Purpose The purpose of this survey was to find factors affecting breakfast skip rates for male students participating in sports, and to determine how to improve their nutrition.
Methods The survey was conducted on 86 male students (58 who played sports and 28 who did not). A questionnaire was supplied to all, containing questions concerning daily food eating behavior. The student's answers were evaluated according to the guidelines of the Ministry of Health and Welfare. In addition, blood pressure, body mass index, and serum levels of uric acid, triglycerides and ferritin were measured in all subjects.
Results The breakfast skip rate was 36% for the sports club affiliation group, and 46.4% for the non-affiliation group. Students who were not supplied with meals from their mothers or dormitory food service had more irregular meal times, skipped breakfast more, and drank less milk and miso soup often than the students supplied with meals. Students playing sports, but not supplied with meals, had a lower evaluation regarding eating habits and higher serum levels of serum uric acid and ferritin, compared to the students supplied with meals.
Conclusions The eating habits of male students are affected by whether they receive meals or not. It is considered that the higher levels of serum uric acid and ferritin in the students not supplied with meals is due to their irregular eating habits and heavy exercise. It is suggested that nutritional guidance is needed for such students.

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Objective Considerable attention has been directed toward the quality of nursing home care, with a more recent focus on residents’ perspectives concerning bio-psychosocial needs. Several researchers have reported professional and patients’ perspectives to be consistently different regarding bio-psychosocial needs. The objective of this study was to examine such differences.
Methods A cross-sectional survey was conducted, with interviews of nursing home residents and a self-administered questionnaire for residential care professions. The data were obtained from 85 matched pairs in 6 nursing homes. The measures for subjective needs of the residents had three dimensions (physical, psychological, and social) covering 8 sub-categories. Analyses of the data offered good evidence of reliability (internal consistency) and content validity.
Results In an agreement statistic analysis using Cohen's kappa, the residents’ and care professional perspectives significantly differed regarding subject needs. In another analysis using t-tests, measures for subject needs derived from residential care professionals were consistently greater than those with nursing home residents. This tendency was generally consistent across sub-categories by ADL levels. However, the ranking order for the 7 sub-categories for subject needs was very similar with both raters.
Conclusion Assessing nursing home residents’ subject needs represents an important and essential component of quality of care. However, needs assessment by the residential care profession is still its infancy and includes failure to consider the residents’ perspective. The future research challenge is to find reasons for the gap in subjective thinking between the groups. In addition, researchers can perform a critical function on behalf of nursing home residents when they suggest improvements to the methodology for assessing residential care professionals views on residents’ needs.

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Objects This study examined the nutritional intakes of elderly people with care needs and of the caregivers, using data of the Comprehensive Survey of the Living Conditions of People on Health and Welfare and the National Nutrition Survey in 1995.
Methods Four groups were categorized: elderly people with care needs (65 and older, n=83), female caregivers (40 and older, n=95), other elderly people (65 and older, n=1,818), and other women (40 and older, n=3,477). The ratios of intakes to dietary reference intakes (DRIs) for energy and 8 nutrients (protein, fat, calcium, iron, vitamin A/B₁/B₂/C), as well as salt, were compared among those four groups.
Results Mean ratios to DRIs in elderly people with care needs were 108% for energy, 85% for calcium, and 101~224% for the other 7 nutrients. Mean salt intake in this group was 11.0 g/day. For many nutrients, ratios to DRIs were significantly lower than those in other elderly people. Mean ratios to DRIs in caregivers were 104~294% for energy and the 8 nutrients, and mean salt intake was 12.8 g/day, with no significant differences from date for other women.
Conclusion This study cast light on the status of the nutrient intake in elderly people with care needs and their caregivers. It was suggested that calcium intake was insufficient in the former.

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 “Neoceader smoking” is widely marketed in drug stores as an over the counter expectorant for cigarette smokers in Japan. Using high-pressure liquid chromatography, we determined that one piece of Neoceader (3 cm) contains 0.79 mg of nicotine, which is equivalent to one-sixth of the amount of nicotine in one Japanese cigarette (Mildseven extra-light, Mildseven super-light, or Sevenstar). Two patients who had switched from cigarette smoking to Neoceader smoking, subsequently became addicted to nicotine. The cotinine concentration in their urine were 937 ng/ml and 2,724 ng/ml, respectively. These findings demonstrate that Neoceader contains nicotine and that its use can lead to nicotine addiction.

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[in Japanese]

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[in Japanese]

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Purpose To identify the respective characteristics of clients useing visiting nursing service and home-help service. Since the past, research on the utilization of in-home care services has usually focused on different services collectively.
Methods Interviews using structured questionnaires were carried out with 134 elderly individuals who were selected in October 1997 from the list for home visit of public health nurses in a town with a population of 36,000. With regard to the utilization of visiting nursing as well as home-help service, the relationship with three factors of the conceptual Andersen's model (predisposing factor, needs factor, enabling factor) were examined.
Results and discussion Of the 134 subjects, 38.1% utilized visiting nursing service and 36.6% used home-help services. Use of visiting nursing service was significantly associated with variables such as declining ADL in the elderly, hospitalization within the past two years, less care-giving by family members, and less resistance to service-use by caregivers. On the other hand, use of home help service was related to less caregiving by family members and resources of visiting nursing. The clients who used both visiting nursing and home-help service had more difficulty with care-giving by family members compared to those who used only nursing service, and the latter were inferior in thems of physical conditions, including ADL, to those who employed only home-helpers.
Conclusion The factors promoting the use of visiting nursing are different to some extent from those for home-help service. Clients using both are characterized by the presence of a broader variety needs.

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Objective The study aim was to evaluate by ALS patients' satisfaction regarding information about invasive ventilators provided by medical doctors.
Methods Semi-structural interviews were conduced for 12 cases (11 patients and 9 family members provided information) at three areas in Japan.
Results 1) Most patients were unsatisfied with the information by doctors;
2) some cases felt strong distrust of doctors' attitudes;
3) more than half of the cases complaind of insufficient information.
Conclusion This study suggests that in the informed consent for ALS patients, doctors' negative attitudes to life prolongation adversely impact on ALS patients. Roles of service providers, patients and family members should be reconsidered for cases of ALS and other incurable diseases.

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 In order to grasp the characteristics and outcomes with infants hospitalized long-term in NICUs, we reviewed all summary charts of 18 perinatal medical centers in Tokyo for the period from January 1989 to December 1998. We sampled 3,000 infants who required neonatal intensive care over 90 consecutive days out of 46,309 registered cases during the decade.
 The duration of hospital stay, making a comparative analysis of the number of days for the 50 percentile, was as follows. As a whole the infants required 125 days until discharge. Infants with 29-30 weeks gestation and infants with birth weights 1,000-1,499 g required shorter stays (106 days in both cases). The “discharge with complications” group required 136 days, and the “discharge on remission” group 119 days. Within the 31-32 weeks gestation group, those with “discharge with complications” required 107 days. Within the 29-30 weeks gestation group, those with “discharge on remission” required 104 days. Infants with 1,000-1,499 g birth weights for the “discharge with complications” and “discharge on remission” groups required 116 and 104 days respectively. Focusing on birthplace, the group of “inside-born” (born at perinatal medical centers) infants required 124 days, and the “outside-born” (born at non-perinatal medical centers) required 127 days.
 Respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) and chronic lung disease (CLD) were often seen in patients under 29 weeks gestation and under 1,000 g birth weight. Hypoxic ischemic encephalopathy (HIE), convulsions, congenital malformations and chromosomal abnormalities were frequent in the groups over 31 weeks and over 1,500 g. Apnoea and transient tachypnoea of newborn (TTN) often occurred in these at 29-30 weeks and 1,000-1,499 g. Also, apnoea and TTN were often seen in the “discharge on remission” group. RDS, apnoea and TTN occured frequently in the “inside-born” infants with over 31 weeks of gestation and over 1,500 g birth weight. There were many cases of HIE and convulsions in the “outside-born” infants of these groups.
 We found infants who required long-term intensive care to comprise three main groups. The first group consisted of infants of 29-30 weeks gestation and 1,000-1,499 g birth weight and demonstrated mild or few complications. The second consisted of under 29 weeks and under 1,000 g and exhibited complications of chronic lung diseases caused by immaturity of respiratory organs. The third was the group of over 31 weeks and over 1,500 g who had complications due to central nervous system disease, congenital malformations and chromosomal abnormalities.

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Purpose The purpose of this study was to evaluate a community-based preventive care program focused on physical and psychosocial status of frail elderly living at home.
Method The study had a prospective cohort design. Community-dwelling frail elderly not applying for the long-term insurance system care were assigned to a participant group (n=71), wishing to participate in the community-based preventive care program, and a non-participant group (n=40) who did not have the intention. The care program included activities and health education for elderly to promote their social contacts. Outcome variables were Activities of Daily Living (FIM), upper extremity function, time required for a 1.5 meter walk, health complaints, cognitive function (MMSE), psychological Quality of Life (QOL), depression (GDS), modified fall-related self efficacy (MFES), self efficacy for health promotion (SEHP), and social network. Data were collected prior to and at 6 months and 12 months after the intervention.
Results 1. At the baseline, the number of female (P=.033) and B day service use (P=.001) in the participant group was significantly greater, and the number reporting falls (P=.017) and A day service use (P=.014) was lower than the non-participant group. MMSE (P=.032), MFES (P=.001), and SEHP scores (P=.017) as well as the social network values (P=.022) in the participant group were significantly higher than for the non-participant group.
 2. The participants demonstrated significant effectiveness in the MMSE scores (P=.002) during the follow-up period, values after both 6-months (P=.002) and 12-months (P=.005) follow-up, being lower than in the non-participant group.
 3. The participant group also demonstrated significant effectiveness in the GDS score (P=.033) during the study period, their values being lower after 12-months (P=.070) than in the other group.
Conclusion The results indicated that the community-based preventive care program to the elderly could effect on cognitive function and depression.

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