Strengths within the Community Perceived by Older Adults Living Alone in a Semi-Mountainous Rural Region: A Qualitative Study.

It is recommended that health promotion activities in the community focus on residents' strengths. Hence, this study explored the community strengths perceived by older adults living alone in a semi-mountainous rural region of Japan. A qualitative, descriptive approach was used. Content analysis was performed using data obtained through face-to-face interviews. Interview data were coded; codes were classified based on similarity to create subcategories and categories. The strengths within the community, as perceived by older adults living alone in a semi-mountainous rural region, were revealed in four categories related to ten subcategories: "loose connections with others", "active community participation", "close relationships with community professionals", and "familiarity with the living environment". Strengths within the community perceived by older adults living alone in a semi-mountainous rural region were cultivated in an environment formed by their past lives. Utilizing these resources may help support community-based societies in semi-mountainous rural regions where depopulation and aging are expected to continue in the future. This study was not registered.

A Review of the Literature on the Regional Strengths Perceived by Older People Living in Local Japanese Communities.

As a super-aging society, health promotion activities in local Japanese communities are increasingly essential. Developing the health-promotion programs must include the perspective of older people residing in these communities and what they believe to be their regional strengths. This study aimed to clarify the elements of regional strengths perceived by older people living in local Japanese communities from the literature review. Using the internet edition of the Japan Medical Abstracts Society (Ichu-shi), the authors examined papers on Japanese regional residents using relevant keywords. Of 342 considered papers, 14 papers were extracted in this study. As a result, the contents related to the regional strengths perceived by the older people living in the local Japanese community were extracted, classified based on the similarity of the meanings and contents, and then summarized into the elements of the strengths. As the regional strengths, three categories were cited for individual elements: "Actions or behaviors underpinned by experience," "Continuing to live with positivity and vigor," and "Extensive support for the subject and their family." Three categories were cited for environmental elements: "A comfortable environment," "Maintaining intimate and friendly interpersonal relations," and "Support that meets the regional characteristics." Along with individual and environmental elements, support from experts in the region was cited. Hence, it was concluded that the active participation of experts is essential for promoting activities in local communities, and that deepening relationship with older people has the potential to improve their quality of life.

[Development of a scale to evaluate the rest levels of male workers].

Objectives　"Rest" has two aspects: "repose," to recover from physical or mental fatigue, and "restore," to re-establish physical, mental, and social health. Many male workers work for prolonged hours, and despite stress, they do not apply coping behaviors, unlike female workers. Consequently, taking sufficient rest is difficult for male workers. The aim of this study was to develop a scale incorporating multiple factors to evaluate the state in which male workers take rest.Methods　A questionnaire survey was conducted involving 330 male workers aged 20-59 years who had been engaged in two manufacturing industries. The questionnaire items were created with reference to an interview survey of male workers in the literature. After discussing with industrial hygiene experts and conducting a pretest to obtain surface validity, 70 items were used for analyses. In the exploratory factor analysis, promax rotation was used with the maximum likelihood method. In the confirmatory factor analysis, goodness of fit was confirmed with the covariance structure analysis. Health-related quality of life, job stress, work engagement, sleep, and self-assessment of rest were used to examine concurrent validity.Results　With the exploratory factor analysis, we introduced a scale containing 15 items, including three subscales: filling with spirit, enthusiasm for work, and recovery from fatigue. The reliability coefficient (Cronbach's alpha) of the three subscales and the overall scale ranged from 0.79 to 0.88 and 0.89, ensuring internal consistency. The confirmatory factor analysis showed a generally good fit. Their scores were correlated with many items of the health-related quality of life, job stress, work engagement, sleep, and self-assessment of rest.Conclusions　A 15-item "Rest Evaluation Scale" was created to evaluate the state in which male workers in the manufacturing industries take rest. Since the validity, reliability, and concurrent validity of this scale were satisfactory, this scale was considered to be an index evaluating the state of rest of male workers.

[Efforts to improve workplaces considering for older workers: A questionnaire survey focusing on company size in Wakayama Prefecture, Japan].

OBJECTIVES: The "Guidelines for Ensuring the Safety and Health of Older Workers (hereafter referred to as "Guidelines")," formulated in 2021, require employers to implement measures that proactively prevent occupational accidents among older workers. This study aimed to clarify the status of awareness of the Guidelines and workplace improvement efforts with consideration of older workers, focusing on company size. METHODS: Overall, 780 businesses in Wakayama Prefecture, Japan, were randomly selected from a Wakayama Occupational Health Support Center workplace list. Anonymous self-administered questionnaires were distributed by mail. The questionnaires comprised questions about the workplace, status of awareness of the Guidelines, comprehensive management of safety and health, considerations for working conditions, workers, workload reduction, work posture, work environment, and safety and health. RESULTS: One hundred and seventy-one businesses (effective response rate: 21.9%) provided questionnaires with complete responses. For the Guidelines, 39.0% of small-sized (less than 50 employees) businesses answered, "never even heard of the name," while many medium-sized (50-99 employees) and large-sized (100 or more employees) businesses answered that they had heard of the name but did not exactly know about it (33.3% of medium-sized businesses and 47.8% of large-sized businesses). Regarding the system that subsidizes the expenses required for the improvement of a working environment for older workers to work safely and securely (hereinafter referred to as the subsidy system), many businesses of all sizes answered that they had "never even heard of the name." In the comprehensive management of safety and health, half of the businesses of all sizes had developed a system that made it easy to consult about the risk against occupational accidents of older workers. Regardless of size, more than half of businesses were able to consider working conditions and workers. However, there were only a few items where more than half of the businesses considered workload reduction, work posture, work environment, and safety and health, regardless of business size. It became clear that workplace improvement had not progressed very much. CONCLUSIONS: These results suggest that to promote workplace improvement that considers older workers, it is necessary to disseminate the Guidelines and proactively take on workplace improvement by utilizing the subsidy system.

Depressive symptoms among Thai male seafarers during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Prevalence of depressive symptoms among seafarers is higher than the general population because of their unique work conditions. Factors that can be changed must be considered and promptly addressed in order to decrease the prevalence of depression. This study aims to clarify the prevalence of depressive symptoms and its related factors among Thai seafarers in an effort to contribute to policies and to prevent depression among Thai seafarers. METHODS: This cross-sectional study was conducted among 381 male seafarers working onboard ocean-going vessels of five Thai shipping companies. The questionnaire items comprised of personal factors, working factors and depressive symptoms. Depressive symptoms were assessed using the Thai version of the Patient Health Questionnaire-9. First, the chi-square test was used for univariate analysis. Then, variables significantly associated by the chi-square test were used for multivariate logistic regression analysis (employing the stepwise method) as independent variables. RESULTS: The average age of participants in this study was 36.4 years. Prevalence of depressive symptoms was 19.5%. One half of the participants (58.3%) reported subjective sleep problems, and most (75.1%) experienced poor coping behaviors. Two thirds (67.5%) were officers, and 10.1% of participants reported that they sometimes or never performed occupational safety behaviors. Regarding work environments, 62.2% reported that their work was disturbed from performing repetitive tasks. Multivariate logistic regression analysis showed two personal factors; sleep problems (Adjusted Odds Ratio (AOR) = 7.97, 95% Confidence interval (CI) = 3.52-18.05) and poor coping behaviors (AOR = 4.46, 95%CI = 1.61-12.34), and three working factors; job assignment (AOR = 2.50, 95%CI = 1.33-4.70), inadequate occupational safety behaviors (AOR = 4.51, 95%CI = 1.85-11.01) and performing repetitive task (AOR = 2.27, 95%CI = 1.16-4.45), were significantly associated with depression. CONCLUSION: During COVID-19 pandemic, 19.5% of Thai male seafarers had depressive symptoms. Personal and working factors including subjective sleep problems, poor coping behaviors, job assignment, performing inadequate occupational safety behaviors and performing repetitive tasks were risk factors of depressive symptoms among Thai male seafarers. Monitoring work environment rigorously and coping with work-related stress of the occupational safety behaviors program should be suggested.

Factors Related to Nutritional Status of Single Older Residents in Semi-Mountainous Rural Regions of Japan: A Cross-Sectional Study.

Japan's notably high aging rate presents the risk of malnutrition. This study aimed to clarify the nutritional status and factors related to the nutritional status of single older residents in a semi-mountainous rural region of Japan. Using a cross-sectional study design, surveys were administered to older adults in the semi-mountainous rural region in the area of Kochi Prefecture, Japan. Factors associated with a risk of malnutrition were identified using binomial logistic regression analysis. In addition, nutritional status was evaluated using the Mini Nutritional Assessment-Short Form (MNA-SF). Among 53 participants, the MNA-SF score was 12.1 ± 1.5 (mean ± standard deviation), and 71.7% had a normal nutritional status. We observed that participation in local residents' association gatherings (odds ratio [OR]: 7.42, 95% confidence interval [CI]: 1.17-47.01) and risk of depression/anxiety (OR: 12.77, 95% CI: 1.99-81.94) were associated with an increased risk of malnutrition, whereas social interaction with friends (OR: 0.11, 95% CI: 0.02-0.76) were associated with a decreased risk. The nutritional status was normal overall. Community health workers should share information on the health of residents and promote social events to enable older residents living alone to continue leading healthy lifestyles.

[Factors Related to Work Engagement in Occupational Health Nurses: From both Aspects of Work Environmental and Individual Factors].

OBJECTIVES: The Ministry of Health, Labour and Welfare (MHLW) states that it is an important issue to realize a work environment where people find their job worth doing, and the MHLW utilizes work engagement as the concept of a job worth doing. In this study, we aimed to clarify the factors related to work engagement in occupational health nurses from both aspects of work environmental and individual factors. METHODS: An anonymous self-administered questionnaire was mailed to 2,172 occupational health nurses who belonged to the Japan Society for Occupational Health and were in charge of practical work. Among them, 720 responded and their responses were analyzed (valid response rate: 33.1%). The Japanese version of the Utrecht Work Engagement Scale (UWES-J) was used to measure their feelings on whether their job is worth doing. Question items at three levels, namely, work level, department level, and workplace level, were selected from the new brief job stress questionnaire as the work environmental factors. Three scales, namely, professional identity, self-management skills, and out-of-work resources, were used as the individual factors. Multiple linear regression analysis was performed to examine the factors related to work engagement. RESULTS: The mean total score of UWES-J was 57.0 points, and the mean item score was 3.4 points. Among attributes, age, having children, and the position of chief or above were positively correlated to the total score, but the number of occupational health nurses in the workplace was negatively correlated to the total score. Among work environmental factors, work-self balance (positive), which is a subscale at the workplace level, and suitable jobs and opportunities to grow up, which are the subscales at the work level, were positively correlated to the total score. Among individual factors, self-esteem as a professional and self-improvement to be professional, which are the subscales of the professional identity, and problem resolution, which is a subscale of self-management skills, were positively correlated to the total score. CONCLUSIONS: In order for occupational health nurses to find their job worth doing, it is desirable that they will have options to choose diverse and flexible work styles, and that their employers will establish a work-life balance for the entire organization. It is preferable that the occupational health nurses can self-improve, and that their employers will provide opportunities for them to develop professionally. The employers should also establish a personnel evaluation system that allows for promotion. Results also suggest that the occupational health nurses need to improve their self-management skills, and that the employers should assign them to positions suitable to their abilities.

[Support for a balance between work schedules and treatment regimens among workers with illness: A questionnaire survey focusing on company size in Wakayama Prefecture, Japan].

OBJECTIVES: The support from businesses to create a balance between work schedules and treatment regimens among employees suffering from illnesses, such as cancer and diabetes, seems to be insufficient. This study aimed to investigate efforts of businesses to support the balance of work schedules and treatment regimens among employees with illness, focusing on company size and to identify potential workplace improvements for such employees. METHODS: Overall, 789 businesses in Wakayama Prefecture, Japan were randomly selected from a workplace list of the Wakayama Occupational Health Support Center. Anonymous questionnaires were distributed by mail. The questionnaires consisted of question items on workplace, current employees who had suffered or were suffering from cancer (employees with cancer), employees with illnesses (diseases such as cancer and diabetes), and support for businesses and employees. RESULTS: Questionnaires with complete responses were collected from 187 businesses (response rate: 23.7%). The ratios of businesses where employees with cancer were engaged or had been engaged were 43.4% for small-sized (less than 50 employees), 70.9% for medium-sized (50-99 employees), and 83.1% for large-sized (100 and more employees) businesses. In all business sizes, the most common support in reinstatement or hiring employees with cancer was "absenteeism for treatment." The most common difficulty that occurred in the workplace due to the presence of employees with cancer was "the insufficient number of workers." The information from the attending physician, etc. necessary for deciding the reinstatement was mostly "the current health condition and physical strength." Additionally, in all business sizes, the most common support for employees with illness to balance work schedule and treatment regimens was "considering measures suitable to the situation such as hospital visits and physical condition." The most common challenge was "securing alternative personnel." The information from the attending physician, etc. necessary for deciding the reinstatement was "the current health condition and physical strength," similar to that for employees with cancer. More than 60% of the businesses of varying sizes reported being unaware of the work-treatment balance support coordinator. CONCLUSIONS: Considering measures suitable to the situation, such as hospital visits and physical condition, securing alternative personnel, and actively disseminating information regarding work-treatment balance support coordinators are recommended as workplace improvements for employees with illnesses.

Mental health problems and their related factors among seafarers: a scoping review.

BACKGROUND: Seafarers are often reported to be engaged in a dangerous physical and psychosocial work environment. However, mental health status among seafarers has not been focused on compared with physical health issues. Systematic, comprehensive reviews of mental health problems and their relevant factors are lacking. This review aimed to clarify beneficial approaches to the mental health problems faced among seafarers using a scoping review to systematically map the evidence regarding mental health issues and their related factors. METHODS: Studies were searched on MEDLINE/PubMed, Science Direct, Academic search complete using EBSCOhost databases, SCOPUS, EMBASE, and Web of science on 20, August 2020. This scoping review was conducted based on the framework of Arksey and O'Malley and Preferred Reporting items for Scoping Reviews flow diagram. The inclusion criteria were studies which determined the relationship between factors relevant to working conditions or working environment, and mental health in seafarers, and etc. Data were narratively summarized and reported. RESULTS: Twenty-four were included in this review while two major findings were clarified. Firstly, the prevalence of stress, depressive symptoms, and burnout have been mentioned for decades. Secondly, factors related to mental health and psychological issues can be categorized as individual and work environmental factors. The individual factors include experience, age, health status (high BMI, poor sleep, and diabetics), and resilience. The work environmental factors consist of two parts. Job demands comprise pressure from contractors/customers/time, working hours, ship department, job title, voyage episodes, period of seafaring, noise, and vibration. The job resources included instrumental support, team cohesion, shipboard caring and effort-reward imbalance. CONCLUSIONS: A beneficial approach to mental health problems faced among seafarers is necessary to understand comprehensively at individual and organization levels. Promoting health behaviors, training resilience, and managing obesity and chronic diseases comprise individual level strategies. Providing seafarers with adequate instrumental support, and practical support to communicate with customers, managing their distinct work-rest hours and adequate effort-reward balance comprise organization level methods.

[The effects of writing and reading aloud the positive events that take place in the workplace on work engagement and the occupational stress of care workers in welfare facilities for long-term elderly care: A crossover trial].

OBJECTIVES: A number of earlier studies have pointed out that care workers in nursing homes for the elderly experience high levels of stress. In recent years, work engagement has been attracting attention as a concept that focuses on the positive psychological aspects of workers. In this study, we examined whether writing and reading aloud positive events that take place in the workplace would be useful as a measure to improve work engagement and to reduce occupational stress among care workers in such facilities. METHODS: Participants included 57 care workers (across 13 groups) working at seven welfare facilities in Wakayama Prefecture, Japan. A crossover trial with two groups the intervention and control groups was used. The intervention group wrote about positive events, and read them aloud for each group at the morning assemblies and other gatherings. The control group continued work as usual. The survey spanned eight weeks. The questionnaire items were sourced from the Japanese version of the Utrecht Work Engagement Scale (UWES), the Brief Job Stress Questionnaire (BJSQ), and included items concerning participants' biographical attributes. The number of positive events that the participants individually wrote about and the frequency of listening to reading about them was asked for at the end of the intervention period. Multiple linear regression analysis was used to examine the relationship between the number of written accounts or the frequency of listening to readings and the amount of change in the scores of the subscales. RESULTS: The median number of positive events that the participants individually wrote about was three (interquartile range 1-5). The number of those who answered that the frequency of listening to readings was rare was 22 (38.6%). Significant differences in the changes in the scores between the two groups were recognized in terms of "absorption," a subscale of the UWES, and the "work control," "work worth," and "family support," subscales of the BJSQ. Multiple linear regression analyses showed that the number of written accounts was associated with the amount of change in absorption and the amount of change in work worth. The frequency of how often the participants listened to the readings was not related to the amount of change across any of the four subscales. CONCLUSION: Writing about positive events during work could enhance "absorption" of UWES and improve "work worth" of BJSQ. It is suggested that writing and reading aloud positive events that take place in the workplace is one of the measures to improve "absorption" and "work worth" among care workers in welfare facilities.

[Trends of Implementation of Nonsmoking at Eating and Drinking Establishments One Year before and after April 2020: Consideration of the Status of Implementation of the Amendment Bill for the Health Promotion Act of Japan].

OBJECTIVE: In this study, we aimed to clarify the transition to the implementation of smoking prohibition at eating and drinking establishments one year before and after April 2020, the time when they became "nonsmoking" in principle following the implementation of the amendment bill for the Health Promotion Act of Japan. METHODS: The total number of nonsmoking/smoking eating and drinking establishments by industry were obtained using the data from "Tabelog®." The number of people who tested positive for COVID-19 by the polymerase chain reaction test on the day of the survey nationwide and the bankruptcy status of the companies (eating and drinking establishments, etc.) for each month were ascertained. RESULTS: In 2020, a state of emergency was declared owing to the increase in the number of people positive for COVID-19, and many eating and drinking establishments went bankrupt. Despite these circumstances, the number of nonsmoking eating and drinking establishments exceeded that of smoking establishments in March 2020 and continued to increase thereafter. Additionally, the number of nonsmoking "restaurants" increased and exceeded that of smoking restaurants in June 2020. The number of nonsmoking "cafes" already exceeded that of smoking "cafes" at the beginning of this survey and continued to increase. The number of nonsmoking "bars" increased, but that of smoking "bars" remained high. CONCLUSION: It is necessary to promote measures against passive smoking while paying attention to the trends for different types of eating and drinking establishments, rather than considering all establishments together.

[Relationship between Work Improvement and Work Engagement in Financial Industry: Examination Based on the Level of Sense of Coherence].

OBJECTIVE: In this study, we aimed to clarify the relationship between workplace improvement and work engagement based on the level of sense of coherence. METHODS: An anonymous self-administered questionnaire survey was conducted on 1,845 regular employees in a financial industry (valid response rate, 78.5%). The questionnaire included the Japanese Sense of Coherence (SOC), Japanese Utrecht Work Engagement Scale (UWES-J), and Mental Health Improvement & Reinforcement Research of Recognition (MIRROR). Multiple linear regression analysis was performed with the total score of UWES-J as the dependent variable and the MIRROR items as the independent variables for each group with high and low SOC levels. RESULTS: Two MIRROR items namely, "It is easy to take a substitute vacation after work on holidays" and "In the workplace, the abilities and ingenuity of each person are utilized", were the negative factors common to the two groups. On the other hand, in the low-SOC-level group, the items "The work policy is decided in a way that everyone is satisfied with", "When the work breaks, I can go home without worrying about other people", and "The superior gives proper explanations about everything to his subordinates" showed negative relationships. In the high-SOC-level group, "The work environment (e.g., air conditioning and lighting) can be adjusted according to the wishes of workers", "No overtime day is set or utilized", "I am allowed to commute to work avoiding crowded times and routes", and "The superiors are trying to make everyone's work proceed smoothly" showed negative relationships. CONCLUSIONS: Depending on the level of SOC, workers' desire for workplace improvement related to UWES-J scores differed.

[Factors Related to Attitudes toward Responses to Stress Survey in Stress Check Program in Financial Industry].

OBJECTIVE: The purpose of this study is to clarify the factors related to attitudes toward responses to a stress survey in the Stress Check Program, which is used to screen for workers with high psychosocial stress at the workplace. METHODS: An anonymous self-administered questionnaire survey was conducted on 1,800 regular staff member of a financial industry (valid response rate: 72.0%). The questionnaire items were the brief job stress questionnaire (BJSQ), the sense of coherence (SOC-13), the Japanese version of the Utrecht work engagement scale (UWES-J), attitudes toward responses to the stress survey, and the concerns of subjects regarding the stress check program. RESULTS: The stress in interpersonal relationships at the workplace in the BJSQ, "concerns about leaking results to the company", "concerns about receiving persistent calls for an interview", and "concerns about a disadvantageous treatment by the company" were positively related to 'writing general truths', whereas the support from the boss in the BJSQ and the subscales of SOC-13 were negatively related to 'writing general truths'. The stress in interpersonal relationships at the workplace and "concerns about receiving persistent calls for an interview" were positively related to 'writing falsehoods', but the "dedication" in UWES-J was negatively related to 'writing falsehoods'. CONCLUSIONS: To obtain authentic answers in the stress survey, it is important (1) to smooth relationships at the workplace, (2) to devise operation systems such as an interview guidance, and (3) to provide support that enhances the ability of workers to cope with stress and work engagement.

[Association of Annual Transition of Implementation of Nonsmoking at Eating and Drinking Establishments with Indices on Population/Household and Economy/Labor: Examination Using Prefectural Data].

OBJECTIVES: The purpose of this study was to clarify the relationship of the annual transition of implementation of nonsmoking at eating and drinking establishments with indices of population/household and economy/labor by prefecture. METHODS: The prefectural rates of eating and drinking establishments implementing nonsmoking (hereafter, nonsmoking rate) were computed in a year using the data from "Tabelog®". Forty-seven prefectures were classified by hierarchical cluster analysis into "prefecture clusters" 1 to 5 in descending order of the median of nonsmoking rates. The indices of population/household (e.g., percentage of the population aged 65 years and over and percentage of nuclear family household) and economy/labor (e.g., prefectural income per capita and percentage of construction and mining workers) were classified by hierarchical cluster analysis into 11 "index clusters", and the representative index in each index cluster was extracted from the results of the Jonckheere-Terpstra test. An ordinal logistic regression analysis was performed using the numbers 1 to 5 of prefecture clusters as dependent variables and the indices representing the index clusters as independent variables. RESULTS: The percentage of the population aged 65 years and over and the percentage of construction and mining workers were positively related to the order of prefectural clusters. CONCLUSIONS: To promote implementation of nonsmoking in eating and drinking establishments in prefectures especially in those with larger numbers of elderly people and construction and mining workers, it is important to inform the persons in charge that implementation of nonsmoking does not affect the number of customers.

[Factors influencing work continuation of cancer patients immediately after diagnosis].

OBJECTIVES: In recent years, efforts made by cancer patients to balance their work schedules and treatment regimens have gained increasing attention. Such workers tend to resign when diagnosed with cancer. A particularly prominent issue is that many of these employees resign immediately after diagnosis. This study aimed to clarify factors influencing continuation of employment from the period immediately after diagnosis up to the first treatment. METHODS: Study aims were explained to 68 employees, who were 20‒64 years and had received a definitive diagnosis of cancer in the last two years. After obtaining informed consent, structured interviews were conducted. RESULT: Informed consent was obtained from 61 patients, of which 60 (98.4%) wished to continue working after diagnosis. Of these 60 patients, 15 (25.0%) had not been working (including those on leave) and 45 (75.0%) had continued employment. The latter comprised the continuation group. There were no significant differences in attributes, company type and size, nor in employment status between the two groups. Subjects in the continuation group sought significantly more consultation for the questionnaire item "Disease, treatment, and symptoms," whereas significantly less consultation was sought for the item "Concerning expenses such as medical bills and living costs." The number of those who had disclosed their illness to colleagues was significantly higher in the continuation group, while the number of those hoping for a "Probationary period for returning to work" and complaining of "Prejudice and misunderstanding of cancer patient's continuation of work" was significantly smaller in the continuation group. The number of those who had undergone surgery and who received a score of 0 to 1 (light work acceptable) on the Eastern Cooperative Oncology Group performance status was significantly higher in the continuation group. As for other factors that had influenced subjects' decision to continue working or not, subjects described two situational attitudes: first, "Gratitude for understanding, consideration, and encouragement of superiors and colleagues" and second, "Impossibility of thinking about work immediately after diagnosis." CONCLUSION: Results revealed that continuation of work immediately after diagnosis was related to the stage of the patient's cancer, their general condition, and whether they had undergone surgery or not. Support from superiors and/or colleagues at the workplace was also beneficial. Medical staff should therefore provide patients with support in overcoming the crisis in which they feel the continuation of work immediately after diagnosis to be an impossibility, and to assist them in making an informed choice regarding their employment status.

The combination of obesity and high salt intake are associated with blood pressure elevation among healthy Japanese adolescents.

We examined the associations of obesity and high salt intake with blood pressure (BP) in a cross-sectional sample of 1679 healthy Japanese adolescents (827 females and 852 males) aged 12-18 years (mean age: 14.9 years) who had no history of treatment for hypertension, diabetes mellitus, or renal disease. Brachial arterial BP of the subject was measured at the left arm using a digital BP monitor with an appropriate cuff size. The weight status was evaluated by body mass index (BMI), and obesity was determined according to the age- and sex-specific cut-off values for adolescents. All subjects were interviewed by dietitians using a food frequency questionnaire to obtain data on their average daily salt intake. In the study subjects, obesity and high salt intake were associated with a significantly increased BP except for diastolic BP in females. In multiple regression analyses, both BMI (z-score) and salt intake were found to be major determinants of systolic BP and diastolic BP after adjustment for potential confounders, including age, sex, and serum lipid and glucose parameters. The association between salt intake and BP values was more pronounced among individuals with obesity than among those with normal weight. These results suggest that high salt intake is associated with BP elevation in healthy adolescents, and the association may become stronger by the presence or severity of obesity.

Health-promoting lifestyles of Japanese expatriates residing in the Philippines and Thailand.

BACKGROUND: The number of Japanese expatriates has increased, many of whom undertake lifestyle changes to improve their health. PURPOSE: We aim to clarify the health-promoting lifestyles of middle and older age Japanese expatriates. METHODS: This is a cross-sectional study. Participants comprised 95 long-term Japanese expatriates residing in popular destinations: the Philippines and Thailand. Health behavior was evaluated using a Japanese version of Health-Promoting Lifestyle Profile II and participants were compared with a group living in Japan. Multiple linear regression analyses were used to examine the factors that correlate with the score of physical activity, a Health-Promoting Lifestyle Profile II subscale. RESULTS: The expatriates had significantly higher scores of physical activity and nutrition than the group living in Japan. Factors positively related to physical activity were communicative literacy, information on health management before leaving Japan, no history of hypertension, and sufficient English proficiency. CONCLUSION: The Japanese expatriates we studied were physically active and were careful about nutrition. To further increase their physical activity, better access to health information and enhancement of communicative literacy and of English proficiency are desired.

[Association of the Status of Implementation of Nonsmoking at Eating and Drinking Establishments with Prevalence of Persons with Subjective Symptoms, Prevalence of Persons with Diseases under Treatment, Medical Expenses, and Mortality Rate: Examination Using Prefectural Data].

OBJECTIVES: The purpose of this study was to confirm the association of the status of implementation of nonsmoking at eating and drinking establishments with the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses, and mortality rate using prefectural data. METHODS: The prefectural rate of eating and drinking establishments implementing nonsmoking (hereafter, nonsmoking rate) was calculated using the data from "Tabelog®". The variables of interest were the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses (total, hospitalization and nonhospitalization expenses), and the mortality rates of malignant neoplasms (lung cancer, stomach cancer, and colon cancer), heart disease, acute myocardial infarction, cerebrovascular disease, cerebral infarction, and pneumonia in each prefecture. The partial correlation coefficient was estimated between the nonsmoking rate and the variable of interest using the smoking rate by prefectural as the control variable. RESULTS: The nonsmoking rate showed a significantly negative correlation with the medical expenses. When eating and drinking establishments were divided into "restaurant", "café", and "bar", the nonsmoking rate also indicated a significantly negative correlation with the medical expenses in any category. It was negatively related to the mortality rates of cerebrovascular disease, cerebral infarction, and pneumonia. The negative correlation was stronger in females than in males. CONCLUSIONS: These results suggest that the implementation of nonsmoking at eating and drinking establishments may reduce the mortality rates of diseases, such as cerebrovascular disease, cerebral infarction, and pneumonia, and medical expenses. Thus, it is important to implement nonsmoking at eating and drinking establishments in line with the Revised Health Promotion Act.

[Factors Related to Salt-Reduction Cognizance and Salt Intake in Women Aged 40-59 Years: Characteristics of Guardians of Medical University Students].

OBJECTIVES: In our previous study in which we aimed to clarify the factors related to salt intake in women aged 40-59 years, salt intake was found to be not related to salt-reduction cognizance. The aim of this research was to clarify factors related to salt intake in those who were cognizant of the importance of reducing their salt intake. METHODS: Two hundred and forty-seven female guardians (effective rate, 32.2%) in a medical university, aged 40-59 years old, participated in this study. The participants were divided into three groups according to their salt-reduction cognizance. RESULTS: There was no significant difference in salt intake between the three groups who were salt-reduction cognizant. Intakes of potassium (mg/1,000 kcal), vegetables, and fruits were higher in those who were cognizant of the importance of reducing their salt intake. The frequencies of consuming stewed foods, miso soup, and vinegared and marinated dishes were also higher. Those who were salt-reduction cognizant were knowledgeable about salt consumption, had experienced making low-salt dishes, used low-sodium seasoning, and made light-tasting dishes by regulating ingredients when cooking. However, when it came to eating, there was no difference in the percentage of those who left most of the broth when eating noodle soups and the frequency with which they added seasoning in terms of salt-reduction cognizance. CONCLUSION: Salt-reduction cognizant women aged 40-59 years made conscious efforts to use less salt at the time of cooking, but made no efforts when eating, even though they were cognizant of the importance of reducing their salt intake.

[The associations of Japan's specific medical checkup with a health promotion lifestyle, health literacy, and social capital by healthcare coverage type].

Objectives　The goal of this study was to determine whether experiencing Japan's specific medical checkup is associated with a health promotion lifestyle, health literacy (HL), and social capital (SC) by type of healthcare coverage.Methods　The subjects were 1,048 residents of A City aged 40 through 74 years. Individuals who had experienced more than one medical checkup during the past two years were categorized as "Consultation." Individuals without that experience were categorized as "No consultation." Data were collected via an anonymous self-administered mail questionnaire survey. Health promotion lifestyles were assessed using a Japanese version of the Health-Promoting Lifestyle Profile (HPLP II). HL was measured with the 14-item Health Literacy Scale. The SC was measured following Hanibuchi's six-item scale.Results　The response rates were 34.4% for males and 39.6% for females. Of the males covered by National Health Insurance (NHI), 68.8% were Consultation. Of the females covered by NHI, 79.4% were Consultation. Of the males covered by social insurance, 91.7% were Consultation, and 72.6% of the females covered by social insurance were Consultation. The consultation ratio of males covered by NHI was significantly lower among those without a co-residential spouse than among those living with a spouse. The physical activity score (a HPLP II subscale) of the females covered by NHI was significantly lower among those without compared to those with consultation. Among the males covered by social insurance, the nutrition score (a HPLP II subscale) was significantly higher among those without compared to those with consultation, and the number of neighbors providing companionship (an item in the SC scale) was larger. Among the females covered by social insurance, the health responsibility score (a HPLP II subscale) was significantly lower among those without than among those with consultation.Conclusion　There were significant relationships between experiencing more than one medical checkup during the past two years and health promotion lifestyles and between that experience and social capital, except for males covered by NHI. Policies based on these results are encouraged to increase participation in medical checkups. Regarding males covered by NHI, support of their participation in medical checkups by people close to them would be an effective way to increase participation.