Objective A critical evaluation was performed on school-based anti-smoking education reported over the past 25 years in Japan.
Methods Relevant papers were retrieved by the key words of “smoking prevention” or “anti-smoking education” and those on anti-smoking education actually performed for pupils or students in Japan were collected. According to the criteria for whether they might be regarded as quasi-experimental studies regarding use of a control group, and performance of pretest and posttest assessment. Response rate, individual behavioral change, target group for evaluation, comparison methods e.g. before-after comparison, and points of evaluation were reviewed for each paper.
Results Of 27 relevant papers, approximately 40% utihzed a control group and pretests were not conducted in 30%. Two kinds of posttest were pevformed; one was an immediate posttest 2 weeks after the anti-smoking education, and the other featured a longer interval. An immediate posttest only, a later posttest only and both posttests were performed in 10, 5, and 10 studies, respectively Eight, or 30%, were regarded as quasi-experimental for which the ranked of the quality of evidence might be II-1. Individual behavioral change was examined in only one paper.
Conclusions Three fourths of the 27 papers reviewed had some drawbacks in terms of study design. One half of the control groups were set in the same school as the education group and the remainders set in separate schools. Preferably, control groups should be set both in and out of the school of the education group. Apretest is an essential step and a posttest at the age of 20 is preferable where possible. Methodological innovation is required for individual identification and follow-up. In addition, objective indices of behavioral change should be analyzed and biases such as arising from selection bias should carefully be watched. Knowledge of epidemiological study designs is of essential importance to improve the quality of evaluations of health education programs.

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Purpose To clarify the content of support for healthy aging, we analyzed age-related changes in functional capacity and factors affecting the maintenance based on a health status survey in elderly people, and also evaluated the results of a survey on functional capacity, living habits, and health in leaders in elderly peopel's clubs.
Methods A questionnaire survey was carried out with (1) 1,000 randomly selected elderly subjects aged≧65 years and (2) 122 leaders in elderly people's clubs to evaluate functional capacity according to The Tokyo Metropolitan Institute of Gerontology Index of Competence, feeling of happiness according to the morale scale established by Lawton, living habits, and health.
 Factors affecting functional capacity were identified by stepwise multiple longistic regression analysis. In addition, the elderly people's club leader group and an age- and sex-matched control group were compared.
Results 1) Functional capacity decreased with age, this being more marked in the females than in the males. In paticular, Instrumental Activites of Daily Living markedly decreased in the females at late ages. 2) Stepwise multiple logistic regression analysis revealed the following positive and negative factors associated with the maintenance of a high functional capacity (functional capacity score≧12).
 The positive factors were: ① hobbies, ② living with the spouse, ③ habitual exercise, ④ positive acceptance of aging, ⑤ psychological stabitity, ⑥ diets with consideration of nutritional balance, ⑦ busy life, and ⑧ talking with friends and acquaintances once a week or more. The negative factors were: ① belonging to a higher age groups, ② living alone, and ③ smoking. 3) In the elderly people's club leader group, the age-related decline was gradual, and functional capacity was maintained at later ages. The group leaders typically ① had hobbies, ② went out almost everyday, ③ exercised almost every day, ④ talked with friends and relatives almost every day, ⑤ had active roles, ⑥ were busy, and ⑦ considered themselves to be healthy more frequently than the control group. The leader group also showed ⑧ a higher total morale scale score and ⑨ a higher score for positive acceptance of aging as a subscale than the control group.
Conclusions Our results suggest that nutrition balance, habitual exercise, hobbies, social roles, frequent contacts with others, positive acceptance of aging, and psychological stability are important for maintaining functional capacity in elderly people. The leaders of elderly people's clubs appear to live a favorable life in terms of the maintenance of functionl capacity. Early preventive measures are necessary to combat decline in functional capacity, particularly regarding Instrumental Activites of Daily Living, in famales at later ages.

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Objective A longitudinal study was analyzed to clarify relationships between infant lifestyle, obesity, features of family life and adolescent obesity.
Subjects and methods Subjects in the present study were born between April 1987 and March 1991, in Enzan City, Yamanashi prefecture. Infant height and weight were measured and questionnaires were collected at medical check-ups at 1.5- and 3-years-of age. Adolescent height and weight were measured in April 2000. Obese adolescents were defined as those with on obesity index ≥20%.
Results At 1.5-years-of age, 883 responses to the questionnaire were obtained, and 737 subjects were followed to adolescence (83.5%). Mean follow-up period was 10 years 11 months.
 A high Kaup index at 1.5-years-of age (odds ratio (OR) 2.61; 95% confidence interval (CI) 1.11-6.12) and when 3-years-of age (OR 5.34; CI 2.54-11.23), as well as maternal obesity (OR 5.32; CI 2.67-10.60) represented risk factors for adolescent obesity.
 Of the lifestyle items, “playing alone inside” at 1.5-years-of age (adjusted OR 3.01; CI 1.01-8.99) and “taking snacks without time constraints” at 3-years-of age (adjusted OR 2.12; CI 1.25-3.61) were additional risk factors.
 In food items, only low intake of cow's milk displayed a significant relationship with adolescent obesity, the link being negative with an adjusted OR of 0.63 (CI 0.41-0.95). Covariance structural analysis was performed and a causal model was constructed. Maternal obesity, obesity at 3-years-of age, playing alone inside, taking snacks without time constraints, and low intake of cow's milk were all associated with obesity in infancy. Maternal obesity affected methods of answering child demands, in turn affecting snacking habits.
Conclusions Adolescent obesity displays relationships with maternal obesity, a high Kaup index in infancy, play activity, snacking habits, and intake of cow's milk. Although genetic factors exert a strong influence, these components of infant lifestyle all play a role in the development of adolescent obesity.

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Purpose The purpose of this study was to forecast the demand for public health nursing visit and visiting nursing agencies' service, and to obtain basic information on public policy after the Long-term Care Insurance Project Plan starts.
Method 8,940 randomly sampled subjects aged 65 and over, and 7,984 aged 64 and below, were selected for the surveys and mailed the questionaire. A total of 5,775 aged 65 and over and 4,774 aged 64 and below responded to the questionaire.
Results 2,474 (42.8%) aged 65 and over and 1,643 (34.4%) aged 64 and below knew the name ‘public health nursing visit’, and the service provided, 1,635 (28.3%) aged 65 and over and 1,073 (22.5%) aged 64 and below, were aware of the visiting nursing agencies' service.
 The percentage of those who desired to use the service was significantly higher among the respondent aged 65 and over than among those aged 64 and below. It was also significantly higher among those who had already experienced the service previously.
Conclusion Awareness of the service and the number of those who use the visit will increase, as those aged 64 and below become more the elderly. We therefore can expect that service demand will increase in the future.

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Purpose To investigate zoonosis and vector surveillance systems in major countries, conducted by quarantine, health and environment authorities, and compare the results with the current Japanese systems.
Methods We elaborated a questionnaire for zoonosis and vector surveillance systems regarding target diseases, vectors, period and area of operation, type of surveillance (active and/or positive), and feedback mechanisms which was then mailed to ten countries having strong trade and tourism links with Japan. We visited some authorities for further discussions.
Results Eight countries which responded answered that all were conducting zoonosis and vector surveillance. Target diseases included those designated by the International Health Regulations and others with a higher priority for control and prevention in the individual countries. The type of surveillance was classified as: regular monitoring of the vector population, active detection of pathogens in vectors during a specific time period of a year, and intensive pathogen characterization when problems occuered.
Conclusions The significance of zoonosis and vector surveillance was recognized through this investigation, where we found differences in target diseases, and type of operation. The results should be utilized for generation of more useful and efficient surveillance systems in Japan.

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Purpose The purpose of this study was to assess the adherence rate after short-term weight reduction programs and to clarify the related life-style factors in community-residing obese women.
Method The study subjects were 243 women who completed twelve-week weight reduction programs held at the health promotion center in Tokyo from 1992 to 1999. The program consisted of exercise training and individualized diet education once a week. They were instructed to increase their daily walking steps. A mail-survey using a present body weight, walking steps, and diet any habits questionnaire was conducted in November 1999.
Results 128 women (54%) responded to the questionnaire. They were 51.6±9.6 years old and 4 years had passed on average after the program. Among these, 126 women provided their present body weight. Their mean BMI was 26.7±2.6 and 25.5±2.6 before and after the program respectively. Their present BMI was 25.8±2.9 which was significantly higher than the value immediately after the program (P<0.01).
 54 women (42.9%) increased their BMI by more than 1 kg/m² after the program (rebound-group). 24 women (19.0%) decreased their BMI by more than 1 kg/m² and 28 women (22.2%) maintained their ideal BMI defined as less than 24 kg/m² after the program (adherent-group). In the other 20 women (15.9%), BMI did not change significantly after the program, but their present BMI was over 24 (27.4±2.8).
 The mean present daily walking-steps were significantly lower in the rebound than the adherent-group although the percentage with a exercise habit did not differ between the two groups. Diet any behavior was also more favorable in the adherent-group.
Conclusion After 4 years on average from the end of short-term body-weight reduction programs, 42.9% of the participants had regained their original weight. Maintaining increased physical activity and a favorable diet is important for persistent weight reduction in obese women.

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