Social Independence of Patients with Neurofibromatosis Type 2 in Japan: Analysis of a National Registry of Patients Receiving Medical Expense Subsidies, 2004-2013.

Although it is important for patients with neurofibromatosis type 2 (NF2) to live independently and maintain good quality of life (QOL), no study has examined the social independence status in this patient population. This study aimed to examine the state of social independence and its contributing factors in patients with NF2 using data from a national registry in Japan during the past decade. A database provided by the Ministry of Health, Labour and Welfare of Japan that contained information about all patients with newly submitted claims for medical expense subsidies for NF2 in Japan between fiscal years 2004 and 2013 was analyzed. Individuals aged 6 to 64 years were deemed eligible for the present study. Categories of "employed," "studying," and "housekeeping" were classified as "socially independent." Multivariate logistic regression analysis was performed to examine associations between demographic variables, neurological features, and social independence status. Of 334 participants, 79% were socially independent at the time of registration. Socially dependent participants had more neurological features than those who were socially independent, whereas sex, age, and family history had no significant associations with social independence status. Multivariate logistic regression analysis revealed that participants with bilateral hearing loss, unilateral hearing loss, blindness, hemiplegia, or seizures had significantly higher odd ratios for being socially dependent compared to participants without these features. Our findings, which suggest that these neurological features could restrict social independence, could contribute to the maintenance of better social functioning and QOL in patients with NF2.

[A questionnaire survey on Japanese workers' views of the work-treatment balance system].

OBJECTIVE: To examine Japanese workers' acceptance and perceptions of the work-treatment balance system proposed by the Japanese Government. METHODS: A questionnaire survey was conducted among 120,000 Japanese workers. Participants were asked about their acceptance of the work-treatment balance system and their attitudes toward disclosing health problems and seeking support in the workplace. RESULTS: Only 7% and 27% of participants accepted the work-treatment balance system and a consultation desk for employees having difficulties at the workplace, respectively. The proportion of those who preferred not to disclose a health problem in the workplace (31%) exceeded those who preferred to do so (15%). Multiple logistic regression analysis indicated that acceptance of the work-treatment balance system and a consultation desk at the workplace was significantly associated with attitudes toward disclosing health problems. Those who worked in smaller workplaces (less than 300 employees) and were employed in sales/customer service, manufacturing, and driving/delivery were significantly less likely to indicate a willingness to disclose a health problem in the workplace. CONCLUSION: Most workers have little understanding of the work-treatment balance system. Further knowledge of the work-treatment balance system must be promoted by both the Government and companies.

Evaluation of neurofibromatosis type 1 progression using a nationwide registry of patients who submitted claims for medical expense subsidies in Japan between 2008 and 2012.

BACKGROUND: No study to date has followed disease progression in patients with neurofibromatosis type 1 (NF1), including the incidence of various manifestations, using a national registry. Here we examined the state of NF1 progression using a nationwide registry of patients who submitted claims to receive medical expense subsidies for NF1 in Japan over a five-year period. A total of 342 eligible patients (194 females and 148 males) with NF1 who newly submitted claims for medical expense subsidies in Japan in 2008 were followed until 2012. RESULTS: More than half of the patients were classified as Stage 5 in 2008. Of the eligible patients, 205 (60%) submitted claims to renew the subsidies between 2009 and 2012. During the study period, NF1 stage progressed in 30 patients, yielding an overall stage progression rate of 19% and progression incidence rate per 100 person-years of 12.2. Both stage progression rate and progression incidence rate were the highest in the 0-19 year age group at the time of registration and, as compared to other age groups, progression of neurological and bone manifestations was more prevalent in this age group. CONCLUSIONS: The progression of neurological and bone manifestations was more prevalent in the 0-19 year age group compared to other age groups. The registry we used in the present study is useful for understanding the characteristics of patients with uncommon conditions, such as NF1. Our findings also highlight the feasibility of conducting quality research using registries of patients with rare diseases, such as NF1, that were not designed specifically for scientific research.

Responses to persuasive messages encouraging professional help seeking for depression: comparison between individuals with and without psychological distress.

BACKGROUND: The persuasive effect of health messages can depend on message features, audience characteristics, and target behaviors. The objective of this study was to compare the responses to persuasive messages encouraging professional help seeking for depression between individuals with and without psychological distress. METHODS: A cross-sectional web-based survey was conducted on Japanese adults aged 35-45 years, who randomly received one of three persuasive messages that aimed to promote help-seeking intentions for depression. The primary message statements were as follows: (1) depression can happen to anyone, (2) depression needs treatment, and (3) depression improves with treatment. Participants rated the messages in terms of comprehensibility, persuasiveness, emotional response, and intended future use. Help-seeking intention for depression was measured using vignette methodology before and after exposure to the messages. Eligible participants who had not received medical treatment for their mental disorders were classified as either distressed (K6 score ≥ 5, N = 824) or non-distressed (K6 score < 5, N = 1133) and analyzed. RESULTS: No significant differences in comprehensibility or persuasiveness scores were observed between the messages, but the distressed group had significantly lower scores than the non-distressed group. Negative emotional responses such as surprise, anger, fear, sadness, guilt, and anxiety were significantly stronger when reading message 2, while a positive emotional response such as happiness was significantly stronger when reading message 3. These emotional responses were more prominent in the distressed than in the non-distressed group. After reading messages 1, 2, and 3, the proportions of participants in the distressed group who reported having a positive help-seeking intention increased by 35.1%, 32.1%, and 27.7%, respectively, and by 6.4%, 17.3%, and 15.2%, respectively in the non-distressed group. Multiple logistic regression analysis among participants having no help-seeking intention before exposure to the messages showed that message 2 had a significantly greater effect of increasing help-seeking intentions in the non-distressed group. CONCLUSION: The exposure to persuasive messages may promote help-seeking intentions for depression. It seems likely that loss framing will work better than neutral and gain framing. Meanwhile, the responses to persuasive messages may differ to some extent between distressed and non-distressed individuals, as individuals with psychological distress are likely to be more susceptible to persuasive messages than those without. TRIAL REGISTRATION: Not applicable; this is not a report of intervention trial.

For making a declaration of countermeasures against the falling birth rate from the Japanese Society for Hygiene: summary of discussion in the working group on academic research strategy against an aging society with low birth rate.

In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.

[Questionnaire surveys on working during treatment in Japanese employees and employers].

OBJECTIVES: When an employee is diagnosed with cancer or another chronic disease, he/she needs support to achieve an acceptable balance between work and treatment. This study aimed to identify barriers to promoting work-treatment balance in Japanese companies. METHODS: Questionnaire surveys were conducted among Japanese employees (n = 2,000) and employers (n = 1,000). Employees were asked about their perceptions of disclosing health problems and seeking support in the workplace. Employers were asked about their perceptions of employees facing difficulty in working and their companies' work environments. RESULTS: Only 6% of employees and 15% of employers acknowledged the work-treatment balance guideline proposed by the Japanese Government. More employees preferred not to disclose a health problem (33%) than preferred to disclose it (18%). The majority (81% of employees and 76% of employers) considered that it would be better for people facing difficulty in working to quit their jobs. About two-thirds of companies have not yet set up a consultation desk for employees facing difficulty in working. Flexible work arrangements, including hourly paid leave, shorter working hours, discretionary work, flextime, and work from home, have been introduced in only some of the companies. CONCLUSIONS: Most employees and employers have little understanding of the work-treatment balance concept. All workers should get fully acquainted with the work-treatment balance guideline proposed by the Japanese Government. It is necessary for each company to create an atmosphere favorable for working during treatment and to provide a consultation service for employees facing difficulty in working.

Differences in Work-Related Adverse Events by Sex and Industry in Cases Involving Compensation for Mental Disorders and Suicide in Japan From 2010 to 2014.

OBJECTIVE: This study aimed to clarify whether work-related adverse events in cases involving compensation for mental disorders and suicide differ by sex and industry using a database containing all relevant cases reported from 2010 to 2014 in Japan. METHODS: A total of 1362 eligible cases involving compensation for mental disorders (422 females and 940 males) were analyzed. RESULTS: Among males, 55.7% of cases were attributed to "long working hours." In both sexes, the frequencies of cases attributed to "long working hours" and other events differed significantly by industry. Among cases involving compensation for suicide, 71.4% were attributed to "long working hours." CONCLUSIONS: The frequency distribution of work-related adverse events differed significantly by sex and industry. These differences should be taken into consideration in the development of industry-specific preventive measures for occupational mental disorders.

Cerebrovascular/cardiovascular diseases and mental disorders due to overwork and work-related stress among local public employees in Japan.

In Japan, overwork-related disorders occur among local public employees as well as those in private businesses. However, to date, there are no studies reporting the state of compensation for cerebrovascular/cardiovascular diseases (CCVD) and mental disorders due to overwork or work-related stress among local public employees in Japan over multiple years. This report examined the recent trend of overwork-related CCVD and mental disorders, including the incidence rates of these disorders, among local public employees in Japan from the perspective of compensation for public accidents, using data from the Japanese Government and relevant organizations. Since 2000, compared to CCVD, there has been an overall increase in the number of claims and cases of compensation for mental disorders. Over half of the individuals receiving compensation for mental disorders were either in their 30s or younger. About 47% of cases of mental disorders were compensated due to work-related factors other than long working hours. The incidence rate by job type was highest among "police officials" and "fire department officials" for compensated CCVD and mental disorders cases, respectively. Changes in the trend of overwork-related disorders among local public employees in Japan under a legal foundation should be closely monitored.

Site-specific immunochemical methylation assessment from genome DNA utilizing a conformational difference between looped-out target and stacked-in nontarget methylcytosines.

We report the sequence-selective immunochemical discrimination of methylcytosine from genomic DNA that we achieved by utilizing selective antibody binding to a looped-out methylcytosine in a bulge region and without using bisulfite treatment, a methylation-sensitive restriction enzyme, or PCR. First, we investigated the affinity of an anti-methylcytosine antibody for methylcytosine in full match, bulge, mismatch and abasic sites using surface plasmon resonance measurement and a microtiter plate to explore the differences as regards antibody binding to the target methylcytosine. The highest affinity, which was comparable to that in a single strand of DNA, was observed in the bulge region. In particular, no affinity was observed in a full match site. This is because there is no interaction such as hydrogen bond or π-π stacking for the bulged methylcytosine, thus enabling only the target in the bulge to be looped out. Methylated and unmethylated genomic DNA were blended to form a model DNA with which to assess the methylation ratio at a specific site. Fragmented DNA was hybridized with a biotinylated probe DNA, which has a sequence capable of forming a single base bulge at the target. The probe design is simple because it consists solely of the elimination of guanine paired with the target cytosine from a full match sequence. As a result, we successfully obtained a linear relationship (r(2)=0.9962) between the immunoassay signal and the methylation ratio of a specific site within 4 h.

Indoor allergen assessment quantified by a thin-layer electrochemical cell and magnetic beads.

We report the electrochemical determination of mite allergen in real house dust by using a thin layer electrochemical flow cell and magnetic beads. Der p1, which is an allergen from Dermatophagoides pteronyssinus, was immunochemically sandwiched between two dispersed monoclonal antibodies; one was modified on the surface of magnetic beads and the other was modified with alkaline phosphatase. After washing the beads, a small volume of p-aminophenol phosphate (p-APP) was added to produce p-aminophenol (p-AP). And then the p-AP concentration was measured electrochemically with a homemade electrochemical cell. The Der p1 assay was completed within 30 min and a low detection limit of 0.3 ng/mL was achieved. This is because the diffusion distance of Der p1 and the detection antibody was reduced to 22.3 µm by using dispersed magnetic beads. Only 10 min was required to complete the entire immunoreaction, and 54% of the Der p1 was confirmed to have immunoreacted in only 1 min of mixing. Furthermore, the p-APP volume could be reduced using the thin-layer electrochemical flow cell. This is advantageous in terms of concentrating p-AP, and provides a high signal-to-noise ratio measurement in a short time. We achieved a high correlation (r=0.967, p<0.001) between our assay and a conventional enzyme-linked immunosorbent assay (ELISA) for real house dust measurements.