腕の加速度データに基づき高精度な睡眠覚醒判定を実現した機械学習アルゴリズム「ACCEL」と，その手法を用いてデータ駆動的に明らかにしたヒト睡眠ランドスケープ（16種類に分類された成人の睡眠パターンの様相）について紹介する．また，現在我々が進めている「子ども睡眠健診」プロジェクトについて紹介する．

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【目的】本研究は幼児の生活リズムを、睡眠、身体活動量、遊びの時間および食事時刻から包括的に調査することを目的とした。【方法】対象者は幼稚園の年長児とした。睡眠は起床時刻、就寝時刻および睡眠時間を、身体活動量は歩数および中高強度活動時間を、小型活動量計を用いて測定した。外遊びおよび室内遊び時間と朝食および夕食開始時刻は質問紙調査とし、保護者が記録した。登園日と休日の睡眠関連指標、身体活動関連指標および各食事開始時刻を変数に投入し、階層クラスター分析によって4群に分類した。4群間の比較はKruskal-Wallis検定を用い、多重比較検定はDann-Bonferroni法を用いた。【結果】分析対象児は73名であった。幼児の睡眠は「遅寝遅起き型」、「短時間睡眠型」、「早寝

型」および「標準型」に分類された。「遅寝遅起き型」は、就寝時刻は22時以降、起床時刻は7時半以降であり、登園日では就寝時刻、起床時刻ともに他の3群と比較して有意に遅かった。「短時間睡眠型」は睡眠時間が8時間台であり、他の群が9時間台であるのと比較して有意に短く、休日では「早寝型」との間に有意差が確認された。「早寝型」は登園日、休日ともに朝食および夕食開始時刻が早かった。しかし、休日の歩数および中高強度活動時間は「標準型」より有意に低かった。「標準型」は、就寝時刻は21時台、起床時刻は7時台であった。また登園日、休日ともに歩数も中高強度活動時間も最も高い数値を示し、特に休日では他の3群と比較して有意に高かった。【まとめ】幼児の生活リズムを睡眠、身体活動量、遊びの時間および食事時刻から調査した結果、「遅寝遅起き型」、「短時間睡眠型」、「早寝型」および「標準型」に分類された。登園日、休日ともに歩数も中高強度活動時間も最も高い数値を示したのは「標準型」であった。

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Background: Recently, sleep education is urged to facilitate positive behavioral change among children, who are often reported as staying up late and having reduced sleep time.

Objective: The purpose of this study is to develop a Stages of Change Scale and a Decisional Balance Scale pertaining to “early to bed, early to rise” habits among upper elementary school and junior high school students.

Methods: Two hundred and twenty-three students in the fifth and sixth grades of two elementary schools as well as seven hundred and thirty students in the first through third grades of three junior high schools in the different municipalities of the Aichi prefecture were asked to complete an anonymous self-administered questionnaire between May and July 2017. The survey inquired about respondents' sleeping habits and included draft scales of Stages of Change and Decisional Balance, both of which were designed to encourage “early to bed, early to rise” habits in students. Each draft was prepared based on preliminary survey results and was later revised to reflect opinions of elementary and junior high school teachers. The validity of the Stages of Change Scale was confirmed through its relation to sleeping habits. With regard to the Decisional Balance Scale, the data for elementary and junior high school students were analyzed separately. The factor structure of the Decisional Balance Scale was examined by exploratory factor analysis. Subsequently, the scale's reliability and validity was ascertained by confirmatory factor analysis as well as its relation to the Stages of Change Scale. To verify the temporal stability of the scales, one hundred and four elementary school students were surveyed two weeks later by the retest method.

Results: All of the respondents answered the questionnaire. Sleeping habits recorded using the Stages of Change Scale showed that those in the maintenance/action stage tend to go to bed early, get up early, and sleep more hours, validating the Stages of Change Scale. The results of the retest method showed a concordance rate of 83.0% and κ coefficient of 0.789 for the Stages of Change. Both values generally confirmed the scale's temporal stability. Regarding the Decisional Balance Scale on “early to bed, early to rise,” the exploratory factor analysis results showed a two-factor structure consisting of 4 “Pros” items (α = 0.826) and 6 “Cons” items (α = 0.893) in elementary school students, 6 “Pros” items (α = 0.880) and 6 “Cons” items (α = 0.896) in junior high school students. As a result, the scale's internal consistency was verified. Tolerable goodness-of-fit indices were obtained in confirmatory factor analysis (elementary school students: CFI = 0.981, GFI = 0.955, AGFI = 0.926, and RMSEA = 0.052, junior high school students: CFI = 0.962, GFI = 0.948, AGFI = 0.924, and RMSEA = 0.068). The results of one-way analysis of variance confirmed differences in the decisional balance scores by stage, in both elementary and junior high school students (p < 0.001, p < 0.001). This correlates with the TTM theory. The retest reliability was in an allowable range.

Conclusions: This research generally confirmed the reliability and validity of the Stages of Change and Decisional Balance Scales, both of which were developed for “early to bed, early to rise.” The results demonstrated the availability of the scales.

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新型コロナ感染症の感染拡大防止のため，人と人とのいわゆる社会的距離が制限され，大学においても通常の対面による保健（健康支援）活動が困難となった。コロナ禍下で学生に生じた様々な健康課題に対し，参加型の生活習慣改善企画「春の生活応援‼脱，ぐーたらキャンペーン」，に特化した「朝活応援‼でGO‼」，情報発信企画「教えて‼〇〇のプロ‼」，Web会議システムを活用した「おうちから相談会」の4つの健康支援を行った。企画後に実施したアンケート調査からは，参加型の生活習慣改善企画は対面せずとも学生の健康習慣にアプローチができることがわかった。また，学生が容易にアクセスできるようオンラインを活用し積極的に健康支援を実施した事によって，これまでよりも多くの学生にアプローチすることができた。オンラインを活用した健康支援について，どれほどの効果やリスクがあるか今後さらなる検討が必要であるが，コロナ禍下のみの一時的な次善策ではなく，アフターコロナにおいても対面支援に加えて活用していくべきだと考える。

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This report deals with the relation between epidemiological factors (age, sex, marriage, commutation, occupation, hours of rising and sleeping, smoking and drinking habits) and pattern of food intake among 679 workers (electrical machinery workers 103, workers of Japan Monopoly Corporations 97, department store workers 164, local public service workers 315).
1. The breakfast omitting rate had no relation with the hour of commutation, custom of night eating, hours of rising and sleeping.
2. The breakfast omitting rate had significant relationship with marriage, appetite, pattern of sleeping (early rising habit or keeping late hours).
3. The breakfast omitting rate was remarkably observed among the department store workers, because working hours begin later as compared with other occupations, that causes a delay in taking breakfast and usually getting up late.

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Mental and physical fitness of the pupils are strongly related to the fullness of the school life. Grades in schoolwork of pupils seemed to be affected by the way of their life styles. Therefore, this report verified the association between grades in schoolwork of pupils and their life styles, especially whether or not eating habits contribute to promote their healthy mind and healthy body in the junior high school pupils. Among the eating habits in the pupils, intake of breakfast every day appeared to be the most important factor for their grades in schoolwork, and also it was associated with their mental and physical fitness. Japanese-style dish that contains a lot of food fibers seemed to be useful for not only daily regular living rhythm but also improving their learning ability. Intake of too much animal fat appeared to be a symbolic life-style that indicated an unfavorable habitual style, such as sleep-less and sedentary habit, so improvement of the fat intake may be expected to form the favorable customs of taking good sleep and exercise every day. These eating habits may promote good condition in the comprehensive daily life-style and grades in schoolwork for the pupils.

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An expert system using computers was developed to change different health behaviors of elementary school children, and the system was evaluated in a pilot study that was designed to refine the system. Third- and fourth-grade children participated in Study 1 that was designed to demonstrate the processes of developing feedback messages. Eight health behaviors, including outdoor play, sleep, and TV game control were analyzed by using this system. Behavioral elements such as gender, stages of change, facilitators, barriers, costs and benefits of each behavior were used to develop messages based on previous research. Finally, 6 school nurses and 11 children confirmed the expressions and the nuances of the messages to adjust for gender, the stage of change and age groups of each behavior. Then, these messages were incorporated into the system software. In Study 2, children (N=97) evaluated their stage of change in each behavior and received message sheets through the expert system. The results indicated high evaluation scores for careful reading, understanding, attention, novelty, and adjustment.

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We distributed a self-administered health questionnaire known as the Todai Health Index (THI) to a group of 191 women, aged 18-22 (average 19.7), who were at the time students in programs of nursing or public health nursing. This sample was divided into three groups on the basis of subject's answers to the question "Do you tend to go to sleep and get up early?" The subjects were classified as "early risers", "night owls" or "intermediates" according to their predilections . The THI yields twelve numerical scores assessing the degree of proneness to various conditions. We developed profiles of the groups using the t-test on the twelve scores as well as the discriminant values for the psychosomatic and neurotic scores. We would not be able to find out consistent trends which we hypothesized between the above question and the THI's twelve numerical scores and two discriminant values. Among the three groups, the intermediate group proved to be the most diffuse in the pattern of its daily cycles. It became clear that it would be difficult to compare the three groups directly. However, the THI's scale, "Irregularity of daily life" measuring the degree to which a person's life lacks a regular rhythm showed the highest degree of correspondence with the above typology. Taking the 25% who scored the highest on this measure and comparing them with the lowest 25%, we found that none of the former reported being early risers, and more reported waking late than those in the regular rhythm group. The regular rhythm group tended to report noticing fewer symptoms of physical or mental ailment. They tended to be emotionally more stable and calm, less prone to depression or anxiety and showed few signs of neurosis or psychosomatic illness. We concluded that the THI's irregular rhythm scale, "Irregularity of daily life" helps in classifying subjects according to the type of lifestyle as well as allowing us to quantitatively distinguish early risers who follow regular schedules from night owls who follow irregular schedules.

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