Availability of Japanese Government's supplemental texts on radiation reflecting the Fukushima Daiichi Nuclear Power Plant accident for elementary and secondary education from dental students' understanding.

Following the Fukushima Nuclear Power Plant accident, the Japanese government created two supplemental texts about radiation reflecting the accident for elementary, middle school, and high school students. These texts were made to explain radiation and consequently to obtain public consent for the continuation of the nuclear program. The present study aimed to evaluate the appropriateness of the content of the texts and to collect the basic data on the level of understanding necessary to improve radiation education. Lectures on radiology including nuclear energy and the Fukushima accident were given to 44 fourth-year dental students in 2013. The questionnaire was administered in 2014 when these students were in their sixth-year. The survey was also administered to 40 first-year students and 41 fourth-year students who hadn't any radiology lectures. Students rated their level of understanding of 50 phrases used in the texts on a four-point scale (understanding = 3, a little knowledge = 2, having heard = 1, no knowledge = 0). Questions on taking an advanced physics course in high school and means of learning about radiation in daily life were also asked. The level of understanding of phrases in the supplemental text for middle and high school students was significantly higher among sixth-year students (mean = 1.43) than among first-year (mean = 1.12) or fourth-year (mean = 0.93) students (p < 0.05). Overall, the level of understanding was low, with scores indicating that most students knew only a little. First-year students learning about radiation from television but four-year and six-year students learning about radiation from newspaper scored significantly higher (p < 0.05). It was concluded that radiation education should be improved by using visual material and preparing educators to teach the material for improving the public's understanding of radiation use-especially nuclear power generation because the phrases used in the supplementary texts are very difficult for students to understand.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake.

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills.

Development of a mutual-assistance capability training program to safeguard the health of local residents in evacuation shelters after a disaster.

The purpose of this study is to create and evaluate a program to enhance the mutual-assistance capability of community members to safeguard their health during time spent in evacuation shelters after a disaster. In previous research, "Supporting people in need of assistance after a disaster, " the participants' awareness of the need for mutual assistance was low and their relevant knowledge and skills were insufficient. Accordingly, this became a priority in the developed program. Twenty-eight people at six different facilities participated in the program. We collected data using a questionnaire survey and group interview with the participants. After conducting the program, the participants' mean scores of mutual-assistance capability were higher than the mean pre-study scores for 25 out of 26 items. The results of group interview implied that the participants acquired [Realization of issues], and not only shared a [Sense of crisis among participants] but also felt a [Sense of responsibility for mutual assistance in the community]. We considered that our mutual-assistance training program at the time of a disaster is effective for developing mutual assistance for safeguarding health where local residents are unprepared to support those in evacuation shelters requiring assistance after a disaster.

Development of a Strengths Measurement Scale for the lifestyle transformation process.

This study aimed to develop a Strengths Measurement Scale (SMS) for assessment of people in the process of transforming their own lifestyle, and to examine the reliability and validity of the SMS. This is to establish a foothold for introducing the Strengths Model into health guidance for the prevention of lifestyle-related diseases. We conducted an anonymous, voluntary questionnaire survey with our SMS comprising 38 items proposed in a preliminary investigation. In total, 1,339 Japanese adults participated, and responses from 1,160 participants (effective response rate of 86.6%) were analyzed. We calculated Cronbach's alpha coefficient for testing the reliability. To test the validity, we examined the construct validity through exploratory factor analyses. Based on the results of the factor analysis performed on the 38 question items of the SMS, we adopted four factors and 36 question items. Cronbach's alpha coefficients of all the factors were 0.80 or above. There were significant, positive correlations between the SMS and the Modified Perceived Health Competence Scale (PHCS), and between the SMS and the Adolescent Resilience Scale (ARS). The reliability and validity of the SMS for the lifestyle transformation process were confirmed, suggesting that the scale is applicable to health guidance for preventing lifestyle-related diseases.

Relationship between identity and attitude toward death in Japanese senior citizens.

This study aimed to clarify the relationship between identity development stages and attitudes towards death among Japanese senior citizens. The subjects were recruited from among approximately 500 students attending educational courses for senior citizens in Prefecture A. We collected the data by using the questionnaire and interview. The contents of questionnaire were Erikson Psychosocial Stage Inventory (EPSI) and Death Attitude Profile-Revised (DAP-R). In the interview, we represented the four developmental stages, and asked the questions from birth to the present. The collection rate was 85.4% (427 subjects). And 10 subjects participated in the interview. In relation to correlations between the EPSI sub-factors and the DAP-R subscales, there were moderately strong, negative correlations between "Integrity" and "Fear of death" and between "Integrity" and "Avoidance of death". In relation to the subjects' reflections on their lives, the following four categories were extracted: [Trust relationships with others], [Self-confidence regarding my own efforts], [Wanting to contribute to society], and [Let things be as they are]. These results suggested that the accomplishment of "Integrity", which is the developmental task in the maturity stage, leads to the attitude of accepting one's whole life. Further, we have clarified that "Integrity" promotes the acceptance of death.

Collaborative agencies and quality discharge support for the long-term care inpatients with mental illness.

Long-term hospitalization is a problem for psychiatric care in Japan. The purpose of this research was to clarify the demands placed on public health nurses' (PHN) involved in the discharge of long-term inpatients (LIPs) with mental illness, and their lack of support. A questionnaire was mailed to 516 health centers, and 112 health centers replied. The response rate was 21.7 percent. The mail survey questionnaire was based on original questionnaire developed by the authors. Significant differences were found among collaborative agencies selected as essential for the discharge support project for the LIPs with mental illness. These differences were evident in the following question items on insufficiency of support: "Incompatibility with the policy of the public health center on discharge support"; "Opposition to discharge of a LIPs with mental illness by hospital staff"; and "Shortage of PHN in charge of the discharge support project for the LIPs with mental illness". It was clarified that the discharge support project required not only the involvement of health and medical welfare personnel but also the cooperation of local human resources such as local residents, neighbor associations, social workers, real-estate agencies and others.

Interventional study for improvement of lung cancer screening rate.

The aim of this study is to evaluate whether leaflet distribution affects lung screening rate, and what factor affects the motivation of consultation. Men and women aged 40 to 59 were targeted to improve screening rate of ages for cancer screening, especially in their prime. Each 1,000 subject, a total of 2,000 were selected and divided into 8 groups in consideration of age group by random sampling method. This group was further divided into two groups, an intervention group including subjects distributed a leaflet and a non-intervention (control) group. A survey was conducted by postal self-administered survey forms. Collection rate was 21.6% for the intervention and 17.6% for the control group. The numbers of respondents who answered that this leaflet was effective for motivation of consulting lung cancer screening and the leaflet was ineffective, were 120 (60.0%) and 80 (40.0%), respectively. This indicated that the leaflet was clearly effective (p<0.01). Actual cancer screening rate was 38.8% for the intervention group and 37.7% for the control group. It was shown that distribution by mail of even a single leaflet made by National Cancer Center was effective for motivation of consultation of lung cancer screening.

Health behavior of elderly people engaged in agriculture in conjunction with information communication technology.

The aim of this study is to clarify the health behavior of elderly people engaged in agriculture and information communication technology (ICT). The participants were 61 people engaged in agriculture in conjunction with ICT systems (group A), and 49 people not engaged in this (group B) from among the people aged 65 years or over in village C, both living located in a mountain areas. Data were collected from August 2009 to June 2011 in two stages: interviews to members of group A through home visits, and a group survey of groups A and B through questionnaires. The results of the study were as follows: 1) members of group A lived with feelings of attachment to the land to which they were accustomed and showed gratitude to their ancestors; 2) in group A, the desire of participants to continue their life was sufficient motivation to look after their own health and maintain independence; and 3) they provided a new challenge and a sense of achievement. The results suggest that the health behavior in group A was behavior adopted voluntarily in order to maintain an independent lifestyle supported by working, and it is likely to be linked to the preservation of health.

The relation between the cancer screening rate and the cancer mortality rate in Japan.

The aim of this research was to clarify the relation between the screening rates for five cancers (lung cancer, stomach cancer, colorectal cancer, uterus cancer, and breast cancer) and their mortality rate by using publicly accessible databases. The used information materials were those prepared by the Ministry of Health, Labour and Welfare, the Center for Cancer Control and Information Services, and the National Cancer Center. Our results were as follows: 1) regarding stomach and colorectal cancers, a positive correlation was found between the screening rate and the mortality rate (p<0.001); 2) in the relation between the screening rate and the mortality rate according to administrative divisions, the mortality rate decreased significantly when the lung cancer screening rate improved (p<0.005); 3) the mortality rate for breast cancer increased in those aged 50 or over; 4) the mortality rate for uterus cancer had been slightly increasing since 1990; and 5) regarding the screening rate, a positive correlation was found between breast cancer and uterus cancer (p<0.001). In future, improvement in lifestyle and in the knowledge of cancer should be promoted to enhance the screening rates.

Challenge of psychiatric rehabilitation for patients with long-term hospitalizations using the Nirje's normalization principles as a valuation standard: two case studies.

This research investigates the current care of hospitalized, chronically mentally ill persons to determine to what extent current hospitalization supports Nirje's principles of normalization. We propose that care-providers try to incorporate rehabilitation programs that help the patients acquire the pattern and rhythm of living necessary for them to live in the community in their daily hospital life rather than to fit the patients into hospital rules or schedule. Therefore, care-providers must look back on their own views of the humanity, disabled people, and support and may have to change them if necessary. It is important that care-providers do not give up having psychiatric patients not give up restoration of normal social living. To develop such individual attempts into rewarding activities, it is necessary to set goals in the hospital and to let an interdisciplinary team work to achieve them. Moreover, the situation is expected to change if efficient care management is implemented to support psychiatric patients in the community. High-quality care to realize independent living of patients in the community including collection and distribution of information, management of symptoms, assistance for self-care, and psychological education is provided at hospitals that maintain the idea of, and strong belief in, providing high-quality care for returning patients to the community. The findings of this study will provide insights into how to design better hospitalization and/or community care for the mentally ill.

Real-time measurement of frozen gait in patient with parkinsonism using a sensor-controlled walker.

Patients with Parkinson's disease develop gait disturbances. Although the use of walkers is very effective for maintaining locomotive ability, patients who have symptoms such as frozen gait (FG) and festinating gait may fall even with a walker equipped with a brake as they cannot use the brake well in an emergency and fail to follow the accelerating walker. None of the studies on walking aids to date have addressed real-time detection of FG or the use of this information for the control of the walking aid, monitoring of the state of improvement in the ambulatory function, or evaluation of the effect of the use of a walker. In this study, we evaluated whether the state called FG, a characteristic symptom of Parkinson's disease, can be detected by the use of a sensor-controlled walker with heel-to-toe pressure sensors. The following two measurements were carried out in one male healthy and a one male patient with stage 3 Parkinson's disease by the Hoehn-Yahr scale showing mild muscle rigidity, hypokinesia, and FG. In the healthy subject, the heel-to-toe pressure showed smooth heel-to-toe shifts during the standing phase. In the patient with Parkinson's disease, the heel-to-toe response time was about 2.4 times longer than in the healthy subject at the beginning of walking, and FG could be recorded as the difficulty in lifting the foot by the toes. Also, when FG was observed during walking, the pressure waves recorded by the same sensors showed two peaks occurring at short interval, indicating double landings.

Investigation of QOL of hospice patients by using EORTC-QLQ-C30 questionnaire.

This study was designed to investigate the quality of life (QOL) of cancer patients being cared for in a hospice, in the expectation that the results would serve as useful basic materials for improving the care of such patients. The subjects were 24 patients who had been diagnosed as having cancer and were hospitalized in the hospice wing of a hospital. The study was carried out as a crossing investigation using the Japanese version of the EORTC-QLQ-C30 Ver.3 questionnaire prepared by the European Organization for Research and Treatment of Cancer. The results of the survey showed that it was important to be prepared to prevent or treat diarrhea at the time of bowel movement and confirmed the need for care aimed at reducing fatigue. In addition, the emotional functioning and financial problems of the patients showed strong correlations with the QOL, revealing the need for psychological and financial support of cancer patients in hospices.

Study of life satisfaction and quality of life of patients receiving home oxygen therapy.

An investigation was conducted by mail using a questionnaire regarding the life satisfaction and quality of life (QOL) of patients receiving home oxygen therapy (HOT) to evaluate their support. QOL was evaluated according to 4 scales: (1) activities, (2) state of health and quality of living, (3) physical symptoms, and (4) economic state. The answers of 90 patients (recovery rate: 60%) who responded to the investigation were analyzed, and the following points were clarified. 1. Most of the subjects visited the hospital regularly, and about half the subjects (50.6%) had been treated by hospitalization during the 3 years prior to the investigation. 2. A large majority of the subjects (77.4%) answered they were satisfied with life. 3. Life satisfaction was closely related to the patients' roles and hobbies, and their activities in their communities and families. 4. The quality of living and the state of health were closely related to mental activity. 5. The economic state was closely related to all items of life satisfaction, quality of living, and state of health. From these results, expansion of the range of activities of patients receiving HOT and providing an economic basis for their living as well as preventing exacerbation of the disease are considered to be important for improving their life satisfaction.