【Background】

In recent years, health economics has had to cope with various medical problems, especially in terms of efficacy, equity, and sustainability in health. We examined two types of studies focusing on the development of human resources in health economics.

【Methods】

First, we counted the number of presentations in each annual meeting of two major scientific societies, the Japanese Economic Association (JEA) and Japanese Medical Economic Association (JMEA), in the last ten years. Second, we conducted semi-structured interviews with eight health economics researchers and qualitatively summarized the results.

【Results】

In the JEA, the proportion of presentations on medical economics rose from 2–6% in the 2000s to 8–10% after 2012. In the JMEA, this figure rose from 40–70% in the 2000s to 70% and over in 2015 and 2016 (particularly increasing after 2013). Collaborative studies by economics and medical researchers increased after 2013. Based on the interviews, we extracted four categories: inadequate education for researchers on health economics, inadequate research posts, inadequate data use, and infrequent collaboration on economics and medical research.

【Conclusion】

Education on health economics has not been well established despite the increasing number of health problems. We recognize the importance of 1) continuous education on health economics, 2) creating jobs for researchers, 3) improvement of the data-use environment, and 4) collaboration between medical and economics research.

【Introduction】

The purpose of this study is to investigate the physical and mental impact of “workation” at a hot spring resort. “Workation” is a work style to work while enjoying the leisure time with coworkers at a resort or a sightseeing region and we call “workation” at a hot spring resort “Onsen workation” as follows.

【Methods】

In total, 133 healthy adults (Mean Age 38.7 year, SD = 10.8) who work in a company and so on where remote work has been introduced were enrolled in this study. Informed consent was obtained from all participants. Participants were divided into two groups; in Group I, subjects spend time freely at a hot spring resort for 2 nights and 3 days (N=104), which is called non-intervention group as follows, and in Group II, subjects spend time at a hot spring resort for 3 nights and 4 days while being provided health related activities such as bathing, exercise, diet, relaxation, and so on (N=29), which is called intervention group as follows. The hot spring resorts where “Onsen workation” was performed were the total of 25 places across the country. In principle, the grouping should have been carried out by the company unit. Peripheral blood circulation, autonomic nerve function, amylase activity in saliva, walking ability and flexibility, self-estimation for health-related 12 items, condition of feeling and mind (POMS2, short version), and scale for gastrointestinal symptoms (GSRS) were measured before and after the stay.

【Results】

Either in non-intervention group and intervention group, amylase activity in saliva, walking ability and flexibility, self-estimation for health-related items, condition of feeling and mind (8 subscales), and scale for gastrointestinal symptoms were significantly improved. Peripheral blood circulation was improved and autonomic nerve function (sympathetic nerve and parasympathetic nerve) was activated significantly in intervention group.

【Conclusion】

This study shows that “Onsen workation” may provide various health effects on body and mind and performing health related activities during the stay may increase the effects. We expect that our contribution to the investigation regarding work style or health promotion using hot spring resorts will lead to the benefits for workers, companies and hot spring resorts.

【Background】

The aim of this study is to survey the effects of the photo walk rally activities (PWR) in engaging environments combined with hot spring bathing (BATH) on mood change and sleep quality.

【Methods】

The 51 participants (age 34.0 ± 2.0) were recruited, and three 90-minutes events were conducted at 3 areas in Kumamoto. After each PWR event was over, they took a hot spring bath. The number of steps and physical activity amount (PA) in each events were measured. Mood changes were measured using a two-dimensional mood scale before and after the PWR+BATH. Sleep latency was measured on the day of survey using an accelerometer and compared with that of the normal life (mean latency of four weekend sleeps before survey). The subjective feeling of sleep was measured by standardized OSA sleep inventory MA version (OSA).

【Results】

The average number of steps and PA in three areas was 8,529 ± 119 steps and 5.9 ± 0.1 Ex, respectively. After each PWR+BATH, there was a significant increase in the comfort level of the moods (P < 0.01). On the day following the survey, subjective feeling of sleep also improved significantly (sleepiness on rising, initiation and maintenance of sleep, refreshing, sleep length of OSA, P < 0.01).

【Conclusion】

It appears that the combination of activity with a game element and hot bathing is useful for achieving physical activity standards. Thereby, it is suggested that this may improve subjective feelings of sleep on the day of the activity.

Background and aim: Various bathing methods have been developed, including bubble baths. Recently, hot water containing ultra fine bubbles (UFB) of less than 1 µm has been used in bathing. This study investigated the difference in stratum corneum water content and moisturization after taking a shower with either conventional heated tap water or with UFB-containing hot water, produced by a UFB generator attached to a UFB water heater (RUF-UE2406AW, Rinnai, Japan).

Method: A randomized controlled study with a within-subjects design was performed with 16 healthy adult women, whose forearms were exposed to a tap water shower or UFB shower at 40°C for 20 s. Stratum corneum water content was measured over time from before the shower to 30 min after. One-way repeated measures analysis of variance and multiple comparisons were used to compare the measurements before and after the shower. Between-group comparisons for the same time points were analyzed using a paired t-test.

Results: The before-and-after comparison of tap-water showers showed increased stratum corneum water content after the shower, which returned to normal after 30 min. In contrast, the effect of the UFB shower persisted across all time points. Compared with the tap-water shower, the UFB shower showed a significantly higher stratum corneum water content at 15 and 30 min after the shower.

Discussion: The UFB shower increased stratum corneum water content, and this moisturization effect persisted after the shower, indicating that UFB showers may be an effective type of bathing for people who experience dry skin after showering.

【Background】

Mitophagy, or mitochondrial autophagy, controls mitochondrial homeostasis to contribute to good physical health. Bathing in hot springs, which has been beneficial for mental and physical health since ancient times, might also induce mitophagy. In this study, I examined the possibility of inducing mitophagy by daily thermal stimulation.

【Methods】

Mitophagy activity monitoring mice were subjected to daily thermal stimulation (40°C for 30 minutes per day) for 3 weeks. After 3 weeks, the heart, skeletal muscle, white fat, and brown fat were removed. Mitophagy activity, mitophagy-inducing genes, and mitochondrial content were quantified.

【Results】

There were no significant differences in mitophagy activity levels, mitophagy-inducing gene expression, mitochondrial DNA levels, or mitochondrial protein levels in each organ of the thermally stimulated mice.

【Conclusion】

Daily thermal stimulation did not induce mitophagy.

【Background】

The purpose of the study was to examine the association between bathing habits and objectively assessed sleep or arterial stiffness.

【Methods】

Study 1 included 202 old adults aged 65 years or older, and Study 2 included 524 participants with CAVI (Cardio-Ankle Vascular Index) in Tarumizu Study 2021. Bathing habits were investigated by questionnaire, and objective sleep was assessed by wearing an ActiGraph for one week.

【Results】

In Study 1, there was no significant association between bathing habits (frequency of bathing at home or in hot springs, frequency of hot springs, and communication in hot springs) and sleep duration or sleep efficiency in old adults. In Study 2, CAVI value of the daily bathed group (n=472) was significantly lower than that of the non-daily bathed group (n=52) (8.6±1.1 vs. 9.3±1.4, p=0.002). There was no significant difference in CAVI values between the bathing hot spring at least once a week (n=124) and not (n=400).

【Conclusion】

No significant association was found between bathing habits and objectively assessed sleep duration or sleep efficiency in old persons. In a community-based cohort that included younger adults, the daily bathed group had lower arterial stiffness than the non-daily bathed group.

【Background】

The epidermis, the outermost layer of the skin, is a thin, strong membrane that protects the body from invasion by foreign substances and bacteria and envelopes the body’s tissues to prevent leakage of internal fluids. The cells that form the epidermis are continuously replaced to maintain healthy epidermal function. However, aging and skin diseases reduce epidermal cell turnover, resulting in the formation of gaps in the epidermis. We comprehensively analyzed the effects of bathing in calcium-chloride springs (calcium ions) on human epidermal cell turnover by performing transcriptome analysis.

【Methods】

Epidermal layers were isolated from skin tissue of six elderly women by enzymatic treatment. Each epidermal layer was divided into a control group and a calcium ion-treated group and incubated for 1 hour at 37 °C. The calcium ion-treated group was treated with 2.0 mM calcium solution. mRNA was extracted from control and calcium ion-treated groups, and transcriptome analysis and subsequent bioinformatics analyses were performed to identify and quantitate differences in gene expression.

【Results】

In the calcium ion-treated group, 757 genes were up-regulated, and 68 genes were down-regulated. Gene ontology analysis revealed that these changes in gene expression correlated with an increase in epidermal cell differentiation and migration.

【Conclusion】

Although bathing in chloride springs is thought to prevent skin dryness, future evaluation of differences in skin moisture content between bathers in hot springs with high and low calcium ion concentrations will help to clarify the benefits of calcium chloride springs, rather than lumping them together as chloride springs.

【Background】

In Japan, there are hot springs known as “Kodakara-no-yu; fertility hot springs”. However, there has been no study on the efficacy of “Kodakara-no-yu” for infertility. Here, we investigated the possibility of improving ovarian function based on the effect of promoting blood circulation by thermal action, of “Kodakara-no-yu “.

【Methods】

The Ca/Na sulfate, bicarbonate, and chloride hot springs (designated as "G" hot springs known as Kodakara-no-yu) and the neutral hypotonic cold mineral hot springs (designated as "P" one without fertility benefits) were used in this study. Female mice were subcutaneously administered an anticancer drug, and four weeks later, follicle development was induced. The next day, the mice were placed in each holding device and locked in a thermostatic chamber kept at 40°C. Two times of bathing were performed for 15 minutes, followed by a 1-hour rest period. Ovulation was induced on the following day and in vitro fertilization was performed.

【Results】

The size of anticancer-drug-treated ovaries was significantly smaller than those of controls with a markedly declined follicle number and many cavities in the medulla, indicating the successful development of the ovarian dysfunction model. In this model, the number of ovulated oocytes was significantly higher in the G group compared with P and the non-bathed control (p <0.05). However, the blastocyst formation rate was not different among the three groups.

【Conclusion】

In bathing mice with ovarian dysfunction, the " Kodakara-no-yu " increased the number of ovulated oocytes, suggesting that it may have a special effect on restoring follicle development.

【Background】

Japanese footbath in public space has attracted attention for their potential in terms of health promotion and tourism resource. On the other hand, hygiene problem has been pointed out, casting a shadow over the pursuit of the cultural value of footbath. The purpose of this research is to present numerical values of the public footbath through a survey and to position the value of footbath.

【Methods】

We conducted interviews and activity surveys with footbath users for the existing public footbaths and social experiments using The Mobile Footbath in Izu-Nagaoka spa area and analyze the actual status of users. To determine the number and interaction activity between users, a fixed-point observation survey was conducted using video cameras. Through interview survey, we asked about their composition, generation, place of residence, whether they stayed overnight, frequency of use, and means of transportation and analyzed.

【Results】

The survey revealed that existing public footbaths are used by a wider range of generations than The Mobile Footbath. In the existing public footbaths, the majority of visitors were from within the prefecture, rather than from outside the prefecture. Users also conversed and interacted with each other among the different groups. In one footbath, the water temperature was below 37°C at the hot-water outlet and the need for regular temperature checks and management became clear.

【Conclusion】

For the existing public footbaths, high frequency of use was observed not only within the city, but also among day-trippers from outside the city, indicating that public footbaths in Izu-Nagaoka spa area create a wide range of opportunities to enjoy hot spring on a daily basis. Future issues to be addressed include improving the design of mobile footbaths so that they can be accepted by multiple generations. The results suggest that footbaths may encourage interaction with others.

【Background】

The purpose of this study is to contribute to the revitalization of hot spring resort areas by observing the effects of a program involving continuous bathing in a highly concentrated carbonated spring on the quality of sleep and promoting the benefits of hot spring workcations to companies.

【Methods】

Four home-based teleworkers (2 males, 2 females; mean age 42.5 years, SD 7.6 years) from the Tokyo metropolitan area who gave informed consent were included in the study. In October 2022, subjects spent 5 days and 4 nights on a workcation at Nagayu hot spring with highly concentrated carbonated water. During their stay, the participants received individual counseling from a ONSEN programmer, performed exercises in a health promotion facility using hot spring, and took daily baths in a high-concentration carbonated spring. Sleep electroencephalogram (EEG) and OSA Sleep Questionnaire were measured one week before and during the stay, and health-related self-assessment peripheral blood circulation and salivary amylase activity were measured before and after the stay.

【Results】

During their stay in Nagayu Onsen, all subjects showed higher total delta power values in the first sleep cycle, duration of the first sleep cycle (excluding REM sleep), total delta power values during non-REM sleep, and ratio of the first sleep cycle to total non-REM sleep than the week before their stay. In addition, all subjects showed improvement in fatigue recovery factor on the OSA Sleep Survey, and peripheral blood circulation after the stay, and those with high level of amylase activity showed its reduction.

【Conclusion】

This result suggests that a stay in Nagayu Onsen with intervention of bathing in highly concentrated carbonated hot spring while teleworking may promote deep and good quality sleep, improve mood and mental state, and contribute to reduce stress. We will continue to pursue the potential of hot spring resorts which is able to enhance the quality of work life while working, and promote the utilization of hot spring resorts for the working generation.