Sweating economy by graded control in well-trained athletes.

Local sweat rates (Msw) at the chest and thigh and the frequency of sweat expulsions (Fsw) were determined in human subjects with (athletes) or without (non-athletes) long-term physical training during moderate bicycle exercise (80 W for 30 min) at ambient thermoneutrality (23 degrees C) and 60% relative humidity. There was a tendency for Msw to be lower in athletes. The rise of Msw with increasing Fsw was significantly less steep and Fsw was also controlled at a significantly lower rate in athletes than in non-athletes. The start of exercise was followed by a temporary decrease in mean skin temperature (Ts) which was less distinct in athletes. The rise in Ts at the end of exercise was significant in athletes (0.80 +/- 0.26 degree C) but not in non-athletes (0.26 +/- 0.33 degree C). The results indicate that long-term physical training leads to improved circulatory heat transfer to the skin and to a more graded nervous control of sweat expulsion and, further, tends to reduce the rate of sweating.

Developing a health service system for the elderly in Japan.

The present public medical care system in Japan was originally designed in 1961 and covers the entire population. However, several converging medical and demographic factors are forcing the Japanese to redesign their system, particularly as it relates to their increasing elderly population. An estimated 17% of the population will be over 65 years of age by 2000, and nearly one million of them will be bedridden. The Japanese legislature is currently considering new legislation that by the end of this century would provide 10 times as many nursing facility beds, 14 times as many temporary-stay beds, and build or renovate 500 times as many care houses (handicapped accessible) as currently exist.

[Correlates associated with desire by caregivers to transfer elderly from home care to institutions].

A questionnaire survey was performed on 183 caregivers of elderly listed on a roster for utilization of day service or short stay service in nursing homes in order to elucidate the following; actual conditions of care at home; percentage desiring to transfer to institutionalized care in hospital, nursing homes and geriatric intermediate care facilities, reasons for continuing care at home; and factors relating to desire for transferring to institutionalized care. Results are as follows; Major items of troubles expressed by caregivers were; "high stress and mental fatigue" (55.7%), "unable to freely go out from home" (54.1%), and "loss of personal time" (46.4%), "heavy burden from food preparation, body discharge disposal and bathing of the elderly" (40.0%). 41.5% of caregivers expressed desire for transfer of elderly to institutional care. Of those who desire transfer to hospital care, 21.1% were continuing home care due to non-availability of appropriate hospital, 44.7% because of inability to meet the demand for assisting in the nursing of the elderly during hospitalization, 26.3% because they were turned away by the hospital. Where transfer to nursing homes was desired but not realized, 20.0% reported lack of nursing homes nearby. Where desire was for transfer to geriatric intermediate care facilities, lack of such facilities was reported by 37.5%. Analysis was performed to elucidate the factors that determine whether a caregiver would demand a transfer to an institutions. Main factors were age of caregiver, family relationships, family finance, the frequency of occurrence of problems with home care, and whether or not they themselves would accept institutional care when that time came. Main factors associated with the cared elderly desiring institutional care were eating ability, speaking ability and mental status score. Analysis of the problems related to desire to transfer to institutional care showed their factors such as whether or not there was room available for home care, financial family burden, perceived interference with personal time by the home care, and perception of appropriateness of coping with symptom change of elderly, all have significant relationships.

[A study of dental status and its contributing factors in mentally retarded persons institutionalized in welfare facilities].

Two hundred and forty-one mentally retarded persons, institutionalized in three private welfare facilities in Oita Prefecture, were assessed for dental status and tooth brushing ability. Information on their life style was also obtained by a questionnaire completed by their supervisors in the facilities. 1) Dental status of mentally retarded subjects was found to be inferior compared to the general Japanese population studied in the survey of dental disease in 1987 by the Ministry of Health and Welfare. Inferior dental status was characterized by a low score for filled teeth and a high score for missing teeth. 2) Both low tooth brushing ability and low intelligence quotient were associated with their poor dental status. 3) Discrepancy between supervisor assessment of tooth brushing ability and actual ability was observed. 4) Periodontitis was observed in young epileptics taking antiepileptic medication at a high rate. However there was no association between the taking of antiepileptic medication and missing teeth score. These results indicate a necessity for more active dental services including the teaching of tooth brushing and early treatment by dentists and supervisors.

[Assessment of occupational exposure to p-tert-butylphenol in synthetic resin factories].

Two cases of occupational vitiligo were observed in a resin factory where p-tert-butylphenol (PTBP) has been used as a starting material or an intermediate of synthetic resin. In this resin factory (A shop) and another resin factory (B shop), occupational exposure to PTBP was assessed in workers charging this chemical into the reaction vessel by means of a gas-chromatographic measurement of the environmental PTBP concentration and their urinary PTBP excretion. Assessment in A shop was made after the working condition was partly improved. Geometrical mean values of 8 h-time-weighted-average (8 h-TWA) of PTBP in air near the charger's breathing zone (personal air) were 0.215 mg/m3 in A shop and 2.12 mg/m3 in B shop. Continuous measurements of PTBP concentration in some stationary air of the shops showed that the maximum environmental PTBP values occurred during charging. Urinary PTBP concentration was increased to the maximum values 2 to 4 h after charging of this chemical and then rapidly decreased. Biological half-lives of urinary PTBP were estimated as 4.4 h in A shop and 4.8 h in B shop. The urinary PTBP concentration was correlated to 8 h-TWA of PTBP in the personal air. In particular, PTBP in urine collected at the end of the shift showed an excellent correlation to PTBP in the personal air (r = 0.84, n = 9, A shop; r = 0.88, n = 11, B shop). These results indicate that biological monitoring using urinary PTBP concentration is a suitable means of assessing exposure to this alkylphenol and the urine collected at the end of shift is the best sample for monitoring. In addition, the present environmental and urinary PTBP values were compared with those described in the literature and the relation of the occupational vitiligo with PTBP exposure is discussed.