In Japan, the number of people 65 and over is increasing while the number of children is decreasing. A greater number of senior citizens live by themselves or husband and wife alone than before.
To realize comfortable and independent life for aged people, it is important to prepare housing and environment which have special services for them.
We would like to explain two housing projects which were planned and are being put into execution in Japan. One is ‘Silver Housing’ multiunit dwellings for the aged built by the Ministry of Construction and the Ministry of Health and Welfare since 1987. The other is ‘Silver Peer’ project which has been pushed forward by the Tokyo Metropolitan Government since 1987.

Objective: As part of the revision on remuneration for medical services in 2012, a new system has been implemented to allow an additional fee for inpatient pharmaceutical services to be added to the basic hospitalization fee.
Methods: We at Kitasato University Kitasato Institute Hospital satisfied all institutional requirements for the new system and were preparing to introduce it from April 2012; however, there was concern about the increased workload due to the additional work of preparing diaries for pharmaceutical services used in calculating the additional fee.
Results: We therefore developed a database titled Diary System for Inpatient Pharmaceutical Services for the preparation and management of diaries.  This system allows pharmacists from various divisions to enter data simultaneously and realizes the unified management of records of services performed at various places in the pharmacy.
Conclusions: Since entered data are automatically reflected in the inpatient pharmaceutical service diary and the monthly summary, an advantage compared to paper diaries in terms of efficiency may be expected.  Furthermore, the monthly summary of the number of service hours by ward and service type may also be used for service analysis.

We evaluated the influence of a twice-weekly group exercise program on visceral fat area (VFA) and plasma adiponectin (APN) in the elderly. Thirty-three community-dwelling elderly (age : 72.4±6.9 yrs) participated in a 12-week supervised, geriatric exercise training program (GET) followed by a 12-week unsupervised GET (u-GET), which included stretching, strengthening, and balance-training exercises. Participants were evaluated for physical fitness, blood glucose, HbA1c, triglyceride, cholesterol, insulin, and APN. VFA was measured by computed tomography. All measurements were taken before the GET (TR1), after 12-weeks of GET (TR2), and at the end of the u-GET (TR3). Twelve weeks of GET produced significant increases in physical function measures. Both walking speed and functional mobility values at TR3 were significantly higher than TR1 values. A significant reduction in VFA was seen at TR3 in men. APN progressively elevated from TR1 to TR3 in women. In the frail elderly, 12 weeks of GET effectively increased functional ability and APN. The beneficial effects on VFA and APN were sustained following the participation in the unsupervised setting, suggesting that the frail elderly should be encouraged to participate and maintain a resistance training routine to achieve preferable effects on both functional ability and cardiovascular risk factors.

Although influenza is a highly contagious acute respiratory illness of global importance, little is known about the disease in tropical countries. An influenza survey was conducted in three sentinel sites in Yangon, Myanmar from September 2003 to December 2004. Throat or nasal swabs were collected from 616 patients with influenza-like symptoms and tested using rapid diagnostic test kits and virus isolation. Influenza B virus was detected in 6 patients from September to October, 2003. Influenza A viruses were detected in 133 patients from June to September, 2004, and the 51 influenza A viruses isolated from 72 specimens were all A⁄H3N2. Influenza virus infections occurred mainly in the rainy season in Yangon, Myanmar, but continuous ongoing influenza surveillance is needed.

BACKGROUND: Sick building syndrome (SBS) refers to the combination of symptoms experienced by occupants of specific building characteristics. This study investigated the associations of children's lifestyle behaviors, allergies, home, and school environment with SBS symptoms. METHODS: A total of 4408 elementary school children living in Sapporo City, Japan participated in this study. SBS was determined on parental answers to MM080 standardized school questionnaires on symptoms that were weekly experienced by these children, and if the symptom is attributed to their home or school environment. The Japanese version of the International Study of Asthma and Allergies in Childhood questionnaire was used to assess wheeze, rhino-conjunctivitis, and eczema. A logistic regression analysis was conducted to evaluate the associations between SBS symptoms and variables by controlling the potential confounders (gender, grade, school, and parental history of allergies). A stepwise backward elimination was conducted to assess independent variables related to SBS. RESULTS: Participants revealed mucosal (6.9%), skin (2.0%), and general (0.8%) symptoms. The presence of one or more allergy was associated with increased mucosal and skin symptoms. Children who skipped breakfast, displayed faddiness (like/dislike of food), had constipation, have insufficient sleep, did not feel refreshed after sleep, and lacked deep sleep showed significantly high odds ratios with SBS symptoms. The stepwise analysis showed faddiness for mucosal symptoms and not feeling refreshed after sleep for mucosal and skin symptoms, whereas constipation and lacking deep sleep for general symptoms were independent variables in increasing the symptoms. We found no significant relationship between SBS in children and schools. Considering children's home, old building, no ventilation, wall-to-wall carpet, and heavy nearby traffic were associated with elevated mucosal symptom, while living in a multifamily home increased general symptoms. Home dampness was an independent variable in increasing all SBS symptoms. CONCLUSIONS Allergies and lifestyle behaviors were associated with increased SBS in children, including skipping breakfast, displaying faddiness, constipation, insufficient sleep, not feeling refreshed after sleep, and the lack of deep sleep. Further, dampness at home was associated with increase in all SBS symptoms. Lifestyle (e.g., eating and sleeping habits) and home (i.e., dampness) improvements might alleviate SBS symptoms in children.
Child ; Cross-Sectional Studies ; Environment ; Housing ; statistics & numerical data ; Humans ; Hypersensitivity ; epidemiology ; etiology ; Japan ; Life Style ; Prevalence ; Schools ; statistics & numerical data ; Sick Building Syndrome ; epidemiology ; etiology ; Students ; statistics & numerical data

Background/Aims: There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children. Methods: This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data. Results: A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturingon-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01). Conclusions Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.

BACKGROUND: We reported that human T cell leukemia virus 1 (HTLV-1) infection is positively associated with atherosclerosis. Recent evidence has revealed a close association of periodontitis with atherosclerosis, endothelial dysfunction, and disruption of the microcirculation. However, the association between HTLV-1 and advanced periodontitis has not been investigated to date. Since hematopoietic activity is closely linked to endothelial maintenance activity and is known to decline with age, we hypothesized that the state of hematopoietic activity influenced the association between HTLV-1 and advanced periodontitis in elderly participants. METHODS: A cross-sectional study was performed including 822 elderly participants aged 60-99 years who participated in a dental health check-up. Advanced periodontitis was defined as a periodontal pocket ≥ 6.0 mm. Participants were classified as having low or high hematopoietic activity according to the median values of reticulocytes. RESULTS: HTLV-1 infection was positively related to advanced periodontitis among participants with lower hematopoietic activity (lower reticulocyte count), but not among participants with higher hematopoietic activity (higher reticulocyte count). The adjusted odds ratio (95% confidence interval) considering potential confounding factors was 1.92 (1.05-3.49) for participants with a lower reticulocyte count and 0.69 (0.35-1.36) for participants with a higher reticulocyte count. CONCLUSIONS Among elderly participants, the association between HTLV-1 infection and advanced periodontitis is influenced by hematopoietic activity. Since hematopoietic activity is associated with endothelial maintenance, these findings provide an efficient tool for clarifying the underlying mechanism of the progression of periodontitis among elderly participants.
Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; HTLV-I Infections ; physiopathology ; Hematopoiesis ; physiology ; Human T-lymphotropic virus 1 ; physiology ; Humans ; Japan ; epidemiology ; Male ; Middle Aged ; Odds Ratio ; Periodontitis ; epidemiology ; virology ; Prevalence ; Risk Factors

BACKGROUND: Human T cell leukemia virus type-1 (HTLV-1) stimulates inflammation activity. Our previous study revealed a positive association between asymptomatic HTLV-1 infection and advanced periodontitis among elderly Japanese individuals with low levels of hematopoietic activity (reflected by reticulocyte levels). Since low hematopoietic activity has been correlated with low-grade inflammation and low-grade inflammation is associated with atherosclerosis, the status of atherosclerosis could, in turn, determine the nature of this association. METHODS: To this end, a cross-sectional study of 907 elderly Japanese individuals (aged 60-99 years), who had participated in dental health check-up during the period 2016-2018, was conducted. Advanced periodontitis was defined as periodontal pocket ≥ 6.0 mm. RESULTS: Among the study population, 295 (32.5%) were found to have atherosclerosis defined as a carotid intima-media thickness (CIMT) of ≥ 1.1 mm. HTLV-1 infection was positively associated with advanced periodontitis in participants with atherosclerosis, but no significant associations were observed among the participants without atherosclerosis. The known risk factors' (including reticulocyte and CIMT) adjusted odds ratio (OR) and 95% confidence interval (CI) of advanced periodontitis were OR 2.01 and 95% CI 1.06-3.81 for participants with atherosclerosis and OR 0.61 and 95% CI 0.34-1.12 for participants without atherosclerosis. CONCLUSION This study found a significant association between HTLV-1 infection and advanced periodontitis among elderly Japanese with atherosclerosis. However, this association is absent in individuals without atherosclerosis, suggesting that atherosclerosis might act as a determinant in the association between HTLV-1 infection and advanced periodontitis among elderly Japanese.

In response to the outbreak of coronavirus disease 2019 (COVID-19) in Japan, a national COVID-19 cluster taskforce (comprising governmental and nongovernmental experts) was established to support the country’s Ministry of Health, Labour and Welfare in conducting daily risk assessment. The assessment was carried out using established infectious disease surveillance systems; however, in the initial stages of the pandemic these were not sufficient for real-time risk assessment owing to limited accessibility, delay in data entry and inadequate case information. Also, local governments were publishing anonymized data on confirmed COVID-19 cases on their official websites as daily press releases. We developed a unique database for nationwide real-time risk assessment that included these case lists from local government websites and integrated all case data into a standardized format. The database was updated daily and checked systematically to ensure comprehensiveness and quality. Between 15 January 2020 and 15 June 2021, 776 459 cases were logged in the database, allowing for analysis of real-time risk from the pandemic. This semi-automated database was used in daily risk assessments, and to evaluate and update control measures to prevent community transmission of COVID-19 in Japan. The data were reported almost every week to the Japanese Government Advisory Panel on COVID-19 for public health responses.