Cross-cultural or geographical differences in child development have been reported (Brazelton et al. 1969, Super 1976), and the development of pre-school children of different social and ethnic groups has been discussed in relation to developmental screening (Frankenburg et al. 1975, Ueda 1977). In Japan, where the population is highly homogeneous in racial background, racioethnic factors are considered to be less important in child development than geographical factors. Our previous studies (Ueda 1976, 1978) revealed that there were differences in child development and patterns of child rearing between Tokyo and Okinawa, the southernmost part of Japan. Ecological and socio-cultural factors which may contribute to these differences were discussed, as were the implications of the results for developmental screening. The purpose of the present study is to complete this line of studies by collecting data on child development in a northern part of Japan and comparing the results with those in Tokyo and Okinawa. By doing so, the author intended to determine the applicability of developmental screening tests on populations in different geographical areas, and to explore the impacts of the environment upon human development. Iwate, the northern part of Japan was chosen and compared with Tokyo, a large metropolitan area in the central part of Japan and Okinawa. The Denver Developmental Screening Test, partly modified as in the previous study in Tokyo (Ueda, 1978) was used to assess the development of children aged between 16 days and 6 years. The sample consisted of 564 normal Iwate children and the 1171 normal Tokyo children who were the sample for the standardization of the DDST in Tokyo and 775 normal Okinawa children. All items of the DDST were compared both statistically acid clinically for the three samples. Differences were found on some items among two and/or three samples and were classified into four groups; 1) items related to urbanization, 2) items related to climate, 3) items related to culture, and 4) items related to body balance. Unless these differences are kept in mind when administering developmental screening test, there will be risks of false negative as well as false positive. But if the DDST is administered with caution and some modifications are made on the norms of some items, it will be applicable and highly valuable in rural areas such as Iwate and Okinawa as well as in urban areas as Tokyo.
Based on the examination data (N=12.964) of the Nationwide Basic Survey on Adult Diseases from 1971 to 1974, the distribution of ECG findings were obtained by the Minnesota Code, and a statistical survey was conducted on the interrelationship between abnormal findings using a Cr coefficient, and on the relationship between the ECG findings and the host and environmental factors. The results are as summarized, b'eiow.1. Results observed from the ECG of Japanese adults had high frequencies of left R waves (19.6%), I-type ST depression (5.67%), J-type ST depression (3.9%), negative T waves (6.37%), flat T waves (5.43%), and so forth.2. Compared with the findings of epidemiological studies in. the U.S. and Europe, some differences were revealed. First, the occurence of two types of ST depression was significantly higher in the ECG findings of Japanese adults, while only I-type ST depression was higher in those of American and European adults. Second, abnormal Q waves, left axis deviation and negative T waves were salient for American and European adults, while left high R waves, J-type ST depression and complete right bundle branch block were salient for Japanese adults. Another difference in frequency was found in the male and female ECG findings. Frequencies of abnormal Q waves, left axis deviation and left high R waves were conspicuous for males, while those ofI- and J-type ST depression, negative T waves and flat T waves were conspicuous for females.3. Premature heart beats and sinus bradycardia were related with aging more closely than others. Frequencies of abnormal Q waves and left axis deviation were noticeable in the male ECG findings, while the frequency of A-V conduction defect were noticeable in the female ECG findings. These findings were related closely with cerebral apoplexy, hypertension and myocardial infarction. They are also related with sympto-matic tightness, breathlessness, rhythm abnormalities, thin skinfold, positive proteinuria and abnormal fundus occuli findings.4. The frequency of left R waves was salient in the hypertension group, irrespective of sex and age, presenting its close relations with blood pressure . The frequency of J-type ST depression was conspicuous in the hypertension group for females at all ages, and in males 40 to 60 years of age, which also shows the close relation with blood pressure. These ECG findings are relevant to anamneses of cerebral apoplexy, hypertension, myocardial infarction and other heart diseases. Especially significant was the relationship with hypertension.Observed from the standpoint by district, occupation, and work condition, the frequencies of left R waves and J-type ST depression were high for those residents in the districts along the coast of the Japan Sea, those engaged in agriculture, fishery and forestry, and those engaged in outdoor physical labor.5. Typical ECG findings closely related with age and blood pressure, were I-type ST depression and negative T-waves. These findings have a relation with all anamneses of cerebral apoplexy, hypertension, myocardial infarction and other heart diseases. They are also related with symptomatic breathlessness, rhythm abnormalities and thin skinfold. The relationship with hypertension was noticeable, and also associated were positive proteinuria and abnormal fundus occuli findings. Observed from the standpoint by district, occupation and work condition, the frequencies were significant for those residents in the districts along the coast of the Japan Sea, those engaged in agriculture, fishery. and forestry, and those engaged in outdoor physical labor. Anlyzing nationwide ECG findings, highlighting the peculiarity of heart diseases, and comparing them with those in the U.S, and Europe, this paper pointed out some racial differences, and proved and existence of epidemiological characteristics from the relationship between ECG findings and host and environmental factors. It further urges that aging and