Objective: The purpose of this study was to review the recent trends of school-based nutrition interventions for children and adolescents in foreign countries.
Methods: A systematic review was carried out using Medline (PubMed) with keywords “Education” [MeSH] AND (“food habits” [MeSH] OR “food preferences” [MeSH]) AND (“school” OR “school-based” OR “cafeteria”) to identify school-based nutrition interventions that targeted students aged 6-18, published in English between 1999 and 2009. Titles and abstracts of 325 articles were screened, of which 230 articles that did not meet our inclusion criteria were excluded. After screening the remaining articles, 27 interventions (17 in elementary schools and 10 in junior high or high schools) were included for this review.
Results: Many studies in elementary schools reported to have multiple levels of approaches including those to children, family, and teachers or school cafeterias, whereas studies in junior high and high schools mainly reported approaches to students only or to students and the school. Outcome measures of dietary behaviors included number, frequency, or score of dietary behavior practices and food or nutrient intake. Evaluation methods such as survey and observation were used. Multilevel interventions were more likely to be effective in elementary schools, but this trend was not found among junior high- and high-school interventions.
Conclusion: This study suggests that the age-appropriate nutrition intervention with both educational and environmental approaches may lead to desirable dietary behavioral changes among children and adolescents in school settings.

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Objective: To clarify the relationship of the cigarette smoking status with other unhealthy lifestyle habits in Japanese employees.
Methods: A cross-sectional questionnaire survey was conducted in 4009 males and 1620 females. Multivariate logistic regression analysis was performed to evaluate the relationship between the cigarette smoking status and each survey item of the lifestyle habits after adjusting for potential confounding factors. Multivariate regression analysis was performed to evaluate the relationship of the duration of smoking cessation with other lifestyle habits.
Results: In both genders, compared to nonsmokers, current smokers drank more sugar-sweetened beverages (odds ratio 2.01 in males, 0.93 in females), preferred strong flavors (OR 2.23 in males, 1.64 in females), added soy sauce to cooked meals (OR 3.02 in males, 1.92 in females), skipped breakfast (OR 2.54 in males, 5.42 in females), and drank more alcohol(OR 2.28 in males, 3.24in females). The current smokers ate snacks, fruit, soy beans and milk products less frequently. Particularly in males, current smokers took less regular exercise, had less physical activity and more sleep problems. The duration of smoking cessation in males was significantly and positively related with physical activity (β=0.052, p<0.01) and was inversely related with the score for undesirable eating habits (β=−0.0160, p<0.01) and alcohol consumption (β=−0.089, p<0.01, adjusted R²=0.124).
Conclusion: Current smokers had multiple unhealthy lifestyle habits compared to nonsmokers in both genders. In addition, the duration of smoking cessation in males appeared to be significantly related to a change in unhealthy lifestyle habits.

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Objective: This study aimed to examine the relation between self-esteem (SE) and sense of value working as a dental hygienist (DH).
Methods: In 2006, we conducted a postal questionnaire survey with 268 members of the Dental Hygienists' Association in certain prefectures. The questionnaire consisted of items concerning age, workplace, participation in workshops, life satisfaction, sense of value working as a DH and SE. Responses were measured on a 5-point scale. SE was measured by Rosenberg's Self-esteem Scale. Factor analysis was performed to consolidate the responses about sense of value working as a DH. A partial correlation analysis was executed to determine any correlation between SE and the extracted factors and other variables.
Results: The number of effective respondents was 107, whose mean age was 43.6 (SD12.3) years. Mean score for SE was 35.2 (SD7.1), and SE score showed a correlation with age (r=0.467, p<0.01). Three factors were extracted and named as “self-realization as a DH”, “social importance as a DH”, and “self-evaluation as a DH”. As a result of partial correlation analysis, SE was correlated with “self-evaluation” (r=0.506, p<0.01), “self-realization” (r=0.307, p<0.01), “social importance as” (r=0.204, p<0.05), and life satisfaction (r=0.354, p<0.01).
Conclusion: Dental hygienists with high SE had a high self-evaluation as a DH as well as a high sense of value working as a DH.

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Three weeks after the Great East Japan Earthquake, we went to an evacuation shelter in the city of Ishinomaki as disaster support nurses. While at the shelter, we collected out-of-date foods with a view to preventing poisoning.
We observed many people suffering from coughs, vomiting, diarrhea, and other such ailments, and cases of infection were increasing among the 360 disaster victims inhabiting the shelter. Some shelter residents stored out-of-date foods under the influence of thoughts along the lines of, “I do not want to see it goes to waste,” and “There is no certainty that I will receive any alternative food supply.”
It was clear that shelter residents were operating under a general attitude of, “We'll just keep it,” and were not in a position to take responsibility for the disposal of their own expired foodstuffs. Recognizing the necessity for protection against infectious diseases, we thus collected out-of-date foods in small A4-sized boxes.
In this way we quickly rectified the situation in the shelter. The out-of-date foods collected filled 5-6boxes. Included among the contents of the collected foods were home-made rice balls (at least a week old and hardened with age), sweet rolls, and bread, among other items.
In an emergency situation, disaster victims typically have no opportunity to select foods for themselves. Under such circumstances, healthcare professionals may provide support for prevention of food poisoning.

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In Japan, after March-11-2011 disaster of tsunami, earthquake and nuclear accidents, many activities are ongoing regarding emergency medicine, public health and epidemiology. However, in health education and promotion (HE & HP), activities are overwhelmed by disastrous situations. The author analyzed dilemmas of Japanese HE & HP, and discovered six remedies; 1) focus not on fixed lifestyles, but on changing daily life, 2) approach people's mental balance and wellbeing, 3) activate horizontal knowledge sharing, 4) empower community formation, 5) activate people's autonomy, and 6) not just describe but carry out health promotion.
To achieve these remedies, the author adopted image mapping/sharing methodology consisting four procedures; (1) by externalizing one's important images, (2) by sorting images horizontally according to negative emotion accompanying images, (3) by arranging images vertically according to positive emotion, and (4) by sharing and exchanging each other using image map.
On May-09- 2011, two months after the tragedy, disastrous damages were still remained in Miyagi prefecture. The author guided image mapping/sharing, and let 27 students to visualize, reflect and share their life experiences after March 11. After visualizing life images, students animated and exchanged one another reflecting unique images. Students interactions were identified either as advocate, enable or mediate, key notions of health promotion.
By this participatory reflection, students revealed and discovered their hidden interests toward other people and society, and such interactions are supposed to be a basis of community development as well as health promotion.

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Authors served with the Nagasaki University Medical Relief Team providing medical relief and health services at Terano Kyodojo evacuation shelter at Otsuchi, Iwate Prefecture, an area severely affected by the massive tsunamni following the Great East Japan Earthquake. The relief team provided medical consultations at a temporary clinic in March 2011, in collaboration with a local general practitioner. The affected area has been characterized by its high level of population aging, which was also reflected in the age composition of the evacuees at the shelter: 38% of evacuees were aged 65 or older. Many patients presented to the clinic requesting routine medication refills for their chronic medical conditions (e.g. hypertention, diabetes, heart diseases and asthma). However, information on their medications had been lost in many cases, and the identification of medicines was thus a critical task. An increasing trend of symptoms apparently due to stress (e.g. insomnia) was also observed. We supported the introduction of infection control measures to prevent possible outbreak of infectious acute gastroenteritis. While most evacuees had experienced extremely stressful circumstances and profound loss, a functional community had already been developed in the shelter. The evacuees were divided into groups, and the group leaders held meetings to share information and to set the necessary shelter rules. Evacuees shared chores and conducted regular physical exercise together. New infection control measures were also discussed among the group leaders, and implemented only after reaching agreement. We believe collaboration with communities will be critical in planning and implementing future public health and restoration efforts in the affected areas.

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