Objective To clarify the effects of nutrient/food intake and lifestyle, especially exercise, on calcaneal bone mass in both male and female high school students.
Methods A total of 798 healthy Japanese high school students (281 boys and 517 girls) were recruited, and their calcaneal bone was assessed by ultrasound using Lunar Achilles. The subjects were thereby divided into a lower bone mass group and a normal bone mass group according to stiffness at the cut-off level of 90 for the boys, and 77 for the girls. Information on lifestyle including frequency of food consumption and regular exercise during the period at junior high school and high school was collected by questionnaire. Nutrient intake was assessed by a semi-quantitative food frequency questionnaire.
Results 1. The intake of total energy and fat in the lower bone mass group was lower than in the normal bone mass group in both sexes.
2. The frequency of subjects not consuming milk in the lower bone mass group was higher than in the normal bone mass group in both sexes. In the boys, the frequency of the subjects who liked to eat green vegetables in the lower bone mass group was lower in the normal bone mass group.
3. The mean stiffness for subjects undertaking exercise during junior high school was higher than in subjects not exercising, even after adjustment for age in both sexes. The frequency of subjects with a habit of sun bathing in the lower bone mass group was significantly lower than in the normal bone mass group in the girls.
4. An analysis using a logistic model was performed to select the factors related to lower bone mass without being confounded with other factors. Lower enegy intake in boys and lower fat intake, no exercise during high school life and no milk consumption in girls were each independently related to lower bone mass.
Conclusion These results suggest that nutrition and exercise habit affect calcaneal bone mass in high school students of both sexes, especially milk consumption being an important factor related to bone mass in girls.

View full abstract

Objective The purpose of the present study was to develop a dispositional version of a stress coping scale (the General Coping Questionnaire, GCQ), especially for university students, and examine its reliability and validity.
Methods In Studies I to IV, 124, 784, 83, 83 university students respectively completed the dispositional version of the GCQ. The questionnaire has four subscales covering emotion expression, emotional support seeking, cognitive reinterpretation, and problem solving, with a five-point Likert format. In Study IV, in addition to the dispositional version of the GCQ, peer rating was also performed to test the validity.
Results In Study I, 32 items were selected as a second version of the scale, reducing from the first version with 54 items. From Studies II to IV, evidence was obtained for the factorial validity, the internal consistency, the test-retest reliability, the construct validity (except cognitive reinterpretation), and the normal distribution of the scores.
Conclusions Standardization of the dispositional version of the GCQ with four subscales was essentially completed, facilitating future studies on coping with stress.

View full abstract

Objective To determine factors affecting self-rated health among the non-institutionalized elderly in Japan.
Methods In 20 municipalities in Japan, 6,094 persons aged 65 years and older who were not institutionalized were selected at random. A questionnaire survey was conducted from September through November 2000. The distribution of self-rated health was rated in terms of dependent variables, with odds ratios and their 95% confidence intervals calculated using unconditional logistic models.
Results Of the study population, 5,565 pesons (91.8%) responded to the survey. Of the respondents, 64.4% answered that they were healthy, while 28.8% were not. The necessity for periodical visit to hospitals and clinics, and lowering of the activity of daily living greatly lowered self-rated health. Compared with those who were 85 years of age or older, a high health status was observed among those aged between 75 and 84 years, but not those aged 65 to 74 years. Those who tried to have exercise periodically, who had a vice-leadership role in a group, who joined social activities, who lived what they considered a worthwhile life, and who had positive positive activities in daily life, had high levels of self-rated halth. Joining social activities for passive reasons elevated the health as well as joining for active reasons such as “because it is fun.”
Conclusion Even if the reason is passive, joining social activities may elevate the self-rated health levels of elderly people.

View full abstract

Purpose To measure the state of health of the elderly population, active and dependent life expectancies were calculated based on the number of people needing nursing care. For this purpose, active life expectancy was defined as the period before nursing care was recognized by insurers as being required. Moreover, to cast light on disorders requiring nursing care, age-adjusted nursing time needed for different ailments per ten thousand elderly population was calculated.
Subjects and Methods Subjects were those 65 years or over living in Taihaku-ku, Sendai City, recognized as needing nursing care by nursing care insurers.
The period before being recognized as needing nursing care was calculated using the Sullivan method, and termed the active life expectancy. Dependent life expectancy=life expectancy−active life expectancy. The number of those needing nursing care caused by each disorder diagnosed by attending physicians, was also age-adjusted by the reference population and multiplied by the nursing time needed for each level of nursing, resulting in the age-adjusted nursing time needed per ten thousand elderly population.
Results Those recognized as needing nursing care were 7.5% (7.7% after age adjustment) of the male elderly population, and 12.5% of the female population (10.7% after age adjustment).
For men, the active life expectancy was 16.1 years for the age of 65, 9.2 years for 75 and 4.4 years for 85, while the dependent one was 2.0-2.1 years for all ages. For women, the active life expectancy was 19.3 years for the age of 65, 11.1 years for 75 and 4.8 years for 85, while the dependent one was 4.6-5.3 years.
The age-adjusted nursing time needed per ten thousand elderly population was 874 hours for men and 1,125 hours for women: of the time 51% was for men with cerebrovascular disease (40% for cerebral infarction), 11% for men with dementia; 37% for women with cerebrovascular disease (26% for cerebral infarction), 20% for women with skeletal diseases, 18% for women with dementia.
Conclusions The active life expectancy for women is longer than for men, by 3.7 years for the age of 65, by 2.3 years for 75 and by 0.5 years for 85. The dependent life expectancy for women is also longer than for men, by 3.2 years for the ages of 65 and 75 and by 2.6 years for 85. Thus, nursing prevention is an urgent issue, especially for women.
The disorders requiring particularly long age-adjusted nursing time are carebrovascular disease (particularly cerebral infarction), dementia and skeletal disorders (particularly among women).

View full abstract

Purposes This study was conducted to examine factors associated with under-utilization of in-home services coverd by the long-term care insurance. Under-utilization was measured in terms of the discrepancy rate between benefits limits and service costs for individuals. Based on the behavioral model, possible predictors were chosen; the level of nursing care as the need factor, living arrangements and income as enabling factors, and family caregiving consciousness as a predisposing factor. Both direct and interaction effects of those factors were examined.
Methods 1,500 people were randomly selected from all people certified as needing long-term care in one ward, Tokyo to be interviewed. People categorized as “requires assistance” or “requires nursing care level 1” were interviewed directly. With people categorized as “level 2” to “level 5”, their primary caregivers were interviewed. Information about in-home service utilization was collected from the insurer.
Results People who were categorized as requiring a lower level of nursing care, lived with others, had a low income, or had high family caregiving consciousness demonstrated significantly greater under-utilization rate as compared with others. An interaction between living arrangements and the level of nursing was observed in this regard. While people who lived alone exhibited low a level of under-utilization rate without regard of the level of nursing care, the rate changed by those who lived with other.
Conclusions Under the new system, informal support might have a significant impact on under-utilization of in-home services. The responsibility for paying 10% of total care costs might be related to under-utilization by people with low income, though reduction of individual co-payments has been introduced for individuals in difficult financial conditions.

View full abstract

Purpose In 2000, a survey of smoking behavior among students of Himeji-Dokkyo University was conducted in order to provide a basis for no smoking movements in the university.
Method Anonymous questionnaires were distributed to students and then gathered it. The analysis examined the relationships among sex and age and the smoking status (smoker, previous smoker, non smoker).
Results Of the smokers, 44.0% started before the age of seventeen years. Non-smokers were more critical of smoking than smokers, with previous smokers occupying an intermediate position. No clear reasons were given for starting smoking although the behaviour of elder students was of importance. Smokers thought that it was desirable to reduce the smoking rate in Japan and that information should be available regarding effects on the body. A small proportion also were in favour of banning cigarette vending machines.
Conclusions Most answer to the question about starting his/her smoking were no positive reason. However, the effect of circumstances is important, because smoking of friends, senior students and family members had a strong influence. It was suggested that many smoking students know smoking is not good for their health, and would like to quit.

View full abstract

Objects A survey of woman's students, who had grown up in a time of change-over of Japanese customs regarding food, was conducted to investigate dietary habits, a focus on actions in response to with set needs, The aim was to obtain to measure prospective health maintenance and promotion.
Methods The authors carried out a questionnaire for woman's students in 6 universities of Kanto area (a junior college and graduate coureses were included) in years 1999 and 2000.
Results In actions regarding the diet, 19.1% of the 815 students responded “I eat everything without fail”, 17.7% “I eat almost everything irrespective of likes and dislikes”, 24.5% “I strive to eat everything”, 19.8% “I leave almost everything I dislike”, and 18.5% “I don't eat what I dislike”.
 The students who resoponded “I leave almost everything I dislike” and “I don't eat what I dislike” had low scores in the questionnaire for dietary and health habits, and they tended to like noodles and popular snacks, and also made frequent use of fast food restaurants.
 There was not a problem with the majority, but about 30% of the students were judged as confirming an unbalanced diet by this questionnaire. It was found that there were “gaps” and “bad habits” in the regular diet. Moreover, we recognized a tendency to prefer convenience and taste to nutritional balance.
Conclusion This simple questionnaire is suitable for rapid identification of unbalanced distary habits, and both “gaps” and “bad habits” in the regular system diet. It is the most important that we induce students who leave or don't eat what they dislike, to strive to eat everything, irrespective of likes and dislikes.

View full abstract

Purpose To assess the utility of an email information exchange system, for subscription by members of a regional medical association, focusing on surveillance of infectious disease.
Methods Questionnaires regarding addition to the mailinglist were first addressed to all 474 members of Yokkaichi regional medical association. After management for about three months, questionnaires focused on utility and application of the system were mailed out.
Result One hundred and seventy-three members (36.5%) responded in the questionnaire survey, then 73 of them (subsequently 75) actually subscribed. Forty-six subscribers (61.3%) responded to the second questionnaire, and 23 of them (56.5%) were in favor of ‘weekly and monthly infectious disease reports transmitted from our research division’, and 22 (47.8%) were in favor of ‘email exchanges of information’.
Conclusion These findings suggest that an electronic information transfer system is a useful medium for regional infectious disease efforts and contributions from primary care physicians.

View full abstract

Objective To ascertain the methods and issues of industrial administration, that have been systematically chosen by the health and welfara administration in the Iwate Prefectural Government, in order to increase public customer satisfaction.
Methods Combined use of TQM and merketing is thought to be the most effective way to increase public customer satisfaction with limited resources. This method secures a quality administrative service capable of corresponding to public needs, by improvement of processes and resources. Therefore we made use of both TQM and marketing.
Results According to a customer satisfaction survey conducted by Iwate Prefectural Goverment in May 2001 (mail survey, sent to 234 people, response rate of 88.9%), public customer satisfaction had increased compared to the previous year in the following areas: provision for the elderly, the declining birthrate, disabled persons and universal design. Also, in a policy evaluation conducted during the same year, 207 services were revised and 30 were temporarily closed, abolished or reduced, 20 were merged, and 23 were expanded.
Conclusions We cannot sufficiently evaluate the effectiveness of the methods yet because they were only just introduced. However, development of the plan and policy evaluation appear to have been quite effective. From now on we will continue to improve our methods, especially to increase the quality of our administrative resources.

View full abstract