Objectives　This study elucidates the differences in risk for a functional decline in general housebound screening using queries with and without definitions.

Methods　This study involved 10,802 community-dwelling older people who lived in four municipalities in Aichi Prefecture. The participants were asked about their frequency of going out in general and for five specific purposes: shopping, hospital visitation, strolling, leisure, and work. A person was defined as being “generally housebound” if he/she answered “less than once per week.” However, a query with the definition of “going out” was used in only one of the four municipalities. Furthermore, we defined a person who goes out once a week, for any of the purposes, as “by-purpose non-housebound.” If the response to the general and purpose-specific queries were inconsistent, we regarded it as an “inconsistent answer.” Additionally, we compared the occurrence rate and hazard ratio for the onset of long-term care insurance certification of general housebound screening using queries with and without definition. We also calculated the occurrence rate and related risk factors for inconsistent answers.

Results　The occurrence rate of general housebound screening using query with and without definition was 2.8% and 11.7%, respectively. Additionally, the hazard ratio for the onset of long-term care insurance certification of general housebound screening using the query with definition was 1.56 times more than that of general housebound screening using query without definition. The rate of inconsistent answers in by-purpose non-housebound using query with and without definition was 2.2% and 10.2%, respectively. However, sex, age, living with spouse and child(ren), years of schooling, self-rated health, depression, habitation in islands, and indicating definition of “going out” were related to inconsistent answers. The prevalence ratio of inconsistent answers in respondents using query with definition was significantly lower than among respondents using query without definition (PR=0.29).

Conclusion　Query with definition reduced the occurrence rate of general housebound and increased the hazard ratio for the onset of long-term care insurance certification. Therefore, a definition should be added to queries asking for the frequency of going out to screen for housebound.

Objectives　We investigated the infectious causes and management of Japanese spotted fever (JSF) and severe fever thrombocytopenia syndrome (SFTS), which are usually tick-borne infections, at a public health center in Ehime prefecture.

Methods　The doctor diagnosing JSF and SFTS at the public health center reported the infectious cases using the questionnaire based on the Ehime Epidemiological Surveillance of Infectious Diseases Program.

Results　There were 91 cases of JSF reported from August 2003, accounting for 56.5% of the whole Ehime prefecture. Since 67.0% of the JSF patients resided near the mountains with citrus cultivations, there were high chances of contact with ticks during farm work or their daily routine even if they did not visit the mountain areas. The distribution of the occupations of the JSF patients was as follows: citrus cultivator, 31.9%; farmer, 14.3%; and retired, 26.4%. The incidence of various clinical symptoms in the JSF patients was as follows: fever and systemic erythema, 100%; tick bite, 73.6%; liver dysfunction, 69.2%; disseminated intravascular coagulation (DIC), 14.3%; and neurological symptoms, 11.0%. The mortality rate was 1.1%. The incidence of DIC, which was considered a severe condition, was significantly low in patients with confirmed tick bites. There were 14 cases of SFTS reported from December 2013, accounting for 42.4% of the whole Ehime prefecture. Notably, 85.7% of the SFTS patients resided in the mountains. Moreover, 85.7% of the SFTS patients were retired. The incidence of various clinical symptoms in the SFTS patients was as follows: fever and marked leucopenia and thrombocytopenia, 100%; tick bite, 57.1%; diarrhea, 71.4%; neurological symptoms, 57.1%; and bleeding tendency, 42.9%. The mortality rate was 35.7%, and the average number of days from onset to death was 11.2 days.

Conclusion　Since this region is one of the leading citrus producing areas in Ehime prefecture, JSF is considered an occupational disease. It is frequently caused by tick bites while working in the mountain areas of citrus cultivations. Hence, citrus growers should be cautious of tick-borne infections. Recently, the number of JSF cases has been gradually decreasing due to awareness and education of the inhabitants. Currently, SFTS is considered a category IV infection disease, but it can rapidly lead to death after the onset of hemophagocytic syndrome. Therefore, doctors should immediately transfer the patients diagnosed with SFTS to a hospital with an intensive care unit.

Objectives　A recent long-term care insurance policy encourages the promotion of various types of “Kayoi-no-ba,” or places to go, not limited to those focusing on functional training, as resident activities are expected to keep older adults from needing care. In this study, Kayoi-no-ba were voluntary groups in which older adults participated, and their attributes were examined in terms of “diversity of participants” and “autonomy of community residents,” based on the type of group.

Methods　The staff from the preventing long-term care division in each of the 38 municipalities in Tokyo selected 175 voluntary groups that met three criteria: (1) more than three community residents participate in activities at least once a month, (2) participants are primarily older adults or multi-generational residents including older adults, and (3) community residents participate in group management. Representatives from 165 groups responded to the questionnaire. For the group categorization, a latent class analysis was performed using the goals and activities of the group. Participants’ age, gender, and health status were used to assess diversity. The number of residents who managed and/or supported group activities and the precise role the residents played in the activities were used to assess autonomy.

Results　The groups were categorized into four types: “Physical Exercises,” where the primary activity was physical exercise; “Multi-purpose,” which included various purposes and activities; “Social Interaction Oriented,” where interaction with others was the goal, but physical exercise was not; and “Non-Interaction,” where social interaction was not the goal. Participants in the Multi-purpose group ranged in age and were more likely to have health problems, such as mobility limitations, dementia, and frailty, than those in the Physical Exercises and Social Interaction Oriented groups. Moreover, the Multi-purpose group had more resident managers and supporters involved in various roles.

Conclusion　The Multi-purpose group had the most diverse participants and autonomy of residents. However, the type of Kayoi-no-ba should not be considered fixed. The support system should encourage flexible changes such as adding a new activity depending on the situation and the varying needs of the residents.