Objective The consultation rate in Japan for mammography screening for breast cancer continues to drop. In order to examine this issue based on demand for mammography, the present study was conducted using Discrete Choice Experiments (DCEs), a type of Stated Preference (SP) method. The objectives of this study were as follows: 1) To consider what attributes of mammography screening are being potentially evaluated by general recipients in the target age group; 2) To verify the validity of the SP method by separating the sample group into sub-groups of previous mammography recipients and non-recipients, and to compare their findings; 3) To predict selection behavior by setting scenarios for screening options possibly in demand in the future.
Methods 800 subjects aged between 40 to 59 years and with no history of breast cancer were randomly selected from the general population of Tokyo. A DCE was conducted using postal self-administered survey forms. A total of 301 survey responses were obtained. Subjects were presented with a pair of hypothetical screenings, including 5 attributes regarding mammography screening, and asked which screening they would prefer to receive. For the entire sample and sub-groups, estimations for parameters were made using the conditional logit model setting the screening attributes as independent variables and the selection of whether or not to receive each screening as a dependent variable. Based on these results, short-time/high-cost and long-time/low-cost screening options were set and selection behavior was predicted.
Results The five attributes regarding mammography screening for all samples -total amount of time taken for the screening; degree of breast pain; possibility of breast cancer being missed during the screening; the effectiveness of reducing deaths caused by breast cancer; and the total cost required for the screening -were each estimated to be significant at the 5% level with coefficient signs consistent with expectations for the entire sample group. Next, comparing the estimated results of the sub-groups, a positive correlation was confirmed between behavior and preference. As for forecast of selection behavior, the percentage of respondents choosing the short-time option was predicted to be the same or higher than for those choosing long-time/low-cost option when the short-time option was offered for ¥7,500 or less.
Conclusion This study shows that subjects place significant value on attributes regarding the screening process as well as actual health outcomes. It also suggests the validity of using the SP methods in examining screening preferences. We found that short-time screening was able to compete against long-time/low-cost screening when it was offered for ¥7,500 or less.
 These results suggest that offering mammography screening with favorable settings could increase the demand.

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Objective To examine associations among appetite, snacking, and body type during infant development. We also investigated whether trends in appetite, snacking, and body type continue through time.
Methods Children (n=1,313) born between April 2000 and March 2004, in Ito City, Shizuoka Prefecture, were enrolled. Data were collected during health checkups at 18 and 36 months of age. The items used for analysis were the child's appetite, snack content, snack-eating style, and gender. The mothers commented on their child's appetite as good, normal, lacking, or irregular. The good and normal responses were grouped under the category good/normal appetite, while lacking and irregular were grouped under the category lacking/irregular appetite. Body types were calculated using an obesity index and classified as underweight, normal, or overweight. Fifteen kinds of snacks at 36 months were classified using cluster analysis. Appetite, snack content, snack-eating style, and body type at 18 and 36 months of age were compared using the McNemar test. Logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) for the appetite categories.
Results There were 664 boys (50.6%) and 648 girls (49.4%) in the study (missing=1). The response rate was 56.5%. Snacks were classified by content as meal substitutes, snacks and sweet foods, or healthy snacks. There was no change in appetite at 18 and 36 months of age. By 36 months, snack content, snack-eating style had changed (e.g. solitary snacking increased.). The highest risk factor for appetite at 36 months was lacking/irregular appetite at 18 months (OR: 4.70, CI: 3.07-7.19), eating snacks without time constraints (OR: 1.81, CI: 1.24-2.65), followed by unsupervised snacking (OR: 2.92, CI: 1.45-5.87), and consuming few healthy snacks (OR: 0.69, CI: 0.48-1.00). The risk factors for lacking/irregular appetite at 18 months of age were eating snacks without time constraints (OR: 1.68, CI: 1.13-2.49), receiving snacks on-demand (OR: 1.49, CI: 1.01-2.19) or from acquaintances (OR: 2.46, CI: 1.46-4.14), and being underweight (OR: 11.47, CI: 3.20-41.15).
Conclusion Education must be started at an early age because lacking/irregular appetite at 18 months was found to continue through to 36 months. In addition, the risk factors for a lacking/irregular appetite differed between 18 and 36 months; thus, education should be based on age.

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Purpose To obtain basic data to formulate policies for preventing women from resuming smoking postpartum, this research sought to identify factors affecting continued abstinence and the resumption of smoking among postpartum women who stopped smoking during pregnancy.
Method An anonymous self-administered questionnaire was sent by mail to 1,736 mothers (1,030 in City A and 706 in City B, Hyogo Prefecture) whose infants were due for their 18-month health check-up in September and October 2007 and collected on the day of the check-up. Items surveyed were the mother's age, full academic background, number of children, family structure, smoking history, attitude toward smoking and knowledge, husband's smoking history, level of satisfaction with abstinence during pregnancy, and child-rearing concerns.
 The number and percentage of valid responses were 754 (73.2%) among 1,030 mothers in City A and 575 (81.4%) among 706 mothers in City B. This study focused on women who had smoked prior to finding out they were pregnant but stopped smoking during their pregnancy.
 The responses for each item of the continued abstinent group and the postpartum relapsed group were sorted by city and compared, and factors influencing postpartum smoking behavior were examined using logistic regression analysis.
Results Of the 754 mothers from City A and 575 mothers from City B, 153 (20.3%) and 105 (18.3%) respectively had smoked before they discovered they were pregnant. Of these, 123 (80.4%) from City A and 88 (83.8%) from City B stopped smoking after discovering they were pregnant on this occasion. Totals of 52 (42.3%) from City A and 45 (51.1%) from City B had resumed smoking at the time of the 18-month health check-up. Logistic regression analysis showed that in cases where the husband smoked the odds ratios for resuming were 42.1 (95% CI: 4.6-387.3) for City A and 13.7 (95% CI: 2.9-65.2) for City B. The odds ratios for those who were pleased they had not smoked during pregnancy were 0.11 (95% CI: 0.04-0.33) for City A and 0.15 (95% CI: 0.04-0.57) for City B. That for mothers from City A who experienced a high level of stress related to child rearing was 6.0 (95% CI: 1.7-21.2).
Conclusion The findings suggest that having a husband who smokes encourages resumption of smoking postpartum and that those who were pleased they did not smoke during pregnancy continue to abstain postpartum.

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[in Japanese]

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Purpose This study assessed the subjective well-being of elderly residents of special nursing homes, and examined related factors, particularly from the perspective of lifestyle.
Methods An interview survey using a structured questionnaire was conducted on 124 elderly individuals (age, ≥65 years) living in one of 8 special nursing homes in 2 prefectures in the Hokuriku region for at least 3 months. All were graded as level II or less on the Dementia Elderly Daily Living Independence Rank from late August to early November 2002. A total of 115 subjects (men, n=26; women, n=89; mean age, 83.16±7.13 years) were included in the analysis. Regarding survey items, the residents’ subjective well-being was measured using the revised PGC Morale Scale, and related factors were categorized into “basic attributes”, “activities of daily living”, “health”, “personal relationships within the facility”, and “freedom in lifestyle”.
Results The mean PGC Morale Scale score was 10.06±3.95 points. As a result of multiple regression analysis, factors related to the subjective well-being of elderly residents of special nursing homes were found to be: “sense of freedom of choice in lifestyle”, “feeling of seeing the staff smile”, “no worrisome disease”, “lack of physical pain”, and “absence of renal disease and urinary organ disease”.
Conclusion Security, human relations being good, an acceptable physical state of health, a degree of freedom in everyday life were found to underly a subjective feeling of happiness in persons living in welfare institutions. It is therefore important that these be taken into account in free choice of a care service, with emphasis on providing a desirable residence environment with good human relations inwelfare institutions.

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