Background: Understanding the long-term effects of environment on health behavior is important for the promotion of population-based physical activity.Purpose: The purpose of this study was to examine the relationship between perceived environment and active commuting among Japanese adults.Methods: Internet-based cross-sectional survey were conducted to 3,000 Japanese adults aged 30-59 years. Seven sociodemographic attributes (gender, age, marital status, employment status, living status, educational attainment and household income), type of commute and International Physical Activity Questionnaire Environment Module were assessed by self-administered questionnaire.Results: Of all respondents to the survey, 2,032 (mean age: 43.8±9.2, male: 62.5%) were employed. Those who use an active commute were 1,401 (68.9%). In both genders, high residential density (male: OR=2.28, female: OR=3.08), good access to shops (OR=2.03, 3.06), public transportation (OR=1.65, 3.78), recreational facilities (OR=1.31, 1.44), presence of sidewalks (OR=1.42, 1.77), crossroads (OR=1.87, 1.76), having a destination (OR=1.84, 2.34), and not having household vehicles (OR=15.13, 41.24) were associated with an active commute. The results indicated some gender differences. Among male, the presence of a bicycle lane and good aesthetics was positively associated with the active commute, while traffic safety was negatively associated. On the other hand, crime safety was associated with the active commute in female.Conclusion: The results indicate that perceived environment was associated with the active commute among Japanese adults.

We aimed to elucidate the impact of the conducting state in exercise programs and the degree of improvement in sit-to-stand power index (STS-PI) on the continuation of Chokin exercise by participants one year from the completion of the intervention period. Subjects participated in a 12-week Chokin exercise class for the elderly, which consisted of 10 body mass-based exercises. As variables indicating exercise conditions, the number of exercise days weekly and the total number of sets performed during the intervention period were adopted. STS-PI was calculated using the time required to perform 10-times-repeated sit-to-stand task, and its relative change (%∆STS-PI) was used to represent the degree of improvement in physical function. Among 52 men and 129 women who responded to the inquiry about the continuation of Chokin exercise one year from the completion of the intervention period, 32 men and 93 women confirmed continuation of the exercise program. Logistic regression analysis showed that %∆STS-PI for men, as well as %∆STS-PI and the number of exercise days weekly for women, were factors associated with the decision of subjects to continue the Chokin exercise. These results indicate that the degree of improvement in STS-PI associated with the Chokin exercise class is a factor for continuing the exercise program one year from the completion of the intervention period, at least in elderly men and women. Furthermore, high exercise frequency during the intervention period may be associated with the decision to continue Chokin exercise after the completion of the intervention among women.

Previous studies showed associations of sedentary behavior with cardiovascular risks, independent of moderate-to-vigorous physical activity. However, few studies have focused on Japanese workers. This study examined the joint association of television viewing time (TV) and walking time (WT) with overweight/obesity among Japanese municipal office workers. A cross-sectional survey collected height, weight, and time spent in TV and WT from 2,175 Japanese workers, aged 22-62 years-old, by self-administered questionnaire. Participants were classified into four categories according to TV (dichotomized into long (>2 hours/day) and short (≤2 hours/day) by the median) and WT (dichotomized into long (≥30 minutes/day) and short (<30 minutes/day) by 30 minutes/day). Odds ratios (OR) for overweight/obesity (body mass index ≥25kg/m²) were calculated according to the four TV/WT categories, adjusted for potential confounders. Overweight/obesity accounted for 30.5% of men and 15.3% of women. Among men, the adjusted ORs (95% CI) of overweight/obesity were 1.14 (0.76, 1.70) for long TV/long WT, 1.13 (0.77, 1.65) for short TV/short WT, and 0.97 (0.67, 1.42) for short TV/long WT, compared with the reference category (long TV/short WT). Among women, the adjusted ORs (95% CI) were 0.70 (0.39, 1.13) for long TV/long WT, 0.55 (0.33, 0.94) for short TV/short WT, and 0.54 (0.33, 0.89) for short TV/long WT. Spending a long time watching television was associated with a higher risk of being obese in Japanese female municipal office workers, independent of WT. Further studies using prospective designs are warranted to develop an effective weight control program for Japanese workers.

Background: Epidemiological findings suggest that weight fluctuations are associated with unfavorable health outcomes compared with stable weight. However, the interrelationship between the weight cycling history and dieting status in a non-clinical male trial on the risk for bio-behavioral health is unclear. Objective: The purpose of this study was to examine the relation between weight cycling history as a result of intentional weight loss and bio-behavioral health in Japanese adult males. Method: A cross-sectional study was performed on a group of 146 Japanese working males (47.5±9.3 yr.). Each subject completed a series of self-reported questionnaires in which information about weight cycling history, current dieting practices, life-styles, and social background were assessed. Results of the physical check up were used to assess biological parameters. Self-reported weight cycling was defined as intentionally losing 10% of one's weight and regaining the lost weight. Results: Cyclers reported a significantly greater incidence of current dieting and recent weight gain compared with non-cyclers. Taking regular meals, eating breakfast everyday, and not eating snacks between meals every day were significantly less frequent among cyclers compared with non-cyclers after controlling for BMI. The adjusted odds ratio for AST abnormality was 5.46 (95%CI: 1.08 −27.67), ALT abnormality was 3.31 (95%CI: 1.24−8.78), and γ-GTP was 3.38 (95%CI: 1.07−10.67) among cyclers, compared with non-cyclers. Conclusion: These findings suggest that a history of weight cycling in men, regardless of current weight status, is associated with adverse bio-behavioral health. The risk for several liver enzyme abnormalities associated with weight cycling history was substantial, independent of relative body weight and lifestyle factors.
Weight ; Health ; brief historical notes, excludes case histories ; Japanese language ; Cephalic index

Objective : To translate the Abbreviated Neighborhood Environment Walkability Scale into Japanese (ANEWS-J) and to examine its reliability.Methods : One hundred sixty three community residents (male: 38.7%, age: 21-69 years old) of 600 who were randomly selected from the registry of residential addresses of Taitoh Ward in Tokyo and Fujinomiya City in Shizuoka Prefecture, responded to mail survey including ANEWS-J. Seventy-seven of 163 answered same questionnaire twice with ten days interval to examine the test-retest reliability.The questionnaire was translated into Japanese and fixed through the processes of preliminary test, backtranslation into English and discussion with authors of original version.Intraclass correlation coefficients (ICCs) were calculated for the evaluation of reliability of ANEWS-J.Results : ICCs of the eight subscales of ANEWS-J were residential density; r=0.95 (95% confidence interval; 0.93-0.97), land use mix - diversity; r=0.96 (0.94-0.98), land use mix - access; r=0.90 (0.84-0.94), street connectivity; r=0.83 (0.74-0.90), sidewalk / bike lane; r=0.82 (0.71-0.89), aesthetics; r=0.85 (0.76-0.91), traffic safety; r=0.81 (0.70-0.89), crime safety; r=0.76 (0.62-0.86).Stratified analyses by gender and residential district showed satisfactory reproducibility of the subscales (r=0.63-0.97). Conclusion : Acceptable reliabilities of all eight subscales of ANEWS-J were confirmed in this study.

Background: Perceived benefits and barriers to exercise are important correlates of exercise participation. Purpose: To develop a short version of the perceived benefits and barriers to exercise scale and to examine its validity and reliability. Methods: A population-based cross-sectional study of 865 participants (age: 20-69 years old, men: 46.5%) was conducted in four cities in Japan (Koganei, Tshukuba, Shizuoka, Kagoshima). Perceived benefits and barriers scale including five benefit subscales (physical benefit, psychological benefit, social benefit, weight management, self-improvement) with 10 items, five barrier subscales (discomfort, lack of motivation, lack of time, lack of social support, poor physical environment) with 10 items and stage of change for exercise behavior were assessed by self-administered questionnaire. Results: Confirmatory factor analyses to examine the construct validity revealed acceptable fit indices (benefit scale: GFI=.980, AGFI=.951, RMSEA=.058, AIC=151.669, barrier scale: GFI=.973, AGFI=.949, RMSEA=.060, AIC=166.084). Seven of ten subscales indicated significant linear associations with stage of change for exercise behavior, criterion-related validity was revealed. The reliability of the scale was found to be good as internal consistency and inter-rater reliability. Conclusion: The short version of the perceived benefits and barriers scale developed in this study demonstrated acceptable construct validity, criterion-related validity, internal consistency and inter-rater reliability.

A 64-year-old man was admitted with intermittent high fever of 4 months duration and with three episodes of arterial embolism in the previous 2 months. Several investigations revealed evidence that those episodes involving bilateral popliteal arteries and the left external iliac artery originated from mycotic emboli. Severe mitral insufficiency due to infective endocarditis was also recognized. The ischemic symptoms improved after medical treatment. Despite antibiotic therapy for 4 weeks, inflammatory signs did not subside. Since aneurysm formation of the left external iliac artery at the embolized portion was detected on CT, mitral valve replacement and aneurysmectomy with femoro-femoral grafting were done concomitantly. Inflammatory signs disappeared immediately after the operation. Pathological findings indicated organization of the mitral vegetation and evidence of active infection in the aneurysm wall. Though aneurysmal change of a symptomatic embolized site is not common, the preoperative evaluation of possible associated mycotic aneurysm is important to decide on surgical strategy for infective endocarditis complicated by embolism.

The purpose of this cross-sectional study is to investigate the difference in physical activity among elderly living in different areas in Japan (“Bunkyo Ward in Tokyo” (Bunkyo) and “Fuchu City in Tokyo” (Fuchu) as urban areas, and “Oyama Town in Shizuoka” (Oyama) as a non-urban area). Participants were 1859 community-dwelling residents aged 65-74 years, randomly selected from the residential registry (response rate: 68.9%). A mail survey using self-administered questionnaires was conducted. Multivariate logistic regression analyses were used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) of various types of physical activity (eg, walking (Walking), going out (Going-out), bicycling (Bicycling), exercise habits (Exercise)), according to residential areas (reference category: Fuchu), stratified by gender, adjusting for socio-demographic variables. There was a significant difference in Going-out (ORs = 0.61 (95% CI: 0.44-0.86) for men, 0.48 (0.33-0.69) for women)), and Bicycling (0.04 (0.03-0.07) for men, 0.04 (0.02-0.07) for women) in Oyama compared to Fuchu. Furthermore, for women, there was a significant difference in Walking (0.56 (0.38-0.81)) and Exercise (0.59 (0.41-0.85)) in Oyama compared to Fuchu. There was a significant difference in Bicycling and Going-out for men in Bunkyo compared to Fuchu, but there was not a significant difference in other items. Low physical activity levels were observed in the elderly in the non-urban area compared to urban areas. The association was stronger in women. Regional difference might need to be taken into account for an effective physical activity intervention.

Introduction: No formal curriculum has been formulated for teaching behavioral science to undergraduate medical students in Japan.
Method: We conducted a survey using the Delphi method to investigate the required competency in behavioral science for graduates in medicine. Then, we developed an outcome-oriented curriculum for teaching behavioral science.
Results: We propose an educational module of behavioral science consisting of 15 sessions of 90-minute lectures, small group discussions, and practice.
Discussion: We recommend including not only lectures but also practices according to problem-based learning as well as team-based learning in the curriculum to achieve the target outcome.

BACKGROUNDEpidemiological findings suggest that weight fluctuations are associated with unfavorable health outcomes compared with stable weight. However, the interrelationship between the weight cycling history and dieting status in a non-clinical male trial on the risk for bio-behavioral health is unclear.

OBJECTIVEThe purpose of this study was to examine the relation between weight cycling history as a result of intentional weight loss and bio-behavioral health in Japanese adult males.

METHODA cross-sectional study was performed on a group of 146 Japanese working males (47.5±9.3 yr.). Each subject completed a series of self-reported questionnaires in which information about weight cycling history, current dieting practices, life-styles, and social background were assessed. Results of the physical check up were used to assess biological parameters. Self-reported weight cycling was defined as intentionally losing 10% of one's weight and regaining the lost weight.

RESULTSCyclers reported a significantly greater incidence of current dieting and recent weight gain compared with non-cyclers. Taking regular meals, eating breakfast everyday, and not eating snacks between meals every day were significantly less frequent among cyclers compared with non-cyclers after controlling for BMI. The adjusted odds ratio for AST abnormality was 5.46 (95% CI: 1.08-27.67), ALT abnormality was 3.31 (95% CI: 1.24-8.78), and γ-GTP was 3.38 (95% CI: 1.07-10.67) among cyclers, compared with noncyclers.

CONCLUSIONThese findings suggest that a history of weight cycling in men, regardless of current weight status, is associated with adverse bio-behavioral health. The risk for several liver enzyme abnormalities associated with weight cycling history was substantial, independent of relative body weight and lifestyle factors.