Aim: Polypharmacy in elderly people is a social issue and has been reported to cause not only drug adverse events, but also falls, dysfunction and cognitive decline. Those events may trigger prolonged length of hospitalization. Therefore, the aim of this study was to investigate whether polypharmacy has a prolonging effect on hospitalization. Methods: The study subjects were 584 patients in a university hospital in Japan who had been admitted for hepatectomy, pancreaticoduodenectomy, gastrectomy or colectomy, and to whom clinical pathways had been applied. In this study, polypharmacy was defined as taking five or more regular oral medications, and prolonged hospitalization was defined as hospitalization longer than that determined by the clinical pathway. Multiple logistic regression analysis was performed to investigate whether polypharmacy affects the length of hospitalization. Results: The subjects were 348 males and 236 females, mean ± SD age of 65.8 ± 12.9 years. Among all subjects, 228 (39.0%) were receiving polypharmacy at admission, and the number of patients with prolonged hospitalization was 262 (44.9%). Multiple logistic regression analysis revealed that the following variables were significantly associated with prolonged hospitalization; polypharmacy (odds ratio = 1.532; 95% confidence interval = 1.010-2.327), age 50-59; 2.971 (1.216-7.7758), age 60-69; 2.405 (1.059-5.909), organ pancreas; 0.298 (0.122-0.708), operation time ≥386 min; 2.050 (1.233-3.432), intraoperative bleeding volume ≥401 mL; 2.440 (1.489-4.038), postoperative delirium; 2.395 (1.240-4.734), postoperative infection; 10.715 (4.270-33.059). Conclusion: The current study revealed that polypharmacy at admission was an independent factor for prolonged hospitalization. In future, measures against polypharmacy are required, collaborating with outpatient clinics, family doctors and dispensing pharmacies.
ObjectivesNon-restorative sleep (NRS) is related to qualitative aspects of sleep. The associations of NRS with exercise (EX; a planned and purposeful activity) and physical activity (PA; daily bodily movement) by gender and age have not yet been clarified. We investigated the associations of EX and/or PA with NRS by gender and age.DesignA cross-sectional study.SettingThe data on gender, age, presence of NRS and engagement in EX and/or PA were obtained from database and questionnaire of specified medical check-ups in FY 2013 in Japan. The analysis was conducted in 2017.ParticipantsThe subjects comprised 90 122 residents (38 603 males and 51 519 females), aged 40–74 years, who had completed the specified medical check-ups.Outcome measureThe presence of NRS was assessed using a question asking whether or not the subjects usually got enough sleep. NRS was considered to be present when the subjects answered ‘No’. Binary logistic regression analysis was used to assess the associations of presence or absence of EX and/or PA with NRS. The OR and 95% CI of NRS prevalence were calculated and compared between those engaged in both EX and PA and the others.ResultsExcept for 40s and 70s among males and 40s and 50s among females, the absence of EX or PA was associated with higher ORs of NRS than referent. ORs were more than twice compared with the referents in males in their 50s (OR 2.030(95% CI 1.675 to 2.459)) and 60s (OR 2.148(95% CI 1.970 to 2.343)) and females in their 60s (OR 2.142(95% CI 1.994 to 2.302)) when they engaged in neither EX nor PA.ConclusionsHealthcare providers must take into account the similarities and differences in the associations of EX and/or PA with NRS by gender and age when they support people with NRS.
An operation leader (OL) of radioactivity decontamination workers is required by law to have accurate knowledge of occupational health management (OHM) such as working environment management, control of operations, and health management as a field supervisor in Japan. The purpose of the current study is to examine the association between anxiety over radiation exposure and the possession/acquisition of the OHM knowledge required for OLs. In this cross-sectional study, data were collected before and after training sessions held by Fukushima Prefecture Labor Standard Associations in Fukushima, Japan, in 2017. Eighty-seven males who completed the questionnaires were enrolled to this study. As a result, acquisition of knowledge of working environment management was significantly associated with an increase of anxiety over radiation exposure after the session comparing the situation before and after the session (knowledge possession; odds ratio = 4.489; 95% confidence interval = 1.216, 16.571). In conclusion, acquisition of accurate knowledge of how to manage working environment management was associated with anxiety over radiation exposure. Although acquisition of said knowledge may contribute to the reduction of physical health risks, it may increase mental health risks. Both mental health support for OLs with accurate knowledge and educational support for those without accurate knowledge are required.
ObjectivesAn operations leader (OL) takes an important role in occupational health management for radiation decontamination workers in Japan, and candidates for the position must participate in a training session to acquire the necessary knowledge as required by law. However, it has not been clarified whether the candidates for the OL position actually possess accurate knowledge regarding occupational health management for such work after the training session. We, therefore, aimed at examining the current occupational health management knowledge among the candidates and investigating factors related to the knowledge, with hypothesis that possession of accurate knowledge is associated with prior experience of having worked in radiation decontamination.DesignA cross-sectional study.SettingThe training sessions held by Fukushima Prefecture Labor Standard Associations in Fukushima, Japan, in 2017.ParticipantsEighty male candidates participated in the training sessions.OutcomeThe number/proportion of correct answers to the questions regarding occupational health management, such as those on working environment management, control of operations and health management.ResultsThe proportion of those who possessed accurate knowledge regarding working environment management, control of operations and health management was 68.8%, 55.0% and 51.2%, respectively. Experience of radiation decontamination work was associated with the possession of inaccurate knowledge regarding working environment management (OR 0.140 (95% CI 0.042 to 0.464)), and the uncertainty of future radiation decontamination work schedules in difficult-to-return zones was associated with the possession of accurate knowledge regarding health management (OR 4.344 (95% CI 1.509 to 12.50)).ConclusionsPrevious experience in radiation decontamination work may hinder the ability to acquire accurate information regarding working environment management among candidates for an OL position. To promote adequate occupational health management for radiation decontamination workers, it is required to establish an effective instructional method for the OL candidate training sessions with consideration of previous relevant experience.
ObjectivesPre-emptive conversations (PCs) about end-of-life (EOL) preferences are beneficial for both elderly people and their families to understand and share the preferences. However, the factors which promote/inhibit PCs have yet to be clarified. We therefore aimed to determine the factors related to having PCs with hypothesis that age, subjective economic status and subjective health status are associated with having PC experience.DesignA cross-sectional study administering a questionnaire and using stratified random sampling by gender and region.SettingResidents aged 65 years or older who were not receiving nursing care as of 1 November 2016, were extracted from the Japanese long-term care insurance system registry in Koriyama City, Fukushima Prefecture, Japan.Participants1575 participants (717 males and 858 females).OutcomePresence or absence of PC experience with family or friends (yes/no).ResultsThe mean age of the participants was 74.0 years. A multivariable logistic-regression analysis revealed that having PC experience was significantly associated with gender (OR=1.907; 95% CI=1.556 to 2.337; p<0.001), subjective economic status (OR=0.832; 95% CI=0.716 to 0.966; p=0.016) and subjective happiness (OR=0.926; 95% CI=0.880 to 0.973; p=0.003).ConclusionsPoor subjective economic status of elderly people may result in the absence of EOL conversation experience with their families and friends, hindering the elderly from sharing and understanding the EOL preferences. To promote PCs about EOL, gerontology and public health professionals should give special consideration to the subjective economic status of elderly people.
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