Heated tobacco products do not help smokers quit or prevent relapse: a longitudinal study in Japan.

BACKGROUND: Heated tobacco products (HTPs) are often marketed as a safer alternative to help cigarette smokers quit. We investigated the link between HTP use and smoking cessation and relapse. METHODS: 7044 adults (≥20 years old) with at least two observations over three waves (2019-2021) of a longitudinal, nationwide, internet-based survey were classified into current (past 30-day), former and never cigarette smokers. ≥1 month and ≥6 months smoking cessation and smoking relapse at 1-year follow-up were assessed in relation to current HTP use at baseline. Generalised estimating equation models were weighted to account for population differences between HTP users and non-users. Adjusted prevalence ratios (APRs) were computed within population subgroups. RESULTS: At baseline, 17.2%, 9.1% and 6.1% of the respondents were current cigarette smokers, HTP users and dual users, respectively. Among current established smokers (having smoked regularly, n=1910), HTP use was significantly associated with a decreased likelihood of ≥1 month cessation within those who reported having used evidence-based cessation measures (APR=0.61), smoking 20+ cigarettes per day (APR=0.62), high school education or less (APR=0.73) and fair/poor health (APR=0.59). Negative associations were also seen for ≥6 months cessation among those aged 20-29 years (APR=0.56) and full-time workers (APR=0.56). Among former smokers (n=2906), HTP use was associated with smoking relapse within those who last smoked >1 year ago (APR=1.54), among women (APR=1.61), those aged 20-29 years (APR=2.09), those reporting high school education or less (APR=2.36), those who were unemployed/retired (AOR=3.31) and never/non-current alcohol users (APR=2.10). CONCLUSION: HTP use did not help smokers quit or prevent former smokers from relapsing. HTPs should not be recommended as a cessation aid.

Workplace Bullying and Patient Aggression Related to COVID-19 and its Association with Psychological Distress among Health Care Professionals during the COVID-19 Pandemic in Japan.

The novel coronavirus disease (COVID-19) pandemic has spread throughout the world. Poor mental health has been reported among healthcare professionals responding to COVID-19. However, no study has examined the impact of COVID-19-related workplace bullying or patient aggression on the mental health of healthcare professionals during the COVID-19 outbreak. This study examined the prevalence of COVID-19-related workplace bullying and patient aggression and its association with psychological distress among healthcare professionals during the COVID-19 outbreak in Japan. This was a cross-sectional study conducted from May 22 to 26, 2020, inviting participants (n = 1,421) from an online survey of full-time employees. We limited the sample to healthcare professionals for further analyses. Using an online self-report questionnaire, workplace bullying and patient aggression related to COVID-19 was measured using nine items with dichotomous response options. Psychological distress was measured using the Japanese version of Brief Job Stress Questionnaire. Among 1,032 participants (72.6%) who completed the survey, 111 healthcare professionals were identified. Among them, 19 participants (17.1%) had experienced any COVID-19-related workplace bullying or patient aggression: 11 participants (9.9%) had experienced any workplace bullying and 12 participants (10.8%) had experienced any patient aggression. Multiple linear regression analysis showed that any bullying or patient aggression related to COVID-19 significantly correlated with psychological distress. It was suggested that a non-negligible proportion of participants experienced workplace bullying or patient aggression related to COVID-19. Preventing and reducing workplace bullying and patient aggression may be effective in improving mental health of healthcare professionals during the COVID-19 outbreak.

Long working hours and depressive symptoms: moderating effects of gender, socioeconomic status, and job resources.

PURPOSE: Systematic reviews and meta-analyses have found inconsistent associations between working hours and depressive symptoms. The purpose of this study was to investigate the possible moderators of this association, using data from a large-scale cross-sectional survey. METHODS: A total of 16,136 Japanese employees (men 83.5%; women 16.5%) responded to a self-administered questionnaire inquiring about overtime working hours during the previous month and depressive symptoms (Center for Epidemiologic Studies Depression scale), as well as moderating factors including gender, age, marital status, socioeconomic status, commuting time, sleeping hours per day, job control and worksite social support (Job Content Questionnaire), neuroticism (Eysenck's Personality Questionnaire Revised), and social desirability (Social Desirability Scale) (response rate, 85%). We conducted sequential regression analyses to investigate the main effects and interaction effects of all moderating variables. RESULTS: The association between overtime working hours and depressive symptoms was significantly moderated by gender (interaction effect: ß = 0.03), age (ß = - 0.02), manager (ß = 0.03), sleeping hours (ß = - 0.02), job control (ß = - 0.03), and neuroticism (ß = 0.02). Among workers engaged in 80 + hours of overtime, higher depressive symptoms were reported by women, younger employees, non-managers, employees with low job control, low worksite social support, and high neuroticism. A significant main effect of long overtime working hours on depressive symptoms was also observed even after controlling for all independent variables (ß = 0.02). CONCLUSIONS: Long overtime working hours is associated with depressive symptoms. We also found significant heterogeneity in the association according to employee characteristics, which may explain the inconsistent findings in previous literature.

Determinants of polyunsaturated fatty acid concentrations in erythrocytes of pregnant Japanese women from a birth cohort study: study protocol and baseline findings of an adjunct study of the Japan environment & Children's study.

BACKGROUND: N-3 polyunsaturated fatty acids (n-3 PUFA) may have multiple beneficial effects on the outcome of pregnancy, maternal health and child development. The present study introduced the protocol of a birth cohort study to examine the beneficial effects of n-3 PUFA status in pregnant Japanese women as an adjunct study of the Japan Environment and Children's Study (JECS). METHODS: The JECS participants in the coastal areas of Miyagi Prefecture were further invited to participate in this adjunct study, and 1,878 pregnant women were enrolled prior to delivery. Their n-3 PUFA status was evaluated with fatty acid profiles in erythrocytes of maternal blood collected from 1,623 mothers at 24-30 weeks of gestation and cord blood from 1,505 deliveries. RESULTS: The baseline results, including comprehensive data on the fatty acid status and determinants affecting the PUFA status, were analyzed. In stepwise multivariate analyses, the cord blood docosahexaenoic acid (DHA) level was found to be significantly influenced by the DHA level in maternal blood, the child's sex, and the gestational period. The maternal DHA level was influenced by fish intake, maternal age, and the prepregnancy body mass index. While cord blood eicosapentaenoic acid (EPA) was influenced by maternal EPA, fish intake, and season at birth, additional factors such as maternal education, household income, and smoking habits affected the maternal EPA content. CONCLUSION: Further studies are warranted to clarify the nutritional impacts of n-3 PUFA in pregnant Japanese women of the cohort study.

Cross-national comparisons of attitudes towards suicide and suicidal persons in university students from 12 countries.

This paper reports the results of a comparative investigation of attitudes to suicide and suicidal persons in 5,572 university students from 12 countries. Participants filled out two scales measuring attitudes towards suicide and suicidal persons, a measure of psychological distress together with the questions about suicidal behavior. Results showed that the highest suicide acceptance scores were observed in Austrian, UK, Japanese and Saudi Arabian samples and the lowest scores were noted in Tunisian, Turkish, Iranian and Palestinian samples. While the highest social acceptance scores for a suicidal friend were noted in Turkish, US, Italian and Tunisian samples, the lowest scores were seen in Japanese, Saudi Arabian, Palestinian and Jordanian samples. Compared to participants with a suicidal past, those who were never suicidal displayed more internal barriers against suicidal behavior. Men were more accepting of suicide than women but women were more willing to help an imagined suicidal peer. Participants with accepting attitudes towards suicide but rejecting attitudes towards suicidal persons reported more suicidal behavior and psychological distress, and were more often from high suicide rate countries and samples than their counterparts. They are considered to be caught in a fatal trap in which most predominant feelings of suicidality such as hopelessness or helplessness are likely to occur. We conclude that in some societies such as Japan and Saudi Arabia it might be difficult for suicidal individuals to activate and make use of social support systems.

Genetic alcohol sensitivity regulated by ALDH2 and ADH1B polymorphisms as indicator of mental disorders in Japanese employees.

AIMS: Alcohol-related disorders (ARD) have been shown to be accompanied by a variety of other comorbid mental disorders. This study evaluated the associations between a variety of mental disorders and genetic alcohol sensitivity. METHODS: A total of 1944 Japanese workers were interviewed regarding their mental disorders by the Mini-International Neuropsychiatric Interview (M.I.N.I.). We investigated the relationship of ADH1B rs1229984 and ALDH2 rs671 polymorphisms' combination with mental disorder risks. Logistic regression analysis was used to evaluate the associations between those polymorphisms and mental disorders, adjusting for sex, age, and job rank. RESULTS: The degree of alcohol sensitivity was classified into five groups according to the combination of ADH1B and ALDH2 genotypes (Group I-V in order starting from the lowest alcohol sensitivity). Those with ALDH2 *1/*1 and ADH1B *1/*1 or with ALDH2 *1/*1 and ADH1B *1/*2,*2/*2 (low sensitivity) were significantly or nearly significantly associated with an increased risk of ARD compared with those with ALDH2 *1/*2 and ADH1B *1/*2,*2/*2 as a reference. Those with ALDH2 *1/*1 and ADH1B *1/*1 were also likely to be at an increased risk of any mental disorder except ARD, as well as disorders without comorbid ARD. This tendency was more apparent among women (OR 11.94, 95% CI 0.73-195.63) and non-drinkers (OR 5.43, 95% CI 1.05-28.23). CONCLUSION: The genotype combination of ALDH2 *1/*1 and ADH1B *1/*1 is significantly associated with an increased risk of any mental disorder, especially ARD. Non-drinkers or women with ALDH2 *1/*1 and ADH1B *1/*1 are likely to suffer from any mental disorder except ARD.

Buffering effects of job resources on the association of overtime work hours with psychological distress in Japanese white-collar workers.

PURPOSE: The purpose of the present study was to investigate the buffering effects of job resources, utilizing the job demands-control (or demand-control-support) and effort-reward imbalance models (i.e., job control, workplace social support, and extrinsic reward), on the association of overtime work hours with psychological distress in Japanese employees. METHODS: A total of 1,198 participants (valid response rate = 93.7 %) from five branches of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales assessing job resources, psychological distress, and demographic characteristics. We obtained the information on working hours in the most recent month from the personnel records of the surveyed company. Multiple logistic regression analyses were conducted. In a series of analyses, interaction term of overtime work hours with each job resource was included in the model. RESULTS: Significant interaction effect of overtime work hours with job control was observed. Among the low job control group, the long overtime (80 h or more) subgroup had a significantly higher prevalence odds ratio of psychological distress compared to the short overtime (44 h or less) subgroup. No significant association of overtime work hours with psychological distress was found among the high job control group. On the other hand, there was no significant interaction effect of overtime work hours with workplace social support or extrinsic reward. CONCLUSIONS: The present findings suggest that high job control has an effect on reducing psychological distress in relation to overtime work hours in Japanese employees.

Loneliness without distress, chosen isolation (solitude) at the workplace, and mental health and job performance: a cross-sectional study of Japanese employees.

While loneliness and social isolation in the workplace affect the mental health and job performance of employees, the effects of loneliness without distress and solitude (i.e., chosen isolation) on these outcomes are unclear. The cross-sectional association was examined by using online survey of full-time employees in Japan (n=846). The results showed that the "loneliness with distress" group had significantly higher psychological distress and lower job performance than the other groups. Work engagement was lower both in the "loneliness with distress" and "loneliness without distress" groups, compared to the "non-loneliness" group. The "unchosen isolation" and the "solitude" groups had poorer scores of psychological distress, work engagement, and work performance, compared to the "non-isolation" group. The preliminary findings showed that loneliness without distress and solitude were associated with poor levels of mental health and job performance and should become a target of mental health promotion interventions in the workplace.

[Development and validation of the University of Tokyo Occupational Mental Health leadership checklist among occupational health specialists].

OBJECTIVES: Recently, occupational health specialists (OHS) are expected to exert leadership to develop high-quality occupational health activities. This study aimed to develop and investigate the reliability and validity of a scale to measure leadership preparation among OHS (The University of Tokyo Occupational Mental Health [TOMH] Leadership Checklist; TLC). METHODS: Based on literature reviews and interviews among OHS, we created potential items consisting of 54 items with six factors (10 items for self-awareness, 10 items for situational awareness, 9 items for vision, 12 items for mindset, 3 items for performance of one's duties, and 10 items for relationship-building). An online survey was conducted with 300 OHS in Japan to verify the scale's reliability and validity. RESULTS: Consequent to the exploratory factor analysis, using the principal factor method and promax rotation, 51 items across the following five factors were identified; "self-awareness", "situational awareness", "vision", "mindset", and "performance of one's duties". The confirmatory factor analysis showed good fit indices; CFI = 0.877, SRMR = 0.050, and RMSEA = 0.072. Cronbach's α ranged from 0.93-0.96. Additionally, the scores of the TLC were significantly positively correlated with work engagement, job satisfaction, and self-efficacy; contrastingly, they were significantly negatively correlated with psychological distress (p < .05). Furthermore, the participants who had experience leadership without authority indicated significantly higher scores of the TLC and its subscales than those who did not (p < .001). DISCUSSION AND CONCLUSIONS: The newly developed TLC appeared to have acceptable levels of reliability and validity. It would be beneficial for OHS to show good leadership.

Effects of participatory organizational interventions on mental health and work performance: A protocol for systematic review and meta-analysis.

INTRODUCTION: Participatory organizational interventions to improve psychosocial working conditions are important for a safe and healthy work environment. However, there are few systematic reviews or meta-analyses investigating the effects of these interventions on workers' mental health and work-related outcomes. We apply the protocol for systematic review and meta-analysis to examine the effect of participatory organizational intervention on mental health and work performance. METHODS AND ANALYSIS: The participants, interventions, comparisons, and outcomes (PICO) of the studies in this systematic review and meta-analysis were defined as follows: (P) inclusion of all workers, (I) participatory organizational intervention, (C) treatment as usual or no intervention (including waitlist control), and (O) mental health and work performance. Published studies will be searched using the following electronic databases: PubMed, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society. Studies that (1) included participatory organizational intervention, (2) included participants who were working as of the baseline survey period, (3) assessed mental health or work performance outcomes, (4) used a cluster randomized controlled trials design, (5) were published in English or Japanese, and (6) were published in peer-reviewed journals (including advanced online publication) will be included. Study selection and the risk of bias assessment will be performed independently by two reviewers. A meta-analysis will be performed to statistically synthesize the included studies. Publication bias will be assessed for meta-bias using Egger's test as well as visually on a funnel plot. We will assess the heterogeneity by using the Q statistic.

Job demands, job resources, and work engagement of Japanese employees: a prospective cohort study.

PURPOSE: Research on the prospective association of job demands and job resources with work engagement is still limited in Asian countries, such as Japan. The purpose of the present study was to investigate the prospective association of job demands (i.e., psychological demands and extrinsic effort) and job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward), based on the job demands-control (JD-C) [or demand-control-support (DCS)] model and the effort-reward imbalance (ERI) model, with work engagement among Japanese employees. METHODS: The participants included 423 males and 672 females from five branches of a manufacturing company in Japan. Self-administered questionnaires, including the Job Content Questionnaire (JCQ), the Effort-Reward Imbalance Questionnaire (ERIQ), the nine-item Utrecht Work Engagement Scale (UWES-9), and demographic characteristics, were administered at baseline (August 2009). At one-year follow-up (August 2010), the UWES-9 was used again to assess work engagement. Hierarchical multiple regression analyses were conducted. RESULTS: After adjusting for demographic characteristics and work engagement at baseline, higher psychological demands and decision latitude were positively and significantly associated with greater work engagement at follow-up (ß = 0.054, p = 0.020 for psychological demands and ß = 0.061, p = 0.020 for decision latitude). CONCLUSIONS: Having higher psychological demands and decision latitude may enhance work engagement among Japanese employees.

Organizational justice and psychological distress among permanent and non-permanent employees in Japan: a prospective cohort study.

BACKGROUND: Organizational justice has recently been introduced as a new concept as psychosocial determinants of employee health, and an increase in precarious employment is a challenging issue in occupational health. However, no study investigated the association of organizational justice with mental health among employees while taking into account employment contract. PURPOSE: The purpose of the present study was to investigate the prospective association of organizational justice (procedural justice and interactional justice) with psychological distress by employment contract among Japanese employees. METHODS: A total of 373 males and 644 females from five branches of a manufacturing company in Japan were surveyed. At baseline (August 2009), self-administered questionnaires, including the Organizational Justice Questionnaire (OJQ), the K6 scale (psychological distress scale), the Eysenck Personality Questionnaire-Revised (EPQ-R), and other covariates, were used. After one-year follow-up (August 2010), the K6 scale was used again to assess psychological distress. Multiple logistic regression analyses were conducted by sex and employment contract. RESULTS: After adjusting for demographic characteristics, psychological distress, and neuroticism at baseline, low procedural justice was significantly associated with a higher risk of psychological distress at follow-up among non-permanent female employees, while no significant association of procedural justice or interactional justice with psychological distress at follow-up was observed among permanent male or female employees. The results of non-permanent male employees could not be calculated because of small sample size. CONCLUSIONS: Low procedural justice may be an important predictor of psychological distress among non-permanent female employees.

Impact of Household Economic and Mothers' Time Affluence on Obesity in Japanese Preschool Children: A Cross-sectional Study.

Although the association between household economic affluence and children's obesity has been reported, the association between mothers' time affluence and obesity remains unclear. We conducted a cross-sectional study using Japanese national survey data (2015). The target population was 2-6-year-old preschool children and their mothers. Subjective household economic affluence and mothers' time affluence were divided into "affluent," "neither," "less affluent," and "non-affluent" groups. Obesity was defined based on the International Obesity Task Force. A logistic regression model was conducted to examine the association between household economic affluence, mothers' time affluence, and children's obesity. A total of 2254 respondents were included in the present analysis. The lower household economic affluence was not significantly associated with higher rates of children's obesity (odds ratio (OR) for the "non-affluent" compared with the "affluent" group was 1.68 (95% CI, 0.93-3.03)). A lower mothers' time affluence was not significantly associated with higher rates of children's obesity (OR for the "non-affluent" compared with the "affluent" group was 1.67 (95% CI, 0.92-3.03)). The prevalence of obesity was not synergistically higher when lower household economic affluence and lower mothers' time affluence were combined.

The relationship between performance feedback from supervisors and subordinates' work engagement among employees in elderly care facilities: structural equation modeling.

Despite the increasing need for nursing care services, the turnover rate of care workers is high in Japan. Since the most common reason for quitting nursing care jobs was problems with interpersonal relationships at work, creating psychosocially safe working environments is urgent. This study aimed to investigate the mediating effects of trust in supervisors (TS) on the association between positive feedback (PF)/negative feedback (NF) and work engagement (WE) based on the job demands-resources theory and conservation of resources theory. We conducted anonymous cross-sectional surveys of 469 employees at elderly care facilities in Japan. Structural equation modeling was used to investigate the causal relationships between the variables. The results showed that PF had significant positive effects on WE, directly and indirectly through TS. By contrast, NF had a nonsignificant positive effect on TS or WE. Tucker-Lewis Index [TLI] was 0.917, Comparative Fit Index [CFI] was 0.927, Root Mean Squared Error of Approximation [RMSEA] was 0.096, and Standardized Root Mean squared Residual [SRMR] was 0.042. The study results indicate that sufficient PF is needed to improve subordinates' WE through TS in elderly care facilities.

Effects of workplace measures against COVID-19 and employees' worry about them on the onset of major depressive episodes: A 13-month prospective study of full-time employees.

BACKGROUND: Workplace measures against COVID-19 may prevent the onset of major depressive episode (MDE) in the working population. This 13-month prospective study aimed to investigate the association of the number of workplace measures against COVID-19 and employees' worry about the measures on the onset of MDE during COVID-19 outbreaks in Japan. METHODS: Data were collected from employees by using online questionnaires at baseline (May 2020) and the 7th survey (June 2021). The onset of MDE during the follow-up was retrospectively measured at the 7th survey, with a self-report scale based on the Mini-International Neuropsychiatric Interview according to the DSM-IV/DSM-5 criteria. Participants were asked to report the number of workplace measures against COVID-19 in their companies/organizations and their worry about these measures (scored 0-3). Multiple logistic regression was conducted of MDE on the number of workplace measures and worry about these, adjusting for demographic and work-related covariates and psychological distress at baseline. RESULTS: Among 968 respondents employed in May 2020, 827 completed the 7th survey in June 2021 (80%). We excluded 75 respondents who reported they had an MDE in May 2020 or earlier. Worry about workplace measures was significantly associated with the onset of MDE after adjusting for the covariates (OR for 1 score increase, 1.53; 95% CI, 1.02-2.32; p = 0.042). No significant association was found between the number of workplace measures and the onset of MDE. CONCLUSIONS: Worrying about workplace measures taken by company/organization may be a risk factor for the onset of an MDE among employees during the COVID-19 pandemic.

Working environment at home and mental health in employees working from home in Japan during COVID-19 pandemic: A cross-sectional study.

OBJECTIVES: This cross-sectional study aimed to examine the associations of a poor working environment at home with psychological distress and psychosomatic symptoms in employees working from home in Japan during the COVID-19 pandemic. METHODS: The data obtained in October 2021 from an online cohort of full-time employees (E- COCO- J) were used. Participants who worked from home for at least some days per month were included. The poor working environment at home was assessed using 11 items based on the Japanese Ministry of Health, Labour and Welfare recommended checklist. The score ranged from 0 to 11. Psychological distress and psychosomatic symptoms were measured by the Brief Job Stress Questionnaire (BJSQ). The associations between total scores of poor working environment and outcomes were examined by multiple regression analysis, adjusted by age, sex, education, living with family, frequencies of working from home, company size, job demand, job control, and workplace social support. RESULTS: Two hundred twenty-six employees who were working at home were included. The mean of the summed scores of poor working environments at home was 2.75. After adjusting the covariates, summed scores of poor working environments were significantly associated with high psychological distress (standardized ß = 0.21, P = .003) and with high psychosomatic symptoms (ß = 0.19, P = .005). For each poor environment, lack of ventilation and difficulty staying hydrated or resting were significantly associated with both outcomes. CONCLUSIONS: Even after adjusting for job stressors and support, working environments at home were associated with employees' mental health. Appropriate measures and education may be needed.

The Association between the Severity of Dysmenorrhea and Psychological Distress of Women Working in Central Tokyo-A Preliminary Study.

This study aims to clarify the association between the severity of dysmenorrhea and psychological distress among working women in central Tokyo and examine the effect modification of job stressors. The participants in this cross-sectional study were 312 women who had undergone health check-ups in the "Marunouchi Hokenshitsu" project. The severity of dysmenorrhea was defined as the degree of daily life disturbance with menstrual pain, and the outcome variable was the K6 scores. To assess the association of psychological distress with the severity of dysmenorrhea, multiple regression analyses were performed. The results revealed that 18.3% of the 289 working women were in the moderate/severe group of dysmenorrhea. In multiple regression analysis, moderate/severe dysmenorrhea was significantly associated with higher levels of psychological distress, but the significance disappeared after adjusting for gynecology such as premenstrual syndrome (PMS) and workplace-related factors. The degree of job control was significantly associated with lower levels of psychological distress and may modify psychological distress caused by dysmenorrhea. Moderate/severe dysmenorrhea may be associated with higher levels of psychological distress in working women, and psychological symptoms of PMS) and the degree of job control were possible effect factors, and there may be effect modification by the degree of job control.

Work engagement and associated factors among Japanese registered dietitians and dietitians: a cross-sectional study.

Healthcare services provided by registered dietitians and dietitians have been changing because of evolving lifestyles and population dynamics, leading to subsequent changes in the occupational status and experiences of these professionals. However, few studies have examined occupational stress among registered dietitians and dietitians. This study involved a cross-sectional survey to investigate the status and associated factors of work engagement among registered dietitians and dietitians, whose professions differ based on licensing processes and scope of work. A total of 3,593 questionnaires were distributed, 1,890 responses were received, and 1,654 valid questionnaires were analyzed. Work engagement was measured using the Utrecht Work Engagement Scale. Multiple regression analysis was conducted to examine the associations between work engagement and each factor. The work engagement scores of dietitians were significantly lower than those of registered dietitians. Further, work engagement was associated with age, workplace, coworker support, and effort-reward ratio for both registered dietitians and dietitians. However, exercise habit was a significant factor associated with work engagement only among dietitians. Work engagement among registered dietitians was comparable to that of typical Japanese workers, whereas it was lower among dietitians. The findings highlight the importance of considering associated factors to improve work engagement further, especially among dietitians.