Michiko Miyakawa - Academia.edu (original) (raw)
Papers by Michiko Miyakawa
International journal of biomedical soft computing and human sciences, 1996
Neural network has attracted interests tO de昭 10P the knowledgeわasefrom the ' itedicac 'database ... more Neural network has attracted interests tO de昭 10P the knowledgeわasefrom the ' itedicac 'database ． Some neural networkO haソ e been 卿 lied to ' he diagnostic syste 〃1， ゐut not to the epid 劭 tio logical ana ！ ys is ． Non − linear characte 厂istiCS derivedfrom ne ： ご厂al netwO 厂k seems ' 0 わ e more app 厂() priate to construct disease ' η ・delS C ・〃 脚 red t・ ・74 ゴ ηα り ・5 ！ 魏 Cσ-〃ieth ・ dS． 伽 ∫ 綴 ソ α "llS・t・ C-・ ・ 伽 んθ 卿 1∫・αゐ 勘 ・ qズ ・ 召1' ・α 1・幽 θ 厂た to the representtation qfthe hype厂tension model ． Fro' n 〃昭 ゴ磁 〃 α ' α わase ， 598 cases were ch ' 丿sen 1 で) ' 舵 learning group・ and 597 cases were chesen to the testing group ， 厂ando ' め ． InPttt りa 厂iables ・ t' sed in rhis st ' tdy were ・ sex ・ age ， ∫・ 1・ ki・ g an "
Blood, 2008
The classic myeloproliferative disorders (MPD) of polycythemia vera (PV), essential thrombocythem... more The classic myeloproliferative disorders (MPD) of polycythemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (IMF) are hematopoietic ones characterized by the overproduction of one or more mature myeloid lineages. Although their clonal nature and cytokine independence were recognized a couple of decades ago, their molecular abnormality was not clarified until the identification of the activating JAK2 V617F mutation. Around 95% of patients with PV have the JAK2 V617F mutation. The JAK2 V617F mutation is found in approximately half of ET and IMF patients. ET patients with JAK2 V617F resemble PV patients such as in their increased erythropoiesis and granulopoiesis, and have increased rates of venous thrombosis compared to JAK2 V617F-negative patients. Accurate genotyping of JAK2 is critical for a diagnosis of MPD and can be useful for treatment decisions. However, compared to Western populations, there is limited information available about JAK2 mutation in a J...
![Research paper thumbnail of [Deterioration of Healthcare Service Quality Provided by Occupational Physicians Due to Dumping by Health Checkup and Switching Health Checkup Organizations]](https://attachments.academia-assets.com/105361026/thumbnails/1.jpg)
](Nihon eiseigaku zasshi. Japanese journal of hygiene, 2018
From 2007, competitive bidding for procurement became widely employed by the Japanese Government,... more From 2007, competitive bidding for procurement became widely employed by the Japanese Government, and health check providers for government workers are selected every year by this method. Deterioration of health check quality due to excessive price competition is a serious concern. The National Federation of Industrial Health Organization (Zeneiren) conducted an investigative research on the contracting of health check providers and occupational physicians in workplaces in 2015-2016 in an effort to prevent low-cost but low-quality health checks. The report of the research is available on the homepage of Zeneiren. In this paper, we provide a brief overview of the report, and deterioration of health check quality due to dumping by and switching of health check providers is discussed from economic and legal viewpoints. Information was obtained from articles in print and on the Internet. A questionnaire survey of health check providers revealed that excessive discounts due to both compe...
Japanese journal of MHTS, 1998
Nihon eiseigaku zasshi. Japanese journal of hygiene, 2016
There are various risks involved in corporate activities conducted both within and outside the co... more There are various risks involved in corporate activities conducted both within and outside the corporation. Among these, health risks are very important and should be managed effectively as an integral part of corporate social responsibility (CSR). A corporation is responsible for health impairments caused by its activities and suffers great moral and economic loss when they occur. It is essential that corporate management takes proper preventive measures against such risks. Occupational physicians possess substantial knowledge of health risks in corporations. In this study, we examine the role of occupational physicians in the management of corporate health risks. Information was obtained from articles in print and on the Internet. Health risks due to corporate activities involve not only the employees of the corporation but also individuals outside the corporation. Each corporation should effectively use available resources to manage health risks. Occupational physicians are one s...
The European Journal of Public Health, 2011
Background: This study aims to confirm associations between subjective social status (SSS) and he... more Background: This study aims to confirm associations between subjective social status (SSS) and health in the Swedish working population, to investigate if SSS is related to health over and above conventional measures of socioeconomic status and to identify factors related to perception of SSS. Methods: The study includes 2358 men and 2665 women in the age group of 19-68 years who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH). SSS was measured using the MacArthur scale, a 10-rung ladder on which individuals indicate where they think they stand in the social hierarchy. Health, health behaviors and social situation were also measured in 2006, while more objective measures of socioeconomic position were derived from registry data and interviews in 2003. Results: Perception of SSS was cross-sectionally related to age-adjusted prevalence of suboptimal perceived general health, sleep disturbances, musculoskeletal symptoms, depressive symptoms and emotional exhaustion. Relative Indices of Inequalities (RII) showed significant relationships between SSS and health, which were attenuated by adjustment for general life satisfaction. Adjustment for occupational grade, education and income further attenuated the relationship. The main predictors of SSS in 2006 were occupational grade, personal income and education in 2003; household financial situation, general life satisfaction and job control in 2006. When ranking their SSS, women put more weight on household financial situation and men on their personal income. Conclusion: SSS is associated with prevalence of several health complaints in the Swedish working population over and above conventional SES, indicating that SSS is a valid measure of social inequality in health.
Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene), 2012
Introduction: Large amounts of radioactive materials were leaked into the environment from the Fu... more Introduction: Large amounts of radioactive materials were leaked into the environment from the Fukushima Daiichi Nuclear Power Plant (FDNPP) of the Tokyo Electric Power Company damaged by the 2011 Great East Japan Earthquake and accompanying tsunami. Increased health impairment risks due to the leaked radioactive materials are of concern over a long period of time and over a wide geographical area. From the results of epidemiologic studies conducted after the Chernobyl accident, the health risks are not anticipated to be very marked. The purpose of the present study is to examine (i) the elevated health risks as viewed by the general population, (ii) tolerance to the risks that the general population suffer from their viewpoint, and (iii) the overall picture as seen by researchers and experts in specialized areas of study after the accident. Method: Information was obtained from articles in print and on the Internet and by interviewing a psychologist and tens of employees of several corporations. Results and Discussion: Epidemiologic studies conducted after the severe accident of the nuclear power plant in Chernobyl revealed an elevated risk of thyroid cancer in children due to 131 I while elevated risks due to radioactive materials other than 131 I were not detected. The amount of radioactive materials leaked into the environment from the FDNPP was less than that in Chernobyl. Therefore, it is possible to estimate that health impairment risks due to the leaked radioactive materials from the FDNPP are low. However, it is impossible to conclude a zero risk. It is likely that the general population does not fully understand the health impairment risks due to the leaked radioactive materials from the FDNPP. Although no increased incidences of diseases other than thyroid cancer of children were scientifically shown en masse from studies in Chernobyl, individual risks and results in the future caused by the severe accident of FDNPP cannot be denied. Much of the general population is apt to demand the security of a zero risk from human-generated disasters such as the severe accident of FDNPP. Many are very intolerant of the health impairment risks factors and wish to avoid any risk altogether. The viewpoint of the general population differs considerably from that of epidemiologists and other research experts. Researchers and experts are often well versed in their own specialized areas but ignorant of other areas. Thus, it is difficult to grasp the complete view of an event under consideration. This so-called 'takotsubo' situation is dangerous in human society. Researchers and experts must make effort to understand areas other than their own specialized areas. Scientific researchers usually possess a great deal of con-論 壇
[Nippon kōshū eisei zasshi] Japanese journal of public health
A model for cost-benefit analysis of medical care of low-birth-weight infants was proposed in ord... more A model for cost-benefit analysis of medical care of low-birth-weight infants was proposed in order to evaluate its economic efficiency using the notion of an expected value, routinely used in economics. The expected cost and benefit when a low-birth-weight infant is born were calculated and compared. Cost includes the hospital charges and the charges for long-term care of a handicapped survivor. Benefit includes the present value of lifetime earnings. Benefit/Cost Ratio was selected as a criterion to determine efficiency, with values exceeding 1 representing the case where the expected benefit exceeds the expected cost, meaning a net economic gain. Actual values were substituted in the model for cost-benefit analysis of care of very-low-birth-weight infants. Benefit/Cost Ratios corresponding to various birth weights were calculated, and the break-even point was found to be about 800 g, which was consistent with several former reports. However sensitivity analysis indicated that Ben...
Pediatrics international : official journal of the Japan Pediatric Society, 2004
The aim of the present study was to elucidate both environmental and behavioral factors that infl... more The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3-6. In 1992 (at age 3) and 1995 (at age 6), 8170 6-year-old children (4176 boys and 3994 girls) were surveyed using a questionnaire on both body build (height and weight) and lifestyle. The correlation between BMI for 3-year-olds and for 6-year-olds were analyzed. From the temporal changes of body build between age 3 and 6 years, we categorized children into four groups: group 1, normal at both age 3 years and 6 years (normal/normal); group 2, overweight at age 3 years and normal at age 6 years (overweight/normal); group 3, normal at age 3 years and overweight at age 6 years (normal/overweight); and group 4, overweight at both age 3 years and 6 years (overweight/overweight). The authors compared the four groups with each other according to sex, concerning frequencies of children who matched the categories of environmen...
Medinfo. MEDINFO, 1995
This study aims to apply a structured neural network system for improving diagnostic capabilities... more This study aims to apply a structured neural network system for improving diagnostic capabilities of hepatobiliary diseases. Several neural networks were organized according to a priori knowledge. A priori knowledge consists of five pathological states. We compared the diagnostic accuracy of discriminant function, ordinary and structured neural networks. The diagnostic capabilities among testing data were 96% by structured neural network, 70% by ordinary neural network, and 66% by discriminant function. The structured neural network had the significantly higher diagnostic accuracy than the other two methods.
Journal of Medical Systems, 1998
This study was designed with a follow up of 16 years to provide the epidemiological model evaluat... more This study was designed with a follow up of 16 years to provide the epidemiological model evaluating the risk of developing diabetes mellitus in Japan. A cohort of 2573 subjects (1851 males and 722 females) from a MHTS in Tokyo, who were nondiabetic (fasting blood glucose (FBS) less than 110 mg/dl) in the initial year, were selected. This cohort was followed every year to identify the occurrence of diabetes mellitus. Diabetes Mellitus was defined as fasting blood glucose over 110 mg/dl, or the initiation of diabetic therapy. We compared two prognosis groups (a normal group and a diabetic group) in terms of age, examination findings, and prevalence of health risks (lifestyle, stress, and working form). We also assessed family history of diabetes and past histories including hypertension, hypercholesterolemia, and hyperuricemia. After assessing each variable by univariate analysis(t-test, ?2test), we employed Cox's proportional hazards model analysis. We used stepwise model adopt...
International Journal of the Addictions, 1992
Using population-based survey data, personal-problematic and socioproblematic factors were examin... more Using population-based survey data, personal-problematic and socioproblematic factors were examined among Japanese in Japan, Japanese-Americans in Hawaii, and Japanese-Americans; Caucasians in California were analyzed as a control group. Caucasian males were more likely to exhibit drinking-related social problems, whereas Japanese males showed more personal-problematic symptoms. Japanese-American men, both in Hawaii and California, were least likely among the three ethnic groups to have personal-problematic symptoms and were more likely to have socioproblematic symptoms than Japanese men. These differences might be explained by differences in the perception of social problems.
Preventive Medicine, 1999
This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NH... more This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Alternative indicators for screening for diabetes mellitus. Type of intervention Screening and secondary prevention. Economic study type Cost-effectiveness analysis. Study population For the effectiveness study the population consisted of males who attended an annual health checkup at a general hospital in Tokyo, Japan. Subjects with a history of diabetes mellitus or gastrectomy were excluded. For the modelled economic evaluation a hypothetical cohort of 1,000 men was used. Setting Hospital. The study was carried out in Tokyo, Japan.
Preventive Medicine, 1999
Background.Obesity in childhood increases the risk of obesity in adulthood. Obesity in adulthood ... more Background.Obesity in childhood increases the risk of obesity in adulthood. Obesity in adulthood is a risk factor for chronic diseases such as hypertension and atherosclerosis. T herefore, it is important to eliminate factors influencing the development of obesity in children from the viewpoint of preventive medicine. T he purpose of this study is to elucidate the relationship between obesity and lifestyle in 3-year-old children in a casecontrol study. Methods.Subjects were selected from the T oyama study at health checkups for 3-yearold children which are done routinely by local governments in Japan on all children of that age.
The Keio Journal of Medicine, 2007
Numerous epidemiologic studies have revealed that smoking is a significant risk factor of many di... more Numerous epidemiologic studies have revealed that smoking is a significant risk factor of many diseases. Some studies reported increase in medical expenditure by smoking using odds or hazard ratios between smoking and diseases in epidemiologic studies. The purpose of the present study is to investigate the ratios of mean medical expenditures between smokers and nonsmokers from studies conducted observing medical expenditure directly in Japan. We collected 11 published articles of studies conducted observing medical expenditures of smokers and nonsmokers directly in Japan. The weighted geometric mean of ratios between age-adjusted mean medical expenditures for smokers and nonsmokers of National Health Insurance and Government-Managed Health Insurance beneficiaries which included many elderly individuals was somewhat greater than 1.0, while the value of Society-Managed Health Insurance that included a small number of elderly people was less than 1.0. Smoking and smokers' indifference to health increase the medical expenditure of the smokers, especially elderly smokers. It was not determined, however, whether the mean medical expenditure of smokers is actually greater than that of nonsmokers.
The Journal of Pediatrics, 1999
disease, gout, arthritis, and some types of cancer. 4,5 Furthermore, previous epidemiologic studi... more disease, gout, arthritis, and some types of cancer. 4,5 Furthermore, previous epidemiologic studies have indicated that obesity in childhood may demonstrate the phenomenon of "tracking," resulting in obesity in adulthood. 6,7 From the viewpoint of preventive medicine, it is important to elucidate
International journal of biomedical soft computing and human sciences, 1996
Neural network has attracted interests tO de昭 10P the knowledgeわasefrom the ' itedicac 'database ... more Neural network has attracted interests tO de昭 10P the knowledgeわasefrom the ' itedicac 'database ． Some neural networkO haソ e been 卿 lied to ' he diagnostic syste 〃1， ゐut not to the epid 劭 tio logical ana ！ ys is ． Non − linear characte 厂istiCS derivedfrom ne ： ご厂al netwO 厂k seems ' 0 わ e more app 厂() priate to construct disease ' η ・delS C ・〃 脚 red t・ ・74 ゴ ηα り ・5 ！ 魏 Cσ-〃ieth ・ dS． 伽 ∫ 綴 ソ α "llS・t・ C-・ ・ 伽 んθ 卿 1∫・αゐ 勘 ・ qズ ・ 召1' ・α 1・幽 θ 厂た to the representtation qfthe hype厂tension model ． Fro' n 〃昭 ゴ磁 〃 α ' α わase ， 598 cases were ch ' 丿sen 1 で) ' 舵 learning group・ and 597 cases were chesen to the testing group ， 厂ando ' め ． InPttt りa 厂iables ・ t' sed in rhis st ' tdy were ・ sex ・ age ， ∫・ 1・ ki・ g an "
Blood, 2008
The classic myeloproliferative disorders (MPD) of polycythemia vera (PV), essential thrombocythem... more The classic myeloproliferative disorders (MPD) of polycythemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (IMF) are hematopoietic ones characterized by the overproduction of one or more mature myeloid lineages. Although their clonal nature and cytokine independence were recognized a couple of decades ago, their molecular abnormality was not clarified until the identification of the activating JAK2 V617F mutation. Around 95% of patients with PV have the JAK2 V617F mutation. The JAK2 V617F mutation is found in approximately half of ET and IMF patients. ET patients with JAK2 V617F resemble PV patients such as in their increased erythropoiesis and granulopoiesis, and have increased rates of venous thrombosis compared to JAK2 V617F-negative patients. Accurate genotyping of JAK2 is critical for a diagnosis of MPD and can be useful for treatment decisions. However, compared to Western populations, there is limited information available about JAK2 mutation in a J...
Nihon eiseigaku zasshi. Japanese journal of hygiene, 2018
From 2007, competitive bidding for procurement became widely employed by the Japanese Government,... more From 2007, competitive bidding for procurement became widely employed by the Japanese Government, and health check providers for government workers are selected every year by this method. Deterioration of health check quality due to excessive price competition is a serious concern. The National Federation of Industrial Health Organization (Zeneiren) conducted an investigative research on the contracting of health check providers and occupational physicians in workplaces in 2015-2016 in an effort to prevent low-cost but low-quality health checks. The report of the research is available on the homepage of Zeneiren. In this paper, we provide a brief overview of the report, and deterioration of health check quality due to dumping by and switching of health check providers is discussed from economic and legal viewpoints. Information was obtained from articles in print and on the Internet. A questionnaire survey of health check providers revealed that excessive discounts due to both compe...
Japanese journal of MHTS, 1998
Nihon eiseigaku zasshi. Japanese journal of hygiene, 2016
There are various risks involved in corporate activities conducted both within and outside the co... more There are various risks involved in corporate activities conducted both within and outside the corporation. Among these, health risks are very important and should be managed effectively as an integral part of corporate social responsibility (CSR). A corporation is responsible for health impairments caused by its activities and suffers great moral and economic loss when they occur. It is essential that corporate management takes proper preventive measures against such risks. Occupational physicians possess substantial knowledge of health risks in corporations. In this study, we examine the role of occupational physicians in the management of corporate health risks. Information was obtained from articles in print and on the Internet. Health risks due to corporate activities involve not only the employees of the corporation but also individuals outside the corporation. Each corporation should effectively use available resources to manage health risks. Occupational physicians are one s...
The European Journal of Public Health, 2011
Background: This study aims to confirm associations between subjective social status (SSS) and he... more Background: This study aims to confirm associations between subjective social status (SSS) and health in the Swedish working population, to investigate if SSS is related to health over and above conventional measures of socioeconomic status and to identify factors related to perception of SSS. Methods: The study includes 2358 men and 2665 women in the age group of 19-68 years who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH). SSS was measured using the MacArthur scale, a 10-rung ladder on which individuals indicate where they think they stand in the social hierarchy. Health, health behaviors and social situation were also measured in 2006, while more objective measures of socioeconomic position were derived from registry data and interviews in 2003. Results: Perception of SSS was cross-sectionally related to age-adjusted prevalence of suboptimal perceived general health, sleep disturbances, musculoskeletal symptoms, depressive symptoms and emotional exhaustion. Relative Indices of Inequalities (RII) showed significant relationships between SSS and health, which were attenuated by adjustment for general life satisfaction. Adjustment for occupational grade, education and income further attenuated the relationship. The main predictors of SSS in 2006 were occupational grade, personal income and education in 2003; household financial situation, general life satisfaction and job control in 2006. When ranking their SSS, women put more weight on household financial situation and men on their personal income. Conclusion: SSS is associated with prevalence of several health complaints in the Swedish working population over and above conventional SES, indicating that SSS is a valid measure of social inequality in health.
Nippon Eiseigaku Zasshi (Japanese Journal of Hygiene), 2012
Introduction: Large amounts of radioactive materials were leaked into the environment from the Fu... more Introduction: Large amounts of radioactive materials were leaked into the environment from the Fukushima Daiichi Nuclear Power Plant (FDNPP) of the Tokyo Electric Power Company damaged by the 2011 Great East Japan Earthquake and accompanying tsunami. Increased health impairment risks due to the leaked radioactive materials are of concern over a long period of time and over a wide geographical area. From the results of epidemiologic studies conducted after the Chernobyl accident, the health risks are not anticipated to be very marked. The purpose of the present study is to examine (i) the elevated health risks as viewed by the general population, (ii) tolerance to the risks that the general population suffer from their viewpoint, and (iii) the overall picture as seen by researchers and experts in specialized areas of study after the accident. Method: Information was obtained from articles in print and on the Internet and by interviewing a psychologist and tens of employees of several corporations. Results and Discussion: Epidemiologic studies conducted after the severe accident of the nuclear power plant in Chernobyl revealed an elevated risk of thyroid cancer in children due to 131 I while elevated risks due to radioactive materials other than 131 I were not detected. The amount of radioactive materials leaked into the environment from the FDNPP was less than that in Chernobyl. Therefore, it is possible to estimate that health impairment risks due to the leaked radioactive materials from the FDNPP are low. However, it is impossible to conclude a zero risk. It is likely that the general population does not fully understand the health impairment risks due to the leaked radioactive materials from the FDNPP. Although no increased incidences of diseases other than thyroid cancer of children were scientifically shown en masse from studies in Chernobyl, individual risks and results in the future caused by the severe accident of FDNPP cannot be denied. Much of the general population is apt to demand the security of a zero risk from human-generated disasters such as the severe accident of FDNPP. Many are very intolerant of the health impairment risks factors and wish to avoid any risk altogether. The viewpoint of the general population differs considerably from that of epidemiologists and other research experts. Researchers and experts are often well versed in their own specialized areas but ignorant of other areas. Thus, it is difficult to grasp the complete view of an event under consideration. This so-called 'takotsubo' situation is dangerous in human society. Researchers and experts must make effort to understand areas other than their own specialized areas. Scientific researchers usually possess a great deal of con-論 壇
[Nippon kōshū eisei zasshi] Japanese journal of public health
A model for cost-benefit analysis of medical care of low-birth-weight infants was proposed in ord... more A model for cost-benefit analysis of medical care of low-birth-weight infants was proposed in order to evaluate its economic efficiency using the notion of an expected value, routinely used in economics. The expected cost and benefit when a low-birth-weight infant is born were calculated and compared. Cost includes the hospital charges and the charges for long-term care of a handicapped survivor. Benefit includes the present value of lifetime earnings. Benefit/Cost Ratio was selected as a criterion to determine efficiency, with values exceeding 1 representing the case where the expected benefit exceeds the expected cost, meaning a net economic gain. Actual values were substituted in the model for cost-benefit analysis of care of very-low-birth-weight infants. Benefit/Cost Ratios corresponding to various birth weights were calculated, and the break-even point was found to be about 800 g, which was consistent with several former reports. However sensitivity analysis indicated that Ben...
Pediatrics international : official journal of the Japan Pediatric Society, 2004
The aim of the present study was to elucidate both environmental and behavioral factors that infl... more The aim of the present study was to elucidate both environmental and behavioral factors that influence body mass index (BMI, kg/m2) among Japanese children from ages 3-6. In 1992 (at age 3) and 1995 (at age 6), 8170 6-year-old children (4176 boys and 3994 girls) were surveyed using a questionnaire on both body build (height and weight) and lifestyle. The correlation between BMI for 3-year-olds and for 6-year-olds were analyzed. From the temporal changes of body build between age 3 and 6 years, we categorized children into four groups: group 1, normal at both age 3 years and 6 years (normal/normal); group 2, overweight at age 3 years and normal at age 6 years (overweight/normal); group 3, normal at age 3 years and overweight at age 6 years (normal/overweight); and group 4, overweight at both age 3 years and 6 years (overweight/overweight). The authors compared the four groups with each other according to sex, concerning frequencies of children who matched the categories of environmen...
Medinfo. MEDINFO, 1995
This study aims to apply a structured neural network system for improving diagnostic capabilities... more This study aims to apply a structured neural network system for improving diagnostic capabilities of hepatobiliary diseases. Several neural networks were organized according to a priori knowledge. A priori knowledge consists of five pathological states. We compared the diagnostic accuracy of discriminant function, ordinary and structured neural networks. The diagnostic capabilities among testing data were 96% by structured neural network, 70% by ordinary neural network, and 66% by discriminant function. The structured neural network had the significantly higher diagnostic accuracy than the other two methods.
Journal of Medical Systems, 1998
This study was designed with a follow up of 16 years to provide the epidemiological model evaluat... more This study was designed with a follow up of 16 years to provide the epidemiological model evaluating the risk of developing diabetes mellitus in Japan. A cohort of 2573 subjects (1851 males and 722 females) from a MHTS in Tokyo, who were nondiabetic (fasting blood glucose (FBS) less than 110 mg/dl) in the initial year, were selected. This cohort was followed every year to identify the occurrence of diabetes mellitus. Diabetes Mellitus was defined as fasting blood glucose over 110 mg/dl, or the initiation of diabetic therapy. We compared two prognosis groups (a normal group and a diabetic group) in terms of age, examination findings, and prevalence of health risks (lifestyle, stress, and working form). We also assessed family history of diabetes and past histories including hypertension, hypercholesterolemia, and hyperuricemia. After assessing each variable by univariate analysis(t-test, ?2test), we employed Cox's proportional hazards model analysis. We used stepwise model adopt...
International Journal of the Addictions, 1992
Using population-based survey data, personal-problematic and socioproblematic factors were examin... more Using population-based survey data, personal-problematic and socioproblematic factors were examined among Japanese in Japan, Japanese-Americans in Hawaii, and Japanese-Americans; Caucasians in California were analyzed as a control group. Caucasian males were more likely to exhibit drinking-related social problems, whereas Japanese males showed more personal-problematic symptoms. Japanese-American men, both in Hawaii and California, were least likely among the three ethnic groups to have personal-problematic symptoms and were more likely to have socioproblematic symptoms than Japanese men. These differences might be explained by differences in the perception of social problems.
Preventive Medicine, 1999
This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NH... more This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Alternative indicators for screening for diabetes mellitus. Type of intervention Screening and secondary prevention. Economic study type Cost-effectiveness analysis. Study population For the effectiveness study the population consisted of males who attended an annual health checkup at a general hospital in Tokyo, Japan. Subjects with a history of diabetes mellitus or gastrectomy were excluded. For the modelled economic evaluation a hypothetical cohort of 1,000 men was used. Setting Hospital. The study was carried out in Tokyo, Japan.
Preventive Medicine, 1999
Background.Obesity in childhood increases the risk of obesity in adulthood. Obesity in adulthood ... more Background.Obesity in childhood increases the risk of obesity in adulthood. Obesity in adulthood is a risk factor for chronic diseases such as hypertension and atherosclerosis. T herefore, it is important to eliminate factors influencing the development of obesity in children from the viewpoint of preventive medicine. T he purpose of this study is to elucidate the relationship between obesity and lifestyle in 3-year-old children in a casecontrol study. Methods.Subjects were selected from the T oyama study at health checkups for 3-yearold children which are done routinely by local governments in Japan on all children of that age.
The Keio Journal of Medicine, 2007
Numerous epidemiologic studies have revealed that smoking is a significant risk factor of many di... more Numerous epidemiologic studies have revealed that smoking is a significant risk factor of many diseases. Some studies reported increase in medical expenditure by smoking using odds or hazard ratios between smoking and diseases in epidemiologic studies. The purpose of the present study is to investigate the ratios of mean medical expenditures between smokers and nonsmokers from studies conducted observing medical expenditure directly in Japan. We collected 11 published articles of studies conducted observing medical expenditures of smokers and nonsmokers directly in Japan. The weighted geometric mean of ratios between age-adjusted mean medical expenditures for smokers and nonsmokers of National Health Insurance and Government-Managed Health Insurance beneficiaries which included many elderly individuals was somewhat greater than 1.0, while the value of Society-Managed Health Insurance that included a small number of elderly people was less than 1.0. Smoking and smokers' indifference to health increase the medical expenditure of the smokers, especially elderly smokers. It was not determined, however, whether the mean medical expenditure of smokers is actually greater than that of nonsmokers.
The Journal of Pediatrics, 1999
disease, gout, arthritis, and some types of cancer. 4,5 Furthermore, previous epidemiologic studi... more disease, gout, arthritis, and some types of cancer. 4,5 Furthermore, previous epidemiologic studies have indicated that obesity in childhood may demonstrate the phenomenon of "tracking," resulting in obesity in adulthood. 6,7 From the viewpoint of preventive medicine, it is important to elucidate