In a cohort study of 7,820 elderly residents, we explored whether the priority items of the basic checklist predict new issuance of a certificate of needed long-term care. We analyzed data using Cox’s proportional hazard regression, with new issuance of a certificate of needed longterm care as the dependent variable, need for secondary prevention services (determined by the basic checklist results) and required level of specific health guidance as independent variables, and sex, age, place of residence, and use of long-term care prevention services as moderator variables.　　The results were as follows. The priority items of the basic checklist to assess need for secondary prevention services were useful for screening in both the younger and older elderly populations. Also, more certificates of needed long-term care were issued to those individuals who received secondary prevention services. Furthermore, partial functional impairment was also significantly associated with issuing a new certificate.

[Objective]The purpose of this study was to compare the effects of superficial and deep insertion of acupuncture needles in the treatment of patients with low back pain and to search for more effective acupuncture methods.
[Methods]A randomized controlled clinical trial was conducted in which 32 patients with low back pain for more than three months of duration were randomly allocated either to a superficial acupuncture group (n = 16) or a deep acupuncture group (n = 16). Treatment was done for the most painful points of the patients. In the superficial insertion group, the needle was only inserted to a depth of 5 mm, whereas in the deep insertion group, the needle was inserted to a depth of about 20 mm, and was manually stimulated (sparrow pecking method) for 20 seconds. Both groups were treated weekly for four weeks. The visual analog scale (VAS) of pain, Roland-Morris Disability Questionnaire (RDQ), and Pain Disability Assessment Scale (PDAS) were used for outcome measurement.
[Result]VAS, RDQ and PDAS scores showed significant differences between groups (VAS:p < 0.05, RDQ:p <0.001, PDAS:p < 0.05) in change over time with the deep insertion group having more favorable results than the superficial insertion group. The degree of change from the baseline at the time of each evaluation was calculated and results for the two groups were compared. The deep insertion group was significantly better in tendency to improve directly after the first treatment (p < 0.01), in cumulative effect after repeated treatment (VAS:p = 0.13, RDQ:p < 0.05, PDAS:p < 0.01), and in sustained effect after completion of treatment (VAS:p < 0.05, RDQ:p < 0.01, PDAS:p <0.05).
[Discussion and Conclusion]The study showed that deep stimulation is a more effective treatment than superficial stimulation. It is thought that the differences of the effects are due to different influences of the treatments on the pain threshold, muscle blood flow, and muscle tones.

Objective: This study aimed to examine the factors influencing the requirement of a certificate of long-term care using a basic checklist and items listed in the Special Health Checkup.

Method: This study included 7,820 individuals living in Uji city, who were selected from among 8,000 elderly individuals who, in 2008, underwent a specific health checkup (hereafter referred to as the ‘specific health checkup for the old-old elderly individuals’) for those aged 75 years and above. They answered questions from basic checklists at the time, and 180 individuals were excluded as they had already qualified for requiring the certificate of long-term care at the time of the checkup. The follow-up period extended from the day of the specific health checkup for the old-old elderly individuals to March 31, 2013. The data were analyzed using the certificate of needing long-term care as the response variable. The explanatory variables were the basic attributes, items listed in the specific health checkup for the old-old elderly individuals, interview sheets, and basic checklists. Cox proportional hazards regression analysis was conducted.

Results: In total, 1,280 elderly individuals qualified for requiring the certificate of needing long-term care. The risk factors for the young-old elderly individuals aged 65 to 74 years were as follows: hepatic dysfunction (hazard ratio {HR}=1.69), the presence of subjective symptoms (HR=1.41), an above-normal abdominal circumference (HR=1.36), old age (HR=1.13), a reduced frequency of going out since the previous year (HR=1.87), the use of support for standing up after being seated on a chair (HR=1.86), no deposit or withdrawals made (HR=1.84), the anxiety of falling down (HR=1.50), an inability to climb stairs without holding a railing or wall (HR=1.49), as well as an increased difficulty in eating tough food items compared with 6 months prior (HR=1.44). The risk factors for the old-old elderly individuals were as follows: a positive reaction on proteinuria (HR=1.27), anemia (HR=1.18), old age (HR=1.10), inability to travel on a bus or train by themselves (HR=1.53), the inability to climb stairs without holding a railing or wall (HR=1.48), weight loss (HR=1.36), a reduced sense of appreciation of the activities they had previously participated in, over a span of 2 weeks (HR=1.30), the use of support for standing up after being seated on a chair (HR=1.23), and the anxiety of falling down (HR=1.20).

Conclusion: The items listed in the specific medical checkup as well as the basic checklists were found to be risk factors for both the young-old elderly individuals and the old-old elderly individuals, indicating the need to utilize these lists for the prevention of nursing even in the late stages of life. Moreover, these results suggest the importance of screening elderly individuals suffering from hyperkinesis using the basic checklist and conducting preventive interventions in order to maintain and improve their physical functions.

　　The process of creating health promotion activities in the community was analyzed by means of document examination. The results showed that the process has four periods, namely, the preparation period, consensus period, planning-implementation period, and continuation period. Based on our results, we propose a general-purpose design for community resident-centered health promotion activities in areas with different characteristics.

BACKGROUND/AIMS: Upper gastrointestinal symptoms are more frequent and severe in female than in male outpatients in Japan. This study compared the upper gastrointestinal symptoms between healthy male and female young adult volunteers using a questionnaire. METHODS: In total, 581 third-grade medical students at Saga Medical School aged 22 to 30 years underwent upper gastrointestinal endoscopy and completed a questionnaire (frequency scale for symptoms of gastroesophageal reflux disease) from 2007 to 2013. Of these 581 students, 298 who were negative for Helicobacter pylori infection and had no particular lesions on endoscopic examination were enrolled in the present evaluation. A symptom was defined as positive when the subject evaluated the frequency of the symptom as sometimes, often, or always. RESULTS: The subjects comprised of 163 males (average age, 23.7 years) and 135 females (average age, 23.1 years). Upper gastrointestinal symptoms were more frequent in the females (75 of 135, 55.6%) than males (69 of 163, 42.3%; P < 0.05), with a high score for 4 symptoms (bloated stomach, heavy feeling in the stomach after meals, subconscious rubbing of the chest with the hand, and feeling of fullness while eating meals). Of the 144 subjects (69 males and 75 females) who complained of these symptoms, the females complained of dysmotility symptoms more often than did the males, but this was not true for reflux symptoms. CONCLUSIONS: This study suggests that females develop upper gastrointestinal symptoms more frequently than do males among the young healthy Japanese population.
Asian Continental Ancestry Group* ; Dyspepsia ; Eating ; Endoscopy ; Endoscopy, Gastrointestinal ; Esophagitis ; Female* ; Gastroesophageal Reflux ; Gastrointestinal Motility ; Hand ; Helicobacter pylori ; Humans ; Japan ; Male* ; Meals ; Outpatients ; Schools, Medical ; Stomach ; Students, Medical ; Thorax ; Unconscious (Psychology) ; Volunteers* ; Young Adult

Objective: The rates of care-needs certification were mainly compared between two cohorts: 7,820 specific health checkup examinees/basic checklist respondents and 29,234 non-examinees/non-respondents.Subjects and Methods: Among approximately 37,000 elderly citizens of X City, the number of individuals newly certified as requiring long-term care were observed from the date of the first specific health checkup in 2008 to March 31, 2013. The aggregated totals of these individuals and associated factors were evaluated.Results: 1. Support Required 1, Support Required 2, and Long-term Care Required (level 1) certified individuals accounted for approximately 80% of newly certified individuals aged 65–74 years. Newly certified individuals aged 75 years and over had similar results with 37.2% of them being certified Support Required 1, 19.4% certified Support Required 2, and 22.9% certified Long-term Care Required (level 1). 2. The primary factors for care-needs certification in individuals aged 65–74 years were arthritic disorder in 27.6%, falls and bone fractures in 11.3%, and malignant neoplasm and cerebrovascular disease, among others. This was similar for individuals aged 75 years or over. 3. Of the 7,820 specific health checkup examinees/basic checklist respondents, 1,280 were newly certified as requiring long-term care (16.4%) compared to 7,878 (26.9%) of the 29,234 non-examinees/non-respondents. Therefore, the latter cohort had a significantly higher rate of individuals who were newly certified as requiring long-term care.Conclusion: Both specific health checkups and basic checklists are effective health policies to protect frailty in community elderlies.