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An increase in the number of herpes zoster patients has been reported since universal varicella immunization was introduced, perhaps because of reduced opportunities for varicella patients to experience the natural booster effect caused by reexposure. We investigated recent trends of varicella zoster virus (VZV)–related central nervous system (CNS) infections at a university hospital in Japan. We enrolled patients with suspected CNS infection during 2013–2022 and tested cerebrospinal fluid samples by real-time PCR for DNA from 7 human herpesviruses. VZV DNA was the most commonly detected in 62 (10.2%) of 615 patients. Kulldorff’s circular spatial scan statistics demonstrated a significant temporal cluster of patients with VZV-related CNS infections during 2019–2022 (p = 0.008). Among persons with such infections, the percentage with aseptic meningitis was significantly higher during 2019–2022 (86.8%), when the temporal cluster of cases occurred, than during 2013–2018 (50.0%) (p = 0.0029).

Abstract Background The association between chronotype and leisure-time physical activity (LTPA) remains unclear. We investigated the difference in regular LTPA and for a sufficient duration between those with evening-type (ET) and morning-type chronotypes (MT). Methods We conducted a cross-sectional analysis using the data of the Aichi Workers’ Cohort Study. It included 3,221 men (mean [standard deviation] age: 45.0 [11.6] years) and 1,294 women (39.8 [11.2] years). Chronotypes were determined with the reduced version of the Morningness-Eveningness Questionnaire. We calculated the metabolic equivalents (METs) consumed per week based on the four types of LTPA: strolling, brisk walking, light- and moderate-intensity PA, and vigorous-intensity PA. Regular LTPA and for a sufficient duration was defined as doing once or more per week and for 30 min or longer per session, respectively. Logistic regression analysis was conducted separately by sex to calculate odds ratios of ET for regular LTPA and for a sufficient duration, adjusted for age and other factors, for each type of LTPA. Results ET men consumed fewer total METs per week than MT men (p

Background: The term “nonrestorative sleep (NRS)” refers to an unrefreshed feeling at wake-up and is a domain of poor sleep quality. Previous research has demonstrated that NRS is linked to a number of diseases and adverse health outcomes, but less is known regarding the link between NRS and diabetes, particularly in Japanese. Methods: We studied 3,665 middle-aged male participants of the Aichi Workers’ Cohort Study who were followed-up from 2002 through 2019. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of incident type 2 diabetes mellitus (T2DM) in relation to NRS adjusted for potential confounding variables. Results: During a median follow-up of 14.6 years, 421 type 2 diabetes cases were identified. Participants with NRS had a higher crude incidence rate of T2DM (11.2/1,000 person-years), compared to participants without NRS (9.3/1,000 person-years). In the fully adjusted model, individuals who reported having NRS had a significantly higher risk of developing T2DM (HR1.36; 95% CI, 1.10–1.67). The association was observed only in participants under 50 years old (HR 1.82; 95% CI, 1.36–2.43), not in the older (50 years or older) participants (P for interaction = 0.025). In contrast, stratified analyses by the presence of shift work, obesity, or sleep duration showed similar associations in all the strata. Conclusion: NRS was associated with higher risk of T2DM in middle-aged Japanese male workers independent of a variety of lifestyle factors and other sleep problems.

Objective: This study examined the longitudinal association of perceived stress, ikigai, and having someone one can count on in middle age with the advanced-level functional competency in older age, which is crucial for the maintenance of independent life among older adults. The issue is especially relevant in super-aged countries like contemporary Japan, where more and more older people live in a household consisting only of older people. Methods: Data were collected in 2019 from a total of 1692 retirees of the Aichi Workers’ Cohort Study participants in which baseline survey including psychological factors was conducted during their employment in 2002. Japan Science and Technology Agency Index of Competence (JST-IC) was used to measure the advanced-level functional competency. Multivariable-adjusted odds ratios (ORs) were obtained for having low JST-IC in later life by the degrees of psychological factors reported in the middle age adjusting for the presence of depressive mood in 2019. Results: Those who were not sure about ikigai (OR: 2.02, 95 % CI: 1.33 to 3.08) and who have no one to count on (OR: 2.19, 95 % CI: 1.52 to 3.16) in the middle age were significantly associated with low JST-IC after retirement. Having much stress was significantly inversely associated with a low JST-IC (OR: 0.69, 95 % CI: 0.50 to 0.97). Conclusion: Having ikigai and someone reliable, and stress during middle age might play a role in preventing impaired advanced-level functional competency. Improved ikigai and increased social interaction and support might improve functional competency. Further research might explore avenues for improving ikigai.

BackgroundIn Japan, challenges were reported in accurately estimating the prevalence of schizophrenia among the general population. Retrieving previous studies, we investigated that patients with schizophrenia were more likely to experience poor subjective well-being and various physical, psychiatric, and social comorbidities. These factors might have great potential for precisely classifying schizophrenia cases in order to estimate the prevalence. Machine learning has shown a positive impact on many fields, including epidemiology, due to its high-precision modeling capability. It has been applied in research on mental disorders. However, few studies have applied machine learning technology to the precise classification of schizophrenia cases by variables of demographic and health-related backgrounds, especially using large-scale web-based surveys. ObjectiveThe aim of the study is to construct an artificial neural network (ANN) model that can accurately classify schizophrenia cases from large-scale Japanese web-based survey data and to verify the generalizability of the model. MethodsData were obtained from a large Japanese internet research pooled panel (Rakuten Insight, Inc) in 2021. A total of 223 individuals, aged 20-75 years, having schizophrenia, and 1776 healthy controls were included. Answers to the questions in a web-based survey were formatted as 1 response variable (self-report diagnosed with schizophrenia) and multiple feature variables (demographic, health-related backgrounds, physical comorbidities, psychiatric comorbidities, and social comorbidities). An ANN was applied to construct a model for classifying schizophrenia cases. Logistic regression (LR) was used as a reference. The performances of the models and algorithms were then compared. ResultsThe model trained by the ANN performed better than LR in terms of area under the receiver operating characteristic curve (0.86 vs 0.78), accuracy (0.93 vs 0.91), and specificity (0.96 vs 0.94), while the model trained by LR showed better sensitivity (0.63 vs 0.56). Comparing the performances of the ANN and LR, the ANN was better in terms of area under the receiver operating characteristic curve (bootstrapping: 0.847 vs 0.773 and cross-validation: 0.81 vs 0.72), while LR performed better in terms of accuracy (0.894 vs 0.856). Sleep medication use, age, household income, and employment type were the top 4 variables in terms of importance. ConclusionsThis study constructed an ANN model to classify schizophrenia cases using web-based survey data. Our model showed a high internal validity. The findings are expected to provide evidence for estimating the prevalence of schizophrenia in the Japanese population and informing future epidemiological studies.

Background: There is limited evidence regarding the relationship between Diabetes mellitus (DM) in middle age and mild cognitive impairment after a follow-up. Therefore, we investigated the relationship between fasting blood glucose (FBG) levels in middle age and cognitive function assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in later life, following over 15 years of follow-up in the Aichi Workers’ Cohort Study in Japan. Methods: Participants were 253 former local government employees aged 60–79 years in 2018 who participated in a baseline survey conducted in 2002. Using baseline FBG levels and self-reported history, participants were classified into the normal, impaired fasting glucose (IFG) and, and DM groups. Total MoCA-J score ranges from 0 to 30, and cognitive impairment was defined as MoCA-J score ≤25 in this study. A general linear model was used to estimate the mean MoCA-J scores in the FBG groups, adjusted for age, sex, educational year, smoking status, alcohol consumption, physical activity, body mass index, systolic blood pressure, total cholesterol, and estimated glomerular filtration rate. Results: The mean MoCA-J score in the total population was 25.0, and the prevalence of MoCA-J score ≤25 was 49.0%. Multivariable-adjusted total MoCA-J scores were 25.2, 24.8, and 23.4 in the normal, IFG, and DM groups, respectively. The odds ratio of MoCA-J score ≤25 in the DM group was 3.29. Conclusion: FBG level in middle age was negatively associated with total MoCA-J scores assessed later in life, independent of confounding variables.

Background: No studies have examined the associations between adult height and ischemic stroke subtypes. Methods: We conducted a population-based case-control study that included 2,451 thrombotic and 687 embolic stroke cases, as well as 1,623 intracerebral and 768 subarachnoid hemorrhage cases without history of stroke aged 40–79 years, and the same number of sex- and age-matched controls. Cases and controls were grouped according to the quintile cut-off values of height in controls, and the third quintile, which was approximately the average height group, was used as the reference group. Height divided by one standard deviation of height in controls was also examined as a continuous variable. The analyses were carried out separately for participants aged 40–59 years and 60–79 years. Results: In both younger and older men, height was linearly inversely associated with total and thrombotic strokes, and the shortest quintile compared to the reference group was associated with increased risks of these strokes. Although height was linearly inversely associated with embolic stroke and intracerebral hemorrhage in younger men, the shortest quintile did not show increased risks of these strokes. Height did not seem to be associated with total stroke and any stroke subtypes in younger women. In contrast, the tallest quintile was significantly associated with increased risks of total stroke and intracerebral hemorrhage, and height tended to be positively associated with these strokes in older women. Conclusion: We reported the associations between adult height and ischemic stroke subtypes for the first time, which differed according to sex and age group.

Abstract Aim Care for people with schizophrenia is shifting the locus from long‐stay mental hospitals to nonspecialized community‐based settings. Knowledge on the care is not a sole property of psychiatric specialists. Community healthcare workers who do not specialize in psychiatry are recommended to learn more about schizophrenia. This review aimed to summarize recent findings on subjective well‐being and physical, psychiatric, and social comorbidities in individuals with schizophrenia. Methods A literature review was conducted. We retrieved findings from existing systematic reviews and meta‐analyses as our preferred method. When data were not available, we referred to other types of studies. Results As per our review, individuals with schizophrenia demonstrated poor subjective well‐being, happiness, and life satisfaction despite individual differences. Pharmacotherapy caused weight gain and constipation, whereas race and hospitalization might affect weight reduction. Individuals with schizophrenia demonstrated poor oral health, a high prevalence of noncommunicable diseases, and unique eating behaviors. Depression, sleep disorders, smoking, and alcohol and drug consumption were frequently found in the individuals. Research findings regarding problematic internet and smartphone use and stress perception were limited. Low health literacy and neglect of preventable behaviors were frequently seen in individuals with schizophrenia. They tended to be less educated, poor, unemployed, unmarried/unattached, and had poor social cognition, resulting in little social support and a small social network. Conclusion Retrieving recent data, we confirmed that individuals with schizophrenia had poor subjective well‐being and suffer from various physical, psychiatric, and social comorbidities.

Abstract The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on mental well-being. Vaccination may have played a pivotal role in enduring this mental health crisis. The present study aimed to longitudinally investigate the association between COVID-19 vaccination and mental health status among Japanese population in 2021. Longitudinal data of 17,089 individuals aged 15–79 years who participated in a nationwide online study were analyzed. Baseline and follow-up mental health statuses were assessed using the Kessler Psychological Distress Scale (K6). General linear and multivariable logistic regression models adjusted for baseline levels of mental distress were used to examine the association between vaccine receipt and follow-up levels of mental health. Mean K6 scores were lower in the vaccinated than in the non-vaccinated participants. Those who had received one or two doses of COVID-19 vaccines were associated with improved mental health at follow-up in subjects with psychological distress at baseline (odds ratio [OR] 1.31 and 1.35, respectively) and were inversely associated with deteriorated mental health status at follow-up in subjects without psychological distress at baseline (OR 0.66 and 0.70, respectively) compared with no vaccination groups, respectively. The present study would indicate that one or two doses of COVID-19 vaccinations contributed to mental well-being in Japan. This finding might provide evidence for promoting vaccination against COVID-19 and emerging infectious diseases in the future.

Abstract Background Low back pain (LBP) is one of the most common musculoskeletal problems affecting daycare (nursery) workers. We aimed to identify the psychosocial factors influencing LBP in daycare workers. Methods We conducted a prospective cohort study with a one-year observation period. The baseline sample was a convenience sample of 444 daycare workers from 34 daycare facilities in Nagoya, Japan, and its suburbs. All the data were collected through a questionnaire survey. The question “Where are you currently feeling LBP?” was used to determine whether the subjects suffered from LBP. We examined the prospective relationships of the psychosocial work characteristics, i.e., high job strain, low social support, effort-reward imbalance, and overcommitment, at baseline and LBP after one year. We used multiple logistic regression analyses to calculate the odds ratios of psychosocial work characteristics for the persistence and onset of LBP, adjusted for age, sex, body mass index, smoking, employment status, occupation, and working schedule. Results At baseline, 270 (60.8%) subjects suffered from LBP. Of 208 who also gave information on LBP one year later, 176 (84.6%) suffered from the persistence of LBP. Low social support at baseline was significantly related to persistent LBP one year later. The incidence of persistent LBP was 89.9% and 80.0% among those with and without low social support at baseline, respectively. The adjusted odds ratio (95% confidence interval) of low social support at baseline for the persistence of LBP was 2.43 (1.01–5.87). Of 150 who were without LBP at baseline and provided information on LBP one year later, 45 (30.0%) suffered from the onset of LBP. None of the psychosocial work characteristics showed significant relationships with the onset of LBP one year later. Conclusion Low social support was related to the persistence, but not to the onset of LBP in a prospective cohort analysis among daycare workers in Japan. High job strain, ERI, or overcommitment did not show a significant prospective effect on LBP.

Objectives: The influence of habitual alcohol consumption on insomnia symptoms in healthy workers remains unclear. In this study, we evaluated the association between habitual alcohol consumption among civil servants and insomnia symptoms such as difficulty falling asleep, difficulty staying asleep, and tiredness after sleep, using longitudinal data. Methods: We enrolled civil servants in a prospective cohort study who completed questionnaires at baseline. Of those, 2861 participants were revaluated in a 5-year follow-up survey. Insomnia symptoms during the past month were assessed using self-reporting. Alcohol drinking habits were assessed by querying the frequency of drinking alcohol as well as the amount of alcohol usually consumed per one occasion. Results: Drinking alcohol every day was less likely to have difficulty falling asleep (odds ratio, 0.42 95% confidence interval, 0.20–0.89), and drinking alcohol 3 or more days a week was associated with difficulty staying asleep (odds ratio, 1.48; 95% confidence interval, 1.16–1.90). Conclusions: Drinking alcohol every day may produce subjective improvement in sleep onset. However, drinking alcohol 3 or more days a week may increase arousal during sleep, which contributes to reduced sleep quality. These results suggest the possibility that long-term daily habitual drinking may reinforce a sense of improvement in subjective sleep onset but may possibly induce sleep disturbance.

Abstract Background Healthcare-related adverse events occur because of complex healthcare systems. The patient safety reporting system is a core component of patient safety initiatives in hospitals. However, hospital management often encounters a cultural barrier with its implementation and struggles to overcome the same. Implementation science would be useful for analysing implementation strategies. This study determines the effects of the implemented strategy on an increase in the number of patient safety reports and the determinants of successful implementation, using the implementation framework. Methods Mixed method analysis was performed in Fujita Health University Hospital (FHUH), a large volume hospital in Japan. We identified strategies to implement the patient safety reporting system by scrutinising internal documents using the Consolidated Framework for Implementation Research (CFIR). The electronic reporting systems developed in 2004 in the FHUH and the number of reports were analysed using the staff data and hospital volumes. Results Reports (n = 110,058) issued between April 2004 and March 2020 were analysed. The number of reports increased from 2004 to 2008 and from 2013 to 2019, reaching 14,037 reports per year. Between 2009 and 2012, the FHUH experienced a stagnation period where the number of reports were not increasing. From the qualitative materials, we identified 74 strategies which contributed to the implementation of the patient safety reporting system. Among these, the domain of ‘intervention characteristics’ in the CFIR contained 12 strategies, ‘outer settings’ contained 20, ‘inner settings’ contained 21, ‘characteristics of individuals’ contained 8, and ‘process’ contained 13. There were two concentrated periods of the implemented strategies, the number was 17 in 2007 and 10 in 2016. These concentrated periods preceded a remarkable increase in the number of patient safety reports. Conclusions A safety culture had been fostered in FHUH in the study period. A relationship between number of strategies and development of a reporting culture was observed. The intensity of adequate strategies was needed for implementation of patient safety reporting system. Therefore, the implementation framework is useful for analysing patient safety initiatives for safety culture.

Background: The job environment has changed a lot during the period of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the association between work-related stress and aggravation of pre-existing disease in workers during the first state of COVID-19 emergency in Japan. Methods: Data were obtained from a large internet survey conducted between August 25 and September 30, 2020 in Japan. Participants who reported that they had a job as well as current history of disease(s) (ie, pre-existing conditions) were included (n = 3,090). Aggravation of pre-existing disease during the state of emergency was self-reported. Work-related stress from April 2020 (since the state of COVID-19 emergency) was assessed according to a job demand–control model. Multivariable logistic regression models were used to analyze the association. Results: Aggravation of pre-existing diseases was reported by 334 participants (11%). The numbers of participants with high demand and low control were 112 (18%) and 100 (14%), respectively. Compared to medium demand, high demand was significantly associated with aggravation of pre-existing diseases (odds ratio 1.77; 95% confidence interval, 1.30–2.42). Low control compared to medium control was also significantly associated with aggravation of pre-existing diseases (odds ratio 1.39; 95% confidence interval, 1.02–1.92). Conclusion: Work-related stress during the first state of COVID-19 emergency was associated with aggravation of pre-existing disease during that period.

Objectives: To examine whether public trust was associated with the utilization of COVID-19 Contact Confirming Application (COCOA) in those who self-reported a history of COVID-19. Study design: Cross-sectional study. Methods: Data were obtained from the Japan Society and New Tobacco Internet Survey, a nationwide online survey conducted from February to March 2021, which also assessed items related to COVID-19 and public trust. We included 453 participants with a history of COVID-19. Participants' reports of their general trust in the national government and the related policies, attitudes toward COVID-19 vaccination, and the adherence to the preventive measures against SARS-CoV-2 spread were compared between COCOA users and non-users controlling for age, sex, and socioeconomic statuses by analysis of covariance. Mediation analysis was conducted to examine whether public trust mediates the associations of certain participants’ characteristics with COCOA utilization. Results: Seventy-six percent (344/453) reported the COCOA utilization. Compared to non-users, the users were younger, more likely to be men and had a tendency to have higher education. They were more willing to get COVID-19 vaccination, adherent to public health measures against the spread of the SARS-Cov-2, and more likely to express trust in government in general and policies related to COVID-19 independent of age, sex, and the socioeconomic status. Trust in government did not mediate the associations of age and education with COCOA utilization. Conclusions: The utilization of digital contact tracing technology for the health of public during pandemic was related to the degree of trust in the government in Japan.

Abstract Aims/Introduction The Japanese government started a nationwide screening program for metabolic syndrome (MetS) to prevent cardiovascular diseases and diabetes in 2008. Although impaired fasting glucose (IFG) is a strong predictor for type 2 diabetes mellitus, the program does not follow up IFG in non‐MetS individuals. This study aimed to examine the risk and the population attributable fraction (PAF) of MetS and IFG for incidence of type 2 diabetes mellitus. Materials and Methods Japanese workers (3,417 men and 714 women) aged 40–64 years without a history of diabetes were prospectively followed. MetS was defined as either abdominal obesity plus two or more metabolic risk factors, or being overweight in the case of normal waist circumference plus three or more metabolic risk factors. IFG was defined as fasting blood glucose 100–125 mg/dL. Results During a mean 6.3 years, 240 type 2 diabetes mellitus cases were identified. Compared with those without MetS and IFG, the multivariable‐adjusted hazard ratios (95% confidence interval) of non‐MetS individuals with IFG, MetS individuals without IFG and MetS individuals with IFG for type 2 diabetes mellitus were 4.9 (3.4–7.1), 2.4 (1.6–3.5) and 8.3 (5.9–11.5), respectively. The corresponding PAFs for type 2 diabetes mellitus incidence were 15.6, 9.1 and 29.7%, respectively. Conclusions IFG represented a higher risk and PAF than MetS for type 2 diabetes mellitus incidence in middle‐aged Japanese individuals. The coexistence of MetS and IFG showed the highest risk and PAF for type 2 diabetes mellitus incidence. The current Japanese MetS screening program should be reconsidered to follow up non‐MetS individuals with IFG.

Abstract Aims/Introduction To prospectively investigate whether simultaneous elevation of gamma‐glutamyl transferase (GGT) and alanine aminotransferase (ALT) is associated with the increase of type 2 diabetes mellitus incidence independent of alcohol drinking, body mass index and triglycerides. Methods A total of 2,775 Japanese male workers who had no history of type 2 diabetes mellitus were followed. High GGT and ALT were defined as the top tertiles (GGT cutpoint: 49 IU/L, ALT cutpoint: 28 IU/L). Three groups were created using these dichotomized GGT and ALT cutpoints: both low, either high or both high. Multivariable Cox proportional hazards models were carried out adjusted for potential confounding factors. Results A total of 276 type 2 diabetes mellitus cases were identified during 12 years (27,040 person‐years) of follow up. Participants with simultaneously elevated GGT and ALT had a significantly higher incidence of type 2 diabetes mellitus, even after adjustment for fasting insulin and fasting blood glucose compared with the group without GGT or ALT elevation. Similar associations were observed in non‐ or light‐to‐moderate alcohol drinkers, as well as in participants with normal weight. However, the association was weaker in participants with triglycerides

Objective: To examine the hypotheses that the depression prevalence would be lower in working cancer survivors compared to non-working cancer survivors and that the depression prevalence of working cancer survivors could be as low as that of the cancer-free general population. Methods: We used the PubMed database to search for relevant literature. Out of 299 matches to the used terms, 17 cross-sectional, quantitative studies that compared depression statuses of working cancer survivors with non-working cancer survivors or cancer-free general samples were considered. Results: In some studies, survivors of breast cancer, Hodgkin lymphoma, and hepatocellular carcinoma indicated a significantly lower depression prevalence compared to non-working survivors with the same cancer types. On the other hand, some studies did not demonstrate a significant difference in the association between depression prevalence and working status among breast cancer and head and neck cancer survivors. Working survivors of breast cancer and malignant brain tumor demonstrated significantly worse scores on the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) compared to the cancer-free general population. However, the depression prevalence was not compared. Conclusions: The existing literature did not consistently support our hypotheses. Working does not function as an absolute prevention method for depression in cancer survivors. Preventive measures against depression are necessary even after cancer survivors return to work. Further research is necessary to determine whether working is effective for preventing depression in cancer survivors.

The possible effects of a neighborhood's built environment on physical activity have not been studied in Asian countries as much as in Western countries. The present study cross-sectionally examined the relationship between geographic information system (GIS) measured residence and worksite neighborhood walkability, and the number of parks/green spaces and sports facilities within a 1 km radius of home and workplace, with self-reported leisure-time habitual (3–4 times per week or more) walking and moderate-to-vigorous intensity habitual exercise among local government workers aged 18 to 64 years living in an urban-suburban area of Aichi, Japan in 2013. A single-level binomial regression model was used to estimate the multivariable odds ratios (ORs) and 95% confidence intervals (95% CIs). Of the 1959 male and 884 female participants, 288 (15%) and 141 (16%) reported habitual walking, respectively, and 18% and 17% reported habitual exercise, respectively. Compared with women who resided in neighborhood with a walkability index of 4–30, those living in an area with that of 35–40 were significantly more likely to engage in leisure-time habitual exercise (multivariable OR: 1.70, 95% CI: 1.08–2.68). Marginally significant positive associations were found between leisure-time habitual exercise and the residential neighborhood's number of parks/green spaces among women, as well as the number of sports facilities among men. In conclusion, a residential neighborhood environment characterized by higher walkability may contribute to the initiation or maintenance of moderate-to-vigorous intensity leisure-time exercise among working women living in an urban-suburban area of Japan. Keywords: Geographic information system, Built environment, Residence, Worksite, Neighborhood, Physical activity, Cross-sectional study

Background: Relatively little evidence exists for type 2 diabetes mellitus (T2DM) prediction models from long-term follow-up studies in East Asians. This study aims to develop a point-based prediction model for 10-year risk of developing T2DM in middle-aged Japanese men. Methods: We followed 3,540 male participants of Aichi Workers’ Cohort Study, who were aged 35–64 years and were free of diabetes in 2002, until March 31, 2015. Baseline age, body mass index (BMI), smoking status, alcohol consumption, regular exercise, medication for dyslipidemia, diabetes family history, and blood levels of triglycerides (TG), high density lipoprotein cholesterol (HDLC) and fasting blood glucose (FBG) were examined using Cox proportional hazard model. Variables significantly associated with T2DM in univariable models were simultaneously entered in a multivariable model for determination of the final model using backward variable selection. Performance of an existing T2DM model when applied to the current dataset was compared to that obtained in the present study’s model. Results: During the median follow-up of 12.2 years, 342 incident T2DM cases were documented. The prediction system using points assigned to age, BMI, smoking status, diabetes family history, and TG and FBG showed reasonable discrimination (c-index: 0.77) and goodness-of-fit (Hosmer-Lemeshow test, P = 0.22). The present model outperformed the previous one in the present subjects. Conclusion: The point system, once validated in the other populations, could be applied to middle-aged Japanese male workers to identify those at high risk of developing T2DM. In addition, further investigation is also required to examine whether the use of this system will reduce incidence.

Objectives: This study investigated restrictions in functional capacity, self-rated health status (SRHS), and psychosocial characteristics of employed cancer survivors in Japan and examined differences in these characteristics between cancer survivors and employees without cancer history. Methods: A cross-sectional survey was carried out. Subjects were local government employees in Japan in 2013 (n=5,474). Using a self-administered questionnaire, we evaluated restrictions in functional capacity, SRHS, and the following psychosocial characteristics: social support, perceived stress, social capital, positive reasons for living (ikigai), and happiness. We examined whether cancer history was associated with restrictions in functional capacity, SRHS, and psychosocial characteristics. Results: A total of 112 employees were cancer survivors. Of these, males of all ages and comparatively younger females had restrictions in functional capacity more frequently than the corresponding subjects without cancer history (males of all ages: 14.5% vs. 2.9%, p

Objectives: To modify the Stressor Scale for College Student (SSCS) by including extracurricular activity-related stressors and to examine the validity and reliability of the Modified SSCS (M-SSCS) to evaluate psychosocial stressors in medical and medical science students. Methods: Third-year medical students (n = 103) and fourth-year medical technology students (n = 95) completed a cross-sectional questionnaire survey. We examined the factorial structure of the M-SSCS using factor analysis. Concurrent validity was assessed by examining the associations of M-SSCS scores with self-rated health status, K6 scale scores, and State–Trait Anxiety Inventory (STAI) scores. Cronbach’s alpha coefficient was calculated to evaluate the reliability of the M-SSCS. Results: Factor analysis yielded seven factors. Stressors related to family, friends, part-time jobs, and extracurricular activity formed independent factors, but study- and fulfillment-related stressors were not distinct. High M-SSCS scores, indicating greater stressor levels, were significantly associated with poor self-rated health status (adjusted odds ratio [95% confidence intervals] = 2.80 [1.08, 7.25], p = 0.034), high K6 scale scores (2.99 [1.00, 8.96], p = 0.050), and high STAI state anxiety (3.32 [1.35, 8.20], p = 0.009) and trait anxiety scores (2.69 [1.31, 5.51], p = 0.007). Cronbach’ s alpha coefficient was 0.916. Conclusions: The M-SSCS showed good concurrent validity and internal consistency in assessing psychosocial stressors in medical and medical technology students. However, further studies are necessary to fully determine the validity of the M-SSCS.

Background: The distributions of socioeconomic status (SES) factors have been changing in Japan. We examined the relationships among SES and self-rated health (SRH) in Japanese adults. Methods: We analyzed 1,178 men and 1,555 women. We showed the distribution of SRH by sex and age and examined cross-sectional relationships among educational attainment, marital/living statuses, working status, household income and expenditure, and fine SRH (defined as excellent, very good, or good). We adjusted for age, subjective symptoms, visiting doctors, monthly equivalent household expenditure (EHE), and living in their own house. Results: The age-standardized prevalence of fine SRH was 79% and 73% among men and women, respectively. Among men, graduating from high school (adjusted odds ratio [aOR] 1.53; 95% confidence interval [CI], 1.07–2.19, relative to graduating from elementary or junior high school) and university or junior college (aOR 1.74; 95% CI, 1.15–2.62) was associated with fine SRH. Among women, graduating from university or junior college was associated with fine SRH (aOR 1.65; 95% CI, 1.12–2.46). Neither marital/living status nor working status was associated with SRH after adjustments for age in either sex. Among women, high EHE and income were associated with fine SRH (the highest expenditure group: aOR 1.80; 95% CI, 1.22–2.65; the highest income group: aOR 2.15; 95% CI, 1.34–3.46, relative to the corresponding lowest group). These simple relationships were not observed for men. Conclusions: High educational attainment was associated with fine SRH. Relationships among household income, EHE, and fine SRH differed by sex.