Trend in maternal-child health services

In Japan, outcome measures for maternal and child health measures such as maternal, perinatal, and infant mortality have consistently shown a trend toward improvement. On the other hand, the problems of the declining birth rate, child abuse, and domestic violence have become evident since the 1990s. In terms of Japan’s maternal and child health, it is necessary to take measures to preserve mental health of mothers and children, and also to respond to family issues such as abuse and violence. The services needed such as comprehensive support centers for families with children and new postpartum care programs have been established. It is necessary to further improve the competence of doctors, public health nurses, and midwives working in the maternal and child health field and to promptly construct a cooperation system in the community

Nanometer-thin TiO2 enhances skeletal muscle cell phenotype and behavior

Ken Ishizaki*, Yoshihiko Sugita*, Fuminori Iwasa, Hajime Minamikawa, Takeshi Ueno, Masahiro Yamada, Takeo Suzuki, Takahiro OgawaLaboratory for Bone and Implant Sciences, The Jane and Jerry Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, UCLA School of Dentistry, Los Angeles, CA, USA*Authors contributed equally to this workBackground: The independent role of the surface chemistry of titanium in determining its biological properties is yet to be determined. Although titanium implants are often in contact with muscle tissue, the interaction of muscle cells with titanium is largely unknown. This study tested the hypotheses that the surface chemistry of clinically established microroughened titanium surfaces could be controllably varied by coating with a minimally thin layer of TiO2 (ideally pico-to-nanometer in thickness) without altering the existing topographical and roughness features, and that the change in superficial chemistry of titanium is effective in improving the biological properties of titanium.Methods and results: Acid-etched microroughened titanium surfaces were coated with TiO2 using slow-rate sputter deposition of molten TiO2 nanoparticles. A TiO2 coating of 300 pm to 6.3 nm increased the surface oxygen on the titanium substrates in a controllable manner, but did not alter the existing microscale architecture and roughness of the substrates. Cells derived from rat skeletal muscles showed increased attachment, spread, adhesion strength, proliferation, gene expression, and collagen production at the initial and early stage of culture on 6.3 nm thick TiO2-coated microroughened titanium surfaces compared with uncoated titanium surfaces.Conclusion: Using an exemplary slow-rate sputter deposition technique of molten TiO2 nanoparticles, this study demonstrated that titanium substrates, even with microscale roughness, can be sufficiently chemically modified to enhance their biological properties without altering the existing microscale morphology. The controllable and exclusive chemical modification technique presented in this study may open a new avenue for surface modifications of titanium-based biomaterials for better cell and tissue affinity and reaction.Keywords: nanotechnology, orthopedic implants, molten TiO2 nanoparticles, surface chemistr

The Association between Utilization of Media Information and Current Health Anxiety Among the Fukushima Daiichi Nuclear Disaster Evacuees

The 2011 nuclear disaster in Fukushima was not only a health disaster, but also an information disaster. Although media can promote health communication following disasters, studies have revealed associations between media information and negative psychological reactions. To clarify the relationship between media utilization and current health anxiety due to radiation exposure, a cross-sectional questionnaire survey was conducted in Fukushima. We selected 2000 subjects from evacuation (i.e., 500) and non-evacuation (i.e., 1500) areas by two-stage stratified random sampling. As the independent variable, participants were asked about current health anxiety due to radiation exposure at the time of answering the questionnaire. For utilization of media about radiation exposure, local media, national media, Internet media, public broadcasts, and public relations information from local government were set as the dependent variables. Questionnaire data were analyzed by evacuation type (i.e., forced/voluntary). In a multivariate logistic regression analysis, the use of public relations information was significantly associated with lower anxiety for the forced evacuees (odds ratio: 0.72; 95% confidence interval: 0.56–0.93). Our findings highlight the importance of public relations information from local government in terms of it being associated with lower current health anxiety, and this could potentially aid in preparing for future disasters

Socioeconomic status, damage-related conditions, and PTSD following the Fukushima-daiichi nuclear power plant accident:The Fukushima Health Management Survey

The Great East Japan Earthquake severely damaged the Tohoku and Kanto districts, and Fukushima Prefecture faced a subsequent nuclear disaster. Few studies have reported the effects of socioeconomic stressors on individuals' mental status following disasters. We analyzed the responses of 60,704 adult residents of a designated restricted area to the PTSD Checklist-Stressor-Specific Version (PCL-S). The relationships between the PCL-S scores and demographic, socioeconomic, and damage-related variables were analyzed using regression analysis to predict participants' severity of PTSD symptoms. Approximately 14.1% of evacuees had severe PTSD symptoms (PCL-S ≥50) eighteen months post-earthquake. The PCL-S scores were higher among women, older adults, less educated people, those with a history of mental illness, and those living outside Fukushima Prefecture. The PCL-S scores increased with participants' scores on the Kessler Psychological Distress Scale. The number of trauma-exposure stressors and socioeconomic stressors were associated with 1.52 and 3.77 increases in the PCL-S score, respectively. Furthermore, psychological distress, unemployment, decreased income, house damage, tsunami experience, nuclear power plant accident experience, and loss of someone close due to the disaster were associated with the prevalence of severe PTSD symptoms. The complex triple disaster of a major earthquake, tsunami, and nuclear accident created significant socioeconomic changes that may be important determinants of PTSD among residents of restricted access areas in Fukushima

The association between self-reported sleep dissatisfaction after the Great East Japan Earthquake, and a deteriorated socioeconomic status in the evacuation area: the Fukushima Health Management Survey

Background: Currently, few studies have thoroughly investigated the socioeconomic factors related to sleep problems among evacuees following a disaster. Objectives: To examine sleep problems in evacuees using data from a large-scale cohort survey of evacuees conducted after the 2011 Great East Japan Earthquake (GEJE). Methods: In sum, 73,433 residents who were living in evacuation zones responded to The 2011 Fukushima Health Management Survey. We excluded 16,659 participants who did not answer the question about sleep problems or those younger than 20 years. Thus, data from 56,774 participants (24,959 men and 31,815 women) were used for this analysis. Evacuees' self-reported sleep dissatisfaction was determined based on their response to the question 'Are you satisfied with the quality of your sleep? '. The response options 'Unsatisfied' and 'Very unsatisfied' were considered as the outcome for the present study. Prevalence ratios (PRs) and 95% confidence intervals (CIs) for the prevalence of self-reported sleep disturbance were estimated using modified Poisson regression models. Results: Of the qualifying survey respondents, 20.3% (4387 men and 7128 women) reported sleep dissatisfaction. Compared with participants living in their own or a relative's home (PR = 1), those living in temporary housing or rental accommodation had a higher prevalence of sleep dissatisfaction (1.47; 95% CI 1.44-1.50 and 2.16; 95% CI 2.07-2.26 in men; 1.39; 95% CI 1.36-1.41 and 1.92; 95% CI 1.86-1.99 in women). Higher educational attainment was also associated with a higher prevalence of sleep dissatisfaction in men, as were job loss and decreased income in both men and women. Conclusion: Self-reported sleep dissatisfaction after the GEJE was associated with a deteriorated socioeconomic status among evacuees. However, future longitudinal studies are warranted

Ifugao males, learning and teaching for the improvement of maternal and child health status in the Philippines: an evaluation of a program

<p>Abstract</p> <p>Background</p> <p>Improving Maternal and Child Health (MCH) is a prioritized global agenda in achieving the United Nations Millennium Development Goal 5. In this challenge, involving males has been an important agenda, and a program with such intent was conducted in <it>Alfonso Lista, Ifugao</it>, of the Philippines. The objectives of this study were: (1) to evaluate the effectiveness in knowledge, attitude, and practice before and after a MCH session; (2) to evaluate the session's effectiveness in relation to socio-demographic characteristics; and (3) to examine if males who have learned about MCH topics can teach another group of males.</p> <p>Methods</p> <p>A male community representative who received a lecture from the health office staff was assigned to teach a group of community males [Group 1, N = 140] in 5 sessions, using educational materials. 10 male volunteers from Group 1 then taught a different group of males [Group 2, N = 105] in their own <it>barangays </it>(villages). To evaluate its effectiveness, a self-administered questionnaire survey pertaining knowledge, attitude and practice regarding MCH was conducted at three different time points: before the session (Time 1, T1), after the session (Time 2, T2), and 3 months following the session (Time 3, T3). A repeated measures analysis of variance was conducted to test for changes over time and its interaction effect between specific socio-demographic variables.</p> <p>Results</p> <p>In Group 1, there was a significant positive increase in knowledge score over time at T1-T2 and T1-T3 (<it>p </it>< 0.001). For attitude, the score increased only at T1-T2 (<it>p </it>= 0.027). The effectiveness in knowledge and attitude did not vary by socio-demographic characteristics. As for practice, majority of the participants reported that they had talked about MCH topics in their community and assisted a pregnant woman in some ways. A comparison between Group 1 and Group 2 revealed that Group 2 had similar effectiveness as Group 1 in knowledge improvement immediately after the session (<it>p </it>< 0.001), but no such improvement in the attitude score.</p> <p>Conclusion</p> <p>Although the change in attitude needs further assessment, this strategy of continuous learning and teaching of MCH topics within community males is shown to improve knowledge and has a potential to uplift the MCH status, including the reduction of maternal deaths, in <it>Alfonso Lista, Ifugao, Philippines</it>.</p

Psychometric evaluation of the Japanese version of Ten-Item Personality Inventory (TIPI-J) among middle-aged, and elderly adults: Concurrent validity, internal consistency and test–retest reliability

Objective: This study aimed to provide a psychometric evaluation of the Japanese version of the Ten-Item Personality Inventory (TIPI-J), and was conducted to confirm the concurrent validity, internal consistency, and test–retest reliability of the measure. Methods: A total of 520 middle-aged (40–64 years old) and 312 older adults (65–79 years old) participated in this study. Participants were registered research volunteers with an internet research company. The TIPI-J assesses the Big Five personality traits (Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness). The NEO-Five-Factor Inventory (NEO-FFI) was used to test concurrent validity. Results: Correlations of corresponding trait measures for the TIPI-J and NEO-FFI ranged from 0.45 (Openness) to 0.70 (Extraversion) for middle-aged, and from 0.33 (Openness) to 0.67 (Neuroticism) for older adults. The correlation values of Openness between the two scales were similar to those for the correlation between TIPI-J Openness and NEO-FFI Extraversion for both middle-aged and older adults, and that for the correlation between TIPI-J Openness and NEO-FFI Conscientiousness for older adults. The relationships between TIPI-J personality scores measured at a two-week interval ranged from 0.74 (Agreeableness) to 0.84 (Extraversion) for middle-aged and from 0.67 (Openness) to 0.78 (Neuroticism and Extraversion) for older adults. Conclusion: The TIPI-J has relatively acceptable concurrent validity, with the exception of Openness, which was considerably weaker than the other traits. The scale has relatively acceptable test–retest reliability. Thus, TIPI-J would be a useful instrument, roughly speaking, for assessing the Big Five personality traits among middle-aged and older adults

Associations of acute medical care with the transfer and acceptance functions of hospitals in a region in Japan with limited medical resources.

BackgroundJapan's health care system may be providing inpatient care inefficiently with a low number of physicians per hospital bed and a long average length of stay (LOS). The present study examined associations of acute medical care with hospital-level factors, such as the transfer and acceptance rates, and mediation effect of LOS, using medical service fees per day as an outcome measure for the provision of acute medical care in hospitals in a region with limited medical resources.MethodsTo analyze the associations of acute medical care with hospital-level factors, this research used multilevel structural equation modeling (SEM) of a dataset that included 225,203 patients admitted to 99 hospitals in Fukushima, Japan. The characteristics of the patients, medical activities, and hospitals, such as the transfer and acceptance rates, were assumed to have both direct and indirect effects through LOS on medical service fees per day.ResultsThe final analysis used data from 165,413 patients discharged or transferred from 79 hospitals. After separating patient-level effects using multilevel SEM, the results revealed that, at the hospital level, the transfer rate had a significant and positive association with increased medical service fees per day, both directly (standardized coefficient [SC] = 0.215) and indirectly (SC = 0.057) through shortened LOS. The number of first hospitalized patients per physician had a significant and positive association with increased medical service fees per day only indirectly through shortened LOS (SC = 0.063). The acceptance rate had a significant and negative association with medical service fees per day only indirectly through prolonged LOS (SC = -0.078).ConclusionsHospital-level factors, such as enhanced transfer function, reduced acceptance function, and a large number of patients for treatment of acute episodes per physician, had positive associations with increased medical service fees per day, either directly or indirectly through LOS

Actual Conditions of Leisure Activity Among Older Community-Dwelling Japanese Adults

For healthy longevity, according to the theoretical framework of “successful aging,” it is not only essential to avoid disease and disability, and to keep high levels of mental and physical functioning, but also to engage with life. Thus, satisfactory leisure activity is important for the aged. We examined actual conditions of leisure activity among older adults in Japan, which can contribute to the development of a standardized leisure activity scale. Participants were 843 community-dwellers (390 men and 453 women, 70.5 ± 6.9 years old) who completed 58 draft leisure activity items. Three procedures (including item selection, factor analyses, and correlation analyses) were conducted to finalize the leisure activity list and evaluate its psychometric properties. Through item selection procedures, 15 items were regarded as inappropriate and were omitted from the analysis. The factor analyses resulted in an 11-factor solution with 43 items. Correlation analysis revealed that Factors 2 (social-public), 5 (social-private), 7 (technology use), 8 (travel), and 10 (developmental activity) had relationships with health outcomes (including functional capacity, social network, subjective well-being, and health literacy). A standardized leisure activity list among modern middle-aged and elderly people was developed, and was associated in part with health outcomes