1.Lifestyle-related Health Problems Confronting Japanese-Brazilians Immigrated to Japan
Tetsuhito FUKUSHIMA ; Masaki MORIYAMA
Journal of the Japanese Association of Rural Medicine 2003;52(2):209-216
To clarify the relation between living habitudes in Japan including daily fare and health, the state of health of 21 Japanese-Brazilians living in Japan was investigated. The relation was analyzed based on their views, about the Japanese customs. Only two persons were found to have adapted themselves to the living environment in Japan, 10 persons were not adaptable sufficiently and 9 suffered from maladaptation. Asked why they were not adaptable, they gave personal relations, difficulty in reading and writing, workplace stress, etc. It was also found that at the present their biggest worry concerned the future, followed by personal relations, Japanese language, work and education in that order. Our investigation brought to light the fact that there was much to be done by the local community in terms of receiving immigrants. When it came to foodstuffs, after visiting Japan, the intake of salt, meat and fruit decreased, and fish increased. Like most Japanese, the Japanese-Brazilians regarded salad and rice-baseddiet healthy, but coffee not good. Referring to some foodstuffs which are customarily eaten less, many said they feel eating a lot of fish and shellfish in Japan is good for the health, but little fruit and little bean food are not good. As for the present health condition, more than half of the subjects said they had some problem. In the relation between the change in weight and the change in eating habit, only the increased intake of sugar was related to weight gain. The effect of the Japanese way of life on their health must be continuously followed up on with the common and different points of the customs in eating between Brazil and Japan taken into account.
2.Promotion of the health care for farmers working in factories in rural district.
Akio NAKAGAWA ; Kenji ABE ; Tetsuhito FUKUSHIMA ; Yoneatsu OSAKI ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1987;36(2):61-68
Today's one of the most important problems both in the industrial hygiene and the community health care is the health protection of farmers who are working in factories. There are many such farmers in the San'in rural districts. We surveyed the working conditions of 370 factories in Shimane Prefecture and found that they had many problems to be solved. The problems in the factories, mostly small-scale factories, are summarized as aging of workers, long working hours, insufficient rest, harmful work and night work.
Even in Sada-cho, where the local government is promoting the comprehensive community health care and encouraging the health care activity of inhabitants, the health care for factory workers is performed insufficiently. Some factories do not carry out even a periodical health examination of the workers.
We established the Sada-cho Occupational Health Association in cooperation with the local government, Izumo Health Center, Shimane Labor Standard Inspection Office and the factories in Sada-cho for the purpose of promoting the unified activity of the industrial hygiene and the community health care.
3.Exposure assessment of Organophosphate Pesticide(DDVP) Based on the Aerial Concentration in the Greenhouse.
Tetsuhito FUKUSHIMA ; Nobumasa HOJO ; Akio ISOBE ; Kuninori SHIWAKU ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1994;42(5):1056-1060
The exposure to the organophosphate pesticide (DDVP) by sprayers was assessed based on the measurements of concentration in the greenhouse. The serum concentrations of DDVP were examined 1 hour after spraying in two men who worked in the greenhouse with gas masks. Their serum concentration level was 21.2 ng/ml and 15.0 ng/ml, respectively, while serum cholinesterase was within normal level in both men. Changes in aerial DDVP concentrations in the greenhouse were examined. The result showed a higher concentration at the lower point (0.7 m high from the ground) than at the higher point (1.4 m high from the ground). The aerial concentration remained high (0.5ppm-2.0 ppm) for two days after spraying and started to decline thereafter to 0.5 ppm or less. On the seventh day, it was undetectable.
From these results, we suggest that the following precautions should be taken toprevent pesticide exposure in the greenhouse. 1. Wearing only a gas mask but also goggles are recommended when pesticides are being sprayed. 2. The work in the greenhouse should be postponed until the second day after spraying because of the aerial residue of pesticide. 3. The frequent ventilation and gas mask are necessary till the seventh day after spraying. 4. Ventilation of the zone near the ground should be done sufficiently when the workers take the half-sitting posture like “buds gathering, ” because they are exposed to higher aerial concentrations of pesticide than when they are working in a standing posture.
4.Living Conditions of the Solitary Elderly and Their Community Health Problems with Reference to Local Characteristics.
Tetsuhito FUKUSHIMA ; Akio ISOBE ; Nobumasa HOJO ; Kuninori SHIWAKU ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1994;42(5):1061-1066
To investigate the problems confronting the present health care system for the elderly in depopulated areas of Japan, we examined the living conditions of solitary aged people in two rural communities, Sada and Koryo, Shimane Prefecture, where the percentage of aged population is the highest among all the prefectures in Japan. Just as community characteristics ofthe two areas are different from each other, so are the features of the elderly's health needs.
Sada is a mountainous agricultural community, where the acreage of cultivated land per household is relatively large. As many families are composed of three generations, only a small number of aged people are living by themselves.
Koryo is a urbanized agricultural community on the outskirts of Izumo City. As the acreage of cultivated land per household is narrower, the average number of family members is smaller, and the percentage of the elderly, especially female, living alone is remarkable.
In Sada as well as Koryo the solitary life of the elderly mostly resulted from the death of their spouse. Their daily contact with their children is scarce, because most childrenlive in big cities far away from their parent's home. The rate of the solitary elderly whose children and their family will return home in future is 27.0% in Sada and 43.4% in Koryo.
Most of the social problems the solitary elderly face are derived from strained household economy. The rate of the elderly whose living expenses are less than 60, 000 yen a month is 41.2% in Sada and 31.6% in Koryo. As the economic resources of the solitary elderly are generally meager, the community should gear up to meet their economic needs.
6.Niacin metabolism and Parkinson's disease.
Environmental Health and Preventive Medicine 2005;10(1):3-8
Epidemiological surveys suggest an important role for niacin in the causes of Parkinson's disease, in that niacin deficiency, the nutritional condition that causes pellagra, appears to protect against Parkinson's disease. Absorbed niacin is used in the synthesis of nicotinamide adenine dinucleotide (NAD) in the body, and in the metabolic process NAD releases nicotinamide by poly(ADP-ribosyl)ation, the activation of which has been reported to mediate 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced Parkinson's disease. Recently nicotinamide N-methyltransferase (EC2.1.1.1) activity has been discovered in the human brain, and the released nicotinamide may be methylated to 1-methylnicotinamide (MNA), via this enzyme, in the brain. A deficiency in mitochondrial NADH: ubiquinone oxidoreductase (complex 1) activity is believed to be a critical factor in the development of Parkinson's disease. MNA has been found to destroy several subunits of cerebral complex 1, leading to the suggestion that MNA is concerned in the pathogenesis of Parkinson's disease. Based on these findings, it is hypothesized that niacin is a causal substance in the development of Parkinson's disease through the following processes: NAD produced from niacin releases nicotinamide via poly(ADP-ribosyl)ation, activated by the hydroxyl radical. Released excess nicotinamide is methylated to MNA in the cytoplasm, and superoxides formed by MNA via complex I destroy complex 1 subunits directly, or indirectly via mitochondrial DNA damage. Hereditary or environmental factors may cause acceleration of this cycle, resulting in neuronal death.
7.Development of a novel self–assessment system for the clinical competence of medical students
Akiko Sugawara ; Gen Kobayashi ; Yoko Moroi ; Tatsuo Suzutani ; Teizo Fujita ; Tetsuhito Fukushima ; Kazunobu Ishikawa
Medical Education 2011;42(4):201-208
To accurately assess the clinical competencies of medical students at Fukushima Medical University, we have developed a novel online self–assessment system, which covers all goals in the "Model Core Curriculum for Medical Education in Japan." We added "Emergency," "Communication skills with staff," and "Simulation–based learning." Following their clinical clerkships, 79 sixth–year medical students assessed themselves and their clinical clerkships.
1)This novel online self–assessment system, consisting of 68 checklists in 15 fields, easily informs us of the actual conditions of clinical clerkships and students' confidence in their clinical competencies.
2)This internet–based self–assessment system revealed the current status and problems of clinical clerkships, prompting feedback to clinical instructors and members of the instruction committee.
3)Students felt "confident" or "confident to a certain degree" in most learning areas; however, simulation–based learning seems to be necessary in several areas, such as clinical skills, where feelings of shame or discomfort may be associated with patient care.
4)Students who had high total self–assessment scores evaluated clinical clerkships favorably. In contrast, students whose self–assessments frequently included "no learning experience" evaluated their clerkships negatively in the educational aspects of "skill" and "attitude."
8.Actual conditions of the health care of school personnel in rural districts of Shimane prefecture, Japan.
Tomoko SHIMIZU ; Kenji ABE ; Tetsuhito FUKUSHIMA ; Akio NAKAGAWA ; Nobuo YOSHIDA ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1984;33(4):775-779
Actual conditions of the health care of school personnel in rural districts of Shimane Prefecture were investigated, concentrating our attention on the structure of diseases, the contents of health examination, factors impeding health, and so forth.
As a result of our investigation we found that the incidence of adult diseases among school personnel is considerably high. Health examinations with complete contents should be practised in the near future.
Further, the establishment of health care system in the work place, the improvement of working conditions considering sufficiently the peculiarity of mental work and of femininity, the independence of school nurses as specialist should be realized on the basis of the understanding of actual problems, which are obtained by examinations of health care conditions at each work place including epidemiological examination.
9.A study of current primary health care in rural district, Japan - Problmes of community-based school health.
Kenji ABE ; Tetsuhito FUKUSHIMA ; Akio NAKAGAWA ; Nobuo YOSHIDA ; Tomoko TAGAWA ; Yosuke YAMANE
Journal of the Japanese Association of Rural Medicine 1986;35(2):165-171
The recent urbanization of rural communities and the associated changes of the living environments influenced the health conditions of children in rural districts of Shimane Prefecture, Japan. It obliged therefore to review the usual school health approach and to evaluate the care system to new trends of critical health problems of children.
A questionnaire was sent to school nurses asking their worries and problems about each step of the scientific school health procedure to recognize the health needs, to analyse the health problems, to plan the appropriate counterplans, to practice and to evaluate.
As a result of our investigations, the following remedies were necessary for the development of rural school health activities.
Firstly, the specialization of school nurses should be established without delay, and their working conditions should be more improved.
Secondary, school nurses should strengthen the contacts with teachers, parents and other school staffs to organize the developed school health system.
Finally, school nurses should make their efforts to delop the community-based school health care which connected the comprehensive community health care.