Aim : To clarify the influence of low skeletal muscle mass and high percent body fat on gait speed in community-dwelling people aged 65-74 years. Method : Body composition and usual gait speed were measured in 197 men and 203 women aged 65-74 years. Subjects were categorized according to whether their skeletal muscle index (SMI) was low (men: &le;6.87kg/m² ; women: &le;5.46kg/m²) or normal, whether their percent body fat (%BF) was high (men: &ge;25%; women: &ge;30%) or normal, and whether their gait speed was slow (men: &le;1.163m/s; women: &le;1.250m/s) or normal. Furthermore, we conducted logistic regression analysis to determine which variables significantly influenced gait speed. Results : The prevalence of low SMI, high %BF, and slow gait speed was 19.8% (n=39), 52.3% (n=103), and 26.7% (n=52) in men and 23.6% (n=48), 62.1% (n=126), and 29.6% (n=60) in women, respectively. The prevalence of low SMI and high %BF in men was significantly higher than in women [men: 12.7% (n=25) ; women: 7.9% (n=16); p<.001]. Adjusted logistic regression analysis demonstrated a significant association between high %BF and slower gait speed [men: odds ratio (OR) 2.4, 95% confidence interval (CI) 1.2-4.9, p=.02; women: OR, 2.2; 95% CI 1.1-4.6; p=.03]. Conclusion : These results suggest that high %BF is a risk factor for slow gait speed in Japanese men and women aged 65-74 years.

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Purpose: This study examines the effectiveness of the pre-post intervention test of community support programs that aim to prevent the social isolation of the elderly. Method: The program was implemented with the participation of 143 community volunteers in a suburban city, Osaka. The program included: 1) home visits: participants visited the elderly in the community; 2) network meetings: after home visits, participants discussed the individuals who were at risk for social isolation; and 3) mastering skills: participants learned how to support the elderly living in the community. The data were collected by questionnaire before and after intervention. Primary outcomes were Community Commitment (CC), and Self-Efficacy Scale for Preventing Social isolation among community-dwelling elders (SES-PS ('Mimamori'Scale)). Data were analyzed by descriptive statistics and paired t-test. Results: 100 out of 143 participants completed questionnaires. Scores between pre-post programs were significantly improved for community commitment. Moreover, there was a significant improvement in the self-efficacy of the prevention of social isolation among the elderly. The level of the interest in elderly people to be supported increased significantly. Conclusion: It was observed that the community support program had a positive influence for improving self-efficacy with the aim of preventing social isolation among the elderly. It also had a positive influence on community commitment. Community support volunteers confirmed the effect of this program.

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Purpose: The purpose of the study was to explore professional skills of public health nurses (PHNs) at the first health guidance to enable subjects' decision-making in setting behavioral goals for the prevention of lifestyle related diseases. Method: The study design was a qualitative semi-structured interview study with five expert PHNs in three municipalities. A qualitative content analysis was performed focusing on PHNs professional intention, settings and intervention and so on at the first health guidance to enable subjects' decision-making in setting behavioral goals for the prevention of lifestyle related diseases. Transcripts were inductively analyzed. Results: Seventy-three<sub categories>, 19<<categories>>, and six 【core categories】 were explored as the professional skills of PHNs; 【Building value of health in client's life】, 【Encouraging taking initiative in building behavioral objective】, 【Finding the cause of health problem in client 's life】, 【Taking priority in retaining quality of life】, 【Working together on setting effective goal】 and 【Decision making of behavioral goal with looking ahead to client's future health】. Conclusion: It was found that for subjects' decision-making in setting behavioral goals for the prevention of lifestyle related diseases, PHNs built the value of health into the client's life, and encouraged taking initiative in building behavior goals. In addition, PHNs allowed the subjects to get accustomed to the behavioral goal, while sharing the process with them.

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Purpose: We aimed to clarify benefits that family facilitators gain by continuous implementation of a family-peer education program on mental disorders. Method: A cross-sectional study was employed. Questionnaires were administered at 38 program sites with sessions that ended after October from 45 sites with sessions in the 2013 fiscal year. The questionnaires were handed to family participants and facilitators during the last session and were collected by mail. Only the facilitators' questionnaires were analyzed for this study. The independent variable was the number of courses served as a facilitator. The dependent variables were the Group Benefit Scale and subscales Instillation of Hope and Secure Emotional Expression from the Therapeutic Factors Inventory-19. Results: The questionnaires were handed to 164 facilitators, 133 were returned, and 130 were valid. The more the respondents had served as facilitators, the more highly evaluated were the following factors: "Since joining the program, my coping as a family has improved greatly" (F=5.60, p<0.05), "Since I started joining the program, I feel much better about myself" (F=15.76, p<0.001), and Instillation of Hope (F=5.29, p<0.05). Discussion: Continuous implementation as facilitators may improve facilitation skills by improving abilities in listening to and praising others. These skills may also help facilitators communicate with their ill family members. Facilitators help families by using their experiential knowledge, thereby making a negative experience meaningful. Being a facilitator may affect the facilitators' ways of living. Therefore, continuous implementation by family facilitators is beneficial for the facilitators.

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Aim: The aim of this study was to clarify factors associated with interdisciplinary team approach of home care for the elderly by home visiting nurse's evaluation. Method: This cross-sectional study was conducted using a self-reported questionnaire survey on 332 home visiting nurses in a metropolitan area. Multiple linear regression analyses were undertaken with Interdisciplinary Team Approach (ITA) as the dependent variable; and demographics, home care nurse's individual factors and environmental factors as independent variables. Results: The valid response number was 133 (40.1%). The mean (SD) score of ITA was 65.2 (14.7). The ITA scores were significantly associated by the multiple regression analysis with 4 factors; the child's spouse as caregiver (β:0.189, p:0.017), difficulty of life support for the elderly or families (β:-0.278, p:0.001), hierarchy and top and bottom relationships (β:-0.208, p:0.009), and having on the job training system of home care system for home visiting nurses (β:0.224, p:0.005) Conclusion: The results indicated the need for improvement of life support skills of home visiting nurse, flexible system without hierarchy of care team, and enhancement of job training about home care systems in a workplace to promote team approach.

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Purpose: Our study identified the kinds of peer support exchanged in support groups by family members of patients with mental disabilities, in order to assist these groups' activities and increase such support. Subjects and Method: Semi-structured interviews were conducted with 7 subjects attending support groups for people with mentally-disabled family members, to elucidate the kinds of peer support they received from, and offered to, other members in their group. Their interview responses were structured according to qualitative inductive analysis. Results: Peer support fell into the following six categories: "Expression of repressed feelings", "Friendly understanding/relating to others with similar problems", "Sharing of experience-based techniques and knowledge", "Opportunity to spend time with other non-disabled people", "Seeing others successfully coping with similar situations", and "Possibility of help from group members if one's family member's illness suddenly worsens." Discussion: The support received by the subjects derived particularly from their peers' "warm acceptance" and "experienced-based advice", as well as the subjects' "opportunity to care for themselves also" and their "knowledge that actual assistance was available". Previously they had felt isolated with their problem, but now felt more relaxed and relieved, and able to return to caring for their disabled family member with renewed energy and confidence. To increase peer support offered in such groups, their members could therefore be made more aware of the value of various kinds of such support, and more opportunities provided for open interaction, relationship-formation and bonds of trust between these groups' members.

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Purpose: The purpose of this study was to clarify the experience and support of family caregivers of terminal cancer patients approaching death at home. Method: The study participants were five home-visiting nurses having over three years of experience in caring for terminal cancer patients and family caregivers and having about ten support cases. The data was collected by semi-structured interviews and analyzed from the view point of the experience and support of family caregivers of terminal cancer patients in near-death at home. Results: Among the experiences of family caregivers, five themes were identified: "determination and dilemma about caring for the dying family member at home"; "perception and confusion close to the family member's death"; "conflict and reconstruction of the intention or emotion between family member's" "presence of the moment of the death and bereavement" and "the experiences and meanings of bereavement". Among the supports for family caregivers three themes were identified: "caring for fragile emotions of family caregivers in the approaching death of their family"; "exploit the family's abilities needed in caring for the dying family member at home"; and "ensuring the physical and emotional well-being and daily life of family caregivers". Discussion: It is important to consider the interventions for family caregivers to overcome several experiences involved in the approaching death of a family member and to support personal growth to live proactively after bereavement.

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Objective: To identify the factors related to the intake of store-bought foods in upper-grade primary school children in Vanuatu. Method: The targets of this study were sixth-, seventh-, and eighth-grade students attending primary schools in both urban and rural areas in Vanuatu. We conducted a self-administered questionnaire survey. The main questionnaire items included intake of store-bought foods, knowledge related to non-communicable diseases (NCDs), health practice attitudes, and guardians' health-related parenting attitudes. Relationships between scores for store-bought food items and each variable were analyzed using a Mann-Whitney U-test and Spearman's rank correlation coefficient. Factors related to store-bought food intake were analyzed using multiple regression analysis. The significance level was set at p<0.05. Results: More than 90 % of the targets of this study consented to participate in the questionnaire survey. The questionnaires were distributed only to the targets who agreed, and 415 questionnaires were distributed (194 in urban areas and 221 in rural areas). All 415 questionnaires were collected and admitted as valid responses. The mean store-bought food intake score was 8.9 (SD=3.1) of a maximum possible score of 16. The univariate analysis shows that residential area (p<0.001), finding local foods delicious (p<0.05) and favorite (p<0.05) ; finding store-bought foods delicious (p<0.01), favorite (p<0.001), and healthy (p<0.05); perception scores for store-bought foods (p<0.001); and scores for household possessions (p<0.01) were significantly associated with the intake of store-bought foods. Discussion: The findings suggest that living in urban areas, disliking local foods, enjoying store-bought foods, and having economic power promote the intake of store-bought foods.

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[in Japanese]

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Purpose: This study aimed to understand the actual state of social capital (SC) and the relationship of SC with social attributes among residents of a fishing village to promote community-based health programs. Method: A questionnaire was sent to all 449 residents in the C area of B city of A prefecture. The questionnaire consisted of questions related to social attributes, self-rated health status, life satisfaction, residence intention, and SC. Results: A total of 220 responses were obtained (response rate: 49.0%). In terms of realities of SC, "relationship with friends" and "relationship with kin" were significantly more numerous among subjects aged 65-74 years. "Relationship with neighborhood", "relationship with kin", and "participation in local events" were significantly less common among subjects aged 20-39 years. Regarding the SC indices evaluated, the "networks and relationships index" showed the highest value (-0.025±0.8), and the scores of the "trust index", "social participation index", "bonding index", and "total index" were significantly less among subjects aged 20-39 years. Discussion: The SC of people living in the C area was higher than that of people in Japan as a whole. This means that people living there trust each other. In contrast, individuals aged 20-39 years and those aged over 75 years had fewer networks. In fishing villages on solitary islands, promoting intergenerational communication and communication with people living in other areas is important to promote health activities and community-based health programs.

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Purpose: To examine the opinions of public health nurses and psychiatric social workers responsible for municipalities' suicide prevention countermeasures regarding the following three areas of concern: residents' awareness of suicide, local characteristics that can influence suicide, and problems in implementing suicide prevention activity. This study also aimed to obtain suggestions for promoting effective suicide prevention activity. Method: Participants were 14 individuals responsible for 12 local healthcare centers and municipalities in prefecture A. Data were collected using semi-structured interviews and subjected to qualitative-descriptive analysis. Results: Three categories were extracted from the opinions of staff responsible for suicide prevention countermeasures regarding residents' awareness of suicide: "high awareness or interest among residents," "accepting suicide as somebody else's problem," and "a tendency to see suicide as taboo." Six categories of local characteristics able to influence suicide were extracted. For established communities, these included "a culture of helping and watching over each other" and "being closed, cliquish, and feudalistic." For newer communities, these included "a convenient lifestyle" and "loneliness and difficulty due to weak community ties." Five categories of problems in implementing suicide prevention activity were extracted, including "a need for analysis and understanding of effects, " "municipalities' resistance and feelings of inability to do the necessary work," and "clarifying responsibility among municipal government departments." Discussion: Staff responsible for suicide prevention countermeasures indicated perceiving relatively rural areas differently than more urban areas, regarding residents' local characteristics and awareness of suicide. Also, staff indicated that problems in the division of roles between public health centers and municipal governments hindered the implementation of suicide prevention activity. These results suggest that public health centers and municipal governments should cooperate in seeking to understand the state of suicide in the community, and that municipal governments should subsequently use their understanding of local residents' characteristics to build frameworks for relationships and improved community bonds. Public health centers may facilitate suicide prevention activity by supporting these efforts.

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[in Japanese]

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[in Japanese]

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