[in Japanese]

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Social-physical environmental approach is gaining greater attention in community health promotion. The purpose of the study was to develop the assessment indices for the social-physical supportive environments for health promotion and to investigate the actual conditions of the environments in nation-wide communities in Japan. Developed assessment indices contained 182 items including 6 areas ; tobaccocontrol, healthy diet, physical activity and exercise, mental health, alcohol, and health administration. Supportive environments were classified to policy and regulation, information and education, physical, and evaluation of residents' health related behaviors. A survey was conducted by mailing a questionnaire including developed assessment indices to all local governments in Japan. Valid respondents were 1,016 autonomies (31.4%). The mean implementation rate of supportive environmental approach in 6 areas was highest in the healthy diet, followed by physical activity and exercise. The lowest rate was seen in the areas of tobacco control and alcohol. In all 6 areas, sufficient informational and educational supportive environment was not shown. As the number of population increased, the mean implementation rate significantly increased in every 6 areas. In autonomies conducting the evaluation of residents' health related behaviors, the implementation rates were higher in every 6 areas, compared to autonomies not conducting the evaluation. The results of this study proposed the supportive environmental indices in each health promotion areas, and clarified the insufficient situations of supportive environments in communities in Japan.

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Hot compresses have been effective in stimulating the autonomic nervous system (ANS). However, there have been no studies on the subjective and physiological effects of hot compresses on menopausal women with dysautonomia. A purpose of this study is to describe psychosomatic changes in menopausal women who received hot compresses to the posterior region of the neck (PRN). Data was collected using a quasi-experimental pretest-posttest design using subjects as their own control. Three women (Case 1 to 3) in menopause received two treatments over three days. The subjective measures were : a simple menopausal index ; a pleasure-displeasure scale and a sleepiness scale. The physiologic measures were : heart rate variability (HRV) ; skin conductance level (SCL) and skin temperature. On the first day we measured subjective and physiological states of subjects in a supine position for reference values (20 minutes) ; applied the treatment of hot compresses to PRN (ten minutes) and remeasuring the states at the end of a 20-minute rest. The second day subjects received a dry compress with pre and post measures corresponding to the first day ; the third day we repeated the measurements and treatment exactly like the first day. Case 1 and 3 had a few changes of SCL and the sympathetic nerve activity of HRV at the moment when they received hot compresses. At the end of the experiment, the peripheral skin temperature decreased and matched their control period. They had few autonomic responses to hot compresses, and it appeared that hot compresses were ineffective in stimulating the ANS. On the other hand, case 2, did have sympathetic nerve reaction to hot compresses. In addition, there was parasympathetic nerve facilitation and peripheral site skin temperature elevation ; for this case hot compresses to the PRN stimulated a pleasurable sensation.

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To examine the effect of foot baths on an ability of elderly women's walking, foot baths (3 times/week) were carried out to 12 elderly women (85±6.69 years old) living in a nursing home and the maximum dynamic plantar pressure and the step lengths were measured before and after the foot baths. The maximum dynamic plantar pressure of the toes tended to increase after the first and second foot baths (p<0.1). Step lengths tended to increase only after the first foot bath (p<0.1). A positive correlation (r=0.4263, p<0.01) between the both values was observed ; the maximum dynamic plantar pressure after the foot baths were elevated with the increase of the step length. These results indicate that the foot baths made increase of ankle flexibility and smoothen the foot movement during walking and may result in the increase of the force of kicking with the toes on the ground and the improvement of walking abilities.

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