Language：English   Publishing type：Research paper (scientific journal)  

Due to the growing number of people with dementia worldwide, the role of dementia supporters is becoming increasingly important. In 2005, a national campaign called the Dementia Supporter Caravan was launched in Japan. However, the impact these trainings have on facilitating the work of dementia supporters is not quite understood. This study aimed to assess the challenges faced by dementia supporters in conducting activities for people with dementia. Our results showed that even after a period of six months since the training session, only half of the supporters had commenced new support activities. Future studies should examine the impact activities conducted by dementia supporters have on people with dementia and their family caregivers.

DOI： 10.1177/1471301220967570

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Language：English   Publishing type：Research paper (scientific journal)  

To improve the quality of care for people with dementia, several local governments in Japan have implemented a subsidized system for screening of dementia. This cross-sectional study aimed to identify factors that promote public intention to undergo dementia screening. A postal survey was conducted in a residential area that lies across the two cities which started a subsidized system for dementia screening. Semi-structured questionnaires were distributed to community-dwelling people aged ≥65 years; a total of 2269 persons were included in the analysis. χ2 test and multiple logistic regression analysis were used to identify factors associated with the willingness to undergo dementia screening. Among the people with dementia, only 28% had undergone a screening test for dementia. The participants who were certified of public long-term care need tended to undergo dementia screening. Approximately 67% of the participants were willing to undergo a dementia diagnosis test. Younger age, female sex, perceived poor health status, having a primary care physician, and independent daily activity level were associated with a greater willingness to undergo dementia screening using a subsidized system. Our study showed that majority of people with possible dementia do not undergo dementia screening. However, majority of people were willing to use a subsidized system for dementia screening. Further studies are required to support the benefits of a subsidized dementia screening in primary care settings. J Am Geriatr Soc 68:-, 2020.

DOI： 10.1002/gps.5326

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Language：Japanese   Publisher：(一財)厚生労働統計協会  

目的 高齢化が進展する都市旧ニュータウンに居住する高齢者を対象に,認知症になったときの居場所,支援に対する希望について,男女別に実態を把握することを目的とした。方法 1960年代に住宅地開発が行われた兵庫県内最古のニュータウンの明舞地区に居住する65歳以上の人全員を対象に,半構造化質問紙を用いた横断調査を2019年5〜9月に実施した。認知症になったときに住みたい場所として,自宅での暮らし,施設への入居など5つの項目から選択してもらい,また認知症・軽度認知障害(MCI)になったときに必要と思う支援として,構造化した5つの支援項目について必要の度合いならびに自由記述による回答を得た。調査協力の得られた2,269人(回収率22.4%)のうち,性別の記載がある2,252人を分析対象とし,居場所と支援希望をアウトカムとして単変量解析ならびに内容分析の手法を用い,男女で比較を行った。結果 認知症となったときの居場所は,男性は「今の家に住み続けたい」の回答が4割と最も多く,女性は「施設・サービス付き高齢者住宅に入居」「今の家に住み続けたい」を希望する人が35%とほぼ同数であった。居宅生活を希望する人は,男女ともに家庭内介護者がいること,男性のみに持ち家(戸建)に住んでいる,近所付き合いをしている人に多い傾向が示された。認知症・MCI診断時の支援として,定量分析の結果は「日常生活支援」を希望する人が最も多かった。定性分析の結果は,想像できない・わからないといった「不明」に関する記述が全体ならびに男性に最も多く,女性高齢者は施設入所,在宅生活の継続といった「居場所」に関する内容が多く記述されていた。結論 認知症時の居場所の希望として,男性は自宅,女性は施設を希望する傾向がみられた。また希望する支援においても女性は「居場所」に関する記載が多く,介護環境の性差がこのような結果につながったと考える。一方の男性は,支援を不明とする回答が多かった。認知症時の住まいや住まい方を本人が選択していけるように,住宅や介護サービスの情報提供,相談場所や介入方法など,性差に着目した認知症施策や制度の設計が求められる。(著者抄録)

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Language：English   Publishing type：Research paper (scientific journal)  

Stigma and social isolation are major challenges in building dementia friendly communities. Information is a key factor in improving knowledge and attitudes about dementia. This cross-sectional survey aimed to investigate public attitudes towards people with dementia in an urban community in Japan. Nearly 90% of the participants responded that they were able to have a good relationship with a person with dementia and help such a person if needed. However, around half of the participants would be ashamed of a family member with dementia. A multiple regression model showed that information from television and educational classes was associated with positive attitudes towards people with dementia among older adults. Information from educational classes and the Internet was likewise associated with positive attitudes among the volunteers. Increasing the availability and accessibility of information on dementia may contribute to improving public attitudes towards people with dementia.

DOI： 10.1177/1471301216682118

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Language：Japanese   Publisher：(株)ワールドプランニング  

認知症高齢者数の増加に伴い、今後、認知症を有する人で運転免許証を保有している人の数も増えると推測される。認知症高齢者の運転事故リスクを回避するうえでは、運転免許証の自主返納が重要な鍵となる。本稿では、地域在住高齢者を対象に、運転免許保有状況と返納に関する実態について検証を行ったので報告する。分析対象者2,261人のうち40.2%が免許保有者であり、また13.8%は免許返納を行っていた。免許保有者の7.3%は認知症を有していた。認知症がある免許保有者の約7割は、近い将来に運転免許証を返納する意思を示していた。免許返納者の特性として、「高齢である」「女性である」「65歳未満家族と同居している」「教育歴が低い」「健康状態が悪い」「認知症検査の受診歴がある」人であった。自主返納をするにあたっては、本人の自覚的な気づきを動機とし自己決断できるよう、医療者の助言などによる支援が重要である。(著者抄録)

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Urban areas in low-and middle-income countries are under chronic water stress, and multiple water source use (MWSU) is common. A detailed study on MWSU is necessary for strengthening water security and enhancing household water resilience to natural disasters which is defined as the ability of a household water system that is exposed to a disaster to resist, accommodate, and recover efficiently in a short time. Surveys were conducted in the Kathmandu Valley, Nepal, before and after the 2015 Gorkha earthquake. A classification of resilient and non-resilient households was based on respondents’ perception scores of their water systems before the earthquake and one month after. Around 80% of households used two to three water sources, and 70% of households were classified as water resilient. Three characteristics of a water resilient household were: (i) use of greater number of water sources, (ii) use of multiple reliable water sources such as piped water, groundwater, and (iii) use of effective adaptive strategies such as water storage in a bigger container. Since the study showed the practice of MWSU enhanced the resilience, protection and management of local water sources (well, spring, stone spouts) by initiatives of local government or communities or both is recommended.

DOI： 10.2166/washdev.2020.042

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Groundwater available in the Kathmandu Valley is not suitable for drinking due to chemical and microbial contamination. We installed a treatment system, which was made with locally available materials and was low-cost, and supplied drinking water to the intervention site where groundwater contains high amounts of ammonia, iron, and turbidity. This research aims to evaluate the socioeconomic impact of treated water distribution. One hundred households were randomly selected and asked to use treated water for drinking, and another 100 households in the nearby community were taken randomly as a control. We conducted questionnaire surveys with the enrolled households before and five months after starting water distribution to assess the water use patterns and quality perceptions. The socioeconomic impact of the intervention was evaluated by a prepost comparison and by the difference-in-difference method. The intervention significantly enhanced most of the parameters of water quality perception, reduced the in-house water treatment, and improved the perceived water stress and quality of life. For the control site, these parameters generally became worse in the post-survey, which suggests that the survey might have affected people’s mindset regarding water security. The system is an option for sustainable management of drinking water in the water-scarce, hard-hit areas in the developing countries.

DOI： 10.3390/w11071323

Web of Science

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Language：Japanese   Publisher：日本ヘルスコミュニケーション学会  

65歳以上の定住外国人の増加、中国帰国者の高齢化に伴い、日本では医療介護の場面で日本語以外を日常生活言語とする言語的マイノリティ高齢者とのコミュニケーションを行う場面が増えている。本稿では言語的マイノリティ高齢者のコミュニケーションの課題について、神戸市が実施している介護ケアの言語通訳者「コミュニケーション・サポーター」を対象としたインタビューから検討した。合計6人の個別インタビューを行い、質的内容分析を行った結果、【介護イデオロギーの違い】【通訳の過少活用】【若年世代との不十分なコミュニケーション】【言語通訳以上の能力の必要性】【文字情報の限界】の5つのテーマが抽出された。介護ケア場面における通訳は、単に言語通訳を行うだけではなく、ケアに対する文化通訳や介護サービスを円滑に提供するため専門職者と高齢者本人、家族の橋渡しの役割を担っていることが把握された。言語的マイノリティ高齢者とのコミュニケーションを向上するうえで、高齢者ケアを担う通訳者養成の研修の充実や活用の促進が求められている。(著者抄録)

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Language：Japanese   Publisher：(一財)仁明会  

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Language：Japanese   Publisher：(一財)厚生労働統計協会  

目的 認知症カフェを拠点にボランティアが、認知症の人を居宅訪問する取り組みが提案されるなど、認知症カフェにおけるボランティア活動の促進が提案されている。しかし認知症カフェでのボランティア活動の実態についてほとんど把握されていない。本研究では、ボランティアが活動する認知症カフェの特性と活動の課題を検証することを目的とした。方法 2017年6月時点で把握された兵庫県の認知症カフェ全数を対象とした。調査期間は2017年6〜8月とし、データ収集は構造化質問紙を用いた。ボランティアが活動している認知症カフェの特性を把握するため、ボランティア活動の有無をアウトカムとし、認知症カフェの基本情報、運営上の課題、地域特性を説明変数とし、χ2検定もしくはWilcoxonの順位和検定を用い分析を行った。また認知症カフェでボランティアが活動するうえでの課題について、自由記述を得て質的内容分析を行った。結果 252の認知症カフェに調査票を郵送し、167の認知症カフェから回答を得た(回収率66.3%)。ボランティアが活動している認知症カフェは85ヶ所(50.9%)あった。ボランティアが活動している認知症カフェは、ボランティアがいないカフェと比べて1回あたりの認知症の人の参加人数が多く、また開設されている地域の総人口に占める認知症サポーター、キャラバンメイトの割合が高かった。認知症カフェでボランティアが活動するうえでの課題として、<ボランティアのコーディネート><ボランティアとしての資質><ボランティアの人選・募集><ボランティアの育成支援>が抽出された。結論 地域における認知症支援の拠点となり得る認知症カフェが、ボランティア活動の促進などその役割を発展するうえで、社会全体で認知症カフェの周知を高める工夫が重要である。またボランティアのコーディネートや人材育成など、すでに経験を持つ機関や認知症カフェが、そのノウハウを共有できる機会が重要であることが示唆された。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00462&link_issn=&doc_id=20190222030004&doc_link_id=1903460&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1903460&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：English   Publishing type：Research paper (scientific journal)  

A composite metric assessing water security's physical dimension at the micro/ community level is lacking but is essential for setting priorities for program and policy implementations. We prepared an objective index (OI) of water security to measure the physical dimension using a model centered on household water-use behavior in developing countries' urban areas. A cross-sectional household survey (n = 1500) with multi-stage cluster design was conducted from December 2015 to February 2016 in the Kathmandu Valley, which has faced long-term, severe water shortage. A structured questionnaire probed socio-demographic characteristics, water sources, frequency and quantity of water use, cost related to water, etc. A 15-item water insecurity scale was used to measure subjective and experiential dimension of water insecurity. The World Health Organization Quality of Life - BREF was used to measure quality of life (QoL). The QoL has been considered as proxy of well-being in this study. The OI measured differential water security within small cities, the utility's service areas for instance, and identified area-specific key dimensions that need improvement. Overall, the OI and its key dimensions can be useful measures to design water-scarcity averting programs and policies, specific to a particular community's needs. The increased OI values were significantly and positively associated with better physical and psychological health and better social relationship domains of QoL suggesting health implications of water security.

DOI： 10.1016/j.ssmph.2018.10.007

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Publishing type：Research paper (scientific journal)   Publisher：IWA Publishing  

Abstract

Building resilience into water systems is very important in urban areas, particularly in less-developed countries, as poor-quality systems have adverse effects on human development and poverty reduction. This mixed-methods study aims to assess the resilience of household water systems and their impact on the quality of life (QOL) after the 2015 earthquake in Nepal. Data were obtained from 1,500 households using a questionnaire and six focus group discussions. The resilience of each household's water system was assessed in terms of residents' pre- and post-earthquake perceptions of water security. Approximately 60% of the households considered their water systems to be resilient. Piped water and wells were associated with stronger perceptions of water system resilience. Participants who considered their household water system to be resilient had higher QOL than those who considered their water systems vulnerable after the earthquake. Qualitative data showed that both the quality and quantity of water deteriorated due to an earthquake. To mitigate the adverse effects of natural disasters on water security, we recommend strengthening the water system infrastructure and operations as well as implementing collaboration between governments and local people.

DOI： 10.2166/wp.2018.117

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Background: Groundwater is a common domestic water source in developing countries, but is persistently contaminated with enteropathogens. However, studies on determinants of diarrhoea have predominantly focused on piped water. This study examines the relationship between groundwater microbial quality and household diarrhoea occurrence (HDO). Methods: Considering it as a proxy of enteropathogens, this study analysed Escherichia coli concentrations in groundwater wells. Ordinary kriging, a geostatistical technique in geographic information systems, was used to interpolate the E. coli concentration to survey points that had secondary survey data (n=942). The relationship between E. coli and HDO using simple and multivariate statistical analyses in SPSS was analysed. Results: A total of 77% of households used groundwater. One-third of households were without piped-water access (PWA), and these households were significantly more likely to use groundwater than those with PWA. Of the 87 households that reported HDO, 77% were groundwater users. Of the groundwater users, the households with HDO consumed groundwater with significantly higher E. coli concentrations than the households without HDO. Of the households without PWA, the increase in the E. coli concentration increased the odds of HDO (adjusted odds ratio=3.15; 95% CI=1.07-9.22). Conclusion: It is suggested that the groundwater microbial quality is a risk factor for HDO and illustrates this by an application of an interpolation technique relevant for developing countries.

DOI： 10.1093/inthealth/ihy037

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

DOI： 10.3390/w10050607

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Language：Japanese   Publisher：(一財)厚生労働統計協会  

目的 生活習慣病は国民総医療費の約3割を占めることが報告されており,医療費の適正化に向けて健康行動を促進することは,公衆衛生上の課題である。栄養状態や喫煙,飲酒習慣などの実態は年齢や性別により異なっており,保健指導を実施していくうえで,年齢や性別によってどのような生活習慣の改善を図るかを検討することは重要と考え,年齢,性別による生活習慣病リスクと医療費支出との関連を検証した。方法 2009〜2012年に実施された日本家計パネル調査の個票データを用いた。生活保護受給世帯,2012年時の年齢が71歳以上となる人を除外し,4年間追跡ができた3,802人のデータを分析対象とした。アウトカムは調査前年の1年間の医療費支出とし,生活習慣病リスクとして喫煙習慣,飲酒習慣,体格指数,平日の睡眠時間とした。調査時年齢,等価可処分所得,教育歴,就労,婚姻,心身症状を調整変数とし,男女および年齢区分別に層化し,ガンマ分布を仮定した一般化線形混合モデルを用いて,生活習慣による医療費支出の相対危険度を算出した。結果 調査初年度の年間医療費支出の平均額は約4万円であり,年齢が高くなるほど医療費支出額,通院・入院した割合は高くなる傾向にあった。40歳代女性以外の年代の男女において,「たばこをやめた」人は「吸わない」人より医療費支出が高く,50歳代男性ではその関連性が有意であった。体格指数が25.0以上の人は,18.5〜24.9の人と比べて医療費支出が高くなる傾向にあり,医療費支出の比が最も高かったのは男女ともに40歳代であった。一方,40歳未満の女性では,体格指数18.5未満の人の医療費支出は,標準体重の人よりも高かった。40歳未満の女性では飲酒習慣がある人は,ない人よりも医療費支出が低い傾向がみられた。睡眠時間と医療費支出との関連について統計学的に有意な差はみられなかった。結論 「喫煙習慣があった」「やせ」「肥満」の人は,そうでない人と比べて医療費支出額が高く,その関連性は性別,年齢によって異なっていた。喫煙対策や適性体重の推進は,医療費抑制の点からも重要であり,疾病に罹患する前に生活習慣の見直しを図れるような保健指導の在り方が今後求められる。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00462&link_issn=&doc_id=20170223110001&doc_link_id=1700005&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1700005&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.trpro.2017.05.320

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Publishing type：Research paper (scientific journal)  

Information regarding domestic water consumption is vital, as the Kathmandu Valley will soon be implementing the MelamchiWater Supply Project; however, updated information on the current situation after the 2015 Gorkha Earthquake (GEQ) is still lacking. We investigated the dynamics of domestic water consumption pre- and post-GEQ. The piped water supply was short, and consumption varied widely across the Kathmandu Upatyaka Khanepani Limited (KUKL) branches and altitude. The reduction in piped, ground, and jar water consumption and the increase in tanker water consumption post-GEQ appeared to be due to the impact of the GEQ. However, the impact did not appear to be prominent on per capita water consumption, although it was reduced from 117 to 99 L post-GEQ. Piped, ground, and tanker water use were associated with an increase and jar water use was associated with a decrease in water consumption. Despite improvements in quantity, inequality in water consumption and inequity in affordability across wealth status was well established. This study suggests to KUKL the areas of priority where improvements to supply are required, and recommends an emphasis on resuming performance. Policy planners should consider the existing inequity in affordability, which is a major issue in the United Nations Sustainable Development Goals.

DOI： 10.3390/w9030222

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: This observational study aimed to assess distress related to the household water supply and to examine the relationship between household water insecurity and psychological health among Nepali postnatal women. METHODS: In total, 300 women consented to participate in the study, of which 267 women were able to participate in a follow-up 1 month after discharge. We developed a household water insecurity scale (HWIS; total score range 0-24 points) by adapting the household food insecurity access scale. RESULTS: The Cronbach's coefficient alpha for the HWIS was moderately acceptable. Psychological health was assessed in terms of postnatal depression and physical health-related quality of life (HRQOL). The median score of the HWIS was 8, and more than 60% of the participants answered that they sometimes or often worried about not having enough water, used only small amounts of water, had a lack of hygiene, and had insufficient time for childrearing. Multiple regression models showed that women with high levels of stress derived from household water insecurity had greater odds of probable depression and lower physical HRQOL scores than did women with low HWIS scores. CONCLUSION: The results suggest that improving water security is necessary to foster maternal psychological health in developing countries.

DOI： 10.2166/wh.2015.166

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Publishing type：Research paper (scientific journal)  

Water security is one of the central global issues today. This study aimed to describe and test the validity and reliability of a household water insecurity scale, and to assess the impact of household water insecurity on psychological distress among 371 women living in urban Nepal. A household interview survey was conducted using a structured questionnaire. Approximately 70% of the participants experienced collecting less water than they needed. Four domains of household water insecurity emerged from the principal components factor analysis: (i) difficulties in house-work related to water, (ii) lost opportunity costs and social interactions related to water, (iii) an insufficient safe water supply, and (iv) difficulties in basic activities related to water. Multivariate regression analysis showed that the domains of 'lost opportunity costs and social interactions', 'difficulties in house-work' and 'difficulties in basic activities' were associated with psychological distress among women. The impact of household water insecurity on psychological distress differed by water supply service levels. The current household water insecurity scale is a simple instrument which can be used to prioritise the target population for water interventions. Further research should be conducted towards the development of a universally applicable measurement tool.

DOI： 10.2166/wp.2015.116

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Language：English   Publisher：(一社)日本国際保健医療学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Maternal milk-borne transforming growth factor (TGF-β plays a potential role in the development of the mucosal immune system in infants. However, it remains unclear what factors determine TGF-β levels in breast milk. We hypothesized that microbial pressures during pregnancy might affect the expression levels of TGF-β in colostrum. OBJECTIVE: This study compared TGF-β2 levels in colostrum of lactating women living in Japan and Nepal with contrasting hygiene statuses. Additionally, we identified environmental and intrinsic factors influencing TGF-β levels in colostrum. METHODS: Breast milk samples and structured questionnaires were collected from 80 women living in Japan and 208 women living in Nepal. A robust regression model was used to identify factors associated with colostral TGF-β levels. RESULTS: Analysis using the Mann-Whitney U test showed that TGF-β levels were significantly higher in Japanese women than in Nepalese women. Japanese women who consumed animal milk daily during pregnancy and had atopic dermatitis expressed lower levels of TGF-β in colostrum, as compared to Japanese women who did not. Among Nepalese women, large family size and higher birth order were associated with lower TGF-β levels and women who gave birth to infants with low birth weight had higher expression of TGF-β levels in milk than women who gave birth to infants with normal birth weight. CONCLUSION: The results suggest that induction of TGF-β levels in colostrum depends on differences in the ethnicity of lactating women. Consumption of animal protein and parturition characteristics may affect TGF-β levels in breast milk, and may explain differences in these levels in breast milk between countries.

DOI： 10.12932/AP0367.32.2.2013

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Language：English   Publisher：(一社)日本アレルギー学会  

DOI： 10.2332/allergolint.13-LE-0577

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J04723&link_issn=&doc_id=20140610220018&doc_link_id=10.2332%2Fallergolint.13-LE-0577&url=https%3A%2F%2Fdoi.org%2F10.2332%2Fallergolint.13-LE-0577&type=Crossref&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00002_2.gif

Language：English   Publisher：JAPAN ASSOCIATION FOR INTERNATIONAL HEALTH  

Objectives<BR>  More than half of those living in developing countries do not have piped water in their homes. Although handwashing is effective for the elimination of microbes from the surface of the palms, thereby preventing the transmission of infectious diseases, the effect of using poor-quality water for handwashing is unclear. This study measured the water quality and the bacteria count on the hands of preschool children in Kathmandu, Nepal.<BR>Methods<BR>  Sixty-two children were asked to follow their normal handwashing technique, and the counts of 3 microbial bacteria—viable bacteria, Escherichia coli, and total coliforms—were measured in the water source and on the children's palms. Microbial samples from the children's palms were collected before and after handwashing. The Wilcoxon signed-rank test was used to compare the number of bacteria on the palms before and after handwashing.<BR>Results<BR>  The children washed their hands with a low volume of stored water without soap. Viable bacteria, E. coli, and total coliforms were detected in the water source. The number of viable bacteria and total coliforms on the palms increased after handwashing. In contrast, the numbers of E. coli colonies did not change after handwashing.<BR>Conclusion<BR>  Handwashing with poor quality of water did not have effect on removal of bacteria from hands. In areas with limited water sources, intervention for handwashing requires strategies for not only promoting hygiene behaviors also water storage management.

DOI： 10.11197/jaih.29.69

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Other Link： http://search.jamas.or.jp/link/ui/2014367673

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: To assess the associations between diarrhoea and types of water sources, total quantity of water consumed and the quantity of improved water consumed in rapidly growing, highly populated urban areas in developing countries. DESIGN: Cross-sectional analysis using population-representative secondary data obtained from an interview survey conducted by the Asian Development Bank for the 2009 Kathmandu Valley Water Distribution, Sewerage and Urban Development Project. SETTING: Kathmandu Valley, Nepal. PARTICIPANTS: 2282 households. METHODS: A structured questionnaire was used to collect information from households on the quantity and sources of water consumed; health, socioeconomic and demographic status of households; drinking water treatment practices and toilet facilities. RESULTS: Family members of 179 households (7.8%) reported having developed diarrhoea during the previous month. For households in which family members consumed less than 100 L of water per capita per day (L/c/d), which is the minimum quantity recommended by WHO, the risk of contracting diarrhoea doubled (1.56-fold to 2.92-fold). In households that used alternative water sources (such as wells, stone spouts and springs) in addition to improved water (provided by a water management authority), the likelihood of contracting diarrhoea was 1.81-fold higher (95% CI 1.00 to 3.29) than in those that used only improved water. However, access to an improved water source was not associated with a lower risk of developing diarrhoea if optimal quantities of water were not consumed (ie, <100 L/c/d). These results were independent of socioeconomic and demographic variables, daily drinking water treatment practices, toilet facilities and residential areas. CONCLUSIONS: Providing access to a sufficient quantity of water-regardless of the source-may be more important in preventing diarrhoea than supplying a limited quantity of improved water.

DOI： 10.1136/bmjopen-2012-002264

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Language：English   Publisher：Japan Society on Water Environment  

Water scarcity is a major issue in the Kathmandu Valley. Also, from a health perspective, it is important to evaluate the relationship between the quantity and quality of available water. In this study, we identified the water source used, and its availability and quality at the source and point of use. This was done by conducting a questionnaire survey and measuring the level of indicator bacteria and free residual chlorine in domestic water sampled at households. The results showed that most households used mixed water sources, with piped water being preferred for consumption. Nonparametric statistical tests showed that the total coliform was significantly high in source water with a longer supply interval and also high in stored water. In addition, but not of statistical significance, Escherichia coli was mostly detected in source water with a longer supply interval and also in stored water. In contrast, the proportion of samples with free residual chlorine was lower in water with a longer supply interval. Partial correlations showed that a longer cleaning interval of water storage vessels was associated with lower water availability and might lead to contamination of stored water. Therefore, safe storage of water should be promoted at the household level, and water supply services should be improved at the regional scale.

DOI： 10.2965/jwet.2013.331

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Language：English   Publishing type：Research paper (scientific journal)  

Improving skills for accessing and utilizing diet/nutrition information is important for preventing non-communicable diseases and frailty among elderly people. With the rapidly increasing number of elderly people in the world, promoting nutrition literacy among them is a pivotal health policy for maintaining and promoting health. This article describes the barriers and catalysts of nutrition literacy among elderly Japanese people (aged ≥75 years). A cross-sectional analysis of the responses to a questionnaire administered to 678 study participants (men = 347, women = 331) was conducted. Logistic regression analysis revealed that more men had limited nutrition literacy than did women. After stratification by gender, the limited nutrition literacy group was associated with cognitive difficulty in men and women, visual impairment in men and hearing impairment in women. Lower education level and economic status were associated with limited nutrition literacy among women. Adjusted odds ratios (ORs) controlling for age, education level and economic status, as well as cognitive, visual and hearing function, indicated that informational support [OR = 5.59, 95% confidence interval (95% CI) = 1.28-24.49] and diet/nutrition information obtained from friends of the participants (OR = 2.16, 95% CI = 1.11-4.20) were both associated with adequate nutrition literacy among men, whereas diet/nutrition information from health professionals (OR = 3.96, 95% CI = 1.97-7.95) had a significant relation with adequate nutrition literacy among women. Moreover, in the adequate nutrition literacy group, men were more likely to be overweight (OR = 2.17, 95% CI = 1.20-3.91). These findings suggested that cognitive and sensory functions should be taken into account when diet information is provided to older adults. Enhancement of social networks is also a key point in improving nutrition literacy. An effective intervention to improve nutrition literacy in elderly people, particular old men, warrants further investigation.

DOI： 10.1093/heapro/dar005

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Language：English   Publishing type：Research paper (scientific journal)  

In order to develop an effective preventive intervention for depression, this cross-sectional study aimed to analyze the relationship between past lifestyle, social activity, and depressive symptoms among community-dwelling elderly people in Japan (n = 887). The Geriatric Depression Scale was used for assessing depressive symptoms. The lifestyle of middle-aged people was assessed using a recall report. The prevalence of depressive symptoms among the subjects was 12.9%. Logistic regression analyses showed that physical exercise, daily intake of well-balanced meals and milk products, and the presence of hobbies were related to the absence of depressive symptoms among both men and women. Among men, avoidance of excess salt and fat was related to the absence of depressive symptoms, while among women, moderate alcohol consumption and good relationships with neighbors were related. Physical exercise, dietary education, and promotion of social activities among middle-aged people were recommended for prevention of depressive symptoms.

DOI： 10.1007/s10597-010-9317-1

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Language：Japanese   Publisher：(学)国際医療福祉大学  

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Language：Japanese   Publisher：(学)国際医療福祉大学  

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Language：Japanese   Publisher：(株)杏林書院  

介護保険認定を受けていない65歳以上の高齢者25名に対し、口腔体操(以下;体操)を自宅で毎日1回実施するよう指導するとともに、週1回、公民館において指導者と一緒に体操を行うようにした。その効果を調べるため、実施前と実施3ヵ月目に、主観的口腔健康感尺度(GOHAI)、うつ状態尺度(GDS)による評価と、反復唾液嚥下テスト(RSST)、咀嚼力テスト、および食品摂取多様性の調査を行い、3ヵ月間でどのように変化したか検討した。その結果、GDSにおける「うつ傾向」者の割合が有意に減少していた。GOHAI、RSST、咀嚼力テストの平均値と食品摂取多様性の数値も改善していたが、統計学的に有意な変化ではなかった。

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J01351&link_issn=&doc_id=20100723090011&doc_link_id=1003838&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1003838&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：Japanese   Publisher：(学)国際医療福祉大学  

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Language：Japanese   Publisher：(学)国際医療福祉大学  

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE. This study explored factors related to cognition of social capital among Japanese older people. METHOD. Using a cross-sectional survey design, data were gathered from 940 people aged over 65 years. Cognition of social capital was compared by gender, and it was regressed on participation in community activities and health behaviors of middle age and current health status. RESULTS. Men had higher cognitive social capital than women (p = .004). Multiple regression analysis shows that men who rested for health during middle age had high cognition of social capital. Cognition of social capital was also related to self-rated health, depression, and cognitive difficulties for both men and women. Daily activity was included among women. DISCUSSION. Participation in community activities and health behaviors during middle age were associated factors for cognition of social capital among the older people, and encouraging cognition of social capital was important for active aging.

DOI： 10.1177/0898264309347816

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Language：Japanese   Publisher：(一財)厚生労働統計協会  

目的 平成17年度の介護保険法改正に伴い,介護予防支援のために地域包括支援センター(包括センター)が,市町村に設置された。本調査では,地域の保健福祉の支援対象として,見守りが必要な後期高齢者を特定するために実施された「お達者チェック」より,包括センターを利用する高齢者の特性について分析を行った。継続的かつ包括的な保健福祉の支援ネットワークの中核としての機能を担う包括センターの利用者が,どのような特性を持つのかを把握することで,包括センターが行う支援方法についての検討を行う。方法 平成19年8〜10月に,小田原市在住の後期高齢者全数を対象に実施された,「お達者チェック」の有効回答者16,110人を対象にした。包括センターの相談有無に関連する要因について,男女別に,世帯,社会活動性および不安について検証した。分析は,多重ロジスティック回帰モデルを用い検定を行った。結果 包括センターに「相談している」と回答した人は,男性413人(6.7%),女性901人(9.8%)であった。相談している人は,相談していない人と比較し,男女とも独居世帯,近所付き合いや趣味・特技がなく,かつ仕事をしていない人であり,身体面および心理的・精神面の不安がある人であった。女性においては,65歳以上家族と同居,相談できる友人・知人がいない,住環境面の不安があることも包括センターへの相談利用に有意に関連していた。結論 包括センターを利用している後期高齢者の特性として,サポートネットワークが低いこと,身体面および心理・精神面の不安を抱えていることが明らかとなった。後期高齢者の増加に伴い,高齢者の不安に対応した保健・福祉のサービスが適切に利用できるように,包括センターの役割がますます重要となってくることが考えられる。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J00462&link_issn=&doc_id=20090717050005&doc_link_id=0903504&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F0903504&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

Language：Japanese   Publisher：(学)国際医療福祉大学  

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Language：English   Publisher：(一社)日本国際保健医療学会  

タイ王国では母子保健活動のひとつとして、母子健康手帳をおよそ20年間活用している。本研究は、母子健康手帳の利用状況の評価および手帳の母親の母子健康増進に対する信念・行動への影響を分析することを目的とし、タイ王国カンチャナブリ県において3〜4歳児をもつ、224名の母親を対象に2005年1月〜2月にかけてインタビューを行った。母子健康手帳の利用状況結果は、手帳の読み(全パートの読み率:14.3%)および自己記録率(全パートの記録率:0.9%)の低さが目立った。重回帰分析結果、母子健康手帳の利用度は母親の信念・行動の両方において関連することがわかった(p=0.001:信念,p=0.039:行動)。その他の関連因子は、信念においては母親の年齢、通学年数、給与、行動は婚姻状況、年齢および職業であることがわかった。本研究の結果より、母親の母子保健に対する信念と行動を喚起するためには、母子健康手帳の活用と包括的なアセスメントが重要である。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2006&ichushi_jid=J02041&link_issn=&doc_id=20060925380006&doc_link_id=10.11197%2Fjaih.21.123&url=https%3A%2F%2Fdoi.org%2F10.11197%2Fjaih.21.123&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Language：Japanese   Publisher：日本老年社会科学会  

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Language：English   Publisher：(一社)日本国際保健医療学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publisher：(一社)日本国際保健医療学会  

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Language：Japanese   Publisher：(一財)厚生労働統計協会  

目的 75歳以上高齢者人口の増加に伴い,同年齢グループにおける要介護認定者の数も増加している。要介護状態にある高齢者は,日常生活動作機能の低下から,自立している高齢者と比較し,生命予後が悪い,転居や施設入所といった居住移動の可能性が高いことが示唆されている。本調査では,75歳以上の居宅高齢者を対象に,介護保険サービス利用と転帰との関連について検証することを目的とした。方法 平成19〜23年度に実施された,75歳以上高齢者の見守り調査の回答者23,620人を分析対象とした。調査時の介護保険利用状況と,5年間の累積生存率をKaplan-Meier法にて,性・年齢階級別に算出した。またCox比例ハザードモデルを用いて,死亡,転出,施設入所のハザード比を性別に算出した。結果 介護保険サービスを利用している人は,3,031人(12.8%)であった。介護保険利用者は,男女ならびにすべての年齢階級において,5年間の累積生存率が有意に低く,特に男性において生命予後が悪くなる傾向にあった。多変量によるハザードモデルでは,80歳以上男性,75〜79歳の女性において,介護保険サービスの利用と死亡との関連が有意であった。また男女ともに介護保険サービスの利用は,施設入所のリスクとなっていたが,転出との関連はなかった。結論 介護保険サービスを利用している75歳以上在宅高齢者は,生命予後は男性において悪く,施設入所する傾向は女性において高いことが明らかとなった。要介護状態となっても,住み慣れた環境で生活できる支援が重要であると考えられる。(著者抄録)

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Language：Japanese   Publisher：日本老年社会科学会  

経済や教育といった社会要因と健康格差について、世界的な関心が高まっている。社会要因は食生活行動、栄養状態と強い関連を示し、その背景として食や栄養に関する情報量や知識との関連が示唆されている。高齢化が著しいわが国では、介護予防や医療費抑制のうえで、高齢者の栄養状態の改善を検討することは、重要な保健課題であるとし、本研究では社会要因と食と栄養の情報源、さらに多様な食品摂取との関連について分析した。分析対象者は地域の75歳以上高齢者645人であり、経済、教育年数によって情報源、食品摂取の多様性に違いがある結果が得られた。多変量解析の結果、本・雑誌、新聞から栄養情報を得ている人は、多様な食品を摂取する傾向にあった。活字を媒体とした情報源が、高齢者の食生活行動を促すうえで有用であることが示唆された。一方で社会経済状況の低い人に対して、アクセスならびに理解しやすい情報媒体の検討が重要であると考えた。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J03917&link_issn=&doc_id=20121029050007&doc_link_id=%2Fdk2geron%2F2012%2F003403%2F008%2F0394-0402%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdk2geron%2F2012%2F003403%2F008%2F0394-0402%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publisher：(一社)日本国際保健医療学会  

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Language：Japanese   Publisher：日本老年社会科学会  

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J-GLOBAL

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：三井住友海上福祉財団  

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Language：Japanese   Publisher：日本公衆衛生学会  

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