Objectives To investigate the effectiveness of the Total Health Promotion Plan (THP) for the prevention of cardiovascular events. Design A cohort study. Setting and Participants The subjects consisted of 141 male employees of a manufacturing office that has implemented the THP since 1996. Measurement and Results We performed a follow-up survey for the occurrence of cardiovascular events, including ischemic heart disease and cerebrovascular incidents, for 13 years. The incidence of cardiovascular events was compared with Kaplan-Meier analysis and log-rank statistics. The office executing THP had a low tendency towards cardiovascular events in comparison with the control office. Conclusions This study suggests that THP is effective for preventing cardiovascular events.
Objectives To investigate the prevalence of benign findings of liver, gallbladder, and kidney detected at abdominal ultrasonography. Design A cross-sectional study. Setting and Participants The subjects consisted of 2,512,520 cases who consulted 371 institutes for health screening,part of the Japan Society of Health Evaluation and Promotion. Measurement and Results We classified the prevalence of liver cyst, hepatic hemangioma, gallbladder polyp, gallstone,and renal cyst into 14 groups every five years by gender, and plotted the results. The prevalence of liver cyst, renal cyst,and gallstone increased with age. The prevalence of gallbladder polyp showed a bell-shaped distribution with a peak at 50-54 years. The prevalence of hepatic hemangioma also showed a bell-shaped distribution with a peak at 45-49 years. Conclusions Liver cyst, renal cyst, and gallstone increase with age, whereas both gallbladder polyp and hepatic hemangioma naturally disappeared.
The system is defined as a network of mutually dependent separate components that cooperate with each other to achieve an objective. Systems can be categorized into the mechanical system having the mechanical nature and the adaptive system adjusting itself depending on the situation. Systems can also be categorized into the mechanical system having the mechanical nature and the adaptive system adjusting itself depending on the situation. For the mechanical system, it is obvious how its components react to a stimulus and the reaction can be accurately predicted. This allows a statistical management approach to effectively work. In contrast, the adaptive system has components that initiate very diverse and basically unpredictable reactions to a stimulus. Systems containing human components are considered as a typical adaptive system. For the adaptive system, the concepts of normalization and standardization are not effective and it is important to orient complicated system behaviors toward a certain objective with a comparatively simple principle. The health care system is intrinsically an adaptive system comprised of patients and health care providers who have the ability to learn from experiences and change themselves. The behaviors of patients and health care providers cannot always be predicted and may transform their imminent environment or a broader environment.In the health care fields, many unpredictable behaviors specific to the complexity adaptive system can be observed. A feature of the health care system that other industries do not have is that the zones of the mechanical system and complexity adaptive system must be concurrently managed. Although most businesses provide within the zone of the mechanical system at present, when businesses will explore opportunities in the zone of the complexity adaptive system, the industries will learn a great deal from the health care system management.