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1.  An overview of the China National Tobacco Corporation and State Tobacco Monopoly Administration 
Objectives
China is facing a serious public health problem in active and passive smokers. Confronted with this, China has taken some measures to control tobacco. However, this information has not been surveyed at academic level. Our aim is to investigate information relating to tobacco controls in China.
Methods
To find information relating to tobacco control, we reviewed and analysed the China National Tobacco Corporation (CNTC) and State Tobacco Monopoly Administration (STMA) mainly by systematic examination of documents made available in the University of California, San Francisco Legacy Tobacco Documents Library and China Tobacco database.
Results
Eleven relevant documents met our research purpose, and 18 further relevant documents were found on the CNTC, STMA and Tobacco China database websites. As a result, 29 relevant articles were included in our analysis. We describe the CNTC and STMA’s history, structure, and relation to the Chinese Government ministry and to other tobacco companies, and China’s tobacco control in detail.
Conclusions
The Chinese cigarette market is dominated by a state-owned monopoly, the STMA. Under the protection of the Law of the People’s Republic of China on Tobacco Monopoly, the STMA controls all aspects of the tobacco industry. As far as the Chinese tobacco monopoly is concerned, although smoking harms people’s health, restraining smoking threatens social stability and government income, which may be more serious problems for any government. China still has a long way to go in creating smoke-free environments.
doi:10.1007/s12199-012-0288-4
PMCID: PMC3541807  PMID: 22696197
China; Epidemiology; Public health; Smoking; Tobacco control
2.  The relationship between suicidal ideation and symptoms of depression in Japanese workers: a cross-sectional study 
BMJ Open  2013;3(11):e003643.
Objectives
The prevalence of suicidal ideation and predictors for suicidal ideation among Japanese workers is unknown, although a previous study reported a 30% prevalence rate of suicidal ideation in a psychosomatic clinical setting. Hence, we evaluated the prevalence of suicidal ideation and its relationship with depressive symptoms among Japanese workers.
Methods
For this purpose, a cross-sectional design was used. Major depressive disorder (MDD) and suicidal ideation in 1266 workers (1100 men and 166 women, aged 20–69 years) were assessed through clinical interviews conducted in accordance with the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders.
Results
A total of 34 and 70 participants were diagnosed with suicidal ideation and MDD, respectively. Suicidal ideation was especially prevalent in 40-year-olds to 49-year-olds. Six of the eight symptoms of MDD (depressive mood, loss of interest, weight loss, psychomotor agitation, worthlessness and concentration loss) were related to suicidal ideation. Depressive mood had the strongest relationship with suicidal ideation, followed by worthlessness and concentration loss. Worthlessness had the highest area under the curve in predicting suicidal ideation, followed by concentration loss and depressive mood.
Conclusions
We conclude that MDD symptoms—particularly depressive mood, worthlessness and concentration loss—are potential predictors of suicidal ideation in Japanese workers.
doi:10.1136/bmjopen-2013-003643
PMCID: PMC3845061  PMID: 24293204
MENTAL HEALTH
3.  Association between Insomnia Symptoms and Hemoglobin A1c Level in Japanese Men 
PLoS ONE  2011;6(7):e21420.
Background
The evidence for an association between insomnia symptoms and blood hemoglobin A1c (HbA1c) level has been limited and inconclusive. The aim of this study was to assess whether each symptom of initial, middle, and terminal insomnia influences HbA1c level in Japanese men.
Methods
This cross-sectional study examined 1,022 male workers aged 22–69 years with no history of diabetes at a Japanese company's annual health check-up in April 2010. High HbA1c was defined as a blood level of HbA1c ≥6.0%. Three types of insomnia symptoms (i.e., difficulty in initiating sleep, difficulty in maintaining sleep, and early morning awakening) from the previous month were assessed by 3 responses (i.e., lasting more than 2 weeks, sometimes, and seldom or never [reference group]).
Results
The overall prevalence of high HbA1c was 5.2%. High HbA1c was positively and linearly associated with both difficulty in maintaining sleep (P for trend  = .002) and early morning awakening (P for trend  = .007). More specifically, after adjusting for potential confounding factors, high HbA1c was significantly associated with difficulty in maintaining sleep lasting more than 2 weeks (adjusted odds ratio, 6.79 [95% confidence interval, 1.86–24.85]) or sometimes (2.33 [1.19–4.55]). High HbA1c was also significantly associated with early morning awakening lasting more than 2 weeks (3.96 [1.24–12.59]).
Conclusion
Insomnia symptoms, particularly difficulty in maintaining sleep and early morning awakening, were found to have a close association with high HbA1c in a dose-response relationship.
doi:10.1371/journal.pone.0021420
PMCID: PMC3128595  PMID: 21747936
4.  Matrix analysis and risk management to avert depression and suicide among workers 
Suicide is among the most tragic outcomes of all mental disorders, and the prevalence of suicide has risen dramatically during the last decade, particularly among workers. This paper reviews and proposes strategies to avert suicide and depression with regard to the mind body medicine equation hypothesis, metrics analysis of mental health problems from a public health and clinical medicine view.
In occupational fields, the mind body medicine hypothesis has to deal with working environment, working condition, and workers' health. These three factors chosen in this paper were based on the concept of risk control, called San-kanri, which has traditionally been used in Japanese companies, and the causation concepts of host, agent, and environment. Working environment and working condition were given special focus with regard to tackling suicide problems. Matrix analysis was conducted by dividing the problem of working conditions into nine cells: three prevention levels (primary, secondary, and tertiary) were proposed for each of the three factors of the mind body medicine hypothesis (working environment, working condition, and workers' health). After using these main strategies (mind body medicine analysis and matrix analysis) to tackle suicide problems, the paper talks about the versatility of case-method teaching, "Hiyari-Hat activity," routine inspections by professionals, risk assessment analysis, and mandatory health check-up focusing on sleep and depression. In the risk assessment analysis, an exact assessment model was suggested using a formula based on multiplication of the following three factors: (1) severity, (2) frequency, and (3) possibility.
Mental health problems, including suicide, are rather tricky to deal with because they involve evaluation of individual cases. The mind body medicine hypothesis and matrix analysis would be appropriate tactics for suicide prevention because they would help the evaluation of this issue as a tangible problem.
doi:10.1186/1751-0759-4-15
PMCID: PMC2994806  PMID: 21054837
5.  Analysis of a tobacco vector and its actions in china: the activities of japan tobacco 
Tobacco Induced Diseases  2010;8(1):13.
Japan Tobacco (JT) is the third largest tobacco company in the world, and China, the world's largest tobacco consumer, is one of the most important targets for JT. To provide information for tobacco control, we reviewed and analyzed JT and its tactics and strategies in the Chinese market mainly by systematic examination of documents which are made available in the University of California, San Francisco Legacy Tobacco Documents Library. As a result, JT has had a special interest to expand sales of its cigarettes in the Chinese market.
doi:10.1186/1617-9625-8-13
PMCID: PMC2984582  PMID: 20979655
6.  Development of a questionnaire to assess ‘Hie’ symptoms using an evidence-based analysis 
Objectives
Certain symptoms and signs are culturally specific. ‘Hie’ (chill sensation) is a major symptom experienced by Japanese people; however, it is not easily understood by Westerners. Although Hie is not life-threatening, it greatly hampers the quality of life in sufferers. To develop a remedy for Hie, valid and reliable measures are required. This is the first study aimed at developing a standardized questionnaire to quantitatively measure Hie symptom.
Methods
This was a cross-sectional study. To identify question items, we conducted a literature search using published books that mention Hie and related symptoms. The first draft of the questionnaire was prepared by selecting 31 items, including three empirically used items, using the Delphi method. A total of 744 Japanese volunteers completed the draft questionnaire. Simple correlation and factor analyses were performed to select items for the final version of Hie questionnaire and for evaluating its test–retest reliability.
Results
The following ten question items were ultimately selected: feeling a breeze, shivery feeling, tolerance, sensitivity to cold, Hie-like sensation in an airplane, dislike of air conditioning, use of gloves, use of an electric blanket, use of heavy clothing and need for heating devices. Of the ten Hie-related question items, five pertained to physical symptoms and the other five to daily behaviours. The internal consistency of the ten-item questionnaire was high, with a Cronbach’s alpha of 0.85. The test–retest reliability of the questionnaire was preserved by the paired two-tailed t test.
Conclusions
A new questionnaire was developed to evaluate the subjective symptom of Hie. This questionnaire demonstrated sufficient reliability and could be used as a tool to assess this symptom.
doi:10.1007/s12199-008-0050-0
PMCID: PMC2698230  PMID: 19568894
Culture; Hie; Japan; Questionnaires; Traditional medicine
7.  A proposed approach to suicide prevention in Japan: the use of self-perceived symptoms as indicators of depression and suicidal ideation 
The incidence of suicide in Japan has increased markedly in recent years, making suicide a major social problem. Between 1997 and 2006, the annual number of suicides increased from 24,000 to 32,000; the most dramatic increase occurred in middle-aged men, the group showing the greatest increase in depression. Recent studies have shown that prevention campaigns are effective in reducing the total number of suicides in various areas of Japan, such as Akita Prefecture. Such interventions have been targeted at relatively urban populations, and national data from public health and clinical studies are still needed. The Japanese government has established the goal of reducing the annual number of suicides to 22,000 by 2010; toward this end, several programs have been proposed, including the Mental Barrier-Free Declaration, and the Guidelines for the Management of Depression by Health Care Professionals and Public Servants. However, the number of suicides has not declined over the past 10 years. Achieving the national goal during the remaining years will require extensive and consistent campaigns dealing with the issues and problems underlying suicide, as well as simple screening methods for detecting depression. These campaigns must reach those individuals whose high-risk status goes unrecognized. In this review paper, we propose a strategy for the early detection of suicide risk by screening for depression according to self-perceived symptoms. This approach was based on the symposium Approach to the Prevention of Suicide in Clinical and Occupational Medicine held at the 78th Conference of the Japanese Society of Hygiene, 2008.
doi:10.1007/s12199-008-0048-7
PMCID: PMC2698228  PMID: 19568891
Depressive disorders; Japan; Prevention and control; Suicide

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