Objectives: Despite the increasing utilization of in-home services, the assessment of in-home services used by those that have certified levels of care needs has been limited to the actual changes in individual outcomes. The purpose of the present study was to determine factors affecting how the utilization of in-home services could have sustained and/or improved or deteriorated the care needs levels of frail persons. We also examined the effect of in-home services used in the lower level of care needs subgroup and the higher level of care needs subgroup during a two-year period.
Subjects and Methods: We used longitudinal data from Izumo City of those individuals with certified levels of care needs to analyze the changes in care need levels in Izumo City between 2002 to 2004. In 2002, 2,651 persons had certified levels of care needs. All permanent residents of care facilities, at care needs level 5 in 2002, those who died since 2002 and people who could not be traced during the two-year follow-up period were excluded. The remaining data from 1,788 frail persons were ultimately analyzed. We arbitrarily divided the changes in care needs levels into two categories: sustained/improved and deteriorated. The care needs levels were also stratified into a lower level of care needs subgroup and a higher level of care needs subgroup at the baseline. Simple statistical analysis and binary logistic regression analysis were used to analyze factors that were thought to be related to in-home service utilization data to predict changes in care needs levels.
Results: Approximately 63.3% of the respondents had a sustained or improved care needs level, and 36.7% of the respondents showed deteriorated of care needs levels. In the lower level of care needs subgroup, utilization of home help/bathing (OR=2.59) was associated with significant sustained/improved care needs levels. In the higher level of care needs subgroup, day care service (OR=0.90) and short stay services (OR=0.87) were significantly related to deteriorated care needs levels, respectively.
Conclusions: This study shows that home help/bathing care in the lower level of care needs subgroup was a significant predictor of sustained/improved levels of care needs for frail persons but that short stay services and day care services in the higher level of care needs subgroup have a negative impact on sustained/improved levels of care needs. Our results suggest that utilization of home help services can prevent deterioration of these levels of care needs in frail persons.

The widespread pursuit of a thin physique may have a detrimental impact on the wellbeing of preadolescents. The influence of body image distortions on the lifestyles, dieting behaviors, and psychological factors was investigated in 631 fifth and sixth grade children in Kyeonggi-do, Korea. Children were classified into three weight groups (underweight, normal, and overweight) and three perception groups (underestimation, normal, and overestimation). Necessary information was obtained by questionnaire, and each subject's weight status was determined by the Rohrer index calculated from the annual measurement records, which were obtained from the school. According to their current weights, 57.4% of children were normal and 32.2% were overweight or obese, 16.6% of the children overestimated their body weight, and 55.2% had an undistorted body image. Overweight children had desirable lifestyles and dietary habits and presented reasonable weight control behaviors. Compared to those without distortion, the overestimated group had greater interest in weight control (P = 0.003) and dissatisfaction with their body weights (P = 0.011), presented unhealthy reasons to lose weight (P = 0.026), and had higher scores for "feeling sad when comparing own body with others" (P = 0.000) and for "easily getting annoyed and tired" (P = 0.037), even though they had similar obesity indices. More subjects from the overestimation group (P = 0.006) chose drama/movies as their favorite TV programs, suggesting a possible role for the media in body image distortion. These findings suggest that body image distortion can lead preadolescents to develop stress about obesity and unhealthy dieting practices, despite similar obesity indices to those without distorted body images. These results emphasize the importance of having an undistorted body image.
Body Image ; Body Weight ; Child ; Depression ; Diet ; Food Habits ; Humans ; Korea ; Life Style ; Obesity ; Overweight ; Surveys and Questionnaires ; Weights and Measures

Cognitive impairments and motor dysfunction are commonly observed behavioral phenotypes in genetic animal models of neurodegenerative diseases. JNPL3 transgenic mice expressing human P301L-mutant tau display motor disturbances with age- and gene dose-dependent development of neurofibrillary tangles, suggesting that tau pathology causes neurodegeneration associated with motor behavioral abnormalities. Although gait ignition failure (GIF), a syndrome marked by difficulty in initiating locomotion, has been described in patients with certain forms of tauopathies, transgenic mouse models mirroring human GIF syndrome have yet to be reported. Using the open field and balance beam tests, here we discovered that JNPL3 homozygous mice exhibit a marked delay of movement initiation. The elevated plus maze excluded the possibility that hesitation to start in JNPL3 mice was caused by enhanced levels of anxiety. Considering the normal gait ignition in rTg4510 mice expressing the same mutant tau in the forebrain, GIF in JNPL3 mice seems to arise from abnormal tau deposition in the hindbrain areas involved in locomotor initiation. Accordingly, immunohistochemistry revealed highly phosphorylated paired helical filament tau in JNPL3 brainstem areas associated with gait initiation. Together, these findings demonstrate a novel behavioral phenotype of impaired gait initiation in JNPL3 mice and underscore the value of this mouse line as a tool to study the neural mechanisms and potential treatments for human GIF syndrome.
Animals ; Anxiety ; Brain Stem ; Cognition Disorders ; Gait ; Humans ; Immunohistochemistry ; Locomotion ; Mice ; Mice, Transgenic ; Models, Animal ; Neurodegenerative Diseases ; Neurofibrillary Tangles ; Pathology ; Phenotype ; Prosencephalon ; Rhombencephalon ; Tauopathies