Background/Aims: The objective of this research is to examine factors related to irritable bowel syndrome (IBS) prevalence in a large population-based study. Methods: A cross-sectional study was conducted with participants in the Miyagi part of the Tohoku Medical Megabank Project CommunityBased cohort study who completed the Rome II Modular Questionnaire. Multivariate odds ratios (ORs) for the presence of IBS and 95% confidence intervals (95% CIs) for the reference group were calculated for each factor. Additionally, a stratified analysis was performed by sex and age group (20-49 years, 50-64 years, and ≥ 65 years). Results: Among 16 252 participants, 3025 (18.6%) had IBS, comprising 750 men (15.5%) and 2275 women (19.9%). Multivariate ORs for the presence of IBS decreased significantly with each year of age (OR, 0.98; 95% CI, 0.98-0.99). Moreover, compared with the reference group, ORs for the presence of IBS were significantly higher in individuals whose home was partially damaged by the Great East Japan Earthquake, those with < 16 years of education, those who spent less time walking, those with high perceived stress (1.77, 1.57-2.01), those with high psychological distress (1.58, 1.36-1.82), and those with high symptoms of depression (1.76, 1.60-1.94). In stratified analyses, a significant relationship was found between psychological factors and IBS prevalence in all sex and age groups. Conclusions This large cross-sectional population-based cohort study identified several factors associated with IBS prevalence. Psychological factors were significantly associated with IBS prevalence across all age groups and sexes.

BACKGROUND: It has been pointed out that prolonged television (TV) viewing is one of the sedentary behaviors that is harmful to health; however, the association between socioeconomic status (SES) and prolonged TV viewing time has not been sufficiently investigated in Japan. METHODS: The study population are the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2752 adults. SES was classified according to the employment status, educational attainment, living status, and equivalent household expenditure (EHE). Prolonged TV viewing time was defined as more than or equal to 4 h of TV viewing per day. Multivariable logistic regression analyses were conducted to examine the association of SES with prolonged TV viewing time. RESULTS: The mean TV viewing time was 2.92 h in all participants. Of 2752 participants, 809 (29.4%) prolonged TV viewing, and the mean TV viewing time of them was 5.61 h. The mean TV viewing time in participants without prolonged TV viewing time was 1.81 h. The mean TV viewing time was prolonged as age classes increased and significantly longer in aged ≥60 years. Prolonged TV viewing time was associated with not working for all age classes and sexes. Only among women, education attainment and living status were also associated with prolonged TV viewing time. For education attainment, the lower the received years of education, the higher odds ratios (OR) of prolonged TV viewing time. For living status, in women aged <60 years, living with others had a significantly higher OR compared to living with spouse. On the other hand, in women aged ≥60 years, living alone had a significantly higher OR. EHE did not have any significant associations with prolonged TV viewing time. CONCLUSIONS In a general Japanese population, it should be noted that the association between SES and prolonged TV viewing time differed by age and sex. Particularly, it must draw attention to the prolonged TV viewing in elderly. The intervention in order to shorten TV viewing time needs to consider these attributes.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Educational Status ; Female ; Humans ; Infant ; Japan ; Male ; Middle Aged ; Prospective Studies ; Sedentary Behavior ; Sex Factors ; Social Class ; Socioeconomic Factors ; Television/statistics & numerical data* ; Young Adult

BACKGROUND: The gender-specific characteristics of individuals at an increased risk of developing depression currently remain unclear despite a higher prevalence of depression in women than in men. This study clarified socioeconomic and lifestyle factors associated with an increased risk of subclinical depression in general Japanese men and women. METHODS: Study participants were residents not receiving psychiatric treatments in 300 sites throughout Japan in 2010 (1152 men, 1529 women). Multivariable-adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) for socioeconomic factors and lifestyle factors were calculated using a logistic regression analysis. RESULTS: Risk of depressive tendencies was significantly higher in men who were single and living alone (OR, 3.27; 95% CI, 1.56-6.88) than those married. The risk was significantly lower in women who were not working and aged ≥ 60 years (OR, 0.39; 95% CI, 0.22-0.68) and higher in men who were not working and aged < 60 years (OR, 3.57; 95%CI, 1.31-9.72) compared with those who were working. Current smoking was also associated with a significantly increased risk of depressive tendencies in women (OR, 2.96; 95% CI, 1.68-5.22) but not in men. CONCLUSIONS Socioeconomic and lifestyle factors were associated with an increased risk of depressive tendencies in general Japanese. Related factors were different by sex.
Adult ; Aged ; Community Psychiatry ; statistics & numerical data ; trends ; Depression ; epidemiology ; Female ; Health Surveys ; Humans ; Japan ; epidemiology ; Life Style ; Male ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors ; Socioeconomic Factors

BACKGROUND: Oral health is thought to be associated with diet quality, and socioeconomic status (SES) affects both oral health and diet. The aim of this study was to investigate the association between the number of teeth and dietary intake as well as nutritional biomarker, considering the subjects' SES. METHODS: We conducted a cross-sectional analysis of data from 2049 individuals aged ≥ 50 years from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010. The number of remaining teeth was categorized into age-specific quartiles (Q1 to Q4). We assessed the adjusted means and 95% confidence intervals for dietary variables by the number of teeth using analysis of covariance. Stratified analyses by SES were also conducted. RESULTS: The intake of grain products was 31 g higher, and those of vegetables and meat were 30 g and 8 g lower, respectively, in Q1 (fewer teeth) than in Q4 (more teeth). Carbohydrate intake was higher whereas protein, minerals (potassium, magnesium, and zinc), vitamins (vitamins A, E, B, B, β-carotene, and folic acid), and dietary fiber intakes were lower among individuals with fewer teeth. Adjusted mean serum albumin levels were low in Q1. The associations between the number of teeth and dietary intake were more evident in individuals with a low SES. CONCLUSIONS Having few remaining teeth was associated with a low nutrient intake and low serum albumin levels in middle-aged and older Japanese adults, and these associations were more evident in individuals with low SES.
Aged ; Aged, 80 and over ; Carbohydrates ; Cross-Sectional Studies ; Diet ; Energy Intake ; physiology ; Female ; Humans ; Japan ; Male ; Middle Aged ; Nutrients ; Nutrition Surveys ; Nutritional Status ; Serum Albumin ; analysis ; Socioeconomic Factors ; Tooth ; Vegetables

Background: Globalization urges us to discuss rationale and policy towards establishing a medical education accrediting body in Japan. Experience of General Medical Council （GMC） suggests us some useful lessons.
Method: Based on our visits and investigation into in GMC, we inquire how Quality Assurance （QA） was introduced in UK with what incentives and how QA has brought reforms in the medical schools in UK.
Result: Since 2003, GMC has changed its policy for QA from ‘inspection’ to ‘dialogue’. Dialogical QA asks a medical school to think critically of their education and consider vigorous actions for further improvements.
Discussion: Implications from the experience of GMC are: 1.QA process in GMC makes medical schools take robust steps towards changes, 2. Sharing the rational and policy for QA created the solid base for its effective implementation, 3. There are possible difficulties in establishing structure to do an enormous amount of coordinating work, which is necessary for constructing ‘dialogue with medical schools’.

Introduction
Recently, an increasing number of registered foreigners get married and bear children in Japan. At the same time, a variety of needs for maternal and child health (MCH) impose burden for medical practitioners. A questionnaire survey was conducted to clarify the situation of MCH service for foreign residents.
Method
Self-report questionnaires developed by “The study group for MCH in a multiethnic and multicultural society” were sent by mail to the pediatricians registered in the Gunma medical association or Gunma pediatric association. In total, target number was 299. The survey period was between 2003/10/6-11/3.
Result
The number of valid response was 167. Out of 167, 155 doctors replied to have experience of caring foreigners. 75% of them had the experience of trouble in communication. For the question of the need of translator, 76.8% of doctors answered “absolutely necessary” or “necessary if the quality of translation is high enough”. Desired competencies for translators were “Accurate translation of diagnosis, hands on of treatment strategy” or “To help taking detailed patient's history”.
For the experience of using MCH handbook in foreign languages, 52.9% of doctors answered “Never used it”.
Discussion
We found that the majority of doctors had difficulty in communicating with foreigners.
To meet the doctors' requirement for the competency of translator, two strategies should be considered. One is to develop professional medical translator through education of basic medical knowledge or Japan's health care system. The other is to train foreigners already engaging in translation.
For communication tools development, user friendly concept should be reflected including 1) adscript of foreign and Japanese languages, 2) illustration usage and 3) eye-friendly materials for elderly. Contents should have explanations including 1) diagnosis and treatment policy for common disease, 2) ways of coping with common symptoms, and 3) the information of a variety of Japan's welfare services.

During the perioperative period after total hip arthroplasty (THA), much attention has been recently paid to deep venous thrombosis, yet there are few reports concerning stroke after THA and there is no such data at all in Japan at present. The purpose of this retrospective study was to elucidate the occurrence rate and the characteristics of stroke cases during the THA perioperative period. A total of 1,551 primary THAs performed between January 1999 and December 2008 were investigated. Cerebral infarction occurred in three patients (0.19%) during three weeks after THA. Concerning the related factors, one male had foramen ovale, one female had untreated diabetes and atrial fibrillation, and one female had severe stenosis of the internal carotid artery. Cerebral infarction occurred at Day 1 in one male, at Day 2 in one female, and at Day 5 in the other female, and they underwent anticoagulant therapy just after their diagnosis. In all three patients, motor paralysis fully improved and they came back to the THA rehabilitation program within Day 9. One male was discharged at 4 weeks, and another two females were discharged at 8 weeks. Because many people eating a more European diet are now getting older in Japan, prophylaxis for not only DVT but also stroke after THA should be emphasized.

The Ibaraki Prefectural University of Health Sciences has introduced an integrated education management system to improve the quality of education. The management system was implemented by the Academic Affairs Committee and is run by the newly-created Kyouiku Suishin Shitsu (Educational Development Services). The management system evaluated past curricula and coordinated the introduction of new courses and integrated curricula designed to stimulate selflearning by students. The management system also integrated the student evaluation system and simultaneously coordinated faculty development workshops for all university staff to improve teaching skills. Several questionnaires showed that the new curricula met students' learning needs and provided a more objective evaluation system. The integrated education management system functions as a positive component in the improvement of the education system for students of allied health professions.

A descending thoracoaortic aneurysm excluded by stent-grafting had expanded during a period of one and a half years. There was no endoleakage but there was shortening of the stent-landing on both proximal and distal sides. Aneurysm seemed to be pressed by blood pressure through the graft in TEE. The aneurysm was replaced by an artificial graft through a left heart bypass. Because ESP diminished during the operation, VIth intercostal arteries were reconstructed immediately, and CSF drainage was performed. Following this procedure there was no paraplegia.

A 84-year-old man was admitted with an abdominal tumor. Prosthetic graft replacement between the aorta and the left external iliac artery was performed 17 years previously. CT scan and angiography showed a large anastomotic pseudoaneurysms at the sites of proximal and distal anastomosis. A Y graft prosthesis replacement was performed. The size of the proximal anastomotic pseudoaneurysm was 7×6×5cm, and that of the distal anastomotic pseudoaneurysm was 15×10×10cm. They resulted from cutting at anastomosis. Large anastomotic pseudoaneurysms at both sites is rare.