear regression analyses with cluster-adjusted standard error estimator showed that the decline in MCS was significantly higher among FLCMC beneficiaries than in those without welfare services (Beta: -4.71, 95% Confidence Interval [CI]: -5.79 to -3.63, p < 0.01), and a decline in MCS among PA recipients was also observed (Beta: -4.27, 95% CI: -6.67 to -1.87 p = 0.02). CONCLUSIONS: Low-income beneficiaries of social welfare may have experienced mental health deterioration during the COVID-19 pandemic. To maintain healthy lives during the pandemic, additional support on mental health for low-income recipients of social welfare services may be required.


Subject(s)
COVID-19 , Pandemics , Adult , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Quality of Life , Japan/epidemiology , Social Welfare
11.
Medicine (Baltimore) ; 101(46): e31937, 2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2135745

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic affected the physical and mental health, socioeconomic status, and community behavior of people worldwide. The aim of this retrospective cohort study was to analyze the impact of the COVID-19 pandemic on the oral health and nutritional status of Japanese older adults based on the results of preoperative assessment in patients who underwent total hip or knee arthroplasty under general anesthesia. This study included older adults (≧65 years) who underwent total hip or knee arthroplasty in whom orthopantomography was performed for preoperative oral health assessment, during January 2019 to December 2021. Gender, age, number of family members living together, number of teeth, body mass index, and serum total protein and serum albumin levels were collected for analysis of this study. A total of 201 patients aged 65 to 89 years participated in the study. While the COVID-19 pandemic has had no impact on the oral health status, there has been a drop in serum albumin level from the results of multivariable-adjusted regression analysis considering age, gender, number of family members, and time. The COVID-19 pandemic has affected the serum albumin level of Japanese orthopedic patients aged 65 years or older.


Subject(s)
Arthroplasty, Replacement, Knee , COVID-19 , Humans , Aged , Nutritional Status , COVID-19/epidemiology , Pandemics , Oral Health , Retrospective Studies , Japan/epidemiology , Serum Albumin/metabolism
12.
Sci Rep ; 12(1): 20347, 2022 Nov 27.
Article in English | MEDLINE | ID: covidwho-2133639

ABSTRACT

This study examined the association between coronavirus disease 2019 (COVID-19)-related stress, exercise habits, and oral health-related quality of life (OHRQoL) in a sample of 215 community-dwelling older adults in Japan (57 men, 158 women; Mage = 74.2 years, SD = 6.0). Data were collected during wellness checkups in October 2020 and included participants' demographic characteristics, measures of instrumental activities of daily living and depressive tendencies, number of teeth, oral hypofunction, OHRQoL, COVID-19-related stress, and exercise habits. Four mutually exclusive groups were created, using the presence or absence of COVID-19-related stress and lack of exercise habits as risk factors for poor OHRQoL (no COVID-19-related stress and no lack of exercise, COVID-19-related stress only, lack of exercise habits only, and both COVID-19-related stress and lack of exercise habits). Poisson regression with robust standard errors provided the prevalence ratio for poor OHRQoL. The presence of both COVID-19-related stress and lack of exercise habits (adjusted prevalence ratio: 2.20, 95% CI: 1.31- 3.69) was associated with poor OHRQoL. The results indicate that COVID-19-related stress and exercise habits should be considered when designing oral health and public health initiatives.


Subject(s)
COVID-19 , Quality of Life , Male , Humans , Female , Aged , Independent Living , Activities of Daily Living , COVID-19/epidemiology , Japan/epidemiology , Cross-Sectional Studies
13.
Front Public Health ; 10: 1042589, 2022.
Article in English | MEDLINE | ID: covidwho-2123481

ABSTRACT

Background: Forest therapy has gained popularity in Japan and even other nations/regions due to its health benefits. In addition, forest therapy has contributed to the development of circular economy and industrial upgrading. Japanese successful practice can serve as a model for other countries in the Asia-Pacific region. To this end, the aim of this study was to determine whether forest therapy can improve the whole well-being of the participants and has a positive effect on the development of circular economy in the region. Methods: Both empirical and inductive research methods were used; empirical approach was conducted to perform comparative analysis of regional data that was retrieved from the research project of Japanese Forestry Agency in 2015. Specifically, the efficacy of forest therapy on physical (blood glucose, blood pressure, body weight) and mental (sleep quality e.g.,) health outcomes among 815 participants was investigated. Regional data are from the statistics of Iiyama City from 1990 to 2005. After the concept of forest therapy became popular in the late 1990s, this element had a great positive impact on the economic benefits of Ishiyama City and other major forest scenic areas. We summarize and analyze a series of policies made by relevant departments of the Japanese government in the years from 2019 to 2021 to promote forest therapy and related circular industry development. Results: Significant (pre-to-post participation) changes in physical measure was observed. Firstly, mean weight of those overweight participants decreased across three different time points (pre-test/enrollment = 79.7 kg, 3-month participation = 77.2, and 6-month participation = 76.8 kg), while overall mean weight of the participants decreased to 61, 60.5, and 60.4 kg, respectively. Secondly, Participant with normal weight showed a decrease on mean HbA1C (from 6.09 to 6.06) at Week 24, while overweight participants demonstrated a slight change 6.03-6.01 after 6 months the average HOMA-IR for overweight participants decreased from 3.5 to 2.5 at Week 24, while participants with normal weight demonstrated a decrease from 2.2 to 1.7 at Week 24. Forest Therapy has emerged in Japan since Mid-1990s and has attracted a large number of tourists all over the world due to its unique health benefits. Conclusion: Forest therapy in Japan has positive effects on whole well-being of Japanese residents and it has helped public mental health promotion and economic growth. Under the guidance and support of government policies, it can promote the development of circular economy and industrial transformation and set a model of Japanese forest therapy development for other countries in the Asia-Pacific region.


Subject(s)
Mental Health , Overweight , Humans , Japan , Forests , Policy
14.
Viruses ; 14(11)2022 Nov 21.
Article in English | MEDLINE | ID: covidwho-2116250

ABSTRACT

An outbreak of coronavirus disease 2019 (COVID-19) occurred in a nursing home in Niigata, Japan, November 2020, with an attack rate of 32.0% (63/197). The present study was aimed at assessing the pre-vaccination seroprevalence almost half a year after the COVID-19 outbreak in residents and staff in the facility, along with an assessment of the performance of the enzyme-linked immunosorbent assay (ELISA) and the chemiluminescent immunoassay (CLIA), regarding test seropositivity and seronegativity in detecting immunoglobulin G (IgG) anti-severe acute respiratory syndrome 2 (SARS-CoV-2) antibodies (anti-nucleocapsid (N) and spike (S) proteins). A total of 101 people (30 reverse transcription PCR (RT-PCR)-positive and 71 RT-PCR-negative at the time of the outbreak in November 2020) were tested for anti-IgG antibody titers in April 2021, and the seroprevalence was approximately 40.0-60.0% for residents and 10.0-20.0% for staff, which was almost consistent with the RT-PCR test results that were implemented during the outbreak. The seropositivity for anti-S antibodies showed 90.0% and was almost identical to the RT-PCR positives even after approximately six months of infections, suggesting that the anti-S antibody titer test is reliable for a close assessment of the infection history. Meanwhile, seropositivity for anti-N antibodies was relatively low, at 66.7%. There was one staff member and one resident that were RT-PCR-negative but seropositive for both anti-S and anti-N antibody, indicating overlooked infections despite periodical RT-PCR testing at the time of the outbreak. Our study indicated the impact of transmission of SARS-CoV-2 in a vulnerable elderly nursing home in the pre-vaccination period and the value of a serological study to supplement RT-PCR results retrospectively.


Subject(s)
COVID-19 , Aged , Humans , Seroepidemiologic Studies , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , Japan/epidemiology , Retrospective Studies , SARS-CoV-2/genetics , Nursing Homes , Vaccination , Immunoglobulin G
15.
BMC Infect Dis ; 22(1): 852, 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2115838

ABSTRACT

OBJECTIVES: There is no report on antibody titers after vaccination against SARS-CoV-2 in Japanese dialysis patients. As dialysis is different between Japan and other countries, changes in antibody titers were examined. METHODS: Baseline characteristics and anti-spike protein antibody titers (Roche) over 90 days after administration of the BNT162b2 messenger RNA vaccine were investigated in dialysis patients. RESULTS: The maximum anti-spike protein antibody titer after the second dose was 738 (327 to 1143) U/mL and was reached at 19 (17 to 24) days after the second dose. Antibody titers decreased over time, with titers of 770 (316 to 1089) U/mL at 15 days, 385 (203 to 690) U/mL at 30 days, 254 (138 to 423) U/mL at 60 days, and 208 (107 to 375) U/mL at 90 days after the second dose. When an antibody titer of 137 U/mL was assumed to be a measure related to breakthrough infection, the proportion of subjects with antibody titers exceeding this level was 90.1% at 15 days, 85.3% at 30 days, 75.0% at 60 days, and 65.4% at 90 days after the second dose. When a decrease in antibody titers below the assumed breakthrough level was defined as an event, subjects with a pre-dialysis albumin ≥ 3.5 g/dL were significantly less likely to experience an event than subjects with a pre-dialysis albumin < 3.5 g/dL. CONCLUSIONS: The presence of anti-spike protein levels ≥ 313 U/mL at 30 days after the second vaccine dose might be a factor in maintaining enough antibody titers at 90 days after. Whether an additional vaccine dose is needed should be determined based on indicators serving as factors in maintaining antibody titers as well as the status of the spread of infection.


Subject(s)
COVID-19 , Vaccines , Humans , COVID-19 Vaccines , Japan , Dialysis , Antibodies, Viral , BNT162 Vaccine , Spike Glycoprotein, Coronavirus , SARS-CoV-2 , COVID-19/prevention & control , Albumins
16.
Crit Care ; 26(1): 354, 2022 Nov 15.
Article in English | MEDLINE | ID: covidwho-2115766

ABSTRACT

BACKGROUND: The survival rate of patients with critical coronavirus disease-19 (COVID-19) over time is inconsistent in different settings. In Japan, a national database was organized to monitor and share the patient generation across the country in an immediate response to the COVID-19 pandemic. This study aimed to evaluate changes in survival over time and the prognostic factors in critical COVID-19 patients receiving mechanical ventilation with/without extracorporeal membrane oxygenation (ECMO) using the largest database in Japan. METHODS: This is a prospective observational cohort study of patients admitted to intensive care units in Japan with fatal COVID-19 pneumonia receiving mechanical ventilation and/or ECMO. We developed a prospective nationwide registry covering > 80% of intensive care units in Japan, and analyzed the association between patients' backgrounds, institutional ECMO experience, and timing of treatment initiation and prognosis between February 2020 and November 2021. Prognostic factors were evaluated by Kaplan-Meier analysis and Cox proportional hazards analysis. RESULTS: A total of 9418 patients were ventilated, of whom 1214 (13%) received ECMO. The overall survival rate for ventilated patients was 79%, 65% for those receiving ECMO. There have been five outbreaks in Japan to date. The survival rate of ventilated patients increased from 76% in the first outbreak to 84% in the fifth outbreak (p < 0.001). The survival rate of ECMO patients remained unchanged at 60-68% from the first to fifth outbreaks (p = 0.084). Age of ≥ 59 (hazard ratio [HR] 2.17; 95% confidence interval [CI] 1.76-2.68), ventilator days of ≥ 3 before starting ECMO (HR 1.91; 95% CI 1.57-2.32), and institutional ECMO experiences of ≥ 11 (HR 0.70; 95% CI 0.58-0.85) were independent prognostic factors for ECMO. CONCLUSIONS: During five COVID-19 outbreaks in Japan, the survival rate of ventilated patients tended to have gradually improved, and that of ECMO patients did not deteriorate. Older age, longer ventilator days before starting ECMO, and fewer institutional ECMO experiences may be independent prognostic factors for critical COVID-19 patients receiving ECMO.


Subject(s)
COVID-19 , Extracorporeal Membrane Oxygenation , Humans , Pandemics , COVID-19/epidemiology , COVID-19/therapy , Respiration, Artificial , Japan/epidemiology , Prospective Studies , Cohort Studies , Registries , Retrospective Studies
17.
Sci Rep ; 12(1): 18934, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2113253

ABSTRACT

Body mass index (BMI) distribution and its impact on cardiovascular disease (CVD) vary between Asian and western populations. The study aimed to reveal time-related trends in the prevalence of obesity and underweight and safe ranges of BMI in Japanese patients with CVD. We analyzed 5,020,464 records from the national Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination dataset over time (2012-2019) and evaluated BMI trends and the impact on in-hospital mortality for six acute CVDs: acute heart failure (AHF), acute myocardial infarction (AMI), acute aortic dissection (AAD), ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Patients were categorized into five groups using the WHO Asian-BMI criteria: underweight (< 18.5 kg/m2), normal (18.5-22.9 kg/m2), overweight at risk (23.0-24.9 kg/m2), obese I (25.0-29.9 kg/m2), and obese II (≥ 30.0 kg/m2). Age was significantly and inversely related to high BMI for all diseases (P < 0.001). The proportion of BMI categories significantly altered over time; annual BMI trends showed a significant and gradual increase, except AAD. In adjusted mixed models, underweight was significantly associated with a high risk of in-hospital mortality in all CVD patients (AHF, OR 1.41, 95% CI 1.35-1.48, P < 0.001; AMI, OR 1.27, 95% CI 1.20-1.35, P < 0.001; AAD, OR 1.23, 95% CI 1.16-1.32, P < 0.001; IS, OR 1.45, 95% CI 1.41-1.50, P < 0.001; ICH, OR 1.18, 95% CI 1.13-1.22, P < 0.001; SAH, OR 1.17, 95% CI 1.10-1.26, P < 0.001). Moreover, obese I and II groups were significantly associated with a higher incidence of in-hospital mortality, except AHF and IS. Age was associated with in-hospital mortality for all BMI categories in six CVD patients. BMI increased annually in patients with six types of CVDs. Although underweight BMI was associated with high mortality rates, the impact of obesity on in-hospital mortality differs among CVD types.


Subject(s)
Cardiovascular Diseases , Heart Failure , Myocardial Infarction , Humans , Body Mass Index , Thinness/complications , Thinness/epidemiology , Thinness/diagnosis , Hospital Mortality , Cardiovascular Diseases/epidemiology , Japan/epidemiology , Risk Factors , Obesity/complications , Obesity/epidemiology , Obesity/diagnosis , Acute Disease , Heart Failure/epidemiology
19.
Bull World Health Organ ; 100(11): 699-708, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2113057

ABSTRACT

The demographic transition towards an ageing population and the epidemiological transition from communicable to noncommunicable diseases have increased the demand for rehabilitation services globally. The aims of this paper were to describe the integration of rehabilitation into the Japanese health system and to illustrate how health information systems containing real-world data can be used to improve rehabilitation services, especially for the ageing population of Japan. In addition, there is an overview of how evidence-informed rehabilitation policy is guided by the analysis of large Japanese health databases, such as: (i) the National Database of Health Insurance Claims and Specific Health Checkups; (ii) the long-term care insurance comprehensive database; and (iii) the Long-Term Care Information System for Evidence database. Especially since the 1990s, the integration of rehabilitation into the Japanese health system has been driven by the country's ageing population and rehabilitation is today provided widely to an increasing number of older adults. General medical insurance in Japan covers acute and post-acute (or recovery) intensive rehabilitation. Long-term care insurance covers rehabilitation at long-term care institutions and community facilities for older adults with the goal of helping to maintain independence in an ageing population. The analysis of large health databases can be used to improve the management of rehabilitation care services and increase scientific knowledge as well as guide rehabilitation policy and practice. In particular, such analyses could help solve the current challenges of overtreatment and undertreatment by identifying strict criteria for determining who should receive long-term rehabilitation services.


Tant la transition démographique vers un vieillissement de la population que la transition épidémiologique des maladies transmissibles vers les maladies non transmissibles ont entraîné une augmentation de la demande en services de réadaptation dans le monde. Le présent document poursuit plusieurs objectifs: décrire l'intégration de la réadaptation dans le système de santé au Japon, et illustrer comment les systèmes de santé contenant des données réelles peuvent être utilisés en vue d'améliorer de tels services, en particulier pour une population nipponne vieillissante. En outre, il offre un aperçu de la manière dont la politique de réadaptation étayée par des faits s'inspire de l'analyse de vastes bases de données sanitaires japonaises, parmi lesquelles: (i) la base de données nationale des demandes de remboursement au titre de l'assurance-maladie et des bilans de santé spécifiques; (ii) la base de données complète de l'assurance pour les soins longue durée; et enfin, (iii) la base de données du système d'information relatif aux attestations de soins longue durée. Le vieillissement de la population a poussé le Japon à inclure la réadaptation dans son système de santé, surtout depuis les années 1990; aujourd'hui, un nombre croissant de personnes âgées ont aisément accès à des services de réadaptation. Au Japon, l'assurance-maladie globale prend en charge la réadaptation intensive aiguë et post-aiguë (ou de rétablissement). De son côté, l'assurance pour les soins longue durée couvre la réadaptation dans les établissements dédiés et les infrastructures collectives accueillant des personnes âgées, avec pour but de contribuer à préserver l'autonomie au sein d'une population vieillissante. L'analyse de vastes bases de données sanitaires peut favoriser une meilleure gestion des services de réadaptation et accroître les connaissances scientifiques, mais aussi orienter les politiques et pratiques en la matière. Ce type d'analyse peut surtout aider à s'attaquer aux enjeux actuels que représentent les traitements excessifs ou insuffisants, en identifiant des critères stricts permettant de déterminer qui doit faire l'objet d'une réadaptation sur le long terme.


La transición demográfica hacia el envejecimiento de la población y la transición epidemiológica de las enfermedades transmisibles a las no transmisibles han aumentado la demanda de servicios de rehabilitación en todo el mundo. Los objetivos de este artículo son describir la integración de la rehabilitación en el sistema sanitario japonés e ilustrar cómo los sistemas de información sanitaria que contienen datos del mundo real se pueden utilizar para mejorar los servicios de rehabilitación, en especial para la población que envejece en Japón. Además, se ofrece una visión general de cómo la política de rehabilitación fundamentada en la evidencia se guía por el análisis de las grandes bases de datos sanitarias japonesas, como: (i) la Base de Datos Nacional de Reclamaciones al Seguro de Enfermedad y Chequeos Médicos Específicos; (ii) la base de datos integral del seguro de cuidados de larga duración; y (iii) la base de datos del Sistema de Información de Cuidados de Larga Duración para la Evidencia. En particular, desde la década de 1990, la integración de la rehabilitación en el sistema sanitario japonés se ha visto impulsada por el envejecimiento de la población del país y, en la actualidad, la rehabilitación se ofrece de forma generalizada a una cantidad cada vez mayor de adultos mayores. El seguro médico general de Japón cubre la rehabilitación intensiva aguda y posaguda (o de recuperación). El seguro de cuidados de larga duración cubre la rehabilitación en instituciones de larga estancia y centros comunitarios para adultos mayores con el objetivo de ayudar a mantener la independencia en una población que envejece. El análisis de las grandes bases de datos sanitarias puede servir para mejorar la gestión de los servicios de atención a la rehabilitación y aumentar los conocimientos científicos, así como para orientar la política y la práctica de la rehabilitación. En concreto, estos análisis podrían ayudar a resolver los problemas actuales de sobretratamiento y subtratamiento, al identificar criterios estrictos para determinar quién debe recibir servicios de rehabilitación de larga duración.


Subject(s)
Insurance, Long-Term Care , Long-Term Care , Humans , Aged , Japan , Insurance, Health , Databases, Factual
20.
Sci Rep ; 12(1): 19640, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2117426

ABSTRACT

We conducted an internet survey to assess sociodemographic variables, lifestyle factors, sleep problems, and comorbidities for sleep apnea syndrome (SAS) in COVID-19 and influenza (FLU) infections. Data from 10,323 workers (50.0% male) were analyzed. COVID-19 was diagnosed in 144 subjects (COVID-19+), and 8,693 were classified as not suspected to be infected (COVID-19-). SAS had been diagnosed in 35.4% of the COVID-19+ subjects, but only 231 (2.7%) of the 8,693 COVID-19- subjects. COVID-19+ subjects were more susceptible to FLU (35.4%) compared to COVID-19- subjects (3.0%). A multivariate analysis revealed that higher risks of COVID-19+ were linked to the following factors: going out without a face mask (OR 7.05, 95% CI 4.53-11.00), FLU+ (OR 6.33, 95% CI 3.80-10.54), excessive exercise before going to sleep (OR 2.10, 95% CI 1.63-2.70), SAS+ (OR 5.08, 95% CI 2.88-8.94), younger age (OR 1.05, 95% CI 1.03-1.07), falling sleep while sitting or talking with someone (OR 3.70, 95% CI 2.30-5.95), and use of hypnotics (OR 2.28, 95% CI 1.20-4.30). Since sleep impairment played a relatively small role in COVID-19+/SAS- subjects, we assume that SAS itself was a more significant risk factor for COVID-19 infection rather than sleep impairment. A better understanding of the mechanisms that result in increased susceptibility to COVID-19 in SAS is vital for helping prevent COVID-19.


Subject(s)
COVID-19 , Life Style , Sleep , Female , Humans , Male , COVID-19/epidemiology , Internet , Japan/epidemiology , Surveys and Questionnaires , Influenza, Human/epidemiology , Sleep Apnea Syndromes/epidemiology
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