1) The number of newly employed medical residents per 100,000 persons and Gini coefficients were calculated using 2005 census data and the numbers of newly employed medical residents from 2003 through 2008.2) The maximum/minimum number of medical residents per 100,000 persons decreased from 9.3 in 2003 to 3.6 to 4.7 from 2004 through 2008. Gini coefficients also decreased from 0.21 in 2003 to 0.17 to 0.19 from 2004 through 2008.3) The interprefectural inequality was large before the introduction of the new system but decreased slightly after its introduction.

In the town which commenced health promotion facilities using hot spring in May, 2000, how the utilization frequency influences afterwards health status and active life expectancy, was investigated by the follow-up study.
The research subjects were all inhabitants aged 40 or more years living in J town with about 10, 000 inhabitants in Toyama Prefecture, Japan. The cooperation request of the survey was carried out to women's association, when the survey was performed in December, 2000.
With regard to the entry survey, the answers of 5, 812 (95.0%)of the 6, 117 registered inhabitants were collected. They were served to the follow-up survey on (1) death, (2) bone fracture, (3) cerebral apoplexy, (4) senile dementia, (5) welfare facilities entrance, (6) long term admission beyond 6 months, (7) bed bound, (8) diabetes mellitus from April, 2001 to March, 2004. The sex-age matched control was randomly selected from the inhabitants participated in the entry survey for case-control study.
As the result, the occurrence rates of (1) death and (2) bone fracture were significantly lower in the group with twice or more utilization of the hot spring per year compared with the group utilizing once or less per year, and (3) cerebral apoplexy showed the slightly significant relationship, even after adjusting with exercise habit and WHO-QOL of confounding factors. The other events were not significantly associated with frequency of hot spring utilization.
It has been indicated that health promotion facilities using hot spring could contribute to active life expectancy via health and welfare promotion.

Objective:
A rapid rise in blood pressure (BP) in the early morning is called morning BP surge and is known to be related to the onset of cerebrovascular or cardiovascular diseases. Exposure to cold temperature aggravates this condition. However, few studies have investigated the relationship between morning BP surge and bedroom temperature (BT). This study examined the effectiveness of a comfortable BT for mitigating morning BP surge.
Methods:
In this study, five healthy male university students (22.8±0.4 years old with BMI 21.7±1.3Kg/m²) volunteered to be subjects. The relative humidity in the bedroom was controlled to 50%, and the BT was set at 10°C and 250°C for two test conditions. From 0:00 to 8:00am, a Portapres Model-2 was used to measure BP continually at each beat. The average BP and heart rate (HR) from 2:00 and 4:00am were used as the baseline BP and HR. The changing rates of BP and HR from 4:00 to 7:30, the time and the BP value when BP started to rise, the time and the BP value when the BP reached the maximum, the BP value at the time of waking, and the time and rate of increase of BP until it reached the peak at temperatures of 10°C and 25°C were compared by means of the Wilcoxon signed ranking test.
Results:
The BP before waking started to rise later at 25°C than that at 10°C. BP rose more slowly at the higher BT than at the lower BT, especially 30 minutes after waking. At the lower BT, BP rose almost linearly, and the maximum rising rates were 37% (153.3mmHg) for systolic BP and 54% (97.6mmHg) for diastolic BP. At the higher BT of 25°C, however, BP reached the first peaks about 20 minutes after waking/getting up, and then remained stable. The maximum rising rate was 30% (14.2mmHg) for systolic BP and 33% (86.5mmHg) for diastolic BP. At the higher BT, BP reached the maximum value 40 minutes later for systolic BP and 60 minutes later for diastolic BP. At the lower BT, systolic BP exceeded the normal range, reached 140mmHg 35 minutes after getting up, remained stable for 55 minutes, and then rose to the maximum value of 153.3mmHg. In contrast, at the higher BT, the first peak of BP was significantly lower than that at the lower BT. Furthermore, the differences in BP between the first peak of BP and the BP value at the time of staring to rise and between the first peaks and the BP value at the time of waking up were significantly lower at the higher BT than those at the lower BT. The rising rates of BP from the time when BP started to rise and from the time of waking until reaching the maximum value were significantly lower at the higher BT than those at the lower BT.
Conclusions:
These results suggest that the margin of the rise in BP, the rising rate of BP, and the peak value of BP in the early morning are significantly lower at a BT of 25°C than those at a BT of 10°C. They also suggest that sleeping at a comfortable BT, especially during winter, may suppress morning hypertension or morning BP surge and indirectly prevent the onset of cerebrovascular and cardiovascular disease as well as related deaths. Although the subjects in this study were healthy young men, it was considered that the benefit of sleeping in warm bedroom for preventing morning BP surge may be increased for the elderly who are highly likely to have already suffered from such underlying diseases as hypertension.

In recent times, an ingestible capsule sensor for the measurement of core body temperature has become available. This equipment was used to measure the relationship between core body temperature and daily living activities such as eating, exercise and bathing etc.
The main findings were as followings:
1. With respect to daily living activities, the core body temperature during bathing showed higher values in comparison with eating and light-grade exercise etc.
2. For the same-grade of exercise (HRmax60%) either in an environmentally controlled room at either constant temperature (25°C) and humidity (50%) or in water (36°C; 50%humidity), the core body temperature showed almost identical changes for peak value and the rise and fall ever time.
3. Atypical work at midnight was associated with a continuous decrease in core body temperature.
4. Atypical sleep in the daytime was associated with a continuous decrease in core body temperature.
5. For daily living activities inducing an increase in core body temperature, the correlation coefficient between core body temperature and heart beats/min was 0.87 (p<0.01).

Background: The pathogeneses of fibromyalgia syndrome (FMS) are related with the living way of a patient, that holds biopsychosocial-existential problems. Especially existential problems are more essential; such patients are sometimes in existential vacuum. It is impossible to care the patients by onlharmacotherapy; that needs psychotherapy and physical therapy. Logotherapy and existential analysis (LTEA) was established by Prof. Viktor Frankl to save such patients, that is one of the experimental psychotherapy. Balneotherapy (BT) is popular all around the world to cure stressful patients. Objective: We have developed Balneo-logotherapy (BLT) for patients with FMS by adding LTEA to the BT, which mainly consists of treatment carried out by taking bathes at a hot spring, a non-ordinary place. We also determined the prognosis one year after the therapy. Method of BLT: After enough motivation and the informed consent, a patient begins BLT program. The mean duration of the therapy was 4.5±1.2 weeks. During the period from the start of the BLT until the time the patient was relieved of Yuatari phenomenon (thermal crisis, bath reaction, YP), the patient was directed to do nothing. Therapist should pay attention to help the patient to overcome YP. After this period, the patient was given free time to do things such as taking a walk. Throughout the period of BLT, patients should write in the simple diary every day and record what they became aware concerning the body and the mind. Subjects and methods: Subjects were 65 patients with FMS (42.0 yrs±11.5, Male: Female = 24:41). Based on pathogenesis, FMS patients were classified into two groups: psychosomatic (PSD) Type (n=30) and PTSD Type (n=35). PSD type was mainly caused by loss of bodily sense (alexithymia) and hyper-adaptation. PTSD Type was mainly caused by trauma such as ill-treatment and war experience. The relationship between having YP or not and the prognosis was also determined. Results: Overall recurrence rate was 30.8%. Recurrence rates for each type were: 23.3% for PSD Type FMS, and 37.1% for PTSD Type. Incidence of YP occurrence was: 80.0% for all cases, 86.7% for PSD Type and 74.3% for PTSD Type. The more severe YP, the better the prognosis (p<0.05). One year after the therapy, cases without recurrence accounted for 69.2% of all the cases. In PSD Type, recurrence was not seen in 73.3%. In PTSD Type, recurrence was not seen in 65.7%. Recurrence rate was lower for the group of patients with development of YP. Discussion: Therapeutic self is most important; to create interpersonal communication to tune in the patient to get aware of intrapersonal communication (according to biopsychosocial-existential model) of the patient. Patient’s psychological movements were; Dependency ⇒ Awareness ⇒ Autonomy ⇒ Reset of the mind (through YP and ASC) ⇒ Intervention by the therapist to make change in behavior through the awareness of his own meaning of life. In this process, occurrence of YP is meaningful. A hot spa is a very suitable place to perform psychotherapy like logotherapy.

BACKGROUND: Despite the fact that there are parents who do not take children with untreated dental caries to a dental clinic, few studies have been conducted to identify the responsible underlying social and family factors. The aim of this study was to investigate whether socioeconomic status and lifestyle factors are associated with dental neglect in elementary school children. METHODS: This study was conducted in 2016 with 1655 children from the Super Shokuiku School Project in Toyama. Using Breslow's seven health behaviors, the survey assessed: the grade, sex, and lifestyle of the children; parental internet and game use and lifestyle; socioeconomic status. The odds ratios (OR) and 95% confidence intervals (CIs) for having untreated dental caries were calculated using logistic regression analysis. RESULTS: Among the children participating, 152 (3.2%) had untreated dental caries. Among them, 53 (34.9%) had not been taken to a dental clinic despite the school dentist's advice. Dental neglect was significantly associated with children in higher grades (OR, 2.08; 95% CI, 1.14-3.78), father's Internet and game use ≥ 2 h/day (OR, 1.99; 95% CI, 1.02-3.88), not being affluent (OR, 2.78; 95% CI, 1.14-6.81), and non-engagement in afterschool activities (OR, 1.99; 95% CI, 1.10-3.62). CONCLUSIONS Socioeconomic status was the strongest factor associated with dental neglect despite the fact that the children's medical expenses are paid in full by the National Health Insurance in Toyama, Japan. Future studies should investigate what factors prevent parents of non-affluent families from taking their children to dental clinics and how they can be socially supported to access adequate medical care.
Age Factors ; Child ; Dental Caries/psychology* ; Female ; Humans ; Japan/epidemiology* ; Life Style ; Male ; Prevalence ; Social Class

BACKGROUND: Health and education are closely linked. However, few studies have explored the correlates of children's academic performance in Japan. We aimed to investigate comprehensively the associations of low academic performance among school children with lifestyles, parental smoke, and socioeconomic status. METHODS: In 2016, children aged 6 to 13 years from the Super Diet Education School Project were surveyed using questionnaires. The survey explored the lifestyles and subjective academic performance of 1663 children and asked their parents about parental smoke and subjective socioeconomic status. Academic performance and socioeconomic status were divided into three levels. Then, we defined subjective academic performance in the lower two levels as low academic performance. The odds ratios (OR) were analyzed by logistic regression analysis. RESULTS: Among all participants, 299 (18.0%) children reported low academic performance. In general, low academic performance was significantly associated with late wakeup time (OR = 1.36 for 6:30 to < 7 a.m. and OR = 2.48 for ≥ 7 a.m.), screen time ≥ 2 h (OR = 1.35), studying at home < 1 h (OR = 1.82), paternal smoke (OR = 1.47), maternal smoke (OR = 1.87), and low socioeconomic status (OR = 1.48). Analyses stratified by grade showed stronger associations between academic performance and socioeconomic status in senior (OR = 1.62 for middle, OR = 1.52 for low in grades 4 to 6) than in junior children (OR = 1.15 for middle, OR = 1.38 for low in grades 1 to 3). CONCLUSIONS Children's lifestyles, parental smoke, and socioeconomic status were significantly associated with low academic performance among Japanese children. Parents and health care providers should take these findings into consideration to prevent children from having low academic performance.
Academic Performance ; statistics & numerical data ; Adolescent ; Child ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; Japan ; Life Style ; Male ; Parents ; Risk Factors ; School Health Services ; statistics & numerical data ; Smoke ; adverse effects ; Social Class