[Nippon kōshū eisei zasshi] Japanese journal of public health Impact Factor & Information

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Website Nippon Koshu Eisei Zasshi / Japanese Journal of Public Health website
ISSN 0546-1766

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    ABSTRACT: Objectives Responses and receptiveness to messages advocating health promotion are expected to vary according to differences in personal characteristics. To increase communication effectiveness, this study examined the differences in perceptions of the effectiveness of messages among Japanese adults by socioeconomic status and other characteristics.Methods A structured questionnaire survey was administered to residents aged 30-59 randomly selected in two cities (Yamaguchi and Iwakuni) of Yamaguchi prefecture. The questionnaire consisted of items on sociodemographic characteristics including sex, age, marital status, education, and household income; the perceived effectiveness of health messages; and other factors. The subjects were shown different messages on several themes (smoking cessation, cancer screening, weight gain) and asked to select those that they considered most effective. The associations between perception and subjects' sociodemographic characteristics were analyzed.Results A total of 445 subjects responded (response rate, 37.1%). The negative messages (health effects of risk behaviors) were generally perceived as the most effective. Sex, age, marital status, education, and income were significantly associated with the perceived effectiveness of health messages: higher income was significantly associated with secondhand smoke in the case of smoking cessation, lower income was associated with addiction in the case of drinking restraints, lower education and middle income were associated with affection, and lower income was associated with own expense in the case of cancer screening.Conclusion Despite some differences among the health themes, personal characteristics including age, sex, and marital and socioeconomic status were associated with the perceived effectiveness of health messages, and our results suggest that health communication may be made more effective by consideration of the sociodemographic characteristics of target populations and subjects.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 08/2015; 62(7):347-56. DOI:10.11236/jph.62.7_347
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    ABSTRACT: Objectives Here we investigated the characteristics of users of an emergency system that tracks elderly people, known as the "elderly monitoring key ring." The relevance of a spreading policy or strategy and the user characteristics were investigated to develop programs conducted by local governments to manage unidentified elderly people with dementia.Methods A questionnaire was conducted in July 2013 in a district of the Ota Ward in Tokyo. The questionnaire was administered to residents >65 years of age (N=7,608), of which 5,166 (67.9%) responded. Fully completed responses (N=4,475) were analyzed with binomial logistic regression analysis using "monitoring key rings" as the dependent variable and simultaneously inputted sex, age, living arrangement, social isolation, Instrumental Activities of Daily Living (IADL), and complaints of memory loss as independent variables. Interviews were also conducted in August 2014 of the staff members (N=12) of six community comprehensive support centers in the Ota Ward.Results The logistic regression analysis results indicated that women used the monitoring key rings 1.64 times more often than men, late elderly used it 4.39 times more often than early elderly, elderly living alone used it 2.14 times more often than elderly not living alone, non-isolated people used it 1.36 times more often than isolated people, IADL non-independent people used it 1.50 times more often than independent people, and people with complaints of memory loss used it 1.37 times more often than those without such complaints. On the other hand, the results of interviews indicated that elderly people living alone, those with worries, and relatively young and healthy elderly people were targets. The main targets of community comprehensive support centers were elderly individuals living alone and early elderly individuals. The utilization rate of elderly people living alone was high; however, that of early elderly people was low. They recognized that people registered with the system tended to have high anxiety, be relatively young and highly independent, and register after learning about the system from their peers or through neighborhood associations.Conclusion Individuals who were female, late elderly, elderly living alone, non-isolated, IADL non-independent, or had complaints of memory loss were most likely to be registered with the key ring. The circumstance of registration which community comprehensive support centers recognize related to the low utilization rate of elderly people who are isolated. In the future, the system should be introduced to socially isolated as well as relatively young elderly people.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 08/2015; 62(7):357-65. DOI:10.11236/jph.62.7_357
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    ABSTRACT: Objective To create a "Health Promotion Checklist for Residents" to help promote healthy habits among local residents.Methods First, we investigated items for a health promotion checklist in the Health Japan 21 (2(nd) edition) and other references. Next, we conducted a questionnaire survey including these checklist items in August 2012. The study subjects were randomly selected Hatsukaichi city residents aged ≥20 years. Anonymous survey forms explaining this study were mailed to the investigated subjects and recovered in return envelopes. Data were compared by sex and age group.Results We created a checklist comprising a 23-item health promotion evaluation index with established scoring. There were 33 questions regarding health checkups; cancer screenings; dental checkups, blood pressure; glycated hemoglobin or blood glucose; dyslipidemia; body mass index; number of remaining teeth; breakfast, vegetable, fruit, and salt intake; nutrient balance; exercise; smoking; drinking; sleep; stress; and mental state. There were also questions on outings, community involvement, activities to improve health, and community connections. The questions were classified into six categories: health management, physical health, dietary and exercise habits, indulgences, mental health, and social activities. Of the 4,002 distributed survey forms, 1,719 valid responses were returned (recovery rate, 43.0%). The mean score by category was 1.69 (N=1,343) for health management, 6.52 (N=1,444) for physical health, 12.97 (N=1,511) for dietary and exercise habits, and 2.29 (N=1,518) for indulgences, all of which were higher for women, and 5.81 (N=1,469) for mental health, which was higher for men. The health management scores were higher among subjects in their 40s and 50s. The physical health score increased gradually with age from the 70 s and older to the 20 s, whereas the dietary and exercise habits increased gradually from the 20 s to the 70 s and older. The 20 s had high scores for indulgences, while mental health was low for the 20 s and 30 s and gradually increased from the 40 s to the 70 s and older. The social activities score (1.93; N=1,539) tended to be higher in the 40 s and older.Conclusion Here we created and attempted to validate a checklist that promotes healthy habits and found that subjects were able to use it to examine their living habits.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 08/2015; 62(7):338-46. DOI:10.11236/jph.62.7_338
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    ABSTRACT: Objectives After bills to launch the Social Security and Tax Number System were enacted in 2013, health and political officials have considered the Healthcare Number System (the System). However, little is known about doctors' awareness and concerns about the System. This study aimed to measure how many doctors disagree with the System, examine the doctors' characteristics, and analyze the benefits and harms of the System that they identified.Methods A cross-sectional survey was conducted of doctors via the Internet. The participants were selected from a convenience sample of a panel of doctors based on stratified sampling including four groups: working at a hospital and <45 years; working at a hospital and ≥45 years; working at a clinic and <45 years; and working at a clinic and ≥45 years. The main outcome was how many doctors agreed or disagreed with the System. The prevalence was calculated for each group, and their characteristics were examined using multivariable logistic regression analysis. The responses to open-ended questions concerning the Systems' benefits and harms were analyzed using qualitative content analysis.Results There were 562 respondents (68%). By group, 16/143 (11%), 25/138 (18%), 31/132 (23%), and 43/149 (29%) doctors, respectively, thought that the System was unnecessary. The variables that correlated with the main outcome were age (per 5 years; odds ratio [95% confidence interval], 1.14 [1.01-1.29]) and type of medical facility (working at a clinic; 1.99 [1.30-3.08]). The doctors identified that unifying information could decrease administrative duties, facilitate inter-facility collaboration, and prevent inappropriate medical consultations. This could result in decreased healthcare costs and personalized healthcare. However, the doctors also identified that integrating information and dealing with big data could increase information leakage and information management, cause over-monitoring of doctors, and enable the inappropriate use of integrated information. This could result in deteriorating healthcare. Since some information should not be integrated, the System raises ethical considerations about privacy.Conclusion Among the doctors surveyed here, 10-30% thought the System was unnecessary. These respondents tended to be older and work at a clinic. The System could decrease the cost of healthcare and enable personalized healthcare but could also increase information leakage and information management, cause over-monitoring of doctors, and enable the inappropriate use of integrated information. Prior to System introduction, we should facilitate consensus-building about protecting and utilizing personal information as well as consider the related ethical issues, and doctors' characteristics and concerns.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 08/2015; 62(7):325-37. DOI:10.11236/jph.62.7_325
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    ABSTRACT: Objectives This study examined the possibility and necessity for expansion and diffusion of a new employment support facility for older job seekers in metropolitan areas based on health and welfare measures. This longitudinal study assessed questionnaire responses from older job seekers at a new facility established in Ota ward in the Tokyo metropolitan area as a compliment to the conventional system comprised of Hello Work and the Silver Human Resources Center.Methods We offered questionnaires to job seekers at their first facility visit and asked them to return them by mail (baseline survey). Follow-up surveys of the same respondents were conducted after 2, 4, 8, and 12 weeks, with questions about demographics, personal status, social activities, mental health, and job search status. The surveys were administered from January 2013 to March 2014.Results We obtained 128 responses (average respondent age: 63.8 years) from 180 baseline survey questionnaires. The respondents included 82 males and 46 females. The response rates were over 90% for all follow-up surveys. Among respondents, 71.4% had less than a senior high school level of education. The average annual household income was less than 3 million yen and less than 1 million yen for 68.0% and 16.0% of the participants, respectively. The life circumstances were "hard" or "very hard" for 56.3% of respondents. Among respondents, 78.9% indicated that they were seeking employment for economic reasons. Women and those over 65 years of age were more likely to search for jobs for their well-being than men and respondents less than 65 years of age. The majority of respondents indicated that they wanted to make use of their abilities or experience and many hoped to work as garbage collectors, cooks, or apartment caretakers.Conclusion We found that the main objective of older job seekers living at this facility was economic acquisition. Men and those less than 65 years of age were at particular risk for economic distress, poor mental health, and were more likely to be searching for regular employment. A relatively higher proportion of women and respondents over 65 years of age were seeking jobs for their well-being; a need for social relationships that may be more pronounced among women in this study population.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 08/2015; 62(6):281-93. DOI:10.11236/jph.62.6_281
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    ABSTRACT: Objectives In order to promote high-quality healthcare activities, public health professionals such as public health nurses must improve their ability to systematically show health needs based on evidence and to lead decision making of superior officers and facility inhabitants for improved planning. This study developed and investigated its reliability and validity of an action scale to show the necessity of healthcare activities (SNH).Methods The items in the SNH were originally selected based on previous studies and refined by researchers; they were subsequently adjusted after a pilot survey. The subjects were full-time public health nurses (PHNs) working at prefectural public health centers or randomly chosen municipal health centers. Questionnaires were distributed by mail. We explained the ethical considerations in writing and those who returned completed questionnaire forms were considered to have given their consent to participate in the study. The study plan was approved by the university Domestic Ethics Committee.Results Among 1,615 questionnaire recipients, 1,088 (67.4%) responded; of these, 1,035 (64.1%) responses were valid. Nineteen of 20 items were selected based on results of item analysis, and exploratory and confirmatory factor analyses showed that the SNH consisted of four factors: show existence of health needs, show evidence for the necessity of addressing health needs, show actual conditions requiring solution, and show priority for resolution. Cronbach's alpha, an SNH reliability coefficient, was 0.948, and individual factor scores were over 0.85, supporting the internal consistency of SNH. The correlation coefficient between SNH and the three other scales including related concepts was 0.6-0.8, with significant differences between scales, supporting the criterion-related validity of SNH. The score increased with increasing PHN experience and job seniority, which were used as the known-group, with significant differences between the lowest group and the top two groups.Conclusion The results confirmed that SNH is a reliable and valid scale to show the necessity of healthcare activities.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 08/2015; 62(6):271-80. DOI:10.11236/jph.62.6_271

  • [Nippon kōshū eisei zasshi] Japanese journal of public health 08/2015; 62(6):294-9. DOI:10.11236/jph.62.6_294
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    ABSTRACT: Objectives: "Quitline" is a telephone helpline that advises smokers who are contemplating quitting. Many countries, including East Asian countries, have been conducting nationwide quitline services; however, this has not been conducted in Japan. The aim of this study was to characterize quitline services abroad and review their efficacy in helping smokers quit, in order to determine an appropriate scheme for Japan. Methods: We investigated the present condition of quitline in Australia, New Zealand, Korea, Hong Kong, Singapore, Taiwan, Thailand, the United States, and the United Kingdom, focusing on its modalities. Subsequently, we searched "Medline"and "Cochrane Database of Systematic Review"using free text terms of "hotlines"and "smoking cessation"to review the efficacy of the modalities used by the quitline services. Relevant articles from the reference lists were also identified. Results: In Asia Pacific countries, various tools were used by the quitline services, including a quit booklet, website, mobile phone service, and e-mail. Some of these countries conducted proactive counseling by a quitline counselor. There have been several meta-analyses and randomized-control trials showing the efficacy of individually tailored materials in quitline services. To introduce an effective quitline service in Japan, it is desirable to provide individually tailored materials. In addition, as Japanese smokers can easily access smoking cessation advice in hospitals, health check-up settings, and pharmacies, quitline services should be connected with this infrastructure. Conclusion: To introduce an effective nationwide quitline service in Japan, it is necessary to provide various individually tailored materials that complement the smoking cessation infrastructure.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 07/2015; 62(3):125-32. DOI:10.11236/jph.62.3_125
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    ABSTRACT: Objectives This study investigated 1) the incidence of bicycle-related accidents and subsequent injuries and 2) the number of injuries (accidents) reported to the police (i.e., examining the number of potential accidents) among community-dwelling Japanese older adults, after examining the percentage of those who were regular cyclists. Methods Based on local resident registration, we mailed questionnaires to 7083 community-dwelling older adults. The questionnaire included questions about the incidence of bicycle-related accidents and subsequent injury within a year, the degree of injury and presence or absence of reporting that injury (bicycle-related accident) to the police. For the bicycle-related accident, we asked regarding both riding and pedestrian accidents (i.e., accidents caused by a bicycle when walking). Results Excluding the blank responses (n=3539, 50.0%), the targets for analysis were 3098 older adults in riding accidents and 2861 older adults in pedestrian accidents. The results showed that 63.0% of older adults (n=1953) routinely rode a bicycle. Among them, 9.4% (n=184) experienced riding accidents, and 3.4% (n=98) experienced pedestrian accidents caused by a bicycle. For the riding accidents, 76.1% (n=140) had some injuries, and for the pedestrian accidents, 55.1% (n=54) had some injuries. Furthermore, in 70.2% (n=59) and 76.9% (n=20) of riding and pedestrian accidents, respectively, those who went to the hospital for treatment of their injury (i.e., injury requiring treatment) did not report the accident to the police. Conclusion The present study revealed that there are many potential bicycle-related accidents in older adults. This suggests that there may be a large gap in the national survey data between reported bicycle-related accidents and the actual number of incidents in older adults.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 07/2015; 62(5):251-8. DOI:10.11236/jph.62.5_251
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    ABSTRACT: Objectives: An outbreak of autochthonous dengue fever was reported in August 2014, with cases suspected mainly from Yoyogi Park in Tokyo. This is the first epidemic of dengue fever in Japan since 1945. Methods: From August to October 2014, the following measures were taken to control the outbreak: 1) risk communication and information sharing; 2) active case finding; 3) vector surveillance in affected sites; and 4) laboratory testing. We also reviewed the surveillance data as reported to the National Epidemiological Surveillance of Infectious Diseases during the 44 epidemiological weeks. results: An official dengue fever call center was set up temporarily for the general public and 3,005 calls were received. The Tokyo Metropolitan Government issued 39 press releases regarding patients and nine related to dengue virus (DENV) detection and vector control activities for the media. Confirmed autochthonous dengue fever cases were reported between the 35th and 44th epidemiological weeks. Out of 160 cases of outbreak, 108 (67.5%) confirmed cases were reported in Tokyo. The estimated illness onset dates were between August 9 and October 7, and estimated dates of infections were between August 3 and October 3, 2014. The data suggest that the infective mosquitoes had already been present in Yoyogi Park at the end of July 2014. During the weekly vector surveillance at Yoyogi Park, a total of 1,152 adult mosquitoes, of which 856 (73.3%) were Aedes mosquitoes, were collected over 11 weeks by a light trap with dry ice. DENV was detected from adult Aedes mosquito samples collected on the 2nd, 9th, and 16th of September, 2014. Serum samples from 240 suspected cases were examined at the Tokyo Metropolitan Institute of Public Health, and 78 were positive for the DENV NS1 antigen, DENV-specific IgM antibody, or DENV nucleic acid with reverse transcriptase polymerase chain reaction (RT-PCR) (NS1: 66 cases; IgM: 50 cases; PCR: 57 cases). Genetic analysis of DENV-positive serum and mosquito samples found all to be categorized as DENV-serotype 1 (gene type I). Phylogenetic analysis of the envelope protein genome sequence from patients and mosquitoes in Tokyo revealed more than 99% similarity with each other and with the strain from the first outbreak-associated patient in Saitama. Conclusion: Measures important for control of infectious disease epidemic were learned during this recent indigenous dengue outbreak in Tokyo. It also highlighted the importance of preparedness for epidemics of indigenous or imported infectious diseases, especially in light of the fact that Tokyo is in preparation for the Olympic and Paralympic Games in 2020.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 06/2015; 62(5):238-50. DOI:10.11236/jph.62.5_238
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    ABSTRACT: Objectives The amount of research relating to evaluation of intervention programs with regard to sense of coherence, a concept of salutogenic stressor coping capacity, is increasing in Japan. However, a nationally representative score of the Japanese version of the sense of coherence scale has not yet been reported. The aim of this study was to describe the 13-item, 7-point Japanese sense of coherence scale (SOC-13), with scoring by sex and age group, and to examine the relationships between the score and locality and city size. Methods Four thousand Japanese men and women were selected by stratified random sampling, and a cross-sectional, self-administered questionnaire survey was conducted using the placement method. Responses were obtained from 2,067 individuals (response rate: 51.7%). This study analyzed 956 men and 1,107 women (mean age [standard deviation]: 50.0 [14.3]). Results The mean score on the SOC-13 was 59.0 (12.2) in all participants, 59.1 (11.8) in men, and 58.9 (12.5) in women. No significant difference was found between men and women (P=0.784). ANOVA and multiple comparison for age difference showed a clear relationship (P<0.05) between higher age and a higher SOC-13 score. Moreover, the results of main and interaction effects in ANCOVA, with independent variables for locality (11 segments) and city size (four segments), were not significant when controlled for age. Conclusion A nationally representative score for the Japanese SOC-13 was acquired. In future research, application of the SOC-13 in Japan for clinical studies is anticipated based on the nationally representative score.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 06/2015; 62(5):232-7. DOI:10.11236/jph.62.5_232
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    ABSTRACT: Objectives: Self-management is essential for individuals with chronic cervical spinal cord injury, but some cases of self-neglect have been reported. The objective of this study was to examine the establishment of self-management in order to help inform community care practice. Methods: This was a qualitative study applying a grounded theory approach with semi-structured home interviews. We interviewed 29 individuals with cervical spinal cord injuries (aged 26-77 years) who were members of each of the three branches of the nationwide self-help group, or the clients of a home-visit nursing care station. Qualitative analysis was implemented from a time transition perspective consisting of the faint awareness period, the seeking period, and the adaptation period. The analysis included the perceptions and methods of self-management. Results: The process of establishing self-management was abstracted into a core category of "continuous adaptation to minimize the extent to which the individual's life was disrupted and to allow them to continue to live within the community". This in turn consisted of seven categories. In the faint awareness period, subjects perceived that they "hardly recognized health maintenance needs", that they had difficulties in acknowledging the necessity of controlling physical conditions, and that they were dependent on caregivers. In the seeking period, they were "driven by handling uncontrollable changes" and they coped with those changes in their own way and sometimes did not consider it necessary to see a doctor. In this period, a process of "searching for the methods of being healthy somehow" begun and they started to understand the degree to which they could cope without medication, together with their own responsibilities, and searched for the best coping methods and acted on advice. In the adaptation period, individuals were "struggling to continue the established health methods"; "managing stress"; "prioritizing their own beliefs over medical regimens"; and "confidently modifying the established self-management methods". They employed self-monitoring, preventative measures for secondary difficulties, and stress management techniques. However, they also avoided medication through self-determination and they prioritized their established lifestyle over medically ideal behavior. Conclusion: Subjects learned sustainable self-management methods through trial and error, although in each period of adaptation, they sometimes failed to acknowledge the necessity of health maintenance and medical care, and they coped with their health care needs in their own way. Future research is essential to develop self-management programs that include the patient's own perspectives, to teach health maintenance methods that enable patients to balance social participation and self-management, and to establish cooperative networks among professionals who support the patient's home care.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 06/2015; 62(4):190-7. DOI:10.11236/jph.62.4_190
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    ABSTRACT: Objectives: Water mist is usually generated using equipment directly connected to the water tap, as its installation is relatively easy. However, there is no legal regulation regarding the maintenance of this equipment, and the quality of the mist has not been sufficiently well investigated. In this study, we sought to establish methods that allow the hygienic maintenance of this equipment. Methods: We monitored the use of the mist generating equipment in five of the 61 institutions in the jurisdiction of Ichinomiya Health Center, examined the resulting water quality, and tested for Legionella bacteria in the mist. If equipment was found to contain bacteria, the contaminated part was identified by counting the number of bacteria in the water after sequentially washing and disinfecting parts of the equipment. We also identified the predominant bacterial species. Results: In the water mists from three of 5 institutions, the number of bacteria greatly exceeded that permitted for drinking-water, even though the residual chlorine level was >0.1 mg/l. However, no Legionella bacteria were detected. Brevundimonas species were predominant in the water mists at each institute. The hose was found to be the contaminated component in each case. Conclusion: Our findings suggest that the number of bacteria in the water mist exceeded the drinking-water quality standard, even with a residual chlorine level of >0.1 mg/l. This study also revealed the importance of the continued drainage of water, following suitable cleaning and disinfection for maintenance of the mist-generating equipment.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 06/2015; 62(4):182-9. DOI:10.11236/jph.62.4_182
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    ABSTRACT: Objectives: In this study, we aimed to compare the risk-recognition of avian influenza between poultry farmers and the general population. Methods: To obtain health-related data, including the participants' awareness of avian influenza, their recognition of potential infection, and their risk image, or their level of fear and understanding an anonymous self-reported questionnaire was administered. We measured the risk image on a 7-point scale, with 1 representing the lowest and 7 representing the highest risk image. Using their responses from 8 questions (4 per factor), We then calculated and averaged the scores to obtain the fear factor and unknown factor scores. Results: This questionnaire was completed by 310 of 1,000 (31.0%) members of the general population and 198 of 976 (20.3%) poultry farmers. The two groups differed significantly in terms of their overall awareness and understanding of severe acute respiratory syndrome (odds ratio=0.49 P=.003), with the general population scoring significantly lower than the poultry farmers. The risk image scores showed significant differences in fear factor (β=-0.89, P<.001) and unknown factor (β=0.74, P<.001), with the risk image for the fear factor being lower and that of the unknown factor being higher in the general population when compared with the poultry famers. Conclusion: We found there to be a definite gap in the recognition of avian influenza between the two subject groups.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 06/2015; 62(3):117-24. DOI:10.11236/jph.62.3_117
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    ABSTRACT: Objectives: To clarify the proportion of HIV patients who inform their physicians of the actual route of transmission and the factors related to non-disclosure in order to improve conditions to support open disclosure in healthcare settings. Methods: We conducted an anonymous self-completed online questionnaire between September and December 2010 of people with HIV. The data from 237 subjects living in Japan were analyzed. To identify factors causing patients to not be truthful to their physicians, odds ratios and confidence intervals (CIs) were calculated, with "discrepancy between the actual route of HIV transmission and the route reported to the physician' as a dependent variable, and sex, age, residential area, route of transmission, presence or absence of consent to undergo HIV testing, time since being diagnosed as infected with HIV, and favorability of physician responses as independent variables. Results: The proportions of patients who had informed their physicians of actual and false routes of HIV transmission were 75.1% and 17.7%, respectively. Among subjects reporting homosexual contact, 97.5% reported the actual route. On the other hand, among subjects reporting heterosexual contact, only 64.3% reported the actual route while 28.6% actually had homosexual contact. Furthermore, 47.4% of the subjects who reported their routes of HIV transmission as sexual contact, but did not disclose whether the contact had been homosexual or heterosexual, actually had homosexual contact. On comparing subjects who had evaluated responses from their physicians favorably and unfavorably, the proportion of those reporting a false route of transmission was significantly higher in the latter group, with the odds ratio being 2.51 (95% CI: 1.26-5.01). Conclusion: AIDS Surveillance Committee reports of HIV and AIDS cases attributed to a homosexual route of infection may be lower than actual numbers. The most common factor related to non-disclosure was the perception of unfavorable responses from physicians; improvements to support open disclosure are thus needed.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 06/2015; 62(3):106-16. DOI:10.11236/jph.62.3_106
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    ABSTRACT: Objectives: The effects of a comprehensive intervention program for community-dwelling elderly on frailty and dietary habits were examined. Methods: We conducted randomized control trials to examine the efficacy of the intervention. To examine lasting changes, we made paired comparisons between pre- and post- intervention and at a three-month follow-up. The subjects were recruited in Hatoyama town, Saitama prefecture. The program was composed of exercise, nutritional education, and social participation and was held from October to December 2011. The exercise program aimed at fall prevention and took place twice per week for 60 min. The nutritional education aimed at prevention of malnutrition, and the social participation program aimed at prevention of "homeboundness"; both were held once per week for 30 min. Questionnaires inquired about frailty and dietary variety. A blood test was conducted to ascertain nutritional state, and a brief self-administered diet history questionnaire was used to estimate food and nutrient intake. To examine the efficacy of the intervention, 22 control subjects (CR) and 21 subjects in the intervention group (IV) were analyzed with intention to treat. To examine lasting changes, 16 subjects in IV who correctly completed surveys at each of the three time points were analyzed, using repeated ANOVA and a multiple comparison procedure. Results: 1. Men comprised 70-80% of subjects, and the average age was 75.7±5.4 and 74.7±5.4 years in IV and CR, respectively. 2. There was no significant difference in pre- and post-intervention changes between IV and CR in frailty, which was the main outcome of the study. 3. A significant difference in pre- and post-intervention values was noted in ① "homeboundness", one of the components of frailty (median [25-75%tile]): IV 0 [0-0] and CR 0 [0-1] (P=0.023); ② nutrient intake (mean±standard deviation [SD], energy ratio [%E]): protein, IV 2.3±0.7 and CR -0.3±2.0 (P=0.002); animal protein, IV 2.4±1.5 and CR -0.5±1.5 (P=0.002); and ③ food intake (mean±SD, g/1000 kcal): fish, IV 18.1±25.1 and CR -4.1±21.9 (P=0.004); egg, IV 5.0±11.2 and CR -2.1±11.3 (P=0.046). All variables improved in IV. 4. Lasting improvement was observed in "homeboundness" and protein intake [%E]. Conclusion: Although the intervention did not improve frailty, it may improve frailty and dietary habits by improving homeboundness and increasing protein intake.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 06/2015; 62(4):169-81. DOI:10.11236/jph.62.4_169
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    ABSTRACT: Objectives: Interventions that promote physical activity to prevent psychological distress and disuse syndromes were carried out in disaster-stricken areas. However, the effect of these interventions to promote physical activity in disaster-stricken areas has not yet been fully clarified. The purpose of this study was to examine the health effects of promoting physical activity in a disaster-stricken area. Methods: We conducted an exercise intervention as part of a health survey project among residents of Ishinomaki-city, Miyagi, Japan in 2012. To determine if changes in health condition differed between intervention participants and nonparticipants, health condition data from 81 participants were compared with data from 81 nonparticipants selected by propensity score matching. Factors including sex, age, original address (pre-quake), and six outcome variables (psychological distress [K6 score], subjective health status, sleep duration, sleep quality, frequency of outings, and time spent walking) were used for matching. A linear mixed model was used for statistical analysis. Results: There were no significant differences in K6 score between participants and nonparticipants (P=0.913). Significant improvements were observed in subjective health status (P=0.011) and outing frequency (P=0.002), but not in other outcome variables. Conclusion: Subjective health status and outing frequency were significantly improved among participants of the exercise intervention. Exercise intervention may be an effective public health strategy in disaster-stricken areas.
    [Nippon kōshū eisei zasshi] Japanese journal of public health 04/2015; 62(2):66-72. DOI:10.11236/jph.62.2_66