This study sought to investigate the association between preliminary advance care and decision making, and care planning and participation in community activities, among the rural and advanced aged community in Japan in efforts to enhance advance care planning when it is direly needed. Subjects were 920 people aged 40-74 years in rural areas identified by cluster sampling and who had consented to participate in the survey. The 15 survey items included sex, age, experiences of care for the elderly, degree of health anxiety, degree of participation in community activities, and self-measurement of home blood pressure. Univariate analysis and binary logistic regression analysis using a step-wise principle were used throughout the survey. Of the 920 participants, 23.8% and 25.0% had previously made decisions on care planning and advance care planning, respectively, which were mutually associated, although decision making on care planning did not necessarily presuppose advance care planning. Odds ratios were high for decision making on care planning, awareness of care planning, advance care planning, and conversations about medical checkups. Also, odds ratios were high for advance care planning on awareness of care planning, decision making on care planning, and high participation in community activities. The results suggest that to help participants “make a decision” or undertake “advance care planning”, it is important to have opportunities to participate in community activities and/or converse with another resident about medical checkups.

　　Despite measures being instituted to prevent agricultural workplace accidents, fatalities still occur. Also research studies evaluating and analyzing work processes involving agricultural machinery are rare. The objectives of this study were, on a trial basis, to generate and examine the usefulness of a work process sheet based on failure mode and effect analysis (FMEA) for prevention of accidents. FMEA is used in medical and other fields. Subjects were 18 of 38 farmers who were interviewed using the work process sheet generated, were assumed to be using agricultural machinery, were located in Prefecture B (a rural area), and had agreed to participate in the survey. The results show that the ratio of accidents to incidents was 1:8. Also, based on the work process sheet for prevention of agricultural workplace accidents, users of agricultural machinery did not pay attention to 10 of the 28 requisite steps. In particular, “I wear a seat belt” and “I regularly use the two-poster safety frame (folding type)”, were commonly not adhered to. Based on the work environment and occupational background, the development of a simpler and more useful working process sheet from an analysis of objective data is warranted.

With an aim at making future community health services more effective, the authors have attempted surveys of the living and health conditions of yellowtail fish breeders for Tarumi Fishermen's Cooperative Association over the past three years.
1st February 25, 1982 54 persons
2nd January 31, 1983 70 persons
3rd January 30, 1984 55 persons
In the last survey, 21 persons out of 55 were the same persons who had taken part in the 1982 and 1983 surveys.
Conclusion
(1) Fishermen get up earlier in the morning and set to work, many skipping breakfast. In the afternoon, they are relatively free. However, none use their leisure hours for promoting physical wellbeing.
(2) Many are liable to catch cold and suffer from lower back pain. Obesity, byperlipemia and liver dysfunction due to excessive alcohol intake are notable.
(3) Compared with farmers, they are youg, but many are out of condition.
(4) Health conditions of those who have undergone medical checkups for the therr years running showed some improovement in obesity and high blood pressure, but the cases of ECC disorder and liver dysfunction have increased.
(5) Bad health conditions derived from personal habtis could be rectified if long-term educational measures and others were implemented.

This is a report on the precision controlled gastric mass screenings conducted under the sponsorship of the Welfare Federation of Agricultural Cooperatives in Nagano Prefecture and the assessment test using some samples of radiographic stomach images.
Physicians and x-ray technicians participated in the test and interpreted in their own ways the radiographs of 30 healthy cases and 20 cases of cancer of the stomach. Experienced physicians and technicians made better scores on the test than those less experienced in reading radiographs. Physicians read a little better that technicians in checkups of different parts regardless of years of experience, but the difference was not significant. In terms of FP and FN percentages (?), physicians scored 40.5% and 20.8% on the first tryout, and 34.0% and 29.0% on the second tryout.
The 1988 mass screening found 67.4% of cancer in antral and angular areas and 23.8% on the lesser curvature side of the angular area.
Grade 5 means that “No doubt about the existence of cancerous lesions.” In the 1983 screening, 25% of the grade 5 cases turned out to be nothing wrong upon close examination. The figure went down to 5.9% in the 1988.