Excess suicides in Japan: A three-year post-pandemic assessment of gender and age disparities.

This study offers an in-depth analysis of Japan's suicide trends three years after the COVID-19 outbreak. Using data from the National Police Agency (January 2010-May 2023), we examined suicide rates across genders and age groups. Employing the quasi-Poisson regression, we predicted monthly death counts. Findings indicate a steady rise in female suicides from April 2020 to January 2023. Notably, male cohorts aged 50-59 and over 80 in 2022 displayed heightened death rates. While these trends may reflect the impacts of the pandemic, it is essential to consider other factors, including socio-economic changes, to fully understand the context of Japan's suicide patterns.

Changes in Place of Death among Patients with Dementia during the COVID-19 Pandemic in Japan: A Time Series Analysis.

BACKGROUND: A key measure of the effectiveness of end-of-life care is the place of death. The COVID-19 pandemic affected end-of-life care and the circumstances of patients with dementia. METHODS: This observational, retrospective cohort study used Japanese national data to examine the numbers and locations of reported deaths among patients with dementia older than 65 years during the COVID-19 pandemic. Locations were grouped as medical institutions, nursing facilities, homes, or all the above. The quasi-Poisson regression model known as the Farrington algorithm was employed. RESULTS: Between December 30, 2019, and January 29, 2023, 279,703 patients who died of causes related to dementia were reported in Japan. A decline was seen in early 2020, followed by increased numbers of deaths in homes, medical facilities, and nursing homes beginning in October 2020, December 2020, and March 2021, respectively. In 2021, the percentage of excess deaths at home peaked at 35.2%, while in 2022, those in medical facilities and nursing homes peaked at 18.8% and 16.6%, respectively. In 2022, the percentage of excess deaths in nursing homes exceeded that of other locations. CONCLUSIONS: The results suggest a change in the preferred place of death, along with pandemic-related visitation restrictions among healthcare facilities. Excess deaths also suggest strained medical resources and limited access to care. Methodological limitations include data from a limited period (2017 onwards) and post-2020 data used to estimate data after 2021, albeit with weighting. Considering these findings, physicians should reconfirm preferred places of death among older patients with dementia.

Early Outcomes of Changes to Collection of Suicide Data in Japan.

This cross-sectional study examines implications of updated categorizations for suicide data collection in Japan.

Effectiveness of psychological first aid in infectious disease pandemics: An overview of systematic reviews.

There is insufficient research on the usefulness of psychological interventions, such as psychological first aid (PFA), during outbreaks. We searched for and critically appraised systematic reviews that examined the effectiveness of PFA during infectious disease outbreaks, such as the novel coronavirus disease (COVID-19). Systematic reviews that examined the efficacy of PFA in the severe acute respiratory syndrome, Middle East respiratory syndrome coronavirus, Ebola virus disease, and COVID-19 outbreaks were searched through PubMed on February 19, 2021. The three included systematic reviews were critically appraised and assessed using AMSTAR-2. One review's overall confidence in its findings was evaluated as "high," which suggested that PFA training had a favorable effect on healthcare personnel. Furthermore, the review also demonstrated that PFA was commonly used during outbreaks and could be delivered through multiple methods, such as a phone or video call. Although it was anticipated that PFA would improve subjective well-being, reports showed no evidence of reduced depression or insomnia. Future studies should examine additional numbers of PFA recipients and conduct quasi-experimental studies to better understand the effectiveness of PFA. Evidence on its effectiveness in infectious disease outbreaks is still lacking, along with research and evaluation methods. Quasi-experimental studies, such as comparisons with other psychological interventions, are required to better understand the effectiveness of PFA.

Facilitators and barriers in implementing the nurse practitioner role in Japan: A cross-sectional descriptive study.

AIM: To investigate the distribution of nurse practitioners (NPs) across Japan and their perceived facilitators and barriers to NP implementation in Japan. BACKGROUND: NP certification examinations have been conducted in Japan since 2011, and by 2020, there were 487 NPs in the country. The momentum of NP implementation is slower in Japan compared with other countries. METHODS: A cross-sectional descriptive study, following the STROBE guidelines, was conducted. Web-based survey questionnaires, developed by the authors, were administered to 248 NPs whose email addresses were maintained by the certification management body. RESULTS: Valid responses were obtained from 101 NPs (response rate: 40.7%), of which 34% were male. The respondents had more than 12 years of registered nurse experience on an average before enrolling in the graduate NP program. 53% were employed as NPs from the beginning, while 25% were initially employed as registered nurses and later advanced to NPs, and 11% still worked as RNs. A majority worked in hospitals with beds. Many NPs perceived the lack of NP national licensure and reimbursement benefits as barriers to NP implementation, whereas recognition from superiors and organizations was considered facilitators. CONCLUSIONS: Despite their small numbers in Japan, NPs take on crucial tasks and contribute to the appropriate distribution of medical resources. The NP licensure system and recognition from superiors and organizations may be necessary to promote NP roles in Japan. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Some certified NPs still work as registered nurses. Recognition from nursing and organization administrators is critical to implementing NPs. To this end, a reimbursement system benefiting the organizations and a legislation facilitating NP employment are required.

Publication Rate in English of Abstracts Presented at the Annual Meeting of the Japanese Society of Psychiatry and Neurology.

BACKGROUND: Relatively low publication rates of abstracts presented at scientific meetings (i.e., 37.3%, 95% CI: 35.3-39.3) have been reported across various fields worldwide. However, no study has investigated the publication rate of abstracts presented at psychiatric meetings and factors associated with full publication in Japan. This study aimed to determine the proportion of conference abstracts in the psychiatric field that reach full publication in English and its associated factors in Japan. METHODS: A retrospective study was conducted to determine the publication rate of abstracts presented at the annual meetings of the Japanese Society of Psychiatry and Neurology (JSPN) in 2013 and 2014, the largest psychiatric meeting in Japan, by searching for full-text publications in PubMed and Google Scholar. Furthermore, we examined factors associated with a successful full publication of the conference abstract. RESULTS: Of the 737 abstracts evaluated, 132 (17.9%) were published in peer-reviewed journals; the publication rates for oral and poster presentations were 12.7% (46/363) and 23.0% (86/374), respectively. In multivariate logistic regression analyses, the following factors were significantly associated with successful publications: poster presentations (odds ratio [OR]: 1.67, 95% CI: 1.10-2.57), original studies (OR: 4.16, 95% CI: 2.44-7.47), and academic institutions (OR: 5.77, 95% CI: 3.44-10.19). CONCLUSIONS: The publication rate in English of the conference abstracts presented at the JSPN annual meetings was relatively lower than those in previous studies. Further encouragement of the publication of the abstracts presented in psychiatric conferences in Japan would be helpful in disseminating scientific findings in the field of psychiatry. This article is protected by copyright. All rights reserved.

Reasons for Suicide During the COVID-19 Pandemic in Japan.

Importance: Although the suicide rate in Japan increased during the COVID-19 pandemic, the reasons for suicide have yet to be comprehensively investigated. Objective: To assess which reasons for suicide had rates that exceeded the expected number of suicide deaths for that reason during the COVID-19 pandemic. Design, Setting, and Participants: This national, population-based cross-sectional study of data on suicides gathered by the Ministry of Health, Labor, and Welfare from January 2020 to May 2021 used a times-series analysis on the numbers of reason-identified suicides. Data of decedents were recorded by the National Police Agency and compiled by the Ministry of Health, Labor, and Welfare. Exposure: For category analysis, we compared data from January 2020 to May 2021 with data from December 2014 to June 2020. For subcategory analysis, data from January 2020 to May 2021 were compared with data from January 2019 to June 2020. Main Outcomes and Measures: The main outcome was the monthly excess suicide rate, ie, the difference between the observed number of monthly suicide deaths and the upper bound of the 1-sided 95% CI for the expected number of suicide deaths in that month. Reasons for suicide were categorized into family, health, economy, work, relationships, school, and others, which were further divided into 52 subcategories. A quasi-Poisson regression model was used to estimate the expected number of monthly suicides. Individual regression models were used for each of the 7 categories, 52 subcategories, men, women, and both genders. Results: From the 29 938 suicides (9984 [33.3%] women; 1093 [3.7%] aged <20 years; 3147 [10.5%] aged >80 years), there were 21 027 reason-identified suicides (7415 [35.3%] women). For both genders, all categories indicated monthly excess suicide rates, except for school in men. October 2020 had the highest excess suicide rates for all cases (observed, 1577; upper bound of 95% CI for expected number of suicides, 1254; 25.8% greater). In men, the highest monthly excess suicide rate was 24.3% for the other category in August 2020 (observed, 87; upper bound of 95% CI for expected number, 70); in women, it was 85.7% for school in August 2020 (observed, 26; upper bound of 95% CI for expected number, 14). Conclusions and Relevance: In this study, observed suicides corresponding to all 7 categories of reasons exceeded the monthly estimates (based on data from before or during the COVID-19 pandemic), except for school-related reasons in men. This study can be used as a basis for developing intervention programs for suicide prevention.

Spatial statistical analysis of regional disparities in suicide among policy units in Japan: Using the Bayesian hierarchical model.

Suicide prevention is a crucial policy issue in Japan to be addressed nationally. Nevertheless, if there are regional differences in suicide, even in adjacent sub-regions, measures may need to be taken at the sub-regional level. Previous studies have not compared regional differences in suicide based on the size of policy units, such as prefectures, secondary medical areas, and municipalities. This study used the number of suicides from open data for 10 years from 2009 to 2018 to obtain shrinkage estimates of the standardized mortality ratio (SMR) using the Bayesian hierarchical model. We visualized and compared the regional disparities in suicide for each policy unit. For each gender and policy unit, adjacent regions had similar clusters of SMRs and positive spatial autocorrelation of global Moran's I (p < 0.001 for each). Comparisons between each policy unit showed that even if the SMR was low for the prefectural units, there were regions with high SMRs in municipalities and secondary medical areas, and vice versa. It was found that assessing suicide solely on a prefecture-by-prefecture basis may overlook regional disparities in suicide. This research emphasizes the need to establish suicide indicators at the secondary medical or municipal level and execute individual suicide prevention interventions in neighboring communities. Prefectures can also play a role in developing collaborative cooperation between neighboring regions by acting as actors.

Correction to: Association between NAT2, CYP1A1, and CYP1A2 genotypes, heterocyclic aromatic amines, and prostate cancer risk: a case control study in Japan.

Following publication of the original article [1], the authors reported a correction in the units in the methods section under "Subjects".

Association between NAT2, CYP1A1, and CYP1A2 genotypes, heterocyclic aromatic amines, and prostate cancer risk: a case control study in Japan.

BACKGROUND: Heterocyclic aromatic amines (HAAs) may confer prostate cancer risk; however, the evidence is inconclusive and the activity of HAA-metabolizing enzymes is modulated by gene variants. The purpose of our study was to determine whether there was evidence of an association between HAA intake, polymorphisms in NAT2, CYP1A1, and CYP1A2 and prostate cancer risk in Japanese men. METHODS: Secondary data analysis of an observational case control study was performed. Among 750 patients with prostate cancer and 870 healthy controls, 351 cases and 351 age-matched controls were enrolled for analysis. HAA intake was estimated using a food frequency questionnaire and genotypes were scored by TaqMan real-time PCR assay. Logistic regression analysis was conducted according to affected/control status. RESULTS: We found that high HAA intake was significantly associated with an increased risk of prostate cancer (odds ratio (OR), 1.90; 95% confidence interval (95% CI), 1.40-2.59). The increased risk of prostate cancer was observed among individuals with the NAT2 slow acetylator phenotype (OR, 1.65; 95% CI, 1.04-2.61), CYP1A1 GA + GG genotype (OR, 1.27; 95% CI, 1.02-1.59), and CYP1A2 CA + AA genotype (OR, 1.43; 95% CI, 1.03-2.00). In addition, CYP1A1 GA + GG genotypes were associated with increased cancer risk in low (OR, 2.05; 95% CI, 1.19-3.63), moderate (OR, 1.72; 95% CI, 1.07-2.76), and high (OR, 2.86; 95% CI, 1.83-4.47) HAA intake groups. CONCLUSIONS: Our results suggest that high HAA intake is a risk factor of prostate cancer, and genotypes related to HAA metabolic enzymes can modulate the degree of the risk.

Associations between estrogen receptor genetic polymorphisms, smoking status, and prostate cancer risk: a case-control study in Japanese men.

OBJECTIVE: Prostate cancer (PCa) is one of the major causes of death among men. Our study investigated the association of ESR1 and ESR2 genotypes with susceptibility to PCa in relation to smoking status in Japanese. METHOD: A case-control study was performed with 750 Japanese prostate cancer patients and 870 healthy controls. After age-matching in case-controls, 352 controls and 352 cases were enrolled in this study. By using logistic regression analysis, the different genotypes from ESR1 and ESR2 were analyzed according to case/control status. RESULT: ESR2 rs4986938 AG and AG + AA genotypes were associated with significantly decreased risk of PCa (AG: OR = 0.68, 95 % CI 0.47-0.97, P < 0.05 and AG + AA: OR = 0.67, 95 % CI 0.47-0.94, P < 0.05). However, there was no significant association between ESR1 rs2234693 and PCa risk. When patients were grouped according to smoking status, the ESR2 rs1256049 AA genotype (OR = 0.48, 95 % CI 0.25-0.95, P < 0.05) and ESR2 rs4986938 AG + AA genotype (OR = 0.64, 95 % CI 0.41-1.00, P < 0.05) showed significantly decreased PCa risk in the ever-smoker group. CONCLUSION: Our results suggest that the estrogen receptor ESR2 has a very important function to predict PCa and that different SNPs have different predictive values. Smoking may influence estrogenic activity and may influence PCa together with the estrogen receptor.