Mental Health Status of Female Sex Workers Exposed to Violence in Yangon, Myanmar.

Female sex workers (FSWs) are at considerable risk of developing mental disorders due to the potential for violence associated with their work. However, few studies have comprehensively investigated the types of violence and their impact on the mental health of FSWs. Using data collected from 403 FSWs in Yangon, Myanmar, we investigated how various types of violence perpetrated by clients, employers, and partners affect the severity of mental disorders (anxiety and depression) among FSWs. Our results indicate that economic violence perpetrated by clients and threats of violence from partners induce severe symptoms of anxiety and depression. Furthermore, sexual and economic violence perpetrated by employers results in severe symptoms of anxiety.

Betel quid chewing and its associated factors in Myanmar: A quantitative study.

BACKGROUND: Betel quid is more widely consumed than tobacco in Myanmar. It brings adverse health effects regardless of whether it contains tobacco; however, Myanmar has no clear prevention strategy. This study aims to show a broader picture of the prevalence of betel quid chewing and the observable characteristics of its consumers in Myanmar by comparing it to tobacco usage. METHODS: This study used the 2015-2016 Myanmar Demographic and Health Survey data. First, we identified characteristics of betel quid consumers by a logit model. Next, we focused on exploring who would be likely to become heavy users, conditioned on being a betel quid consumer by controlling for possible sample selection bias. RESULTS: We found differences in characteristics for betel chewers and tobacco smokers, and for betel quid users and heavy users. CONCLUSION: These results suggest that betel quid consumption should be regulated by a specific prevention strategy rather than by Myanmar's existing tobacco prevention strategy.

Geriatric Depressive Symptoms in Myanmar: Incidence and Associated Factors.

Myanmar is one of many countries currently facing a growing older adult population; yet, the mental health status of the country's older adults is understudied. This is the first article to investigate the prevalence of geriatric depressive symptoms and its associated factors in Myanmar. We use data from the most recent large-scale older adult survey conducted in 2016, which employed the four-item short version of the Geriatric Depression Scale (GDS-4). Descriptive statistics reveal that, depending on the threshold applied, about 16% to 56% of the surveyed older adults have indications of depressive symptoms. We find that both economic and health status have a statistically significant association with depressive symptoms, but no basic individual characteristics are associated with it. Our findings suggest the importance of a social security system for older adults. Expanding the scope of the pension scheme and improving the provision of health care may be among the important policy options.

Suicide by persons with foreign background in Japan.

PURPOSE: This study examined trends in the suicide rates of persons with foreign background in Japan. METHODS: Using the nationwide death records in the Vital Statistics of Japan, we first reported the age-adjusted suicide rates of 8 foreign nationals (Brazil, China, Korea, Peru, the Philippines, Thailand, the United Kingdom, and the United States) in Japan by sex from 1980 to the mid-2010s. We also computed rate ratios to compare the suicide rate of each group with those of the Japanese population. Second, we focused on Koreans, who had the highest suicide rate in Japan. We compared the suicide rates of Koreans in Japan with Koreans in South Korea to examine whether their suicide rates were more closely related to those of their country of origin or those of their host country. RESULTS: We found that the suicide rates of Koreans and Chinese in Japan were similar to or higher than those of Japanese, while other groups tended to show lower suicide rates. Most notably, Koreans displayed consistently high suicide rates from 1980 to the mid-2010s, which were nearly twice as high as those of the Japanese population. Korean males and females in Japan had higher suicide rates than those in South Korea. CONCLUSIONS: Immigrants in Japan were not necessarily influenced by the suicide rates of the host country. The high suicide rates among Korean residents in Japan might be explained by various disadvantages and adversities that they face in Japan.

Minimum Legal Drinking Age and Youth Health: Evidence From Japan.

OBJECTIVE: Recent studies showed that reducing the minimum legal drinking age (MLDA) could cause negative health outcomes among youth. This evidence was drawn primarily from a limited set of geographical regions. This study seeks to widen available evidence by using data from Japan, where the government started considering reducing the MLDA from 20 to 18. METHOD: Using a regression discontinuity design, we compared emergency service event rates related to alcohol intoxication and mortality rates through external causes between those who were slightly younger and older than the age of 20. RESULTS: We showed that granting legal access to alcohol at age 20 doubled the use of emergency services used for alcohol intoxication but had little impact on mortality as measured by traffic fatalities, suicide, and other accidents. CONCLUSIONS: Our findings suggest that lowering the MLDA in Japan will increase (potentially reckless and excessive) drinking behavior among young adults ages 18 and 19 but will not increase their mortality from accidents.

Mothers' autonomy and childhood stunting: evidence from semi-urban communities in Lao PDR.

BACKGROUND: Childhood stunting (height-for-age z-scores below - 2), a form of chronic undernutrition, remains a global health burden. Although a growing literature has examined the association between mothers' autonomy and childhood stunting, these studies have been limited to countries in South Asia or Sub-Saharan Africa where women have relatively lower social status than do men. Little research has analyzed the effect of mothers' autonomy on childhood stunting in Lao PDR, where women's social status is relatively high compared to that in other countries. METHODS: We conducted a cross-sectional questionnaire and body scale measurement targeting 100 mothers and their 115 children (<5 years old) from semi-urban communities in Lao PDR, which is the country with the highest prevalence of childhood stunting in the Indochina region. As dimensions of women's autonomy, we measured self-esteem, self-efficacy, decision-making power, freedom of mobility, and control of money. We then analyzed how each dimension was associated with the likelihood of childhood stunting. RESULTS: The likelihood of childhood stunting was significantly lower if mothers had higher self-efficacy for health care (OR = 0.15, p = 0.007), self-esteem (OR = 0.11, p = 0.025), or control of money (OR = 0.11, p = 0.041). In contrast, mothers' decision-making power and freedom of mobility were not significantly associated with childhood stunting. CONCLUSIONS: We clarified which dimensions of women's autonomy were associated with childhood stunting in Lao PDR. A closer examination of mothers' autonomy will aid proper understanding of the determinants of childhood stunting.

School and seasonality in youth suicide: evidence from Japan.

BACKGROUND: Seasonality in youth suicide has been speculated to be associated with the school calendar, as it tends to increase at the beginning of the academic year or after a long break, but robust empirical evidence remains scarce. METHODS: We examined the nationwide death records in the Vital Statistics of Japan to investigate the seasonal patterns of suicide among youth. Our data set included 108 968 suicides by individuals who died at 6-26 years of age between 1974 and 2014 in Japan. The daily frequencies of death were plotted against the Japanese school calendar, which has little regional and temporal variations. We also estimated a Poisson regression model to uncover the cyclical patterns of suicide deaths. RESULTS: We found that the frequencies of suicide by middle school students (ages 12-15 years) and high school students (ages 15-18 years) sharply increased around the dates when a school session began in April and September. These tended to be low during school breaks. The results of regression analysis suggested middle school students were more than twice as likely to die by suicide when the summer break ended and the second semester began, compared with the baseline week in July. Similarly, the frequency of suicide for high school students also increased by ∼40% at the end of the summer break. Importantly, no such pattern was found for those aged 18-26 years. CONCLUSIONS: Our findings strongly indicate that the cyclical pattern of youth suicide is closely related to the school calendar.

Generation of dopaminergic neurons and pigmented epithelia from primate ES cells by stromal cell-derived inducing activity.

We previously identified a stromal cell-derived inducing activity (SDIA), which induces differentiation of neural cells, including midbrain tyrosine hydroxylase-positive (TH(+)) dopaminergic neurons, from mouse embryonic stem cells. We report here that SDIA induces efficient neural differentiation also in primate embryonic stem cells. Induced neurons contain TH(+) neurons at a frequency of 35% and produce a significant amount of dopamine. Interestingly, differentiation of TH(+) neurons from undifferentiated embryonic cells occurs much faster in vitro (10 days) than it does in the embryo (approximately 5 weeks). In addition, 8% of the colonies contain large patches of Pax6(+)-pigmented epithelium of the retina. The SDIA method provides an unlimited source of primate cells for the study of pathogenesis, drug development, and transplantation in degenerative diseases such as Parkinson's disease and retinitis pigmentosa.