This study clarified the effects of continuous supports for childcare on child development and environment. The subjects were all the children and caregivers who used childcare centers belonged to association of authorized child night care. Caregivers and childcare professionals were asked to answer questionnaires both in 1998 and 2000. Among data of 1,949 caregivers and 2,905 children (by professionals) in 1998, 2,186 caregivers and 2,839 children in 2000, 551 caregiver-child matching data of both years were used for discriminant analysis. The results were as follows ; 1. Continuous supports related to reduce problem behaviors of children. 2. Also continuous supports promoted to increase suitable rearing environment and caregivers self efficacy. Further research must be done to establish more effective evidence-based support for childcare.

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The relationships of the rate of waiting for admission to nurseries for infants up to 2 years of age (ratio of infants waiting for admission to nurseries and the number of infants that have been admitted to nurseries) with the employment rate of women aged 25-39years and with socioeconomic factors in 694 municipalities in Japan were investigated. According to the results of analysis, the relationships between the rate of waiting for admission to nurseries for infants of 0-2 years of age and employment rate of women aged 25-39 years could be divided into the following four groups : one group in which the nursery admission waiting rate for infants and employment rate of women were both higher than national average rates (75 municipalities), one group in which the employment rate of women was lower than the national average rate but the nursery admission waiting rate for infants was higher than the national average rate (95 municipalities), one group in which the nursery admission waiting rate for infants and employment rate of women were both lower than national average rates (193 municipalities), and one group in which the employment rate of women was higher than the national average rate but the nursery admission waiting rate for infants was lower than the national average rate (331 municipalities). Thus, the results showed that differences in the employment rate of women and admission vacancies in nurseries have arisen due to differences in the characteristics of municipalities in Japan. The results indicate the necessity for the establishment of a national government policy to ensure that there is an adequate number of nurseries, particularly in large cities, and for the government to take administrative measures such as providing subsidies for construction of new nurseries in areas with high land prices and for compensation for increased nursery operating costs.

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The purpose of this study was to clarify the factors to promote professional skills for collaboration. The subjects were 987 professionals for health-social services ; care workers, home helpers, visiting nurses, physical therapists, occupational therapists and social workers. Professionals were asked to answer a questionnaire on "Evaluation of Professional Skills and Knowledge (EPSK, 79 items)" , sex, and experience as professional/ manager. According to the results of logistic analysis by stepwise method, collaboration skill was promoted among the professionals who get higher mark on "making a rapport", "explanation", "follow up", "information management", "making suitable plan", "risk management", "keeping relation", "evaluation of team system", "clarify the scale of validity" and "experience as professional". Further research must be done to develop effective system for professionals to promote collaborating skills.

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The purpose of this study was to determine the factors related to self-assessed physical fitness and life style of elderly patients with chronic respiratory failure. The subjects were 99 people (60 men and 39 women) who participated in breathing classes conducted at seven public health centers in Aomori Prefecture. After explaining the purpose of the investigation to the subjects, the subjects were instructed to fill out questionnaires. The items investigated were sex, age, underlying disease, hospitalization in the past year, percent vital capacity (%VC), transcutaneous arterial oxygen saturation, and body mass index (BMI). It was found that self- assessment of physical fitness by the subjects was closely related to %VC and BMI and also closely related to two aspects of life style, walking status and drinking status, which were thought to depend on %VC. The results suggest that self - assessment of physical fitness, one of the indexes of subjective health, must be taken into account in order to provide appropriate guidance regarding life style.

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The purpose of this study was to clarify the factors related to self-efficacy by focus group interview method, and to develop action plan to improve the self-efficacy for health behavior among middle-aged women. Two focus group interviews were designed, the subjects of first one were 5 residents who attended a series of health classes, and the other were 8 health care professionals in a urban city on the main island of Japan. Details in the focused group session are tape-recorded and analyzed by using the conceptual framework of Bandura (1997). The results suggested that the five effective methods to improve the self-efficacy for health behavior among the middle-aged women as follows : 1) to set clear target of each person for improving data, 2) to give chances to notice the vicarious experiences by others, 3) to get effective advices by professionals based on clear evidence, 4) to be motivated by positive physiological and affective expectations, and 5) to get useful information for healthy life style.

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Factors that effect utilization of in - home health and welfare services were examined on troublesome old people of 3,531 persons by logistic regression analysis for the daily life of staying home. As the result, the lowering of ADL affected the utilization on the most service, and the degree is different by the service. And, the one person living very greatly affected the utilization of meal delivery service and home - help service. In the nursing care insurance system, the certification of nursing care needs is fundamentally carried out only by the situation of the mind and body of the aged and not by the family make-up. However, the service level offered actually is low, and it is very difficult to send the staying home life only in the service provided in the insurance, when the family nursing cannot be expected. Therefore, it is desired to pull up the service level offered by the insurance to the grade which does not need family care, or to construct the system which complements the insurance.

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The purpose of this study was to clarify risk factors of mortality for elderly by focusing on the social network ties, which defined as amount of interaction with close relatives and friends. The subjects were all the residents of 60 years of age and older in an agricultural village near a large urban center on the main island of Japan. A mail survey of 663 residents was designed to get a clear picture of social network ties were like in this village and peoples life styles, etc. A total of 61 subjects deceased within five years period after the baseline survey. The results were as follows : 1) The mortality was higher among the elderly of 75 years of age and older, and of the dependent on moving and changing clothes. 2) Also, mortality was higher among the elderly who had weak social network ties (less than 36 times per year) and dependent on changing clothes by logistic regression analysis adjusting for age and sex. 3) Strong social network ties reduced mortality even adjusting for age, sex, activity of daily living, and health status. These findings suggest a strong influence of social network ties to mortality, and a useful prevention strategy that would ensure the provision of support services to avoid a health decline for the elderly.

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