Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH)
Online ISSN : 2187-8986
Print ISSN : 0546-1766
ISSN-L : 0546-1766
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Original article
  • Yoshihito TOMITA, Kazuhiko ARIMA, Shin-ya KAWASHIRI, Ritsu TSUJIMOTO, ...
    2019 Volume 66 Issue 7 Pages 341-347
    Published: July 15, 2019
    Released: July 23, 2019
    JOURNALS FREE ACCESS

    Objectives This study aimed to explore the association of difficulties in activities of daily living (ADL) (activities related to bending, spine extension, standing endurance, and walking) with fear of falling among community-dwelling older adults.

    Methods We recruited 642 older adults (men, n=267; women, n=375) aged 65 years and over. The mean age was 72.2±5.1 years. Fear of falling, falls in the previous year, pain (low back pain or knee pain), comorbidity, and cataracts were assessed using a self-administered questionnaire. ADL difficulties were assessed individually, such as activities related to bending (getting in or out the car, picking up a lightweight object, putting on socks or stockings, and lifting a 5 kg object from the floor), spine extension (reaching an object above your head), standing endurance (standing on your feet for 2 h), and walking (walking 100 m on a level surface, climbing 10 steps without stopping, and walking down 10 steps). The independent association between fear of falling and each ADL difficulties was assessed using logistic regression analysis.

    Results Participants with fear of falling, compared with those without fear of falling, had an older age (74.8 and 71.6 in men, 73.3 and 71.0 in women, respectively; P<0.01), more falls in the previous year (21% and 9% in men, 28% and 11% in women, respectively; P<0.05), pain (80% and 61% in men, 82% and 64% in women, respectively; P<0.01), and comorbidity (23% and 15% in women, respectively; P<0.05). Multivariate logistic regression analysis identified each ADL difficulties except walking 100 m on a level surface as being independently associated with fear of falling after adjusting for age, body mass index, sex, falls in the previous year, pain, and comorbidity.

    Conclusion ADL difficulties, such as activities related to bending, spine extension, standing endurance, and walking, except for walking 100 m on a level surface, were associated with fear of falling.

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  • Akiteru ISONO, Kazuko SAEKI, Hikaru HONDA
    2019 Volume 66 Issue 7 Pages 348-355
    Published: July 15, 2019
    Released: July 23, 2019
    JOURNALS FREE ACCESS

    Objective Students find it difficult to take the decision to evacuate from tsunamis. This study explores junior high school students' risk perception regarding tsunamis and their willingness to evacuate.

    Methods The study surveyed 251 junior high school students from the 7th to 9th grades in Town B, located at the east coast of Prefecture A, Japan, using data from an anonymous questionnaire that was administered with parental consent. Demographic factors (school, grade, and gender), willingness to evacuate, risk perception, tsunami experiences, recognition of tsunami hazard households, and household preventive actions were evaluated. Pearson's chi-squared test and Fisher's exact test were used to analyze the relationship between risk perception and willingness to evacuate. The study was approved by the Ethics Committee of Hokkaido University.

    Results Valid data were collected from 158 students (62.9%). Of these, 141 (89.2%) were enrolled in a school located in a coastal area. Male students accounted for 81 responses (51.3%) and female students for 77 (48.7%). As for willingness to evacuate, 147 (93.0%) responded that they would evacuate if they heard an evacuation order and 112 (70.9%) responded that they would evacuate if they experienced a persistent tremor. Regarding household altitude, 66 (41.8%) of the students live in houses located less than 15 meters above sea level. The results indicate that 125 (79.1%) of the students discuss tsunamis with their family members. The primary factor promoting the willingness to evacuate after hearing an evacuation order is living in a household under 15 meters in altitude (100% vs. 82.4%, P<0.001) and the major factors for willingness to evacuate after feeling a persistent tremor are living in a household under 15 meters in altitude (84.8% vs. 35.3%, P<0.001) and discussing tsunamis with their families (76.8% vs. 48.5%, P=0.001).

    Conclusion The results suggest that to promote a willingness to evacuate immediately, recognizing the household's altitude is important, as it can give junior high school students a clearer sense of the danger of tsunamis. In addition, the study suggests that discussing the matter within families is a significant factor that promotes willingness to evacuate.

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  • Hina SATO, Atsuko TAGUCHI, Takuhiro YAMAGUCHI, Junko OMORI
    2019 Volume 66 Issue 7 Pages 356-369
    Published: July 15, 2019
    Released: July 23, 2019
    JOURNALS FREE ACCESS

    Objectives Developmental disorders can hinder the acquisition of cognitive function, verbal ability, gross motor skills, and social skills. Therefore, it is necessary to detect them as soon as possible and to consider methods of providing support. Under these circumstances, preschool teachers are responsible for facilitating the support system. This study aimed to describe and classify the support provided by preschool personnel to parents of children with special needs, and to consider the measures necessary to promote support for such parents.

    Methods Self-administered questionnaires were distributed to authorized preschool principals and teachers. The questionnaire for principals addressed facility factors within the preschool support system, and that for preschool teachers addressed the teaching factors related to their knowledge and attitude, collaboration among those inside and outside the facility, and support for parents of children with special needs. In addition, we examined the status of support provided to parents for each of the children with special needs picked up by a preschool teacher. To investigate the factors related to the implementation of support to parents, we conducted a multiple logistic regression analysis with the facility and preschool teaching factors as independent variables, and the presence or absence of preschool teachers’ support for parents from as a dependent variable.

    Results Overall, 10.8% of the children in the surveyed preschools had special needs. Among the surveyed principals and teachers, 73.4% responded that they provided support to parents by “developing a healthy relationship,” while 39.5% reported that they provided support by “communicating about the child's developmental problems.” In the generalized regression analysis on 535 children with special needs excluding missing values, factors associated with “communicating about the child's developmental problems” were “reflecting on the support that was offered in the teacher-parent conference,” “collaborating with other professional staff to a high degree,” and “being confident in providing support to parents.”

    Conclusion This study revealed factors related to providing support for parents of children of concern. The findings suggested that, to promote the provision of support for parents and to establish an early support system for children with developmental disorders, it is necessary to examine ways to conduct a support conference to review actions of preschool teachers retrospectively and to strengthen cooperation with other institutions. It might be effective to solve problems related to developmental disorders at the preschool level through the Community Association for Supporting Developmental Disorders.

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  • Hideya INOUE, Tomoyuki SUZUKI, Mihoko KOJIMA, Eiji INOSHITA, Jongchan ...
    2019 Volume 66 Issue 7 Pages 370-377
    Published: July 15, 2019
    Released: July 23, 2019
    JOURNALS FREE ACCESS

    Objective In recent years, studies have reported a prefectural-level disparity in life expectancy. Therefore, we analyzed the related factors using the National Database (NDB), which includes data pertaining to the specific health checkup conducted for 20 million individuals. By doing so, we aimed to obtain basic data for developing future health promotion measures.

    Methods We used specific health checkup items from NDB Open Data for 2014, and life expectancy data from Prefecture Life Table for 2015. The specific health checkup items were adjusted by age using Japanese population data for 2015. A multiple linear regression analysis was conducted using specific health checkup items that were significantly related to average life expectancy as explanatory variables.

    Results In men, excessive drinking, smoking, antihypertensive drug use, systolic blood pressure, and hyperglycemia were independently and inversely related to life expectancy. In women, smoking and antihypertensive drug use emerged as significant factors.

    Conclusions Analysis using NDB Open Data showed that lifestyle factors such as smoking and drinking, and cardiovascular risk factors such as high blood pressure and hyperglycemia, were strongly related to life expectancy. These result suggest that it is necessary to focus on the above factors when prefectural authorities implement health promotion measures.

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