Objective This study investigated psychosocial factors underlying the mental health problems of single-child high school students in China, where society and the family situation have been rapidly changing since introduction of the open-economy policy.
Method Three hundred and ten college-bound high school students in Heilong Jiangsheng Harbin completed self-administrative questionnaires in February, 2000. The subjects were divided into single-child and non single-child groups. Analysis of correlations was performed for general attributes, mental conditions measured by General Health Questionnaire (GHQ), personality variables, stressors, and emotion support network. Cause-and-effect factors were also analyzed using Covariance Analysis.
Result In the single-child and in non single-child groups, the percentage suffering neurotic tendencies were 73% and 39%, and the values for a tendency to depression were 63% and 25%, respectively. In the single-child group, anxiety, interpersonal dependence, and perceived stressors were significantly higher while the perceived self-esteem and emotional support from family members were significantly lower than in the non single-child group. Among the variables, having siblings was highly correlated with all the measured factors influencing mental health. The results indicated that a poor emotional support network could cause low self-esteem, high anxiety trait, strong interpersonal dependence, and increased sensitivity to stressors and worsening of mental health.
Conclusion The incidence of mental health related problems was found to be significantly higher in the single-children than in the non single-children. Thus having siblings has positive effects on mental health. The emotional support network also plays an important role in the mental condition, development of a healthy personality, and building a positive attitude toward stressors.

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Purpose This paper will discuss an analysis of the demand for vaccination for the elderly as a high-risk group. Influence of the governmental endorsement and/or subsidy on these demand is, then, evaluated from the estimation results.
Methods Original data were obtained from two surveys conducted by the author for the elderly living with and without descendents. Information was collected about the elderly themselves, the household, experience of influenza and immunization in the last season, and the hypothetical questionnaire about immunization was answered by each respondent to be applied for Conjoint Analysis. Three estimations are performed for the actual behavior, Conjoint Analysis and the joint estimation of these two methods.
Results Experience of influenza and immunization in the last season, proved to be two of the most important determinants. Among the others estimated parameters, cost of immunization, the number of immunization to complete for effectiveness, availability of the immunization at night or on a weekend, and the governmental endorsement greatly affected the immunization demand. Moreover, the superiority of the statistical properties of the joint estimation was confirmed.
Conclusions The estimation results imply that about 8.9 million elderly people would demand vaccination if there was no cost and there was a governmental endorsement. This would be reduced to be 3.2 million if the cost was 6,000 yen (about 50 dollars) and there was no governmental endorsement. Governmental endorsement alone would increase the number by 2.0 million. The change from no cost to only 500 yen (about 4 dollars) would depress the demand by 1.6 million.

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Purpose We conducted a comprehensive mass health examination for elderly subjects aged 70 or above, living in the community, to assess early deterioration to long-term care conditions and promote healthy and successful aging (“Otasha-Kenshin”). In this study, we clarified characteristic differences between participants and non-participants.
Subjects & methods A mass health examination was offered in October 2001 to 863 community elderly, including individuals suffering from falls (and fractures), incontinence, malnutrition, depression, mild cognitive impairment and less of functional capacity. Among the total, 438 (50.8%) opted for the “Otasha-Kenshin” examination.
 Differences in characteristics between the participants and non-participants were examined, parameters including sex and age distribution, self-rated health, functional capacity by the TMIG Index of Competence, depressed status by the General Health Questionnaire (GHQ), subjective well-being by the Philadelphia Geriatric Center Morale Scale: A revision (PGC-MS), frequency of falls, and prevalence of chronic diseases. The comparison was based on the results of measurements from the final survey conducted in 2000.
Results 1) The participation rate in the “Otasha-Kenshin” was 49.0% in males and 51.0% in females. The average age was 75.3 year olds in participants and 76.4 in non-participants, the difference being significant (t=3.97, P<0.0001).
2) Non-participants had a significantly lower level of self-rated health than participants.
3) There was no significant difference in hand grip strength between participants and non-participants.
4) Non-participants showed significantly lower level of functional capacity and subective well-being, and they were more likely to be in a depressed state than participants.
5) There was no significant difference in fall rate between participants and non-participants.
6) The prevalence of hypertension and diabetes (found in more than 5% among the sugjects surveyed in 2000) was not significantly different between participants and non-participants.
Conclusion With aging of society, new and specialized health maintenance systems for the elderly are essential, both for the prevention of deterioration to a long-term care condition (a bed-ridden status) and for the promotion of successful aging with autonomy. Participants in “Otasha-Kenshin” appear to be healthier and more independent than non-participants who were more frail and at higher risk group of a long-term care condition and a bed-ridden status.
 The major reason for non-participation in the health examination found in this study was subjective or mental deterioration rather than the presence of chronic illness or any geriatric syndtome per se. Frail elderly people like the non-participants in this study should be encouraged and mentally supported to avoid aggravation of their health status through intensive or specialized health surveillance system such as home-visit nursing.

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Purpose Annual medical checkups are presumed to be important with the well-being of aged individuals. The purpose of this study was to investigate factors related to participation in medical checkups of elderly persons at home.
Methods A survey was performed targeting so-called young elderly persons living at home in 3 regions in Hokkaido Prefecture, a large city (Sapporo), an ex-coalmining town (Yubari) and a small farming town (Takasu). The study populations were asked about medical checkups, economic status, self-rated health status, activities of daily living (ADL) and basic characteristics such as age, sex and occupation. We used the Mantel-Haenszel method for statistical analysis.
Results 1) Elderly males who received medical checkups within the last 1 year (participants) had a shorter period of education, were less likely to have or to have had the smoking habit, undertook more physical activity, had better eating habit, more often rated their own health as good or normal, and had a better physical ADL & instrumental ADL, than those who had never received medical checkups (non-participants). Regionally, the items that showed significant differences included: “live with the spouse”, “do not smoke” and “do not have physical pain or disabilities” in Sapporo; “enjoy physical activity”, “have good eating habit” and “have good instrumental ADL” in Yubari; and “engaged in agriculture/fishery work” and “had outpatient visits in the last three months” in Takasu.
2) Elderly female participants who had outpatient visits in the last three months had anxiety about their own health, significantly different from non-participants. Regionally, the items that showed significant differences included: “often drink alcohol” in Sapporo; “still working right now”, “was engaged in agriculture/fishery work in the past” and “had outpatient visits in the last three months” in Yubari; and “have own house”, “do not smoke” and “pay attention to eating habit” in Takasu.
3) The item which showed a significantly high rate both for male and female participants was “still working right now”.
Conclusions This study indicates that medical checkups should be recommended to the elderly, taking into account not only their basic characterstics such as sex and occupation, but also lifestyle, self-rated health status and ADL, which are associated with medical checkup participation.

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Background Exposure to smoking scenes in movies and TV dramas has been known to be a trigger for young people starting habitual smoking, but it has not been clarified to what extent youth is routinely exposed to smoking scenes in television programs in Japan.
Objective To clarify the status quo of smoking scenes and smoking-related items in serial TV dramas targeting young audience in Japan.
Method Seven TV dramas targeting a young audience broadcast between July and September, 2001 were analyzed. A total of 63 hours of TV programs were divided into units of three minutes (a total of 1,264 units). All the units were reviewed for smoking scenes, description of social contexts related to smoking behavior, existence of smoking and smoking-related items.
Findings Among the 1,264 three-minute units, 129 (10.2%) contained smoking behavior, and 258 (20.4%) depicted smoking environment with presence of smoking-related items. Smokers were male actors (126 units, 97.7%), aged 20-40 years (118 units, 91.5%), leading actors (72 units, 55.8%), and were smoking alone (80 units, 62.0%). Smoking places mainly took place in indoor settings (56 units, 43.4%). Ashtrays were the most frequently observed smoking-related items (8.1% of the total units).
 The smoking scenes with actions other than smoking itself accounted for 70 units (54.3% of the smoking scenes).
 As for the actions other than smoking, working (28 units, 21.7%) and eating (17 units, 13.2%) were commonly observed. Regarding smoking scenes without any other actions, 32 units (24.8%) were observed in the beginning or ending telops, and 27 units (20.9%) showed a person smoking without doing anything else. There were only 3 units (0.2%) which were against smoking behavior.
 Approximately 30% of the Japanese serial television drama scenes featured tobacco use in story plots. As the general features of the smoking scenes, most of them do not necessarily require smoking in the story. Furthermore, there was little consideration about separation of designated smoking areas.

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