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Biomedical subjects

Keiko Nakamura

Publications and source records attributed to Keiko Nakamura.

At least 37 records · Page 2Linked to original sources

Improvement in maternal health literacy among pregnant women who did not complete compulsory education: policy implications for community care services.

This paper examined factors that influence the improvement in maternal health literacy among pregnant women in Paraguay, including those who did not complete compulsory education but participated in a community-based antenatal care program. Structured interviews were conducted to evaluate the pregnant women's maternal health literacy during their first, second, and third visits to the program in the Caazapa Region. The associations between individual maternal health knowledge scores and its gains, healthcare personnel capabilities, available health facility equipment, community social network, and living environment were analyzed by multiple regression analysis. The mean maternal health knowledge score from 124 women who completed three-consecutive assessments increased between the first and third interviews. Higher capabilities of healthcare personnel and better living environment were significantly related to gains in the maternal health knowledge score (p<0.01). Wider application of a community-based antenatal care program to meet the needs of those who are functionally illiterate in the standard language of the country, training for community healthcare personnel to improve capabilities, and resources for social network in the community would contribute to the improvement in maternal health literacy.

Adolescent↗

Dietary supplement consumption among urban adults influenced by psychosocial stress: its pronounced influence upon persons with a less healthy lifestyle.

In order to examine the consumption of dietary supplements among urban adults and the impact of psychological stress on supplement use in relation to lifestyle, 375 interviews of a population-based sample of urban Japanese in 2002 were analysed. The usage of various supplements, stress process (daily stressors, psychological moderators, stress outcomes), personal health practices (smoking, alcohol drinking, physical exercise, fruit and vegetable juice consumption, health-conscious eating habits) and other background factors were measured. We examined the impacts of stress on the use of vitamin tablets and capsules, vitamin-enriched health drinks and health drinks for intestinal adjustment. The percentages of these three categories of supplement user were 26.9, 18.7 and 35.7%, respectively. After adjusting for potential confounders, subjects with 'two or more' daily stressors out of the eight stressors investigated consistently showed 2-fold higher levels of consumption of either vitamin tablets and capsules or vitamin-enriched drinks compared with their counterparts with 'one or less' daily stressors. Stress-outcome indicators also related, to a greater or less extent, to the elevated consumption of various supplements. Further lifestyle-stratified analyses revealed that the stress-supplementation relationships were weaker in subjects fulfilling more than three of the five investigated health practices (i.e. the healthy lifestyle group), but stronger in subjects with fewer than two healthy practices (i.e. the less healthy lifestyle group). In conclusion, dietary supplement consumption is independently associated with stress in urban adults. The uncontrolled use of supplements for the self-medication of stress or to compensate for unhealthy behaviour represents a health concern for the general population.

Adult↗

Green tea consumption in everyday life and mental health.

OBJECTIVE: Green tea has been widely acknowledged in Japan to induce a pleasurable mental feeling. Recent laboratory studies have suggested positive psychological effects as a result of consuming green tea. The present study examined whether green tea consumption in everyday life in Japan is associated with positive mental health. DESIGN: A cross-sectional study was performed in February-March 2002. SETTING AND SUBJECTS: The subjects of the study consisted of a general population of 600 Japanese aged 20-69 years. Responses of 380 subjects, obtained by home-visit interview, were analysed. The questionnaire inquired about consumption of brewed green tea and other beverages, perceived mental health status, lifestyle and others. The 12-item General Health Questionnaire (GHQ 12) was used for the assessment of mental ill-health (GHQ score >or=4). RESULTS: After adjustments for age, area, perceived mental stress, lifestyle and daily caffeine intake, the consumption of brewed green tea was not statistically associated with any decrease in risk of mental ill-health among either males or females (odds ratio (OR)=0.78, 95% confidence interval (CI)=0.47-1.29 for males; OR=0.77, 95% CI=0.51-1.14 for females). Daily caffeine intake (100 mg) inclusive of green tea, black tea, coffee and other caffeine-containing beverages was associated with a higher risk of mental ill-health among females (OR=1.26, 95% CI=1.01-1.56). CONCLUSIONS: The results provide population-based evidence on the consumption of brewed green tea in everyday life and mental health, together with information on consumption patterns of various beverages and lifestyles.

Adult↗

Variation of health status among people living on boats in Hue, Vietnam.

OBJECTIVES: To examine patterns of disease and injury in people living on boats in Hue City, Vietnam, and their relations to socioeconomic conditions, sanitary practices, disease prevention proficiency, and people's preference to continued living on boats. METHODS: The subjects were 3737 people aged 5 years and over living on boats in Hue City, Vietnam. Diseases and injuries were diagnosed according to ICD-10. The associations between disease/injury and socioeconomic conditions, sanitary practices, disease prevention proficiency, and preference to continued living on boats were analysed by logistic regression. MAIN RESULTS: The prevalence rates of certain infectious and parasitic diseases, diseases of the respiratory system, diseases of the skin and subcutaneous tissue, diseases of the digestive system, and injuries were 85.3%, 78.0%, 51.2%, 15.4%, and 13.2%, respectively. Various associations were seen between diseases/injuries and socioeconomic conditions. Patterns of disease were strongly influenced by sanitary practices. Better disease prevention proficiency was significantly related to lower prevalence of the first three categories of diseases/injuries regardless of sex, age, or socioeconomic status (p < 0.05, p < 0.001, p < 0.001, respectively). Diseases were more prevalent among people who preferred not to continue living on boats. CONCLUSIONS: This large scale comprehensive field study illustrated major diseases and injuries among people living on boats. Variations in health status showed a web-like relation of socioeconomic conditions, sanitary practices, disease prevention proficiency, and preference to continued living on boats. Measures to develop disease prevention proficiency reduce the risk of disease and injury.

Adolescent↗

Critical contribution of sanitation infrastructure and primary medical care to child health status in Japan from 1955 to 2000.

We examined the associations between prefectural health status of children and sanitation infrastructure, medical care services and socioeconomic status in Japan during 1955-2000. Four indicators of child health status: infant mortality rate (IMR), Ascaris lumbricoides prevalence and height and weight of elementary school children, and five prefectural social indicators: water supply, sewerage, number of physicians, income and women's education, were calculated over five-year intervals and examined by correlation and panel data analyses. Associations between paediatric health and five social indicators were significant (p<0.001) until 1970. After adjustment for income or education, water supply diffusion rate showed a significantly negative association with IMR until the 1980s. A significantly positive correlation was observed between the number of physician and paediatric health from 1955-70 after adjustment for income. Water supply development showed a positive association with paediatric health after adjustment for economic or educational impact during the phases of rapid and steady economic growth, while medical care showed a positive correlation with paediatric health after adjustment for income during only the phase of rapid economic growth. Relationships between child health status and social indicators have changed over time with stage of economic development.

Animals↗

Cause-specific mortality differences across socioeconomic position of municipalities in Japan, 1973-1977 and 1993-1998: increased importance of injury and suicide in inequality for ages under 75.

BACKGROUND: Socioeconomic inequality in health has been a major concern in public health. This study examined socioeconomic inequality in regional mortality and the impact on inequality by cause of deaths in 1973-1977 and 1993-1998 using municipal statistics in Japan. METHODS: The municipalities across the country (N = 3244 in 1973-1977 and 3334 in 1993-1998) were classified into quintiles according to the index of socioeconomic position (SEP) obtained by principal component analysis of municipal indicators related to income and education. Mortality gradient by SEP for selected major causes of death in the population aged 0-74 years was examined using standardized mortality ratio by quintile and rate ratio of mortality across quintiles. As a measure of cause-specific impact on inequality, the number of excess deaths from each cause in the lower four SEP quintiles compared with the highest quintile was calculated. RESULTS: Mortality gradient by SEP and excess deaths in the lower SEP quintiles due to injury and suicide markedly increased from 1973-1977 to 1993-1998 for both males and females. In contrast, stroke, especially cerebral haemorrhage, showed a decrease in mortality gradient and excess deaths. For females in 1993-1998, a negative gradient of mortality by SEP was found, and cancer contributed the higher all-cause mortality in the higher SEP quintile. CONCLUSIONS: The relative importance of socioeconomic inequality in regional mortality of stroke decreased, while that of injury and suicide increased. The prevention of injury and suicide, in addition to stroke, in socioeconomically disadvantaged regions, and cancer in urban areas with higher SEP should be given priority.

Adolescent↗

Increased excess deaths in urban areas: quantification of geographical variation in mortality in Japan, 1973-1998.

To quantify the magnitude of geographical health inequality by sex and age group, and to observe the change in regional distribution of health disadvantage, this study estimated excess deaths attributable to the mortality variation among municipalities across Japan from 1973 through 1998. The municipalities (N = 3340 in 1995) were divided into quintiles according to standardized mortality ratio (SMR). Using the mortality of the lowest SMR quintile as the standard, the number of excess deaths (ED) and its ratio to observed deaths (EDR) were estimated by sex, age group (total population and under 65-year population) and regional block in 1973-1977, 1978-1982, 1983-1987, 1988-1992 and 1993-1998. Total annual ED in 1993-1998 was estimated as 47,124 for males and 46,562 for females, representing EDR of 9.9 and 11.6%, respectively. The under 65-year population had a higher EDR than the total population. Rural regions showed a marked decrease in EDR in contrast to the increase in urban regions over time. The present study suggests that the reduction of a large number of deaths, especially premature deaths, is expected by elimination of geographical health inequality, and that health policies for urban residents are prioritized.

Female↗

Municipal socioeconomic status and mortality in Japan: sex and age differences, and trends in 1973-1998.

The purpose of this study was to examine the sex and age differences and the time trends in the association between municipal socioeconomic status (SES) and all-cause mortality across Japan from 1973 to 1998. Sex-specific mortality of municipalities (N=3319 in 1995) by age groups (total, under 75-year, and over 75-year populations) was linked to municipal SES indicators related to income, education, unemployment and living space, and two SES composite indices formulated by principle component analysis (Index 1 related to lower income and education, and Index 2 related to unemployment and overcrowding). The relation was assessed using mortality gradients by SES quintiles and Bayesian hierarchical Poisson regression. The results showed that a lower SES was related to higher mortality for all SES indicators and composite indices. The mortality gradient was steeper for the under 75-year population than the total and over 75-year populations, and the relation between mortality and income- and education-related indicators/index was stronger for males than for females. The time trend showed an increase in the relation for Index 2, while a decrease for Index 1. This study demonstrated that lower municipal SES had an adverse influence on population health, and the influence was marked for males and premature death. Although a substantial health disadvantage still remained in lower SES areas, the impact of SES factors on geographical health variation changed over time; the association with mortality has weakened for income and education, while it has strengthened for unemployment and living space.

Age Distribution↗

Health values and health-information-seeking in relation to positive change of health practice among middle-aged urban men.

BACKGROUND: Preventive health practice is an important component of health promotion strategy. The objectives of this cohort study were to assess changes of health practices over 3 years among middle-aged Japanese men and to examine the factors related to their positive changes in lifestyle. METHODS: Three hundred thirty-four randomly selected men in Tokyo completed two face-to-face structured interviews, one in 1998 and the other in 2001. Daily health practices, health values, health-information-seeking, socioeconomic characteristics, and health status were assessed. A Health Practice Index (HPI) was calculated to reflect overall health behavior. According to the change of HPI, the mode of change in general health practice between the first and second interview was classified as positive change, no change, and negative change. RESULTS: Percentages of the subjects who engaged in eight identified healthy practices ranged from 31.7% to 54.5% at baseline. The follow-up interval revealed the adoption of each particular healthy or unhealthy practice as 5.7% to 33.6%. A high value placed on health independently associated with positive change of general health practice (OR = 2.95, 95% CI = 1.23 to 7.08), and inversely associated with negative change (OR = 0.45, 95% CI = 0.18 to 1.10); consciously seeking health information associated with positive change (OR = 2.16, 95% CI = 1.07 to 4.36) after controlling for socioeconomic and health status. CONCLUSION: Considerable opportunity remains for urban middle-aged men to further improve their health behavior. Health values saliency, sensitively designed health information, and health status perception, as well as socioeconomic status, should be considered for successful promotion of healthy lifestyle among the adult male population.

Cohort Studies↗

Wide range of socioeconomic factors associated with mortality among cities in Japan.

The aim of this study was to identify socioeconomic factors associated with mortality among cities in Japan. Sex-specific and age-adjusted mortality rates for 1990 and 1995 were calculated by 779 local administrative units across the nation. One hundred indicators related to socioeconomic factors were compiled and divided into eight categories: economy, education, living conditions, vegetation and open space, transport, preventive activities, medical care and demography. Composite socioeconomic indices were formulated using factor analysis of the socioeconomic indicators by category, and the association between the indices and mortality rates was examined by correlation analysis and multiple regression analysis. Nineteen composite socioeconomic indices were obtained from factor analysis, and all indices except educational expenditure-related index were significantly correlated with mortality rates. Unemployment, old housing, primary health resources and density were independently positively associated, and higher education, public library activity, health check-up participation and population growth were independently negatively associated with both 1990 and 1995 male mortality rates. For female mortality, higher income, unemployment, spacious dwelling, old housing, less vegetation, road facility, numbers of cars per population, primary health resources and density were independently positively associated, and higher education, public library activity and health check-up participation were independently negatively associated. The relationship between mortality and socioeconomic conditions was stronger in males than in females, and higher income and less vegetation were associated with higher mortality only for females. The present study demonstrated a close link between mortality and a wide range of socioeconomic conditions by using a number of indicators compiled from various data sources. The results promote a deeper understanding of socioeconomic health determinants and development of multi-sectoral health policy to improve population health.

Adult↗

Participatory research to enhance vision sharing for Healthy Town initiatives in Japan.

This paper presents the results of a participatory research project conducted by the Tokyo Citizens' Council for Health Promotion (Citizens' Council) to enhance vision sharing, thereby aiding the implementation of Healthy Town initiatives. The Citizens' Council conducted a survey to elucidate citizen interests and expectations regarding Healthy Towns. The project had three stages: (i) a survey; (ii) dissemination of the results; and (iii) evaluation of the impact of the survey's findings. The survey was conducted among ordinary citizens, community group members, health promotion practitioners and members of the Citizens' Council. Responses from 476 ordinary citizens, 400 community group members, 316 health promotion practitioners and 387 members of the Citizens' Council were received and analyzed. Major criteria that respondents required of a Healthy Town were: adequate sports facilities and walking/jogging trails (44.5%); easy access for senior citizens, small children and people with disabilities (42.2%); and parks, clean rivers and other natural features (33.1%). Prioritized criteria given by specific respondent groups were (i) a town with little crime and few traffic accidents (ordinary citizens: 37.2%) and (ii) a town where people help each other (health promotion practitioners: 36.7%; members of the Citizens' Council: 31.5%). Factor analysis revealed that the structure of citizen views on criteria for a Healthy Town had the following three dimensions: (i) health conducive physical living environment; (ii) social networks and mutual help; and (iii) societal discipline/rules and good access to services. The research results were disseminated to the general public, community groups and members of the Citizens' Council. The results substantiated citizen views, which were then incorporated into plans towards realizing Healthy Towns initiatives. This research effort generated a vision of the creation of Healthy Towns by the participation of citizens in a megacity.

Adult↗

[Measurement of effective dose of the assisting person in diagnostic X-ray examination].

We measured the effective dose received by the person assisting the patient at diagnostic X-ray examination. Measurement was done when a patient's chest, abdomen, lumbar vertebrae, hip joint, skull, cervical vertebrae, or knee joint was examined by radiography. A body phantom including human bones exposed to radiation was used in the role of the patient. Some exposure conditions for these measurements were the same as those used routinely in computed radiography. Effective dose was measured directly with an ionization survey meter. As a result, the effective dose of the person assisting with axial projection of the hip joint was 124 microSv, which was higher than that for other regions and projections. If the assisting person helped a patient without using any protective device, the effective dose would be low enough to ignore. However, because medical staff are frequently exposed to radiation, optimal protection is crucial to prevent unnecessary radiation.

Hip Joint↗

Pilot study of using GIS to visualize health status distribution: case study of Songjiang District, Shanghai.

The aim of this study was to investigate the geographic variation in mortality indicators in Songjiang District of Shanghai under rapid change with urbanization. Geographic Information System (GIS) was used to visualize the distributions of health status and to test the extent of spatial auto-correlation in the indictors. In 2001, total crude mortality was 687/100,000 for the district; the rates for the townships (N=15) in the district ranged from 444/100,000 to 805/100,000. GIS maps indicated that the mortality was higher in the marginal areas of the district. Significant positive auto-correlations were found in total crude mortality rates, death rate for infectious diseases, and death rates for digestive diseases. The measures that consider intra-region inequality in health needs will be required in the regions under urbanization.

Adolescent↗

Interplanetary dust from the explosive dispersal of hydrated asteroids by impacts.

The Earth accretes about 30,000 tons of dust particles per year, with sizes in the range of 20-400 microm (refs 1, 2). Those particles collected at the Earth's surface--termed micrometeorites--are similar in chemistry and mineralogy to hydrated, porous meteorites, but such meteorites comprise only 2.8% of recovered falls. This large difference in relative abundances has been attributed to 'filtering' by the Earth's atmosphere, that is, the porous meteorites are considered to be so friable that they do not survive the impact with the atmosphere. Here we report shock-recovery experiments on two porous meteorites, one of which is hydrated and the other is anhydrous. The application of shock to the hydrated meteorite reduces it to minute particles and explosive expansion results upon release of the pressure, through a much broader range of pressures than for the anhydrous meteorite. Our results indicate that hydrated asteroids will produce dust particles during collisions at a much higher rate than anhydrous asteroids, which explains the different relative abundances of the hydrated material in micrometeorites and meteorites: the abundances are established before contact with the Earth's atmosphere.

Journal Article↗

Visual localisation of community health needs to rational decision-making in public health services.

The objectives were to visualise the locations of community health needs and to develop a community health needs assessment geographic information system (GIS) for rational decision-making in public health services. We compiled census data, digital data of basic planning maps, digital data of topographic maps, contents of registers of medical and welfare facilities, and statistics of establishments into a geographical database; visualised geographical distributions of specific community health needs by integrating sets of indicators to reflect individual needs; and quantified their clustering by the nearest neighbour method. The database aggregated 3400 items of demographic, life and environmental factors. Thematic maps and clustering values showed different patterns of geographical distribution of the individual community needs. Means to match needs with services in smaller geographical units were discussed. This GIS will support appropriate resource allocation, intersectoral collaboration and greater transparency in planning and implementing services, by visualising locations of community health needs.

Adolescent↗

Rice gene expression in response to N-acetylchitooligosaccharide elicitor: comprehensive analysis by DNA microarray with randomly selected ESTs.

N-acetylchitooligosaccharides are potent elicitors to suspension-cultured rice cells, inducing a set of defense reactions. Expression of defense-related genes is considered to play an important role in defense reactions, and we employed microarray analysis of 8987 randomly selected expressed sequence tags to analyze the changes in gene expression caused by N-acetylchitooctaose. In this experiment, 166 genes were significantly induced and 93 genes were repressed. RNA gel blot analysis of 16 of these genes confirmed the microarray results. Of the 259 ESTs identified as responsive to N-acetylchytooctaose, 18 genes are related to signal transduction, including five calcium-dependent protein kinases (CDPKs). Among these, three novel CDPKs responsive to N-acetylchitooctaose were isolated.

Amino Acid Sequence↗

Novel gene encoding a Ca2+-binding protein and under hexokinase-dependent sugar regulation.

A cDNA encoding a predicted 15-kDa protein was earlier isolated from sugar-induced genes in rice embryos (Oryza sativa L.) by cDNA microarray analysis. Here we report that this cDNA encodes a novel Ca2+-binding protein, named OsSUR1 (for Oryza sativa sugar-up-regulated-1). The recombinant OsSUR1 protein expressed in Escherichia coli had 45Ca2+-binding activity. Northern analysis showed that the OsSUR1 gene was expressed mainly in the internodes of mature plants and in embryos at an early stage of germination. Expression of the OsSUR1 gene was induced by sugars that could serve as substrates of hexokinase, but expression was not repressed by Ca2+ signaling inhibitors, calmodulin antagonists and inhibitors of protein kinase or protein phosphatase. These results suggested that Os-SUR1 gene expression was stimulated by a hexokinase-dependent pathway not mediated by Ca2+.

Amino Acid Motifs↗

[Nursing measures against adverse reaction from anti-cancer chemotherapy].

Combination chemotherapy for leukemia develops bone marrow suppression. Infection or hemorrhage disorders the treatment, and may influence the clinical result. The caring staff must understand the pathology of bone marrow suppression. Visitors observe the hospital rules. Foods are also limited, city water and uncooked foods are prohibited. To keep oral cavity clean, pretreatment of some decayed teeth, and frequent gargling with sterilized water are needed. Defecation control is important. Sitz bath or shower toilet is helpful. Hand cleaning is essential for before a meal, after defecation and after a going out. Bathing is fundamental to cleaning body. No bathing is dirty. Medical catheters are checked up every day. Thrombocytopenia(< 30,000/microliter) develops a spontaneous bleeding. Severe thrombocytopenia(< 10,000/microliter) does a fatal organ bleeding.

Antineoplastic Agents↗