Consumer Policy and Market Norms: Routes of socioeconomic development abstracted from literature concerning consumer fraud and product safety (Japanese)

In recent years, the evaluation of the public-private partnership (PPP) has been an important issue in discussions relating to public service reform. The increasing trend of an overwhelming number of public services being provided through the private sector lies in the government's traditional approach of outsourcing. Meanwhile, new methods of using the private sector such as the private finance initiative (PFI), the designated manager system, and market testing also draw attention, but it appears that the introduction of these methods into local governments is not always a smooth process. While an effort is being made to overcome the institutional restrictions and problems associated with the introduction of these initiatives, differing attitudes of local governments toward the promotion of PPPs seem to have a significant impact. This paper aims to analyze and evaluate PPPs from an empirical perspective, looking at the public services that the government outsourced to private companies in various forms and then deriving policy implications. This paper consists of the following four studies: I. Factors for promoting PPP in local governments (YAMAUCHI Naoto, ISHIDA Yu, OKUYAMA Naoko) II. Does government spending trigger private contributions? (MATSUNAGA Yoshiho, OKUYAMA Naoko) III. Evaluation of PPPs in home-visit nursing care services (SUZUKI Wataru, HOTTA Satoko) IV. Outsourcing of waste collection and factors for its promotion (IWATA Kenji)

Age-Dependent Association Between Modifiable Risk Factors and Incident Cardiovascular Disease

BACKGROUND: There have been limited data examining the age-dependent relationship of wide-range risk factors with the incidence of each subtype of cardiovascular disease (CVD) event. We assessed age-related associations between modifiable risk factors and the incidence of CVD. METHODS AND RESULTS: We analyzed 3 027 839 participants without a CVD history enrolled in the JMDC Claims Database (mean age, 44.8±11.0 years; 57.6% men). Each participant was categorized as aged 20 to 49 years (n=2 008 559), 50 to 59 years (n=712 273), and 60 to 75 years (n=307 007). Using Cox proportional hazards models and the relative risk reduction, we identified associations between risk factors and incident CVD, consisting of myocardial infarction, angina pectoris, stroke, and heart failure (HF). We assessed whether the association of risk factors for developing CVD would be modified by age cat-egory. Over a mean follow-up of 1133 days, 6315 myocardial infarction, 56 447 angina pectoris, 28 079 stroke, and 56 369 HF events were recorded. The incidence of myocardial infarction, angina pectoris, stroke, and HF increased with age category. Hazard ratios of obesity, hypertension, and diabetes in the multivariable Cox regression analyses for myocardial infarction, angina pectoris, stroke, and HF decreased with age category. The relative risk reduction of obesity, hypertension, and diabetes for CVD events decreased with age category. For example, the relative risk reduction of hypertension for HF decreased from 59.2% in participants aged 20 to 49 years to 38.1% in those aged 60 to 75 years. CONCLUSIONS: The contribution of modifiable risk factor to the development of CVD is greater in younger compared with older individuals. Preventive efforts for risk factor modification may be more effective in younger people.</p

The effect of trunk rotation during shoulder exercises on the activity of the scapular muscle and scapular kinematics

[Background]In patients with shoulder disease, kinetic chain exercises including hip or trunk movement are recommended. However, the actual muscle activation and scapular kinematics of these exercises are not known. The purpose of this study was to examine the effect of trunk rotation on shoulder exercises that are devised to improve scapular function. [Methods]Thirteen healthy young men participated in this study. Scaption, external rotation in the first and second positions, and prone scapular retraction at 45°, 90°, and 145° of shoulder abduction were performed with and without trunk rotation. Electromyography was used to assess the scapular muscle activity of the upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA), and electromagnetic motion capture was used to assess scapular motion. The muscle activity ratio, which is the activity of the UT to the MT, LT, and SA, was calculated. These data were compared between 2 conditions (with and without trunk rotation) for each exercise. [Results]Adding trunk rotation to scaption, the first external rotation, and the second external rotation significantly increased scapular external rotation and posterior tilt, and all 3 exercises increased LT activation. In addition, trunk rotation with scapular retraction at 90° and 145° of shoulder abduction significantly decreased the UT/LT ratio. [Conclusions]Our findings suggest that shoulder exercises with trunk rotation in this study may be effective in patients who have difficulty in enhancing LT activity and suppressing excessive activation of the UT or in cases in which a decreased scapular external rotation or posterior tilt is observed

Effects of two stretching methods on shoulder range of motion and muscle stiffness in baseball players with posterior shoulder tightness: a randomized controlled trial

Background: The cross-body stretch and sleeper stretch are widely used for improving flexibility of the posterior shoulder. These stretching methods were modified by Wilk. However, few quantitative data are available on the new, modified stretching methods. A recent study reported the immediate effects of stretching and soft tissue mobilization on the shoulder range of motion (ROM) and muscle stiffness in subjects with posterior shoulder tightness. However, the long-term effect of stretching for muscle stiffness is unknown. The objective of this study was to examine the effects of 2 stretching methods, the modified cross-body stretch (MCS) and the modified sleeper stretch (MSS), on shoulder ROM and muscle stiffness in baseball players with posterior shoulder tightness. Methods: Twenty-four college baseball players with ROM limitations in shoulder internal rotation were randomly assigned to the MCS or MSS group. We measured shoulder internal rotation and horizontal adduction ROM and assessed posterior shoulder muscle stiffness with ultrasonic shear wave elastography before and after a 4-week intervention. Subjects were asked to perform 3 repetitions of the stretching exercises every day, for 30 seconds, with their dominant shoulder. Results: In both groups, shoulder internal rotation and horizontal adduction ROM were significantly increased after the 4-week intervention. Muscle stiffness of the teres minor decreased in the MCS group, and that of the infraspinatus decreased in the MSS group. Conclsuions: The MCS and MSS are effective for increasing shoulder internal rotation and horizontal adduction ROM and decreasing muscle stiffness of the infraspinatus or teres minor