Empowering Community Health Workers in Japan: Determinants of Non-Communicable Disease Prevention Competency.

BACKGROUND: Community health workers (CHWs), hailing from the general populace, play a pivotal role in fortifying healthcare systems, with a primary focus on mitigating non-communicable diseases (NCDs) and elevating overall life expectancy. To assess the aptitude of CHWs in NCD prevention, we introduced the Community Health Workers Perceptual and Behavioral Competency Scale for preventing non-communicable diseases (COCS-N). This study examines the multifaceted interplay of individual and community factors that influence CHWs' COCS-N scores. METHODS: The research design is a secondary analysis using data from a self-administered questionnaire survey of 6480 CHWs residing in municipalities across Japan, which obtained 3120 valid responses, between September to November 2020. The COCS-N was employed as the dependent variable, while the independent variables were individual-related factors, including years of community health work, health literacy, and community-related factors, such as CHWs' sense of community. To ascertain the significance of associations between individual and community factors and CHWs' competency, an analysis of covariance (ANCOVA) was utilized to compare the three groups Q1/Q2/Q3 by low, medium, and high scores on the COCS-N scale. Statistical significance was considered to be indicated by a p-value of less than 0.05. RESULTS: The ANCOVA analysis revealed that three factors were significantly linked to CHWs' competence. These comprised individual factors: "years of CHWs" (mean ± SD Q1: 6.0 ± 6.0, Q2: 7.8 ± 7.0, Q3: 8.2 ± 7.7, p < 0.001) and "health literacy" (Q1: 27.7 ± 6.6, Q2: 30.4 ± 6.9, Q3: 33.8 ± 7.8, p < 0.001), as well as a community factor: "Sense of community" (Q1: 14.8 ± 3.7, Q2: 16.5 ± 3.5, Q3: 18.2 ± 3.6, p < 0.001). CONCLUSIONS: Our finding is that a positive association was derived between COCS-N scores and certain determinants. Notably, "years of CHWs" and "health literacy" in the individual domain, along with the "Sense of community" in the communal context, were firmly established as being significantly associated with CHWs' competency. Consequently, CHWs need training to increase their "health literacy" and "sense of community", to acquire high competency in NCD prevention, which will lead to the empowerment of CHWs and maintain their motivation to continue.

Determinants of Self-Rated Health Disparities among Independent Community-Dwelling Older Adults: An Age-Stratified Analysis.

In response to the distinctive healthcare requirements of independent, healthy, community-dwelling older adults in Japan and other developed countries with aging populations, the current study examined the differences in factors associated with self-rated health (SRH) between the following two age groups: young-old (65-74) and old-old (75 and above). Age-stratified analysis was used to provide a comprehensive understanding of the unique health challenges faced by these demographic segments and to inform the development of targeted interventions and health policies to improve their well-being. The results of a cross-sectional study of 846 older adults in Yokohama, Japan, who completed self-administered questionnaires, revealed that high SRH was consistently linked with the low prevalence of concurrent medical issues in both age groups (<75 and ≥75) (ß: -0.323, p < 0.001 in the <75 group; ß: -0.232, p < 0.001 in the ≥75 group) and increased subjective well-being (ß: 0.357, p < 0.001 in the <75 group; ß: 0.244, p < 0.001 in the ≥75 group). Within the ≥75 age group, higher SRH was associated with more favorable economic status (ß: 0.164, p < 0.001) and increased engagement in social activities (ß: 0.117, p = 0.008), even after adjusting for age, sex, and economic status. These findings may inform the development of targeted interventions and policies to enhance the well-being of this growing population in Japan and other developed countries.

Factors Contributing to Life-Change Adaptation in Family Caregivers of Community-Dwelling Individuals with Acquired Brain Injury.

Acquired brain injury (ABI) is a public health issue that affects family caregivers, because individuals with ABI often require semi-permanent care and community support in daily living. Identifying the characteristics of family caregivers and individuals with ABI and examining life-change adaptation may provide valuable insights. The current study sought to explore the factors contributing to life-change adaptation in family caregivers of community-dwelling individuals with ABI. As a secondary analysis, a cross-sectional study was conducted using data obtained in a previous study of 1622 family caregivers in Japan. We hypothesized that life-change adaptation in family caregivers of individuals with ABI would also be related to family caregivers' characteristics and the characteristics of individuals with ABI. In total, 312 valid responses were analyzed using Poisson regression analysis. The results revealed that life-change adaptation in family caregivers of individuals with ABI was related to sex (prevalence ratio [PR]: 0.65, confidence interval [CI]: -0.819;-0.041) and mental health (PR: 2.04, CI: 0.354; 1.070) as family caregivers' characteristics, and topographical disorientation (PR: 1.51, CI: 0.017; 0.805) and loss of control over behavior (PR: 1.61, CI: 0.116; 0.830) as the characteristics of individuals with ABI, after adjusting for the effects of the caregiver's age, sex, and the duration of the caregiver's role. The current study expands existing knowledge and provides a deeper understanding to enhance the development of specific policies for improving caregiving services and supporting families.

Subjective Well-Being and Related Factors among Independent, Healthy, Community-Dwelling Older Adults in Japan.

(1) Background: Subjective well-being (SWB) is internationally recognized as an important health-related factor for most age groups and is particularly influential for life quality and expectancy in independent, healthy, community-dwelling older adults. However, the physical function and community participation correlates of SWB in independent living older adults in super-aging societies and other influencing factors remain underexplored. (2) Methods: A total of 926 independent, healthy, community-dwelling older adults aged 65 years and above registered in Yokohama, Japan, were included. Respondents' mean age was 78.1 years (standard deviation = 6.7), and 74.0% were women. The dependent variable was SWB. The independent variables were respondents' demographic characteristics, physical factors (visual, hearing, and cognitive functions, and mobility), and community and social factors (participation in community groups, social networks, and community commitment. (3) Results: The mean (standard deviation) WHO-5 score was 16.3 (5.1). Significant factors associated with WHO-5 score were visual function (odds ratio [OR]: 0.708; 95% confidence interval [CI]: 0.352-0.690), hearing function (OR: 0.615; CI: 0.431-0.878), community groups (OR: 1.310; CI: 1.003-1.059), community commitments (OR: 1.180; CI: 1.132-1.231), and social networks (OR: 1.525; CI: 1.142-2.037) adjusted for the effects of demographic factors. (4) Conclusions: These findings are important because factors associated with SWB are likely to contribute to individual well-being and longevity and to developing a healthy super-aged society.

Factors associated with community commitment among older adults: a stratified analysis of community group leaders and members.

BACKGROUND: Community commitment through group activities in the community is associated with improved health outcomes in older adults and has a ripple effect on community development. However, factors associated with community commitment through group activities in the community have not been examined. The purpose of this study was to examine individual factors and group-related factors in association with community commitment among older adult leaders and members of community groups in Japan. METHODS: We mailed self-administered questionnaires to all older adults participating in a community group (N = 1,898) in a ward of Yokohama city, the largest designated city in Japan. Variables included demographic characteristics, community commitment (Community Commitment Scale), individual factors, and group-related factors. We used logistic regression analysis to assess the association among study variables. RESULTS: A total of 1,154 people completed the questionnaire. The valid response rate was 48.8%. Respondents' mean age was 78.3 years (standard deviation [SD] = 6.1, range 65-100 years), 79.6% were women, 55.9% were married, and 10.0% were employed. Factors associated with community commitment among group leaders were scores for self-efficacy in the health promotion scale (SF-15; mean ± SD: 48.5 ± 7.1), 5-item World Health Organization Well-Being Index (mean ± SD: 17.9 ± 4.3), and Lubben Social Network Scale, Japanese version (mean ± SD: 19.5 ± 6.9), as well as a perception of deriving pleasure from group participation (mean ± SD: 91.2 ± 9.4). Factors associated with community commitment among group members were economic status (Sufficient; n [%]: 749 [85.9]), frequency of going out (mean ± SD: 5.1 ± 1.8), years of group participation (mean ± SD: 6.2 ± 5.0), and perceptions of their role in the group (Yes; n [%]: 254 [30.4]) as well as the above factors for leaders. A supplementary qualitative analysis of participants' free-text responses extracted seven categories: community support, resource mobilization, partnership action, asset management, participatory decision-making, linkages and networking, and community dissemination, related to perception of a role in the group. CONCLUSION: Our results emphasize the importance of considering the different associations of community commitment through group activities in the community between group leaders and members, including the role of older adults in community groups, and suggest different approaches for group leaders and members.

Arabidopsis Pol II-Dependent in Vitro Transcription System Reveals Role of Chromatin for Light-Inducible rbcS Gene Transcription.

In vitro transcription is an essential tool to study the molecular mechanisms of transcription. For over a decade, we have developed an in vitro transcription system from tobacco (Nicotiana tabacum)-cultured cells (BY-2), and this system supported the basic activities of the three RNA polymerases (Pol I, Pol II, and Pol III). However, it was not suitable to study photosynthetic genes, because BY-2 cells have lost their photosynthetic activity. Therefore, Arabidopsis (Arabidopsis thaliana) in vitro transcription systems were developed from green and etiolated suspension cells. Sufficient in vitro Pol II activity was detected after the minor modification of the nuclear soluble extracts preparation method; removal of vacuoles from protoplasts and L-ascorbic acid supplementation in the extraction buffer were particularly effective. Surprisingly, all four Arabidopsis Rubisco small subunit (rbcS-1A, rbcS-1B, rbcS-2B, and rbcS-3B) gene members were in vitro transcribed from the naked DNA templates without any light-dependent manner. However, clear light-inducible transcriptions were observed using chromatin template of rbcS-1A gene, which was prepared with a human nucleosome assembly protein 1 (hNAP1) and HeLa histones. This suggested that a key determinant of light-dependency through the rbcS gene transcription was a higher order of DNA structure (i.e. chromatin).

Adsorption of tungsten onto zeolite fly ash produced by hydrothermally treating fly ash in alkaline solution.

Fly ash (FA) was hydrothermally treated in an alkaline solution to produce zeolite fly ash (Z-FA). The properties of the FA and Z-FA were investigated. The amounts of tungsten (W) adsorbed onto the FA and Z-FA surfaces were evaluated. Z-FA was produced by hydrothermally treating FA in an alkaline solution. The specific surface area and pore volume of the Z-FA were greater than those of the FA. More W was adsorbed onto the Z-FA surface than onto the FA surface. The adsorption isotherms for W were fitted using both the Freundlich and Langmuir equations. The equilibrium concentrations of W adsorbed onto the FA and Z-FA surfaces were subsequently reached within 20 h. The pseudo-second-order model more accurately described the data than did the pseudo-first-order model. Sodium hydroxide solutions (1-50 mmol/L) were used to easily recover W from Z-FA, indicating that Z-FA was useful for recovering W from aqueous solutions.

A study on the adsorption of heavy metals by using raw wheat bran bioadsorbent in aqueous solution phase.

Raw wheat bran (R-WB) was used as a biomass adsorbent. The properties of R-WB were investigated. Moreover, the adsorption of cadmium and lead ions onto R-WB was evaluated. Adsorption equilibrium of cadmium and lead ions onto R-WB was achieved within 10 h, indicating that the adsorption followed a pseudo-second-order model rather than a pseudo-first-order kinetic model. The adsorption amount increased with increasing temperature. Correlation coefficient of the Langmuir equation is 0.999 for cadmium and 0.996 for lead ions, and that of the Freundlich equation is 0.994 for cadmium and 0.993 for lead ions. The negative ΔG value implied that the adsorption of cadmium and lead ions onto R-WB is a spontaneous process. The positive ΔS value indicated an increase in randomness at the solid-liquid interface. The optimal conditions for the adsorption column experiment were investigated (space velocity (SV) 2.2 1/h, linear velocity (LV) 0.1 m/h for cadmium; SV 6.51 1/h, LV 0.23 m/h for lead ions). Further, repeated adsorption-desorption of the cadmium and lead ions could be effected by using 0.01 mol/L HCl or 0.01 mol/L HNO3 solution. Consequently, polluted water could be successfully purified by using a column filled with this bioadsorbent.

Study of adsorption mechanism of heavy metals onto waste biomass (wheat bran).

In this study, raw wheat bran (R-WB), a type of waste biomass (WB) was treated with Pectinase PL (P-WB), and the properties (yield percentage, carboxy group surface concentration, the solution pH, and specific surface area) of R-WB and P-WB were investigated. The surface concentration of carboxy groups on R-WB (3.56 mmol/g) was greater than that of P-WB (2.11 mmol/g). In contrast, the specific surface area of P-WB (24.98 m²/g) was greater than that of R-WB (3.25 m²/g). In addition, the adsorption of cadmium and lead ions to WB was evaluated. Adsorption of the heavy-metal ions reached equilibrium within 9 h, and the experimental data was fitted to a pseudo-second-order model. More heavy-metal ions were adsorbed onto R-WB than onto P-WB. The correlation coefficient between the amount of ions adsorbed and the number of carboxy groups or pectin exceeded 0.884 and 0.975, respectively. This study indicated that wheat bran was useful for the removal of cadmium or lead ions from aqueous solutions. The adsorption mechanism of cadmium and lead ions to WB was associated with presence of carboxy group in pectin.

Application of activated carbons from coal and coconut shell for removing free residual chlorine.

This study investigated the removal of free residual chlorine by activated carbon (AC). ACs were prepared from coal (AC1) and coconut shell (AC2). The specific surface area of AC1 was larger than that of AC2. The removal of free residual chlorine increased with elapsed time and amount of adsorbent. The removal mechanism of free residual chlorine was the dechlorination reaction between hypochlorous acid or hypochlorite ion and AC. Moreover, AC1 was useful in the removal of free residual chlorine in tap water. The optimum condition for the removal of free residual chlorine using a column is space velocity 306 1/h; liner velocity 6.1 m/h.

Study on analysis of waste edible oil with deterioration and removal of acid value, carbonyl value, and free fatty acid by a food additive (calcium silicate).

This study investigated the regeneration of waste edible oil using a food additive (calcium silicate, CAS). Waste edible oil was prepared by combined heat and aeration treatment. Moreover, the deterioration of edible oil by combined heat and aeration treatment was greater than that by heat treatment alone. The acid value (AV) and carbonyl value (CV) increased with increasing deterioration; conversely, the tocopherol concentration decreased with increasing deterioration. The specific surface area, pore volume, and mean pore diameter of the 3 CAS formulations used (CAS30, CAS60, and CAS90) were evaluated, and scanning electron microscopic images were taken. The specific surface area increased in the order of CAS30 (115.54 m(2)/g) < CAS60 (163.93 m(2)/g) < CAS90 (187.47 m(2)/g). The mean pore diameter increased in the order of CAS90 (170.59 Å) < CAS60 (211.60 Å) < CAS30 (249.70 Å). The regeneration of waste edible oil was possible with CAS treatment. The AV reduced by 15.2%, 10.8%, and 23.1% by CAS30, CAS60, and CAS90 treatment, respectively, and the CV was reduced by 35.6%, 29.8%, and 31.3% by these 3 treatments, respectively. Moreover, the concentrations of tocopherol and free fatty acids did not change with CAS treatment. The characteristics of CAS were not related to the degree of change of AV and CV. However, the adsorption mechanism of polar and non-polar compounds generated in waste edible oil by CAS was related with the presence of silica gel molecules in CAS. The findings indicated that CAS was useful for the regeneration of waste edible oil.