Persistence of Mental Health Deterioration Among People Living Alone During the COVID-19 Pandemic: A Periodically-repeated Longitudinal Study.

BACKGROUND: This longitudinal study aimed to investigate how psychological distress levels changed from early to middle phases of the new coronavirus (COVID-19) pandemic depending on the living arrangements of individuals. METHODS: An internet-based, longitudinal survey of 2,400 Japanese people was conducted every 5-6 weeks between February 2020 and January 2021. The presence of severe psychological distress (SPD) was measured using the Kessler's psychological distress scale. Living arrangements were classified into two groups (ie, living alone or living with others). Mixed-effects logistic regression analysis was performed to assess whether changes in SPD status were different depending on living arrangements. RESULTS: Of 2,400 respondents, 446 (18.5%) lived alone. Although the proportion of SPD in both individuals living alone and those living with others increased to the same extent in the early phase of the pandemic, the distress levels decreased after the early phase of the pandemic in the group living with others, compared with the group living alone, for which SPD remained high. The odds ratio (OR) of developing SPD in interaction term with survey phases tended to be higher among those who lived alone than those who lived with others in Phase 6 (OR 1.89; 95% confidence interval [CI], 0.99-3.64) and Phase 7 (OR 1.88; 95% CI, 0.97-3.63). CONCLUSION: During the COVID-19 pandemic, those living alone are persistently at a higher risk of SPD compared to those living with others. Effective countermeasures targeting those living alone, such as enhancing online communication or providing psychological therapies, are essential.

Objectively Measured Intensity-specific Physical Activity and Hippocampal Volume Among Community-dwelling Older Adults.

BACKGROUND: The hippocampus is a brain structure important for memory and cognitive function. Physical activity may help prevent hippocampal atrophy. However, few studies have measured sedentary behavior (SB) and intensity-specific physical activity using an accelerometer. This study aimed to examine the cross-sectional associations of objectively-determined SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) measured by an accelerometer with hippocampal volume among community-dwelling older adults using compositional data analysis (CoDa) approach. METHODS: This cross-sectional study was part of the Neuron to Environmental Impact across Generations (NEIGE) study. A randomly recruited sample of 485 Japanese older adults (47% male; aged 65-84 years) wore tri-axial accelerometers (Omron Healthcare) for 7 consecutive days in 2017. Hippocampal volume was measured with magnetic resonance imaging and the left and right hippocampal volumes were automatically segmented using FreeSurfer software. Associations of sedentary and physically active behaviors with hippocampal volume were examined with compositional linear regression analysis based on isometric log-ratio transformations of time use adjusted for potential confounding factors. RESULTS: The relative proportion of time spent in MVPA, compared to the other two activities, was significantly positively associated with right hippocampal volume (ß: 57.1, P-value = 0.027). However, no association existed between higher proportions of MVPA and left hippocampal volume, or between proportions of SB or LPA with either left or right hippocampal volumes. CONCLUSION: The proportion of time spent in MVPA, relative to the other two activities, was significantly positively associated with right hippocampal volume. MVPA may be beneficial for maintaining hippocampal volume.

Associations between work-related stressors and QALY in a general working population in Japan: a cross-sectional study.

OBJECTIVE: To investigate an association between quality-adjusted life years (QALY) and work-related stressors (job strain, effort/reward imbalance, and poor support from supervisor and coworkers), and estimate loss in QALY caused by these stressors. METHODS: A cross-sectional study investigated data from a third-wave survey (in December 2017) of a 2-year prospective cohort study of Japanese workers. At baseline (first-wave survey), 5000 participants were recruited from workers who registered with an internet survey company. A total of 2530 participants responded to the second-wave survey 1 year later. Participants were then further recruited to the third-wave survey. An online questionnaire collected information regarding health-related quality of life (measured by EQ-5D-5L), job strain, supervisor and coworker support (Brief Job Stress Questionnaire), effort/reward imbalance (Effort/reward Imbalance Questionnaire), and demographic variables (age, sex, education, occupation, work contract, smoking, and alcohol drinking). Multiple linear regression analysis of the QALY score calculated from responses to EQ-5D-5L was employed on standardized scores of the work-related stressors and adjusted for demographic variables (SPSS version 26). RESULTS: Data of 1986 participants were analyzed. Job strain (unstandardized coefficient, b = - 0.013, p < 0.01) and effort/reward imbalance (b = - 0.011, p < 0.01) and coworker support (b = 0017, p < 0.01) were significantly associated with QALY score in the fully adjusted model. CONCLUSION: Job strain, effort/reward imbalance, and poor coworker support may be associated with a reduced QALY score among workers. A substantial impairment in QALY associated with the work-related stressors indicates that workplace interventions targeting work-related stressors may be cost-effective.

Changes in Psychological Distress During the COVID-19 Pandemic in Japan: A Longitudinal Study.

BACKGROUND: This longitudinal study aimed to examine the changes in psychological distress of the general public from the early to community-transmission phases of the COVID-19 pandemic and to investigate the factors related to these changes. METHODS: An internet-based survey of 2,400 Japanese people was conducted in two phases: early phase (baseline survey: February 25-27, 2020) and community-transmission phase (follow-up survey: April 1-6, 2020). The presence of severe psychological distress (SPD) was measured using the Kessler's Six-scale Psychological Distress Scale. The difference of SPD percentages between the two phases was examined. Mixed-effects ordinal logistic regression analysis was performed to assess the factors associated with the change of SPD status between the two phases. RESULTS: Surveys for both phases had 2,078 valid respondents (49.3% men; average age, 50.3 years). In the two surveys, individuals with SPD were 9.3% and 11.3%, respectively, demonstrating a significant increase between the two phases (P = 0.005). Significantly higher likelihood to develop SPD were observed among those in lower (ie, 18,600-37,200 United States dollars [USD], odds ratio [OR] 1.95; 95% confidence interval [CI], 1.10-3.46) and the lowest income category (ie, <18,600 USD, OR 2.12; 95% CI, 1.16-3.86). Furthermore, those with respiratory diseases were more likely to develop SPD (OR 2.56; 95% CI, 1.51-4.34). CONCLUSIONS: From the early to community-transmission phases of COVID-19, psychological distress increased among the Japanese. Recommendations include implementing mental health measures together with protective measures against COVID-19 infection, prioritizing low-income people and those with underlying diseases.

Is objectively measured light-intensity physical activity associated with health outcomes after adjustment for moderate-to-vigorous physical activity in adults? A systematic review.

BACKGROUND: An increasing number of studies have demonstrated that light-intensity physical activity (LPA) confers health benefits after adjustment for moderate-to-vigorous physical activity (MVPA). The purpose of this systematic review was to summarize existing epidemiological evidence on associations of objectively measured LPA with health outcomes in adults. METHODS: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched on PubMed, Web of Science, CINAL, and Cochrane Library for articles analyzing the association between objectively determined LPA and health outcomes that were published up to January 2017. Data were extracted regarding authors, publication year, country of survey, study setting, number of participants, study design, physical activity (PA) assessment (type of accelerometer and intensity), health outcomes, confounders, and results (summary measures and association). A coding system was used to summarize the results. RESULTS: Of the 3254 studies identified, 24 cross-sectional and 6 longitudinal studies were included in this review. Most of the studies targeted the Western population. LPA was inversely associated with all-cause mortality risk and associated favorably with some cardiometabolic risk factors including waist circumference, triglyceride levels, insulin, and presence of metabolic syndrome. Only a small amount of data were available on mental health and cognitive function. CONCLUSIONS: LPA appears to be beneficially associated with important health outcomes after adjustment for MVPA in the adult population. Although current global PA guidelines recommend only MVPA, promoting LPA may confer additional health benefits.

[Descriptive epidemiology of accelerometer-measured moderate to vigorous physical activity in Japanese older adults].

AIM: Most physical activity (PA) guidelines for health promotion recommend moderate to vigorous PA (MVPA) lasting at least 10 minutes (long-bout MVPA). However, recent studies have shown the beneficial effects of short-bout MVPA (intermittent and lasting <10 minutes). Therefore, we aimed to clarify the detailed patterns of MVPA of community-dwelling older adults using accelerometers. METHODS: This is a cross-sectional descriptive study. Community-dwelling older Japanese adults (total: 1,210; 70-80 years of age) randomly selected from residential registries of 3 municipalities (Bunkyo, Fuchu, and Oyama) were asked to wear an accelerometer (HJA-350 IT; Omron Healthcare, Japan). MVPA was classified by bout length (1-4, 5-9, 10-19, 20-29, and > 30 minutes). The mean frequency and duration of MVPA by each bout length and the proportion of long-bout MVPA were described. RESULTS: Valid data were obtained from 450 participants (men: 56.7%; mean age: 74 years). The mean±standard deviation of the frequency and duration of MVPA bouts were 21.8±14.6 times/day and 2.1±0.9 min, respectively. The total duration of MVPA was 46.5±33.0 min/day. Long-bout MVPA accounted for 26.9%±23.5% of daily MVPA, whereas MVPA of 1-4 minutes accounted for 43.4%. CONCLUSIONS: Older adults performed about 45 minutes of MVPA a day, but most of this was short-bout MVPA, which is overlooked by current WHO PA guidelines. In particular, short-bout MVPA was frequent among older women and those living in rural areas.

Organizational justice and insomnia: a prospective cohort study examining insomnia onset and persistence.

PURPOSE: Insomnia is one of the most common health problems and causes a large social burden. Psychosocial work-related factors are reported to be associated with both insomnia onset and insomnia persistence. However, the association between organizational justice (OJ) and insomnia remains unclear. The objective of this study was to examine the effect of OJ on insomnia persistence, as well as insomnia onset. METHODS: A prospective cohort study with a 1-year observational period was conducted. Self-reported questionnaire data from 1588 employees were analyzed. OJ was measured using the Japanese version of the OJ questionnaire, which has four components (distributive, procedural, interpersonal, and informational). Insomnia was assessed with the Athens Insomnia Scale. Logistic regression analysis was used to explore the effects of OJ on insomnia. RESULTS: Among non-insomniac subjects at the baseline (n = 1236), low overall OJ was a risk of insomnia onset even after adjustment for lifestyle and work-related variables (adjusted odds ratio 0.66; 95% confidence interval 0.51-0.85). The procedural, interpersonal, and informational justice components were also associated with insomnia onset. Among insomniac subjects at the baseline (n = 352), low overall OJ, as well as the procedural and interpersonal justice components, was associated with insomnia persistence. Although these associations became insignificant after adjustment, the interpersonal justice component showed a marginally significant association with insomnia persistence (p = 0.058). CONCLUSIONS: OJ, especially interpersonal justice, was revealed as an associated factor for both insomnia onset and persistence. These findings may provide useful information for prevention of insomnia among working population.

A cross-sectional study of the association between city scale and daily steps in Japan: Data from the National Health and Nutrition Survey Japan (NHNS-J) 2006-2010.

Objective There is little evidence showing that inhabitants of urban areas engage in more physical activity than do rural ones, although accumulating evidence concerning the best neighborhood environments conducive to physical activity supports the idea. This study sought to fill the research gap by examining the association between city scale and daily steps using data from Japan's National Health and Nutrition Survey (NHNS).Methods We analyzed data from 15,763 men and 18,479 women aged 20 years and older who participated in a one-day pedometer measurement during any part of the NHNS between 2006 and 2010. The data obtained for these years were combined into a single data set. City scale was categorized into 5 groups based on population: 1) 12 large cities and 23 wards, 2) population greater than 150,000, 3) population 50,000-150,000, 4) population less than 50,000, and 5) towns and villages. Differences in daily steps among city scale groups were analyzed using an ANCOVA, adjusting for age by gender. The Bonferroni method was employed for multiple comparisons, and linear regression was used to test for linear trends. Subgroup analyses were performed by age (20-39, 40-64, older than 64), and job status. The study was approved by the Tokyo Medical University ethics committee, and use of these data complied with the Statistics Act of Japan.Results The steps per day for men after adjusting for age were Group 1 : 7,494±4,429 (mean±SD), Group 2 : 7,407±4,428, Group 3 : 7,206±4,428, Group 4 : 6,911±4,428, and Group 5 : 6,715±4,429. Women's daily steps according to city scale group were 6,767±3,648, 6,386±3,647, 6,062±3,646, 6,069±3,649, and 6,070±3,649 for Groups 1 through 5, respectively. There were overall statistically significant differences (ANCOVA, P<0.001) between both genders. The larger the city scale, the more mean daily steps that were taken by both men and women (P values for both trends <0.001). Subgroup analyses revealed significant differences in the mean daily steps by city scale, regardless of age or job status for both genders. There were no significant differences among Groups 3, 4, or 5 among unemployed men, men older than 64, or overall women, which differed from the results for men with jobs, who took fewer steps in smaller cities.Conclusions Our study showed that men and women living in larger cities took more steps compared to those living in smaller cities. Subgroup analyses further revealed that the associations between city scale and physical activity differed according to gender, age, and job status.

Gender differences in association between psychological distress and detailed living arrangements among Japanese older adults, aged 65-74 years.

PURPOSE: Past studies have shown that living alone is detrimental to older adults' mental health. However, there has been little focus on how older adults' psychological distress differed by more detailed living arrangement, as well as by gender. The present study investigates various living arrangements in association with psychological distress among older men and women. METHODS: Data from community-dwelling Japanese older adults were collected through a mail survey (n = 1,807, aged 65-74 years, 51.5 % men). Psychological distress level was measured using Kessler's six-item psychological distress scale. Living arrangements were categorized into four groups; "living with spouse only", "living with spouse and other family", "living with other family without spouse" or "living alone". Multiple logistic regression analyses were used to examine the associations of living arrangements with psychological distress level. RESULTS: Older adults living alone were observed to have higher psychological distress. In addition, gender-stratified analyses showed that higher distress levels were observed among older men living with family, but without a spouse (OR: 2.85, 95 % CI: 1.51-5.39). In contrast, higher distress was observed among older women living with spouse and other family (OR: 1.53, 95 % CI: 1.03-2.28). CONCLUSIONS: Psychological distress in older Japanese adults was associated with living arrangements, but such associations differed by gender. The association of living with a spouse on older men's mental health was striking, while living with any family was found to be rather important for older women, aged 65-74 years.

Association between workplace social capital and systolic blood pressure among 23 173 workers at 367 small-sized and medium-sized enterprises in Japan: a cross-sectional study.

OBJECTIVES: Social capital (SC) has been shown to be inversely associated with elevated blood pressure. While SC in the workplace may also be associated with blood pressure, it has not been extensively studied. We aimed to investigate the association between workplace SC and systolic blood pressure (SBP). DESIGN: A cross-sectional study. SETTING: 367 small-sized and medium-sized companies in Japan. PARTICIPANTS: A total of 23 173 participants (15 991 males and 7182 females) aged ≥18 years. EXPOSURE OF INTEREST: SC was assessed using individual responses to eight 4-point Likert questions used in the Brief Job Stress Questionnaire. Workplace SC was assessed as the mean of individual-level responses to the SC questions from those working in the same company. OUTCOME MEASURE: Systolic blood pressure (SBP) RESULTS: A multilevel linear regression model revealed that higher workplace-level SC was linked with lower SBP (coef.=-0.53 per 1SD increment in workplace SC, 95% CI=-1.02 to -0.05) among females in the age-adjusted model, which remained statistically significant after adjusting for other covariates. After adjusting for individual-level SC, this association was attenuated and became non-significant (coef.=-0.41, 95% CI=-0.87 to 0.05), while individual-level SC was inversely associated with SBP (coef.=-0.43, 95% CI=-0.73 to -0.13). Among males, we did not find any evidence of significant inverse associations either in relation to workplace SC (coef.=-0.12, 95% CI=-0.46 to 0.21) or individual-level SC (coef.=0.19, 95% CI=-0.01 to 0.39). CONCLUSIONS: Our study findings suggested that workplace-level SC can affect SBP differently by sex.

[Commute mode - physical activity and the possibility of change to active commuting among Japanese workers: a descriptive study by region].

OBJECTIVES: Changing the mode of commuting from nonactive by car or motorcycle to active by walking, cycling, or public transport is expected to benefit health. However, the proportion of nonactive commuters who can change their commute mode to active forms remains unclear. The aim of this study was to determine the proportions of nonactive commuters and of those who can change their commute mode to an active form in various regions in Japan. METHODS: In this descriptive study, data were used from an online survey conducted from April to May 2021. Participants included 3,000 adults (20 to 79 years), who were registered with an online survey company. Workers were asked their means of transportation to work and commuting time. Workers using a car or motorcycle for more than 1 minute for commuting were defined as nonactive commuters, and the others were defined as active commuters. Then, nonactive commuters were asked about the possibility of changing their commute mode to active commuting (0%-100%, 11 options in 10% increments). The possibility of change was classified into four groups, i.e., impossible (0%), difficult (10%-40%), probably possible (50%-90%), and possible (100%). The proportions of nonactive commuters and nonactive commuters who can transition to active commuting were described by region. RESULTS: A total of 2,683 participants answered the survey, including 1,647 workers, of whom 1,551 were commuters. The nonactive commuters accounted for 41.4% of commuters overall. The proportion of nonactive commuters was higher in rural than in urban regions. The proportion of nonactive commuters who could change their commute mode was 32.9% of the nonactive commuters or 12.8% of all workers. Among the nonactive commuters, the proportion who could change their commute mode was higher in urban than in rural regions. Of the total workers, the proportion of nonactive commuters who could change their commute mode was higher in rural regions. CONCLUSION: Nonactive commuters accounted for 41.4% of all commuters. The proportion of nonactive commuters who could change their commute mode among nonactive commuters was higher in urban regions. However, in rural regions, as the proportion of nonactive commuters was high, the proportion of nonactive commuters who could change their commute mode among total workers was also high. These results suggest that some of nonactive commuters can change their commute mode from nonactive to active commuting, in rural as well as in urban regions.

Association between the Decrease in Medical Visit Frequency and Chronic Disease Worsening in the Early Stages of COVID-19 - A Longitudinal Study.

Objective This longitudinal study aimed to clarify the changes in the medical treatment behavior of Japanese patients with chronic diseases during the early phase of the coronavirus disease 2019 (COVID-19) pandemic and examine the factors associated with disease worsening. Methods Subjects with chronic diseases were selected from a panel survey that started at the beginning of the COVID-19 pandemic consists of 2,400 participants recruited via the Internet. Medical treatment behaviors (decrease in medical visit frequency, inability to take regular medications, and utilization of telephone/online medical care), psychological distress, and sociodemographic factors were evaluated at baseline (May 2020) and at the follow-up survey (February 2021). A worsening of chronic diseases was defined as those who answered "yes" to the question, "Has-the-condition-of-the-chronic-disease-worsened?". The factors related to the worsening of chronic diseases at follow-up were examined. Results A total of 514 participants (mean age 61.6±12.9 years) were analyzed. The percentage of participants who reported decreasing medical visit frequency was 34% at the baseline and 16.5% at follow-up, and those who reported a worsening of chronic diseases was 5.1% and 5.1%, respectively. A worsening of chronic diseases at follow-up was significantly associated with a younger age, a decreased frequency of medical visits, unemployment, a history of smoking, and psychological distress. Conclusions A decreased frequency of medical visits was observed among one-third of the participants with chronic disease in the early stage of the pandemic, and it reduced by half at follow-up. In the early stages of an emerging infectious disease pandemic, decreased regular hospital/clinic visits can lead to a worsening of chronic diseases. Those who had psychological distress, unemployment, and a history of smoking were vulnerable to a worsening chronic disease.

Mental illness and a high-risk, elderly Japanese population: characteristic differences related to gender and residential location.

PURPOSE: Examining the sociodemographic determinants of psychological distress is important in identifying specific subgroups in need of further intervention. However, there are few studies focusing on older populations and on the role of gender or location of residence. To try to clarify characteristics of a population at high risk for mental illness, we examined the sociodemographic determinants of psychological distress in older adults living in three different locations. METHODS: A mail survey was used to collect data on levels of psychological distress and sociodemographic characteristics from a population-based sample of 1894 older adults who lived in Bunkyo (urban setting), Fuchu (suburban setting) and Oyama (rural setting) in Japan (aged 65-74 years, 51.3% men). Psychological distress level was measured based on Kessler's six-item psychological distress scale (K6) and dichotomized into two groups with a cut-off score of 5 (0-4 or 5-24). Multiple logistic regression analyses were used to examine the associations between sociodemographic factors, specifically gender and location of residence, and psychological distress levels. RESULTS: The variables of older age, living in Bunkyo, living in Oyama and living alone were significantly associated with high psychological distress. Although these associations were observed in men, no associations were observed in women. Location-specific analyses showed significant associations between sociodemographic and psychological distress among men living in Oyama, but not among those in Bunkyo or Fuchu. CONCLUSIONS: Sociodemographic factors were significantly correlated with psychological distress, particularly among older men in rural areas. Characteristics of a population at high risk for mental illness may vary based on gender and location of residence. Health promotion initiatives for older adults may be more effective if they take these demographic factors into account.

Estimation of cutoff score for the 7C of vaccination readiness scale.

The 7C of the vaccination readiness scale provides a score to evaluate the willingness and readiness to get vaccinated (vaccination readiness). This cross-sectional study clarifies the cutoff vaccination readiness score to determine whether an individual is willing to be vaccinated. We conducted an online survey of 774 participants. The vaccination readiness scores for the full and short survey versions were calculated. The coronavirus disease 2019 vaccination status was used to determine whether the participant was willing to be vaccinated. Receiver operating characteristic curve analysis was performed using the Youden index. The Youden Index was at its maximum when the cutoff score was 4.02 for the full version (area under the curve [AUC]:0.94) and 4.07 for the short version (AUC:0.90). Vaccination readiness scores greater than 4 on both the full and short version may indicate a willingness to be vaccinated. This cutoff value facilitates the interpretation of the 7C scale results.

Development, validity, and reliability of the Japanese version of the 7C of vaccination readiness scale.

BACKGROUND: The 7C of the vaccination readiness scale measures the 7 psychological components that structure people's vaccination readiness. We aimed to develop the Japanese version of this scale (7C scale Japanese version) and to assess its validity and reliability. METHODS: The full and short versions of 7C scale Japanese were developed based on translation guidelines provided by the ISPOR Task Force. An Internet survey, including 709 participants, was performed to assess the scale's validity and reliability within a confirmatory factor analysis (CFA) framework (men: 38.8%, age range: 20-92 years). Invariance analysis using multiple-group CFA was conducted to test cross-cultural validity between participants in this study and those in the 7C original version study. McDonald's omega and intraclass correlation coefficient were calculated to evaluate internal consistency and test-retest reliability, respectively. To clarify the criterion validity, regression analysis, with previous COVID-19 vaccination status as the dependent variable, was performed to calculate pseudo R2. RESULTS: The 7C scale Japanese version exhibited good content validity, structural validity, configural invariance, and criterion validity. The results showed good internal consistency, and test-retest reliability, except for the "calculation" component. CONCLUSIONS: 7C scale Japanese version exhibited acceptable reliability and validity; however, "calculation" may be a less reliable subscale.

Suggestions for new organizational-level item pools for the national Stress Check Program from management philosophy and mission statement: A qualitative study using unsupervised learning.

OBJECTIVE: This study aimed to obtain suggestions for new organizational-level item pools that companies could utilize to accomplish management philosophy and mission statements in the context of survey and work environment improvements for the national Stress Check Program. METHODS: A qualitative study was conducted using unsupervised learning. A large amount of text data related to management philosophy and mission statements were collected, that is, management messages described on the websites of all companies listed on the Tokyo Stock Exchange. For the main analysis, topic modeling was performed on the nouns from the management messages using Latent Dirichlet Allocation (LDA) to build a model consisting of 10 latent topics, each represented by a group of the 10 most frequently reoccurring nouns. Each group of nouns was qualitatively summarized based on the topic model. RESULTS: In total, 22 524 nouns were extracted from the management messages of 3575 companies. A topic model consisting of 10 latent topics was constructed using the LDA. The suggestion for new item pools included new technologies, business plans/strategies, company shareholders, health/happiness/wealth, profits/sales, development of society, a sustainable society, safety and security, customer/consumer satisfaction, corporate social responsibility, fairness, transparency, and human rights. CONCLUSION: The suggestions for potential item pools were derived from management philosophy and mission statement that are not covered in the existing survey. The suggestions could be useful for motivating employers to implement work environment improvement. Future studies need to make definite items and investigate whether they correlate to job stressors and mental health among workers.

Victimization and witnessing of workplace bullying and physician-diagnosed physical and mental health and organizational outcomes: A cross-sectional study.

BACKGROUND: Compared to the numerous reports on mental health outcomes of workplace bullying victims, research on organizational outcomes of witnesses and physical health outcomes of victims and witnesses is scarce. Therefore, the purpose of this study was to investigate the relationship between bullying victimization and witnessing and various physical and mental health outcomes and organizational outcomes such as sickness absence, work performance, and job satisfaction. METHODS: This study used cross-sectional data from a nationally representative, community-based sample of 5,000 Japanese residents aged 20-60. We analyzed data from 1,496 respondents after excluding those not working at the time of the survey and those with missing values. Workplace bullying, psychological distress, physical complaints, and job satisfaction were assessed with the New Brief Job Stress Questionnaire and work performance with the World Health Organization's Health and Work Performance Questionnaire. In addition, subjective health status, physician-diagnosed mental or physical illness, and sickness absence were asked as one item. Hierarchical multiple regression analysis or Poisson regression analysis was conducted to assess the association between victimization/witnessing workplace bullying and health and organizational outcomes. RESULTS: Both victimization and witnessing workplace bullying were significantly associated with psychological distress, physical complaints, subjective poor health, physician-diagnosed mental disorders, and job dissatisfaction. Victimization of workplace bullying was further associated with physician-diagnosed respiratory diseases, sickness absence (≥7 days), and poor work performance. Victims were absent from work for 4.5 more sick days and had 11.2% lower work performance than non-victims. CONCLUSIONS: The results showed that both victimization and witnessing workplace bullying were significantly associated with physical and mental outcomes and various organizational outcomes. Organizations should implement further measures to prevent personal and organizational losses due to workplace bullying.

Individual-level social capital and COVID-19 vaccine hesitancy in Japan: a cross-sectional study.

To reduce vaccine hesitancy, it is important to identify factors that can intervene at the individual or community level. Social capital is a possible factor because it is associated with various vaccine hesitancy, such as for measles and influenza. However, limited studies have explored the association between social capital and vaccination for COVID-19, which is an unprecedented pandemic and infodemic. Therefore, this study aimed to clarify the association between social capital and COVID-19 vaccination during the pandemic. This cross-sectional study used quota sampling for an online-based survey. Participants were asked whether they had previously been vaccinated for COVID-19 and their intention to receive a COVID-19 vaccine booster. Social capital was evaluated using three measures (individual-level civic participation, social cohesion, and reciprocity). Multiple logistic regression analysis was performed to clarify the association between social capital and previous COVID-19 vaccination status as well as intention to receive a COVID-19 booster. Participants were 2,313 individuals, of whom 87.2% had received a COVID-19 vaccine; 72.3% intended to obtain a COVID-19 booster. Individuals with any social capital are more likely to receive a COVID-19 vaccination than those with none (OR: 1.73, 95%CI: 1.18-2.54; OR: 1.58, 95%CI: 1.22-2.05; OR: 3.05, 95%CI: 2.15-4.33). These indicators were also associated with the intention to receive a COVID-19 booster. Thus, our results suggest that among the general public, those with individual-level social capital are more likely to receive a COVID-19 vaccination than those with none. Social capital may be a factor that can reduce vaccine hesitancy during a pandemic.

Perceived neighborhood environment and walking for specific purposes among elderly Japanese.

BACKGROUND: Recent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults. METHODS: This population-based, cross-sectional study enrolled 1921 participants (age: 65-74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders. RESULTS: Access to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00-1.51), 1.39 (1.14-1.71), and 1.48 (1.21-1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women. CONCLUSIONS: Specific environment-walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in promoting physical activity among elderly Japanese.

[Comparison of the two methods of defining high-stress on the Japanese Stress Check Program].

OBJECTIVES: In Japan, companies are required to implement a "stress check program" to prevent mental health problems in workers. To identify "high-stress" workers, the Brief Job Stress Questionnaire (BJSQ) is recommended. According to the stress check program manual issued by the government, high-stress can be defined using two criteria, either the "sum method" (simply summing the scores for each scales) or the "score converted method" (using converted scores according to the conversion table for each scales). In this study, we examined the differences in results found using these two criteria on "stress check program" data. METHODS: We used data of 71,422 workers in 117 companies and organizations who conducted stress checks in 2016. The prevalence of high-stress was calculated by applying the two criteria simultaneously, and the chi-square test was used to compare the proportion of workers with high-stress. We subsequently divided participants into the four following groups and calculated the proportion of each group: group A was defined as having high-stress by both criteria; group B, only by the sum method; group C, only by the score converted method; and group D, not defined as high-stress by either criterion. We compared the average values of stress response among four groups using the Kruskal-Wallis test, and further compared the average values between group B and group C using the Bonferroni method. RESULTS: The average age of participants was 43.7 ± 11.1, and 66.8% were males. The proportion of those defined as having high-stress were 11.7% using the sum method and 13.2% using the score converted method; the proportion of high-stress workers was thus significantly higher when using the score converted method (p <.001). Physical stress response was higher in group B; however, lack of vigor, irritation, fatigue, and depression were higher in group C (p <.01). CONCLUSIONS: Compared to the sum method, 1.5% more high-stress workers were observed using the converted method, and this result was similar for individual and employment-related factors. Furthermore, workers were more likely to be judged as having "high-stress" when the score of the physical stress response was higher in the sum method. Hereafter, it is important to consider which criteria are applied when discussing proportions of high-stress. Further research is needed to examine which criteria will predict health disorders.