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The present study was conducted to evaluate the protective effect of seasonal influenza vaccination on the development of influenza-like illness (ILI), as well as to investigate factors related to the development of ILI among patients in a Japanese dialysis facility. One hundred eighty-three hemodialysis (HD) patients were followed up from November 2008 to March 2009. During the follow-up period, 17 patients developed ILI. We compared the characteristics of these 17 patients to patients without ILI. Compared to the non-ILI group ( N = 166), the ILI group ( N = 17) showed a non-significantly lower rate of influenza vaccination (70.6% vs. 86.7%, P = 0.07), while any other factor did not differ between the two groups. Influenza vaccination tended to reduce the risk of ILI (Odds ratio = 0.37, 95% CI = 0.12 to 1.14, P = 0.07). The findings of the present study suggested that the influenza vaccine was 60% effective to prevent ILI among HD patients, although the effectiveness was not statistically significant. [ABSTRACT FROM AUTHOR]

Objective. The etiology of mixed connective tissue disease (MCTD) has not been elucidated in detail. Case control studies of MCTD and systemic lupus erythematosus (SLE) were conducted in order to compare factors related to these two diseases. Methods. We selected 48 MCTD and 54 SLE female patients throughout Japan from 2009 to 2010. Controls were 182 female patients who visited the clinics of general internal medicine during the study periods. Results. Smoking and walking a longer time showed an increased age-adjusted risk for MCTD as well as SLE. On the other hand, frequent intake of bread increased the risk of MCTD and high intake of green tea decreased the risk of MCTD. Even after an additional adjustment of smoking and drinking, frequent intake of bread increased the risk of MCTD, while walking increased the risk of SLE. Conclusion. The present study suggests that Westernization of dietary habits (i.e. frequent intake of bread and low intake of green tea) may increase the risk of MCTD, while walking may increase the risk of SLE (probably due to exposure to the sunlight) among Japanese females. Further studies are needed to confirm the result of the present study. [ABSTRACT FROM AUTHOR]

Objective: The incidence of kidney cancer is high in Western Europe, and Northern Europe and North America, while it is low in Asia. Although the incidence of kidney cancer in Japan is lower than the rates in the other industrialized countries, there is no doubt that it is increasing. In this paper, we would like to introduce the result of the studies, which evaluate the risk factors for kidney cancer in the Japanese population. Methods: Relevant studies were identified in the PubMed database using a combination of "Japan", "kidney cancer", "risk", "case-control" and "cohort", and in the ICHUSHI database (Japanese database) using a combination of "kidney cancer", and "risk factor". Results: Seven studies were identified in the database and one cohort study (Hirayama Cohort study) was selected from their references. These studies found a positive association with kidney cancer risk for hypertension, diabetes mellitus, kidney diseases, dialysis, cancer, obesity, fondness for fatty food, milk, black tea, driving experience, a positive family history of cancer, and the vitamin D receptor AA genotype at the Apa I. On the other hand, a negative association with the kidney cancer risk is found for an intake of starchy roots (i.e., taro, sweet potato and potato), and an educational level. Conclusion: There are twelve possible risk factors for kidney cancer and two possible preventive factors. In Japan, however, drinking black tea and milk may be a surrogate for westernized dietary habits while eating starchy roots may be a surrogate for traditional Japanese dietary habits. Additional studies may be needed to evaluate the risk factors for kidney cancer. [ABSTRACT FROM AUTHOR]

The incidence of renal cell cancer has been increasing worldwide. Although the incidence of renal cell cancer in Japan is lower than the rates in the other industrialized countries, there is no doubt that it is increasing. In this paper, we would like to introduce the result of our studies, which evaluate the risk factors for renal cell cancer in Japan. Hypertension, diabetes mellitus, kidney diseases, fondness for fatty food and black tea showed an increased risk of renal cell carcinoma while an intake of starchy roots such as taro, sweet potato and potato reduced the risk of renal cell carcinoma. In Japan, however, drinking black tea may be a surrogate for westernized dietary habits while eating starchy roots may be a surrogate for traditional Japanese dietary habits. Further studies may be needed to evaluate risk factors for renal cell cancer because the number of renal cancer cases was small in our studies in spite of a large population-based cohort study. [ABSTRACT FROM AUTHOR]

Background: Although the incidence of kidney cancer in Japan is lower than the rates in the other developed countries, there is no doubt that in Japan the incidence rate of kidney cancer has increased recently. Methods: We evaluated the risk factors of kidney cancer using the database of the Japan Collaborative Cohort (JACC) study in 62,869 subjects (25,348 men and 37,521 women). Cox-proportional hazards model was used to determine age-and-sex adjusted relative risk. Results: During the follow-up of 7.6 years, we identified 40 incident cases of kidney cancer (renal cell carcinoma). Hypertension and kidney disease were revealed as significant risk factors for kidney cancer. Both systolic and diastolic blood pressure showed a positive relation to the development of kidney cancer risk. Conclusion: The present study suggests that hypertension and kidney disease may be associated with an increased risk for the development of kidney cancer. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is reported as being a risk factor associated with kidney cancer in Western countries. The incidence of both kidney cancer and DM is lower in Japan than the other developed countries, albeit on the rise. Methods: We evaluated the risk factors for kidney cancer mortality using the database of the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) study. The analytic cohort included 46 462 males and 64 326 females aged 40–79 years old. The Cox proportional hazards model was used to determine age- and sex-adjusted relative risk and its 95% confidence intervals. Results: DM showed an increased, age- and sex-adjusted hazard ratio for kidney cancer mortality, but it failed to achieve statistical significance after controlling for other factors. Conclusion: The present study showed that DM increased the risk of kidney cancer death among the Japanese population. However, further studies may be needed to confirm the findings in the present study because DM failed to remain as a significant risk factor after controlling for other factors because of the small number of kidney cancer deaths in the present study. [ABSTRACT FROM AUTHOR]

Objectives: A few epidemiological studies have indicated that a patient's past medical history may contribute to the risk of developing idiopathic pulmonary fibrosis (IPF). A relationship between a history of selected disorders and the risk of IPF was assessed in a multicentre hospital-based case- control study in Japan. Methodology: Included in the study were 104 patients of IPF, aged 40 years or over, who had been diagnosed within the previous 2 years, in accordance with the most recent criteria. Control subjects, aged 40 years or over, consisted of 56 hospitalized patients diagnosed as having acute bacterial pneumonia and four outpatients with the common cold. Adjustment was made for age, gender, region, pack-years of smoking, employment status, occupational exposure and BMI. Results: Medical histories of hypertension, hyperlipidaemia, coronary heart disease, diabetes mellitus, hepatitis C virus infection, tuberculosis, asthma, atopic dermatitis and allergic rhinitis were not statistically significantly associated with the risk of IPF, although cases were more likely to have suffered from allergic rhinitis and less likely to have been asthmatics than control subjects. Having a child with a history of allergic rhinitis, but not of asthma or atopic dermatitis, was significantly related to an increased risk of IPE Conclusions: These findings suggest that a genetic predisposition to allergic rhinitis may be associated with an increased risk of IPE . [ABSTRACT FROM AUTHOR]

Since the 1970s, the burden of caregiving has been the subject of rather intense study, a trend that will continue with the rapid graying of populations worldwide. Since the Long-Term Care insurance system began in 2000, few cross-sectional studies have attempted to identify factors related to the feelings of burden among caregivers looking after the impaired elderly in Japan. In the present report, among 46 pairs of caregivers and impaired elderly, the elderly receiving regular nurses’ visits in Kyoto Prefecture, Japan were assessed for problems with activities of daily living, the severity of dementia, the presence of behavioral disturbance, and cognitive impairment. The caregivers were asked to complete questionnaires in relation to their feelings of burden and caregiving situation. The results indicated that caregivers of impaired elderly with behavioral disturbances were more likely to feel a ‘heavier burden.’ Those temporarily relieved of caregiving three or more hours a day were less likely to experience ‘heavier’ caregiver burden than those who were not. Moreover, caregivers who found it ‘inconvenient’ to use care services tended to be more likely to feel a ‘heavier’ caregiver burden than those who did not. Recourse to respite services, which are ideally positioned to help, proved inconvenient because of their advance reservation system. More ready access to respite services in emergencies could do much to reduce caregiver burden. [ABSTRACT FROM AUTHOR]

Abstract This longitudinal study investigates the caregiving experiences among Japanese caregivers who provided informal care at home for disabled elderly between 1998 and 1999. Forty-seven caregivers of the impaired elderly continued caregiving at home in Matsuyama Town, a rural area of northern Japan, while 18 caregivers discontinued it. The mean score of the Center for Epidemiologic Studies Depression Scale in 1998 among those who gave up caregiving was significantly higher than that of those who continued caregiving, indicating that depression predicts early discontinuation of care in the home. This is one of the few studies in Japan to suggest that initial caregiver depression is a factor in the decision to terminate care for the disabled elderly at home. [ABSTRACT FROM AUTHOR]

Objective To determine whether opinions of others may discourage the use of public services for the elderly. Design Users and non-users were compared regarding several variables including caregivers' concerns about opinions of others. Setting Matsuyama Town, located in a rural area of northern Japan. Subjects Seventy pairs of (1) elderly persons in need of care assessed by the procedure employed by the Ministry of Health and Welfare, and (2) their respective family caregivers. Measures Cognitive function (Hasegawa Dementia Rating Scale), diagnosis of dementia, activities of daily living (ADL: Barthel Index), caregivers' burden (Zarit Caregiver Burden Interview), behavioral disturbances (Dementia Behavioural Disturbance Scale), caregiver interviews. Results A logistic regression analysis revealed that those who looked after the elderly with severe dependency in ADL were three times more likely to use public services (OR = 3.33, 95% CI = 1.02 – 10.88, p = 0.04). Those concerned about what others think or say were less likely to use public services (OR = 0.22, 95% CI = 0.06 – 0.78, p = 0.01) than those who did not. Conclusions Caregivers' undue concern for the opinions of others apparently deterred them from using public services. The overriding notion of care for the elderly as a family duty is still prevalent in rural Japan. It would be useful for the government to launch a public awareness programme to help caregivers understand the benefits of services available for the elderly. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

AbstractA case-control study was conducted to evaluate the factors associated with admission to a geriatric hospital. Case studied were 13 Japanese elderly who were admitted to a geriatric hospital because their female caregivers had found it impossible to look after them at home. We used 35 pairs of elderly and female caregivers, who were receiving domiciliary visits by nurses, in the catchment area of the hospital. The present study revealed that elderly with dementia (vs without; Odds ratio = 6.69) and with moderately limited activities of daily living (Barthel Index 61 +) (vs severely limited activities of daily living: Barthel Index 0–60; Odds ratio = 6.62), caregivers being a daughter-in-law (vs other kinship; Odds ratio = 6.30), were risk factors. [ABSTRACT FROM AUTHOR]

AbstractThe present study was conducted in an attempt to investigate factors related to depression of caregivers who looked after the disabled elderly residing in a community in southern Japan. A questionnaire survey was carried out of 45 pairs of caregivers and the disabled elderly who received regular visits from a practice nurse, who was located in Onga County, Fukuoka, in southern Japan. Twenty-four out of 45 caregivers (53.3%) scored above the conventional cut-off of the Center for Epidemiologic Studies Depression Scale (CES-D). The proportion of children-in-law caregivers was significantly smaller (0% vs 23.8%, P = 0.01) and the proportion of caregivers who had consulted a physician within 1 month prior to the study was greater in the depressed than that in the non-depressed (79.2% vs 47.6%, P = 0.03). The elderly whose caregivers were depressed (group 1) had more behavioural disturbances than those of the non-depressed caregivers (group 2) (1.92 ± 2.38 vs 0.52 ± 0.87, P = 0.01) A multiple logistic regression analysis revealed that only behavioural disturbance was positively related to depression (odds ratio: 4.29, 95% confidence interval: 1.28–14.37). More behavioural disturbances led the caregivers to depression or the depressed caregivers failed to take care of the elderly, which resulted in an increase in the number of the behavioural disturbances of the elderly. [ABSTRACT FROM AUTHOR]

A dramatic increase in the number of elderly people in Japan has led to a concurrent increase in the number of frail elderly in need of care. It is estimated that the number of frail elderly will reach 3.9 million by the year 2010. Family members are often both physically and mentally burdened with caring for the frail elderly. The present study was conducted to identify the risk factors for institutionalization among the frail elderly receiving in-home care in Japan. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Twenty-four community residing elderly people in need of care, who were registered with the municipal welfare center in Miyagi Prefecture, Japan, and their principal caregivers participated in the study. The principal caregivers completed a self-administered questionnaire involving their demographic status, provided data on their utilization of formal services and completed the Center for Epidemiologic Studies Depression Scale (CES-D). The health visitors examined the activities of daily living (ADL) and mental status of these 24 elderly individuals. More than half the caregivers appeared to be depressed. The non-depressed caregivers used significantly more services than the depressed caregivers even after the caregivers' age was statistically controlled. [ABSTRACT FROM AUTHOR]

This paper covers our recent work regarding cross-sectional studies on caregiver burden, changes in caregiver burden, appropriateness of the LTC insurance assessment scheme, attitude towards caregiving among caregivers, and the development of the short version of the Japanese version of the Zarit Caregiver Burden Interview (J-ZBI_8). [ABSTRACT FROM AUTHOR]

Background. Health education and screening are two components of preventive health services in Japan since 1983. This study investigated their relationships with all-cause mortality as they are studied insufficiently in Hokkaido, Japan.Methods. This study enrolled 1,532 men and 1,653 women aged 40–97 years from 1,702 randomly selected households of 60 areas during 1984–1985 and followed them until 2002. At baseline survey, staffs of 45 health centers collected sociodemographic, medical, behavioral, and dietary information including health education and screening from study subjects with informed consent.Results. For men, age-adjusted Cox proportional hazard model indicated lower mortality for those who received health education (RR = 0.76, P < 0.01) and screening (RR = 0.83, P < 0.05) than those who did not. Health education showed lower mortality even after adjusting for many variables. Similarly for women, health education (RR = 0.66, P < 0.01) and screening (RR = 0.64, P < 0.001) revealed lower age-adjusted mortality. Almost similar results were found for both services when models were adjusted for many variables and when the deaths including lost to follow-up cases of the first 4 years of baseline survey are excluded.Conclusions. This study shows protective effects of health education and screening over all-cause mortality for both sexes. However, further studies are needed to confirm the results. [Copyright &y& Elsevier]