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Sato A, Oomori Y, Nakano R, Matsuura T. Nonalcoholic Fatty Liver Disease in Japan Continue to Increase Even after the Launch of Specific Health Checkups. Intern Med 2024; 63:763-771. [PMID: 37532550 PMCID: PMC11009008 DOI: 10.2169/internalmedicine.1715-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/19/2023] [Indexed: 08/04/2023] Open
Abstract
Objective To examine the trends and relationships between nonalcoholic fatty liver disease (NAFLD) and hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia from fiscal year (FY) 2008, when specific health checkups (SHCs) were initiated in Japan, to FY 2019 and the relationship between NAFLD trends and dietary nutrition. Methods A total of 48,332 participants (25,121 men and 23,211 women) diagnosed with NAFLD who underwent health checkups, including ultrasonography, from FY 2008 to FY 2019 were included. A fatty liver was diagnosed using ultrasonography. The dietary nutrient intake status was based on data from the National Health and Nutrition Survey, Japan. Results Over 12 years, NAFLD prevalence increased from 26.9% to 43.1% in men (p<0.0001) and from 9.9% to 17.9% in women (p<0.0001) in all body mass index (BMI) groups except for obese II (according to the World Health Organization Asia-Pacific criteria) in men and underweight in women and almost all age groups. T2DM prevalence increased in men (from 9.0% to 10.7%, p=0.0234), and obesity and higher waist circumference rates increased in women (from 16.0% to 18.0%, p=0.0059 and from 8.1% to 10%, respectively, p=0.0006). The dietary nutrient intake increased with regard to the total fat, fat/energy ratio, saturated fatty acids, monounsaturated fatty acids, and n6/n3 fatty acid ratio in both men and women, and these nutrient trends were correlated with NAFLD prevalence (all p≤0.0005). Conclusion In Japan, NAFLD increased in both men and women regardless of the BMI and age, even after starting SHCs. An unbalanced fat intake may be one of the major reasons for this increase.
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Affiliation(s)
- Akira Sato
- Department of Health Management, St. Marianna University Yokohama Seibu Hospital, Japan
- Department of Clinical Examination, Sasaki Foundation Shonan Health Examination Center, Japan
| | - Yumiko Oomori
- Department of Clinical Examination, Sasaki Foundation Shonan Health Examination Center, Japan
| | - Rika Nakano
- Department of Radiology, Sasaki Foundation Shonan Health Examination Center, Japan
| | - Tomokazu Matsuura
- Medical Department, Sasaki Foundation Shonan Health Examination Center, Japan
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2
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Shimizu K. Development of an Improved Adenovirus Vector and Its Application to the Treatment of Lifestyle-Related Diseases. Biol Pharm Bull 2024; 47:886-894. [PMID: 38692864 DOI: 10.1248/bpb.b23-00837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
The number of patients with lifestyle-related diseases such as type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), has continued to increase worldwide. Therefore, development of innovative therapeutic methods targeting lifestyle-related diseases is required. Gene therapy has attracted considerable attention as an advanced medical treatment. Safe and high-performance vectors are essential for the practical application of gene therapy. Replication-incompetent adenovirus (Ad) vectors are widely used in clinical gene therapy and basic research. Here, we developed a novel Ad vector, named Ad-E4-122aT, exhibiting higher and longer-term transgene expression and lower hepatotoxicity than conventional Ad vectors. We also elucidated the mechanisms underlying Ad vector-induced hepatotoxicity during the early phase using Ad-E4-122aT. Next, we examined the therapeutic effects of the genes of interest, namely zinc finger AN1-type domain 3 (ZFAND3), lipoprotein lipase (LPL), and lysophospholipid acyltransferase 10 (LPLAT10), on lifestyle-related diseases using Ad-E4-122aT. We showed that the overexpression of ZFAND3 in the liver improved glucose tolerance and insulin resistance. Liver-specific LPL overexpression suppressed hepatic lipid accumulation and improved glucose metabolism. LPLAT10 overexpression in the liver suppressed postprandial hyperglycemia by increasing glucose-stimulated insulin secretion. Furthermore, we also focused on foods to advance research on the pathophysiology and treatment of lifestyle-related diseases. Cranberry and calamondin, which are promising functional foods, attenuated the progression of MASLD/NAFLD. Our findings will aid the development of new therapeutic methods, including gene therapy, for lifestyle-related diseases such as T2DM and MASLD/NAFLD.
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Affiliation(s)
- Kahori Shimizu
- Laboratory of Biochemistry, Faculty of Pharmacy, Osaka Ohtani University
- Laboratory of Biochemistry and Molecular Biology, Graduate School of Pharmaceutical Sciences, Osaka University
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Takase H, Takeuchi Y, Fujita T, Ohishi T. Excessive salt intake reduces bone density in the general female population. Eur J Clin Invest 2023; 53:e14034. [PMID: 37272759 DOI: 10.1111/eci.14034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/06/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Osteoporosis is a multifactorial disorder in which nutrition is associated with its onset and progression. Excessive salt intake is closely associated with the onset and progression of various diseases, such as osteoporosis and hypertension. We investigated the effects of dietary salt intake on bone density in the general female population. METHODS In 884 female participants (60.1 ± 10.1 years old) who visited our hospital for an annual physical checkup, salt intake (g/day) was assessed using a spot urine sample, and bone density was evaluated as a speed of sound (m/s) of ultrasonic pulses in a calcaneus by quantitative ultrasound. We investigated the relationship between bone density and salt intake and the differences in bone density or salt intake between the presence and absence of lifestyle-related diseases such as hypertension, diabetes mellitus and dyslipidaemia. RESULTS The average bone density and salt intake were 1497 ± 26 m/s and 8.5 ± 1.8 g/day, respectively. Univariate and multivariate regression analyses revealed that bone density was significantly negatively associated with salt intake. Bone density was lower, and salt intake was higher in participants with hypertension, diabetes mellitus and dyslipidaemia than in those without. After adjusting for age, hypertension, diabetes mellitus and dyslipidaemia, bone density was negatively correlated with salt intake. CONCLUSIONS We confirmed that excessive salt intake reduces bone density independently of age and lifestyle-related diseases in the general female population. Since dietary salt intake is a modifiable factor, osteoporosis can be prevented by dietary intervention, including salt reduction.
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Affiliation(s)
- Hiroyuki Takase
- Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan
| | - Yuki Takeuchi
- Department of Orthopedic Surgery, Enshu Hospital, Hamamatsu, Japan
| | - Tomotada Fujita
- Department of Orthopedic Surgery, Enshu Hospital, Hamamatsu, Japan
| | - Tsuyoshi Ohishi
- Department of Orthopedic Surgery, Enshu Hospital, Hamamatsu, Japan
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Tanaka K, Hitosugi M, Takaso M, Nakamura M, Takeda A. Affecting Factors of Prostate Volume in Forensic Autopsied Decedents. Healthcare (Basel) 2023; 11:healthcare11101486. [PMID: 37239771 DOI: 10.3390/healthcare11101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Because decedents undergoing forensic autopsies would have behaved normally before death, prostate volume according to age group can be confirmed with forensic autopsy materials. The objectives of this study were to first confirm the current prostate volume by age and then determine diseases that can influence prostate volume using forensic autopsy materials. Prostate specimens were collected from forensic autopsies performed at Shiga University of Medical Science, Japan, between January 2015 and December 2019. Overall, 207 decedents were included in the study. Prostate volume was measured by the Archimedes' principle. Concomitant diseases were determined by the past medical histories and autopsy results. The mean crude prostate volume was 29.1 ± 10.3 mL (range, 2.8-88.0 mL). The crude prostate volume increased with age. The mean corrected prostate volume (divided by body surface area) was significantly higher in patients with atherosclerosis than in those without. However, multiple regression analysis revealed that only age influenced the corrected prostate volume. Age was the only significant influencing factor for prostate volume. We propose applying age estimation using prostate volume for forensic medicine purposes. Because prostate volume was not influenced by concomitant disease, it would be valuable to estimate the decedent's age using the prostate volume.
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Affiliation(s)
- Kota Tanaka
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Masahito Hitosugi
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Marin Takaso
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Mami Nakamura
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
| | - Arisa Takeda
- Department of Legal Medicine, Shiga University of Medical Science, Otsu 520-2192, Japan
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Rey Velasco E, Pedersen HS, Skinner T. Analysis of Patient Cues in Asynchronous Health Interactions: Pilot Study Combining Empathy Appraisal and Systemic Functional Linguistics. JMIR Form Res 2022; 6:e40058. [PMID: 36538352 PMCID: PMC9812272 DOI: 10.2196/40058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/21/2022] [Accepted: 11/21/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Lifestyle-related diseases are among the leading causes of death and disability. Their rapid increase worldwide has called for low-cost, scalable solutions to promote health behavior changes. Digital health coaching has proved to be effective in delivering affordable, scalable programs to support lifestyle change. This approach increasingly relies on asynchronous text-based interventions to motivate and support behavior change. Although we know that empathy is a core element for a successful coach-user relationship and positive patient outcomes, we lack research on how this is realized in text-based interactions. Systemic functional linguistics (SFL) is a linguistic theory that may support the identification of empathy opportunities (EOs) in text-based interactions, as well as the reasoning behind patients' linguistic choices in their formulation. OBJECTIVE This study aims to determine whether empathy and SFL approaches correspond and complement each other satisfactorily to study text-based communication in a health coaching context. We sought to explore whether combining empathic assessment with SFL categories can provide a means to understand client-coach interactions in asynchronous text-based coaching interactions. METHODS We retrieved 148 text messages sent by 29 women who participated in a randomized trial of telecoaching for the prevention of gestational diabetes mellitus (GDM) and postnatal weight loss. We conducted a pilot study to identify users' explicit and implicit EOs and further investigated these statements using the SFL approach, focusing on the analysis of transitivity and thematic analysis. RESULTS We identified 164 EOs present in 42.37% (3478/8209) of the word count in the corpus. These were mainly negative (n=90, 54.88%) and implicit (n=55, 60.00%). We distinguished opening, content and closing messages structures. Most of the wording was found in the content (n=7077, 86.21%) with a declarative structure (n=7084, 86.30%). Processes represented 22.4% (n=1839) of the corpus, with half being material (n=876, 10.67%) and mostly related to food and diet (n=196, 54.92%), physical activity (n=96, 26.89%), and lifestyle goals (n=40, 11.20%). CONCLUSIONS Our findings show that empathy and SFL approaches are compatible. The results from our transitivity analysis reveal novel insights into the meanings of the users' EOs, such as their seek for help or praise, often missed by health care professionals (HCPs), and on the coach-user relationship. The absence of explicit EOs and direct questions could be attributed to low trust on or information about the coach's abilities. In the future, we will conduct further research to explore additional linguistic features and code coach messages. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001240932; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380020.
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Affiliation(s)
- Elena Rey Velasco
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Liva Healthcare, Copenhagen, Denmark
| | | | - Timothy Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Sakai A, Nagao M, Nakano H, Ohira T, Ishikawa T, Hosoya M, Shimabukuro M, Takahashi A, Kazama JJ, Okazaki K, Hayashi F, Yasumura S, Ohto H, Kamiya K. Effects of External Radiation Exposure Resulting From the Fukushima Daiichi Nuclear Power Plant Accident on the Health of Residents in the Evacuation Zones: the Fukushima Health Management Survey. J Epidemiol 2022; 32:S84-S94. [PMID: 36464304 PMCID: PMC9703929 DOI: 10.2188/jea.je20210286] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Associations have been reported between lifestyle-related diseases and evacuation after the Great East Japan Earthquake (GEJE). However, the relationship between lifestyle-related diseases and the effective radiation dose due to external exposure (EDEE) after the GEJE remains unclear. METHODS From among 72,869 residents of Fukushima Prefecture (31,982 men; 40,887 women) who underwent a comprehensive health check in fiscal year (FY) 2011, the data of 54,087 residents (22,599 men; 31,488 women) aged 16 to 84 years were analyzed. The EDEE data of 25,685 residents with incomplete results from the basic survey, performed to estimate the external radiation exposure dose, were supplemented using multiple imputation. The data were classified into three groups based on EDEE (0 to <1, 1 to <2, and ≥2 mSv groups and associations between the incidence of diseases and EDEE from FY2011 to FY2017 were examined using a Cox proportional hazards model, with FY2011 as the baseline. RESULTS A higher EDEE was associated with a greater incidence of hypertension, diabetes mellitus, dyslipidemia, hyperuricemia, liver dysfunction, and polycythemia from FY2011 to FY2017 in the age- and sex-adjusted model. However, after further adjustment for evacuation status and lifestyle-related factors, the significant associations disappeared. No association was found between EDEE and other lifestyle-related diseases. CONCLUSION EDEE was not directly associated with the incidence of lifestyle-related diseases after the GEJE. However, residents with higher external radiation doses in Fukushima Prefecture might suffer from lifestyle-related diseases related to evacuation and the resultant lifestyle changes.
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Affiliation(s)
- Akira Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Masanori Nagao
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Tetsuo Ishikawa
- Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Junichiro J. Kazama
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kanako Okazaki
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Fumikazu Hayashi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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Mori Y, Araki M, Morishita S, Imai M, Edahiro Y, Ito M, Ochiai T, Shirane S, Hashimoto Y, Yasuda H, Ando J, Ando M, Komatsu N. Clinical features of acquired erythrocytosis: Low levels of serum erythropoietin in a subset of non-neoplastic erythrocytosis patients. Cancer Med 2022; 12:1079-1089. [PMID: 35775283 PMCID: PMC9883404 DOI: 10.1002/cam4.4958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/17/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Acquired erythrocytosis can be classified into polycythemia vera (PV) and non-neoplastic erythrocytosis (NNE). The vast majority of PV patients harbor JAK2 mutations, but differentiating JAK2 mutation-negative PV from NNE is challenging due to a lack of definitive molecular markers. METHODS We studied the clinical features of 121 patients with erythrocytosis of which 47 (38.8%) were JAK2 mutation-positive and also fulfilled the diagnostic criteria for PV, and 67 (55.4%) JAK2 mutation-negative erythrocytosis patients who were diagnosed as NNE. Diagnosis was strictly based on driver mutation analysis and central pathology review. RESULTS No JAK2 mutation-negative PV patients were found in our cohort. The NNE group showed significantly younger (p < 0.01) age with higher frequency of smoking (p < 0.001), alcohol consumption (p < 0.001), and diabetes mellitus (p < 0.05), whereas the PV group (n = 47) showed significantly higher white blood cell count, platelet count, and lactate dehydrogenase (p < 0.001). Although serum erythropoietin (EPO) levels were significantly higher in NNE compared to PV (p < 0.001), approximately 40% of the NNE patients had EPO levels below the lower range of normal, fulfilling a minor diagnostic criterion of PV and raising the possibility of PV misdiagnosis. CONCLUSION Low EPO levels in JAK2 mutation-negative erythrocytosis may not be a reliable diagnostic criterion for distinguishing PV from NNE.
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Affiliation(s)
- Yosuke Mori
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Marito Araki
- Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan,Department of Advanced HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Soji Morishita
- Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan,Department of Advanced HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Misa Imai
- Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan
| | - Yoko Edahiro
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan,Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan,Department of Advanced HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Masafumi Ito
- Department of PathologyJapanese Red Cross Aichi Medical Center Nagoya Daiichi HospitalNagoyaJapan
| | - Tomonori Ochiai
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan,Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan,Department of Advanced HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Shuichi Shirane
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan,Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan,Department of Advanced HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Yoshinori Hashimoto
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan,Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan,Department of Advanced HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Hajime Yasuda
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Jun Ando
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan,Department of Cell Therapy and Transfusion MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Miki Ando
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan
| | - Norio Komatsu
- Department of HematologyJuntendo University Graduate School of MedicineTokyoJapan,Laboratory for the Development of Therapies Against MPNJuntendo University Graduate School of MedicineTokyoJapan,Department of Advanced HematologyJuntendo University Graduate School of MedicineTokyoJapan,PharmaEssentia Japan KKTokyoJapan
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Egashira M, Son D, Ema A. Serious Game for Change in Behavioral Intention Toward Lifestyle-Related Diseases: Experimental Study With Structural Equation Modeling Using the Theory of Planned Behavior. JMIR Serious Games 2022; 10:e28982. [PMID: 35188465 PMCID: PMC8902675 DOI: 10.2196/28982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/01/2021] [Accepted: 11/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health activities should be tailored to individual lifestyles and values. To raise awareness of health behaviors, various practices related to health education, such as interactive activities among individuals with different backgrounds, have been developed. Moreover, serious games have been used as a tool for facilitating communication. However, there have been few investigations that are based on the framework of the theory of planned behavior on the mechanisms of health-related behavioral intention change from playing serious games. OBJECTIVE We aimed to investigate the mechanisms of behavioral intention change among various age groups after an intervention using a serious game to increase awareness of lifestyle-related diseases. METHODS Adults, undergraduates, and high school students played a serious game, called Negotiation Battle, and answered a questionnaire-Gaming Event Assessment Form for Lifestyle-related Diseases-before, immediately after, and 2-4 weeks after the game. The questionnaire was composed of 16 items based on the theory of planned behavior. We used structural equation modeling to compare responses from the 3 groups. RESULTS For all 3 age groups (adults: mean 43.4 years, range 23-67 years; undergraduates: mean 20.9 years, range 19-34 years; high school students: mean 17.9 years, 17-18 years), perceived behavior control was the key factor of behavioral intention change. Immediately after the game, causal relationships between perceived behavioral control and behavioral intention were enhanced or maintained for all groups-adults (before: path coefficient 1.030, P<.001; after: path coefficient 2.045, P=.01), undergraduates (before: path coefficient 0.568, P=.004; after: path coefficient 0.737, P=.001), and high school students (before: path coefficient 14.543, P=.97; after: path coefficient 0.791, P<.001). Analysis of free descriptions after intervention suggested that experiencing dilemma is related to learning and behavioral intention. CONCLUSIONS The study revealed that the serious game changed the behavioral intention of adolescents and adults regarding lifestyle-related diseases, and changes in perceived behavioral control mediated the alteration mechanism.
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Affiliation(s)
- Mahiro Egashira
- Division of Science Interpreter Training Program, Komaba Organization for Educational Excellence, The University of Tokyo, Tokyo, Japan
| | - Daisuke Son
- Department of Community-Based Family Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Arisa Ema
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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Kaku T, Suzuki M, Tominaga T, Ogawa A, Shimizu A, Watanabe K, Watanabe K, Maeda T, Matsuda Y. [Efficacy of the Extract from Fermentation of Soybean and Rice Bran on Hyperglycemia]. YAKUGAKU ZASSHI 2022; 142:289-293. [PMID: 35228381 DOI: 10.1248/yakushi.21-00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In recent years, lifestyle-related diseases such as hypertension and diabetes have been on the rise. These conditions can cause serious conditions such as myocardial and cerebral infarctions. Therefore, proper control of blood pressure and blood glucose levels is important issues in preventive medicine. Traditional fermented foods have been shown to have various functions, and their effects on lifestyle-related diseases have attracted particular attention. In this study, we investigated the effects of fermented soybeans and rice bran (OE-1) and supplements containing OE-1 on blood glucose levels and weight changes. We identified an inhibitory effect on elevated blood glucose levels upon administration of OE-1, and this effect was thought to be due to digestive enzyme inhibition. These effects of foods containing OE-1 are expected to have a positive effect on the prevention and improvement of lifestyle-related diseases as health foods.
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Affiliation(s)
- Teppei Kaku
- Department of Clinical Pharmacy, Nihon Pharmaceutical University
| | - Miiru Suzuki
- Department of Clinical Pharmacy, Nihon Pharmaceutical University
| | | | | | | | | | | | - Tomoji Maeda
- Department of Clinical Pharmacy, Nihon Pharmaceutical University
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10
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Tsurusawa N, Chang J, Namba M, Makioka D, Yamura S, Iha K, Kyosei Y, Watabe S, Yoshimura T, Ito E. Modified ELISA for Ultrasensitive Diagnosis. J Clin Med 2021; 10:5197. [PMID: 34768717 PMCID: PMC8585087 DOI: 10.3390/jcm10215197] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
An enzyme-linked immunosorbent assay (ELISA) can be used for quantitative measurement of proteins, and improving the detection sensitivity to the ultrasensitive level would facilitate the diagnosis of various diseases. In the present review article, we first define the term 'ultrasensitive'. We follow this with a survey and discussion of the current literature regarding modified ELISA methods with ultrasensitive detection and their application for diagnosis. Finally, we introduce our own newly devised system for ultrasensitive ELISA combined with thionicotinamide adenine dinucleotide cycling and its application for the diagnosis of infectious diseases and lifestyle-related diseases. The aim of the present article is to expand the application of ultrasensitive ELISAs in the medical and biological fields.
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Affiliation(s)
- Naoko Tsurusawa
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
| | - Jyunhao Chang
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
| | - Mayuri Namba
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
| | - Daiki Makioka
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
| | - Sou Yamura
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
| | - Kanako Iha
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
| | - Yuta Kyosei
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
| | - Satoshi Watabe
- Waseda Research Institute for Science and Engineering, Waseda University, Tokyo 169-8555, Japan;
| | - Teruki Yoshimura
- School of Pharmaceutical Sciences, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu 061-0293, Hokkaido, Japan;
| | - Etsuro Ito
- Department of Biology, Waseda University, Tokyo 162-8480, Japan; (N.T.); (J.C.); (M.N.); (D.M.); (S.Y.); (K.I.); (Y.K.)
- Waseda Research Institute for Science and Engineering, Waseda University, Tokyo 169-8555, Japan;
- Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
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11
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Okada K, Watahiki T, Horie K, Takayama T, Aida Y, To K, Shida T, Ishige K, Nishiyama H, Shoda J, Suzuki H. The prevalence and clinical implications of pancreatic fat accumulation identified during a medical check-up. Medicine (Baltimore) 2021; 100:e27487. [PMID: 34731128 PMCID: PMC8519203 DOI: 10.1097/md.0000000000027487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/15/2021] [Indexed: 01/05/2023] Open
Abstract
Fatty pancreas (FP) is characterized by pancreatic fat accumulation and the subsequent development of pancreatic and metabolic complications. However, FP has not been categorized in the manual for abdominal ultrasound in cancer screening and health check-ups in Japan, and the pathology of FP has not been fully elucidated.Nine hundred and nineteen people who underwent a medical check-up had the severity of their pancreatic fat accumulation categorized after transabdominal ultrasonographic examination. The relationships between FP, lifestyle-related diseases, and fatty liver disease at this time were assessed using stratification analysis.The prevalence of FP was 46.8% (430/919). People with FP were more likely to be male and had higher prevalences of lifestyle-related diseases, including fatty liver disease. Men and women were similarly represented in each tertile of pancreas brightness. Older age; high waist circumference, triglyceride and glucose index, serum low-density lipoprotein-cholesterol, hepatic steatosis index; and low serum amylase were associated with the presence of severe FP. Moreover, the group with severe liver steatosis had a higher prevalence of FP and a higher pancreatic brightness score. Logistic regression analysis showed that individuals with liver steatosis were more likely to have severe FP.The severity of FP is associated with features of lifestyle-related diseases and the severity of liver steatosis. These findings suggest that high visceral fat content is associated with more severe fatty pancreas as a phenotype of ectopic fat accumulation, as well as fatty liver disease.
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Affiliation(s)
- Kosuke Okada
- Division of Medical Sciences, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
- Tsukuba Preventive Medicine Research Center, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Takahisa Watahiki
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Kaoru Horie
- Tsukuba Preventive Medicine Research Center, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Takako Takayama
- Tsukuba Preventive Medicine Research Center, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Yuka Aida
- Tsukuba Preventive Medicine Research Center, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Keii To
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Takashi Shida
- Division of Medical Sciences, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
- Tsukuba Preventive Medicine Research Center, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Kazunori Ishige
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Hiroyuki Nishiyama
- Tsukuba Preventive Medicine Research Center, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
- Department of Urology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Junichi Shoda
- Division of Medical Sciences, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
| | - Hideo Suzuki
- Tsukuba Preventive Medicine Research Center, University of Tsukuba Hospital, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki, Japan
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12
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Moriyama M, Kazawa K, Jahan Y, Ikeda M, Mizukawa M, Fukuoka Y, Harada K, Rahman MM. The Effectiveness of Telenursing for Self-Management Education on Cardiometabolic Conditions: A Pilot Project on a Remote Island of Ōsakikamijima, Japan. J Prim Care Community Health 2021; 12:21501327211030817. [PMID: 34238053 PMCID: PMC8274085 DOI: 10.1177/21501327211030817] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Providing self-management education for residents with cardiometabolic conditions in remote islands is a challenge due to the shortage of primary care practitioners (PCPs), specialist physicians, and nurses. Therefore, we applied telenursing with lifestyle-related chronic diseases in remote island residents in Japan. This project aimed to improve the self-management behavior, cardiometabolic indicators, self-efficacy, and quality of life (QoL) of residents with cardiometabolic risks. Methods: We chose Ōsakikamijima Island, Hiroshima Prefecture, Japan, which is designated under the Remote Islands Development Act. The project was conducted from 2013 to 2014. The residents aged over 40 and under 75 years old, selected from the annual specific health check-up examination and from PCPs for screening cardiometabolic risks (urinary protein, glycohemoglobin A1c, systolic and diastolic blood pressure (BP), Low-density lipoprotein cholesterol, High-density lipoprotein cholesterol, and triglyceride) were included. The effectiveness of telenursing for self-management education was 6-month-long with a 6-month follow-up and evaluated by a single-group pre-and post-test design. Face-to-face health education was applied at the initial interview followed by telenursing (biweekly telephone calls till third-month, and a monthly telephone call during the fourth and fifth-month) by the trained nurses outside the island. To enhance participants’ self-monitoring health behavior changes, the nurses used motivational interviewing and behavior change techniques based on the transtheoretical model. Results: A total of 130 residents, 42 agreed to participate, 41 finished the 6-month program, and 33 completed the 12-month follow-up. Most of their behavior changes like self-management behaviors, cardiometabolic indicators, and self-efficacy at 6-month were improved significantly except QoL. Among the 12-month study periods, self-management behaviors, body mass index, systolic BP, diastolic BP, and self-efficacy (sense of control), (all P < .05) showed significant improvement. Conclusion: This study results indicated that telenursing might be effective to improve the lifestyles-related behaviors in chronic diseases on the remote island of Ōsakikamijima, Japan.
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Affiliation(s)
| | | | | | - Mika Ikeda
- Division of Health, Ōsakikamijima town, Hiroshima, Japan
| | | | | | - Koji Harada
- International University of Health and Welfare School of Health Sciences, Odawara, Japan
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13
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Grunseit AC, Bohn-Goldbaum E, Thomas M, Seabury R, Rissel C, Crane M. Service provider perspectives on implementing the NSW Get Healthy at Work program. Int J Qual Stud Health Well-being 2021; 16:1945205. [PMID: 34219612 PMCID: PMC8259863 DOI: 10.1080/17482631.2021.1945205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: One approach increasingly used by governments to deliver on public initiatives is to partner with private enterprise through public–private partnerships. This study is a qualitative process evaluation of an Australian state-wide workplace health programme “Get Healthy at Work” from the currently under-researched perspective of the private service providers. Methods: Semi-structured interviews were conducted with nine service providers. Interviews were transcribed and analysed inductively. Results: Service providers reported an alignment of motives and skills between the programme and their organizations as a benefit of the partnership. However, they also described misalignments: between the potential and realized value of the programme to businesses and service providers; the programme cycle and business operational processes; and the capacity building approach and businesses’ expectations of the service.Conclusions: Although several hallmarks of a well-functioning private–public partnership were evident, misalignments of process and expectations challenged sustained partnership involvement by providers. Careful consideration must be given to the ongoing management functioning of cross-sector engagement and partnering in health promotion practice in order to ensure public health goals are being met, but also that the model is mutually sustainable.
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Affiliation(s)
- Anne C Grunseit
- The Australian Prevention Partnership Centre, Glebe, Australia.,Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Erika Bohn-Goldbaum
- The Australian Prevention Partnership Centre, Glebe, Australia.,Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Margaret Thomas
- Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | | | - Chris Rissel
- Sydney School of Public Health, The University of Sydney, Camperdown, Australia.,NSW Ministry of Health, Glebe, Australia
| | - Melanie Crane
- The Australian Prevention Partnership Centre, Glebe, Australia.,Sydney School of Public Health, The University of Sydney, Camperdown, Australia
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14
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Ahn SI, Cho S, Choi NJ. Effectiveness of Chitosan as a Dietary Supplement in Lowering Cholesterol in Murine Models: A Meta-Analysis. Mar Drugs 2021; 19:26. [PMID: 33435383 DOI: 10.3390/md19010026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/18/2020] [Accepted: 01/06/2021] [Indexed: 11/21/2022] Open
Abstract
This study presents a meta-analysis of studies that investigate the effectiveness of chitosan administration on lifestyle-related disease in murine models. A total of 34 published studies were used to evaluate the effect of chitosan supplementation. The effect sizes for various items after chitosan administration were evaluated using the standardized mean difference. Using Cochran’s Q test, the heterogeneity of effect sizes was assessed, after which a meta-ANOVA and -regression test was conducted to explain the heterogeneity of effect sizes using the mixed-effect model. Publication bias was performed using Egger’s linear regression test. Among the items evaluated, blood triglyceride and HDL-cholesterol showed the highest heterogeneity, respectively. Other than blood HDL-cholesterol, total cholesterol, and triglyceride in feces, most items evaluated showed a negative effect size with high significance in the fixed- and random-effect model (p < 0.0001). In the meta-ANOVA and -regression test, administering chitosan and resistant starch was revealed to be most effective in lowering body weight. In addition, chitosan supplementation proved to be an effective solution for serum TNF-α inhibition. In conclusion, chitosan has been shown to be somewhat useful in improving symptoms of lifestyle-related disease. Although there are some limitations in the results of this meta-analysis due to the limited number of animal experiments conducted, chitosan administration nevertheless shows promise in reducing the risk of cholesterol related metabolic disorder.
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15
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Pageau F, Cornaz CD, Gothuey I, Seaward H, Wangmo T, Elger BS. Prison Unhealthy Lifestyle and Poor Mental Health of Older Persons-A Qualitative Study. Front Psychiatry 2021; 12:690291. [PMID: 34867505 PMCID: PMC8639530 DOI: 10.3389/fpsyt.2021.690291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mental healthcare and lifestyle habits in prison, especially for older individuals, has been shown to be suboptimal. Most psychiatric conditions left untreated worsen food choices, physical inactivity, and substance abuse. In turn, bad habits lead to poorer mental health. Methods: To comprehensively illustrate this downward spiraling, we completed a thorough analysis of data obtained through semi-structured qualitative interviews. There were 50 interviews of aging incarcerated people included in this article. They were analyzed following a classical six-stepped thematic analysis. Results: According to our participants, sports are not well-adapted to aging individuals, nor to people with medical conditions. Prison is even more unadapted for those who both are aging and have medical conditions. Also, food served is less than optimal. According to our interviews, the older imprisoned individual often does not have access to food adapted to his or her medical conditions. Sport is maladapted for older incarcerated individuals and mostly tailored for younger ones. Finally, boredom and lack of responsibility hinder change toward a better lifestyle for older adults in prison. Conclusion: Our paper shows why prison environmental modifications are needed to help older adults with their lifestyle habits. It also exposes an original way to see the relationship between mental health and lifestyle habits.
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Affiliation(s)
- Félix Pageau
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Corinne Devaud Cornaz
- Unit of Health Law and Humanitarian Medicine, Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| | - Isabelle Gothuey
- Unit of Health Law and Humanitarian Medicine, Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| | - Helene Seaward
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Unit of Health Law and Humanitarian Medicine, Center for Legal Medicine, University of Geneva, Geneva, Switzerland
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16
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Aida A, Svensson T, Svensson AK, Chung UI, Yamauchi T. eHealth Delivery of Educational Content Using Selected Visual Methods to Improve Health Literacy on Lifestyle-Related Diseases: Literature Review. JMIR Mhealth Uhealth 2020; 8:e18316. [PMID: 33295296 PMCID: PMC7758165 DOI: 10.2196/18316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 08/07/2020] [Accepted: 11/19/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Lifestyle-related diseases, such as stroke, heart disease, and diabetes, are examples of noncommunicable diseases. Noncommunicable diseases are now the leading cause of death in the world, and their major causes are lifestyle related. The number of eHealth interventions is increasing, which is expected to improve individuals' health literacy on lifestyle-related diseases. OBJECTIVE This literature review aims to identify existing literature published in the past decade on eHealth interventions aimed at improving health literacy on lifestyle-related diseases among the general population using selected visual methods, such as educational videos, films, and movies. METHODS A systematic literature search of the PubMed database was conducted in April 2019 for papers written in English and published from April 2, 2009, through April 2, 2019. A total of 538 papers were identified and screened in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. Finally, 23 papers were included in this review. RESULTS The 23 papers were characterized according to study characteristics (author and year of publication, study design and region where the study was conducted, study objective, service platform, target disease and participant age, research period, outcomes, and research method); the playback time of the educational videos, films, and movies; and the evaluation of the study's impacts on health literacy. A total of 7 studies compared results using statistical methods. Of these, 5 studies reported significant positive effects of the intervention on health literacy and health-related measures (eg, physical activity, body weight). Although most of the studies included educational content aimed at improving health literacy, only 7 studies measured health literacy. In addition, only 5 studies assessed literacy using health literacy measurement tools. CONCLUSIONS This review found that the provision of educational content was satisfactory in most eHealth studies using selected visual methods, such as videos, films, and movies. These findings suggest that eHealth interventions influence people's health behaviors and that the need for this intervention is expected to increase. Despite the need to develop eHealth interventions, standardized measurement tools to evaluate health literacy are lacking. Further research is required to clarify acceptable health literacy measurements.
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Affiliation(s)
- Azusa Aida
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Thomas Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.,School of Health Innovation, Kanagawa University of Human Services, Kawasaki-shi, Japan
| | - Akiko Kishi Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ung-Il Chung
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,School of Health Innovation, Kanagawa University of Human Services, Kawasaki-shi, Japan.,Clinical Biotechnology, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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17
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Abstract
The production and accumulation of advanced glycation end-products (AGEs) are hypothesized to have a causal role in the development of the complications associated with aging and lifestyle-related diseases, such as diabetes, atherosclerosis and hyperlipidemia. Therefore, it is important to reduce the production and accumulation of AGEs. In the present study, the ability of sodium 4-phenylbutyrate (PBA) on inhibition of glycation was assessed. In vitro, PBA inhibited the glycation of albumin and collagen by up to 42.1 and 36.9%, respectively. Furthermore, when spontaneously diabetic KK mice were administered PBA (20 mg/day) or vehicle orally, glycosuria developed rapidly in the control mice, but after 6 weeks, only one treated mouse was glycosuric. In addition, the weight gain and HbA1c levels were significantly lower in the treated mice compared with the untreated mice (weight gain, 36.0 g vs. 39.4 g, P<0.01; HbA1C level, 3.96 vs. 4.78%, P<0.01; respectively). These results suggested that PBA also inhibited glycation in vivo. Further studies are required to determine whether PBA may be effective for the therapy or prevention of aging or lifestyle-related diseases caused by the accumulation of AGEs. The method of administration and the side-effects of PBA have already been established as PBA is already used clinically. Therefore, the repurposing of PBA for reducing AGE levels may be a potential option to reduce complications associated with aging.
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Affiliation(s)
- Kazuhiko Ono
- Department of Drug Informatics and Translational Research, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka 814-0180, Japan
| | - Manabu Nakashima
- Department of Immunological and Molecular Pharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka 814-0180, Japan
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18
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Aida A, Svensson T, Svensson AK, Urushiyama H, Okushin K, Oguri G, Kubota N, Koike K, Nangaku M, Kadowaki T, Yamauchi T, Chung UI. Using mHealth to Provide Mobile App Users With Visualization of Health Checkup Data and Educational Videos on Lifestyle-Related Diseases: Methodological Framework for Content Development. JMIR Mhealth Uhealth 2020; 8:e20982. [PMID: 33084586 PMCID: PMC7641773 DOI: 10.2196/20982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/22/2020] [Accepted: 09/14/2020] [Indexed: 12/13/2022] Open
Abstract
Background The number of people with lifestyle-related diseases continues to increase worldwide. Improving lifestyle behavior with health literacy may be the key to address lifestyle-related diseases. The delivery of educational videos using mobile health (mHealth) services can replace the conventional way of educating individuals, and visualization can replace the provision of health checkup data. Objective This paper aimed to describe the development of educational content for MIRAMED, a mobile app aimed at improving users’ lifestyle behaviors and health literacy for lifestyle-related diseases. Methods All videos were based on a single unified framework to provide users with a consistent flow of information. The framework was later turned into a storyboard. The final video contents were created based on this storyboard and further discussions with leading experts and specialist physicians on effective communication with app users about lifestyle-related diseases. Results The app uses visualization of personal health checkup data and educational videos on lifestyle-related diseases based on the current health guidelines, scientific evidence, and expert opinions of leading specialist physicians in the respective fields. A total of 8 videos were created for specific lifestyle-related diseases affecting 8 organs: (1) brain–cerebrovascular disorder, (2) eyes–diabetic retinopathy, (3) lungs–chronic obstructive pulmonary disease, (4) heart–ischemic heart disease, (5) liver–fatty liver, (6) kidneys–chronic kidney disease (diabetic kidney disease), (7) blood vessels–peripheral arterial disease, and (8) nerves–diabetic neuropathy. Conclusions Providing enhanced mHealth education using novel digital technologies to visualize conventional health checkup data and lifestyle-related diseases is an innovative strategy. Future studies to evaluate the efficacy of the developed content are planned.
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Affiliation(s)
- Azusa Aida
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Thomas Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,School of Health Innovation, Kanagawa University of Human Services, Tonomachi, Japan
| | - Akiko Kishi Svensson
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Hirokazu Urushiyama
- Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuya Okushin
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gaku Oguri
- Department of Cardiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoto Kubota
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaomi Nangaku
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Toranomon Hospital, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ung-Il Chung
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan.,School of Health Innovation, Kanagawa University of Human Services, Tonomachi, Japan.,Clinical Biotechnology, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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19
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Thilsing T, Sonderlund AL, Sondergaard J, Svensson NH, Christensen JR, Thomsen JL, Hvidt NC, Larsen LB. Changes in Health-Risk Behavior, Body Mass Index, Mental Well-Being, and Risk Status Following Participation in a Stepwise Web-Based and Face-to-Face Intervention for Prevention of Lifestyle-Related Diseases: Nonrandomized Follow-Up Cohort Study. JMIR Public Health Surveill 2020; 6:e16083. [PMID: 32673269 PMCID: PMC7380905 DOI: 10.2196/16083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/10/2020] [Accepted: 04/12/2020] [Indexed: 01/18/2023] Open
Abstract
Background Recent evidence suggests the effectiveness of stepwise, targeted approaches for the prevention of lifestyle-related diseases with combinations of web-based and face-to-face interventions showing promising results. Objective This paper reports on 1-year changes in health-risk behaviors, BMI, self-rated health, mental well-being, and risk of disease at 1-year follow-up after participation in a stepwise intervention that targeted persons at high risk of disease and persons with health-risk behavior. To this end, we distinguish between participants who took up the full intervention (web-based plus face-to-face) and those who received only the web-based intervention. Methods The Early Detection and Prevention (Danish acronym: TOF) pilot study was conducted as a nonrandomized, 1-year follow-up intervention study in two municipalities in the Region of Southern Denmark. A total of 9400 citizens born between 1957 and 1986 (aged 29 to 60 years) were randomly sampled from participating general practitioner (GP) patient-list systems and were invited to take part in the study. Participants were subsequently stratified into risk groups based on their responses to a questionnaire on health-risk behavior and data from their GP’s electronic patient record (EPR) system. All participants received a digital personal health profile with individualized information on current health-risk behavior and targeted advice on relevant health-risk behavior changes. In addition, patients at high risk of disease, as indicated by their digital health profile, were offered a targeted intervention at their GP. Patients who were not deemed at high risk of disease but who exhibited health-risk behaviors were offered a targeted intervention at their municipal health center (MHC). At 1-year follow-up, health-risk behaviors, self-rated health, BMI, and mental well-being were reassessed by questionnaire, and current information on diagnoses and medical treatment was retrieved from the EPRs. Results Of 598 patients at high risk of disease or with health-risk behavior, 135 took up the targeted intervention at their GP or MHC and 463 received the personal health profile only. From baseline to 1-year follow-up, the number of patients with unhealthy eating habits decreased, mean mental well-being increased, and smoking prevalence decreased in patients who had received the digital personal health profile alone. Among patients who took up the targeted intervention, unhealthy eating habits and sedentary lifestyles decreased and significant reductions in mean BMI were observed. At 1-year follow up, no health-risk behaviors were detected among 17.4% of patients who at baseline had exhibited health-risk behaviors or high risk of disease. Conclusions A stepwise targeted preventive approach using web-based and face-to-face elements may lead to favorable lifestyle changes. Specifically, a web-based approach may improve smoking and eating habits and mental well-being, whereas supplementary face-to-face interventions may be necessary to improve exercise habits and BMI. Trial Registration ClinicalTrials.gov NCT02797392; https://clinicaltrials.gov/ct2/show/NCT02797392 International Registered Report Identifier (IRRID) RR2-10.1186/s12875-018-0820-8
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Affiliation(s)
- Trine Thilsing
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anders Larrabee Sonderlund
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens Sondergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Nanna Herning Svensson
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Janus Laust Thomsen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lars Bruun Larsen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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20
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Abstract
Objective To examine the degree of metabolic abnormalities and their association with the sociodemographic background or mental illness/cognitive disability among homeless men in Nagoya, Japan. Methods We interviewed 106 homeless men (aged 54.2±12.7 years) and measured their metabolic parameters. Mental illness and cognitive disability were diagnosed using the Mini-International Neuropsychiatric Interview and Wechsler Adult Intelligence Scale-III test, respectively. Associations between metabolic abnormalities and the sociodemographic background or mental illness/cognitive disability were analyzed. Results There were significant correlations of liver dysfunction (AST≥35 IU, ALT≥35 IU, γ-GTP≥75 IU), hypertension [systolic/diastolic blood pressure (BP) ≥140/90 mmHg], and dyslipidemia (HDL <40 mg/dL) with the history/duration of homelessness (over 2 times/year) and residence status (living on the streets). Although the mean body mass index (BMI), BP, HbA1c, and LDL in participants living in temporary residences were similar to those obtained from the general population data from National Health Nutrition Survey (NHNS) 2016, the systolic/diastolic BP in those living on the street was significantly higher than in the general population, and the HDL in those living in temporary residences was significantly lower than in those reported in the NHNS 2016 data. In the group with cognitive disability, the ALT, TG, and BMI values were significantly higher and the HDL level significantly lower in those living in temporary residences than in those living on the streets. Conclusion Stressful conditions while living on the streets may exacerbate hypertension and liver dysfunction, and unhealthy food habits when living in a temporary residence may exacerbate low HDL levels. In addition, an inability to self-manage due to cognitive disability may increase the ALT, TG, and BMI values. The provision of homeless people with the skills to sustain independent living conditions and ensure a healthy diet is required.
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Affiliation(s)
- Mayumi Yamamoto
- Health Administration Center, Gifu University, Japan
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Japan
- Department of Endocrinology and Metabolism, Gifu University Hospital, Gifu University, Japan
| | - Ryo Horita
- Health Administration Center, Gifu University, Japan
- Department of Psychiatry, Gifu University Hospital, Gifu University, Japan
| | - Tadahiro Sado
- Faculty of Health Promotional Sciences, Tokoha University, Japan
| | - Akihiro Nishio
- Department of Psychiatry, Gifu University Hospital, Gifu University, Japan
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Sakai A, Nakano H, Ohira T, Maeda M, Okazaki K, Takahashi A, Kawasaki Y, Satoh H, Ohtsuru A, Shimabukuro M, Kazama J, Hashimoto S, Hosoya M, Yasumura S, Yabe H, Ohto H, Kamiya K. Relationship between the prevalence of polycythemia and factors observed in the mental health and lifestyle survey after the Great East Japan Earthquake. Medicine (Baltimore) 2020; 99:e18486. [PMID: 31895781 PMCID: PMC6946557 DOI: 10.1097/md.0000000000018486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We have been examining the Comprehensive Health Check of the Fukushima Health Management Survey of residents of 13 municipalities who were forced by the government to evacuate due to the 2011 Great East Japan Earthquake (GEJE). Our findings showed that evacuation is a risk factor for polycythemia and suggested that experiencing an unprecedented disaster and exposure to chronic stress due to evacuation might be a cause of polycythemia.We analyzed the relationship between the prevalence of polycythemia and the following factors observed in the Mental Health and Lifestyle Survey in an observational study with a cross-sectional design: traumatic symptoms, depression status, socioeconomic factors such as residential environment, and working situation after the GEJE. Target population of the survey included men and women who were at least 15 years of age and who lived in the evacuation zones specified by the government. Participants analyzed consisted of 29,474 persons (12,379 men and 16,888 women) who had participated in both the 2011 Comprehensive Health Check and Mental Health and Lifestyle Survey from June 2011 through March 2012.The prevalence of polycythemia was not associated with mental states associated with traumatic symptoms (Post-Traumatic Stress Disorder Checklist Scale ≥ 44) and depression status (Kessler 6-item Scale ≥ 13). Furthermore, multivariate analysis showed that there was a tendency for males to develop polycythemia, with characteristics such as being aged 65 years and older, highly educated, obese (body mass index ≥ 25), hypertensive, diabetic, having liver dysfunction, and a smoker being significantly related to the prevalence of polycythemia.Our findings conclusively demonstrated that polycythemia was not significantly related to psychological factors, but was significantly related to the onset of lifestyle-related disease after the GEJE.
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Affiliation(s)
- Akira Sakai
- Department of Radiation Life Sciences
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Disaster Psychiatry
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Gastroenterology
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Metabolism and Endocrinology, Juntendo University, Tokyo
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Radiation Health Management
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Diabetes, Endocrinology, and Metabolism
| | - Junichiro Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Nephrology and Hypertension
| | | | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Public Health
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey
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22
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Noguchi M, Kojima S, Sairenchi T, Kinuta M, Yamakawa M, Nishizawa H, Takahara M, Imano H, Kitamura A, Yoshida T, Shintani A, Saito I, Yokoyama T, Shimomura I, Iso H. Japan Trial in High-Risk Individuals to Enhance Their Referral to Physicians (J-HARP)-A Nurse-Led, Community-Based Prevention Program of Lifestyle-Related Disease. J Epidemiol 2019; 30:194-199. [PMID: 30982808 PMCID: PMC7064550 DOI: 10.2188/jea.je20180194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background It is uncertain whether health counselling after community-based health checkups for high-risk individuals of lifestyle-related disease enhances their referral to physicians. Methods We performed a clustered randomized controlled trial of untreated high-risk individuals aged 40 to 74 years who were screened from the annual health checkup in 2014 and 2015 under the national health insurance in 43 municipalities around Japan, assigning 21 intervention and 22 usual care municipalities. The high-risk conditions were severe forms of hypertension, diabetes, dyslipidemia (for men), and proteinuria. For the intervention group, the theory-based health counselling was performed to enhance referrals to physicians, while each municipality performed its own standard counselling for the usual care group. Data on clinical visits and risk factors were collected systematically and anonymously from the databases of health insurance qualification, health insurance claims, and annual health checkups. Hypotheses are that the cumulative proportion of seeing physicians (clinical visits) is higher in the intervention than the usual care groups, and that those in the intervention group have lower cumulative incidence of composite outcomes associated with lifestyle-related diseases. Results The numbers of subjects for the analyses were 8,977 in the intervention group and 6,733 in the usual care group. Among them, 6,758 had hypertension, 2,147 had diabetes, 2,861 had dyslipidemia, and 1,221 had proteinuria in the intervention group, with corresponding numbers of 4,833, 1,517, 2,262, and 845, respectively, in the usual care group. There were no material differences in mean levels and proportions of major cardiovascular risk factors between the two groups. Conclusions We expect to provide scientific evidence on the effectiveness of health counselling.
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Affiliation(s)
- Midori Noguchi
- Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University.,Amagasaki City Office
| | - Sumi Kojima
- Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University.,Amagasaki City Office
| | - Toshimi Sairenchi
- Department of Public Health, Dokkyo Medical University School of Medicine
| | - Minako Kinuta
- Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University
| | - Miyae Yamakawa
- Department of Health Sciences, Osaka University Graduate School of Medicine
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine Osaka University
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Graduate School of Medicine Osaka University
| | - Hironori Imano
- Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University
| | - Akihiko Kitamura
- Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University.,Tokyo Metropolitan Institute of Gerontology
| | | | - Ayumi Shintani
- Department of Medical Statistics, Graduate School of Medicine Osaka City University
| | - Isao Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine
| | | | - Iichiro Shimomura
- Department of Health Sciences, Osaka University Graduate School of Medicine
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Graduate School of Medicine Osaka University
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Ikeda K, Kasuga M, Hosoi T, Yoshii M, Sugiyama M, Wako A, Ozawa K. [Implementation and Evaluation of Genetic Testing Seminars about Lifestyle-related Disease Prevention in Pharmacy Insurance-The Need for Cooperation between the Pharmacy and the University in Genetic Testing]. YAKUGAKU ZASSHI 2017; 137:1517-1531. [PMID: 29199260 DOI: 10.1248/yakushi.16-00243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A seminar titled "Implementation and evaluation of genetic testing of lifestyle-related disease genes" was held for pharmacists, medical clerks, and clerks of pharmacy insurance, with the aim of holding seminars led by pharmacists for the general public (including patients) in the future. The subject of the seminar was single nucleotide polymorphisms in obesity-related genes and alcohol metabolism-related genes. The purpose of the seminar was to contribute to the prevention of lifestyle-related diseases of the general public. We evaluated it by administering a questionnaire to the participants before and after the seminar. After the seminar, 55% of pharmacists answered that they would like to or would strongly like to participate in genetic testing (for lifestyle-related diseases and drug metabolism-related genes) of the general public. However, some participants did not wish to do so. A customer satisfaction (CS) analysis found that this was mainly because they did not want to know the results of genetic testing of others, which they felt should be private. Most (82%) of the pharmacists answered that assistance and advice was "very necessary" or "necessary" in the participation of genetic testing. These findings show that collaboration between pharmacies and universities will be important for future seminars to the general public.
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Affiliation(s)
- Kayo Ikeda
- Department of Pharmacotherapy, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | | | - Toru Hosoi
- Department of Pharmacotherapy, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Michiko Yoshii
- Department of Pharmacotherapy, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Masanori Sugiyama
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | | | - Koichiro Ozawa
- Department of Pharmacotherapy, Graduate School of Biomedical and Health Sciences, Hiroshima University
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24
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Kawamura A, Kajiya K, Kishi H, Inagaki J, Mitarai M, Oda H, Umemoto S, Kobayashi S. Effects of the DASH-JUMP dietary intervention in Japanese participants with high-normal blood pressure and stage 1 hypertension: an open-label single-arm trial. Hypertens Res 2016; 39:777-785. [PMID: 27412796 PMCID: PMC5101423 DOI: 10.1038/hr.2016.76] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 04/12/2016] [Accepted: 04/24/2016] [Indexed: 02/07/2023]
Abstract
The Dietary Approaches to Stop Hypertension (DASH) diet is recommended by the American Heart Association to lower blood pressure (BP); however, its effects in Japanese participants have not been rigorously studied. We assessed the effects of the DASH-Japan Ube Modified diet Program (DASH-JUMP), a modified DASH diet, on cardiometabolic and inflammatory biomarkers in Japanese participants with untreated high-normal BP or stage 1 hypertension. Fifty-eight participants (30 men and 28 women; mean age 54.1±8.1 years) with untreated high-normal BP or stage 1 hypertension followed the DASH-JUMP (salt 8.0 g per day) for 2 months. After the intervention period, they resumed their usual diets for 4 months. The DASH-JUMP significantly decreased the participants' body mass index values (24.6±3.5 kg m-2 at baseline23.2±3.3 kg m-2 at 2 months, P=0.000), BP (153±14/91±11 mm Hg at baseline130±16/80±9 mm Hg at 2 months, P=0.000 and 139±16/85±10 mm Hg at 6 months, P=0.000), fasting serum glucose level (100±26 mg dl-194±15 mg dl-1 at 2 months, P=0.003) and fasting insulin level (6.9±5.9 μIU ml-14.4±2.7 μIU ml-1 at 2 months, P=0.000). The mean compliance of the participants for the DASH-JUMP diet was 88.5%. The DASH-JUMP diet reduced cardiovascular risk factors and may be an effective nutritional strategy for preventing cardiovascular events.
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Affiliation(s)
- Atsuko Kawamura
- Department of Molecular Physiology and Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Ube, Japan
- Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Katsuko Kajiya
- Department of Molecular Physiology and Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroko Kishi
- Department of Molecular Physiology and Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Junko Inagaki
- Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Makoto Mitarai
- Central Research Institute, Maruha Nichiro Corporation, Tsukuba, Japan
| | - Hiroshi Oda
- Central Research Institute, Maruha Nichiro Corporation, Tsukuba, Japan
| | - Seiji Umemoto
- Center for Clinical Research, Yamaguchi University Hospital, Ube, Japan
| | - Sei Kobayashi
- Department of Molecular Physiology and Medical Bioregulation, Yamaguchi University Graduate School of Medicine, Ube, Japan
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25
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Miyazaki A, Oguri A, Ichida F. Non-high-density lipoprotein cholesterol as a cardiovascular risk screening tool in children. Pediatr Int 2016; 58:439-44. [PMID: 26717033 DOI: 10.1111/ped.12891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 06/19/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Non-high-density lipoprotein cholesterol (non-HDL-C) is now recognized as a strong predictive factor for cardiovascular disease in adults, but there have been few reports on non-HDL-C in children. METHODS A total of 5853 4th and 7th grade schoolchildren were included in the screening for lifestyle-related disease from 2010 to 2011 in Takaoka City. The children underwent anthropometric measurements and non-fasting blood tests to measure total cholesterol (TC), HDL-C, triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C). The relationship between percent overweight and each lipid level was analyzed, and children above the 97th percentile level with respect to both TC (220 mg/dL) and non-HDL-C (152 mg/dL) were compared and assessed. The relationship between non-HDL-C and the prevalence of metabolic syndrome was also analyzed among 150 obese children. RESULTS Non-HDL-C positively correlated with percent overweight and TG rather than did TC (r = 0.273, 0.360 vs 0.118, 0.179, all P < 0.001). In the screening using TC criteria, several subjects with increased HDL-C were miscategorized as hyperlipidemic, whereas none were miscategorized using the non-HDL-C criteria. The sensitivity of the identification of increased LDL-C was lower when the criteria for TC were used rather than the criteria for non-HDL-C (80.8% vs 98.3%). Among obese children, the prevalence of metabolic syndrome increased significantly and was accompanied by an increase in non-HDL-C (P = 0.009). CONCLUSION Instead of TC, non-HDL-C would serve as a better and useful cardiovascular risk screening tool for lifestyle-related disease in school children.
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Affiliation(s)
- Ayumi Miyazaki
- Department of Pediatrics, Japan Community Health care Organization Takaoka-Fushiki Hospital, Toyama, Japan
| | - Ayako Oguri
- Takaoka City Medical Association, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Faculty of Medicine, Toyama University, Toyama, Japan
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Abstract
We know experientially that not only nutrient factors but also non-nutritive functional food factors are playing important roles in maintenance of homeostasis, health promotion, and disease prevention. Although some of these effective behaviors are supported by accumulating scientific evidences, it is in general difficult to determine properly in human. Therefore, the discovering of novel biomarker and developments of the analytical method are one of the prudent strategies to understand disease etiology and evaluate efficacies of functional food factors via monitoring the pathophysiological alteration in live body, tissue, and cells. This review describes recent our findings on (1) formation mechanism, bioactivities, quantitative determination of cholesterol ozonolysis product, secosterol as possible biomarker for lifestyle-related disease, and (2) chemical biology approach for the investigating molecular mechanisms of most promising cancer chemopreventive food factors, isothiocyanate-inducing bioactivities.
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Affiliation(s)
- Noriyuki Miyoshi
- a Laboratory of Biochemistry, Graduate School of Integrated Pharmaceutical and Nutritional Sciences , Graduate Program in Food and Nutritional Sciences, University of Shizuoka , Shizuoka , Japan
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27
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Sakaura H, Miwa T, Yamashita T, Kuroda Y, Ohwada T. Lifestyle-Related Diseases Affect Surgical Outcomes after Posterior Lumbar Interbody Fusion. Global Spine J 2016; 6:2-6. [PMID: 26835195 PMCID: PMC4733377 DOI: 10.1055/s-0035-1554774] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/16/2015] [Indexed: 01/31/2023] Open
Abstract
Study Design Retrospective study. Objective Hyperlipidemia (HL) and hypertension (HT) lead to systemic atherosclerosis. Not only atherosclerosis but also bone fragility and/or low bone mineral density result from diabetes mellitus (DM) and chronic kidney disease (CKD). The purpose of this study was to examine whether these lifestyle-related diseases affected surgical outcomes after posterior lumbar interbody fusion (PLIF). Methods The subjects comprised 122 consecutive patients who underwent single-level PLIF for degenerative lumbar spinal disorders. The clinical results were assessed using the Japanese Orthopaedic Association (JOA) score before surgery and at 2 years postoperatively. The fusion status was graded as union in situ, collapsed union, or nonunion at 2 years after surgery. The abdominal aorta calcification (AAC) score was assessed using preoperative lateral radiographs of the lumbar spine. Results HL did not significantly affect the JOA score recovery rate. On the other hand, HT and CKD (stage 3 to 4) had a significant adverse effect on the recovery rate. The recovery rate was also lower in the DM group than in the non-DM group, but the difference was not significant. The AAC score was negatively correlated with the JOA score recovery rate. The fusion status was not significantly affected by HL, HT, DM, or CKD; however, the AAC score was significantly higher in the collapsed union and nonunion group than in the union in situ group. Conclusions At 2 years after PLIF, the presence of HT, CKD, and AAC was associated with significantly worse clinical outcomes, and advanced AAC significantly affected fusion status.
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Affiliation(s)
- Hironobu Sakaura
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan,Address for correspondence Hironobu Sakaura, MD, PhD Department of Orthopaedic Surgery, Kansai Rosai Hospital3-1-69 Inabaso, Amagasaki, Hyogo 660-8511Japan
| | - Toshitada Miwa
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
| | - Tomoya Yamashita
- Department of Orthopaedic Surgery, Osaka Rosai Hospital, Kitaku, Sakai, Japan
| | - Yusuke Kuroda
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
| | - Tetsuo Ohwada
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan
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Abstract
Decreased nitric oxide (NO) availability due to obesity and endothelial dysfunction might be causally related to the development of lifestyle-related diseases such as insulin resistance, ischemic heart disease, and hypertension. In such situations, instead of impaired NO synthase (NOS)-dependent NO generation, the entero-salivary nitrate-nitrite-NO pathway might serve as a backup system for NO generation by transmitting NO activities in the various molecular forms including NO and protein S-nitrosothiols. Recently accumulated evidence has demonstrated that dietary intake of fruits and vegetables rich in nitrate/nitrite is an inexpensive and easily-practicable way to prevent insulin resistance and vascular endothelial dysfunction by increasing the NO availability; a NO-rich diet may also prevent other lifestyle-related diseases, including osteoporosis, chronic obstructive pulmonary disease (COPD), and cancer. This review provides an overview of our current knowledge of NO generation through the entero-salivary pathway and discusses its safety and preventive effects on lifestyle-related diseases.
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Affiliation(s)
- Jun Kobayashi
- Division of Pathophysiology, Department of Clinical Dietetics and Human Nutrition, Faculty of Pharmaceutical Science, Josai University, Saitama 350-0295, Japan.
| | - Kazuo Ohtake
- Division of Pathophysiology, Department of Clinical Dietetics and Human Nutrition, Faculty of Pharmaceutical Science, Josai University, Saitama 350-0295, Japan.
| | - Hiroyuki Uchida
- Division of Pathophysiology, Department of Clinical Dietetics and Human Nutrition, Faculty of Pharmaceutical Science, Josai University, Saitama 350-0295, Japan.
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29
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Shiga T, Shimbo T, Yoshizawa A. Multicenter investigation of lifestyle-related diseases and visceral disorders in thalidomide embryopathy at around 50 years of age. ACTA ACUST UNITED AC 2015; 103:787-93. [PMID: 26033770 PMCID: PMC5157726 DOI: 10.1002/bdra.23363] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 01/09/2015] [Accepted: 02/02/2015] [Indexed: 12/14/2022]
Abstract
Background In utero exposure to thalidomide causes a wide range of birth defects, including phocomelia, hearing loss and visceral disorders, known as thalidomide embryopathy (TE). Fifty years after the first report of TE, we conducted the first cross‐sectional multicenter study to investigate the development of lifestyle‐related diseases and identify risk factors for visceral disorders in subjects with TE. Methods Seventy‐six cases with TE (31 men, 45 women) underwent medical examinations between 2011 and 2014 to determine the types of TE‐related anomalies (limbs, auditory organs, or visceral organs) and lifestyle‐related diseases present. Logistic multiple regression analyses, adjusted for gender and age, were conducted between TE and lifestyle‐related diseases and to evaluate association between block vertebra and gallbladder aplasia. Results Fatty liver (FL), nonalcoholic FL disease and dyslipidemia were detected in 52.6%, 35.0%, and 23.7% of subjects, respectively, with higher incidences among men. Dyslipidemia was detected in 40.0% of subjects with FL and was significantly associated with FL (odds ratio = 8.86; p = 0.008). Block vertebrae were detected in 44.4% of subjects with gallbladder aplasia, and this association was significant (odds ratio = 9.96; p = 0.006). Conclusion Subjects with TE have also a risk for lifestyle‐related disease as well as the general Japanese population. In addition, cervical spine radiography and magnetic resonance imaging are recommended to assess block vertebrae in subjects with TE with gallbladder aplasia who develop shoulder pain. Birth Defects Research (Part A) 103:787–793, 2015. © 2015 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Tomoko Shiga
- Division of Medical Check-up, Department of General Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takuro Shimbo
- Department of Clinical Study and Informatics Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Atsuto Yoshizawa
- General Internal Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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Tominaga T, Matsushima M, Nagata T, Moriya A, Watanabe T, Nakano Y, Hirayama Y, Fujinuma Y. Psychological impact of lifestyle-related disease disclosure at general checkup: a prospective cohort study. BMC Fam Pract 2015; 16:60. [PMID: 25971680 PMCID: PMC4437684 DOI: 10.1186/s12875-015-0272-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 04/27/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Little is known about psychological impact of disclosing lifestyle-related diseases. Previous studies discussed the long-term psychological impact of disease disclosure, and a significant psychological impact was not observed. This study clarified the psychological impact on anxiety state of patients when lifestyle-related diseases are disclosed at general checkups for local residents. In particular, this study evaluated the short-term impact on patients, and how the notification of abnormal values and the disclosure of disease at general checkups affect patients' subsequent behavioral changes. METHODS The study design was a prospective cohort study. We compared the anxiety state of participants using a self-administered anxiety assessment scale, State-Trait Anxiety Inventory (STAI), before and after Physician's explanation of abnormal values in markers of lifestyle-related diseases. The participants were those between the age of 40 and 75 years who underwent general checkups at two primary care facilities. In addition, we assessed the effects on lifestyle habits and the psychological impact caused by general checkup using STAI and a survey on behavioral changes one month after the checkup. RESULTS The valid response rate at the survey of the general checkup was 92% (534/578). Of those who showed abnormal levels in markers of lifestyle-related diseases, anxiety was augmented significantly among those who responded that the physician had told them of their diagnosis compared to those who responded that the physician had not told them of their diagnosis (Wilcoxon rank-sum test, P < 0.007). The percentage of patients whose state anxiety scale of STAI increased ≥5 points was 30% in the disease disclosed group (33/111) and 17% in the disease undisclosed group (27/159), respectively. The risk ratio was 1.5 (95% CI: 1.1-2.0). One month after the general checkup, overall anxiety diminished regardless of whether diagnosis of lifestyle-related diseases was disclosed to patients notified of abnormal values. In addition, improvements in daily life behaviors as a result of notification of abnormalities or disclosure of diagnosis at general checkup were not observed. CONCLUSION Even in a general checkup for the general population, disclosing non-critical diseases such as lifestyle-related diseases exacerbated anxiety as a short-term psychological impact.
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Affiliation(s)
- Tomokazu Tominaga
- Musashi-Koganei Clinic, Japanese Health and Welfare Co-operative Federation, 1-15-9 Honcho koganeishi, 181-0004, Tokyo, Japan.
| | - Masato Matsushima
- Division of Clinical Epidemiology, Jikei University School of Medicine, 3-25-8 Nishishimbachi, 105-8461, Minato-ku, Tokyo, Japan.
| | - Takuya Nagata
- Division of Clinical Epidemiology, Jikei University School of Medicine, 3-25-8 Nishishimbachi, 105-8461, Minato-ku, Tokyo, Japan.
| | - Akinari Moriya
- Division of Clinical Epidemiology, Jikei University School of Medicine, 3-25-8 Nishishimbachi, 105-8461, Minato-ku, Tokyo, Japan.
| | - Takamasa Watanabe
- Kita-Adachi Seikyo Clinic, Tokyo Hokuto Health Co-operative, 3-1-5 Iriya, 121-0836, Adachi-ku, Tokyo, Japan.
| | - Yuko Nakano
- Japan Small Animal Cancer Center, 2-27-4 Nakatomiminami, 359-0003, Tokorozawa, Saitama, Japan.
| | - Yoko Hirayama
- Oji Seikyo Hospital, Tokyo Hokuto Health Co-operative, 3-4-15 Toshima, 114-0003, Kita-ku, Tokyo, Japan.
| | - Yasuki Fujinuma
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, 3-22-1 Ukima, 115-0051, Kita-ku, Tokyo, Japan.
- Interprofessional Education Research Center (IPERC), Graduate School of Nursing, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8670, Chiba City, Chiba, Japan.
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Shima T, Seki K, Umemura A, Ogawa R, Horimoto R, Oya H, Sendo R, Mizuno M, Okanoue T. Influence of lifestyle-related diseases and age on the development and progression of non-alcoholic fatty liver disease. Hepatol Res 2015; 45:548-59. [PMID: 24976563 DOI: 10.1111/hepr.12384] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/15/2014] [Accepted: 06/23/2014] [Indexed: 02/08/2023]
Abstract
AIM Although non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome, the clinical association between non-alcoholic steatohepatitis (NASH) and lifestyle-related diseases such as obesity, type 2 diabetes mellitus (DM), hypertension (HT) and dyslipidemia (DL) has not been clarified. We studied the influence of lifestyle-related diseases and age on the development and progression of NAFLD. METHODS We enrolled 550 patients with biopsy-proven NAFLD (284 men, 266 women; average age, 52 and 62 years, respectively). The effect of lifestyle-related diseases and age (≤49 vs ≥50 years) on the frequency of NASH and advanced fibrosis (≥stage 3) was studied. RESULTS Prevalence of obesity, DM, HT and DL in male and female NASH patients was 75%/67%, 53%/54%, 66%/77% and 85/79%, respectively. DM patients had a higher frequency of NASH in the older male NAFLD group and a higher frequency of advanced fibrosis in the older female NASH group. With the increasing number of complicating lifestyle-related diseases, the rate of NASH increased in male NAFLD patients. In both sexes, aging resulted in the development of NASH and progression of liver fibrosis. Multivariate logistic regression analysis revealed that age and DM were significantly associated with the development of NASH in male NAFLD patients and progression of fibrosis in female NASH patients. CONCLUSION Age is strongly associated with the development and progression of NASH. Type 2 DM may play the most crucial role among lifestyle-related diseases in the development and progression of NASH.
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Affiliation(s)
- Toshihide Shima
- Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan
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EGUCHI M, OHTA M, YAMATO H. The effects of single long and accumulated short bouts of exercise on cardiovascular risks in male Japanese workers: a randomized controlled study. Ind Health 2013; 51:563-571. [PMID: 23892902 PMCID: PMC4202748 DOI: 10.2486/indhealth.2013-0023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 07/08/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to determine whether accumulated short bouts of exercise can achieve the same cardiovascular benefits as a single long bout of exercise in sedentary male Japanese workers and to compare the programs' relative effects on oxidative stress. Twenty-three sedentary male workers were randomly assigned into 2 different exercise programs: a Long-bout group, which performed a single period of continuous exercise (Long-bout group: 30 min × 1) 3 d per week, and a Short-bouts group, which performed 3 short bouts of exercise (Short-bouts group: 10 min × 3) 3 d per week. Cardiovascular risk factors, including the plasma thiobarbituric acid-reactive substances (TBARS) level, were examined at baseline and after both 10 and 20 wk. In the Long-bout group, waist circumference and maximum oxygen uptake (VO2max) significantly improved after 20 wk. The Short-bouts group demonstrated significant increases in VO2max after 10 weeks and in HDL-C after 20 wk. Plasma TBARS significantly decreased after 20 weeks in the Long-bout group and tended to decrease (but not significantly) in the Short-bouts group. These results indicate that accumulated short bouts of exercise are an effective option, especially for busy workers, for incorporating exercise into one's lifestyle.
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Affiliation(s)
- Masafumi EGUCHI
- Department of Health Development, Institute of Industrial
Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Masanori OHTA
- Department of Health Development, Institute of Industrial
Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Hiroshi YAMATO
- Department of Health Development, Institute of Industrial
Ecological Sciences, University of Occupational and Environmental Health, Japan
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