Biomedical subjects

Takehito Takano

Publications and source records attributed to Takehito Takano.

At least 19 recordsLinked to original sources

PubMed2007

Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan.

OBJECTIVES: To formulate an index representing area deprivation and elucidate the relation between the index and mortality in Japan. STUDY DESIGN: Ecological study for prefectures (N=47) and municipalities (N=3366) across Japan. METHODS: Based on socioeconomic indicators of seven domains of deprivation (i.e. unemployment, overcrowding, low social class and poverty, low education, no home ownership, low income and vulnerable group), an index was formulated using the z-scoring method. The relation between the index and mortality was examined by correlation analysis, hierarchical Poisson regression and comparison of standardized mortality ratio according to the index. RESULTS: The deprivation index ranged from -7.48 to 10.98 for prefectures and from -16.97 to 13.82 for municipalities. The index was significantly positively correlated with prefectural mortality, especially in the population aged under 74 years: r=0.65 for men and r=0.41 for women. At the municipal level, hierarchical Poisson regression showed a significant positive coefficient of the index to mortality for both men and women, and excess mortality in the most deprived fifth compared to the least deprived fifth was 26.4% in men and 11.8% in women. CONCLUSIONS: We formulated a deprivation index, which was substantially related to mortality at the prefectural and municipal levels. This study highlights the higher risk of dying among populations in socially disadvantaged areas and encourages the use of indices representing area socioeconomic conditions for further studies of area effects on health.

Adult↗

PubMed2007

Vitamin D receptor polymorphism among rickets children in Mongolia.

BACKGROUND: It was reported that 32% of children under five years old in Mongolia had symptoms of rickets. Vitamin D receptor (VDR) gene polymorphism has received attention in relation to bone metabolism. We therefore investigated whether VDR polymorphism is related to high prevalence of rickets in Mongolia and to bone properties in childhood. METHODS: We conducted a case-control study in Ulaanbaatar involving 80 children aged 7-10 years with a history of rickets (cases) and 72 children with no history of rickets (controls). VDR polymorphism was assessed using BsmI, ApaI, and TaqI, and bone properties were determined by measuring age standardized tibial cortical speed of sound (TCSOS). FINDINGS: Each allelic frequency was verified to satisfy the Hardy-Weinberg equilibrium in cases, controls, and the total sample. The VDR polymorphisms among cases (BB 3%, Bb 18%, bb 80%; AA 15%, Aa 38%, aa 47%; and TT 81%, Tt 17%, tt 3%) did not differ significantly from those among controls (BB 1%, Bb 13%, bb 86%; AA 16%, Aa 46%, aa 38%; and TT 86%, Tt 13%, tt 1%). There were no significant differences in TCSOS according to the VDR genotype among either cases or controls. CONCLUSIONS: The VDR polymorphism does not play a major role in the development of rickets in Mongolia and has no effect on TCSOS in childhood.

Bone Density↗

PubMed2006

Training of healthcare personnel to improve performance of community-based antenatal care program.

BACKGROUND: The present study was performed to evaluate the effectiveness of a training course designed to improve the knowledge, skills, and attitudes of healthcare personnel to allow them to provide a comprehensive community-based antenatal care (ANC) program in rural Paraguay. METHODS: Sixty-eight of 110 healthcare personnel in the Caazapa Region of Paraguay participated in a nine-day training course between November 1997 and March 1998. The knowledge of the participants related to maternal healthcare services was assessed both before and after the training course, and enrollment rates of pregnant women in ANC before and after the training were compared as a measure of patient satisfaction. The participants were also asked to evaluate the appropriateness of each individual method used in the training course. RESULTS: The average scores of the participants' knowledge increased significantly from 41.0 before to 60.1 after training (p<0.001). The enrollment rates of pregnant women in ANC increased from 2.2 times per pregnancy in 1996 to 3.4 times in 1998 (p<0.001). The participants reported that role-playing, demonstrations using visual information, and hands-on practice at a hospital were useful training methods. CONCLUSIONS: Continuous training for healthcare personnel in rural Paraguay contributes to an increase in their capacity to carry out community-based ANC program. The participants reported that learning through peer-educators, interactive communications, role-playing, and supervision provided in actual community services were beneficial. Continuous supervision should be provided to enable healthcare personnel to maintain the knowledge and skills acquired in the training.

Clinical Competence↗

PubMed2006

Association of swaddling, rickets onset and bone properties in children in Ulaanbaatar, Mongolia.

OBJECTIVES: To examine the influence of duration of completely or partially wrapped swaddling on rickets onset and bone properties in children of school age. STUDY DESIGN: Case-control study. METHODS: Subjects were 73 children aged 7-10 years with a history of rickets (cases) and 70 children with no history of rickets (controls) in Ulaanbaatar, Mongolia. The periods of completely and partially wrapped swaddling, rickets onset and age-standardized mid-tibial cortical speed of sound (TCSOS) were examined. The associations between swaddling duration and rickets onset and that between swaddling duration and TCSOS were analysed. RESULTS: All except one control child were completely wrapped from the first month after birth. The durations of completely wrapped and partially wrapped swaddling were similar among cases (3.6 and 4.7 months) and controls (3.1 and 4.4 months) (P=0.42 and P=0.65, respectively). Standardized TCSOS values of cases and controls were -0.572 and -0.038, respectively (P=0.06). The duration of swaddling did not show associations with rickets onset and standardized TCSOS among both cases and controls. Standardized TCSOS of cases with skeletal deformities at examination (-1.467, n=18) was lower than that of cases without skeletal deformities (-0.280, n=55) (P<0.01) and controls (-0.038, n=69) (P<0.001). CONCLUSIONS: The practice of swaddling itself neither influences rickets onset nor bone properties in school-aged children in Ulaanbaatar. Bone properties of school-aged children who had suffered from rickets and with skeletal deformities were poorer than those in children without skeletal deformities and children without a history of rickets. Prevention of persistent skeletal deformities among the children who have suffered from rickets is critical to promote healthy bone development in Mongolia.

Case-Control Studies↗

PubMed2006

Association of household demographic variables with child mortality in Côte d'Ivoire.

The associations between household demographic variables and mortality of children aged less than five years were investigated using data from the 1998 Demographic and Health Survey (DHS) of the Republic of Côte d'Ivoire, Western Africa. Of the total of 1992 children born to women included in the study population during the 5-year period preceding the survey, 260 (13%) had died and 1732 (87%) were alive at the time of the survey. Logistic regression analyses used to compare biosocial variables between the deceased and living children showed that the sex of the child, birth interval and mother's occupation were associated with child's survival status. After adjusting for their effects, household demographic variables (i.e. number of household members, number of household members under 5 years [HM-5Y], number of household members 5 years or older [HM+5Y], the proportion of HM-5Y among all household members, and the ratio of HM-5Y to HM+5Y) were shown to be associated with the child's survival status. This study provided insight into the effects of intra-household competition among children and availability of care-givers as potential determinants of child survival. The results indicate that improvement of the childcare environment and reproductive intervention are necessary to reduce child mortality in West African countries.

Adolescent↗

PubMed2006

Association of parental and children behaviors with the health status of preschool children.

BACKGROUND: Parental and children behaviors can be associated with health promotion and illness prevention in preschool children. METHODS: We interviewed mothers of 804 out of 1000 households with children aged 3 to 5 years randomly sampled in Tokyo, in 1997. Child health status was categorized as: "good", that is, good general health with no sick days; "poor", that is, fair to poor with frequent sick days; or "moderate". RESULTS.: Good health status was associated with playing outside (OR=1.19, 95% CI: 1.03, 1.37) and family income (OR=1.38-1.78, depending on family income). Mothers of children with poor health were less likely to have good health behavior themselves (OR=0.76, 95% CI: 0.64, 0.90) and were more often sick (OR=1.55, 95% CI: 1.24, 1.94). CONCLUSION: Outdoor playing, good health practice of the mother and high income are associated with a better health status of urban preschool children.

Child Welfare↗

PubMed2006

Tibial cortical bone properties of preadolescents and their mothers in an urban area associated with lifestyle: a longitudinal study.

AIM: A 12-mo follow-up observation was performed to evaluate the tibial cortical bone properties of preadolescent children and their mothers in a densely populated area of Tokyo in association with their lifestyle in the context of healthy bone development of urban children. METHODS: Fifty-four volunteer mother-child pairs were examined twice: once in the 1st grade of elementary school and once in the following year. Tibial cortical speed of sound (TCSOS) was measured by non-invasive quantitative ultrasonometry. Nutritional intake and recreational activity were examined using a structured interview. RESULTS: TCSOS of the children showed a positive association with intake of vegetables, including potatoes and fruits (1st grade, r = 0.31, p < 0.05; 2nd grade, r = 0.33, p < 0.05), and inversely correlated with indoor recreational activities (1st grade, r = -0.28, p < 0.05). The z-score of TCSOS of the mothers was correlated with intake of milk, dairy products and eggs (r = 0.35, p < 0.001). However, there were no statistically significant correlations in TCSOS between children and their mothers. CONCLUSION: A 1-y longitudinal study in urban children indicated the effects of specific types of food intake and recreational activities of children on tibial bone properties.

Adult↗

PubMed2006

Extracurricular sports activity around growth spurt and improved tibial cortical bone properties in late adolescence.

AIM: To elucidate whether extracurricular sports activity during rapid growth correlates with improved bone properties in late adolescence, a longitudinal observation was performed among 96 high-school enrollments (46 boys and 50 girls, born in 1981-1982) in metropolitan Tokyo. METHODS: In each year of high school, tibial cortical speed of sound (TCSOS) was measured by quantitative ultrasonometry, and participation in extracurricular sports activity (ECSA) since primary school was examined by structured questionnaire. We calculated the number of years since peak height velocity (ysPHV) based on annual records of height from 6 to 18 y of age to indicate progression of puberty. RESULTS: The increase in TCSOS during high school in boys (32.5 m/s) was significantly greater than that in girls (5.4 m/s). The magnitude of positive association between ysPHV and TCSOS attenuated gradually over time. ECSA in grades 7-9 in boys and in grades 4-6 in girls were significant predictors of TCSOS throughout high school, independent of potential confounders. CONCLUSION: The bone benefits of ECSA around the growth spurt are maintainable in subsequent years. The importance of physical activities that are integrated into the ordinary lifestyle of children and adolescents during this crucial period is emphasized.

Adolescent↗

PubMed2006

Social course patterns of urban dwellers with tuberculosis under fragile living conditions in Tokyo, Japan.

BACKGROUND: People under fragile-living conditions show a high rate of interruption of tuberculosis treatment. We examined the social courses of fragile-living urban dwellers with tuberculosis without customary and regular access to a conventional residence and investigated the factors associated with interruption of treatment. METHODS: One hundred and nineteen tuberculosis patients without customary and regular access to a conventional residence who were discharged from a hospital with the largest number of tuberculosis beds in Tokyo between January 1998 and October 2000 were followed up. The associations between demographic, social, and clinical characteristics and interruption of treatment were examined. RESULTS: The subjects (mean age, 51.2 years) were followed up for a median of 342 days. The percentage of cases of interruption of treatment during inpatient care among patients with alcohol problems (56%) was significantly higher than that among patients without such problems (11%). The proportion of cases of interruption of treatment during outpatient care among patients who were literally homeless before admission (40%) was significantly higher than that in others (5%), and that among those who used transient hostels after the initial inpatient treatment (55%) was significantly higher than that in others (4%). The prevalence of drug resistance was higher in cases with than without a history of tuberculosis treatment (P<0.05). CONCLUSIONS: Factors associated with interruption of tuberculosis treatment in patients under fragile-living conditions were identified. Interruption during inpatient care was significantly associated with alcohol problems, and interruption during outpatient care was significantly associated with the use of transient hostels.

Adult↗

PubMed2005

Calculation of prefectural disability-adjusted life expectancy (DALE) using long-term care prevalence and its socioeconomic correlates in Japan.

OBJECTIVES: The objectives of this study were: (1) to determine the disability weight, "utility", for calculation of disability-adjusted life expectancy (DALE) using the prevalence of long-term care; (2) to calculate prefectural DALE; and (3) to clarify the relation between DALE and area socioeconomic conditions in Japan. METHODS: Disability utility by care level (support and levels I-V) of long-term care insurance was determined by a survey of 236 professionals with four standard utility measures: EuroQol-5D, time trade-off, standard gamble, and visual analogue scale. DALE at age 65 (DALE65) and age-adjusted weighted disability prevalence (WDP) of 47 prefectures were calculated using the determined utilities, prevalence of long-term care, and life tables. The relationships of DALE and WDP to mortality from major causes and socioeconomic indicators were examined by correlation analysis. RESULTS: The determined utilities were: support, 0.78; level I, 0.68; level II, 0.64; level III, 0.44; level IV, 0.34; and level V, 0.21. The prefectural DALE65 ranged from 17.11 to 15.29 years for men and from 20.21 to 18.42 years for women. Strong correlations were found between DALE65 and mortality for both sexes. Male DALE65 was correlated with no socioeconomic indicators, while female DALE65 was correlated with some indicators. WDP was positively associated with indicators representing socioeconomic disadvantage, such as unemployment rate and percentage of elderly single households. CONCLUSIONS: The socioeconomic correlates of DALE and WDP suggested that favorable socioeconomic policies, in addition to a decrease in mortality from major causes, will contribute to significant extension of the independence period in the elderly. The method proposed here encourages the practical use of health expectancy in health policy, especially at local and regional levels.

Aged↗

PubMed2005

Municipal health expectancy in Japan: decreased healthy longevity of older people in socioeconomically disadvantaged areas.

BACKGROUND: Little is known about small-area variation in healthy longevity of older people and its socioeconomic correlates. This study aimed to estimate health expectancy at 65 years (HE65) at the municipal level in Japan, and to examine its relation to area socio-demographic conditions. METHODS: HE65 of municipalities (N = 3361) across Japan was estimated by a linear regression formula with life expectancy at 65 years and the prevalence of those certificated as needing nursing care. The relation between HE65 and area socio-demographic indicators was examined using correlation coefficients. RESULTS: The estimated HE65 (years) ranged from 13.13 to 17.39 for men and from 14.84 to 20.53 for women. HE65 was significantly positively correlated with the proportion of elderly and per capita income, and negatively correlated with the percentage of households of a single elderly person, divorce rate, and unemployment rate. These relations were stronger in large municipalities (with a population of more than 100,000) than in small and medium-size municipalities. CONCLUSION: A decrease in healthy longevity of older people was associated with a higher percentage of households of a single elderly person and divorce rate, and lower socioeconomic conditions. This study suggests that older people in urban areas are susceptible to socio-demographic factors, and a social support network for older people living in socioeconomically disadvantaged conditions should be encouraged.

Aged↗

PubMed2005

Variations in societal characteristics of spatial disease clusters: examples of colon, lung and breast cancer in Japan.

BACKGROUND: Spatial analyses and ecological studies are essential for epidemiology and public health. The present study combining these two methods was performed to identify spatial clusters of selected types of cancer in Japan and to determine their societal characteristics focusing on homogeneity among clusters. RESULTS: Spatial clusters of high mortality rates of male colon and lung cancer and of female breast cancer were identified by the spatial scan statistic using Japanese municipal data (N = 3360) from 1993 to 1998 and also municipalities were divided into four societal clusters based on socioeconomic indicators and population density (urban-rich, suburban, rural-poor, and clutter). Five, seven, and four mortality clusters were identified for lung, colon and breast cancer, respectively. For colon and breast cancer, most municipalities of all except one cluster were included in a single societal cluster (urban-rich). The municipalities associated with mortality clusters for lung cancer belonged to various societal clusters. CONCLUSION: Increased mortality rates of colon and breast cancer can be explained by homogenous societal characteristics related to urbanisation, although there were exceptional areas with higher mortality rates. The regional variation in lung cancer mortality rate appeared to be due to heterogeneous factors. These findings and the analysis performed in the present study will contribute to both nationwide and region-specific cancer prevention strategies.

Journal Article↗

PubMed2005

Accumulation of health risk behaviours is associated with lower socioeconomic status and women's urban residence: a multilevel analysis in Japan.

BACKGROUND: Little is known about the socioeconomic differences in health-related behaviours in Japan. The present study was performed to elucidate the effects of individual and regional socioeconomic factors on selected health risk behaviours among Japanese adults, with a particular focus on regional variations. METHODS: In a nationally representative sample aged 25 to 59 years old (20,030 men and 21,076 women), the relationships between six risk behaviours (i.e., current smoking, excessive alcohol consumption, poor dietary habits, physical inactivity, stress and non-attendance of health check-ups), individual characteristics (i.e., age, marital status, occupation and household income) and regional (N = 60) indicators (per capita income and unemployment rate) were examined by multilevel analysis. RESULTS: Divorce, employment in women, lower occupational class and lower household income were generally associated with a higher likelihood of risk behaviour. The degrees of regional variation in risk behaviour and the influence of regional indicators were greater in women than in men: higher per capita income was significantly associated with current smoking, excessive alcohol consumption, stress and non-attendance of health check-ups in women. CONCLUSION: Individual lower socioeconomic status was a substantial predictor of risk behaviour in both sexes, while a marked regional influence was observed only in women. The accumulation of risk behaviours in individuals with lower socioeconomic status and in women in areas with higher income, reflecting an urban context, may contribute to their higher mortality rates.

Adult↗

PubMed2005

The spread of drug abuse in rapidly urbanizing communities in Vientiane, Lao People's Democratic Republic.

To determine the prevalence of drug abuse in city neighborhoods in a developing country undergoing rapid urbanization, we performed a household survey on the spread of drug abuse in Vientiane, Lao People's Democratic Republic. A total of 1497 households from 17 villages were selected by the stratified random sampling method from urban districts in the city of Vientiane. Participatory style research was employed to increase both the sensitivity of detection and the reliability of information gathered. Local key players shared in the participatory process in this study. We worked with national and city officers and community leaders, as well as with neighborhood leaders who had received previous training for this survey, and conducted household surveys using face-to-face interviews. We inquired about the spread of drug abuse by asking if the families interviewed recognized drug abuse problems in their community. To examine the extent of urbanization of individual villages, the urban index was calculated by principle component analysis from the following eight indicators: income, occupation, parents' educational histories, diffusion of telephones, ownership of livestock, diffusion of plumbing for running water and distance from the Vientiane city center to the village. Distance was calculated by the Geographic Information System. Among the 17 villages included in the study, the average percentage of recognition of drug abuse in the community was 63.2%. The relationship between recognition of cases of drug abuse in the community and the urban index showed a significant correlation, with a Spearman coefficient of 0.650 (p < 0.01). The high reliability of participatory style surveys is also discussed. In conclusion, city neighborhoods in a developing country undergoing rapid urbanization showed evidence of the spread of drug abuse, which was associated with the urban index. Participatory style research activity was recommended to help raise awareness of community participation in anti-drug-abuse activities.

Adult↗

PubMed2005

Socioeconomic pattern of smoking in Japan: income inequality and gender and age differences.

PURPOSE: To elucidate the influence of individual socioeconomic status on smoking in Japanese adults. METHODS: Using a nationally representative sample (20,206 men and 21,093 women aged 18 to 54 years), the relation between smoking and socioeconomic characteristics was analyzed by sex and age group (18 to 24, 25 to 39, and over 40 years). RESULTS: The smoking prevalence was 57.0% for men and 16.6% for women. Living in an urban area was a negative factor for smoking in men, while a positive factor in women. Being married was positively associated with smoking in the younger population, but negatively associated in the older population. A relation between lower income and smoking was found in all groups, except in men aged 18 to 24 years. The income-related difference was most pronounced in the population aged 25 to 39 years: OR of smoking for the highest income quintile compared with the lowest was 0.60 (95% CI, 0.51-0.71) for men and 0.29 (95% CI, 0.23-0.35) for women. CONCLUSIONS: Socioeconomic status, especially income, substantially predicted smoking in the Japanese population, while the impact differed according to sex and age groups. Effective anti-smoking strategies require consideration of the gender and age differences in the socioeconomic pattern of smoking.

Adult↗

PubMed2005

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↗

PubMed2005

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↗

PubMed2005

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↗