Association of maternal psychological distress and the use of childcare facilities with children's behavioral problems: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

BACKGROUND: Childcare facilities are a factor that lowers the established association of mother's postnatal psychiatric symptoms with children's behavioral problems. However, no studies have considered the prenatal psychiatric symptoms yet. This study examined whether the use of childcare facilities moderates the association of maternal psychological distress in early pregnancy and at two years postpartum with behavioral problems in children aged four years. METHODS: The present study was based on the data from 23,130 mother-child pairs participating in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. K6 was used to classify maternal psychological distress in early pregnancy and at two years postpartum into four categories: none in both prenatal and postnatal periods (none), only the prenatal period (prenatal only); only the postnatal period (postnatal only); both prenatal and postnatal periods (both). The children's behavioral problems were assessed using the Child Behavior Checklist for Ages 1½-5 (CBCL) aged four years. The clinical range of the externalizing, internalizing, and total problem scales of the CBCL was defined as having behavioral problems. To examine whether availing childcare facilities moderates the association between maternal psychological distress and children's behavioral problems, we conducted a stratified analysis based on the use of childcare facilities or not, at two years of age. The interaction term between maternal psychological distress and use of childcare facilities was included as a covariate in the multivariate logistic regression analysis to confirm the p-value for the interaction. RESULTS: The prevalence of the clinical ranges of externalizing problems, internalizing problems, and clinical range of total problems were 13.7%, 15.4%, and 5.8%, respectively. The association of maternal psychological distress with a high risk of children's behavioral problems was significant; however, the association between prenatal only psychological distress and externalizing problems in the group that did not use childcare facilities was not significant. Interactions between the use of childcare facilities and maternal psychological distress on behavioral problems in children were not significant. CONCLUSIONS: Use of childcare facilities did not moderate the association of maternal psychological distress in early pregnancy and at two years postpartum with behavioral problems in children aged four years.

Heated Tobacco Products Have Reached Younger or More Affluent People in Japan.

BACKGROUND: The trend of the diffusion of heated tobacco products (HTPs) is a great concern because HTPs have become available worldwide. This study examined the sociodemographic characteristics of HTPs users in Japan, where HTPs were first launched. METHODS: This cross-sectional study used data from an online survey conducted in 2017. A total of 4,926 participants, aged 20-69 years, were included. The dependent variable was the type of tobacco products used. The independent variables were age and equivalent income. Two analyses estimated the odds ratios (ORs) for 1) being smokers compared to "non-smokers," and 2) being "HTP smokers" compared to "only combustible cigarette smokers." Analyses were stratified by sex. Educational attainment and occupation were also used in the sensitivity analyses. RESULTS: The percentages of "non-smokers," "only combustible cigarette smokers," and "HTP smokers" were 82.8%, 14.2%, and 3.0%, respectively. When compared to the oldest participants (aged 60-69), the youngest participants (aged 20-29) tended to be "HTP smokers" (OR 7.90; 95% confidence interval [CI], 3.09-20.22 for men and OR 9.28; 95% CI, 2.14-40.28 for women). Compared to participants with the lowest incomes (<2 million), those with the highest incomes (≥4 million) tended to use HTPs (OR 2.93; 95% CI, 1.56-5.49 in men and OR 1.82; 95% CI, 0.73-4.54 in women). These trends were consistent when analyses included only smokers. There were consistent results in other SES measurements, including educational attainment and occupation. CONCLUSIONS: Younger or more affluent people tended to use HTPs, although smoking rates among these populations were generally lower. New tobacco control efforts are required.

[Differences in nonsmokers' exposure to secondhand smoke at the workplace across job categories in Japan: A cross-sectional study].

Objectives　Differences in exposure to secondhand smoke at the workplace, based on job category, have been assessed in some countries. While differences due to socioeconomic status have been assessed in Japan, few studies have been conducted to examine differences across job categories. We aimed to clarify the differences in nonsmokers' exposure to secondhand smoke at the workplace across job categories in Japan.Methods　This cross-sectional study used data from an online survey conducted in 2017. A total of 1,739 participants, aged 20-69 years, were included. The dependent variable was exposure to secondhand smoke at the workplace, whereas the independent variable was job category, which was classified into the following 7 categories: 1) Management, Professional, and Technical; 2) Clerical; 3) Sales and Service; 4) Security; 5) Agriculture, Forestry, and Fishery; 6) Production Process, Transport, Cleaning, Packaging, etc.; and 7) Transportation, Machine Operation, Construction, and Mining. Analysis included estimates of the prevalence ratios (PRs) for the differences in exposure to secondhand smoke based on job category. In the analyses, sex, age, educational status, income, smoking environment at business, and awareness of secondhand smoke were considered covariates.Results　The mean age of the participants was 43.3 years (SD=11.9); men constituted 60.5% of the study participants. A total of 529 individuals (30.4%) were exposed to secondhand smoke at the workplace in the past month. Of these, 171 (27.9%), 155 (27.1%), 116 (33.7%), 10 (45.5%), 7 (31.8%), 39 (34.5%), and 31 (58.5%) were found from the 1st to the 7th category, respectively. In the multivariate analysis, PRs (95% confidence interval) of exposure to secondhand smoke at the workplace among non-smokers were 1.27 (1.04-1.56), 1.61 (1.02-2.56), and 1.75 (1.33-2.31) for the Sales and Service category; Security category; and Transportation, Machine Operation, Construction, and Mining category, respectively, compared to the Clerical category.Conclusion　Certain job categories may not be able to benefit from secondhand smoke prevention measures, although the measures have been promoted by the revised Health Promotion Act. It is, thus, necessary to monitor the situation of exposure to secondhand smoke at the workplace across diverse settings.

Does Cigarette Smoking Increase Traffic Accident Death During 20 Years Follow-up in Japan? The Ibaraki Prefectural Health Study.

BACKGROUND: Annually, more than 1.2 million deaths due to road traffic accidents occur worldwide. Although previous studies have examined the association between cigarette smoking and injury death, the mortality outcome often included non-traffic accident-related deaths. This study aimed to examine the association between cigarette smoking and traffic accident death. METHODS: We conducted a prospective cohort study using data from the Ibaraki Prefectural Health Study conducted from 1993 through 2013. The cohort included 97,078 adults (33,138 men and 63,940 women) living in Ibaraki Prefecture who were aged 40-79 years at an annual health checkup in 1993. We divided participants into four smoking status groups: non-smokers, ex-smokers, and current smokers who smoked <20 and ≥20 cigarettes per day. Hazard ratios (HRs) of traffic accident death were calculated using a Cox proportional hazards model. RESULTS: During 20 years of follow-up, the average person-years of follow-up were 16.8 and 18.2 in men and women, respectively. Among men, after adjusting for age and alcohol intake, HRs for traffic accident death among current smokers of <20 cigarettes/day and ≥20 cigarettes/day compared to non-smokers were 1.32 (95% confidence interval [CI], 0.79-2.20) and 1.54 (95% CI, 0.99-2.39), respectively. In contrast, among women, we found no association between smoking status and traffic accident deaths. CONCLUSION: In this prospective cohort study, we found a positive association, though marginally significant, between smoking and traffic accident death among men in Japan. Among women, because of the smaller number of deaths among smokers, adequate estimation could not be obtained.

Does the Type of Temporary Housing Make a Difference in Social Participation and Health for Evacuees of the Great East Japan Earthquake and Tsunami? A Cross-Sectional Study.

BACKGROUND: Although the majority of survivors of the huge Great East Japan Earthquake and Tsunami evacuated to two types of temporary housings, prefabricated housing and rented housing, health effects of these different environments were unclear. We examined whether prevalent social participation in prefabricated housing brought larger health benefits than in rented housing using the largest health survey data of the disaster survivors. METHODS: This cross-sectional study used a 2012 survey by the Miyagi Prefectural Government, in which almost all of evacuees were targeted (response rate: 61.6%). Self-rated health (SRH) and psychological distress measured via K6 score were the dependent variables, and social participation was the independent variable. Odds ratios of the social participation on health variables were estimated using logistic regression models. To assess the contribution of social participation, the population attributable fraction (PAF) was estimated. RESULTS: The participants lived in prefabricated and rented housing numbered 19,726 and 28,270, respectively. Participants in prefabricated housing had poorer SRH and K6 than those in rented housing. The proportions of participants engaging in social participation of prefabricated and rented housing were 38.2% and 15.4%, respectively. The absence of social participation was significantly associated with poor SRH and K6 among participants in both housing types. The PAFs of social participation with good SRH were 39.5% in prefabricated housing and 14.4% in rented housing. For K6, the PAFs were 47.1% and 19.5% in prefabricated and rented housing, respectively. CONCLUSION: Compared to the residents in rented housing, residents in prefabricated housing had more frequent opportunities for social participation, which was associated with larger health benefits.

Inhibitory Effects of Baicalein Derived from Japanese Traditional Herbal Medicine on SN-38 Glucuronidation.

PURPOSE: The chemotherapeutic agent irinotecan is hydrolyzed to its active form SN-38 by human carboxyesterases, but SN-38 is converted into the inactive form SN-38G by hepatic UDP-glucuronosyltransferases (UGTs). The aim of the present study was to evaluate the inhibitory effects of two b-glucuronidase-treated Japanese traditional herbal medicines (kampo), Hange-Shashin-To (TJ-14) and Sairei-To (TJ-114) on SN-38 glucuronidation, and the deglycosylation of baicalin (BG) and glycyrrhizic acid (GL) derived from TJ-14 and TJ-114 to form their respective aglycones, baicalein (BA) and glycyrrhetinic acid (GA). METHODS: The inhibitory effects of b-glucuronidase-treated TJ-14 and TJ-114 on SN-38 glucuronidation by human liver microsomes were examined. BA and GA, which were enzymatically converted from BG and GL present in TJ-14 and TJ-114, were examined in the same manner. Furthermore, the enzymatic activities were measured by using recombinant UGT1A1 and UGT1A9 isoforms instead of human liver microsomes. BA, GA, SN-38, and their glycosides/glucuronides were analyzed with an LC-MS system. RESULTS: As regards the linear initial reaction rate, SN-38 glucuronidation by human liver microsomes was significantly inhibited by the addition of b-glucuronidase-untreated TJ-14 and TJ-114, but was more strongly inhibited by the addition of b-glucuronidase-treated TJ-14 and TJ-114. The results of LC-MS analysis and pharmacokinetic studies suggested that BA is the main inhibitor of SN-38 glucuronidation. In the Dixon plot, BA showed competitive inhibition of SN-38 glucuronidation, and the inhibition constant was 8.70 ± 3.24 mM. Previous reports, studies of recombinant UGT isoforms indicated that SN-38 glucuronidation was mainly catalyzed by UGT1A1. CONCLUSIONS: These findings strongly suggested that SN-38 glucuronidation is inhibited by BA. BA could act as a pharmacokinetic regulating factor associated with SN-38 glucuronidation. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.

Differences in exercise capacity and muscle glycogen metabolism in C57BL/6J and BALB/cA mice.

This study compared differences in exercise capacity as well as muscle glycogen content and degradation, and mitochondrial enzyme activity between C57BL/6J and BALB/cA mice. In exercise tests, grip strength was higher in BALB/cA mice. In Rotarod and Inverted screen test, C57BL/6J mice had significantly longer exercise durations and showed differences in motor function and muscle endurance time. Glycogen in the liver and muscle of C57BL/6J mice was significantly decreased after 20 min of swimming. Muscle glycogen content in BALB/cA mice was higher than in C57BL/6J, but swimming induced no decrease in glycogen content. Glycogen phosphorylase in muscle was inactive in the absence of AMP, and its activity increased in a concentration-dependent manner with the addition of AMP in C57BL/6J mice. In BALB/cA mice, phosphorylase activity was increased by AMP, but not further increased by higher concentrations of AMP. The citrate synthase activity in muscle did not differ between C57BL/6J and BALB/cA mice. The results of this study suggested that the reactivity of muscle glycogen phosphorylase to AMP differs among strains of mice and affects glycogen availability during exercise.

A rare case of a testicular lesion related to hand, foot, and mouth disease.

Introduction: Hand, foot, and mouth disease generally occurs in children. In rare cases, hand, foot, and mouth disease affects the testicles. Case presentation: A 29-year-old man presented to our emergency department with testicular pain for several days after the onset of hand, foot, and mouth disease. Ultrasonography revealed hypoechoic mass-like areas in the right testis. A mild inflammatory response was noted, tumor markers and urinary data were normal, and tests for infection were all negative. Antibiotics were initiated and ultrasonography was performed in every subsequent examination. Testicular pain disappeared 6 months later. Conclusion: We encountered a rare case of a testicular lesion related to hand, foot, and mouth disease that was successfully treated. The careful selection of treatment for testicular pain and scrotal enlargement in young adult males, such as surgery and symptomatic treatment, based on their medical history and laboratory findings, is important.

Associations between vision, hearing and tooth loss and social interactions: the JAGES cross-sectional study.

BACKGROUND: Difficulties in communication due to vision, hearing and tooth loss have a serious impact on health. We compared the association between and attribution of each of these factors on social interaction. METHODS: This cross-sectional study examined data from the 2016 Japan Gerontological Evaluation Study (n=22 295) on community-dwelling people aged ≥65 years in Japan. The dependent variable was the frequency of meeting friends as a measure of social interaction, and less-than-monthly was defined as fewer social interactions. The independent variables were self-reported degrees of vision, hearing (5-point Likert scale) and tooth loss (five categories), with 'poor' or '0 teeth' defined as the worst category. Sex, age, educational attainment, comorbidity and residential area were used as covariates. Poisson regression analysis with multiple imputations was used to estimate the prevalence ratios (PRs) of fewer social interactions by each status. Subsequently, the population attributable fraction (PAF) was calculated to assess the public health impact. RESULTS: The number of participants with fewer social interactions was 5622 (26.9%). Proportions of fewer social interactions among those with the worst vision, hearing and number of teeth categories were 48.7%, 40.1% and 32.0%, respectively. Their corresponding PRs of fewer social interactions were 1.72 (95% CI 0.97 to 3.05), 1.35 (95% CI 0.99 to 1.85) and 1.23 (95% CI 1.10 to 1.37), respectively. The total PAF for vision, hearing and number of teeth was 8.3%, 5.0% and 6.4%, respectively. CONCLUSION: Self-reported vision, hearing and tooth loss were associated with fewer social interactions. The magnitude of these impairments was largest in vision, followed by tooth and hearing loss.

The association between socioeconomic status and reactions to radiation exposure: a cross-sectional study after the Fukushima Daiichi nuclear power station accident.

Risk perception and individual reactions to risk are not necessarily comparable, and socioeconomic status may affect individual reactions to risk. This study aimed to investigate the association between socioeconomic status and reactions to radiation exposure risk. This cross-sectional study, based on a self-reported online survey was conducted between 3 March and 21 March 2012, one year after the accident at Fukushima Daiichi nuclear power station. We used feelings of anxiety and risk-averse behavior concerning radiation exposure as dependent variables, and equivalent income and educational attainment as independent variables. Multiple logistic regression analysis was applied to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) with adjustment for possible confounders. Among 10 000 participants, 23.0% felt anxious and 12.0% engaged in risk-averse behavior for radiation exposure. Participants with a higher socioeconomic status tended not to feel anxious but undertook risk-averse behavior. Participants in the highest quartile income category did not report feeling anxious but showed prevalent undertaking of risk-averse behavior for radiation exposure compared to the lowest income category (for anxiety, aOR, 0.77; 95% CI, 0.64-0.93, for risk-averse behavior, aOR, 1.33; 95% CI, 1.04-1.69). University or graduate-school graduates were associated with greater risk-averse behavior compared to junior high school or high school graduates (aOR, 1.49; 95% CI, 1.29-1.73). Socioeconomic status may affect reactions to radiation exposure risk. Risk communication strategies should consider the socioeconomic status of those affected.