A systematic review of nonrandomized controlled trials on the curative effects of aquatic exercise

Hiroharu Kamioka1, Kiichiro Tsutani2, Yoshiteru Mutoh3, Hiroyasu Okuizum4, Miho Ohta5, Shuichi Handa4, Shinpei Okada6, Jun Kitayuguchi7, Masamitsu Kamada7, Nobuyoshi Shiozawa8, Sang-Jun Park4, Takuya Honda4, Shoko Moriyama41Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo, Japan; 2Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, 3Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan; 4Mimaki Onsen (Spa) Clinic, Tomi City, Japan; 5Laboratory of Aqua, Health, and Sports Medicine, 6Physical Education and Medicine Research Foundation, Nagano, Japan; 7Physical Education and Medicine Research Center Unnan, Unnan City, Japan; 8Department of Longevity and Social Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanBackground: The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of nonrandomized controlled trials (nRCTs).Methods: Study design was a systematic review of nonrandomized controlled trials. Trials were eligible if they were nonrandomized clinical trials. Studies included one treatment group in which aquatic exercise was applied. We searched the following databases from 2000 up to July 20, 2009: MEDLINE via PubMed, CINAHL, and Ichushi-Web.Results: Twenty-one trials met all inclusion criteria. Languages included were English (N = 9), Japanese (N = 11), and Korean (N = 1). Target diseases were knee and/or hip osteoarthritis, poliomyelitis, chronic kidney disease, discomforts of pregnancy, cardiovascular diseases, and rotator cuff tears. Many studies on nonspecific disease (healthy participants) were included. All studies reported significant effectiveness in at least one or more outcomes. However results of evaluations with the TREND and CLEAR-NPT checklists generally showed a remarkable lack of description in the studies. Furthermore, there was the problem of heterogeneity, and we were therefore not able to perform a meta-analysis.Conclusion: Because there was insufficient evidence on aquatic exercise due to poor methodological and reporting quality and heterogeneity of nRCTs, we were unable to offer any conclusions about the effects of this intervention. However, we were able to identify problems with current nRCTs of aquatic exercise, and propose a strategy of strengthening study quality, stressing the importance of study feasibility as a future research agenda objective.Keywords: aquatic exercise, systematic review, nonrandomized controlled trials&nbsp

Education for Disaster Prevention in England : Analysis of Secondary Geography Textbooks

The purpose of this study is to clarify the aims, contents and activities of education for disaster prevention on geographical education in England, by analysis of secondary textbooks. Thereby, we want to contribute the improvement of Japanese geographical education. As a result, we clarified the following: 1) when students study a natural disaster in UK, they learn a plurality of cases including domestic and foreign regions, 2) all textbooks contain activities that students can form attitudes and decide what to do for disaster prevention. On the basis of these results, we suggest improvements of education for disaster prevention. The first is to develop a clear understanding of a natural disaster with multi-area including Japan. The second is to place contents and activities for forming a value relevant to awareness of disaster prevention into Japanese geography textbook. The third is to set an activity to learn practical strategies for disaster prevention in the real world

Characteristics of the stone monuments in Saijo, Higashi-Hiroshima City, southwest Japan, and their significance for teaching materials of social studies.

本稿の目的は，広島県東広島市旧西条町に分布する石碑の特徴を明らかにすると共に，小学校や中学校社会科の地域学習における石碑の教材的意義を検討することである。調査の結果，202基の石碑が確認され，寺社や公共施設，溜池などに石碑の立地が多くみられた。石碑の建立年との関連を検討すると，第二次世界大戦の終戦を境に，石碑の主な建立目的が地域社会に貢献した人物や行為の顕彰から，寺社への寄附に関連したものへと変化していったことが明らかになった。社会科教材としての意義については，1）学習指導要領への適合と2）石碑の情報量という観点から検討を行い，石碑のもつ教材的意義を3つに分類した。各分類において，具体的な活用方法を考察し想定される学習の展開を提示した。本稿は，「地域学習」の不振の要因のひとつである，地域に即した資料の不足の改善の一助になると期待される。An objective of this study is to clarify the characteristics and distribution of the stone monuments in Saijo, Higashi-Hiroshima City, Hiroshima Prefecture, and discuss their significance for elementary and junior high school social studies teaching materials. Two hundred two monuments were recognized in this area. They were mostly located in temples, shrines, public institutions, roadsides, and irrigation ponds. The purpose of erecting monuments has changed over 150 years from the Meiji era to the present day, which reflects the transition of the history of the local community or local people’s consciousness about their community. All monuments were classified into three levels considering their significance for elementary and junior high school social studies teaching materials: i.e., A. Useful and sufficient information; B. Useful but insufficient information; and C. Others. As a result, we defined 6 monuments as level A, 71 as level B, and 125 as level C. We propose an example of a social studies teaching plan including information about the monuments according to each level. The monuments directly provided information about the history of the local community and the location of historical events; therefore, the teaching plan using information about the monuments has possibility to improve for social studies

ジョセイカイゴシャ ニ オケル ヨウツウ ノ ジッタイ ト カンレンヨウイン ニ カンスル オウダンケンキュウ

本研究は,横断研究により,女性介護者における腰痛との関連要因を明らかにすることを目的とした。4カ所の特別養護老人ホームに勤務する女性介護職員88人を対象として,腰痛の有無,経験年数,Body Mass Index(BMI),握力,長座体前屈,指床間距離(Finger-Floor Distance : FFD),抑うつ自己評価スコア(the Center for Epidemiologic Study Depression Scale : CES-D),SF-8による身体的健康度(Physical Health Score : PHS)と精神的健康度(Mental Health Score : MHS),疲労の自覚症状を調査した。腰痛の有無を目的変数とし,その他の変数を説明変数とした多重ロジスティック回帰分析を行った。49人(55.7%)が,慢性的な腰痛を訴えていた。多重ロジスティック回帰分析の結果,腰痛の発生は,身長がオッズ比(OR)1.12,95%信頼区間(95%CI)1.02-1.23,SF-8による身体的健康度(PHS)が,OR : 0.89(95%CI : 0.86-0.97),精神的健康度(MHS)がOR : 0.90(95%CI : 0.81-0.99)で有意であった。本研究は,身長が高いことは中腰姿勢を助長し,腰痛を起こす原因になるかもしれないこと,身体・精神的な健康の程度は,腰痛と関係があることが明らかになった。今後,交代勤務に伴う睡眠障害や慢性疲労との関連性も含めて検討すべきであることが示唆された。The objective of this cross-sectional study was to reveal the actual conditions and related factors of low back pain among female caregivers in special nursing homes for the elderly.The participants were 88 female caregivers in four facilities for the elderly. We surveyed the existence of low back pain, employment period, Body Mass Index (BMI), grip power, sitting forward flexion, Finger-Floor Distance (FFD), the Center for Epidemiologic Study Depression Scale (CES-D), Physical Health Score (PHS) and Mental Health Score (MHS) by using SF-8 and subjective symptoms of fatigue. Multinomial logistic regression model was used to investigate how far low back pain was related to mental and physical health status, flexibility, power, employment period, and BMI.55.7% (N=46) of the participants notified the presence of chronic lumbago. The result of multinomial logistic regression model showed that the existence of low back pain was significant in the following variables : 1) Odds ratio (OR)=1.12 (95% confidence interval : 95%CI=1.02-1.23) for height, 2) OR=0.89 (95% CI=0.81-0.97) for PHS, 3) OR=0.90 (95% CI=0.81-0.99) for MHS.Our findings suggest that height may reinforce a half-crouching position, thus it can be a cause of low back pain, and that the degree of physical and mental health is related to low back pain. It was also suggested that lumbago prevention and/or reduction strategy should include the relevance of sleep interruption and chronic fatigue with shift work when this problem is examined in future