Objective This study was conducted to examine whether an educational videotape might change peoples' attitudes toward participating in future cohort studies by a prospective randomized controlled trial.
Methods The participants were recruited from the residents of Kamogawa-city (139 at a health promotion festival, 54 from a nursery care study class, 53 from an elderly class, and 9 individuals who had not attended a health checkup for more than 10 years). All participants were randomized into a control group and an intervention group, and were asked to fill out a questionnaire designed to evaluate attitudes toward participating in future cohort studies. Those in the intervention group, however, were also asked to watch a videotape, produced by the authors to explain the objectives, significance, and security policies of a cohort study planned to be conducted in the same city, before completing the questionnaire.
Results In the intervention group, 44% (54/123) showed a positive attitude to future participation, while the figure was only 25% (31/122) in the control group (Cochran-Mantel-Haenszel χ²: P=0.0025).
Conclusion The videotape proved to be a useful tool for informing the general public about the nature of cohort studies and to increasing probable participation.

View full abstract

Objective The purpose of this study was to identify significant factors for loneliness in older adults in Nepal.
Methods The subjects (N=195) were members of the Newar caste/ethnicity, aged 60 years and above (mean(±SD) 68.81(±7.69) years and 52% male) and living in Katmandu City. Data were collected by face-to-face interview using a three-item loneliness scale, developed based on the University of California at Los Angeles (UCLA) Loneliness Scale and prepared with a translation and back translation technique from English into Nepalese. The data were analyzed using logistic regression analyses.
Results More than two-thirds of Newar elderly experience some type of loneliness. A statistically significant correlation was found between feelings of loneliness and age, sex, household status, total family size, network size, social participation, self-reported health, chronic health problems, working status, instrumental activities of daily living (IADL), and perceived economic satisfaction. Results of logistic regression analyses showed age, network size, and perceived economic satisfaction to be significant factors for loneliness.
Conclusion Loneliness is an important public health issue, predicting low quality of life among older adults. The present results indicate many elderly Nepalese experience some form of loneliness, with age, network size and perceived economic satisfaction as significant factors. However, this result may not be generalized to the greater population of Nepalese older adults and the external validity of the UCLA Loneliness Scale is an important criterion to examine in future research.

View full abstract

Objective The objective of the present study was to examine the utility of QuantiFERON^® TB-2G (QFT) in tuberculosis contact investigations performed by a public health center.
Methods Adachi City Public Health Center, Tokyo, started using QFT in its laboratory service in June, 2005. The results of QFT, as well as tuberculin skin tests (TSTs) performed in tuberculosis contact investigations in the 10 month period since then were here analyzed. QFT was carried out for 67 contacts two months after their last contact with the index case. TST was given simultaneously.
Results Of the total of 67 contacts investigated during the period, 9 were positive for QFT, 5 were doubtful positive, and the remaining 53 were negative. Among 48 subjects tested with TST, 22 had strong reactions with erythema ≧30 mm, out of which 4 were positive for QFT. In addition, there were 5 QFT-positives among the remaining 26 with weak tuberculin reactions. These 9 subjects with positive QFT were indicated for chemoprophylaxis.
Conclusions Adachi City Public Health Center is pioneering the application of new technology for detection of latent tuberculosis infection in contact investigations of the inhabitants. As expected from trial findings, QFT was shown to be a useful tool in a practical setting for the purpose of detecting TB infection, with greater accuracy than with TST, independent of the history of BCG vaccination. This approach can help avoid both over-diagnosis and under-diagnosis.

View full abstract

Background and Objectives Recently, Japanese infant's bedtime has become late and it is reported that this might have a bad influence on infant's growth.
The purpose of the present study was to investigate the actual situation and interrelationships between night waking and other sleep problems in Japanese 4-month -old infant.
Methods The subjects were 194 mothers and infants who participated in health checkups at four months after delivery in Fukuoka City. The questionnaire consisted of 3 components: 1) infant's and mother's sleep practices and sleep problems; 2) coping behavior for infant's sleep; 3) perceptions of child-care and maternal health. Their responses were linked to health checkup's results. The subjects were divided into two groups; Waking Group (n=111) who was wakening one or more times from 0-6 a.m. and Sleeping Group (n=83) who was sleeping throughout the night. The proportion of Waking Group was constituted 57.2% in all infants. Infant's growth, sleep, and sleep problems were compared between two groups.
Results The mean infant's bedtime was 10:28 p.m., and the proportion of infants reported to go to bed at 10 p.m. or later was 69.4%. The proportion of infants with irregular bedtimes was 16.5%. Twenty-eight point six percent of infants had sleep problems like difficulty settling, severe night waking and were suspected to be high risk of sleep disorders.
 Infants in the Waking Group were found to have more numbers of sleep problems than in the Sleeping Group. The proportion with difficulty settling was higher in the Waking Group. Additionally, the proportion with irregular bedtimes was higher in the Waking Group. However, infant's height and weight did not significantly differ between two groups.
Conclusions Late bedtime and high proportion of night waking in 4-month-old infants were found to be characteristic in Fukuoka city. There is a possibility that night waking reflects delayed development of circadian rhythms.

View full abstract

Background In recent years, medical safety has become a great concern to Japanese citizens. Many healthcare programs have been introduced in consequence, and beneficial effects have been repeatedly confirmed. However, hospitals need to make considerable investments for such programs and it is often difficult for healthcare administrators to judge which program should be given priority under budgetary constraints.
Purposes The purposes of this study were to review original articles on economic evaluation of medical safety management, to evaluate their quality levels, and to offer information for judgment by decision makers.
Methods Using criteria including full economic evaluation we searched for original articles in the following electronic databases: MEDLINE; the Cochrane Library; the NHS Economic Evaluation Database 2005; and the Ichushi website. Then, we evaluated the quality of the economic studies found using the check list established by Drummond and others (1997).
Results Five papers met the inclusion criteria. Three covered infection control, one adverse drug events and one blood transfusions.
Conclusion Economic evaluation of medical safety management has not been fully demonstrated. Cost-effectiveness of medical safety management has not been fully elucidated. It is necessary to perform economic studies of medical safety management, evaluate quality, and provide information useful for medical decision making.

View full abstract

Objective The purpose of this study was to examine mental health status and related factors among 1st generation Japanese returnees from China and Chinese spouses living in Japan for ten years or more.
Methods The subjects were 99 individuals (mean age=63.9 years), all 1st generation Japanese returnees and their Chinese spouses, living in the Kanto region of Japan. The subjects completed a questionnaire survey, which included items regarding demographics, state of social activity in Japan, self-care behavior, the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence and physical health. The questionnaire survey also incorporated the General Health Questionnaire 12 (GHQ12). The results of the survey were first analyzed by T- and χ²-tests. Logistic regression analysis was then performed in order to identify factors related to the GHQ12.
Results The participants scored high scores on the GHQ12, with 72.7% showing a potential for mental health problems (GHQ12 more than 3). Major complaints were “cannot do useful things” 74.7%, “don't feel happy” 72.7%, “feeling under psychological strain” 59.6%, “unable to make decisions” 57.6%, “feeling depressed” 56.6%, “feeling worried and cannot sleep” 55.5%. The results of the logistic regression analysis revealed that those with potential mental health problems had a higher language barrier (OR: 5.48, 95%CI: 1.52-19.82), fewer providers of health care information (OR: 5.25, 95%CI: 1.32-20.95), fewer voluntary conversations with young people (OR: 3.51, 95%CI: 1.05-11.74), and lower self-rated health (OR: 15.49, 95%CI: 4.11-58.48).
Conclusions In this study, Japanese returnees and their Chinese spouses were found to have mental health problems, significantly associated with a high language barrier, limited information on health care, few conversations with young people, and low self-rated health. Our findings suggest that this population requires immediate assistance to improve their mental health. Furthermore, comprehensive and culturally sensitive health care programs are necessary.

View full abstract