Changes in pancreatic cancer mortality, period patterns, and birth cohort patterns in Japan: analysis of mortality data in the period 1968-2002

<p><b>OBJECTIVES</b>The 5-year survival rate for pancreatic cancer is known to be lower than that for cancer at any other site in the body, and the proportion of pancreatic cancer deaths among all cancer deaths has been increasing in Japan. The aim of this study was to investigate pancreatic cancer mortality in the light of temporal and geographical trends in the 47 prefectures of the country between 1968 and 2002.</p><p><b>METHODS</b>To survey the geographical aspects of pancreatic cancer mortality, we mapped the direct age-adjusted mortality rates of persons aged 40 years and older by sex in seven 5-year periods (1968-1972 to 1998-2002). We also evaluated the changes in period and birth cohort trends using estimable functions based on the age-period-cohort models in each prefecture.</p><p><b>RESULTS</b>During the observation period the Hokkaido and Tohoku regions had high mortality rates for both sexes. No significant increase in period trends was observed from 1973 to 2002, but significant increases in cohort trends were observed from 1913 to 1962-in two prefectures, for males, and in four prefectures, for females.</p><p><b>CONCLUSIONS</b>The results of this study reveal a combination of time trends in pancreatic cancer mortality and changes in period or birth cohort trends. The changes in cohort trends in each prefecture were more variable than the period trends. This finding probably indicates the need for further investigation of the cohort-related factors involved in the prevalence of pancreatic cancer. Further research on mortality in the 47 prefectures needs to be conducted while taking the two time effects into account.</p>

Randomized controlled trial to evaluate effectiveness of exercise therapy (Takizawa Program) for frail elderly

<p><b>OBJECTIVE</b>Although exercise therapy intervention for frail elderly people was not of great interest in the past, it has recently drawn attention as a method to prevent and improve conditions requiring care since the enforcement of the Long-Term Care Insurance Law and the revision of the long-term care insurance system. This randomized controlled trial was performed to evaluate the effects of exercise therapy using the Takizawa Program.</p><p><b>METHODS</b>In this randomized controlled trial, we evaluated the effects of exercise therapy on the frail elderly, including those who need a high level of care, in terms of two factors: the range of motion and the functional independence measure. The subjects were 145 females admitted to special nursing homes for the elderly. They were stratified according to their care levels and randomly assigned to either the exercise therapy intervention group or the control group.</p><p><b>RESULTS</b>The range of motion values in the flexions of both shoulders, the right knee extension, and the dorsal flexions of both ankles significantly increased only in the exercise therapy intervention group. The functional independence measure score did not improve in the exercise therapy intervention group.</p><p><b>CONCLUSION</b>Exercise therapy should be used for the frail elderly requiring a high level of care.</p>

Effects of physical exercise on fall risk factors in elderly at home in intervention trial

<p><b>OBJECTIVE</b>In this study, we used an intervention approach to examine the effects of physical exercise on elderly people living at home in a rural area.</p><p><b>METHODS</b>Two regions in a village were randomly assigned as the control and intervention regions. The subjects were 60 years of age or older and were able to carry out their activities of daily living independently. The numbers of subjects were 56 and 81 for the control and intervention regions, respectively. In the control region, lectures on health were provided twice. In the intervention region, instructions on ten types of physical exercise were provided six times during this three-month study. In addition, the subjects in the intervention region were instructed to do, exercises by themselves at home three days per week. The effects were compared by evaluating motor functions in maximum step length, 10-m full-power walking parameters, right knee extension torque, right hip flexion torque, and stepping time on a 40-cm staircase; data were obtained before and after the intervention.</p><p><b>RESULTS</b>Analysis of covariance (ANCOVA) showed significant improvements in right maximum step length, the mean of the right and left maximum step lengths, and right hip flexion torque in the intervention region.</p><p><b>CONCLUSION</b>The three-month physical exercise program improves the motor functions of the elderly.</p>

Effects of Physical Exercise on Fall Risk Factors in Elderly at Home in Intervention Trial

Objective: In this study, we used an intervention approach to examine the effects of physical exercise on elderly people living at home in a rural area. Methods: Two regions in a village were randomly assigned as the control and intervention regions. The subjects were 60 years of age or older and were able to carry out their activities of daily living independently. The numbers of subjects were 56 and 81 for the control and intervention regions, respectively. In the control region, lectures on health were provided twice. In the intervention region, instructions on ten types of physical exercise were provided six times during this three-month study. In addition, the subjects in the intervention region were instructed to do exercises by themselves at home three days per week. The effects were compared by evaluating motor functions in maximum step length, 10-m full-power walking parameters, right knee extension torque, right hip flexion torque, and stepping time on a 40-cm staircase; data were obtained before and after the intervention. Results: Analysis of covariance (ANCOVA) showed significant improvements in right maximum step length, the mean of the right and left maximum step lengths, and right hip flexion torque in the intervention region. Conclusion: The three-month physical exercise program improves the motor functions of the elderly.

Randomized Controlled Trial to Evaluate Effectiveness of Exercise Therapy (Takizawa Program) for Frail Elderly

Objective: Although exercise therapy intervention for frail elderly people was not of great interest in the past, it has recently drawn attention as a method to prevent and improve conditions requiring care since the enforcement of the Long-Term Care Insurance Law and the revision of the long-term care insurance system. This randomized controlled trial was performed to evaluate the effects of exercise therapy using the Takizawa Program. Methods: In this randomized controlled trial, we evaluated the effects of exercise therapy on the frail elderly, including those who need a high level of care, in terms of two factors: the range of motion and the functional independence measure. The subjects were 145 females admitted to special nursing homes for the elderly. They were stratified according to their care levels and randomly assigned to either the exercise therapy intervention group or the control group. Results: The range of motion values in the flexions of both shoulders, the right knee extension, and the dorsal flexions of both ankles significantly increased only in the exercise therapy intervention group. The functional independence measure score did not improve in the exercise therapy intervention group. Conclusion: Exercise therapy should be used for the frail elderly requiring a high level of care.

Endocrine disrupting chemicals in Hungarian canned foods

The aim of this study was to clarify the worldwide residual levels of organochloride compounds, such as BHC and DDT, which were reportedly concentrated in animal tissues by biological food chains. As a part of the investigation of endocrine disrupting chemicals (EDCs), we had a chance to measure the level of these compounds in Hungarian canned foods.Seven kinds of canned foods were purchased at a market in Budapest, Hungary, and the concentrations of eighteen organochloride compounds (α-BHC; β-BHC; γ-BHC; δ-BHC; p,p'-DDT; p,p'-DDE; p,p'-DDD; o,p'-DDT; heptachlor; heptachlor-epoxide; aldrin; dieldrin; endrin; oxychlordane; trans-chlordane; cischlordane; trans-nonachlor; and cis-nonachlor) were measured.Other than DDT and its metabolites, none of the EDCs were detected (levels <0.4 ppb). DDT and its metabolites, however, were detected in fish, meat and chicken liver pate. One of the DDT metabolites was detected quite frequently: p,p'-DDE was detected at a level of 1.8 ppb in fish soup concentrate, 2.3 ppb in Hungarian luncheon meat, 0.5 ppb in special luncheon meat, and 0.6 ppb in chicken liver pate.Of eighteen organochloride compounds examined, only DDT and its metabolites were detected in fish, animal meat, and animal liver. It is suggested that the DDT contamination in fish and meat is worldwide even after the ban of its use.