Objective: From a financial viewpoint, it is important that international medical care and cooperation in recipient countries by NGOs or governments of donor countries, and health promotion carried out by recipient countries' governments, are carried out efficiently. In this paper, we performed analysis of factors that determine life expectancy and infant mortality rates in recipient countries, in consideration of the socioeconomic environment.
Methods: We used data from World Development Indicators 2002 and 2003, published by the World Bank, and Human Development Indicators 2002, published by the United Nations Development Programme. We analyzed 68 countries classified as middle and low income countries by the World Bank, because complete data for these countries were available. We used life expectancy and infant mortality rates as health indicators and did multiple regression analysis; with these indicators as dependent variables, and with socioeconomic environmental data as independent variables. Furthermore, we undertook multiple regression analysis after carrying out group divisions of the countries according to the numbers of refugees, birthrates, and expenditures on armaments.
Results: We ascertained the following points. 1) For improving health of people in recipient countries, it is important to secure safe drinking water, improve literacy, and increase income and the possibility of access to basic medicines. 2) For countries where there are a lot of refugees, it is important to increase the measles vaccine inoculation rate. 3) In countries where there are few refugees, life expectancy will be prolonged by as much as three years if the measles vaccine inoculation rate increases by just 10%. 4) In countries with a high armaments expenditure rate in proportion to GNI, it is important to secure access to sanitary toilet facilities. 5) Life expectancy in countries tends to shorten if life expectancy in their neighboring countries is short. 6) The rate of public health expenditures in proportion to GDP has no affect on health. 7) If the literacy rate rises 10%, life expectancy will be prolonged by about 1.2 years and the infant mortality rate will decrease about 6%.
Conclusion: Though improvement of the socioeconomic environment is more effective for improving life expectancy and infant mortality rates in recipient countries than medical conditions, the effectiveness differs according to the number of refugees, the birthrate and expenditures on armaments.

View full abstract

Objectives: Little attention has been paid to mental health of inhabitants of methylmercury-polluted areas. The objective of this study was to examine the factors relating to the conditions and characteristics of mental health of inhabitants residing in a methylmercury-polluted area.
Methods: The eligible subjects of the study were inhabitants over the age of 40 years (n=301) living in two fishing village districts that were polluted by high concentrations of methylmercury. The study was conducted in two phases. In the first phase, a structured questionnaire was used to gather information on the current health condition and experience with Minamata disease of each subject through interviews. In the second phase, the General Health Questionnaire (GHQ)-30 was distributed to measure the psychological distress of the respondents.
Results: There were 133 (44.2%) study subjects. Factor analysis of the data collected using the GHQ was carried out and five factors that accounted for 57.9% of the total variance were selected. The first factor was labeled “depression and anxiety”. Depression and anxiety were significantly associated with self-rated health status, the number of subjective symptoms, monthly outpatient visits and the receipt of compensation. Covariance structure analysis using the Amos 4.0 program demonstrated that depression and anxiety were significantly associated with the subjects' health condition, which in turn was influenced by experience with Minamata disease.
Conclusion: Depression and anxiety of the inhabitants may be directly caused by the health condition. Further investigations with more precise and detailed measurements are needed to corroborate the causal relationship.

View full abstract

Objective: The purpose of this study was to check a simple sampling and easy gas analysis of tobacco smoke for effective tobacco intervention in medical education.
Methods: The mainstream of tobacco smoke was sampled by a syringe (50ml) at five, ten and twenty seconds. The extracted mainstream was moved to a commercial PET bottle (2000ml), and measured with gas detector tubes. The sidestream, which rises from the tip of the cigarette, was collected into a commercial PET bottle for a duration of 30 or 60 seconds. Formaldehyde, acetaldehyde, ammonia, hydrogen cyanide, and nitrogen oxides (NO, NO₂) in the tobacco smoke were measured. Then, these gasses in the tobacco smoke of four brands of cigarettes were compared. This trial was conducted in third-year medical students, and the changes in attitudes to smokers and tobacco itself were investigated.
Results: The method of sampling 50ml for 5 seconds produced the highest concentration of each gas in the mainstream. The gas concentration in the sidestream increased as the sampling time increased. The gas concentration in mainstream of “Lucia” was the highest of the used four brands, and the gas concentrations in the sidestream of “Mild Seven Prime” were higher than those of the other brands. Many medical students obtained knowledge about the toxicity of smoking by this experiment study.
Conclusion: We studied a simple sampling method of tobacco smoke, and gas analysis with gas detector tubes. This method is recommended for tobacco education and intervention in medical education.

View full abstract