The purpose of this study was to clarify the factors limiting food choices of elderly people living in a mountainous region. Focus group interviews were conducted with elderly residents of Unnan City, Shimane Prefecture, to examine their attitudes toward healthy eating habits and factors limiting the variety of food intake. Results of quantitative text analysis showed that attitudes toward healthy eating could be classified into three categories: “balance of health and food”, “eating each food groups”, and “taking care of own health”. The factors limiting the intake of a variety of foods could be classified into three categories: “economic reasons”, “limiting about meat and fish”, and “limiting about potatoes”. Attitudes toward the intake of balanced meals and each food were extracted as attitudes toward healthy eating among the elderly. Economic factors (including the priority given to saving money rather than health) and social environmental factors such as family members living together were included as factors limiting the dietary habits of elderly people living in mountainous regions. There is a need to develop a strategic approach to dietary instruction based on the individual life background of community residents.

Objective: There are many observational and clinical studies on pain treatment in farmers; however, little is known about the effects of interventions based only on randomized controlled trials (RCTs) on diseases of the musculoskeletal system or connective tissue (D-MSCT). This review aimed to summarize evidence on the effects of non-surgical interventions for pain relief and symptom improvement in farmers with D-MSCT.Materials and Methods: We searched seven databases, including MEDLINE, and three clinical trial registries, including the International Clinical Trials Registry Platform, from inception up to February 15, 2021, to identify studies that included at least one treatment group wherein nonsurgical interventions were applied. We focused on 1) pain relief and symptom improvement and 2) quality of life and improvement in physical fitness.Results: Four studies (three on low back pain and one on knee osteoarthritis) met all the inclusion criteria. Overall, the risk of bias was high, and meta-analysis could not be performed due to heterogeneity. However, a participatory ergonomic approach, exercise centered on strength training with a transtheoretical model, and/or a combination of both could be included in effective educational programs, at least in the short term, to prevent and/or reduce exacerbation of D-MSCT in farmers. Based on internal and external validity, we could postulate a future research agenda and a conceptual education model to prevent D-MSCT in farmers.Conclusion: Participatory ergonomic intervention, exercise centered on strength training, and/or a combination of both could be included for effective educational programs to prevent and reduce exacerbation of D-MSCT in farmers. High-quality RCTs with a less risk of bias will be implemented for many agricultural work types in various parts worldwide (especially developing countries and regions) during the COVID-19 pandemic.

  The primary objective of this study was to collect evidence that individuals who use hot spring facilities and public baths have a low risk of being infected with COVID-19. The secondary objective was to comprehensively summarize the research issues that remain to be explored in the field of balneology considering results of previous research.  Literature databases used were CINHAL, Cochrane Library (Clinical Answer, Cochrane Protocol, Cochrane Review, Editorials, Special Collections, Trials), Ichushi Web (in Japanese), MEDLINE, and Web of Science Core Collection. For each database, we selected results from the time it was opened through July 26, 2021. When intervention studies and experimental were searched, the following modified PICOS was used the following: P (Participant: no restrictions on the presence or absence of illness), I (Intervention: normal breathing or intentional sneezing, coughing, conversation), C (Comparison: no restrictions), O (Outcome: markers that simulate the flow of indoor air, the dynamics of droplets, and droplets in bathrooms and dressing rooms), and S (Study design: including intervention studies and experiments without a control group). For observational studies, PECOS included: P (participants: unlimited with or without disease), E (Exposure: public bathing facility), C (comparison: unrestricted), and S (study design: cross-sectional study, cohort study, and case-control study).  For the primary objective, no studies met the eligibility criteria, and at the time of this study there was no evidence that the use of hot spring facilities or public baths presented a low risk of being infected with COVID-19. Regarding the secondary objective, there were 15 relevant studies. In the context of a society that is strongly influenced by COVID-19, our literature review identified four research issues: “A. Use of hot spring facilities and public baths has a low risk of COVID-19 infection”, “B. The quality of hot springs and the room temperature and water temperature of public baths make SARS-CoV-2 inactivate/attenuate”, “C. Hot spring facilities, public baths, bathing habits at home lead to prevention of COVID-19 and alleviation of symptoms”, “D. Bathing for survivors of COVID-19 is effective for various rehabilitation of patients”. Suitable research approaches for each issue would be required in order to grasp each evidence.