Association of food access and neighbor relationships with diet and underweight among community-dwelling older Japanese

Background: Food access is important for maintaining dietary variety, which predicts underweight. The aim of this study was to examine the association of food access and neighbor relationships with eating and underweight.Methods: We analyzed cross-sectional data from 102,869 Japanese individuals aged 65 years or older. The perceived availability of food was assessed using the presence or absence of food stores within 1 km of the home. Level of relationships with neighbors was also assessed. The odds ratios (ORs) and 95% confidence intervals (CIs) for infrequent food intake and underweight were determined using logistic regression analysis.Results: The proportion of men and women having low access to food was 25-30%. Having low food access (OR 1.18; 95% CI, 1.12-1.25 for men and OR 1.26; 95% CI, 1.19-1.33 for women) and a low level of relationship with neighbors (OR 1.38; 95% CI, 1.31-1.45 for men and OR 1.57; 95% CI, 1.48-1.67 for women) was associated with infrequent intake of fruits and vegetables in both sexes. Association between low food access and infrequent intake of fruits and vegetables was higher among men with low levels of neighbor relationship (OR 1.34; 95% CI, 1.23-1.46) than among men with high levels of relationship (OR 1.10; 95% CI, 1.03-1.18).Conclusions: Low perceived availability of food is a risk factor for low dietary variety among older people. Furthermore, high levels of relationship with neighbors may relieve the harmful effect of low food access.　　　© 2017 The Authors. Publishing services by Elsevier B.V. on behalf of The Japan Epidemiological Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/ by/4.0/)

ホウリツ ジム ショクイン ニ カンスル イチコウサツ : ナゴヤ チク オ チュウシン ニ

ビジネス実務の実態についてはさまざまな調査研究が進められ、その内容が明らかにされている。しかし、その多くは企業におけるワーカーを対象としたものであった。企業など組織体においては、IT化の波が押し寄せ、ワーカーを取り巻く環境は激変した。そのことは法律事務所においても同様であることが予測される。本稿では、法律事務所の事務職員、および秘書または秘書的業務担当者の実態について、また法律事務所におけるIT化にともなう環境変化や課題などについて把握し、今後の研究の基礎的作業として、名古屋地区の法律事務所を対象とした調査を実施した結果の中から、事務所の構成、業務内容について若干の考察を試みた。While there have been various researches to reveal the contents of business work in corporations, those peculiar to law offices are almost neglected. Considering the fact that the quality and quantity of office work have been totally changing nationwide since the introduction of information technology, the contents of work in law firms are no exceptions. In this study some thoughts are given to the actual conditions of the employees in law firms of the Nagoya area, which will contribute to the further study in this area

「ヴェズレー」におけるペイターの建築観

ペイター(Walter Pater, 1839-94)は1894年、フランス中世の聖堂建築に関する二篇のエッセイを発表した。「アミアンのノートルダム大聖堂」("Notre-Dame d\u27Amiens")と「ヴェズレー」("Vezelay")である。前者はゴシック様式の大聖堂を、後者はロマネスク建築の代表例であるサント・マドレーヌ聖堂をとりあげている。これらの作品は「フランスの大聖堂」("Some Great Churches in France")というタイトルで『ナインテイーンス・センチユリー』誌の3月と6月号にそれぞれ掲載され、のちに『雑纂』(Miscellaneou Studies)に収められた。1893年ペイターの生涯における最後の旅の体験から生まれたこれらのエッセイには、聖堂の建つ土地の霊の印象と、実際に聖なる空間を廻って感知したことがらが見事に織り込まれている。建築に関する該博な知識を駆使し、精妙な洞察力でもってペイターが明らかにしたフランス中世の聖堂建築の特徴とは何か。彼が追求する理想の建築様式とはどのようなものなのか。幾世紀にもわたる人間の歴史が刻みこまれているヴェズレーの聖堂をめぐって、建築における見られるよりはむしろ感知される精神性というものをペイターがどのように読み解いているのかを考察したい

「いちかわ かぞえうた」プロジェクト活動報告（1）

　近年、市川市は、高い人口流動率による地域への関心の薄さ等、首都近郊特有の地域課題を抱えている。そこで市川市内にある保育者養成課程を有する大学に在籍する筆者らは、令和２年（2020）度大学コンソーシアム市川産官学連携プラットフォーム協議会共同研究助成を受け、「いちかわ　かぞえうた」プロジェクトを立ち上げた。本プロジェクトは、和洋女子大学と昭和学院短期大学の学生と教員が連携、協働し、市川で育つ子どもが地域に親しみ愛着が持てる遊び歌とそれに付随する「遊びバリエーション」の創作と普及活動を通じ、地域文化遺産の利活用と地域活性化に資する学生の教育、育成の２点を目的としている。　創作した遊び歌を、地域の子どもを通じて家庭や地域コミュニティーに広めることにより、「地域愛」を育むと共に、地域文化遺産の利活用を促す。また、市川で学ぶ学生が「いちかわ」を題材にした遊び歌とそれに付随する児童文化財や身体表現を創作し、保育所、幼稚園、認定こども園や地域で開催されるイベントでの実演を通じ地域の人と関わることで、地域活性化に資する人材の養成、育成を目指している。本稿は、これまでに創作した遊び歌とそれに付随する児童文化財、身体表現の制作、創作活動に焦点を当て報告する

Associations of Overweight, Obesity, and Underweight With High Serum Total Cholesterol Level Over 30 Years Among the Japanese Elderly: NIPPON DATA 80, 90, and 2010.

BACKGROUND:The trend of association between overweight and high serum total cholesterol (TC)among the elderly is unclear. In addition, there is little evidence of risk of underweightfor high TC. Therefore, we examined the trend of association of overweight or underweight with high TC among Japanese elderly people using nationwide population-based data.METHODS:Data of the National Survey on Circulatory Disorders and National Health and NutritionSurvey for 1980, 1990, 2000, and 2010 were used in the analysis. High TC was definedas 220 mg/dL and above. For participants aged ≥50 years, sex-specific odds ratios (ORs)of overweight or underweight compared with normal body mass index participants forhigh TC were calculated using a logistic regression model adjusted for age, smoking, drinking, exercise, food, and treatment of hyperlipidemia.RESULTS:A total of 5,014, 4,673, 5,059, and 2,105 participants enrolled in these surveys in 1980,1990, 2000, and 2010, respectively. Although overweight was positively and significantlyassociated with high TC in 1980, the association has gradually weakened since (ORs in 1980 and 2010 were 2.44; 95% confidence interval [CI], 1.83-3.24 and 0.92; 95% CI, 0.66-1.27 among men and 1.43; 95% CI, 1.18-1.72 and 1.08; 95% CI, 0.81-1.44 among women, respectively). While underweight was inversely and significantlyassociated with high TC in 1980, the association also gradually weakened among women(ORs in 1980 and 2010 were 0.28; 95% CI, 0.12-0.60 and 0.37; 95% CI, 0.10-1.28 among men and 0.39; 95% CI, 0.26-0.57 and 0.96; 95% CI, 0.58-1.57 among women,respectively).CONCLUSIONS:These findings provide evidence that high TC prevention efforts must expand the target to not only overweight but also to normal and underweight people

COVID-19 vaccine effectiveness against severe COVID-19 requiring oxygen therapy, invasive mechanical ventilation, and death in Japan: A multicenter case-control study (MOTIVATE study).

INTRODUCTION: Since the SARS-CoV-2 Omicron variant became dominant, assessing COVID-19 vaccine effectiveness (VE) against severe disease using hospitalization as an outcome became more challenging due to incidental infections via admission screening and variable admission criteria, resulting in a wide range of estimates. To address this, the World Health Organization (WHO) guidance recommends the use of outcomes that are more specific to severe pneumonia such as oxygen use and mechanical ventilation. METHODS: A case-control study was conducted in 24 hospitals in Japan for the Delta-dominant period (August-November 2021; "Delta") and early Omicron (BA.1/BA.2)-dominant period (January-June 2022; "Omicron"). Detailed chart review/interviews were conducted in January-May 2023. VE was measured using various outcomes including disease requiring oxygen therapy, disease requiring invasive mechanical ventilation (IMV), death, outcome restricting to "true" severe COVID-19 (where oxygen requirement is due to COVID-19 rather than another condition(s)), and progression from oxygen use to IMV or death among COVID-19 patients. RESULTS: The analysis included 2125 individuals with respiratory failure (1608 cases [75.7%]; 99.2% of vaccinees received mRNA vaccines). During Delta, 2 doses provided high protection for up to 6 months (oxygen requirement: 95.2% [95% CI:88.7-98.0%] [restricted to "true" severe COVID-19: 95.5% {89.3-98.1%}]; IMV: 99.6% [97.3-99.9%]; fatal: 98.6% [92.3-99.7%]). During Omicron, 3 doses provided high protection for up to 6 months (oxygen requirement: 85.5% [68.8-93.3%] ["true" severe COVID-19: 88.1% {73.6-94.7%}]; IMV: 97.9% [85.9-99.7%]; fatal: 99.6% [95.2-99.97]). There was a trend towards higher VE for more severe and specific outcomes. CONCLUSION: Multiple outcomes pointed towards high protection of 2 doses during Delta and 3 doses during Omicron. These results demonstrate the importance of using severe and specific outcomes to accurately measure VE against severe COVID-19, as recommended in WHO guidance in settings of intense transmission as seen during Omicron

レイメイキ ノ カンゴ キョウイクシャ ガ カンガエル カンゴ ノ ダイガク キョウイク ノ アリカタ ニ カンスル ケンキュウ

わが国では1990年代、一気に看護系大学が急増し、大学教育は学士課程教育の一環でありかつ専門職業人として位置づけられた。このような中、実際の教育現場で大学としての教育がどのように教員に認識・理解され教育方法はどのように変化してきたのか。本研究では看護大学教育黎明期に活躍した教育者へのインタビューにより、参加者が当時大切にしていたことや専修学校教育と何を意識的に変えたのか、また何を行ったのかを明らかにし、今の看護の大学教育の課題を探るとともに看護の大学教育を担う教員たちへの示唆を得る目的で行った。その結果、【看護学の存在を確信していた】【学部教育は大学院を含む構造の一部という認識があった】【大学の看護教育としての教育環境を整えた】の3大カテゴリーが抽出された。看護大学教育の黎明期に教育を担った参加者が当時から大切にしていたことは看護学という独自の学問の存在の確信であった。看護学を体系化し、看護を科学として伝えられるように努力をしてきた参加者たちは看護学を教えるのに学校の種類は関係ないという認識を持っていた。看護の大学教育は大学院までを含んで完成されるものであるが、学部教育は専門職業人教育であり、良き実践者の養成という視点が最も重要である。参加者の姿勢から、看護の本質を常に追求する姿勢を看護教員こそが持ち続ける必要があるのだということを今回の研究で改めて示されたと考える。The establishment of nursing colleges in Japan increased rapidly in the 1990s\u27. Universityeducation forms a part of the bachelor degree education program and nursing fell under the rubric of a profession. Under such circumstances, it is important to understand how a university education was perceived/understood by faculties in a real university setting and to ask how methods of education have changed. Based on interviews with nursing educators who took an active part in the dawning era of university education of nursing, this research clarifies the participantsc\u27ontemporary values and what they deliberately changed in order to distinguish themselves from standard vocational technical schools. This research was conducted in order to obtain helpful suggestions for faculties who bear the burden of a university education of nursing, while investigating the challenges associated with current nursing education programs at universities themselves. Three major categories were extracted from the results:[Confidence in Nursing Science Exists], [There is a Perception that the Undergraduate Program is Part of a Larger Structure that Includes Graduate School], and [A University Nursing Education Environment was Established]. The participants, who were nursing educators during the dawning era of university education of nursing, valued the conviction that there was an independent Nursing Science from the very beginning. These participants, who systemized Nursing Science and made efforts to convey nursing as a science, understood that the type of school is not relevant to teaching Nursing Science. The structure of a university education of nursing as a whole should include graduate school. However, it is the undergraduate program that is considered to be the primary education for nursing professionals and is seen as most important in the training of good practitioners. This research formally points out that it is necessary for nursing educators to continuously adopt a standard of exploration in further developing the nature of nursing

Cシ ノ トクテイ コウレイシャ ニトッテ ケンコウジョウ ノ アンシン トハ

高齢化が進む東北地方のB県C市の特定高齢者にとって"健康上の安心"を構成する要素は何か記述することを目的に、13名の協力者に対し半構成的インタビューを行ない質的に分析した。その結果、安心を構成する要素の中核カテゴリーとして【つながっている】、大カテゴリーとして《人生を認め合える》《今現在のつながりが残っている》《自分の体をやりくりできる》が抽出された。C市の高齢者が健康上安心して生活できるためには、互いに人生を認め合い共に過ごしてきた仲間がいることとそこから生まれた自尊感情が基盤となり、そのつながりに支えられ、更に今現在もそのつながりが残っていることが必要であった。現在のつながりは人や情報、行きたい場所の存在と移動手段などであるが、それらのつながりに支えられて、自分のからだをやりくりできるという自己効力感の存在が認められ、それらが特定高齢者の安心を支えていた。特定高齢者の自己効力感に働きかけ、自尊感情を尊重しながら、活動や参加という場や手段の提供により人や情報とのつながりを維持していくという視点は、ICFの健康の概念である「生活機能-身体状況だけでなく活動・参加-で生きる全体をとらえる」ことに通じていることが明らかになり、これからの高齢者支援の重要な視点として再確認された。The purpose of this study is to identify some factors that make the "tokutei" elderly people living in C city feel secure about their health. Based on interviews with thirteen "tokutei" elders, three major caregories were found as well as a core category that constitutes their secure feeling of "being related to someone or something." Besides these categories, the study also shows that the "tokutei" elderly people have self‑efficacy in their health management. As the notion of ICF suggests, the feeling of "being related" and selfefficacy will bring the elders confidence in their health management. Therefore, these findings should be taken into account when we try to build a support system for the "tokutei" elderly people