Association Between Lifestyle Habits and the Prevalence of Abdominal Obesity After the Great East Japan Earthquake: The Fukushima Health Management Survey.

BACKGROUND: The proportion of overweight individuals living in the evacuation zone of Fukushima increased after the Great East Japan Earthquake. However, the change in the prevalence of abdominal obesity has not been reported. Lifestyle habits and changes in these habits after the disaster might have affected the onset of abdominal obesity; however, the association between the two is unclear. METHODS: This study evaluated 19,673 Japanese participants of the Fukushima Health Management Survey. We used data from general health check-ups conducted in 13 municipalities between 2008 and 2010. Follow-up examinations were performed from June 2011 to March 2013. Changes in the proportion of individuals with abdominal obesity before and after the disaster were compared. Then, lifestyle habits affecting these changes were assessed. RESULTS: We found that 34.2% and 36.6% of participants (P < 0.001), both evacuees (37.0% and 42.1% [P < 0.001]) and non-evacuees (32.8% and 34.0% [P < 0.001]), had abdominal obesity before and after the disaster, respectively. Abdominal obesity was positively associated with smoking cessation, snacking after dinner, and non-breakfast skipping after the disaster and alcohol drinking before and after the disaster (all P < 0.05). Smoking cessation was positively associated with abdominal obesity in both evacuees and non-evacuees and in both men and women (all P < 0.01). CONCLUSION: The prevalence of abdominal obesity increased among residents in the area affected by nuclear disaster. It might be associated with not only lifestyle habits before the disaster but also changes in these habits after the disaster, especially smoking cessation.

Involvement of Japanese Care Managers and Social Workers in Advance Care Planning.

Successful advance care planning relies heavily on effective communication between the elderly and their families, care managers, and social workers. However, care managers and social workers are often not adequately prepared to conduct such discussion. The aim of the present study was to identify the specific challenges facing Japanese care managers and social workers when involvement in advance care planning. Two focus group discussions were held between August and November 2017, involving eleven care managers and three social workers employed at two long-term care facilities actively pursuing advance care planning initiatives. Four main themes were identified, through content analysis, as barriers and facilitators: client readiness, communication, variation-rich client individuality, and difficult-to-explain end-of-life options. This study revealed the importance of building rapport with the residents and their families in order to assess their readiness to discuss care options and preferences. Obstacles included lack of medical knowledge of care managers and social workers. Study findings suggested that a multi-disciplinary team, facilitated by care managers and social workers, was fundamental to achieving the goals of advance care planning.

Health-related behavior of the people who neglect the specific health guidance for metabolic syndrome control.

In 2008, Japan introduced a metabolic syndrome screening and intervention program specifically targeting individuals aged 40 to 74 years of age. However, the consultation and follow-up rates for the intervention are still low. The present study aims to identify characteristics of health-related behavior of the people who neglect it. We conducted a group interview targeting public health nurses and qualified dieticians of "A" prefectural branch office of the Japan Health Insurance Association who were regularly involved in performing the intervention. Qualitative content analysis was used to analyze the data, and four themes were extracted: Self-taught practices, Defiance, Hesitation, and Resignation. Our results suggest that the public health advisors recognize the importance of modification of clients' health-related misperception, improve their skills to develop a positive rapport with clients, and be involved in creating a supportive environment conducive to a healthy lifestyle.