Japanese Journal of Health and Research
Online ISSN : 2434-8481
Print ISSN : 2432-602X
ISSN-L : 2432-602X
Volume 38
Showing 1-11 articles out of 11 articles from the selected issue
  • Risae Nishimoto, Sawako Okamoto, Tatsuya Noda, Tomoaki Imamura
    2017 Volume 38 Pages 1-10
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    To realize the Japan vision of community healthcare, cases considered to be advanced and/or excellent regarding community healthcare initiatives and recommended by the hospital associations were examined for the trends and challenges in hospital strategies.

    [Methods]

    Studies were undertaken on 76 reports submitted as advanced/excellent cases from 58 hospitals throughout Japan based on a survey by a research team supported by the Japanese Ministry of Health, Labor and Welfare. The relationships between nine engagement items and four hospital demographics were examined by descriptive statistics and Fisher’s exact tests.

    [Results]

    In total, 181 cases, which represented all nine items, were reported. We found that region classification, hospital size, and patient to doctor ratio were significantly related with reorganization and new construction of community-based integrated care wards. Significant relationships were also obtained between information and communications technology (ICT) introduction for the community healthcare and patient to doctor ratio, and between engagement with dementia care and hospital size. Engagement with dementia care was reported in only four cases.

    [Discussion]

    The findings suggest that there is a predisposition towards repurposing and/or construction of new community-based integrated care wards in regional city hospitals, hospitals with a high patient to doctor ratio, and/or small-scale hospitals. As observed from the low number of dementia strategies, there is some concern regarding delays within system development. Countermeasures are required for hospitals that have not yet introduced ICT. This study revealed different approaches among hospitals based on demographics regarding their engagement in community healthcare initiatives.

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  • Shinichiro Kubo, Tatsuya Noda, Tomoya Myojin, Tsuneyuki Higashino, Hir ...
    2017 Volume 38 Pages 11-19
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) contains monthly claims for reimbursement of medical expenses and is managed by two types of personal identification (IDs) of a patient. Errors occur in linking the information of two IDs to a patient (patient matching). In this study, we summarize important points to identify.

    [Methods]

    The 2013 NDB data were used to identify errors that interfere with patient matching and to reveal the number and frequency of such errors.

    [Results]

    Both ID information include life event-related changes, such as an insurance provider’s ID number, employer, employee (patient) career changes, retirement, and a patient’s name change due to marriage. In addition, different patients are often identified as the same patient, which is called as Type I errors, such as persons who have same surnames, given names and birthdays, and twins who are dependents with the same surname. Furthermore, variations in writing used at different healthcare providers and even typos when computerizing potentially identify one patient as different individuals (Type II errors). Our 1-year follow-up study revealed that changes in the IDs occur in approximately 11% of patients; hence, these patients are usually excluded from cohort studies. Type I and II errors also occurred simultaneously in approximately 0.8% of patients, suggesting that an estimated 1% of patients may be difficult to follow-up.

    [Conclusion]

    Problems with patient matching include life event-related changes in patient IDs used in the NDB and insufficiency of key variables in patient matching. A cohort of patients with different names, regardless of anonymity, may be used as training data to investigate the accuracy of matching. Further study is needed to improve the patient matching system used in the NDB.

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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    2017 Volume 38 Pages 20-27
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS
  • Tomoko Matsuda, Atsushi Tanaka, Toru Matsuda, Tadayuki Ahiko, Ryo Kawa ...
    2017 Volume 38 Pages 28-37
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    In Japan, mortalities from bathing accidents occur in 14,000 to 19,000 people annually nationwide. Previous studies have suggested the accidents occurred more frequently in "winter season," "at home," and in "elderly people." The aim of this study was to determine the association between atmospheric temperatures and bathing accidents and to construct risk models to identify high-risk days for bathing accidents in the Shonai region of Yamagata Prefecture.

    [Methods]

    Ambulance dispatch data were collected from the emergency departments of Tsuruoka City and Mikawa Town from 2009 through 2013. Atmospheric temperatures in the area were collected from the Japan Meteorological Agency website. Logistic regression models were used to determine odds ratios for days with accidents per -1℃ change. Threshold values of the temperatures used to classify the days with accidents were determined by receiver operating curve analysis.

    [Results]

    We identified 451 ambulance dispatch cases due to bathing accidents. The odds ratio for occurrence of bathing accident on given a day with was 1.05 (95% confidence interval [CI] 1.03–1.06) per -1℃ in average temperature. The threshold values for the average, highest, and lowest temperatures in the winter season were 7.4℃, 7.1℃, and 1.2℃, respectively. When a day met these three threshold temperatures, the odds ratio for bathing accident to occur on that day was 2.13 (95%CI 1.44–3.15). When a day met threshold value for the average and lowest temperatures, the odds ratio for bathing accident to occur on that day was 2.03 (95%CI 1.39-2.97).

    [Conclusion]

    We constructed a model with a simple scoring system based on particular thresholds for the average, highest, and lowest atmospheric temperatures, and confirmed that lower temperatures, in general, are associated with bathing accidents in this region. Based on this model, a day with greater than two-fold increased risk of bathing accidents was identified for this region.

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  • Yuki Tamura
    2017 Volume 38 Pages 39-45
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    We have recently shown that heat stress 1) induces mitochondrial biogenesis, 2) improves mitochondrial dysfunction in denervated and aged muscles. However, its underlying mechanisms have been not understood. In this study, we tested our hypothesis that heat stress activates transcription of mitochondrial-related genes in skeletal muscle.

    [Methods]

    ICR mice were involved in this study. Mice were exposed into a hot environmental chamber (40ºC, 30 min). Immediately after treatment or three-hour after treatment, gastrocnemius muscles were collected. We performed several biochemical experiments such as real-time PCR and western blotting.

    [Results and Discussion]

    We found that heat stress increases mitochondrial genes encoded by both nDNA and mtDNA three-hour after heat stress treatment. We further examined next hypothesis that heat stress will activate tumor suppressor gene p53, which would contribute to increased expressions of mitochondrial-related genes. Unexpectedly, we did not observe data supporting p53 activation, based on no detectable changes in phosphorylated p53 and translocations of p53 proteins into nuclear and mitochondria from cytosol.

    [Conclusion]

    We here provide evidences that heat stress increases mitochondrial-related genes in skeletal muscle. We also found that p53 would not contribute to mitochondrial transcriptional activations.

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  • Naoyuki Hayashi, Akane Miyaji
    2017 Volume 38 Pages 46-50
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    Full-body bathing is known to induce circulatory challenges, e.g., an increase in blood pressure and a decrease in peripheral blood flow. We postulated that foot bathing has smaller effect on circulation. To examine the effect of foot bath on circulation, we observed ocular and cerebral blood flow during foot bath.

    [Methods]

    We measured ocular blood flow, middle cerebral blood flow, mean blood pressure and heart rate, and speculated core temperature in seven healthy males (27±1 yrs). The subjects took a foot bath at a temperature of 41°C for 30 min. In control trial, the subjects kept resting for 30 min.

    [Results]

    Heart rate significantly decreased at the last 10-min period of the foot bath by 2.4±1.8 bpm and blood flow velocity in middle cerebral artery significantly increased by 4.2±2.4%, compared to the resting baseline. No significant differences were shown in the other variables. No significant interaction was observed.

    [Conclusion]

    This study implied that circulatory challenge is limited during 30-min footbath, while the core temperature is maintained, in healthy young subjects.

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  • Takeshi Nakamura, Hiroshi Iwakura
    2017 Volume 38 Pages 51-59
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    To prevent frailty and sarcopenia in an ageing society, exercise and nutrition are very important. On the one hand appetite loss is a problem in care requiring and demented people, on the other hyperphagia which is an obesogenic factor is also an issue that should be addressed. In Japan, there is a traditional custom to take a bath and its possibility to suppress the appetite. Although the mechanism of appetite control is explained partially due to change of gastrointestinal motility and its blood distribution, but it is not fully understood. We focused on appetite regulating hormones especially ghrelin which is thought to stimulate eating behavior and evaluated the effect of bathing on hormones at several temperatures.

    [Methods]

    Two healthy male subjects (18.5<BMI<25) were participated voluntarily in four trials (bathing in three different temperatures: 42℃, 33℃ and 40℃ for 15 minutes. control: no bathing). Trials began 0730 in the morning after an overnight fast. Before the start of each trial, subjects rested in a semi-supine position for 30 minutes. Subjects were bathing 15 minutes each conditions. After this, they rested for 45 minutes. Blood sample were collected at 0(before bathing), 15, 30, 60 minutes and acylated ghrelin, glucose, insulin, lactate, free fatty acid and GLP-1 were measured. Deep body temperatures were also measured at the same time. The visual analogue scale was used to assess hunger before and after the course of trials. Plasma acylated ghrelin concentrations were determined by enzyme immunoassay.

    [Results]

    Plasma acylated ghrelin concentrations seemed to be suppressed by bathing at 40℃ for 15 minutes and increased at 42℃ for 15 minutes.

    [Conclusion]

    These findings demonstrate that appetite change on bathing might be affected by plasma acylated ghrelin concentrations.

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  • Hideaki Kashima, Masaki Fujimoto, Masako Endo (Yamaoka), Yoshiyuki Fuk ...
    2017 Volume 38 Pages 60-66
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    The aim of present study was to examine the effect of footbath on postprandial gastrointestinal activity and diet induced thermogenesis.

    [Methods]

    After five healthy subjects immersed their legs to knees into water bath controlled by 43-45 °C during 15 min, and then following 15 min, they ingested 400 kcal standard meal. As control condition, they ingested standard meal without footbath. Heart rate (HR), superior mesenteric artery blood flow (SMABF), gastric emptying (GE) and oxygen consumption were measured before and after ingestion of standard meal. During footbath, skin temperature in forehead, chest, forearm and lateral vastus muscle was monitored.

    [Results]

    Skin temperature in all areas significantly increased during footbath. SMABF, GE and oxygen consumption were not differed between both conditions.

    [Conclusion]

    Footbath did not acutely affect postprandial gastrointestinal activity and oxygen consumption.

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  • Jun Sugawara, Tsubasa Tomoto
    2017 Volume 38 Pages 67-74
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS

    [Background]

    Sudden death in the bath frequently occurs in Japan. It might be partly due to post- bathing orthostatic intolerance and syncope. However, underpinning mechanisms are fully unknown. The aim of this study was to determine the effect of short-term bathing on postural change-related hypotension.

    [Methods]

    Thirteen healthy men (29-57 yrs) underwent 5-min bathing (41℃) and were measured arterial stiffness (via brachia-ankle pulse wave velocity [baPWV]) and baroreflex sensitivity (BRS) before and after the bathing. BRS was evaluated with the sequence method from mean arterial pressure and heart rate responses to the postural change following the 5-minute sitting in the bath without (control condition) and with hot water (bathing condition).

    [Results]

    There was no significant difference in standing-induced hypotension between the control and bathing conditions because of large variability (-32.5±11.2 and -34.2±13.8 mmHg, respectively). Following the bathing baPWV was significantly decreased, whereas BRS gain was significantly attenuated. Extent of standing-induced hypotension was significantly associated with BRS gain (r=-0.736, P=0.006) in the control condition, and then such significant correlation was disappeared after the bathing. Change in orthostatic hypotension (from the control condition to the bathing condition) tended to correlate with BRS gain in the control condition (r=0.531, P=0.076), whereas baPWV did not contribute to change in orthostatic hypotension.

    [Conclusion]

    Our results suggest that after the short-term bathing BRS was attenuated but extent of standing-induced hypotension was not influenced remarkably. However, lower BRS might contribute to greater hypotnesion at the orthostatic challenge after the bathing.

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  • [in Japanese]
    2017 Volume 38 Pages 75-78
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS
  • [in Japanese]
    2017 Volume 38 Pages 79-83
    Published: 2017
    Released: October 19, 2019
    JOURNALS FREE ACCESS
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