Factors Associated with Food Form in Long-Term Care Insurance Facilities.

We examined factors related to dietary intake status (food form) of long-term care facility (LTCF) residents to identify factors related to proper food form choice for older individuals requiring nursing care. We surveyed 888 residents from 37 LTCFs in Japan. We evaluated basic information (age, sex, body mass index [BMI]), food form (swallowing-adjusted diet class), Barthel Index (BI), Clinical Dementia Rating (CDR), simply evaluated eating and swallowing functions, the number of present/functional teeth, oral diadochokinesis, repetitive saliva swallowing test (RSST), and modified water swallowing test. To clarify factors associated with food form, participants who had good nutrition by oral intake were categorized into the dysphagic diet (DD) and normal diet (ND) groups. Multi-level analyses were used to detect oral functions associated with food form status. Among objective assessments, BMI (odds ratio [OR] 0.979, 95% confidence interval [CI] - 0.022- to 0.006, p = 0.001), BI (OR 0.993, 95% CI - 0.007 to - 0.004, p < 0.001), CDR 3.0 (OR 1.002, 95% CI 0.002‒0.236, p = 0.046), present teeth (OR 0.993, 95% CI - 0.007 to - 0.001, p = 0.011), functional teeth (OR 0.989, 95% CI - 0.011 to - 0.005, p < 0.001), and RSST (OR 0.960, 95% CI - 0.041 to - 0.007, p = 0.006) were significantly associated with DD vs ND discrimination. Simple evaluations of coughing (OR 1.056, 0.054‒0.198, p = 0.001) and rinsing (OR 1.010, 0.010‒0.174, p = 0.029) could also discriminate food form status. These simple evaluations provide insight into the discrepancies between food form status and eating abilities of LTCF residents. Periodic evaluations by the nursing caregiver may help to prevent aspiration by older individuals with dysphagia.

[Cancer screening rates and characteristics of low-participating groups in Sapporo city].

Objectives　The purpose of this study was to assess the situation of regional cancer screening of individuals in Sapporo city through an independent survey and to identify groups with low cancer screening rates.Methods　We conducted a self-administered questionnaire survey on 3,000 men aged 40 to 69 years and 4,000 women aged 20 to 69 years living in Sapporo (response rate = 32.4%). The contents of the survey were quoted from the health slips of the Comprehensive Survey of Living Conditions related to cancer screening, as well as basic and cancer-related attributes. We analyzed the relationship between cancer screening participation rate, basic attributes, and cancer-related attributes using the χ2 test or logistic regression analysis.Results　The screening rates recorded in this study for gastric, colon, and lung cancers were 67.4%, 59.2%, and 66.1%, respectively in men, and 48.7%, 47.7%, and 53.4%, respectively in women. The screening rates were 52.7% and 56.1% for uterine and breast cancers, respectively.　The participation rate of non-working individuals and those who had National Health Insurance was significantly lower for all cancer types among both men and women. Regarding attributes and cancer screening, the odds ratio of working to non-working individuals was 3.00 to 3.09 in men and 1.41 to 2.46 in women. The odds ratio of non-National Health Insurance individuals was 3.47 to 4.26 in men and 1.47 to 2.52 in women. In addition, there was a significant association between awareness and rates of Sapporo city cancer screening in both men and women, with the exception of stomach cancer screening in women. Furthermore, the odds ratio of awareness was 1.41 to 1.74 in men and 1.24 to 1.48 in women.Conclusion　The cancer types with screening rate below 50% were gastric and colon cancers in women. In men, the screening rate for gastric, colon, and lung cancers exceeded 50%. The cancer-screening rate was found to be low among both non-working men and women, those with national health insurance, or those who do not recognize the Sapporo city cancer screening (regional screening). The characteristics of the group with low participation status in Sapporo city, which was the only parameter not reported in the Comprehensive Survey of Living Conditions, has been clarified.