To determine the background of aged people who need bathing assistance, we analyzed data of the Survey on Demand for Health and Welfare Services of Japan as of 1997. The survey covered 21, 723 persons aged 65 years or older, and 1, 193 caregivers who provide care to persons 65 years or older throughout Japan. The main parameters were aged people's sex, age, marital status, health condition, degree of bed rest, and needs of care in daily life; relation between caregivers and aged people; life with care giver; job; family composition; use of home care services; demand for home care services; caregivers' sex, age, health condition, and employment status; and demand for home care services. Subjects were divided into three groups, those who need bathing assistance, those who do not need bathing assistance, and those who do not need care in daily life, and the rate was shown for each item. The results indicated that the rate of those who need bathing assistance was higher among (1) aged people who were older, have poor health, and are in bed alweys or almost alweys, (2) aged people who needed care in daily life, used home care service, and required home care service, and (3) aged people whose caregivers required home care services.
Aged people who need bathing assistance are subject to frequent bathing accidents, so we need to pay attention to safe bathing service.

Late-onset Brown-Séquard syndrome (BSS) is a rare condition resulting from a spinal cord injury that develops weeks to years after a blunt trauma. Acute-onset BSS after a blunt injury has been rarely reported. Here, we report on a case of BSS, in a 58-year-old man, that developed immediately after a motor vehicle accident. Upon admission, loss of right thoracic motion, complete right paresis, and loss of pain and temperature sensations below the C3 level on the left side were observed. Magnetic resonance imaging showed hyperintensities within the cervical spinal cord at the C2–C3 level, confirming the diagnosis of BSS. Thoracic motion rapidly recovered, but other neurological sequelae persisted. BSS related to cervical cord injury should be suspected when patients develop hemiparesis and contralateral sensory loss immediately after a blunt trauma. Likewise, clinicians should be aware that unilateral loss of thoracic motion could be an important sign of BSS.
Brown-Sequard Syndrome ; Cervical Cord ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Motor Vehicles ; Paresis ; Sensation ; Spinal Cord Injuries ; Wounds, Nonpenetrating

Middle-aged people with a serum total cholesterol of more than 220 mg/dl at the latest health examination (n=197) at a chemical company were invited to join a health education program for 6 months. Participants meeting inclusion criteria were randomly assigned to an intervention (n=96) and a control group (n=92). Periodical interviews and blood tests were performed every 2 months for both groups. The intervention group was educated by health professionals in the factories through programs developed for hypercholesterolemia. After a 6-month intervention, the reduction of cholesterol levels and the differences between the groups were analysed.The mean total cholesterol (TCH) levels at the baseline measurement were 239.7 mg/dl in the intervention group and 236.5 mg/dl in the control group. During the intervention period, decreased levels of TCH were 27.1 mg/dl for the intervention group and 18.5 mg/dl for the control group. Declines in body weight, TCH and triglyceride levels in the intervention group were significantly larger than those in the control group. The decline of apoprotein-B was also significantly larger in the intervention group while high-density lipoprotein cholesterol levels essentially did not change.The health education by health professionals proved to be useful in reducing the risk factor levels for coronary heart disease. These results suggest that health education would also be useful against other major risk factors in cardiovascular diseases.

OBJECTIVEThe purpose of this study was to evaluate the effects of stage-matched repeated individual behavioral counseling as an intervention for the cessation of smoking.

METHODSWe conducted a multisite randomized controlled trial that enrolled smokers unselected for their readiness to quit. There were 979 smokers with hypertension or hypercholesterolemia recruited from 72 study sites and randomly allocated to the intervention or control group. Smokers in the intervention group received stage-matched individual counseling consisting of a 40 minute initial session and four 20-30 minute follow-up sessions. Smokers in the control group received individual behavioral counseling for hypertension or hypercholesterolemia.

RESULTSThe point prevalence abstinence rate at 6 months, validated by carbon monoxide testing, in the intervention group (13.6%) was 5.4 times higher (p<0.001) than that in the control group (2.5%). When the data were analyzed based on the baseline stage of change, there were significant differences in the abstinence rates at 6 months in smokers versus controls with each stage of change except in immotives. The odds ratio was 6.4 (p<0.001) in precontemplators, 6.7 (p<0.001) in contemplators, and 6.2 (p<0.01) in preparators. There was a positive, consistent effect of the intervention regardless of study site (worksite or community) or the presence of hypertension or hypercholesterolemia.

CONCLUSIONSWe showed the effects of an intervention with repeated individual behavioral counseling on the cessation of smoking in smokers unselected for their readiness to quit. This result suggests that stage-matched individual counseling, based on the transtheoretical model, is effective in smokers with a lower motivation to quit as well as those ready to quit.

OBJECTIVETo examine the effectiveness of a small-scale smoking cessation intervention program conducted annually for ten years in an occupational setting in Japan.

METHODSWe conducted an annual intervention program promoting smoking cessation in male smokers from 1993 to 2002 in an occupational setting in Hyogo, Japan. Trends in smoking prevalence in this worksite were compared with a control group from two similar worksites of the same company. The intervention program was carried out by medical students (the fourth year of a six-year course) who received training on the protocol prior to the intervention. This protocol consisted of one initial group session, followed by periodical correspondence for two months. Successful cessation of smoking was determined by self-declaration of abstinence for longer than four weeks after intervention, confirmed by an expiratory carbon monoxide concentration of less than nine ppm. Smoking prevalence was determined by a self-administered questionnaire provided at the annual health checkup.

RESULTSThe proportion of smokers who participated in the program was 3.47% on average. Abstinence rates following each intervention ranged from 13.3% to 60.0%, with the prevalence of male smokers at the intervention worksite decreasing from 56.2% in 1993 to 47.0% in 2002. In contrast, the smoking prevalence of the control worksites remained largely unchanged, being 60.2% in 1995 and 57.6% in 2002. At the end of the study, the intervention worksite had a significantly lower prevalence of smokers in either the crude or age-adjusted rate.

CONCLUSIONA small-scale but repeated smoking cessation intervention program at a worksite can reduce smoking prevalence more efficiently than the natural trends.

OBJECTIVETo clarify the methodological issues for the High-risk and population Strategy for Occupational Health Promotion Study (HIPOP-OHP study), which is a 4-year non-randomized control trial, an interim assessment of male participants was performed 3 years after the baseline survey.

METHODSWe had approximately 2,500 and 4,000 participants in the intervention and control groups, respectively. The population measures and prevalence of risk factors at each year, and between the baseline and 4th examinations were compared between the two groups. The personal trends of returning participants who were in the study at the 1(st) and 4(th) examinations were also evaluated.

RESULTSDuring the 3 years, an increase in serum HDL cholesterol (2.7 mg/dl), and a reduction in the prevalence of hypertriglycemia detected with fasting blood samples (3.6%) and current smokers (5.4%) were observed in the intervention group. The mean HDL cholesterol level was significantly higher in the intervention group than in the control group at the 4th examination, reversed from the baseline survey. The serum non-HDL cholesterol level was significantly increased only in the control group. There was also a significant increase in the prevalence of hypertriglycemia nad high plasma glucose detected with fasting blood samples in the control group. The return participation rate after 3 years was 72.2% for the intervention group and 74.9% for the control group. The above-mentioned changes for risk factors were mainly due to returning participants at each examination.

CONCLUSIONThese interventional methods may be effective in improving overall cardiovascular risk factors in the population. However, the low return participation rate will dilute the effect of the intervention.

OBJECTIVEThe INTERMAP Study is an international cooperative study on the relationship between macro- and micro-nutrient intakes and blood pressure. The present study-ancillary to INTERMAP-is to evaluate validity of the INTERMAP Tables of Food Composition in Japan (ITJ) formulated by modifying the Standard Tables of Food Composition in Japan (STJ), including factoring in changes in weight and nutrient composition of individual foods due to cooking.

METHODSWith chemical analytical values of 96 meals prepared in two university hospitals in Japan as the "gold standard", validity of calculated values based on the ITJ was examined for six major components (energy, protein, lipid, carbohydrate, sodium, potassium) by comparison of mean values, correlation, and linear regression analysis.

RESULTSAlthough both the ITJ-based and STJ-based calculated values for all six components were significantly higher than the analytical values, differences from the analytical values were generally less marked for the ITJ-based values than for the STJ-based values. The STJ-based values were significantly higher than the ITJ-based values for protein and potassium. Analytical values showed slightly stronger correlations with the ITJ-based calculated values (r=0.876 for total energy, r=0.789 for lipid, r=0.832 for potassium) than with the STJ-based calculated values, except for carbohydrates.

CONCLUSIONSThe ITJ was considered to have greater validity than the STJ. To obtain more accaurate data in nutritional surveys, food composition tables in which changes in nutrient compositions due to cooking methods are taken into consideration should be used.

Objectives: We developed the multimodal program Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC program). The aim of our study is to show algorithm of the home-based resistance training prescription and its compliance. Methods: We recruited 30 patients aged≥70 years scheduled to receive first-line chemotherapy for advanced pancreatic or non-small-cell lung cancer. Three educational sessions were planned in 8-week study period. Our resistance training consists of 3 or 5 of following 5 exercises components: (1) sit-to-stand, (2) calf raise, (3) knee extension, (4) knee raise, (5) side leg raise. Physiotherapist chose optimal prescription according to the modified Borg-scale. We assessed patient compliance, and safety. Results: Median proportion of days in which patients performed full or modified exercise program was 91%. Adverse events possibly related to the NEXTAC program were observed in 5 patients and included muscle pain (grade 1 in 2 patients), arthralgia (grade 1 in one patient), dyspnea on exertion (grade 1 in one patient), and plantar aponeurositis (grade 1 in one patient). Patient physical function and physical activity were maintained during the study period. Conclusion: Our resistance training showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non-small-cell lung cancer receiving concurrent chemotherapy. Although this study was not designed to show the efficacy of the resistance training, our data indicate a potential protective effect on physical function and physical activity.

BACKGROUND: The gender-specific characteristics of individuals at an increased risk of developing depression currently remain unclear despite a higher prevalence of depression in women than in men. This study clarified socioeconomic and lifestyle factors associated with an increased risk of subclinical depression in general Japanese men and women. METHODS: Study participants were residents not receiving psychiatric treatments in 300 sites throughout Japan in 2010 (1152 men, 1529 women). Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) for socioeconomic factors and lifestyle factors were calculated using a logistic regression analysis. RESULTS: Risk of depressive tendencies was significantly higher in men who were single and living alone (OR, 3.27; 95% CI, 1.56-6.88) than those married. The risk was significantly lower in women who were not working and aged ≥ 60 years (OR, 0.39; 95% CI, 0.22-0.68) and higher in men who were not working and aged < 60 years (OR, 3.57; 95%CI, 1.31-9.72) compared with those who were working. Current smoking was also associated with a significantly increased risk of depressive tendencies in women (OR, 2.96; 95% CI, 1.68-5.22) but not in men. CONCLUSIONS Socioeconomic and lifestyle factors were associated with an increased risk of depressive tendencies in general Japanese. Related factors were different by sex.
Adult ; Aged ; Community Psychiatry ; statistics & numerical data ; trends ; Depression ; epidemiology ; Female ; Health Surveys ; Humans ; Japan ; epidemiology ; Life Style ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors ; Socioeconomic Factors

BACKGROUND: Oral health is thought to be associated with diet quality, and socioeconomic status (SES) affects both oral health and diet. The aim of this study was to investigate the association between the number of teeth and dietary intake as well as nutritional biomarker, considering the subjects' SES. METHODS: We conducted a cross-sectional analysis of data from 2049 individuals aged ≥ 50 years from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010. The number of remaining teeth was categorized into age-specific quartiles (Q1 to Q4). We assessed the adjusted means and 95% confidence intervals for dietary variables by the number of teeth using analysis of covariance. Stratified analyses by SES were also conducted. RESULTS: The intake of grain products was 31 g higher, and those of vegetables and meat were 30 g and 8 g lower, respectively, in Q1 (fewer teeth) than in Q4 (more teeth). Carbohydrate intake was higher whereas protein, minerals (potassium, magnesium, and zinc), vitamins (vitamins A, E, B, B, β-carotene, and folic acid), and dietary fiber intakes were lower among individuals with fewer teeth. Adjusted mean serum albumin levels were low in Q1. The associations between the number of teeth and dietary intake were more evident in individuals with a low SES. CONCLUSIONS Having few remaining teeth was associated with a low nutrient intake and low serum albumin levels in middle-aged and older Japanese adults, and these associations were more evident in individuals with low SES.
Aged ; Aged, 80 and over ; Carbohydrates ; Cross-Sectional Studies ; Diet ; Energy Intake ; physiology ; Female ; Humans ; Japan ; Male ; Middle Aged ; Nutrients ; Nutrition Surveys ; Nutritional Status ; Serum Albumin ; analysis ; Socioeconomic Factors ; Tooth ; Vegetables