This center was established at its downtown in 2011. In order to either maintain or promote health-welfare status at the elderly life stage, the center has been providing regular physical exercise courses using hot spring water pumped up there. These activities have been performed cooperating with all 32 community general support centers covered whole the city.  Main findings and indication from our activities in these10 years were as follows:  1．Total number of attendants increased from around 60 to 90 thousands a year. About one fourth of them were the QOL (Quality of Life) tour member aged 65 years or more attending twice a week in every 3-month by the courtesy bus, and the others aged 40 years or more attended with their own ways.   The attendants aged 75 years or more has gradually increased to 70〜80% of QOL tour member. For the other member, it has been in 20〜30% these 10 years.  In addition to the physical exercise in 33〜36°C hot spring water consisted of walking, stretch & flex, aquatic exercise for joint-musculoskeletal pain and others, power-up rehabilitation, exercise for joint-musculoskeletal pain and others were performed on floor, too. The grade of these exercise consisted of 30, 40 and 50% of maximum heart rates depending on physical examination results of 5 m-walk, timed up & go test (TUG), the 30 seconds chair-stand test (CS30), hand grip, functional reach and posture forward bending, and doctors’ inspection.  2．On the follow-up of the physical examinations measured every 3-month, 5 m-walk, hand grip and CS30 were shown to be suitable items due to the availability as the routine examination. The results are substantially useful for reviewing each attendant status in longitudinal course, and indicate our treatments for them.  3．The attendants increased and distributed over the whole city in these 10 years. However, as the proportion of new ones is several percentages each year, the exchange of attendants was less than we expected. This indicates that we should have closer communication with community general support centers in order to distribute our activities to people who need health-welfare promotion, but have never been in the center. On top of that, the usage of our center should be increased for people of middle ages for ideal prevention.

  This center was established at its downtown in 2011. In order to either maintain or promote health-welfare status at the elderly life stage, the center has been providing regular physical exercise courses using hot spring water pumped up there. These activities have been performed cooperating with all 32 community general support centers covered whole the city.  Main findings and indication from our activities in these10 years were as follows:  1．Total number of attendants increased from around 60 to 90 thousands a year. About one fourth of them were the QOL (Quality of Life) tour member aged 65 years or more attending twice a week in every 3-month by the courtesy bus, and the others aged 40 years or more attended with their own ways.   The attendants aged 75 years or more has gradually increased to 70〜80% of QOL tour member. For the other member, it has been in 20〜30% these 10 years.  In addition to the physical exercise in 33〜36°C hot spring water consisted of walking, stretch & flex, aquatic exercise for joint-musculoskeletal pain and others, power-up rehabilitation, exercise for joint-musculoskeletal pain and others were performed on floor, too. The grade of these exercise consisted of 30, 40 and 50% of maximum heart rates depending on physical examination results of 5 m-walk, timed up & go test (TUG), the 30 seconds chair-stand test (CS30), hand grip, functional reach and posture forward bending, and doctors’ inspection.  2．On the follow-up of the physical examinations measured every 3-month, 5 m-walk, hand grip and CS30 were shown to be suitable items due to the availability as the routine examination. The results are substantially useful for reviewing each attendant status in longitudinal course, and indicate our treatments for them.  3．The attendants increased and distributed over the whole city in these 10 years. However, as the proportion of new ones is several percentages each year, the exchange of attendants was less than we expected. This indicates that we should have closer communication with community general support centers in order to distribute our activities to people who need health-welfare promotion, but have never been in the center. On top of that, the usage of our center should be increased for people of middle ages for ideal prevention.

  The studies on the effects of balneotherapy in combination with other therapies (kinesitherapy, bath agents, diet therapy, pharmaceutical therapy, climatotherapy and phototherapy, and multiple therapies) published in past two decades have been reviewed. The effects of the combined baleotherapies on diabetes, rheumatoid arthritis, osteoarthritis, psoriasis vulgaris, atopic dermatitis, ankylosing spondylitis, stiff neck, chronic back pain, peripheral circulatory failure, emphysema, bronchial asthma, and fibromyalgia syndrome have been suggested or evidenced. The health promotion effects of combined balneotherapies among healthy or ill-healthy persons have also been showed.

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.

OBJECTIVESOnly a few long-term follow-up studies with a focus on the association between lung function and mortality in the Japanese population have been undertaken. In this study, we examined the associations of lung function, smoking and the results of allergy skin tests with mortality in a longitudinal study of the Japanese population.

METHODSBaseline measurements were performed on residents of Fukui, Japan in 1972, and a follow-up survey was conducted in 2002. By employing a nested case-control design, 596 cases (deaths) and 596 age and sex-matched controls (survivals) were selected. Lung function was assessed using forced vital capacity (FVC) expressed as the normal percent predicted (FVC %pred) and the ratio of forced expiratory volume in 1 second (FEV(1)) to FVC (FEV(1)/FVC). Allergy skin tests were performed with extracts of house dust, candidia and mixed fungal samples (bronchomycosis). The Brinkman index was used to assess smoking intensity. The Cox proportional hazards model was used to evaluate whether lung function was associated with mortality after adjustment for other potential confounding variables.

RESULTSThose categorized into the first- or second-lowest quartile of FVC %pred had a higher mortality [hazard ratios (HRs) and 95% confidence intervals (CIs): 2.01 (1.26-3.19) and 1.84 (1.11-3.05)], respectively. On top of these, heavy smoking (BI≥400) was associated with a higher mortality [HR and 95% CI: 1.73 (1.18-2.53)]. There were only weak of associations between the results of allergy skin tests and mortality.

CONCLUSIONSThese results suggest that FVC %pred of lung function and smoking can serve as long-term independent predictors of mortality.