Objective Health care costs have been increasing year by year and health programs are needed which will allow reduction in the burden. The present community-based ecological study examined the relationship between implementation of dental health care programs and health care costs for the metabolic syndrome.
Methods We calculated the monthly health care cost for the metabolic syndrome per capita for each municipality in Okayama Prefecture (n=27) using the national health insurance receipts for 1997 and 2007 for diabetes mellitus, hypertension, cardiovascular disorder, cerebral vascular disorder, and atherosclerosis as principal diseases. Information was obtained from each municipality on the implementation of public dental health services consisting of 10 programs, including visits for oral hygiene guidance, health consultation for periodontal disease, preventive long-term care, participation of dental hygienists in public health service, programs for improving oral function in the aged, and etc. The municipalities were divided into two groups based on the implementation/ non-implementation of each dental health program. Then, the change in health care cost for metabolic syndrome per capita between 1997 and 2007 was compared between the two groups according to each dental health program.
Results Health care costs for metabolic syndrome were reduced in decade in the municipalities which executed dental health care programs such as ‘preventive long-term care’ or ‘health consultation for periodontal disease’, being greater in the municipalities which did not. More decrease in health care costs was further observed in the municipalities where the other seven programs were also implemented.
Discussion Any direct relationship between dental health programs and health care costs for the metabolic syndrome remains unclear. However, our data suggests that costs might be decreased in municipalities which can afford to implement dental health programs.
Conclusion Health care costs for the metabolic syndrome in municipalities which executed dental health care programs tended to decrease in ten years.

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Objective The aim of this study was to clarify relationships between participation in community activities and psychosocial and physical health of community-dwelling elderly.
Methods The participants of the present study were 413 people selected on the basis of a random 1/3 extraction of people aged 65 or older and living in a rural community in Miyagi prefecture. The baseline survey was conducted in February 2008. One year later, we conducted a follow-up survey to clarify how participation in community activities influenced the elderly. Finally, we analyzed data for 218 people, focusing on influences on psychosocial and physical health using the logistic regression model. The state of community activity was treated as a dependent variable, and mental and physical health indicators were assessed as the independent variables.
Results Of the elderly sample, 63 persons were found to be frequent participants in community activities, 60 were infrequent participants, and 95 did not participate. The frequently participating individuals displayed significantly better results for declines in depression (OR=0.34, 95% CI: 0.13–0.89), and social participation (OR=0.12, 95% CI: 0.05–0.29), as well as the TMIG index of competence (OR=0.26, 95% CI: 0.08–0.78) as compared with those who did not participate.
Conclusion These results suggest that community activities prevent deterioration of mental health, improve social health, and maintain higher-level functional capacity among community-dwelling elderly individuals.

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Objective This investgation aimed to determine in a research setting why people in the general population consent to participate in genetic epidemiological studies.
Methods The present study was conducted as a supplement to the baseline survey of an ongoing population-based cohort study in the Takashima and Makino areas in Shiga Prefecture, Japan. Division of the cohort study was into two main parts: a basic survey and a genetic analysis. Eligible participants included 2,195 attendees of a national health checkup in the abovementioned areas in 2003. All were asked at the checkup site whether or not they wished to participate in the cohort study. Subsequent to the informed consent process for the cohort study, they were given a multiple-choice questionnaire on reasons for their decision of whether or not to participate in the basic survey and/or genetic analysis parts. A total of 2,171 attendees responded to the questionnaire.
Results No major differences in reasons for participation and non-participation were observed between the basic survey and genetic analysis. The most frequently cited reason for participation was expectation of some individual benefits from participation, followed by finding social value in the cohort study. Underlying trust in physicians and medical institutions in general was also an important factor. On the other hand, the main reasons for non-participation were lack of time and the time-consuming nature of the cohort study. Concerns regarding potential for invasion of privacy and breach of confidentiality were not prominent reasons for non-participation.
Conclusion The study uncovered reasons why people in the general population might consent or dissent regarding participation in genetic epidemiological studies.

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Objective The purpose of this study was to generate appraisal standards for functional measures in independent elderly people with physical frailty, “Tokutei”, or persons aged 40 and older who require light assistance, “Youshien”.
Methods A total of 3,852 subjects for whom functional measures were available, including grasp strength, one-leg standing time, timed up & go (TUG), and 5-m walking time, were analyzed from a database obtained from the Ministry of Health, Labour and Welfare. The upper limit and lower limit of each quintilededuced from the functional measurements were adopted to construct the appraisal standard.
Results The functional measures were higher in Tokutei than in Youshien. Comparing Tokutei and Yoshien, one or more level difference in the five divided groups was observed for the one-leg standing time. There were differences of three or more levels between Tokutei and Yoshien in the TUG and the 5-m walking time.
Conclusion The present study allowed development of appraisal standards for elderly having physical frailty and for persons aged 40 and older requiring light assistance in daily living.

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Objective The aim of the present study was to elucidate the relationship between eating and tooth brushing habits in the second grade of elementary school with first molar caries in the third to sixth grades.
Methods Subjects were 130 students at one elementary school in the Tokai region who were in the second grade in 2002, for which eating and tooth-brushing habits were ascertained by a self-administered questionnaire survey. A follow-up survey was conducted based on the 2002 to 2006 school dental examination record and analyses were performed on data from 104 students without first molar dental caries in the second grade.
Results The incidences of first molar caries in the third grade were higher among students who ate cookies at least once daily or every 2 to 3 days, compared with those who ate cookies once a week or not at all in the second grade. Incidences were also higher among those whose daily frequency of tooth brushing was once or sometimes compared with twice or three times or more. Furthermore, the incidences of first molar caries in the fourth, fifth and sixth grades were higher among students who ate candy at least once daily or every 2 to 3 days, compared with those who ate candy once a week or not at all in the second grade.
Conclusion The intake frequency of cookies was related to the first molar caries in the third grade, and of candy for that in the fourth to sixth grades. Moreover, first molar caries in the third grade were also related to the daily frequency of second-grade tooth brushing. These findings suggest the importance of measures encouraging lower-grade elementary students to establish and maintain habits of tooth brushing and of limiting consumption of sweets, such as cookies and candy, in order to prevent caries in their permanent teeth during elementary school.

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[in Japanese]

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