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1.  A cross-sectional study of workplace social capital and blood pressure: a multilevel analysis at Japanese manufacturing companies 
BMJ Open  2013;3(2):e002215.
Objectives
We examined the contextual effect of workplace social capital on systolic blood pressure (SBP).
Design
Cross-sectional.
Setting
A conglomerate from 58 workplaces in Japan.
Participants
Of the 5844 workers at a Japanese conglomerate from 58 workplaces, 5368 were recruited. Individuals who received drugs for hypertension (n=531) and who lacked information on any variable (n=167) were excluded from the analyses, leaving 4735 individuals (3281 men and 1454 women) for inclusion.
Primary and secondary outcome measures
Systolic blood pressure.
Results
The contextual effect of workplace social capital on SBP was examined using a multilevel regression analysis with a random intercept. Coworker support had a contextual effect at the workplace level (coefficient=−1.97, p=0.043), while a lack of trust for coworkers (coefficient=0.27, p=0.039) and lack of helpfulness from coworkers were associated with SBP (coefficient=0.28, p=0.002).
Conclusions
The present study suggested that social capital at the workplace level has beneficial effects on SBP.
doi:10.1136/bmjopen-2012-002215
PMCID: PMC3586077  PMID: 23386581
Social Capital; Occupational Health; Stress
2.  Taxation Categories for Long-term Care Insurance Premiums and Mortality Among Elderly Japanese: A Cohort Study 
Journal of Epidemiology  2013;23(1):41-46.
Background
This cohort study examined the association between taxation categories of long-term care insurance premiums and survival among elderly Japanese.
Methods
A total of 3000 participants aged 60 years or older were randomly recruited in Y City, Japan in 2002, of whom 2964 provided complete information for analysis. Information on income level, mobility status, medical status, and vital status of each participant was collected annually from 2002 to 2006. Follow-up surveys on survival were conducted until August 2007. Hazard ratios (HRs) were estimated by a Cox model, using taxation categories at baseline. In these analyses, age-adjusted and age- and mobility-adjusted models were used.
Results
A significantly higher mortality risk was seen only in the lowest taxation category among men: as compared with men in the second highest taxation category, the HR in the lowest category was 2.53 (95% CI, 1.26–5.08, P = 0.009). This significant association between taxation category and mortality was lost after adjustment for mobility. There was no other difference in mortality among taxation categories in men or women.
Conclusions
The present findings only partly supported our hypothesis that taxation category is a good indicator of socioeconomic status in examining health inequalities among elderly Japanese.
doi:10.2188/jea.JE20120011
PMCID: PMC3700237  PMID: 23258217
Japan; income; cohort study; aged; long-term care
3.  Age-Period-Cohort Analysis of Chronic Obstructive Pulmonary Disease Mortality in Japan, 1950–2004 
Journal of Epidemiology  2012;22(4):302-307.
Background
We examined trends in chronic obstructive pulmonary disease (COPD) mortality in Japan.
Methods
An age-period-cohort model was used to examine trends in COPD mortality by age, time period, and birth cohort among adults aged 40 years or older from 1950 to 2004.
Results
During the study period, the age-standardized rate of COPD mortality substantially decreased from 71.3 per 100 000 to 19.7 in men and from 41.7 to 4.3 in women. The period effects rapidly declined during the early period in both sexes. They have increased in recent years in men but have continued to decrease in women. The cohort effects began increasing in the 1865–1869 birth cohort, peaked in the 1880–1889 cohort, and decreased thereafter among the recent cohorts.
Conclusions
An early decrease in the period effects might have been associated with changes in disease structure and misclassification of COPD in the early period. Changes in cohort effects might have been mostly associated with changes in cigarette consumption and smoking prevalence in the Japanese population. Changes in those effects may also be a proxy for other social changes over time.
doi:10.2188/jea.JE20110092
PMCID: PMC3798648  PMID: 22447209
age-period-cohort model; birth cohort analysis; COPD; secular trends
4.  The Influence of Diabetes Mellitus on Short-Term Outcomes of Patients with Bleeding Peptic Ulcers 
Yonsei Medical Journal  2012;53(4):701-707.
Purpose
Little information is available on the influence of diabetes mellitus on the short-term clinical outcomes of patients with bleeding peptic ulcers. The aim of this study is to investigate whether diabetes mellitus influences the short-term clinical outcomes of patients with bleeding peptic ulcers using a Japanese national administrative database.
Materials and Methods
A total of 4863 patients treated by endoscopic hemostasis on admission for bleeding peptic ulcers were referred to 586 participating hospitals in Japan. We collected their data to compare the risk-adjusted length of stay (LOS) and in-hospital mortality of patients with and without diabetes mellitus within 30 days. Patients were divided into two groups: patients with diabetes mellitus (n=434) and patients without diabetes mellitus (n=4429).
Results
Mean LOS in patients with diabetes mellitus was significantly longer than those without diabetes mellitus (15.8 days vs. 12.5 days, p<0.001). Also, higher in-hospital mortality within 30 days was observed in patients with diabetes mellitus compared with those without diabetes mellitus (2.7% vs. 1.1%, p=0.004). Multiple linear regression analysis revealed that diabetes mellitus was significantly associated with an increase in risk-adjusted LOS. The standardized coefficient was 0.036 days (p=0.01). Furthermore, the analysis revealed that diabetes mellitus significantly increased the risk of in-hospital mortality within 30 days (odds ratio=2.285, 95% CI=1.161-4.497, p=0.017).
Conclusion
This study demonstrated that presence of diabetes mellitus significantly influences the short-term clinical outcomes of patients with bleeding peptic ulcers.
doi:10.3349/ymj.2012.53.4.701
PMCID: PMC3381484  PMID: 22665334
Bleeding peptic ulcers; diabetes mellitus; health care quality; retrospective studies; databases
5.  Disability-Adjusted Life Years (DALY) for Cancer in Japan in 2000 
Journal of Epidemiology  2011;21(4):309-312.
Background
We used disability-adjusted life years (DALY) to estimate the cancer burden in Japan for the year 2000.
Methods
We estimated years of life lost (YLL) by using mortality data and years lived with disability (YLD) by using incidence data. The DALY for cancer was calculated as the sum of YLL and YLD.
Results
For all cancers combined, 2 733 884 years of DALY were estimated in men and 2 091 874 years were estimated in women. Among men, stomach and lung cancers accounted for the largest proportions of DALY, followed by liver cancer and colorectal cancer. Among women, the greatest contributors to DALY were stomach, colorectal, breast, and lung cancers.
Conclusions
The national cancer burden in Japan was expressed in terms of DALY, which might be useful in assessing future changes with respect to mortality and morbidity in Japan.
doi:10.2188/jea.JE20110017
PMCID: PMC3899425  PMID: 21628841
cancer; DALY; disability-adjusted life years; premature mortality; years lived with disability
6.  Duration of androgen deprivation therapy with maximum androgen blockade for localized prostate cancer 
BMC Urology  2011;11:7.
Background
Primary androgen deprivation therapy (ADT) is a treatment option not only for advanced but also for localized prostate cancer. However, the appropriate duration for primary ADT for localized prostate cancer has not been defined and few studies have addressed this issue. In this study, we aimed to determine the appropriate duration of ADT for localized prostate cancer.
Methods
Sixty-eight consecutive patients with localized prostate cancer who underwent a prostatectomy following neoadjuvant ADT were retrospectively reviewed. Factors associated with pT0, which is regarded as serious cancer cell damage or elimination, were investigated.
Results
Of the 68 males, 24 (35.3%) were classified as pT0. The median duration of neoadjuvant ADT in the pT0 and non-pT0 groups was 9 months and 7.5 months, respectively (p = 0.022). The duration of neoadjuvant ADT from when PSA reached < 0.2 ng/ml to surgery was longer in the pT0 group than that in the non-pT0 group (median 5 months against 3 months, p = 0.011). pT0 was achieved in 5 of 6 patients (83.3%) who received ADT for ≥10 months after PSA reached < 0.2 ng/ml. No other clinical characteristics predicted conversion to pT0.
Conclusions
Continuous ADT for ≥10 months after PSA reached < 0.2 ng/ml induced serious prostate cancer cell damage in most patients (> 80%) and may be sufficient to treat localized prostate cancer.
doi:10.1186/1471-2490-11-7
PMCID: PMC3116482  PMID: 21569574

Results 1-6 (6)