Abstract

Background

The purpose of this study was to develop a cervical cancer education program for students and evaluate the process for female students of an HPE teacher education university who were training to become Japanese Health and Physical Education teachers.

Methods

This study used Action Research (AR) methodology. In developing program, we analyzed the description of the teaching material development process, the lectures, and the students’ report contents, which was the main activity in the program development. Thirty five third- and fourth-year students majoring in health promotion at a Health and Physical Education teacher education university, which trains Health and Physical Education teachers in Tokyo, Japan, participated in this study.

Results

After a review of the prototype version of the cervical cancer education material, six out of nine reviewers determined that it can be published. In the revised cervical cancer education materials, messages from students, university lecturers, and gynecologists have been added as a column in the section on 'how to prevent cervical cancer. Analysis of the contents of the texts (16,792 characters in total) of 35 student reports resulted in the generation of 51 codes, 3 categories, and 15 subcategories.

Conclusions

This study reflects the intentions of female university students to contribute their knowledge to the development of educational materials on cervical cancer, which, alongside the lectures, have deepened the knowledge and awareness of cervical cancer. Based on this, the teaching material development process, lectures by experts, and students’ mindset after learning about cervical cancer is reported in this study. There is a need for more educational programs on cervical cancer that are implemented through the education of female university students.

This paper explores the cause-and-effect relationships among a set of health indices using causal discovery. The data we used to analyze was obtained from wearable devices, Traditional Chinese Medicine (TCM) diagnosis, and self-assessment of subjects in an experiment. Firstly, three machine learning algorithms were employed to address the issue of excessive missing values in the integrated dataset, and the coherence of this improved data was validated by statistical test. The NOTEARS algorithm was then employed to assess the causal relationships within the overall population as well as within subgroups based on gender, physical activity levels, and sleep duration. The results demonstrated that the NOTEARS algorithm yielded interesting and plausible outcomes, suggesting the presence of causal connections between variables of wearable devices and TCM diagnosis, as well as daily lifestyle habits.

Alzheimer's disease (AD), an incurable disease, poses a major health problem. It is important to identify patients with mild cognitive impairment (MCI) and early AD. Clock rendering test (CDT) is an effect way to screen AD patients quickly in the community. However, the current CDT methods require specific equipment to collect features, and the existing prediction models are inefficient in early warning of MCI. To solve the problem, this paper replaces digital pen with fingertip interaction, and proposes an early warning model for AD early dCDT images based on ResNet50. The dCDT tests were carried out on normal cognitive elderly, MCI patients and mild AD patients, and the results were used to verify the analysis and classification ability of the ResNet50-based early AD prediction model, in contrast to the clock score-based early AD prediction model. The comparison shows that the ResNet50-based early AD prediction model is efficient in early warning than the other model, and is suitable for large-scale screening of AD patients in the community, in the absence of doctors.

Background: In the post–COVID-19 pandemic era, many countries have launched apps to trace contacts of COVID-19 infections. Each contact-tracing app (CTA) faces a variety of issues owing to different national policies or technologies for tracing contacts. Objective: In this study, we aimed to investigate all the CTAs used to trace contacts in various countries worldwide, including the technology used by each CTA, the availability of knowledge about the CTA from official websites, the interoperability of CTAs in various countries, and the infection detection rates and policies of the specific country that launched the CTA, and to summarize the current problems of the apps based on the information collected. Methods: We investigated CTAs launched in all countries through Google, Google Scholar, and PubMed. We experimented with all apps that could be installed and compiled information about apps that could not be installed or used by consulting official websites and previous literature. We compared the information collected by us on CTAs with relevant previous literature to understand and analyze the data. Results: After screening 166 COVID-19 apps developed in 197 countries worldwide, we selected 98 (59%) apps from 95 (48.2%) countries, of which 63 (66.3%) apps were usable. The methods of contact tracing are divided into 3 main categories: Bluetooth, geolocation, and QR codes. At the technical level, CTAs face 3 major problems. First, the distance and time for Bluetooth- and geolocation-based CTAs to record contact are generally set to 2 meters and 15 minutes; however, this distance should be lengthened, and the time should be shortened for more infectious variants. Second, Bluetooth- or geolocation-based CTAs also face the problem of lack of accuracy. For example, individuals in 2 adjacent vehicles during traffic jams may be at a distance of ≤2 meters to make the CTA trace contact, but the 2 users may actually be separated by car doors, which could prevent transmission and infection. In addition, we investigated infection detection rates in 33 countries, 16 (48.5%) of which had significantly low infection detection rates, wherein CTAs could have lacked effectiveness in reducing virus propagation. Regarding policy, CTAs in most countries can only be used in their own countries and lack interoperability among other countries. In addition, 7 countries have already discontinued CTAs, but we believe that it was too early to discontinue them. Regarding user acceptance, 28.6% (28/98) of CTAs had no official source of information that could reduce user acceptance. Conclusions: We surveyed all CTAs worldwide, identified their technological policy and acceptance issues, and provided solutions for each of the issues we identified. This study aimed to provide useful guidance and suggestions for updating the existing CTAs and the subsequent development of new CTAs.

BACKGROUND<p>Internet content about the Human Papilloma Virus (HPV) vaccine may affect people's decisions to get vaccinated. Therefore, it is important to provide information on all the aspects of the HPV vaccine on YouTube, one of the most popular social media platforms. However, few studies have focused on Japanese videos about these vaccines.</p> OBJECTIVE<p>This study aimed to describe the YouTube content on HPV vaccines by analyzing the related Japanese videos in context of the account characteristics, attitude towards the vaccine, and thumbnail characteristics.</p> METHODS<p>Relevant videos with keywords “HPV vaccine” and “cervical cancer vaccine” uploaded before November 11, 2021 were collected using the YouTube data application programming interface. The videos were accessed using unique IDs after being independently coded by two different coders. Differences in the coding results were resolved by discussion. The main outcome measures included channel information and classification, attitude towards HPV vaccine, description of reimbursement, designation of the vaccine, and the thumbnail details.</p> RESULTS<p>As of November 11, 2021, positive and negative attitude videos regarding HPV vaccines accounted for approximately 44% of the Japanese YouTube videos. In the year 2013, an increase in negative videos was observed, while from 2019 onwards, majority of the videos uploaded had positive attitudes towards the vaccine. Videos with negative tones generally used the terminology "cervical cancer vaccines ". Majority of the negative videos were uploaded by individual accounts, whereas all the videos uploaded by medical workers were positive or neutral. Only four videos mentioned side-effect compensation. The most frequently used thumbnails were the photographs of people who appeared in the videos.</p> CONCLUSIONS<p>This study summarizes the characteristics of Japanese YouTube videos about the HPV vaccine. Compared to the English version, there are fewer anti-vaccine videos in Japan, but there is also a lack of videos uploaded by credible authorities.</p>

本研究は、原発事故による県外避難者の生活やメンタルヘルスにおける課題を明らかにすることを目的とした。対象者は原発事故で首都圏に避難中の4,905世帯とした。調査期間は2017年10月～2018年1月であった。回収できた362部(回収率7.4%)を集計の対象とした。調査の結果、気分・不安障害調査票(K6)得点13点以上の割合は20.2%であった。17点以上の割合は10.8%であった。ロジスティック回帰分析の結果、経済的困難「なし」群に対し、「あり」群における心理的苦痛の調整済みオッズ比は3.906と有意な正の関連を示した。自由記述の分析では、経済的な悩み・不安、仕事に関する悩み・不安、加齢に対する悩み・不安などの課題が明らかとなった。これらの結果から、個別具体的な支援活動を強化すること、複雑に絡み合う生活課題を解決するワンストップの相談機関の設置を制度化すること、民間支援団体が新たなコミュニティ育成のために行う交流会やイベントへの公的支援を充実させる必要性が示唆された。(著者抄録)

Background and objectives: Infection with human papillomavirus (HPV) is the main cause of cervical cancer, and vaccination is an effective method to prevent HPV infection. In Japan, adverse reactions were reported in some HPV-vaccinated people in March 2013, and while Japan’s Ministry of Health, Labor, and Welfare withdrew active recommendation of the vaccine in June 2013, the social movement to refuse vaccination has continued. The Ministry of Health, Labor, and Welfare (MHLW) has devised a plan to accurately disseminate information that promotes vaccination, but less than 1% of the eligible population was vaccinated, and the number has not increased. Besides, inaccurate information about health information can disseminate rapidly on social networks. Social networking services (SNS), mainly used by young people, can be used by the public to obtain medical information. However, according to the World Health Organization (WHO), SNSs are prone to spreading inauthentic and misleading information when it comes to information related to health and medical care. “Infodemic” is defined as a situation in which unidentified and false information is widely disseminated on SNS, causing WHO to issue international alerts. This study aimed to organize information about HPV vaccination disseminated on SNS in Japan. Methods: We extracted 208 tweets with the keyword “HPV vaccine” posted in Japan between April 1, 2014, and September 30, 2017. The extracted tweets included data points such as ID, language, posting date and time, and latitude and longitude. The location information of the senders was obtained from the latitude and longitude, and the tweets were organized by prefecture, city, town, village, and ID. Then, we evaluated whether the information at the URLs was accurate by examining retweets, likes, and the number of comments on the tweet. Python version 3.7.7 was used to extract the tweets. Results: The results of classification of the tweets by prefecture are as follows: the Hokkaido prefecture accounted for four tweets; the northeast, six tweets; southern Kanto, 123 tweets; northern Kanto-Koshin, six tweets; Hokuriku, five tweets; Tokai, 35 tweets; Kinki, 10 tweets; Chugoku 4 tweets; Shikoku, three tweets; and Kyushu, nine tweets. A total of 93 users posted tweets; four users posted five or more tweets; 14 users posted 2–4 tweets, and 75 users posted one tweet. In particular, 66 tweets in Kanagawa prefecture, 14 tweets in Shizuoka prefecture, and two tweets in Tokyo were posted from the same ID. Regarding the type of tweet, there were 109 tweets, 65 retweets, and 34 replies. There were 137 tweets with and 71 tweets without URLs. When organized by the linked URL, 50 posts linked to a blog, 46 posts linked to a news item, seven posts linked to Facebook, five posts linked to a government agency homepage, four posts linked to YouTube, three posts linked to the home page of the City Council rep, two posts linked to a medical site, and 20 posts linked to other sources that could not be categorized. In terms of the authenticity of the posts, 25 tweets were judged as “accurate,” 14 were judged to be “inaccurate,” and 16 were judged as “unknown.” We classified the posts as follows; “accurate” for those that contained accurate information and “inaccurate” for those that contained inaccurate information. Discussion: The distribution of tweets and the uneven distribution of the users suggest that few people spread information about the HPV Vaccine on Twitter in Japan. Regarding the content, more than half of the tweets could not be judged as accurate or inaccurate because the verification results regarding adverse reactions of the HPV vaccine were not published at the time of sending, and in news and blog articles, personal opinions were stated rather than authentic medical information. In this study, we clarified the characteristics of tweets regarding HPV vaccination in Japan and the status of transmission. In the future, it will be necessary to change the keywords and time periods for which tweets need to be extracted, and the data set used for the analysis will need to be compared and examined.

© 2019 Elsevier GmbH Introduction: The utilization of information and communications technology (ICT) devices is a new way to record and analyze health data of the elderly. This time-series study aimed to analyze health changes, and the correlation between pulse manifestation and health indicators, in the elderly. Methods: We conducted continuous 93-day monitoring of health data and pulse records in 8 elderly participants. A time series method was used to analyze health changes in participants. The correlation between pulse manifestation and health indicators was analyzed using a structural equation model. Results: During the use of ICT devices, the number of steps taken by the elderly showed a significant increase (p < 0.05). According to the time series prediction formula, the number of steps predicted on day 94 was 8869.8. In practice, steps on day 94 were 8267.3; the difference between these values was within 10%. Personal health information, health habits, and physiological indicators had a direct impact on pulse manifestation; influence coefficients were 0.14, 0.18, and 0.05 respectively. Conclusion: Through the use of ICT devices, we can understand the health status of the elderly and make behavior predictions. Pulse manifestation data can indicate the health status of the elderly. Thus, ICT devices can be used as health management tools and assist doctors in making simple diagnoses.

© 2019 The Author(s). Following publication of the original article [1], the author reported that the funding information was missing from the original article. The funding information is as follows: This study was supported by the National Natural Science Foundation of China (No.71603068). The project is online and offline health management service path of middle-aged and young people's hypertension in community:a research based on process reengineering.

© 2019, Springer Nature Switzerland AG. Pulse diagnosis is a typical diagnosis of Traditional Chinese Medicine (TCM). However, it is not clear if there is any relationship between the result of pulse diagnosis and other health related data. In this study, we investigate this and analyze pulse diagnosis data from a TCM doctor and a pulse diagnostic instrument (PDI) by Random Forest. Subjects’ vital signs and pulse diagnosis data from a TCM doctor are used as training data. We classify vital signs which have the PDI’s diagnoses labels. As a result, classification accuracies were over 60% in all cases. Our experiment results imply that better pulse diagnosis may be made with assistance of personal health data analysis.

© 2018 IEEE. This study used wearable devices and traditional Chinese medicine (TCM) diagnosis, which verifies the promotion of wearable devices on the health habits of the elderly, and the correlation between pulse diagnosis and health. We used wearable devices and TCM diagnosis (including TCM doctor diagnosis and Pulse diagnosis instrument) to record health information for the elderly. One-way repeated measures analysis of variance (ANOVA) was used to determine health changes. Correlation analysis was used to determine the relationship between pulse and health indicators. There was significant change in the number of steps for the elderly before and after using the wearable device. Systolic blood pressure (SBP) was negatively correlated with pulse wave time. Diastolic blood pressure (DBP) was negatively correlated with pulse duration. Pulse diagnosis can be used as an indicator to report the health of the elderly. And used wearable devices can quantify health indicators and improve the health awareness.

高齢者の居住・食事形態とQOLの関連を明らかにすることを目的に、所沢市在住の65歳以上の高齢者1556名(男性712名、女性838名、不明6名)へWHO-QOL26を用いた質問紙調査を行った。その結果、孤食群(310名)は共食群(1060名)よりも、WHO-QOL26の「身体的領域」「環境領域」および全体QOLの得点が有意に低かった。また、居住形態が同居で、かつ食事形態が孤食の群(72名)では、QOLがとくに低いことが分かった。

© 2018 The Author(s). Background: In China, demands for disease prevention and health care and the prevalence of chronic non-communicable diseases have increased. TCM and general hospitals are increasingly utilizing TCM strategies for chronic non-communicable disease care and prevention. This study aimed to investigate health care professionals' (HCPs') perceptions of TCM for prevention, their TCM knowledge, and their abilities to provide such services in TCM and general hospitals. Methods: This cross-sectional study investigated Chinese medicine hospitals and Chinese medicine departments in general hospitals in five Chinese cities. A self-designed questionnaire used to study 400 HCPs focused on basic demographic data, the demand for and effects of TCM for prevention and treatment, and their perceptions of such service implementation. The data analysis included chi-squared tests and descriptive and multi-factor analyses. Results: The 335 HCP respondents comprised 230 (68.7%) females and 105 (31.3%) males, 75.5% of whom overall had knowledge of TCM preventive and health care services. Respondents older than 40 years (28.6%) had greater knowledge of and satisfaction with TCM for preventive and health care services than younger respondents. Moreover, 97.7% of the older respondents were clearly willing to provide TCM preventive services for chronic diseases, 67.8% of whom indicated that their hospitals already provided TCM for prevention and treatment. According to the chi-squared test results, the TCM service characteristics in hospitals, hospital outlooks regarding TCM and TCM development in hospitals were the primary factors affecting the respondents' perceptions of TCM for chronic disease care and prevention. The multivariate analysis showed high satisfaction as significantly associated with older providers and those with lengthier work experience, particularly among those who worked in hospitals that provided typical TCM services and had positive attitudes towards TCM. Conclusion: The study HCPs had relatively satisfactory knowledge of and positive attitudes towards TCM for chronic disease care and prevention and would use it in practice. Their perceptions and satisfaction levels correlated closely with the successful application of TCM for preventive care and treatment in hospitals. While the use of TCM for prevention and treatment was well developed in some hospitals, further improvements are warranted.

In this study, we use wearable devices to monitor the health and physiological indicators of the elderly, and analyze the effects of the elderly's walking steps and sleep as the measurable health and physiological indexes. Eighteen cases of the elderly who received health management services are selected. We establish the generalized linear mixed model, and Pearson correlation analysis result shows statistically significant for the number of walking steps and systolic blood pressure/diastolic blood pressure. The number of walking steps is positively correlated with the systolic/diastolic pressure. The more walking steps and the better the sleep quality, the more stable the daily blood pressure is. Therefore, it is possible to effectively control the elderly's blood pressure by exercising and managing sleeping. It can be better for the elderly to have self-esteem health managed by using wearable devices, and encourage the elderly to exercise at a certain extent.

The aim of this study is to investigate the associations between social capital and antenatal depression among Chinese primiparas. A cross-sectional design was used and a questionnaire survey was conducted with 1471 participants using the intercept method at the provincial hospital in Zhejiang in 2016. Antenatal depression was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) and social capital was assessed by the Chinese version of Social Capital Assessment Questionnaire (C-SCAQ). The prevalence of antenatal depression was assessed among Chinese primiparas in their third trimesters. The antenatal depression prevalence among subgroups with lower social trust (ST), social reciprocity (SR), social network (SN), and social participation (SP) were significantly higher than those among higher score sub-groups. In the fully adjusted model, primiparas' antenatal depression was significantly associated with ST, SR, SN, and SP. Compared to the structural social capital, the cognitive social capital was a more crucial dimension to the prevalence of antenatal depression. For future community pregnancy health care management programs in China, it might be beneficial to add more social capital related intervention.

災害復興におけるソーシャル・キャピタルの役割が注目されている。ソーシャル・キャピタルとは「社会関係資本」と訳され、他者への信頼感、助け合いの意識、ネットワーク、社会参加などで評価される人間関係の強さを表す概念である。先行研究において、災害発生時、ソーシャル・キャピタルの豊かな地域ではPTSDやうつといった精神疾患の発症リスクが低いとの報告も行われている。本研究では福島第一原子力発電所事故からの避難者を対象にソーシャル・キャピタルとメンタルヘルスの関連について調査を行った。その結果、高齢者を対象とした調査、子育て中の母親を対象とした調査のいずれも、個人レベルのソーシャル・キャピタルが豊かなほどメンタルヘルスが悪化しにくいことが明らかとなった。今後、ソーシャル・キャピタル醸成の視点を取り入れた災害復興政策を行っていくことが重要であると考えられた。(著者抄録)

Maternal malnutrition during pregnancy can lead to a small for gestational age (SGA) status among infants. In the present study, we compared the lipid levels during the second trimester in women who delivered SGA infants at term with those in women who delivered appropriate for gestational age infants at term, to examine whether abnormalities in maternal lipid levels could be a risk factor for the delivery of an SGA infant. We enrolled pregnant women who gave birth at the National Center for Child Health and Development (NCCHD), their infants, and who volunteered in a Birth cohort study at the NCCHD. We analyzed a total of 843 blood samples obtained from the women during the second trimester. Moreover, we used multi-regression analysis to assess the relationship between low-density lipoprotein cholesterol (LDL-C) levels during the second trimester and the risk of delivering an SGA infant. The adjusted odds ratio (OR) for LDL-C levels was 0.99 (95% CI, 0.98-0.99). These results indicate that a low LDL-C level during the second trimester was associated with an increased risk of delivering an SGA infant at term. The finding would not only help predict future SGA infant birth, but can also help prevent SGA infant birth.

【目的】「自殺」、「就職活動」をキーワードに含む新聞記事を対象に大学生の就職活動に関連した自殺の新聞報道の内容を分析し、その特徴を明らかにすることを目的とした。【対象・方法】新聞社データベース(朝日新聞:聞蔵II、読売新聞:ヨミダス歴史館)を使用し、「自殺」、「就職活動」、「大学生」をキーワードとして含む記事とした。抽出した記事についてデータベースを作成し、記事件数、文字数、写真の有無、相談窓口に関する記載の有無等について時系列分析を行った。【結果・考察】研究の結果、大学生の就職活動に関連した自殺の新聞報道において、自殺を扇情的に報道しない、自殺要因を単純化して報道しない等と定めた世界保健機関のガイドラインや朝日新聞社社内指針中に抵触する記事が見受けられた。今後、大学生の就職活動に関連した自殺の新聞報道を行う場合、自殺抑止に貢献する記事を掲載した上で扇情的でない報道が必要と考えられる。(著者抄録)

本研究は、原発事故によって福島県から東京都・埼玉県に避難されている高齢者の個人レベルのソーシャル・キャピタル(以下、SC)とメンタルヘルスの関連を明らかにすることを目的とした。調査は2014年3、4月に実施し、3,599世帯を対象に自記式質問紙調査を行った。回収できた772世帯分(回収率21.5%)の中から、65〜85歳までの高齢者229名分を分析の対象とした。多重ロジスティックモデルにより、個人レベルのSCとストレスとの関連について分析したところ、性、年齢、経済状況、持病の有無、転居回数を調整しても、近隣住民への信頼・助け合いの意識などの認知的指標や近隣であいさつを交わす人数、趣味・娯楽活動への参加頻度といった構造的指標が低い群ほど、高いストレス状態にあることが統計学的に有意に認められた。したがって、豊かなSCを醸成することによりメンタルヘルスを向上させる支援が今後重要になると考えられる。(著者抄録)

東日本大震災に伴う福島第一原子力発電所事故により、2016年3月現在でも避難指定区域外の多くの住民が自主的に避難を続けている。自主避難者の中でも特に、子育て中の母親は経済的な負担や放射線被曝への心配に加え、子育て負担の増加や家族関係の変化、避難先での人間関係の希薄化等よるメンタルヘルスの悪化が指摘されている。本研究では、子どもを持ち自主的に避難を続ける20歳から49歳までの母親241名を対象とし、家族関係及びソーシャル・キャピタルとメンタルヘルスとの関連について明らかにすることを目的とした。同居家族の有無と母親の抑うつ状態(CES-D:26点以上)との関連について多重ロジスティックモデルによる分析を行ったところ、母子のみで生活する母親は家族と同居する母親に比べ2.502倍(95%CI:1.125-5.563)抑うつが疑われる状態にあることが明らかになった。また、近隣住民への信頼感が高い母親に比べ、低い母親は5.434倍(95%CI:1.384-21.339)、地域活動への参加頻度が高い母親に比べて、低い母親は3.244倍(95%CI:1.083-9.718)抑うつが疑われる状態にあることが明らかになった。今後、特に母子のみで避難する母親の支援においては、子育てサークル等の地域で行われるインフォーマルな組織への参加を通して、他者への信頼感や地域活動への参加度を高め、ソーシャル・キャピタルを醸成していくことが重要であると考えられる。(著者抄録)

<p>本研究は, 原発事故によって福島県から東京都・埼玉県に避難されている高齢者の個人レベルのソーシャル・キャピタル (以下, SC) とメンタルヘルスの関連を明らかにすることを目的とした. 調査は2014年3, 4月に実施し, 3,599世帯を対象に自記式質問紙調査を行った. 回収できた772世帯分 (回収率21.5%) の中から, 65～85歳までの高齢者229名分を分析の対象とした. 多重ロジスティックモデルにより, 個人レベルのSCとストレスとの関連について分析したところ, 性, 年齢, 経済状況, 持病の有無, 転居回数を調整しても, 近隣住民への信頼・助け合いの意識などの認知的指標や近隣であいさつを交わす人数, 趣味・娯楽活動への参加頻度といった構造的指標が低い群ほど, 高いストレス状態にあることが統計学的に有意に認められた. したがって, 豊かなSCを醸成することによりメンタルヘルスを向上させる支援が今後重要になると考えられる.</p>

本研究は、東日本大震災から1年経過した時期および2年経過した時期に、埼玉県内または東京都において避難生活を送る福島県民の世帯に対して行ったアンケート調査の結果である。2011年に発生した東日本大震災は、原子力発電所事故を伴ったことによって、全国に県外避難者を生み出したことが、これまでの自然災害と決定的に異なる特徴である。震災から1年後の2012年調査の結果からは、男性において生活費の心配や失業がストレス反応に影響していることが示され、女性において住宅の被災状況や人間関係、原発に対する賠償問題などがストレス反応に影響していることが示された。一方、2013年調査の結果からは、男女ともに苦しい経済状況、健康状態の悪化、避難者というスティグマ、家族関係や近隣関係、住環境などがストレス反応に影響していることが示され、年月の経過とともに、ストレスが、震災の直接的影響よりも避難生活に起因するものになってきていることが明らかとなった。(著者抄録)

本研究は、東日本大震災に伴って発生した福島原子力発電所事故の2年後に、福島県内の仮設住宅において避難生活を送る住民の心的外傷後ストレス症状と、そのストレスに影響を与える身体・心理・社会的要因を明らかにしたものである。2,425世帯に対して無記名で任意回答のアンケート用紙を配布し、745名(回答率30.7%)の回答を得た。欠損値を除く661名の解析を行ったところ、IES-Rの平均値が34.20±20.56であり、PTSDの可能性に対する高いリスクを示すカットオフ値24/25を超えた者が62.56%であった。PTSDの可能性との関連を多重ロジスティック回帰分析で検討した結果、「経済的困難」(OR:2.34、95%CI:1.30〜4.24)、「賠償の心配」(OR:4.16、95%CI 1.26〜13.76)、「持病の悪化」(OR:2.94、95%CI:1.63〜5.30)、「新疾患の罹患」(OR:2.20、95%CI:1.21〜3.99)、「相談者の不在」(OR:1.92、95%CI:1.07〜3.42)が有意な予測因子として認められた。これまでに世界各地で報告されてきた他の災害と比較しても、原発事故被災者にきわめて高い外傷後ストレス症状が認められた理由として、事故に対する補償や賠償といった問題など、本災害の人為災害としての要素が重要であると考えられた。(著者抄録)

本研究は,農山村で行なわれる農作業が大学生の身体活動量・気分に及ぼす影響について検討した。2013年5月と10月の農作業に参加した大学生4名を対象とし,3軸加速度センサー使用身体活動量計(アクティマーカー,EW4800-KR,パナソニック製)を用い,各農作業の歩数と身体活動強度(METs)および身体活動量(Ex)を計測した。また,農作業前後の気分をPOMS短縮版により測定した。その結果,5月の農作業の身体活動量は,歩数が最小11,386歩,最高25,341歩,3〜4METs未満の身体活動量が最小5.0Ex,最高16.9Exであった。4METs以上では,最小0.5Ex,最高9.0Exであった。10月の農作業の身体活動量は,歩数が最小4,975歩,最高21,965歩,3〜4METs未満の身体活動量が最小5.0Ex,最高17.0Exであった。4METs以上では,最小0.8Ex,最高5.2Exであった。気分の変化については,農作業後に「活気」が上がり,「緊張」,「抑うつ」等のネガティブ尺度が下がる傾向がみられた。今後は,症例数を増やしての分析や作業内容の違いによる影響を検討する必要がある。(著者抄録)

The world has become an aging society with exponentially increasing social security benefit expenditure and nursing care costs. To help solve these issues and challenges, utilization of advanced ICT is highly expected to allow more elderly people to remain independent for their proactive social participation irrespective of age. In this study, we propose a human-centric safe and secure framework of ubiquitous living environments (Ubi-Liven) for the elderly people towards seamless integration of the cyber-enabled ubiquitous holistic living support system with a physical living environment. We further address and discuss the design and technical issues for the implementation of a smart living environment on the fly under the proposed framework, empowered by ubiquitous assistive technologies such as cloud, IoT and big data analytics based on life logs to provide holistic support for the elderly's activities of daily living and healthcare.

今回の調査によってカザフのナウルズおよびコジェに見る文化的特徴と歴史的変容について以下のことが明らかになった。(1) 独立後, ナウルズはカザフ国内最大級の祝祭であり, 民族の伝統的なイベントとして現在に受け継がれている。誰でも祭りに参加することができるよう, 広場では無料でコジェが配られていたり, さまざまな民族の音楽やダンスが披露されていたりした。その他, 中央アジアの伝統料理であるシャシリクやバウルサックを売る店も見られ, 食や伝統芸能を通してカザフ人の世代間交流や, 異なる民族同士の交流が図られていた。(2) ナウルズが近づくと各家庭でコジェ作りが行われ, 家族・親戚・友人の往来が始まる。コジェに入れる具材は地域の特産によって少々異なるが, 7つ (以上) の食材を入れることと, 白色の食材を入れ全体の色を整えることはすべての家庭で共通していた。コジェに使われる食材はカザフの食卓には欠かせない馬肉や, 穀物類が中心でカザフの日常生活をよく表すものであった。コジェを白色の食材で整える理由は, 白が家畜の乳の色であり, 新年を迎えるにあたって一家の繁栄や幸福を願うからであった。(3) インタビュー対象者の出身地域によってナウルズを公に祝いコジェ作りも行っていた家庭, 家の中だけでコジェを作り祝っていた家庭, 全く祝わず, コジェも作らなかった家庭の3つに分けられた。ソ連との地理的・心理的距離や政治的影響力, カザフ人の人口密度が影響している可能性が指摘された。独立後, 伝統を復興させるために都市部でナウルズを教える, コジェを無料で配るなどの活動も行われ, 現在のナウルズの基盤となった。 調査の中で, 都心部と農村部でのナウルズの祝い方やコジェに加えられる材料が異なることがたびたび指摘された。そのため, 今後農村部を含めたカザフ国内全体の調査が必要である。また, より詳細で信頼性のある調査にしていくために調査員を増やし, インタビューを継続することが必要である。カザフ社会の時代の流れに呼応する文化の変容を見守りつつ, 調査で得られたデータをもとに, カザフの伝統的な祝祭と食文化についてさらに深く体系的に明らかにしていきたい。

Background. Although age-adjusted mortality from gastric cancer has been decreasing in Japan, the crude incidence of gastric cancer shows a slight increase. Methods. We have observed trends in the incidence of gastric cancer by sex and 20-year age groups over the past two decades (1976-1996). Source data were obtained from the cancer statistics materials provided by the Research Group for Population-Based Cancer Registration in Japan. Simultaneously, we observed changes in the prevalence of Helicobacter pylori infection and in serological atrophy of the gastric mucosa, and compared the results with those involving changes hi the incidence of gastric cancer. Results. A slight decline was observed in all age groups over 40 years old, in both men and women, between 1986 and 1996. However, a marked decline in incidence was observed for those aged 20-39 years. The prevalence of H. pylori infection declined in both sexes between 1989 and 1998. The frequency of serological atrophy of the gastric mucosa significantly declined in all age groups between 1989 and 1996, with young age groups experiencing a more marked decrease. Conclusion. The marked decline in gastric cancer incidence observed in the young population will also begin to occur in the elderly population in the future.

Background. There are still insufficient data on the frequency of seroconversion and seroreversion of Helicobacter pylori antibodies. The frequency of serochange and related factors were investigated in this study over 9 years. Subjects and methods. Using sera from 3104 workers who underwent health checks in 1989 and again in 1998, II. pylori antibodies were measured. Those with intermediate serology were excluded from the study. Information on past history was collected using a questionnaire. Results. Of the 912 seronegative and 1286 seropositive subjects in 1989, seroconversion was observed in 57 and seroreversion in 91 subjects. Seroconversion and seroreversion rates over the 9-year period were 6.3% and 7.1%, respectively, giving rates per 1000 person-years (with 95% confidence interval) of 7.0 (5.2-8.7) and 7.9 (6.3-9.4), respectively. Subjects that reported abdominal symptoms or gastric fiberscope use showed significantly higher seroconversion rates than controls (8.7 vs. 4.5 and 9.2 vs. 1.6, respectively), which remained significant after adjustment for age and gender. Those with a history of duodenal ulcers, a smoking habit or a drinking habit showed significantly lower seroreversion rates than controls (3.5 vs. 8.9, 5.4 vs. 9.2 and 5.9 vs. 13.3, respectively). After adjustment, the association between seroreversion and smoking habit disappeared, while the associations with history of duodenal ulcers and drinking habit remained. Conclusions. Those with a history of nonspecific abdominal symptoms and those with a history of gastric fiberscope use showed higher seroconversion rates. Alcohol consumption and duodenal ulcers may inhibit the autoeradication of H. pylori, possibly through increased acid secretion.

Helicobacter pylori infection is thought to be a causal risk factor for gastric carcinoma. Recently, diagnostic accuracy of serological kits for H. pylori infection that were made in Western countries has been reported to be lower when used among Oriental populations. Diagnostic accuracy of two serological kits [HMI-CAP and HM-CAP with antigens extracted from clinically isolated Japanese H. pylori strains (J-HM-CAP)] was investigated in 440 samples from a Japanese patient population by using the C-13-urea breath test as gold standard. According to the original optimal cut-off value, HIM-CAP provided 87.5 % sensitivity and 84.8 % specificity with 86.8 % accuracy and J-HM-CAP provided 95.5 % sensitivity and 81.9 % specificity with 92.3 % accuracy. This study suggests that antigens from HM-CAP are satisfactory for examining a Japanese patient population, but that using local antigens improves accuracy.

The Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study) included in its self-administered questionnaires some single-item questions concerning physical activity. We examined the validity of the questions among 1,730 Japanese adults and the reliability of the questions among 1,075 Japanese adults. The validity of the sports and physical exercise questions was estimated by comparing the self-administered questionnaire responses with the time spent on the activity and the energy expenditure index for the previous 12-month period, elicited by the interviewing method used in the Japan Lifestyle Monitoring Study with a minor modification. The Spearman's rank correlation coefficients ranged from 0.43 to 0.60, showing moderate correlations. On the other hand, test-retest reliability was estimated by comparing the responses from two separate surveys conducted roughly one year apart. Weighted kappa coefficients of sports and physical exercise questions, classified according to sex and age, ranged from 0.39 to 0.56, showing moderate reliability
and those of a question about walking ranged from 0.25 to 0.39, showing fair reliability. We suggest that measuring physical activity level with these single-item questions may be appropriate for establishing baseline data that reflects long-term physical activity in a large-scale cohort study targeting lifestyle-related diseases. validity, reliability, physical activity, single-item question, lifestyle-related disease.

Background: Helicobacter pylori is a major cause of various gastroduodenal diseases. Some risk factors related to H. pylori infection have been reported; however, studies on the relationship between H. pylori infection and smoking or drinking habits have given conflicting results. In the present study, these relationships were investigated by collecting sera and information from 8837 subjects.
Methods: Serum H. pylori immunoglobulin G antibody was measured by an enzyme-linked immunoassay. In addition to sex and age, information on smoking and drinking habits was collected by questionnaire. Age- and sex-adjusted odds ratios (95% confidence interval) of smoking and alcohol consumption were calculated for H. pylori seropositivity using logistic regression models.
Results: Current smokers had a 0.82 (0.74-0.91)-fold greater risk of H. pylori seropositivity than those who had never smoked. Current cigarette consumption showed a dose-dependently negative association with H. pylori seropositivity, and the association between smoking and H. pylori infection was strong in younger subjects. Current drinkers had a 0.88 (0.79-0.98)-fold greater risk of H. pylori seropositivity than those who had never drunk alcohol. The volume of alcohol consumed showed a negative association with H. pylori seropositivity.
Conclusions: In the current study, smoking was negatively associated with H. pylori infection. The risk of H. pylori seropositivity decreased linearly with cigarette consumption per day. Increased gastric acidity in the stomach through smoking may be a cause of the dose-dependently negative association between H. pylori and smoking. Drinking was negatively and dose-dependently associated with H. pylori positivity, although the effect of drinking was weaker than that of smoking. (C) 2000 Blackwell Science Asia Pty Ltd.

Although there are many reports of the high diagnostic accuracy of commercially available serologic kits for Helicobacter pylori infection in Western countries, they rarely has been investigated in oriental population. Accordingly we examined their usefulness in 492 Japanese patients with dyspeptic symptoms. Diagnostic accuracy of 4 imported serologic kits (HEL-p TESTTM, HM CAP(TM), G.A.P IgG(TM), Helico G2(TM)) was investigated using the C-13-urea breath test as the gold standard. When intermediate results were excluded, the sensitivity, specificity and accuracy of these serologic tests ranged from 88.6% to 97.8%, 67.9% to 85.9%, and 87.9% to 91.4%, respectively, which were comparable with reported median accuracy in the Western population. However, there were many intermediate results in these tests, ranging from 5.3% to 23.0%. Their usefulness seemed to be limited in our patient population because of the large number of intermediate results. (C) 2000 Elsevier Science Inc. All rights reserved.