Medical benefits for workmen under social insurance in Japan

Japan was the first Asian country to introduce social insurance measures and she has expanded them during the last few decades. The first social insurance law was passed in 1922 dealing with worker's health insurance in general. It was followed by many schemes of social insurance. National Health Insurance in 1938, Seamen's Insurance in 1939, Employees' Pension Insurance in 1941 and so forth. After World War II the new Constitution was enacted by which the Japanese Government was made responsible for the provision of medical care services for the whole nation. At present approximately the whole population is covered by either one or more of the various social insurance schemes. The main social insurance programs are shown in Figure 1 and Table 1. Most of these insurance schemes are compulsory under Japanese law. Since it would be too difficult and complicated to explain all of these forms of social insurance in detail, we will discuss only about two schemes directly related to medical care services for the workers; namely, the Health Insurance Scheme for non. occupational diseases and disorders (sickness or injury off the job) and Workmen's Compensation Insurance for occupational diseases and disorders (sickness or injury on the job).</p

A critical review of health services in Japan

Japan was the first Asian country to introduce social insurance measures and it has expanded them during the last few decades. The first social insurance law was passed in 1922, dealing with worker's health insurance, and it was followed by the National Health Insurance in 1938, Seamen's Insurance in 1939, and Employees' Pension Insurance in 1921. However, these were seldom widely available in actual practice because of the characteristics of public assistance which limited them to the poor.</p

Nursing practitioners' perception of inpatients' anxiety, self-esteem, purpose-in-life and health locus of control.

Nursing practitioners' perception of inpatients' anxiety, self-esteem, purpose-in-life and health locus of control.</p

Pathophysiology of reversible sudden deafness--epidemiological study.

Many aspects of the etiology and pathophysiology of reversible sudden deafness remain obscure. In order to better understand the pathophysiology of reversible sudden deafness we compared the results of two therapies which have different mechanisms of action. The results of therapy with tranexamic acid alone in 49 cases (57 ears) of sudden deafness were compared with the results of treatment with so-called antisludging agents in 65 cases (69 ears) using the chi square contingency test. The same therapeutic effect was observed in both groups despite the different modes of chemical action of the two therapeutics. A series of processes involving an increase in permeability of vascular walls and related edema, and extravascular red cell oozing due to hypoxia or anoxia leading to tissue damage in the inner ear seem to be important factors in the etiology and pathophysiology of reversible sudden deafness.</p

Helicobacter pylori infection: relationship between seroprevalence and dietary preference in a rural area.

In order to evaluate the relationship between Helicobacter pylori (H. pylori) infection and dietary preference, a cross-sectional study was performed among 626 residents in a rural area of Japan. Seropositive rates were 88.7% in males and 71.4% in females, and these increased with age for both sexes [male P &#60; 0.05 and female P &#60; 0.01]. The relationship between H. pylori-seropositivities and salted-food intake, after adjustment for age, demonstrated a significant result in the &#34;almost every day&#34; group in males with an odds ratio (OR) of 8.39 and with 95% confidence intervals (CI) of 1.02-69.30. As regards an association between seropositivities of H. pylori and levels of serum pepsinogens for the screening of chronic atrophic gastritis (low pepsinogen values used were a pepsinogen I level below 70 ng/ml and a pepsinogen I/pepsinogen II ratio below 3.0), the ORs of H. pylori-seropositivities for low pepsinogen cases were 6.32 [95% CI: 1.42-28.03] in males and 12.72 [95% CI: 4.57-35.46] in females. With regard to the relationship between low pepsinogen cases and light-colored vegetables intake, a significant low OR for the low pepsinogen cases was obtained in the &#34;almost every meal&#34; group in females after adjustment for age and seropositivities of H. pylori with an OR of 0.37 and with 95% CI of 0.15-0.92.</p

Women's anxiety in old age and long-term care provision for the elderly.

The purpose of this study was to verify the differences in women's anxiety in old age, the expected long-term care provision, and the expected final location for terminal care for the women themselves and for their parents. In addition, we examined factors that related to their anxiety and needs. The subjects were 1,000 women of the Seikatsu Club customer cooperative association in Chiba; 539 responded to our survey. The subjects were more anxious for their parents than for themselves. They more strongly expected long-term care for their parents to be provided by their family than they expected the same for themselves. Although no differences were observed in the expected location for terminal care, most subjects expected their home to be the terminal location. Analysis by the multiple logistic regression model indicated that the following factors were significantly related to the anxiety in old age: age odds ratio [OR = 1.81], employment [OR = 2.25] for women, and planning to live with parents [OR = 2.42], housing conditions [OR = 0.56] for parents. The following factors were significantly related to the expected long-term care provision: age [OR = 2.22] for women, and age [OR = 2.15], living with parents [OR = 3.58], and employment [OR = 2.33] for parents. Age [OR = 2.14] for women, and planning to live with parents [OR = 2.09] for parents were significantly related to the expected final location of terminal care. This survey showed that women expected long-term care for their parents to be provided by their family, while many expected public long-term care services for themselves. This is the biggest difference in women's outlook on long-term care for their parents and for themselves. Multivariate analysis suggested that women aged 40 years or over, who will need long-term care in the future, tended to expect public home care services for themselves. It is virtually certain that the demand for public home care services will increase in the future.</p

Training intensities for aerobic exercise determined on untrained healthy men.

The purpose of this study was to determine the aerobic training intensity from the maximal and submaximal running exercise in 21 untrained adult men. To accomplish this, we evaluated the relationship between physiological (oxygen intake and heart rate) and physical parameters (running speed) of training intensity, and determined the training intensity at the submaximal exercise. Oxygen intake and heart rate were measured by a treadmill test. The maximal oxygen intake (VO2 max), and the aerobic threshold (AerT) and anaerobic threshold (AT) were measured to determine respiratory gas exchange. Running capacity was measured by a 12-min running and treadmill test. For the maximal exercise, there was a significant correlation (r = 0.88, P &#60; 0.01) between VO2 max and 12-min running distance (speed). In addition, the oxygen intake and heart rate at AerT and AT in the submaximal exercise were linearly correlated with running speed. Three levels of training intensity at the submaximal exercise were termed: light, moderate, and heavy. Since AerT was the lower limit intensity and AT was the upper limit, we took the middle of their values as the moderate intensity. The end point for the determination of the training intensity at the submaximal exercise was estimated to be 85% VO2 max and 180 beats.min-1.</p

A review of the trend in facilities for health services in the community.

After the Second World War, the field of medicine has changed remarkably in Japan. A comprehensive health and medical care system has been organized to meet the increasing needs and demands for health and medical care services. Health centers have played an important role in promoting health care activities in the community. The authors describe the development of health centers and other health care facilities in Japan. The authors propose that it is necessary to build a new health facility specifically designed for public health nurse activities, termed a &#34;public health nurse station&#34;. The authors also describe the status of the health care facilities in service and the activities of the stations and evaluated them. It is concluded that the stations have brought many changes in the field of health and medical care; moreover that the station should not become a substitute for a health center but should be a facility for public health nurse activities in a community. Health centers should also play important roles for comprehensive medical services in the future.</p

Comparative analysis on the physique and batting records of the players in the National Summer High School Baseball Tournaments before and after the adoption of metal bats.

To clarify the influence of the introduction of metal bats on the physique and batting records of the players in the National Summer High School Baseball Tournaments, a comparative analysis was conducted between height, body weight, body-weight ratio (body weight/height), batting average and home run average of the best four teams' players (n = 493) and those of the other teams' players (n = 4,590) in three periods: the period of the use of wooden bats, that of the use of both wooden and metal bats and that of the use of metal bats. In the period of metal bat use, the mean values of physique of the best four teams' players were significantly larger (P &#60; 0.05) and their average number of home runs was significantly higher than those of the other teams' players (P &#60; 0.01). The only significant differences between the two groups in those indices for each time period were for height in the wood and metal/wood periods. This study demonstrated that the differences between the home run average and physique, including height, body weight and body-weight ratio of the best four teams and the rest of the teams were the greatest after the use of metal bats. These findings suggest that the importance of the home run average increased and was associated with large-size of physique after the use of metal bats in the National Summer High School Baseball Tournaments.</p

Relation between the instrumental activities of daily living and physical fitness tests in elderly women.

A cross-sectional study was conducted to quantitatively evaluate the relationship between the instrumental activities of daily living (IADL) and various physical fitness tests in elderly women living at home. The study focused on the total population of those women aged 65 years and over living in Y Town, Hyogo Prefecture, Japan, who visited a nursing home for day services. A total of 128 subjects were divided into two groups: dependent in IADL group (n = 49) and independent in IADL group (n = 79). The magnitude of the relation was evaluated by the odds ratio (OR). The following tests showed a significant decrease in IADL: knee-raising test [age-adjusted OR = 4.23, 95% confidence interval (CI) 1.81-9.87], height (age-adjusted OR = 4.09, 95% CI 1.75-9.56), grip strength (age-adjusted OR = 3.68, 95% CI 1.57-8.60), sit-and-reach test (age-adjusted OR = 2.76, 95% CI 1.20-6.34), and standing on one leg with closed eyes (age-adjusted OR = 2.56, 95% CI 1.09-5.97). Multivariate analysis using Hayashi's quantification method I indicated that knee-raising was the test most highly correlated with decreased IADL. These results suggest that measurement of knee-raising ability, muscle strength of the lower extremities and flexibility of hip joint could be the most useful factors to assess the level of instrumental self-support ability.</p