The Report on Toyama City Care Prevention Center in These 10 Years / 日本温泉気候物理医学会雑誌

  This center was established at its downtown in 2011. In order to either maintain or promote health-welfare status at the elderly life stage, the center has been providing regular physical exercise courses using hot spring water pumped up there. These activities have been performed cooperating with all 32 community general support centers covered whole the city.  Main findings and indication from our activities in these10 years were as follows:  1．Total number of attendants increased from around 60 to 90 thousands a year. About one fourth of them were the QOL (Quality of Life) tour member aged 65 years or more attending twice a week in every 3-month by the courtesy bus, and the others aged 40 years or more attended with their own ways.   The attendants aged 75 years or more has gradually increased to 70〜80% of QOL tour member. For the other member, it has been in 20〜30% these 10 years.  In addition to the physical exercise in 33〜36°C hot spring water consisted of walking, stretch & flex, aquatic exercise for joint-musculoskeletal pain and others, power-up rehabilitation, exercise for joint-musculoskeletal pain and others were performed on floor, too. The grade of these exercise consisted of 30, 40 and 50% of maximum heart rates depending on physical examination results of 5 m-walk, timed up & go test (TUG), the 30 seconds chair-stand test (CS30), hand grip, functional reach and posture forward bending, and doctors’ inspection.  2．On the follow-up of the physical examinations measured every 3-month, 5 m-walk, hand grip and CS30 were shown to be suitable items due to the availability as the routine examination. The results are substantially useful for reviewing each attendant status in longitudinal course, and indicate our treatments for them.  3．The attendants increased and distributed over the whole city in these 10 years. However, as the proportion of new ones is several percentages each year, the exchange of attendants was less than we expected. This indicates that we should have closer communication with community general support centers in order to distribute our activities to people who need health-welfare promotion, but have never been in the center. On top of that, the usage of our center should be increased for people of middle ages for ideal prevention.

The Report on Toyama City Care Prevention Center in These 10 Years / 日本温泉気候物理医学会雑誌

  This center was established at its downtown in 2011. In order to either maintain or promote health-welfare status at the elderly life stage, the center has been providing regular physical exercise courses using hot spring water pumped up there. These activities have been performed cooperating with all 32 community general support centers covered whole the city.  Main findings and indication from our activities in these10 years were as follows:  1．Total number of attendants increased from around 60 to 90 thousands a year. About one fourth of them were the QOL (Quality of Life) tour member aged 65 years or more attending twice a week in every 3-month by the courtesy bus, and the others aged 40 years or more attended with their own ways.   The attendants aged 75 years or more has gradually increased to 70〜80% of QOL tour member. For the other member, it has been in 20〜30% these 10 years.  In addition to the physical exercise in 33〜36°C hot spring water consisted of walking, stretch & flex, aquatic exercise for joint-musculoskeletal pain and others, power-up rehabilitation, exercise for joint-musculoskeletal pain and others were performed on floor, too. The grade of these exercise consisted of 30, 40 and 50% of maximum heart rates depending on physical examination results of 5 m-walk, timed up & go test (TUG), the 30 seconds chair-stand test (CS30), hand grip, functional reach and posture forward bending, and doctors’ inspection.  2．On the follow-up of the physical examinations measured every 3-month, 5 m-walk, hand grip and CS30 were shown to be suitable items due to the availability as the routine examination. The results are substantially useful for reviewing each attendant status in longitudinal course, and indicate our treatments for them.  3．The attendants increased and distributed over the whole city in these 10 years. However, as the proportion of new ones is several percentages each year, the exchange of attendants was less than we expected. This indicates that we should have closer communication with community general support centers in order to distribute our activities to people who need health-welfare promotion, but have never been in the center. On top of that, the usage of our center should be increased for people of middle ages for ideal prevention.

Balneotherapy in Combination with Other Therapies / 日本温泉気候物理医学会雑誌

  The studies on the effects of balneotherapy in combination with other therapies (kinesitherapy, bath agents, diet therapy, pharmaceutical therapy, climatotherapy and phototherapy, and multiple therapies) published in past two decades have been reviewed. The effects of the combined baleotherapies on diabetes, rheumatoid arthritis, osteoarthritis, psoriasis vulgaris, atopic dermatitis, ankylosing spondylitis, stiff neck, chronic back pain, peripheral circulatory failure, emphysema, bronchial asthma, and fibromyalgia syndrome have been suggested or evidenced. The health promotion effects of combined balneotherapies among healthy or ill-healthy persons have also been showed.

Interprefectural inequalities in the population-adjusted numbers of newly employed medical residents / 医学教育

1) The number of newly employed medical residents per 100,000 persons and Gini coefficients were calculated using 2005 census data and the numbers of newly employed medical residents from 2003 through 2008.2) The maximum/minimum number of medical residents per 100,000 persons decreased from 9.3 in 2003 to 3.6 to 4.7 from 2004 through 2008. Gini coefficients also decreased from 0.21 in 2003 to 0.17 to 0.19 from 2004 through 2008.3) The interprefectural inequality was large before the introduction of the new system but decreased slightly after its introduction.

Nested case-control study on associations between lung function, smoking and mortality in Japanese population

<p><b>OBJECTIVES</b>Only a few long-term follow-up studies with a focus on the association between lung function and mortality in the Japanese population have been undertaken. In this study, we examined the associations of lung function, smoking and the results of allergy skin tests with mortality in a longitudinal study of the Japanese population.</p><p><b>METHODS</b>Baseline measurements were performed on residents of Fukui, Japan in 1972, and a follow-up survey was conducted in 2002. By employing a nested case-control design, 596 cases (deaths) and 596 age and sex-matched controls (survivals) were selected. Lung function was assessed using forced vital capacity (FVC) expressed as the normal percent predicted (FVC %pred) and the ratio of forced expiratory volume in 1 second (FEV(1)) to FVC (FEV(1)/FVC). Allergy skin tests were performed with extracts of house dust, candidia and mixed fungal samples (bronchomycosis). The Brinkman index was used to assess smoking intensity. The Cox proportional hazards model was used to evaluate whether lung function was associated with mortality after adjustment for other potential confounding variables.</p><p><b>RESULTS</b>Those categorized into the first- or second-lowest quartile of FVC %pred had a higher mortality [hazard ratios (HRs) and 95% confidence intervals (CIs): 2.01 (1.26-3.19) and 1.84 (1.11-3.05)], respectively. On top of these, heavy smoking (BI≥400) was associated with a higher mortality [HR and 95% CI: 1.73 (1.18-2.53)]. There were only weak of associations between the results of allergy skin tests and mortality.</p><p><b>CONCLUSIONS</b>These results suggest that FVC %pred of lung function and smoking can serve as long-term independent predictors of mortality.</p>

Studies on the Relationship Between Core Body Temperature Measured by an Ingestible Capsule Sensor and Daily Living Activities with Special Reference to Exercise, Bath and Sleep / 日本温泉気候物理医学会雑誌

In recent times, an ingestible capsule sensor for the measurement of core body temperature has become available. This equipment was used to measure the relationship between core body temperature and daily living activities such as eating, exercise and bathing etc.<br>The main findings were as followings:<br>1. With respect to daily living activities, the core body temperature during bathing showed higher values in comparison with eating and light-grade exercise etc.<br>2. For the same-grade of exercise (HRmax60%) either in an environmentally controlled room at either constant temperature (25°C) and humidity (50%) or in water (36°C; 50%humidity), the core body temperature showed almost identical changes for peak value and the rise and fall ever time.<br>3. Atypical work at midnight was associated with a continuous decrease in core body temperature.<br>4. Atypical sleep in the daytime was associated with a continuous decrease in core body temperature.<br>5. For daily living activities inducing an increase in core body temperature, the correlation coefficient between core body temperature and heart beats/min was 0.87 (p<0.01).

Nested Case-Control Study on Associations between Lung Function, Smoking and Mortality in Japanese Population

Objectives: Only a few long-term follow-up studies with a focus on the association between lung function and mortality in the Japanese population have been undertaken. In this study, we examined the associations of lung function, smoking and the results of allergy skin tests with mortality in a longitudinal study of the Japanese population. Methods: Baseline measurements were performed on residents of Fukui, Japan in 1972, and a follow-up survey was conducted in 2002. By employing a nested case-control design, 596 cases (deaths) and 596 age and sex-matched controls (survivals) were selected. Lung function was assessed using forced vital capacity (FVC) expressed as the normal percent predicted (FVC %pred) and the ratio of forced expiratory volume in 1 second (FEV1) to FVC (FEV1/FVC). Allergy skin tests were performed with extracts of house dust, candidia and mixed fungal samples (bronchomycosis). The Brinkman index was used to assess smoking intensity. The Cox proportional hazards model was used to evaluate whether lung function was associated with mortality after adjustment for other potential confounding variables. Results: Those categorized into the first- or second-lowest quartile of FVC %pred had a higher mortality [hazard ratios (HRs) and 95% confidence intervals (CIs): 2.01 (1.26−3.19) and 1.84 (1.11−3.05)], respectively. On top of these, heavy smoking (BI≥400) was associated with a higher mortality [HR and 95%CI: 1.73 (1.18−2.53)]. There were only weak of associations between the results of allergy skin tests and mortality. Conclusions: These results suggest that FVC %pred of lung function and smoking can serve as long-term independent predictors of mortality.

Epidemiological aspects of self-reported sleep onset latency in Japanese junior high school children.

The purpose of this study was to investigate the relationships between sleep onset latency (SOL) and other sleep-wake patterns and media use habits in Japanese schoolchildren. A total of 9,718 junior high school children responded (12.8 years) and 9199 questionnaires were used in the present analyses. The questionnaire assessed sleep-wake patterns, TV viewing and videogame habits. Overall, 72.1% of the subjects reported short SOL (20 min) were strongly associated with disturbed sleep manifested especially by increased risk of night awakenings, decreased sleep depth, and bad sleep in general (overall sleep quality). Prolonged SOL was also associated with daytime sleepiness, difficulties in falling asleep, bad morning feeling and sleep insufficiency. We found a U-shaped relationship between sleep period and SOL. Increase in bedtime was accompanied by increased risk of prolonged SOL. The impact of ultra-short and ultra-long SOL (or=40 min) was also analysed. Long durations of watching television and playing videogame were significantly associated with prolonged SOL. After adjustment for sex, girls presented significantly higher risk of prolonged SOL. Body mass index adjustment did not reveal any significant results. SOL presents a significant component of sleep-wake habits; poor sleep hygiene and insufficient sleep time significantly increase SOL. Parents, healthcare practitioners and children themselves should be aware of the potentially negative influence of prolonged SOL. Additionally, the optimal coherent sleep-wake schedule must be promoted in parallel with the limitation on the viewing TV and game practices.

Body image, body satisfaction and dieting behavior in Japanese preadolescents: The Toyama birth cohort study

<p><b>OBJECTIVES</b>To examine the relationships between body image, body satisfaction and dieting behavior in the context of pubertal changes in Japanese preadolescents.</p><p><b>METHODS</b>A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12-13) born in Toyama prefecture.</p><p><b>RESULTS</b>The percentages of those who perceived themselves fat, wanted to be thinner, and had tried dieting, which increased with body mass index (BMI), were significantly higher in girls than in boys (34.2% vs. 20.0%, 58.0% vs. 26.0%, and 17.3% vs. 5.7%, respectively). Independent of sex and BMI, those who wanted to be thinner and those who had tried dieting were more frequently observed in those who perceived themselves fat, and those who had tried dieting were more frequently observed in those who wanted to be thinner. Pubertal changes were significantly associated with dieting behavior, but their relationships to body image and body satisfaction differed between sexes; for boys, those who perceived themselves fat were more frequently observed in those without pubertal changes; whereas for girls, those who wanted to be thinner were more frequently observed in those with pubertal changes.</p><p><b>CONCLUSIONS</b>Dieting behavior of Japanese preadolescents was associated with whether they perceived themselves fat and wanted to be thinner, sometimes independent of whether they were actually overweight. Pubertal changes might induce a positive perspective of growing fat among boys and a desire to be thinner among girls, with the consequence that dieting behavior would be reinforced in those with pubertal changes.</p>

Attenuation of Early Morning Surge in Blood Pressure with Special Reference to Bedroom Temperature / 日本温泉気候物理医学会雑誌

<b>Objective</b>:<br>A rapid rise in blood pressure (BP) in the early morning is called morning BP surge and is known to be related to the onset of cerebrovascular or cardiovascular diseases. Exposure to cold temperature aggravates this condition. However, few studies have investigated the relationship between morning BP surge and bedroom temperature (BT). This study examined the effectiveness of a comfortable BT for mitigating morning BP surge.<br><b>Methods</b>:<br>In this study, five healthy male university students (22.8±0.4 years old with BMI 21.7±1.3Kg/m²) volunteered to be subjects. The relative humidity in the bedroom was controlled to 50%, and the BT was set at 10°C and 250°C for two test conditions. From 0:00 to 8:00am, a Portapres Model-2 was used to measure BP continually at each beat. The average BP and heart rate (HR) from 2:00 and 4:00am were used as the baseline BP and HR. The changing rates of BP and HR from 4:00 to 7:30, the time and the BP value when BP started to rise, the time and the BP value when the BP reached the maximum, the BP value at the time of waking, and the time and rate of increase of BP until it reached the peak at temperatures of 10°C and 25°C were compared by means of the Wilcoxon signed ranking test.<br><b>Results</b>:<br>The BP before waking started to rise later at 25°C than that at 10°C. BP rose more slowly at the higher BT than at the lower BT, especially 30 minutes after waking. At the lower BT, BP rose almost linearly, and the maximum rising rates were 37% (153.3mmHg) for systolic BP and 54% (97.6mmHg) for diastolic BP. At the higher BT of 25°C, however, BP reached the first peaks about 20 minutes after waking/getting up, and then remained stable. The maximum rising rate was 30% (14.2mmHg) for systolic BP and 33% (86.5mmHg) for diastolic BP. At the higher BT, BP reached the maximum value 40 minutes later for systolic BP and 60 minutes later for diastolic BP. At the lower BT, systolic BP exceeded the normal range, reached 140mmHg 35 minutes after getting up, remained stable for 55 minutes, and then rose to the maximum value of 153.3mmHg. In contrast, at the higher BT, the first peak of BP was significantly lower than that at the lower BT. Furthermore, the differences in BP between the first peak of BP and the BP value at the time of staring to rise and between the first peaks and the BP value at the time of waking up were significantly lower at the higher BT than those at the lower BT. The rising rates of BP from the time when BP started to rise and from the time of waking until reaching the maximum value were significantly lower at the higher BT than those at the lower BT.<br><b>Conclusions</b>:<br>These results suggest that the margin of the rise in BP, the rising rate of BP, and the peak value of BP in the early morning are significantly lower at a BT of 25°C than those at a BT of 10°C. They also suggest that sleeping at a comfortable BT, especially during winter, may suppress morning hypertension or morning BP surge and indirectly prevent the onset of cerebrovascular and cardiovascular disease as well as related deaths. Although the subjects in this study were healthy young men, it was considered that the benefit of sleeping in warm bedroom for preventing morning BP surge may be increased for the elderly who are highly likely to have already suffered from such underlying diseases as hypertension.

Health Effects of Spa with Special Reference to It's Chemical Content / 日本温泉気候物理医学会雑誌

In Japan, balneotherapy is now on fashion as one of complementary therapies. Nevertheless, in the ageing society, we are facing to needs in relation to evidence-based health care on every direction. This paper reviews current articles on the use of balneotherapy in health care.<br>We made a systematic review on related articles in the Medline and Cochrane Library database from 1966 to 2005 that included randomized controlled and non-randomized clinical trials using balneotherapy. We also tried to classify spas in determining the chemical composition and their health effects. Ten kinds of spas (acidic, salty, sulfur, magnesium, carbon dioxide, arsenical-ferruginose, selenium, radon, sulfate, bicarbonate) were classified, and three disorders such as skin, joint/muscleskelton and circulatory system have been mainly treated by balneothrapy. In half of articles, randomized controlled trial appeared as the comparative method.<br>In future, certain developed methods are requested to investigate effects of spas consisting of huge diversity of chemical content.

Does the Hot Spring Contribute to the Active Life Expectancy?-The 3 years follow-up survey in the J town which commenced health promotion facilities using hot spring- / 日本温泉気候物理医学会雑誌

In the town which commenced health promotion facilities using hot spring in May, 2000, how the utilization frequency influences afterwards health status and active life expectancy, was investigated by the follow-up study.<br>The research subjects were all inhabitants aged 40 or more years living in J town with about 10, 000 inhabitants in Toyama Prefecture, Japan. The cooperation request of the survey was carried out to women's association, when the survey was performed in December, 2000.<br>With regard to the entry survey, the answers of 5, 812 (95.0%)of the 6, 117 registered inhabitants were collected. They were served to the follow-up survey on (1) death, (2) bone fracture, (3) cerebral apoplexy, (4) senile dementia, (5) welfare facilities entrance, (6) long term admission beyond 6 months, (7) bed bound, (8) diabetes mellitus from April, 2001 to March, 2004. The sex-age matched control was randomly selected from the inhabitants participated in the entry survey for case-control study.<br>As the result, the occurrence rates of (1) death and (2) bone fracture were significantly lower in the group with twice or more utilization of the hot spring per year compared with the group utilizing once or less per year, and (3) cerebral apoplexy showed the slightly significant relationship, even after adjusting with exercise habit and WHO-QOL of confounding factors. The other events were not significantly associated with frequency of hot spring utilization.<br>It has been indicated that health promotion facilities using hot spring could contribute to active life expectancy via health and welfare promotion.

Review on Japanese Articles of Spa's Health Promotion Effects in past 20 Years / 日本温泉気候物理医学会雑誌

The studies on spa's health promotion effects on healthy or slightly unhealthy persons published in past two decades in Japan have been reviewed. Multidimensional findings from these studies have suggested that the spa resort using may have the effects of increasing and retention of skin and body temperature, improving peripheral circulation function, lowering blood pressure, improving gastrointestinal hormones secretion and increasing gastric mucosal blood flow, bettering metabolism, regulating the function of immune system, regulating the balance of autonomous nervous and internal secretion systems, relieving stress and relaxing, improving the quality of life (QOL), relieving the symptoms of those who are slightly unhealthy, promoting physical strength and fitness, promoting the well-being of the aged, reducing medical expenses of individuals or the community, keeping skin in good shape and restraining the skin's aging.<br>Of the 58 papers reviewed, the studies of hot spring bathing effects on increasing and retention of skin and body temperature, improving peripheral circulation function and lowering blood pressure were the most in numbers (12 papers, 20.7%), and then the studies of relieving the symptoms of those who were slightly unhealthy (10 papers, 17.2%). Case-control studies (26 papers, 44.8%) were the most used study designs, and then the clinical observation (20 papers, 34.5%). No findings from any one study reviewed in this paper showed that the spa resort using had definite evidence of health promotion effects. Probable effects were suggested from 32 studies (55.2%), but findings from the rest ones (26 papers, 44.8%) showed little evidence to support this consideration. Recently randomized controlled trials (RCT) had been used in studying the health effects of spa resort using in Japan and showed significantly better effects in the intervention group. However, the intervention methods used in the studies were comprehensive health education combing the instructions in appropriate ways of hot spring bathing and education on lifestyle and exercise. It was difficult, if not impossible, to separate the effect of hot spring bathing alone from the combination. The outcomes as effects used in the studies were blood profile, physique and other non-specific items. It may be also difficult to design and carry out a near perfect RCT study on the health promotion effects of spa resort using in field in the future. However, based on experience from past studies it is practicable and important to purse better epidemiological methods such as randomizing and crossover design. On the other side, as specific readers can be influenced marvelously by one book, the health conditions of users may be improved greatly and continuously by some spa. While evidence-based health care places emphasis on RCT, it is also extremely important to inspect the health promotion effects of spa using systematically and rapidly from the viewpoint of narrative-based health care.

Body Image, Body Satisfaction and Dieting Behavior in Japanese Preadolescents: The Toyama Birth Cohort Study

Objectives: To examine the relationships between body image, body satisfaction and dieting behavior in the context of pubertal changes in Japanese preadolescents. Methods: A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12–13) born in Toyama prefecture. Results: The percentages of those who perceived themselves fat, wanted to be thinner, and had tried dieting, which increased with body mass index (BMI), were significantly higher in girls than in boys (34.2% vs. 20.0%, 58.0% vs. 26.0%, and 17.3% vs. 5.7%, respectively). Independent of sex and BMI, those who wanted to be thinner and those who had tried dieting were more frequently observed in those who perceived themselves fat, and those who had tried dieting were more frequently observed in those who wanted to be thinner. Pubertal changes were significantly associated with dieting behavior, but their relationships to body image and body satisfaction differed between sexes; for boys, those who perceived themselves fat were more frequently observed in those without pubertal changes; whereas for girls, those who wanted to be thinner were more frequently observed in those with pubertal changes. Conclusions: Dieting behavior of Japanese preadolescents was associated with whether they perceived themselves fat and wanted to be thinner, sometimes independent of whether they were actually overweight. Pubertal changes might induce a positive perspective of growing fat among boys and a desire to be thinner among girls, with the consequence that dieting behavior would be reinforced in those with pubertal changes.

Studies on Safe Bathing Based on the Measurement of Cerebral Hemodynamics during Bathing / 日本温泉気候物理医学会雑誌

Frequently occurred sudden deaths in the bath have become to serious problem in Japan. Sudden death in the bath possibly concerned with neurally mediated syncope. During and after bathing, bather is possibly tended to occur orthostatic intolerance by thermal stress to the circulatory dynamics. The experiment was performed focused on changes in cerebral and cardiovascular hemodynamics by postural change in the bathing to discuss the safe way of bathing.<br>On 9 healthy young subjects, 41±1°C bathing was performed 15 minutes, change in oxidized hemoglobin (ΔOxyHb) on the forehead as an indicator of cerebral blood flow was monitored by near-infrared spectroscopy method at interval of 0.5s through the experiment. In sitting and upright position, blood pressure and heart rate were measured before bathing, at 5 minutes, 10 minutes and 15 minutes (upright with head down) after immersion and after bathing.<br>Some subjects felt dizziness at upright during and/or after bathing. It suggests that orthostatic stress under heat stress is implicative even for healthy young. ΔOxyHb for subjects with dizziness at upright during bathing is significant lower below the baseline than it for subject without dizziness.<br>Degrees of depression of systolic blood pressure, elevation of heart rate and depression of cerebral blood flow by standing at 10 minutes after starting immersion were significant larger than their values before bathing. Degree of elevation of heart rate and depression of cerebral blood flow by standing with head down were significant smaller than their value at standing without head down. It suggests that upright with head down reduce the orthostatic stress to the cerebral and cardiovascular hemodynamics.

Effect of moderate alcohol intake on nocturnal sleep respiratory parameters in healthy middle-aged men

<p><b>PURPOSE</b>It is known that a moderate to large volume of alcohol produces deterioration in obstructive sleep apnea (OSA), however, no consensus has been achieved with respect to the influence of a moderate volume of alcohol on mild to moderate OSA. In this study, we investigated the influence of alcohol on OSA-associated parameters in healthy middle-aged males drinking a moderate volume of alcohol (<1 g alcohol/kg bodyweight per day).</p><p><b>METHODS</b>Subjects were 23 healthy males (mean age of 46.0) with a habitual ingestion of moderate a mounts of alcohol. Respiratory sleep parameters were measured through the fitting of an Apnomonitor III (Chest Inc.) and portable sleep monitoring device (Actiwatch: AMI Inc.) to subjects on three nights; an alcohol-free night, a night on which they drank alcohol with dinner, and a night on which they drank alcohol within 30 minutes before retiring to bed. The measurements were categorized into the early and late halves of assumed sleep for analysis.</p><p><b>RESULTS</b>The apnea-hypopnea index was significantly higher when drinking alcohol before retiring [mean (SD): 7.8 (8.2) events/hour] than the values on the alcohol-free day [2.9 (4.5) events/hour] and when drinking alcohol with dinner [3.8 (5.3) events/hour]. Furthermore, drinking alcohol before retiring resulted in lower arterial blood oxygen saturation (SpO(2)) during the early half of sleep [94.8 (1.4) %] when compared to the values on the alcohol-free day [95.7 (1.3) %] and drinking alcohol with dinner [95.4 (1.6) %]. In addition, the percentage of time with SpO(2)<92% (hypoxic event) during the early half of sleep [4.9 (9.3) %] was significantly higher than the values on the alcohol-free day [1.2 (1.8) %] and when drinking alcohol with dinner [1.4 (1.8) %].</p><p><b>CONCLUSION</b>These results suggest that moderate ingestion of alcohol within 30 minutes before retiring aggravates OSA-associated parameters in healthy males.</p>

Balneotherapy in medicine: A review

Bathing in water (balneotherapy or spa therapy) has been frequently and widely used in classical medicine as a cure for diseases. This paper reviews the present literature on the use of balneotherapy in dermatologic, chronic musculoskeletal (inflammatory and non-inflammatory), metabolic and psychological conditions.We performed a systematic review on related papers appearing in the Medline and Cochrane Library database from 1966 to 2003 that included randomized controlled and non-randomized clinical trials using balneotherapy. We also determined to reflect where possible the chemical compositions of spas.The major dermatologic and musculoskeletal diseases that are frequently treated by balneotherapy with a remarkable rate of success are atopic dermatitis, psoriasis, rheumatoid arthritis (RA), ankylosing spondylitis, osteoarthritis and low back pain. Moreover, the effects of spa therapy on several metabolic conditions are discussed. The mechanisms by which broad spectrums of diseases respond to spa therapy probably incorporate chemical, thermal and mechanical effects.The importance of balneotherapy either alone or as complement to other therapies should be considered after, or accompanying, orthodox medical treatments.

Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents: The Toyama birth cohort study

<p><b>OBJECTIVES</b>To analyze the path to dieting behavior in Japanese preadolescents.</p><p><b>METHODS</b>A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12-13) born in Toyama prefecture.</p><p><b>RESULTS</b>While increasing with body mass index (BMI), the percentage of those who had tried dieting was higher in those who perceived themselves fat than in those who perceived themselves thin or average. Of those who wanted to be thinner, 16.1% of boys and 26.8% of girls had tried dieting. Path analysis in nonobese subjects (2,116 boys and 2,334 girls) showed that (1) body image was primarily based on BMI, (2) body image led to body dissatisfaction, and (3) body dissatisfaction led to dieting behavior. Pubertal changes had a significant effect on body image (path coefficient <0)for boys and body satisfaction (path coefficient >0) for girls, in addition to that on BMI. Maternal BMI had a significant effect on BMI but not on body image, body satisfaction, or dieting behavior.</p><p><b>CONCLUSIONS</b>Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents. Pubertal changes may reinforce dieting behavior, but the mechanism may differ by sex.</p>

Body Image and Body Satisfaction Play Important Roles in the Path to Dieting Behavior in Japanese Preadolescents: The Toyama Birth Cohort Study

Objectives: To analyze the path to dieting behavior in Japanese preadolescents. Methods: A cross-sectional study of dieting behavior among 5,244 preadolescents (2,452 boys and 2,792 girls aged 12-13) born in Toyama prefecture. Results: While increasing with body mass index (BMI), the percentage of those who had tried dieting was higher in those who perceived themselves fat than in those who perceived themselves thin or average. Of those who wanted to be thinner, 16.1% of boys and 26.8% of girls had tried dieting. Path analysis in nonobese subjects (2,116 boys and 2,334 girls) showed that (1) body image was primarily based on BMI, (2) body image led to body dissatisfaction, and (3) body dissatisfaction led to dieting behavior. Pubertal changes had a significant effect on body image (path coefficient <0) for boys and body satisfaction (path coefficient >0) for girls, in addition to that on BMI. Maternal BMI had a significant effect on BMI but not on body image, body satisfaction, or dieting behavior. Conclusions: Body image and body satisfaction play important roles in the path to dieting behavior in Japanese preadolescents. Pubertal changes may reinforce dieting behavior, but the mechanism may differ by sex.

Balneotherapy in Medicine: A Review

Bathing in water (balneotherapy or spa therapy) has been frequently and widely used in classical medicine as a cure for diseases. This paper reviews the present literature on the use of balneotherapy in dermatologic, chronic musculoskeletal (inflammatory and non-inflammatory), metabolic and psychological conditions. We performed a systematic review on related papers appearing in the Medline and Cochrane Library database from 1966 to 2003 that included randomized controlled and non-randomized clinical trials using balneotherapy. We also determined to reflect where possible the chemical compositions of spas. The major dermatologic and musculoskeletal diseases that are frequently treated by balneotherapy with a remarkable rate of success are atopic dermatitis, psoriasis, rheumatoid arthritis (RA), ankylosing spondylitis, osteoarthritis and low back pain. Moreover, the effects of spa therapy on several metabolic conditions are discussed. The mechanisms by which broad spectrums of diseases respond to spa therapy probably incorporate chemical, thermal and mechanical effects. The importance of balneotherapy either alone or as complement to other therapies should be considered after, or accompanying, orthodox medical treatments.