Objectives The 2004 Niigata-Chuetsu earthquake of Japan caused a great deal of damage, and people living in the affected region are still struggling to reconstruct their lives. The aim of this study was to determine factors associated with psychological distress in people living in a town at the epicenter 3 years after the earthquake. Methods We conducted a cross-sectional study from June 2007 to January 2008. Participants included 225 individuals living in Kawaguchi (age C20 years) who reported psychological symptoms. Information on family structure, employment status, alcohol use, social network, and extent of house damage was elicited by public health nurses conducting structured interviews. Levels of psychological distress were assessed with the Kessler Psychological Distress Scale (K10), with a K10 score C25 defined as psychological distress. Results The mean age of participants was 66.1 ± 12.9 years. The prevalence of psychological distress varied among different employment classes, being 5/73 (6.8%) for participants with paid employment, 12/50 (24.0%) for fulltime housewives, and 11/101 (10.9%) for those who were unemployed (v 2 = 8.42, P = 0.015). It also varied between participants who had lost contact with people in the community and those who had no change in social contact [9/20 (45.0%) vs. 19/189 (10.1%), respectively; v 2 = 19.04, P \ 0.001]. Multiple logistic regression analysis showed that age [odds ratio (OR) 0.95, 95% confidence interval (CI) 0.91-0.98], poor or loss of contact with people in the community (OR 6.97, 95% CI 1.85-26.2), and lack of employment (full-time housewives or unemployed individuals) (OR 6.74, 95% CI 1.62-28.0) were associated with psychological distress. Conclusions People who lose their social network are at a very high risk for post-earthquake psychological distress and require appropriate care.

CRP is a significant predictor of osteoporotic fracture in elderly Asian women who have substantially lower CRP levels than Caucasians. Mechanisms explaining such an association should be further studied.

The Niigata-Chuetsu earthquake significantly increased long-term mortality from AMI in both men and women. Clinicians and policymakers in public health must recognise the need for long-term prevention of AMI in earthquake disaster areas.

Sufficient vitamin D status, i.e., serum 25(OH)D ≥ 71 nmol/L, is associated with low limb and vertebral fracture risk in community-dwelling elderly women.

Objective Clarifying the characteristics of attention-deficit/ hyperactivity disorder (ADHD) symptoms in childhood is important for the prevention and management of this disorder. The purpose of this study was to determine the prevalence of ADHD symptoms in Japanese preschool children based on evaluations performed by parents or teachers. Methods A questionnaire survey was performed to evaluate the estimated prevalence of ADHD symptoms in preschool children in Niigata City, Japan. The first survey, conducted in 2003, involved an evaluation of ADHD symptoms by their school teachers. The second survey, conducted in 2006, involved an evaluation of the symptoms by parents. The teacher survey included 9,956 children, and the parent survey included 7,566 children. Parents and teachers assessed ADHD symptoms in children using a 14-item questionnaire based on DSM-III-R. Children with a score of 8 or higher were classified as having ADHD symptoms. Results The overall prevalence of ADHD symptoms was 2,349/7,566 (31.1%) in the parent survey and 431/9,956 (4.3%) in the teacher survey, with a prevalence ratio of 7.2 (95% CI: 6.5-7.9). Likelihood ratio test indicated that variables significantly associated with the presence of ADHD symptoms were gender, age, school type, interaction between gender and observer, and interaction between school type and observer (each with P \ 0.0001). ConclusionsThe large difference between the estimated prevalence of ADHD symptoms in Japanese preschool children from teacher and parent surveys suggests that compared to teachers, parents consider their children's symptoms much more serious. Thus, parental evaluation of ADHD symptoms using DSM criteria may be inappropriate for ADHD screening.

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Current standard-dose calcium supplements (eg, 1000 mg/d) may increase the risk for cardiovascular events. Effectiveness of lower-dose supplements in preventing bone loss should thus be considered. This study aimed to assess whether calcium supplements of 500 or 250 mg/d effectively prevent bone loss in perimenopausal and postmenopausal Japanese women. We recruited 450 Japanese women between 50 and 75 years of age. They were randomly assigned to receive 500 mg of calcium (as calcium carbonate), 250 mg of calcium, or placebo daily. Medical examinations conducted three times over a 2-year follow-up period assessed bone mineral density (BMD) of the lumbar spine and femoral neck. One-factor repeated measures ANOVA was used for statistical tests. Subgroup analyses were also conducted. Average total daily calcium intake at baseline for the 418 subjects who underwent follow-up examinations was 493 mg/d. Intention-to-treat analysis showed less dramatic decreases in spinal BMD for the 500-mg/d calcium supplement group compared to the placebo group (1.2% difference over 2 years, p ¼ 0.027). Per-protocol analysis (!80% compliance) revealed that spinal BMD for the 500-mg/d and 250-mg/d calcium supplement groups decreased less than the placebo group (1.6%, p ¼ 0.010 and 1.0%, p ¼ 0.078, respectively), and that femoral neck BMD for the 500-mg/d calcium supplement group decreased less relative to the placebo group (1.0%, p ¼ 0.077). A low-dose calcium supplement of 500 mg/d can effectively slow lumbar spine bone loss in perimenopausal and postmenopausal women with habitually low calcium intake, but its effect on the femoral neck is less certain. Calcium supplementation dosage should thus be reassessed. (Clinical Trials Registry number: UMIN000001176). ß

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