The validation of Chinese version of workplace PERMA-profiler and the association between workplace well-being and fatigue.

BACKGROUND: Well-being is an important issue in workplace. One of these assessment tools of well-being, Workplace PERMA Profiler, is based on Seligman's five dimensions well-being. Prolonged fatigue may last for a long time, leading a great impact on both employees and enterprises. However, rare studies about the association between well-being and fatigue had been investigated. Our aim is to establish the Chinese version Profiler, and to discovery the association between workplace well-being and fatigue. METHODS: The Chinese version was established according to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) task force guidelines. In the study, researchers employed simple random sampling by approaching individuals undergoing health checkups or receiving workplace health services, inviting them to participate in a questionnaire-based interview. Prolonged Fatigue was evaluated by Checklist Individual Strength (CIS). The reliability was evaluated by Cronbach's alphas, Intra-class Correlation Coefficients (ICCs), and measurement errors. Moreover, confirmatory factor analysis and correlational analyses were assessed for the validity. RESULTS: The analyses included 312 Chinese workers. Cronbach's alphas of the Chinese version ranged from 0.69 to 0.93, while the ICC ranged from 0.70 to 0.92. The 5-factor model of confirmatory factor analysis revealed a nearly appropriate fit (χ2 (82) = 346.560, Comparative Fit Index [CFI] = 0.887, Tucker-Lewis Index [TLI] = 0.855, Root Mean Square Error of Approximation [RMSEA] = 0.114, Standardized Root Mean Square Residual [SRMR] = 0.060). Moreover, the CIS and its four dimensions were significantly and negatively associated with the Positive Emotion, while they are positively associated with Engagement dimension except CIS-Motivation dimension. CONCLUSION: The Chinese version Workplace PERMA-Profiler indicate nice reliability and validity. Furthermore, all CIS dimensions were negatively influenced by Positive Emotion, while commonly positively associated with Engagement.

Development of a risk assessment tool for Japanese sex offenders: The Japanese Static-99.

In Japan, sexual offending, especially paraphilic sexual offending, has become a major problem, and approximately 3000 people are arrested for frotteuristic and voyeuristic behavior each year. Considering the repetitive nature of such behaviors, determining the recidivism risk is imperative. Globally, Static-99 is one of the most widely used actuarial risk assessment tools to predict recidivism among sex offenders. However, sexual offending is largely influenced by social and cultural backgrounds, and whether risk factors identified in the West are applicable to other countries is unknown. Therefore, we developed a Japanese version of the Static-99 and examined its reliability and validity with 167 Japanese paraphilic sex offenders. The results showed good internal consistency (Cronbach's alpha coefficient = 0.88) and predictive accuracy (area under the curve = 0.76). The results indicate that the Japanese Static-99 can be used with Japanese sex offenders. Moreover, risk factors identified in the Western context are applicable to Japanese sex offenders despite the different nature and manifestations of their offending.

Walking the tightrope between work and home: the role of job/home resources in the relation between job/home demands and employee health and well-being.

The present study investigated the role of job/home resources in the relation between job/home demands and exhaustion, job satisfaction, work-home interference, and home-work interference during the COVID-19 pandemic. We explored the prevalence of job/home demands and resources during the COVID-19 pandemic, and examined whether working at different locations (i.e., working from home or at the office) affects how both job/home demands and resources are associated with employees' health and well-being. An online cross-sectional survey study using self-report questionnaires was carried out among the networks of the International Commission on Occupational Health (ICOH) association (N=153). The findings of this study illustrated that (1) cognitive job demands/resources and emotional home demands/resources were crucial in predicting employee health and well-being; (2) a conceptual match was detected between corresponding demands and resources; (3) subgroup analysis showed that employees were not heavily affected by the different working locations during the pandemic. In conclusion, this study confirms the positive role of job/home resources. We suggest that cultivating specific job/home resources and establishing an appropriate match between specific job/home resources and corresponding job/home demands is necessary to ensure employees' health and well-being in times of a pandemic.

Effect of stress management based on cognitive-behavioural therapy on nurses as a universal prevention in the workplace: a systematic review and meta-analysis protocol.

INTRODUCTION: The mental health status of nurses affects not only their well-being but also the organisational outcomes and the quality of patient care. Hence, stress management strategies are critical as a universal prevention measure that address an entire population and are not directed at a specific risk group to maintain nurses' mental health in the workplace. No systematic review or meta-analysis has been conducted to evaluate the effect of cognitive-behavioural therapy (CBT) that specifically focuses on universal prevention. Therefore, the aim of this study is to examine the effectiveness that is reported in published randomised controlled trial (RCT) studies. METHODS AND ANALYSIS: This systematic review and meta-analysis will analyse published studies selected from electronic databases (ie, Cochrane Central Register of Controlled Trials, PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, Web of Science and the Japan Medical Abstracts Society). The inclusion criteria for studies are that they (1) were conducted to assess the effect of CBT on the mental health of nurses as a universal prevention, (2) used an RCT design and (3) provided sufficient results (sample sizes, means and SD) to estimate the pooled effect sizes with 95% CIs. Studies will be excluded if they only targeted nurses who had been screened as being at high risk in terms of their mental health and indicated that they required the prevention. The methodological quality of the included studies will be assessed using the Cochrane Collaboration's risk of bias tool. ETHICS AND DISSEMINATION: Ethical approval is not required because this study is based on information obtained from previous studies. The results and findings of this study will be submitted for publication in a peer-reviewed international scientific journal. Results from this study will be helpful when implementing CBT strategies for nurses as a universal preventative measure in the workplace and for managing stress-related outcomes. PROSPERO REGISTRATION NUMBER: CRD42020152837.

The ongoing activities of livelihood support counselors following nuclear disaster under the COVID-19 restrictions: A preliminary survey.

BACKGROUND: This preliminary study aims to understand the state of support provided in the evacuation areas of the 2011 Fukushima nuclear disaster, during the novel coronavirus 2019 (COVID-19) restriction. METHODS: A self-administered survey was conducted with 18 livelihood support counselors from two Social Welfare Councils in November 2020. We investigated the number of consultations since the COVID-19 pandemic and the impact of telephonic consultation as opposed to in-person consultations through visits to counselees' homes. RESULTS: Counselors have been continued offering supports to their counselees even under the COVID-19 restrictions, in fact, fifty percent of counselors have increased the consultations. Although some counselors had a sense of unease or concern about telephonic consultation due to the inability to see their non-verbal expressions, there were some advantages of telephonic consultation, in that the counselors were able to have longer sessions and listen more attentively to severe issues. CONCLUSIONS: Notably, livelihood support counselors in this study have increased the number of consultations while utilization telephonic consultations, despite the adverse conditions created by the COVID-19 restriction. Moreover, certain advantages of telephonic consultation instead of in-person consultation have been identified. It may be an effective support method avoiding in-person contacts, that also considers infection-prevention measures.

Longitudinal association between adolescent work values and mental health and well-being in adulthood: a 23-year prospective cohort study.

Personal values developed in adolescence may influence mental health and well-being over the life course. Using data from 684 respondents in the Youth Development Study (61.9% of respondents in the baseline survey), we explored the effects of work values at ages 14-15 on positive and negative emotions, as well as psychological resources (self-esteem and mastery), at ages 37-38. We adjusted for socioeconomic status and the baseline scores of these outcomes using linear regression analyses. Having the work value of getting ahead in adolescence was positively associated with self-esteem in adulthood. Work values in adolescence did not predict positive emotions, negative emotions, or mastery in adulthood. Valuing one's growth in adolescence may help develop self-esteem in adulthood.

Japanese version of the 42-item psychological well-being scale (PWBS-42): a validation study.

BACKGROUND: The aim of this study was to examine the internal consistency, structural validity, and convergent/known-group validity of the Japanese version of the 42-item Psychological Well-Being Scale (PWBS-42). METHODS: The PWBS-42 includes six 7-item subscales designed to measure the following dimensions of eudaimonic psychological well-being: 1) autonomy, 2) environmental mastery, 3) personal growth, 4) positive relations with others, 5) purpose in life, and 6) self-acceptance. A questionnaire was administered to 2102 community residents in Tokyo aged 30 or over as a part of the Midlife in Japan (MIDJA) survey, in 2008. The internal consistency reliability was tested using Cronbach's α. Structural validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations of the Japanese PWBS-42 subscales with life satisfaction, negative affect, negative adjectives, positive affect, positive adjectives, self-esteem, and perceived stress scales. RESULTS: Data from 1027 respondents (505 males and 522 females) were analyzed (valid response rate = 56.2%). Cronbach's α values ranged from 0.70 to 0.78 for five of the subscales, while that for purpose in life was lower (0.57). EFA yielded a five-factor structure: The first two factors consisted of negative and positive items mostly from the environmental mastery, purpose in life, and self-acceptance subscales. The third, fourth, and fifth factors consisted mostly of items from the positive relations with others, autonomy, and personal growth subscales, respectively. As hypothesized, the scores for life satisfaction, negative and positive affect/adjectives, self-esteem and perceived stress were significantly correlated with all subscales of the Japanese PWBS-42. CONCLUSION: The subscales of the Japanese version of the PWBS-42 showed accep. levels of reliability and support for convergent validity in the Japanese population. The factor structure was slightly different from the theoretical 6-factor model: items of three subscales (environmental mastery, purpose in life, and self-acceptance) loaded together on two factors. This finding may be interpreted in light of the interdependent self construal found in Japan in which these three components could be closely linked.

[A two-year program to promote participatory workplace environmental improvements at small enterprises with fewer than ten employees].

OBJECTIVE: This study aimed to determine the influence of participatory workplace environmental improvement program on reducing job stress and workers' psychological distress at small enterprises (i.e., less than 10 employees). Furthermore, this study aimed to clarify important factors for success of this program as well. METHODS: The model program was tested in a small enterprise with eight employees between October 2014 and January 2017. Moreover, five employees participated in the annual work environment improvement workshops for two consecutive years. During both years, the New Brief Job Stress Questionnaire (80-item version) was used to measure work-related stress before (baseline) and after (post-three months and post-12 months) the workshops. To assess the extent of an intervention effect, the questionnaire data were analyzed using the Friedman test and the multiple comparison test annually. In addition, continuous data were analyzed during the two years. The statistical significance of the differences across time was determined at the p < .10 cutoff value because the number of participants was small. The effect size was also calculated. The participants were interviewed regularly. RESULTS: For both years, the employees implemented action plans within one month of completing the workshops. In the first year, the data for the Friedman test indicated a significant change in role conflict, job resources (workgroup-level), respect for individuals, fair personnel evaluations, work-self balance (positive), workplace social capital, and job satisfaction. In the multiple comparison test, significant changes manifested in role conflict and workplace social capital. In the second year, significant changes were found regarding role conflict and fair personnel evaluations for the Friedman test, demonstrating significant changes in role conflict in the multiple comparison test. As per the two-year survey results, the Friedman test indicated significant changes in role conflict, respect for individuals, and fair personnel evaluations, while the multiple comparison test demonstrated no significant changes. Over time, favorable changes were found regarding role conflict in the first year; however, undesirable changes were found regarding the other statistically significant items. The interviews revealed both positive and negative opinions. CONCLUSIONS: This study found the effects of the participatory workplace environment improvement program to be limited. Thus, the program should be improved to reduce its adverse effects as well as the participants' negative opinions.

Age-Related Trends in the Prevalence of Type 2 Diabetes among Japanese and White and Black American Adults.

Aim: To compare the prevalence of poor glycemic control in probability samples of Japanese and American adults, and to determine the association with their somatic phenotypes. Material and Methods: Blood samples and anthropometric measures were obtained from 382 Japanese, 32-79 years of age, randomly selected to reflect the 23 wards of Tokyo. HA1c values were compared to 1215 Americans, 35-86 years of age, from a national study across the 48 continental states, along with an over-sampling of African-Americans from one city (www.midus.wisc.edu). Body Mass Index (BMI) and Waist-hip ratio (WHR) were also assessed. Results: Many Japanese now have high HA1c approaching Caucasian-American levels, although elevated HA1c (>6.5%, 48 mmol/mol) is not nearly as prevalent as among African-Americans. Significant age-related trends were evident in both countries, with poor glycemic control occurring at younger ages in males and rarely found until old age in Japanese women. Japanese had higher HA1c levels at BMIs of 23-25, in contrast to Americans with Type 2 diabetes who more typically had a BMI over 30. Central adiposity predicted HA1c levels better than BMI, a relationship also apparent at a smaller WHR in Japan. Conclusion: The prevalence of high HA1c in Tokyo almost rivals white Americans, but those statistics are dwarfed by the 37% of Afr-Amer adults identified with Type 2 diabetes. Elevated HA1c was more common in men, reflecting central adiposity, but poor glycemic control was also widespread among overweight Afr-Amer women. Type 2 diabetes was higher among older Japanese, when more women succumb. Overall, the findings highlight the societal and clinical challenges posed by demographic trends in both countries.

Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall.

BACKGROUND: The aim of this study is to examine the relationship between personal values in adolescence retrospectively assessed and psychological distress in adults in a representative sample of community adults in Japan. METHODS: We used the J-SHINE data collected in 2010 and 2017. Personal values in adolescence were retrospectively measured in the 2017 survey in two ways: (1) value priorities developed from Schwartz's theory of basic values; and (2) commitment to values measured by Personal Values Questionnaire II (PVQ-II). Psychological distress was measured by using K6 in 2010. Multiple regression analysis was conducted to clarify the association between personal values in adolescence and psychological distress in adults, adjusting for sociodemographic variables, smoking, alcohol drinking, and economic status at age 15. RESULTS: Enduring active challenging, cherishing family and friends, and the commitment to values were significantly and negatively associated with psychological distress in adults. Pursuing one's interest was significantly and positively associated with psychological distress. CONCLUSIONS: Having a value priority of enduring active challenging, cherishing family and friends, and the commitment to values in adolescence may reduce psychological distress in adults.

Factors associated with long-term prescription of benzodiazepine: a retrospective cohort study using a health insurance database in Japan.

OBJECTIVES: Current clinical guidelines discourage long-term prescription of benzodiazepines and Z-drugs (BZD); however, the practice continues to exist. The aim of this study was to investigate the proportion of long-term BZD prescriptions and its risk factors. DESIGN: Retrospective cohort study using a health insurance database. SETTING: Japan. PARTICIPANTS: A total of 86 909 patients were identified as outpatients aged 18 to 65 years who started BZD between 1 October 2012 and 1 April 2015. After excluding patients who underwent surgery on the day of first BZD prescription (n=762) and patients without 8 months follow-up (n=12 103), 74 044 outpatients were analysed. MAIN OUTCOME MEASURES: We investigated the proportion of long-term prescriptions for ≥8 months among new BZD users. We assessed patient demographics, diagnoses, characteristics of the initial BZD prescription and prescribers as potential predictors of the long-term BZD prescription. Multivariable logistic regression was performed to assess the association between long-term prescription and potential predictors. RESULTS: Of the new BZD users, 6687 (9.0%) were consecutively prescribed BZD for ≥8 months. The long-term prescription was significantly associated with mood and neurotic disorder, cancer, prescription by psychiatrists, multiple prescriptions, hypnotics and medium half-life BZD in the initial prescription. CONCLUSION: Despite the recent clinical guidelines, 9% of new BZD users were given prescriptions for more than 8 months. Physicians should be aware of risk factors when prescribing BZDs for the first time.

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.

Organizational Justice and Refraining from Seeking Medical Care Among Japanese Employees: A 1-Year Prospective Cohort Study.

BACKGROUND: Using a 1-year prospective design, we examined the association of organizational justice (i.e., procedural justice and interactional justice) with refraining from seeking medical care (RSMC) among Japanese employees. METHODS: We surveyed 2695 employees (1994 men and 701 women) from two factories of a manufacturing company in Japan. A self-administered questionnaire comprising scales for measuring organizational justice (Organizational Justice Questionnaire) and potential confounders (i.e., demographic and socioeconomic characteristics as well as health-related behaviors) was administered at baseline (from April to June 2011). At 1-year follow-up (from April to June 2012), a single-item question was used to measure RSMC during the follow-up period. Multiple logistic regression analysis was conducted by gender. RESULTS: After adjusting for potential confounders, low procedural justice and low interactional justice at baseline were found to be significantly associated with higher odds of RSMC during the 1-year follow-up for male employees (odds ratio = 1.33 [95% confidence interval = 1.16-1.52], p < 0.001 and 1.15 [95% confidence interval = 1.02-1.29], p = 0.019, respectively). Similar patterns were observed for female employees (odds ratio = 1.37 [95% confidence interval = 1.08-1.74], p = 0.009 and 1.23 [95% confidence interval = 1.02-1.50], p = 0.035 for low procedural justice and low interactional justice, respectively). CONCLUSIONS: The present study provided evidence that the lack of organizational justice is positively associated with RSMC among Japanese employees, independently of demographic and socioeconomic characteristics as well as of health-related behaviors.

[Readiness factors to improve the work environment using an employee participatory approach: Development and validation of readiness state checklist].

OBJECTIVES: The employee participatory approach is an effective method for improving work environments. However, there are some challenges in executing this method in each workplace because of such factors as a lack of employee interest or motivation to commit to the activity. Research was conducted to clarify readiness factors to improve the workplace environment using an employee participatory approach. Additionally, we developed a checklist to efficiently measure the readiness factors. METHODS: A pool of readiness items for the employee participatory approach was created from expert consensus and interviews with practitioners. A total of 300 Japanese workers (150 men; 150 women) responded to a survey after being recruited by an internet research company. After exploratory factor analysis (EFA), path analysis with categorical variables was conducted by the robust maximum likelihood method with defined readiness as an endogenous variable and resource for readiness as an external variable, then threshold (θ) and path coefficients (γ) were estimated. We set the level of the item according to the threshold per item, and the highest pass coefficients for each level with 0.60 or more items were adopted in the checklist. Finally, the relationship between each level and the readiness and related items (psychosocial factors, work engagement, and psychological stress responses in the workplace) was confirmed in the ANOVA. RESULTS: As a result of the EFA, a three-factor structure with 71 items was developed. The path analysis extracted the first factor (workplace acceptability) with three items and the second factor (supervisor's leadership) with two items. The third factor, preferences for the workplace, was judged insufficient because the relevant item was not adequately related to the readiness state. Finally, the checklist was created to determine four levels judged by the five items. Significant differences were observed in each level and readiness state by ANOVA. CONCLUSIONS: To facilitate the participatory approach method, it was suggested that the status of workplace acceptance, supervisor's leadership, and preferences for the workplace might be important. In addition, using the checklist developed in this study, it is possible to assess the readiness state for improving the work environment using an employee participative approach, as well as to set promotion targets in each workplace.

Effects of a Multi-Component Workplace Intervention Program with Environmental Changes on Physical Activity among Japanese White-Collar Employees: a Cluster-Randomized Controlled Trial.

PURPOSE: This study aimed to investigate effects of a flexible multi-component workplace intervention program for improving physical activity among Japanese white-collar employees in a cluster randomized controlled trial design. METHODS: A total of 208 worksites and nested employees were approached. Any worksite interested in a 3-month physical activity promotion intervention and white-collar workers aged 18 years or older were eligible. The worksites were randomly assigned to an intervention or a control, stratified by worksite size. The intervention worksites were offered an intervention program that allows these worksites to select intervention components from a set of options, including environmental changes. The control worksites were offered feedback and basic occupational health services. Physical activity level was measured using a self-reported questionnaire at baseline and at 3 and 6 months of follow-up. RESULTS: Three worksites (92 employees) were allocated to the intervention and five worksites (98 employees) to the control worksites. The overall physical activity level in the intervention worksites significantly increased compared with the control worksites (Coeff = 0.45, SE = 0.19, p = 0.018). For subgroup analyses, the intervention effect on the overall physical activity level was significant among medium- and large-sized worksites but not among small-sized worksites. CONCLUSION: This trial showed a significant and positive effect of the intervention program on physical activity. The program is unique because of its flexibility and feasibility. However, small worksites might receive less benefit from the program, indicating a need for further support and/or new technologies. TRIAL REGISTRATION: UMIN Clinical Trials Registry (ID=UMIN000024069).

Associations among workplace environment, self-regulation, and domain-specific physical activities among white-collar workers: a multilevel longitudinal study.

BACKGROUND: Psychological and environmental determinants have been discussed for promoting physical activity among workers. However, few studies have investigated effects of both workplace environment and psychological determinants on physical activity. It is also unknown which domains of physical activities are promoted by these determinants. This study aimed to investigate main and interaction effects of workplace environment and individual self-regulation for physical activity on domain-specific physical activities among white-collar workers. METHODS: A multi-site longitudinal study was conducted at baseline and about 5-month follow-up. A total of 49 worksites and employees within the worksites were recruited. Inclusion criteria for the worksites (a) were located in the Kanto area, Japan and (b) employed two or more employees. Employee inclusion criteria were (a) employed by the worksites, (b) aged 18 years or older, and (c) white-collar workers. For outcomes, three domain-specific physical activities (occupational, transport-related, and leisure-time) at baseline and follow-up were measured. For independent variables, self-regulation for physical activity, workplace environments (parking/bike, signs/bulletin boards/advertisements, stairs/elevators, physical activity/fitness facilities, work rules, written policies, and health promotion programs), and covariates at baseline were measured. Hierarchical Linear Modeling was conducted to investigate multilevel associations. RESULTS: Of the recruited worksites, 23 worksites and 562 employees, and 22 worksites and 459 employees completed the baseline and the follow-up surveys. As results of Hierarchical Linear Modeling, stairs/elevator (γ=3.80 [SE=1.80], p<0.05), physical activity/fitness facilities (γ=4.98 [SE=1.09], p<0.01), and written policies (γ=2.10 [SE=1.02], p<0.05) were significantly and positively associated with occupational physical activity. Self-regulation for physical activity was associated significantly with leisure-time physical activity (γ=0.09 [SE=0.04], p<0.05) but insignificantly with occupational and transport-related physical activity (γ=0.11 [SE=0.16] and γ=-0.00 [SE=0.06]). Significant interaction effects of workplace environments (physical activity/fitness facilities, work rules, and written policies) and self-regulation were observed on transport-related and leisure-time physical activity. CONCLUSIONS: Workplace environments such as physical activity/fitness facilities, written policies, work rules, and signs for stair use at stairs and elevators; self-regulation for physical activity; and their interactions may be effective to promote three domain-specific physical activities. This study has practical implications for designing multi-component interventions that include both environmental and psychological approaches to increase effect sizes to promote overall physical activity.

Culture and social hierarchy: Self- and other-oriented correlates of socioeconomic status across cultures.

Current theorizing on socioeconomic status (SES) focuses on the availability of resources and the freedom they afford as a key determinant of the association between high SES and stronger orientation toward the self and, by implication, weaker orientation toward others. However, this work relies nearly exclusively on data from Western countries where self-orientation is strongly sanctioned. In the present work, we predicted and found that especially in East Asian countries, where other-orientation is strongly sanctioned, high SES is associated with stronger other-orientation as well as with self-orientation. We first examined both psychological attributes (Study 1, N = 2,832) and socialization values (Study 2a, N = 4,675) in Japan and the United States. In line with the existent evidence, SES was associated with greater self-oriented psychological attributes and socialization values in both the U.S. and Japan. Importantly, however, higher SES was associated with greater other orientation in Japan, whereas this association was weaker or even reversed in the United States. Study 2b (N = 85,296) indicated that the positive association between SES and self-orientation is found, overall, across 60 nations. Further, Study 2b showed that the positive association between SES and other-orientation in Japan can be generalized to other Confucian cultures, whereas the negative association between SES and other-orientation in the U.S. can be generalized to other Frontier cultures. Implications of the current findings for modernization and globalization are discussed. (PsycINFO Database Record

Cumulative incidence of suicidal ideation and associated factors among adults living in temporary housing during the three years after the Great East Japan Earthquake.

BACKGROUND: The effect of disasters on suicidality is not known. We aimed to retrospectively determine the cumulative incidence of suicidal ideation during the 3 years after the Great East Japan Earthquake among residents in temporary housing without prior suicidal ideation, as compared to the general population. Moreover, we aimed to identify the risk factors for the onset of suicidal ideation. METHODS: A cross-sectional survey involving face-to-face interviews was conducted 3 years after the earthquake with adult community residents in disaster-affected areas and a control area using the World Health Organization Composite International Diagnostic Interview version 3.0. We compared the cumulative incidence of suicidal ideation between the two areas using the Cox proportional hazard model and examined risk factors for the onset of suicidal ideation using a multiple logistic regression analysis. RESULTS: Among 1019 respondents in the disaster-affected areas, the cumulative incidence of suicidal ideation over 1, 2, and 3 years after the earthquake was 1.4%, 2.4%, and 2.8%, respectively, which was significantly higher than that in the control area. Not being married, being injured in the disaster, and poor subjective physical health were associated with the onset of suicidal ideation. LIMITATIONS: We estimated the time of onset of suicidal ideation based on the respondents' current age and self-reported onset age, which limits the accuracy of the onset timing. CONCLUSIONS: We revealed a higher incidence of suicidal ideation in temporary housing residents and identified several risk factors, which suggests the importance of developing countermeasures to prevent suicide after a disaster.

Population health and regional variations of disease burden in Japan, 1990-2015: a systematic subnational analysis for the Global Burden of Disease Study 2015.

BACKGROUND: Japan has entered the era of super-ageing and advanced health transition, which is increasingly putting pressure on the sustainability of its health system. The level and pace of this health transition might vary across regions within Japan and concern is growing about increasing regional variations in disease burden. The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) provides a comprehensive, comparable framework. We used data from GBD 2015 with the aim to quantify the burden of disease and injuries, and to attribute risk factors in Japan at a subnational, prefecture-level. METHODS: We used data from GBD 2015 for 315 causes and 79 risk factors of death, disease, and injury incidence and prevalence to measure the burden of diseases and injuries in Japan and in the 47 Japanese prefectures from 1990 to 2015. We extracted data from GBD 2015 to assess mortality, causes of death, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), life expectancy, and healthy life expectancy (HALE) in Japan and its 47 prefectures. We split extracted data by prefecture and applied GBD methods to generate estimates of burden, and attributable burden due to known risk factors. We examined the prefecture-level relationships of common health system inputs (eg, health expenditure and workforces) to the GBD outputs in 2015 to address underlying determinants of regional health variations. FINDINGS: Life expectancy at birth in Japan increased by 4·2 years from 79·0 years (95% uncertainty interval [UI] 79·0 to 79·0) to 83·2 years (83·1 to 83·2) between 1990 and 2015. However, the gaps between prefectures with the lowest and highest life expectancies and HALE have widened, from 2·5 to 3·1 years and from 2·3 to 2·7 years, respectively, from 1990 to 2015. Although overall age-standardised death rates decreased by 29·0% (28·7 to 29·3) from 1990 to 2015, the rates of mortality decline in this period substantially varied across the prefectures, ranging from -32·4% (-34·8 to -30·0) to -22·0% (-20·4 to -20·1). During the same time period, the rate of age-standardised DALYs was reduced overall by 19·8% (17·9 to 22·0). The reduction in rates of age-standardised YLDs was very small by 3·5% (2·6 to 4·3). The pace of reduction in mortality and DALYs in many leading causes has largely levelled off since 2005. Known risk factors accounted for 34·5% (32·4 to 36·9) of DALYs; the two leading behavioural risk factors were unhealthy diets and tobacco smoking in 2015. The common health system inputs were not associated with age-standardised death and DALY rates in 2015. INTERPRETATION: Japan has been successful overall in reducing mortality and disability from most major diseases. However, progress has slowed down and health variations between prefectures is growing. In view of the limited association between the prefecture-level health system inputs and health outcomes, the potential sources of regional variations, including subnational health system performance, urgently need assessment. FUNDING: Bill & Melinda Gates Foundation, Japan Ministry of Education, Science, Sports and Culture, Japan Ministry of Health, Labour and Welfare, AXA CR Fixed Income Fund and AXA Research Fund.