The objective of this study was to implement and evaluate the effectiveness of a program developed using mixed research methods to encourage people who did not regularly receive check-ups to receive regular specific health check-ups. In this study, we developed individualized support plans based on the responses to preliminary assessments of knowledge, attitudes, and behaviors associated with health check-ups. The support program was executed through an interview with public health nurses where specific health guidance was offered. We made evaluations based on the responses to the assessment sheet that was completed one year after the support and whether the individual has been attending health check-ups subsequently. Public health nurses provided 30.8 minutes of support (on average) to 18 participants, with ages ranging from 44 to 68 years, who consented to participate in the study. Knowledge, attitudes, and behaviors associated with health check-ups were found to have improved or maintained one year after the support program. Seventeen participants (94.4%) went for subsequent check-ups, indicating the efficacy of the support program. The originality and novelty of the present program lies in the fact that it promoted preventive health check-ups rather than specific health check-ups. Besides, the assessment and support methods found in the program were highly specific. The challenges are to make the information easy to understand through training and study sessions and implement the support program through the National Health Program in other municipalities.

  Floating toe is defined that the toe has no contact with the floor surface during standing. Therefore, the decreased stability limits in the forward direction in people with floating toe are expected. The effects of toes on the stability limits have been examined by divided into two groups: the great toe and the other toes. However, the stability limits affected by each toe should be investigated because of the different anatomical functions of each toe. The purpose of this study was to investigate the effects of a floating toe on the forward stability limits. Ten healthy young females performed the maximal voluntary forward-leaning during standing under the six conditions: no lifting toes and each lifting toe from great to little toe condition. The toe was pulled upward through a string using a weight. The stability limits were calculated by the displacements of center of pressure in the sagittal plane. The stability limits under the lifting great toe condition were smaller than the other conditions. Interestingly, those under the lifting second toe condition were reduced compared to the lifting third toe condition, but no change was shown between the lifting from the third to fifth toes and no lifting condition. These results suggest that the lifting great or the second toe, but not the lifting from the third to fifth toes, restricts the forward stability limits.

  The effects of stretching the skin over the anterior surface of the thigh with application of various pressures at the stimulation site while standing, on the movements of the subcutaneous tissue (Experiment 1) and direction of the postural response (Experiment 2) were investigated. Subjects in each experiment were 16 different healthy young adults. In both experiments, the skin around the muscle-tendon junction of the rectus femoris was stretched proximally with an amplitude of 7.5 mm and velocity of 10 mm/s. The pressure was set from 0 to 200 g in steps of 25 g in Experiment 1, and from 0 to 350 g in steps of 50 g in Experiment 2. In Experiment 1, skin stretching was performed with the subject's body fixed. Using an ultrasonic scanner, the resulting movements of the deep skin, superficial fascia, and deep fascia were analyzed. Movements of the deep skin and superficial fascia were apparent in all subjects at all pressures. For deep fascia, the proportion of subjects showing movement increased as the pressure increased beyond 50 g. In Experiment 2, the subjects were instructed not to resist any postural responses and the direction of the postural response to skin stretching was measured. All subjects showed forward leaning at 0 g. The proportion of subjects showing backward leaning increased as the pressure increased. These results suggest that forward leaning might occur by stretching of the skin and subcutaneous tissue, and backward leaning might occur with stretching of the fascia in addition to these tissues.

  We investigated muscle activity and the joint sounds associated with knee flexion in standing. Thirteen healthy young adults were asked to flex their knee to 45° once per second for 5 repetitions from a quiet standing posture. Joint angle, anterior movement and joint sounds of the knee, and muscle activity of the rectus femoris (RF), biceps femoris (BF), and gastrocnemius medialis (GcM) were measured. Only GcM activity started approximately 50 ms prior to the onset of knee flexion, which suggests that GcM could be strongly related to the release of knee locking. RF activity peaked about 60 ms after RF onset (first RF peak). Approximately 50 ms after the first RF peak, the first joint sound was observed along with acceleration peaks in joint angle and anterior movement of the knee. This finding suggests that the first joint sound could be related to higher RF tension and/or friction caused by the quick sliding of the femur on the tibia. The RF peak was followed by low activity for about 60 ms, before switching to an increase in activity to reach a second RF peak. Approximately 50 ms after the second peak, a second joint sound was observed. This suggests that the second joint sound is associated with higher RF tension to resist the fall of the center of gravity, which leads by a stretch reflex of the RF.

  In the past study, Transferring Art Movement Assessment (TAMA) tool was developed to assess nurses' low back loads while repositioning patients. In this study, the tool was developed to estimate the compressive force (Fc) on a nurse's lower back. A total of 15 participants' and 60 repositioning motions were analyzed. The average Fc was 5.9 ± 1.5 kN, and the maximum Fc was 6.3 ± 1.4 kN. The overall score of the TAMA tool was 6.7 ± 1.9 points. There was a significant strong negative correlation between the average Fc, and the overall score (r = -0.70, p < 0.01). The maximum Fc yielded the same trend (r = -0.73, p < 0.01). Given these correlations, the formula to obtain the average Fc was determined to be -0.58 × overall score (points) + 9.82, and -0.59 × overall score (points) + 10.26 for the maximum. The developed TAMA tool makes it possible to assess a nurse's low back load according to NIOSH criteria.