Mariko Nishikitani

This cross-sectional study examined lifestyle and behavioral factors associated with information and communications technology (ICT), particularly smartphone, use among older adults in rural and suburban Japan. After excluding respondents with missing key data, the 2021 survey included 783 senior club members (valid response rate, 59%) and 172 Silver Human Resources Center registrants (20%), who completed partly different questionnaires. ICT users (n = 589; mean age 73.4, SD 5.0) were younger than non-users (n = 366; mean age 77.6, SD 5.2), whereas sex, marital status, and living alone were similar. After adjustment for age, sex, marital status, living arrangement, and survey source, ICT users were more likely to recognize the benefits of an information society (OR 2.59, 95% CI 1.86–3.63) and be interested in digital training (OR 3.08, 95% CI 1.91–4.97), while their lower risk aversion remained significant (OR 0.66, 95% CI 0.49–0.89). Among senior club members, ICT users were more dissatisfied with pandemic-related reductions in social interaction (OR 1.89, 95% CI 1.38–2.59) and leisure activities (OR 1.76, 95% CI 1.27–2.42). Among center registrants, ICT use was unrelated to subjective health, psychological burden, or social isolation but was associated with lower loneliness (OR 0.33, 95% CI 0.13–0.86). ICT use among community-dwelling older adults was associated not only with age but also with attitudes toward digital society, willingness to learn, risk orientation, and loneliness. Digital inclusion strategies should address behavioral and psychosocial factors alongside access and technical skills.

This study examined information and communications technology (ICT) usage, particularly smartphone usage, among older adults living in rural and suburban areas in Japan to identify lifestyle and behavioral factors associated with ICT usage. A 2021 survey compared ICT users (mean age 73.4, SD 5.0) and non-users (mean age 77.6, SD 5.2), finding users significantly younger, although both groups were similar in sex ratio (46% females), marriage rate (74%), and percentage of those living alone (12%). Age-adjusted odds ratios revealed that ICT users were more likely to agree with information society benefits (OR 2.59, 95% CI 1.86–3.63) and showed greater interest in digital training sessions (OR 3.08, 95% CI 1.91–4.97). Although status quo bias and risk aversion levels were lower among users in the initial simple analysis, risk aversion remained significant after adjustment (OR 0.66, 95% CI 0.49–0.89). During the COVID-19 pandemic, ICT users were more likely to express dissatisfaction with reduced social interaction opportunities (OR 1.89, 95% CI 1.38–2.59) and leisure activities (OR 1.76, 95% CI 1.27–2.42), whereas differences in employment and medical access remained insignificant. No association was found between ICT use and subjective health, psychological burden, or social isolation. However, loneliness was significantly lower among ICT users (OR = 0.33, 95% CI 0.13–0.86). Overall, a younger age, approval of a digital society, interest in ICT learning, and lower risk aversion may promote ICT use among retired older adults, suggesting a socially active and adaptive mindset.

This study estimated the incidence of extraintestinal pathogenic Escherichia coli (E. coli; ExPEC) infections at Kyushu University Hospital from 2013-2018, analyzing 63,041 hospitalized and 178,690 outpatients aged ≥20 years. ExPEC infections were defined as E. coli detection in sterile specimens or urine specimens (≥103 CFU/mL) with increased SOFA scores or urological infection diagnosis codes. The incidence rate was substantially higher in hospitalized patients (1,209.3 per 100,000 person-years) compared to outpatients (94.5 per 100,000 person-years), with females showing slightly higher rates in both groups. Age was a significant risk factor, with incidence rates increasing markedly in patients ≥60 years (inpatients: 1,431.6; outpatients: 125.3 per 100,000 person-years). Importantly, the study revealed that relying solely on diagnostic names underestimated the true number of ExPEC infection cases. The precision rate, defined as the proportion of cases (n=61) with both E. coli isolated and clinically inflammatory symptoms who received an infectious disease diagnosis (n=46), was at most 75% in female outpatients. It is suggested that comprehensive microbiological data combined with clinical criteria provides more accurate surveillance. These findings establish baseline incidence rates for ExPEC infections in a Japanese hospital setting and highlight the clinical significance of these infections, particularly in elderly hospitalized patients.

Objectives: This study aimed to assess differences in health condition, effort–reward imbalance (ERI), and quality of working life (QWL) between medical professionals (MPs) in the Philippines and Japan. Methods: After adjustment using propensity score matching, 86 MPs in the Philippines and 598 MPs in Japan were included in the main analysis, which assessed health condition (General Health Questionnaire [GHQ‐30], subjective health, and sleep), ERI, and QWL. ERI was evaluated on the basis of the perceived effort required for work and the reward received, whereas QWL focused on stress in working environment. Results: MPs in the Philippines had poorer subjective health (23.5% vs. 12.9%, p < 0.01) compared with their Japanese counterparts. MPs in the Philippines significantly had poorer subjective health (23.5% vs. 12.9%, p < 0.01), higher proportion of ERI due to higher effort (12.9% vs. 5.0%, p < 0.01) and higher QWL scores compared with those in Japan. This trend was particularly prevalent among doctors in the Philippines. Gender‐based disparities in domestic burden were observed among Japanese MPs (female; 4.0 ± 2.1 h vs. male; 2.7 ± 1.8 h, p < 0.01), which was potentially linked to worse working life balance and health status in female. Conclusions: Our results indicated that MPs in the Philippines experienced stronger work‐related stress compared with those in Japan. Despite Japanese MPs exhibiting lower proportion of ERI, gender‐based disparities in domestic burden were found, potentially suggested to an imbalance of working life balance and health status between female and male MPs in Japan.

九州北部の5つの大学病院で働く対人業務のある医療専門職を対象に，2020年に労働災害や医療事故の発生状況を調査し，リスク要因を探索的に評価した．4職種（看護師1,305人，医師481人，放射線技師90人，薬剤師51人）を抽出し，過去1年間の労働災害および医療事故の発生とヒヤリ・ハット経験の回答に基づき職種別に高リスク群と低リスク群に分け，精神健康調査GHQ，主観的健康感，努力–報酬不均衡モデルで示される職業性ストレス，仕事や生活の時間的要因を比較し評価した．調査結果では，全職種で職業性ストレスと労災・医療事故リスクとの有意な関連が示された．薬剤師を除く高リスク群には精神健康の問題も見られた．看護師と医師の高リスク群は，低リスク群に比べ労働時間が長く，夜勤回数も多かった．睡眠不十分と家事時間はリスクとの関連を示さなかった．職業性ストレスは病院間の違いや性，年齢等の交絡因子を調整したマルチレベル混合効果ロジスティック回帰分析でも，全職種で労災・医療事故リスクと有意な関連を示した．この結果から，医療専門職の職場でのストレスを軽減することが，労災・医療事故リスクの低減につながる可能性があると示唆された．

Background: Ensuring an appropriate continuum of care in maternal, newborn, and child health, as well as providing nutrition care, is challenging in remote areas. To make care accessible for mothers and infants, we developed a telehealth care system called Portable Health Clinic for Maternal, Newborn, and Child Health. Objective: Our study will examine the telehealth care system’s effectiveness in improving women’s and infants’ care uptake and detecting their health problems. Methods: A quasi-experimental study will be conducted in rural Bangladesh. Villages will be allocated to the intervention and control areas. Pregnant women (≥16 gestational weeks) will participate together with their infants and will be followed up 1 year after delivery or birth. The intervention will include regular health checkups via the Portable Health Clinic telehealth care system, which is equipped with a series of sensors and an information system that can triage participants’ health levels based on the results of their checkups. Women and infants will receive care 4 times during the antenatal period, thrice during the postnatal period, and twice during the motherhood and childhood periods. The outcomes will be participants’ health checkup coverage, gestational and neonatal complication rates, complementary feeding rates, and health-seeking behaviors. We will use a multilevel logistic regression and a generalized estimating equation to evaluate the intervention’s effectiveness. Results: Recruitment began in June 2020. As of June 2022, we have consented 295 mothers in the study. Data collection is expected to conclude in June 2024. Conclusions: Our new trial will show the effectiveness and extent of using a telehealth care system to ensure an appropriate continuum of care in maternal, newborn, and child health (from the antenatal period to the motherhood and childhood periods) and improve women’s and infants’ health status. Trial Registration: ISRCTN Registry ISRCTN44966621; https://www.isrctn.com/ISRCTN44966621

Background: The number of single-living workers separated from their spouses and families has been increasing due to the need to create a balance between life and work. Workers are assigned everywhere in globalized workplaces while also caring for their family members in the context of Japan's aging society. At the same time, the mental and health status of persons living separately from their families is a matter of concern. The development of interpersonal communication means using information and communications technology (ICT) tools and the internet is remarkable, enabling simultaneous 2-way communication across distances and national borders. The easy accessibility to simultaneous communication is expected to improve the psychosocial status of isolated family members. Objective: This study aims to clarify the health benefits of ICT by using a psychosocial health assessment, the characteristics of ICT tools, and the frequency of communication among the workers and their families who live separately. Methods: This was a cross-sectional study planned and conducted in Japan. Study participants, including adults who live separately from other family members or have separately living family members due to work, were recruited to answer a web response survey about ICT usage status, health status, and life and society evaluation. This study recruited 73 participants divided into 2 groups by their communication tools and frequencies, and their separated life, health, and psychosocial status were statistically compared. Results: Among the 73 study participants, 15 were categorized in the high communication-skilled (HCS) group that used both types of ICT tools to communicate frequently: "live," such as video chat and voice call, and "nonlive," such as SMS text message service and email. A simple comparison between the HCS and reference groups showed significant differences in the cohesion with the neighborhood (P=.03), perceived social position (P=.01), and happiness (P<.001); however, there were no significant differences in the health (psychological distress, P=.08; self-rated health, P=.07), lifestyle (drinking, P>.99; current smoking, P=.37), and dyadic trust in family members living separately (P=.80). Further, in a multivariate regression analysis adjusted for confounding factors, such as educational history, age, gender, and job status, poor subjective health showed a prevalence odds ratio of less than 1 (OR 0.17, 95% CI 0.03-1.02). The HCS group showed significant positive relationships in the cohesion score with the neighborhood (P=.01; beta=2.40, 95% CI 0.56-4.24), perceived social position (P=.03; beta=1.17, 95% CI 0.11-2.23), and happiness score (P=.002; beta=1.46, 95% CI 0.58-2.34) in the same multivariate regression models. Conclusions: This study suggested that people who frequently communicate with separated family members by taking advantage of various ICT tools can maintain a better mental state and better social relations among those who live alone and are separated from their families.

Precarious employment can negatively affect health, but workers may be healthy if they earn enough income. This study uses equivalent disposable income and examines the interaction between income classes and employment types to clarify whether workers’ health improves as the income classes rise. In Japan, nonstandard workers, called nonregular employees, have remained high since 2013. Therefore, using data from the national cross-sectional Comprehensive Survey of Living Conditions 2013, an official survey performed in Japan, we targeted a sample of employees aged 18 to 45 who graduated during the economic recession. Our final sample included 8282 employees (4444 males and 3838 females). The health (general and mental) status indicators used the dichotomized self-rated health and scores of the K6 questionnaires scored in the national survey. The association between income and health was almost proportional. Female workers tended to improve their health as their income class increased; however, this tendency was not observed in male workers, especially nonregular employees. Although the associations were weakened by added income information on the regression models, nonregular employees always showed inferior health to regular employees. The health status of nonregular employees, especially female nonregular employees, is statistically significantly lower than that of regular employees, even when the economic class is similar. In conclusion, improving low incomes for nonregular employees could improve health challenges, but income alone may not result in the same health status for regular and nonregular employees.

BACKGROUND The number of single-living workers separated from their spouses and families has been increasing due to the need to create a balance between life and work. Workers are assigned everywhere in globalized workplaces while also caring for their family members in the context of Japan’s aging society. At the same time, the mental and health status of persons living separately from their families is a matter of concern. The development of interpersonal communication means using information and communications technology (ICT) tools and the Internet is remarkable, enabling simultaneous two-way communication across distances and national borders. The easy accessibility to simultaneous communication is expected to improve the psychosocial status of isolated family members. OBJECTIVE This study aimed to clarify the health benefits of ICT by assessing a psychosocial health assessment, the characteristics of ICT tools, and the frequency of communication among the workers and their families who live separately. METHODS This was a cross-sectional study planned and conducted in Japan. Study participants, adults who live separately from other family members or have separately living family members due to work, were recruited to answer a web response system questionnaire about ICT usage status, health status, and life and society evaluation. This study recruited 73 participants divided into two groups by their communication tools and frequencies, and their separated life, health, and psychosocial status were statistically compared. RESULTS Among 73 study participants, 15 were categorized in the high communication skilled (HCS) group that used both types of ICT tools of “live,” such as video chat and voice call, and “non-live,” such as short message service and e-mail, to communicate frequently. A simple comparison between the HCS and reference groups showed significant differences in the cohesion with the neighborhood, perceived social position, and happiness but no significant differences in the health, lifestyle, and dyadic trust in family members living separately. However, in a multivariate regression analysis adjusted for confounding factors, such as educational history, age, gender, and job status, poor subjective health showed a prevalence odds ratio (POR) of <1 [0.17, 95% confidence interval (95% CI) = 0.03–1.02]. The HCS group showed significant positive relationships in the cohesion score with the neighborhood (β = 2.40, 95% CI = 0.56–4.24), perceived social position (β = 1.17, 95% CI = 0.11–2.23), and happiness score (β = 1.46, 95% CI = 0.58–2.34) in the same multivariate regression models. CONCLUSIONS This study suggested that people who frequently communicate with separated family members by taking advantage of various ICT tools can maintain a better mental state and better social relations among those who live alone and are separated from their families. CLINICALTRIAL