For three-year-old children whose mothers visited a health center in Tokyo for consultation about childrearing problems in 1976 and 1996, their co-sleeping with adult and the related fac tors were examined. The major results were as follows.1. In 1996, the proportion of mothers who co-sleep with toddlers is high among those with jobs, and the mothers who experienced co-sleeping in their own childhood and whose child has evolopmental risk tend to co-sleep.2. Sleeping arrangements, including co-sleeping, of children with developmental risks differ in quality from that of handicapped children.3. Mother's co-sleeping behavior is interrelated with her intention of childcare, information source of childrearing, consultants in neighborhood and the matter of her major interest. From these results, it is suggested that sleeping arrangements of children is associated with factors concerning both mothers and children and it is recognized as an indicator of assessing mother's nurturing behavior and child's developmental risks.
The objective of this study is to identify the determinants of hospital utilization in developing countries, with modification of significant variables of the preceding studies. In order to ex amine variables which influence hospital utilization time (days from the recongnition of specific problem to consultation in the modern hospital), Andersen and Newman's health behavioral model, in which modified medical pluralism factors and medical recommendation factors are in corporated, was applied. A survey was conducted for 147 outpatients of a hospital in Kavre dis trict, adjacent to Katmandu, Nepal. The result of stepwise multiple regression analysis shows that hospital utilization time was significantly influenced by medical pluralism factors of not only the use of traditional therapy but also that of modern health care before hospital consultation. In addition, patients' sex, age, access time to hospital, and subjective judgment on severity of illness play important roles in the hospital utilization time. Although medical recommendation factors showing who recommended hospital consultation was not significantly related with hospital uti lization time, there is need for future research to grasp directly whether the patients concerned and medical staff at health care facilities recommended hospital consultation to patients.
While the reporting system of death cases in Thailand looks working properly at the national level, there still is a problem that "unknown causes of death" amount to half of the total number of deaths. For improving the quality of the system, the situation of registration at a local level needs to be analyzed. In Khonkaen province, one of the major provinces in the northeast Thailand, copies of deathregistration were summarized by the Provincial Health Office. In the present research, data inJanuary (dry season) and July (rainy season) in 1996 were investigated. The total number ofdeath reports was 1, 632 (976 males, 619 females and 37 unknown gender) for the two months . The two months being compared, there was no significant difference in terms of sex ratio.The average age at death was 53.9 years as a whole. The average age of males was 49.7 yearsand that of females was 60.6 years, showing about 10 years difference. It was 1, 607 examples that their places of death were mentioned: 1, 000 (62.4%) at home, 541 (33.8%) in medical facilities and 66 (4.1%) in other places, mostly outside, which includedunexpected accidents such as traffic accidents.Deaths at home amounted to almost two thirds of the entire death cases. Of the total number of 1, 461 cases, only 601 (41.1 %) were attached with death certificates; there were 860death reports (58.9%) without medical certificate. In 974 cases which received medical care before death, 506 (52.0%) died in hospitals and456 (46.8%) died at home. Almost all the cases (99.2%) for deaths in medical facilities wereattached with death certificates. However, up to 95.7% of persons who once received medicaltreatment but eventually died at home were not attached with death certificates . In addition, 390 cases (90.1 %) in the group who did not have medical treatment before death died at home . It is necessary to extend opportunities of medical services to elder people. But, even if medial services became available, it is not enough just to increase access to medical services, con sidering that only half of the people eventually received medical certificates.
Using data collected in the health promotion project in Saitama Prefecture in 1995, this study examined the relationship between women's bone mineral density and the number of childbirths. The data consisted of bone mineral density measured at Os calcis by ultrasound bone densitometer (Achilles, Luner) and answers to the questionnaire about age, stature, body weight, number of childbirths, and various items concerning lifestyle. Of 1, 173 women studied, 548 experienced menopause and 625 did not. Multiple regression analysis showed the positive correlation between bone mineral density and the number of childbirths among the subjects who experienced menopause and among the whole subjects. Among the primiparous and multiparous women who were over 45 years of age, the more childbirths the higher the mean bone mineral density, though the nulliparous women over 45 years had a higher density.
The purpose of this paper is to investigate the validity of the developmental screeningmethod which was originally devised by the author. The subjects were 11 young adults aged 23 -25 years old (1971-73 birth cohorts) and their parents, 19 in number, who answered thequestionnaire of developmental problems in the early adulthood; a semi-structured interviewmethod by means of telephone or home visit was conducted. There were two major findings. First, the validity rate was 89.5%, while the false negativerate was 0%. Second, three subjects were identified as the targets of primary prevention and intervention, and the questionnaire survey by telephone or home visit revealed that all of themhad developmental problems. It is thus concluded that this screening method is valid .