Objective: To develop effective prevention measures against serious injuries in primary school students, the involved factors of serious injuries inside school were surveyed.

Methods: Our study examined the data from primary schools of 7 prefectures in Japan. The study period was one year, from April 2007 to March 2008, and the 70,701 cases of school injuries which required medical treatment in medical institution were examined. The involved factors that influence hospitalization were investigated by logistic regression analysis.

Results: 1) Among the total number of injuries (70,701), 882 (1.2%) cases required hospitalization. 2) The injuries that needed hospitalization occurred the most frequently during recess. 3) Among the 207 cases of hospitalization-required injuries that occurred when the lower grade students were outside the school building in the school area during recess, 134cases (64.7%) happened while they were using playground equipment. The incidence of hospitalization was significantly higher (3.30 fold) than when no playground equipment was in use.

Conclusion: The results of this study indicate the importance to implement safety measures related with the use of playground equipment during recess time to prevent serious injuries of students, especially when they are not under the supervision of teachers. Furthermore, it is necessary to guide the lower grade students concerning the risk of fall from playground equipment such as monkey bar and climber.

The Japanese Ministry of Health, Labour, and Welfare has set a goal of zero cases of measles by 2012 and has adopted initiatives towards its elimination. However, it remains necessary to improve the understanding of immunization by Japanese people. This study assessed the seroprevalence of measles and rubella antibodies in high school students and analyzed the effects of health education related to infection and immunity. In 2008 and 2010, 1,155 students attending S high school in G prefecture, Japan, attended a health education class titled, “Basics about infection and the immune system”. Measles and/or rubella antibody titers were measured in 563 consenting students. An identical survey of five questions was administered before and after the class and the changes in knowledge were assessed in all 1,155 students. In this study, the seroprevalence of measles and rubella antibodies was 83.5% and 80.4%, respectively. In an analysis of the responses to the survey administered to 1,155 students before and after attending the health education class, the mean total score increased from 3.38 points to 4.29 points for the five questions (perfect score = 5 points) (p<0.0001). Mean scores were then calculated for students whose antibody titers were not measured, students whose antibody titers were measured, and a control group. The mean score increased to 4.58 points after the class in the students whose antibody titers were measured; however, the degree of increase was smaller in the students whose antibody titers were not measured (4.10 points) and the control group (3.88 points).

The results of this study suggest that the seroprevalence in high school students is insufficient to eliminate measles and rubella, and the health education is effective for improving understanding about infection and immunity.

Background: Disordered eating attitudes and behaviors are experienced among young women in Japan as well as in many westernized countries. To understand the psychopathology of disordered eating attitudes toward food and eating, instruments that evaluate eating attitudes from different dimensions can be useful and contribute to the prevention of eating-related health issues in the general population. The aim of this study was to evaluate the validity and reliability of the Japanese version of the recently developed Disordered Eating Attitude Scale (DEAS).

Methods: The DEAS English version was translated into Japanese and the consistency of contents was confirmed. The DEAS Japanese version was applied to 144 female university students. Internal consistency was determined (Cronbach’s Alpha), convergent validity was assessed by correlations with Eating Attitude Test-26 (EAT-26) and test-retest reliability was assessed with a sub-sample (n = 62).

Results: The internal consistency was .76. The DEAS total score was positively correlated with EAT-26 total scores (r = 0.53). The correlation between test-retest was r = 0.705. The Japanese version of DEAS showed an acceptable level of validity and reliability.

Conclusion: It is suggested the DEAS could be applied to Japanese females and used for further cultural comparison with Spanish and English speaking populations.

The goal of the present study was to determine if a daily living non-exercise physical activity intervention increases physical activity and self-efficacy in sedentary college students. Daily living non-exercise activities are defined as physical activity not classified as exercise or sports such as household chores and movement/travel. A 10-week health promotion program aimed at increasing daily non-exercise physical activities was implemented in which participants were randomly assigned to either an intervention (n = 23) or control group (n = 19). Participants in the intervention group were provided advice about their daily living non-exercise physical activity during weekly individual counseling sessions. The intervention and control groups also attended two seminars providing health-related information.

A survey was administered for 1 week before the start of the program and after the end of the program to assess levels of physical activity of the two groups using a physical activity monitor. They were also asked to complete a questionnaire regarding general self-efficacy and the SF-36®Health Survey. The intervention group exhibited significant increases in moderate-intensity physical activity and general self-efficacy compared with the controls. Based on their answers to the SF-36® Health Survey, scores for the intervention group for the categories of bodily pain and general health changed positively and significantly; however, these changes in the intervention group were not significantly different from those of control group. Given that the target setting designed to increase daily non-exercise physical activities during the intervention was not very demanding, the repeated attainment of less-demanding targets resulted in enhanced self-efficacy in sedentary students. Conclusions: These results demonstrate that health promotion programs designed to increase daily non-exercise physical activities as the first step in promoting behavioral change are effective in shifting sedentary students from inactive to active lifestyles.

The purpose of this study was to investigate teaching-learning processes for training life skills. A life skills training program with a focus on assertive communication skills was conducted at elementary schools in Chiba prefecture and Tokyo on 278 fifth-grade students. The basic training for life skills development includes the following five stages;

1) Instruction: Learning the meaning of assertive communication skills (cognitive domain), 2) Modeling: Observing the model, 3) Practice: Participating in role-play, 4) Feedback: Receiving positive feedback and comments on their role-play from other students, 5) Reinforcement: Writing a statement declaring the intention to use assertive communication in everyday life.

Cognitive domain (how to develop assertive communication skills) was used in the instruction stages, and self-efficacy formation (affective domain) was used in the modeling, practice, and feedback stages.

Students were placed into one of four training programs: a cognitive and self-efficacy formation training program (80 students), a cognitive domain training program (55 students), a self-efficacy formation training program (56 students), and a program for basic development of life skills (87 students). An assertiveness scale, self-efficacy scale and self-esteem scale for children were used for evaluation before the class, right after the class, a week after the class and a month later. Formative assessment was used in class. The main results were as follows:

1) The group which adopted cognitive domain development attained skills more effectively immediately after the class. The group that adopted affective formation (self-efficacy formation) was able to attain the skills more effectively after one week, and also one month after the class. 2) It was effective to incorporate cognitive development and self-efficacy formation into the teaching-learning process when trying to develop assertive communication skills.

It can be concluded from this study that, in addition to the five basic processes of life skill development, it is effective to incorporate a ‘how to develop’ assertive communication skills program as well as self-efficacy formation into the teaching-learning process for assertive communication training.

To study the effectiveness of two-dose measles vaccination, we examined the antibody titer in the serum of first graders before and after the introduction of the two-dose measles-rubella (MR) vaccination program.

A total of 826 first graders (553 boys and 273 girls) who entered school from 2004 to 2009 were studied. We compared the measles IgG antibody in the serum (enzyme immunoassay) and measles antibody positive rate before and after the introduction of the two-dose MR vaccination program in 2007.

The measles IgG antibody titer (4.9 ± 1.6) (M ± SD) and antibody positive rate (97.8%) after the introduction of the two-dose MR vaccination program were significantly higher than the values (3.3 ± 1.9 and 93.4%, respectively) recorded before its introduction.

We concluded that the implementation of two-dose measles vaccination for preschool children resulted in a significantly enhanced measles serum antibody titer among first graders. To eradicate measles, we recommend the two-dose MR vaccination.