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1.
Nutrients ; 12(1)2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31906499

RESUMO

: Cardiometabolic risks were increasing in Fukushima residents after the Great East Japan Earthquake. We examined the association between dietary patterns and cardiometabolic risks in those aged ≥16 years. Dietary patterns were derived by principal component analysis for participants who underwent at least one diet assessment using a short-form food frequency questionnaire during 2011-2013 and a health checkup in 2014 and 2015 (n = 15,409 and 14,999, respectively). In 2014, the adjusted prevalence ratio (PR) and 95% confidence interval (CI) in the highest versus lowest quartile of accumulative mean scores were 0.97 (0.96-0.99) for overweight/obesity, 0.96 (0.95-0.97) for total cholesterol (TC) ≥220 mg/dL, 0.96 (0.95-0.98) for low-density lipoprotein cholesterol (LDL-C) ≥140 mg/dL, and 0.97 (0.96-0.99) for triglycerides ≥150 mg/dL for a vegetable diet and 1.03 (1.01-1.04) for TC ≥220 mg/dL and 1.02 (1.01-1.04) for LDL-C ≥140 mg/dL for a juice/milk diet. In 2015, we found consistently significant associations for the vegetable and juice/milk diets, and the PR and 95% CI were 0.99 (0.98-1.00) for HDL-C <40 mg/dL for a meat diet. The continuous promotion of the vegetable pattern diet is necessary to reduce cardiometabolic risks, particularly dyslipidemia, in Japan.

2.
Magn Reson Med ; 83(2): 731-748, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31513311

RESUMO

PURPOSE: To compare cerebral blood flow (CBF) and cerebrovascular reserve (CVR) quantification from Turbo-QUASAR (quantitative signal targeting with alternating radiofrequency labeling of arterial regions) arterial spin labeling (ASL) and single post-labeling delay pseudo-continuous ASL (PCASL). METHODS: A model-based method was developed to quantify CBF and arterial transit time (ATT) from Turbo-QUASAR, including a correction for magnetization transfer effects caused by the repeated labeling pulses. Simulations were performed to assess the accuracy of the model-based method. Data from an in vivo experiment conducted on a healthy cohort were retrospectively analyzed to compare the CBF and CVR (induced by acetazolamide) measurement from Turbo-QUASAR and PCASL on the basis of global and regional differences. The quality of the two ASL data sets was examined using the coefficient of variation (CoV). RESULTS: The model-based method for Turbo-QUASAR was accurate for CBF estimation (relative error was 8% for signal-to-noise ratio = 5) in simulations if the bolus duration was known. In the in vivo experiment, the mean global CVR estimated by Turbo-QUASAR and PCASL was between 63% and 64% and not significantly different. Although global CBF values of the two ASL techniques were not significantly different, regional CBF differences were found in deep gray matter in both pre- and postacetazolamide conditions. The CoV of Turbo-QUASAR data was significantly higher than PCASL. CONCLUSION: Both ASL techniques were effective for quantifying CBF and CVR, despite the regional differences observed. Although CBF estimated from Turbo-QUASAR demonstrated a higher variability than PCASL, Turbo-QUASAR offers the advantage of being able to measure and control for variation in ATT.

3.
J Affect Disord ; 260: 432-439, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31539677

RESUMO

BACKGROUND: The present study examined the data from the Fukushima Health Management Survey conducted after the Great East Japan Earthquake to identify disaster-related factors affecting the mental health status of adolescents following the disaster and obtained basic data necessary in providing mental healthcare. METHODS: The study included 2808 adolescents aged 15-19 years (male: 1327; female: 1481) who completed the 2011 edition of the registered questionnaire. The Kessler Psychological Distress Scale scores, age, sex, health status, sleep satisfaction level, Great East Japan Earthquake experience, experience of losing a loved one, change in employment status, change in residence, and awareness of the impact of radiation on health were examined. RESULTS: Psychological distress was significantly correlated with sex, health status, sleep satisfaction of, experience of losing a loved one, change in employment status, extreme anxiety regarding the acute health impact of radiation, and extreme anxiety regarding the impact of radiation on health in adolescents and the next generation. LIMITATIONS: The present study is limited because of its cross-sectional design, due to which, the causal relationship between each factor and psychological distress could not be clarified. CONCLUSIONS: The results of the present study suggest that appropriate mental healthcare should be administered immediately following an earthquake to adolescents who have lost a loved one and experienced anxiety regarding the health impact of radiation following a nuclear accident.

4.
Magn Reson Med Sci ; 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31761840

RESUMO

In the 1980's some of the earliest studies of arterial spin labeling (ASL) MRI have demonstrated its ability to generate MR angiography (MRA) images. Thanks to many technical improvements, ASL has been successfully moving its position from the realm of research into the clinical area, albeit more known as perfusion imaging than as MRA. For MRA imaging, other techniques such as time-of-flight, phase contrast MRA and contrast-enhanced (CE) MRA are more popular choices for clinical applications. In the last decade, however, ASL-MRA has been experiencing a remarkable revival, especially because of its non-invasive nature, i.e. the fact that it does not rely on the use of contrast agent. Very importantly, there are additional benefits of using ASL for MRA. For example, its higher flexibility to achieve both high spatial and temporal resolution than CE dynamic MRA, and the capability of vessel specific visualization, in which the vascular tree arising from a selected artery can be exclusively visualized. In this article, the implementation and recent developments of ASL-based MRA are discussed; not only focusing on the basic sequences based upon pulsed ASL or pseudo-continuous ASL, but also including more recent labeling approaches, such as vessel-selective labeling, velocity-selective ASL, vessel-encoded ASL and time-encoded ASL. Although these ASL techniques have been already utilized in perfusion imaging and their usefulness has been suggested by many studies, some additional considerations should be made when employing them for MRA, since there is something more than the difference of the spatial resolution of the readout sequence. Moreover, extensive discussion is included on what readout sequence to use, especially by highlighting how to achieve high spatial resolution while keeping scan-time reasonable such that the ASL-MRA sequence can easily be included into a clinical examination.

5.
J Med Case Rep ; 13(1): 328, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31699140

RESUMO

BACKGROUND: Globally, cervical cancer is the fourth most common cancer in women. Here, we report a case of cutaneous lymphangitis carcinomatosa arising from cervical cancer, an extremely rare and treatment-resistant condition. CASE PRESENTATION: A 64-year-old Japanese woman presented with genital bleeding. She was diagnosed as having stage IB1 squamous cell cervical cancer and subsequently treated with radiotherapy. Approximately 2 years after the curative radiotherapy, she developed itching, skin rash, and small nodules on her left femoral and pubic area. Slight 18F-fluorodeoxyglucose uptake was detected at her left femoral skin on positron emission tomography with computed tomography. A histopathological examination was performed on a biopsy sample from an erythematous macule on her left femoral skin and vulva. Consequently, she was diagnosed as having cutaneous lymphangitis carcinomatosa arising from cervical cancer. Paclitaxel (135 mg/m2), cisplatin (50 mg/m2), and bevacizumab (15 mg/kg) combination therapy was administered every 21 days. Both itching and rash improved after three treatment cycles. After the completion of six cycles, skin erythema in the femoral and vulval area disappeared completely. Our patient experienced a 25-month symptom-free interval after the last chemotherapy session. CONCLUSION: Our findings suggest that combination chemotherapy plus bevacizumab is an effective therapeutic option in patients with cutaneous lymphangitis carcinomatosa arising from cervical cancer.

7.
Tohoku J Exp Med ; 248(4): 239-252, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31406089

RESUMO

Many studies have consistently reported the bidirectional relationship between problem drinking and psychological distress following a disaster, but the risk factors of problem drinking following a disaster remain unclear. In this study, we therefore aimed to explore the risk factors associated with the incidence of problem drinking among evacuees after the Great East Japan Earthquake of March 11, 2011. We used the data for evacuees of the Fukushima Daiichi nuclear power plant accident, obtained from the Mental Health and Lifestyle Survey. A total of 12,490 individuals from 13 municipalities, which included the evacuation order areas after the accident, completed surveys between 2012 and 2013. The CAGE (Cutting down, Annoyed by criticism, Guilty feeling, and Eye-opener) questionnaire was used to screen the participants for alcohol dependence, and a score ≥ 2 indicated problem drinking. Logistic regression models were applied to investigate the possible predictors of problem drinking. The results showed that insufficient sleep and heavy drinking (≥ 4 drinks per day) were significant risk factors for the incidence of problem drinking in both men and women. Additional risk factors included family financial issues due to the disaster and trauma symptoms among men and a diagnosed history of mental illness among women. Other remaining variables were not significantly associated with problem drinking. The present study is the first to identify the risk factors for problem drinking following a compound disaster. Our findings could be used to develop a primary intervention program to improve evacuees' health and lives following a disaster.


Assuntos
Alcoolismo/epidemiologia , Terremotos , Acidente Nuclear de Fukushima , Inquéritos Epidemiológicos , Adulto , Idoso , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Fatores de Risco , Inquéritos e Questionários
8.
Front Psychiatry ; 10: 283, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31130880

RESUMO

This study examined parental recognition of bullying victimization and associated factors among evacuated children after the 2011 Fukushima Daiichi Nuclear Power Plant accident, using a 3-year follow-up data (wave 1: January 2012; wave 2: January 2013; wave 3: February 2014). The sample included the caregivers of 2,616 children in the first-sixth grades of elementary school, who lived in one of the 13 municipalities that were the target areas of the Mental Health and Lifestyle Survey, conducted as part of the Fukushima Mental Health Management Survey. Across 3 years, around 80% of caregivers responded "not true," 15% responded "somewhat true," and 5% responded "certainly true" in response to a question about bullying victimization of their children. Being male was significantly associated with the parental recognition of bullying victimization at wave 1 and wave 3. At wave 1, experiencing the nuclear plant explosion was significantly associated with parental recognition of bullying victimization. Moreover, age at wave 3 was negatively associated with parental recognition of bullying victimization. Our findings will be helpful for establishing community- and school-based mental health care for children, parents, and teachers.

9.
J Affect Disord ; 247: 11-19, 2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30640025

RESUMO

BACKGROUND: The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) is a widely used self-report measure of PTSD. The reliability/precision and validity of the updated PCL version for the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (PCL-5) have only been evaluated in limited populations. This study aimed to examine the factor structure, reliability/precision, and validity of the PCL-5 as assessed by convergent and discriminant relationships with related constructs among Japanese individuals who experienced various traumatic events. METHODS: We conducted an online survey of Japanese adults using the PCL-5 and other assessments for PTSD, depression, anxiety, other psychiatric comorbidities, and functionality. A total of 3090 individuals who met a probable diagnosis of PTSD and another 1837 who had experienced traumatic events but did not meet the probable PTSD diagnosis answered the questionnaires. RESULTS: Confirmatory factor analysis demonstrated the best fit with a 7-factor model. This factor structure was temporally stable across 2 time points for 4 months. The total and subscale scores showed good internal consistency and modest test-retest reliability. The convergent and discriminant relationships of the PCL-5 total score with related constructs were demonstrated. LIMITATIONS: This study did not use the gold standard interview to assess the diagnostic status of PTSD. Also, the sampled population was younger and had lower incomes in comparison to the census data. CONCLUSIONS: Our results support the utility of the PCL-5 for assessing PTSD symptoms in Asian populations.


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/etnologia , Lista de Checagem , Análise Fatorial , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Autorrelato , Transtornos de Estresse Pós-Traumáticos/etnologia , Inquéritos e Questionários , Adulto Jovem
10.
Magn Reson Med ; 81(1): 410-423, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30230589

RESUMO

PURPOSE: In vessel-encoded pseudo-continuous arterial spin labeling (ve-pCASL), vessel-selective labeling is achieved by modulation of the inversion efficiency across space. However, the spatial transition between the labeling and control conditions is rather gradual, which can cause partial labeling of vessels, reducing SNR-efficiency and necessitating complex postprocessing to decode the vessel-selective signals. The purpose of this study is to optimize the pCASL labeling parameters to obtain a sharper spatial inversion profile of the labeling and thereby minimizing the risk of partial labeling of untargeted arteries. METHODS: Bloch simulations were performed to investigate how the inversion profile was influenced by the pCASL labeling parameters: the maximum (Gmax ) and mean (Gmean ) labeling gradient were varied for ve-pCASL with unipolar and bipolar gradients. The findings in the simulation study were subsequently confirmed in an in vivo volunteer study. Moreover, conventional and optimized settings were compared for 4D-MRA using four-cycle Hadamard ve-pCASL; the visualization of arteries and the presence of the partial labeling were assessed by an expert observer. RESULTS: When using unipolar gradient, lower Gmean resulted in a steeper spatial transition, whereas the width of the control region was broader for higher Gmax . The in vivo study confirmed these findings. When using bipolar gradients, the control region was always very narrow. Qualitative comparison of the 4D-MRA demonstrated lower occurrence of partial labeling when using the optimized gradient parameters. CONCLUSION: The shape of the ve-pCASL inversion profile can be optimized by changing Gmean and Gmax to reduce partial labeling of untargeted arteries.


Assuntos
Artérias/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Angiografia por Ressonância Magnética , Marcadores de Spin , Adulto , Algoritmos , Velocidade do Fluxo Sanguíneo , Circulação Cerebrovascular , Simulação por Computador , Meios de Contraste , Feminino , Voluntários Saudáveis , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Processamento de Imagem Assistida por Computador , Imagem Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Movimento (Física) , Risco , Razão Sinal-Ruído
11.
Magn Reson Med Sci ; 18(2): 170-177, 2019 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-30318501

RESUMO

We evaluated 3D pseudo-continuous arterial spin labeling (pCASL) using turbo spin echo with a pseudo-steady-state (PSS) readout in comparison with the other major readout methods of 3D spiral and 2D echo-planar imaging (EPI). 3D-PSS produced cerebral blood flow (CBF) values well correlated to those of the 3D spiral readout. By visual evaluation, the image quality of 3D-PSS pCASL was superior to that of 2D-EPI. The 3D-PSS technique was suggested useful as pCASL readout.


Assuntos
Artérias/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Circulação Cerebrovascular/fisiologia , Imagem Ecoplanar/métodos , Imagem Tridimensional/métodos , Neuroimagem/métodos , Marcadores de Spin , Adulto , Encéfalo/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Razão Sinal-Ruído
12.
Magn Reson Med ; 81(3): 1553-1565, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30311694

RESUMO

PURPOSE: When using simultaneous multi-slice (SMS) EPI for background suppressed (BGS) arterial spin labeling (ASL), correction of through-plane motion could introduce artefacts, because the slices with most effective BGS are adjacent to slices with the least BGS. In this study, a new framework is presented to correct for such artefacts. METHODS: The proposed framework consists of 3 steps: (1) homogenization of the static tissue signal over the different slices to eliminate most inter-slice differences because of different levels of BGS, (2) application of motion correction, and (3) extraction of a perfusion-weighted signal using a general linear model. The proposed framework was evaluated by simulations and a functional ASL study with intentional head motion. RESULTS: Simulation studies demonstrated that the strong signal differences between slices with the most and least effective BGS caused sub-optimal estimation of motion parameters when through-plane motion was present. Although use of the M0 image as the reference for registration allowed 82% improvement of motion estimation for through-plane motion, it still led to residual subtraction errors caused by different static tissue signal between control and label because of different BGS levels. By using our proposed framework, those problems were minimized, and the accuracy of CBF estimation was improved. Moreover, the functional ASL study showed improved detection of visual and motor activation when applying the framework as compared to conventional motion correction, as well as when motion correction was completely omitted. CONCLUSION: When combining BGS-ASL with SMS-EPI, particular attention is needed to avoid artefacts introduced by motion correction. With the proposed framework, these issues are minimized.

13.
J Sleep Res ; 28(2): e12771, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30311710

RESUMO

We investigated the psychometric properties of the simplified Japanese version of the Athens Insomnia Scale (AIS-SJ) using baseline data from the Fukushima Health Management Survey. Data from 22 878 men and 27 669 women aged 16 years and older were analysed (Mage  = 52.9 ± 18.6). Participants lived in the Fukushima evacuation zone and experienced the Great East Japan Earthquake. The AIS-SJ was used to assess participants' insomnia symptoms, and its validity was examined by administering the Kessler 6-item Psychological Distress Scale (K6) and assessing education, self-rated health and disaster-related experiences. A confirmatory factor analysis revealed that the two-factor model was a better fit than the one-factor model. The AIS-SJ and its subscales had acceptable reliability (Cronbach's alpha, 0.81). Test of measurement invariance confirmed strict invariance across groups for the participants' characteristics of gender and mental illness history, but not for participants' age. AIS-SJ scores exhibited a near-normal distribution (skewness, 0.45; kurtosis, -0.89). There were significant age differences only among women, and gender differences in AIS-SJ scores with small effect sizes. The AIS-SJ scores had weak-to-moderate correlations with mental illness history, bereavement, experiencing the tsunami, experiencing the nuclear power plant incident, housing damage and losing one's job (polyserial correlations, 0.36, 0.17, 0.13, 0.18, 0.13, and 0.15, respectively), and strong correlations with self-rated health (polyserial correlation, 0.51), psychological distress (rs , 0.60) and post-traumatic stress disorder (rs , 0.60). The AIS-SJ is a useful instrument for assessing community dwellers' insomnia symptoms.

14.
Magn Reson Med ; 81(5): 2995-3006, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30506957

RESUMO

PURPOSE: The recently introduced "Acquisition of ConTRol and labEled imaging in the Same Shot" (ACTRESS) approach was designed to halve the scan time of arterial spin labeling (ASL) -based 4D-MRA by obtaining both labeled and control images in a single Look-Locker readout. However, application for vessel-selective labeling remains difficult. The aim of this study was to achieve a combination of ACTRESS and vessel-selective labeling to halve the scan time of vessel-selective 4D-MRA. METHODS: By Bloch equation simulations, Look-Locker pseudocontinuous-ASL (pCASL) was optimized to achieve constant static tissue signal across the multidelay readout, which is essential for the ACTRESS approach. Additionally, a new subtraction scheme was proposed to achieve visualization of the inflow phase even when labeled blood will have already arrived in the distal arteries during the first phase acquisition due to the long duration of the pCASL labeling module. In vivo studies were performed to investigate the signal variation of the static tissue, as well as to assess image quality of vessel-selective 4D-MRA with ACTRESS. RESULTS: In in vivo studies, the mean signal variation of the static tissue was 8.98% over the Look-Locker phases, thereby minimizing the elevation of background signal. This allowed visualization of peripheral arteries and slowly arriving arterial blood with image quality as good as conventional pCASL within half the acquisition time. Vessel-selective pCASL-ACTRESS enabled the separated visualization of vessels arising from internal and external carotid arteries within this shortened acquisition time. CONCLUSION: By combining vessel-selective pCASL and ACTRESS approach, 4D-MRA of a single targeted arterial tree was achieved in a few minutes.

15.
Sleep Med ; 68: 63-70, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32028228

RESUMO

BACKGROUND: Currently, few studies have thoroughly investigated the socioeconomic factors related to sleep problems among evacuees following a disaster. OBJECTIVES: To examine sleep problems in evacuees using data from a large-scale cohort survey of evacuees conducted after the 2011 Great East Japan Earthquake (GEJE). METHODS: In sum, 73,433 residents who were living in evacuation zones responded to The 2011 Fukushima Health Management Survey. We excluded 16,659 participants who did not answer the question about sleep problems or those younger than 20 years. Thus, data from 56,774 participants (24,959 men and 31,815 women) were used for this analysis. Evacuees' self-reported sleep dissatisfaction was determined based on their response to the question 'Are you satisfied with the quality of your sleep? '. The response options 'Unsatisfied' and 'Very unsatisfied' were considered as the outcome for the present study. Prevalence ratios (PRs) and 95% confidence intervals (CIs) for the prevalence of self-reported sleep disturbance were estimated using modified Poisson regression models. RESULTS: Of the qualifying survey respondents, 20.3% (4387 men and 7128 women) reported sleep dissatisfaction. Compared with participants living in their own or a relative's home (PR = 1), those living in temporary housing or rental accommodation had a higher prevalence of sleep dissatisfaction (1.47; 95% CI 1.44-1.50 and 2.16; 95% CI 2.07-2.26 in men; 1.39; 95% CI 1.36-1.41 and 1.92; 95% CI 1.86-1.99 in women). Higher educational attainment was also associated with a higher prevalence of sleep dissatisfaction in men, as were job loss and decreased income in both men and women. CONCLUSION: Self-reported sleep dissatisfaction after the GEJE was associated with a deteriorated socioeconomic status among evacuees. However, future longitudinal studies are warranted.

16.
PLoS One ; 13(12): e0208114, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30532174

RESUMO

OBJECTIVE: In the workplace depression and suicide are serious mental health problems. A lack of knowledge and mental health skills along with the stigma toward mental health problems often results in delays in seeking professional help. Interventions targeting not only persons with mental health problems but also people around the individual are warranted in order to encourage supporting behavior within entire workplace. In the present study, we investigated the efficacy of our newly developed educational training program in the management with depression and suicidal risk in the workplace as a single-arm pilot trial. METHODS: The program is a two-hour (2-h) training course for employees based on the Mental Health First Aid (MHFA) program which aims to increase public mental health literacy. We conducted this program at a company workplace among 91 employees, and ultimately 83 participants completed the self-rated questionnaires. Changes in confidence and practical skills in early intervention of depression and suicide-prevention, and stigma toward mental health problems were evaluated using self-rated questionnaires at 3 time-points; pre-program, immediately post-program, and 1 month after the program. RESULTS: Confidence and practical skills were significantly improved even 1 month after the program, and stigma reduced just after the program. CONCLUSIONS: Our pilot study suggests that the program has a positive impact on encouraging employees to support their co-workers with mental health problems, and is applicable for busy workers due to its short duration. A single-arm design, evaluation using self-rated questionnaire and short-term follow up period are the main limitations of the present study. Hence, future research is required to validate the effects of this program with control groups, and also to assess long-term effectiveness and objective changes such as absenteeism and sick leave. TRIAL REGISTRATION: UMIN Clinical Trials Registry (UMIN-CTR) R000023258.


Assuntos
Depressão/prevenção & controle , Alfabetização em Saúde/organização & administração , Saúde Mental/educação , Suicídio/prevenção & controle , Local de Trabalho/organização & administração , Adulto , Depressão/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Estresse Ocupacional/psicologia , Administração de Consultório , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Estigma Social , Suicídio/psicologia , Adulto Jovem
17.
J Radiol Prot ; 38(4): 1428-1440, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30375359

RESUMO

After the Fukushima disaster in 2011, affected residents experienced increased radiation-related anxiety and reduced subjective wellbeing. We investigated whether reduction of radiation-related anxiety promoted wellbeing among evacuees in Fukushima and assessed the role of mental health distress as a mediator. We used data from questionnaire surveys of evacuees in the 2011 and 2012 fiscal years (N = 34 312). We used radiation risk perception as an indicator of radiation-related anxiety and the frequency of laughter as an indicator of wellbeing. We measured changes in radiation risk perception from 2011 and 2012, and the frequencies of laughter and mental health distress (Kessler 6-item scale) in 2012, and investigated associations between radiation risk perception and frequency of laughter with and without covariates of mental health distress. Perceived genetic risk in 2011 had a significant inverse association with the frequency of laughter. Lowering of radiation risk perception was significantly associated with the frequency of laughter in the absence of covariates of mental health distress, but not in their presence. Lowering of radiation risk perception was also significantly associated with low mental health distress. Reduction of radiation-related anxiety promoted wellbeing via alleviation of mental health distress.


Assuntos
Ansiedade/epidemiologia , Acidente Nuclear de Fukushima , Exposição à Radiação , Estresse Psicológico/epidemiologia , Ansiedade/etiologia , Atitude Frente a Saúde , Feminino , Humanos , Riso , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estresse Psicológico/etiologia
18.
Int J Law Psychiatry ; 60: 57-63, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30217332

RESUMO

The relationship between the number of nurses in psychiatric wards and frequency of use of seclusion and restraint has been unclear. We aimed to clarify this relationship in Japanese general psychiatric wards while controlling for patient and ward-level characteristics. We hypothesized that seclusion and mechanical restraint are less likely to be used in a ward with more nurses. We used data for individual admissions from April 2015 to March 2017 in hospitals participating in the Psychiatric Electronic Clinical Observation (PECO) system, which extracted data from each hospital's electronic health record system. We analyzed the data of 10,013 admissions in 113 wards of 23 hospitals. We examined the relationships between the number of nurses per 10 beds in each ward and the use of seclusion and mechanical restraint, controlling for the patients' age, sex, diagnosis, voluntary versus involuntary admission, prescribed dose of antipsychotics, severity of symptoms, and length of stay, in addition to ward-level characteristics including ward size, location (urban or rural), and type of ward (acute ward or not), using multilevel multivariate logistic regression analyses. The fraction of admissions exposed to at least one episode of seclusion or mechanical restraint was 36.7% and 14.9%, respectively. The odds ratios of the number of nurses per 10 beds for the use of seclusion and mechanical restraint were 2.36 and 1.74, respectively, indicating that both seclusion and mechanical restraint were actually used more frequently in wards with more nurses. A possible explanation is that patients anticipated to need coercive measures are more likely to be admitted to wards with many nurses. Increasing the number of nurses in a ward may not contribute to reducing the use of seclusion and restraint.


Assuntos
Número de Leitos em Hospital , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Unidade Hospitalar de Psiquiatria , Restrição Física , Isolamento Social , Feminino , Humanos , Japão , Masculino , Restrição Física/estatística & dados numéricos
19.
BMJ Open ; 8(6): e018943, 2018 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-29961000

RESUMO

OBJECTIVE: Few studies have comprehensively examined changes in smoking status and related factors after a disaster. We examined these factors among residents of an evacuation area in Fukushima after the Great East Japan Earthquake. METHODS: The study participants included 58 755 men and women aged ≥20 years who participated in the Fukushima Health Management Survey in 2012 after the disaster. Smoking status was classified as either current smokers or current non-smokers before and after the disaster. The participants were divided into the following groups: (1) non-smokers both before and after the disaster, (2) non-smokers before and smokers after the disaster, (3) smokers before and non-smokers after the disaster and (4) smokers both before and after the disaster. The adjusted prevalence ratios and 95% CIs of changes in smoking status for demographic, disaster-related and psychosocial factors were tested using logistic regression analysis that was stratified by smoking status before the disaster. RESULTS: Among the 44 729 participants, who were non-smokers before the disaster, 634 (1.4%) began smoking after the disaster. Among the 14 025 smokers before the disaster, 1564 (11.1%) quit smoking after the disaster, and the proportion of smokers in the evacuation area consequently decreased from 21.2% to 19.6%. In the multivariable model, factors significantly associated with beginning smoking included being a male, being younger, having a lower education, staying in a rental house/apartment, house being damaged, having experienced a tsunami, change jobs and the presence of traumatic symptoms and non-specific psychological distress. On the contrary, factors associated with quitting smoking included being a female, being older, having a higher education and having a stable income. CONCLUSION: The proportion of smokers slightly decreased among residents in the evacuation area. The changes in smoking statuses were associated with disaster-associated psychosocial factors, particularly changes in living conditions, having experienced a tsunami, change jobs and developing post-traumatic stress disorder.


Assuntos
Terremotos , Acidente Nuclear de Fukushima , Fumar/epidemiologia , Tsunamis , Adulto , Idoso , Estudos Transversais , Ex-Fumantes/psicologia , Ex-Fumantes/estatística & dados numéricos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , não Fumantes/psicologia , não Fumantes/estatística & dados numéricos , Prevalência , Fumantes/psicologia , Fumantes/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-29890768

RESUMO

After the Fukushima nuclear power plant accident, numerous evacuees reported poor mental health status and high-risk perceptions of the health effects of radiation. However, the temporal associations between these variables have not yet been examined. Using data from the Fukushima Health Survey, we examined changes in risk perception of the health effects of radiation over time and assessed the effects of mental health on such changes using logistic regression analysis. Risk perception for delayed effect pertains a brief on health effect in later life (delayed effect), whereas that of genetic effect pertains a brief on health effect of future children and grandchildren (genetic effect). We found that many participants showed consistently high or low-risk perceptions over all three study years (2011⁻2013) (for delayed effect: 59% and 41% of participants were in the low and high-risk perception groups, respectively; for genetic effect: 47% and 53%, respectively). Stronger traumatic reactions (≥50 on the PTSD Checklist⁻Specific) significantly affected the odds of being in the high-risk perception group for the delayed and genetic effects, with the associations being strongest soon after the disaster: The adjusted ORs (95%CIs) were 2.05 (1.82⁻2.31), 1.86 (1.61⁻2.15), and 1.88 (1.62⁻2.17) for the delayed effect in 2011, 2012, and 2013, respectively, and 2.18 (1.92⁻2.48), 2.05 (1.75⁻2.40), and 1.82 (1.55⁻2.15) for the genetic effect. As initial mental health status had the strongest impact on later risk perceptions of radiation, it should be considered in early response and communication efforts.


Assuntos
Acidente Nuclear de Fukushima , Nível de Saúde , Inquéritos Epidemiológicos , Saúde Mental/estatística & dados numéricos , Exposição à Radiação/efeitos adversos , Adolescente , Adulto , Família , Feminino , Humanos , Japão , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Exposição à Radiação/estatística & dados numéricos , Medição de Risco , Fatores de Tempo , Adulto Jovem
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