Objectives: In addition to an aging population, the number of single-person households is increasing in semi-mountainous areas. The nutritional status of older adults living alone has also been studied as they are prone to undernutrition. In this study, we aimed to develop a risk prediction model and a simple assessment sheet for screening undernutrition using factors related to food environment accessibility among older adults living alone in semi-mountainous areas.

Methods: This study included 181 participants (36 men, 145 women) living alone in four semi-mountainous areas (mean age, 83.6 years). Factors related to accessibility to the food environment were measured using 30 predefined items. The Mini-Nutritional Assessment Short Form was used for the nutritional status assessment.

Results: An exploratory factor analysis was performed using 30 items of the food environment accessibility, among which, 16 items were extracted. On the basis of the results of a logistic regression analysis using 17 items including age, 10 items were selected to be included in the logistic model to predict the risk of undernutrition. The risk prediction model showed fair discrimination (area under the curve=0.722) and calibration capabilities (Hosme–Lemeshow test, p=0.822). A simple rating sheet was developed using a model to predict undernutrition risk using factors related to food environment accessibility among older adults living alone in semi-mountainous areas.

Conclusions: A simple assessment sheet was developed to evaluate the undernutrition risk using factors related to food environment accessibility among older adults living alone in semi-mountainous areas.

The relationship between alcohol consumption and incident ischemic heart disease and stroke is characterized by a J- or U-shape. This denotes that light drinking has a preventive effect on cardiovascular diseases. Effects of alcohol drinking on lipid metabolism including an increase in HDL cholesterol concentration and a decrease in LDL cholesterol concentration are the main reasons for the anti-atherosclerotic action of alcohol. The antithrombotic effect of alcohol through the inhibition of platelet function is also involved in the lower incidence of ischemic arterial disease in drinkers. Capacitative Ca²⁺ entry, a main mechanism for platelet aggregation, is inhibited by ethanol. Ethanol also inhibits plasmalemmal phospholipase A₂ activity and consequent thromboxane A₂ production. French paradox is a phenomenon showing the merit of red wine consumption for the prevention of ischemic heart disease. In addition to ethanol, red wine contains anti-oxidative polyphenol compounds, represented by resveratrol, which has an antiplatelet action. Resveratrol also inhibits the capacitative Ca²⁺ entry in platelets. Furthermore, ethanol and resveratrol show a synergic inhibitory action on platelet aggregation, which may be caused by the reduction in the Ca²⁺ sensitivity of the contractile apparatus of platelets and the attenuation of COX-1 activity. Thus, the strength of the antithrombotic action is thought to differ depending on alcohol beverage. Decreases in concentrations of coagulation factors including fibrinogen are also involved in the alcohol-induced antithrombotic action. Alcohol drinking causes hemorrhagic diathesis as well as antithrombotic tendency.

Objectives: Virtual reality (VR) and three-dimensional (3D) images have become increasingly popular. It has been reported that visually induced motion sickness (VIMS) is more frequently caused by viewing these images. We propose a method to control VIMS by controlling visually evoked postural responses (VEPRs) using galvanic vestibular stimulation (GVS). In this study, we focused on the effect of VEPRs on body sway and conducted a transfer function analysis between the GVS and body sway. On the basis of the results of this investigation of the causes of VIMS, countermeasures must be considered.

Methods: The experiment involved 15 healthy young adults, comprising six males and nine females, all aged 21 years. The subjects were asked to maintain a Romberg posture while viewing an image that included a large number of randomly positioned moving spheres with their peripheral vision. In addition, body sway during GVS as an external stimulus was measured for 120s for each task.

Results: The transfer function analysis of the body sway showed that the influence on the equilibrium function was significantly enhanced not only by the GVS but even more so by viewing the video clips synchronized to the GVS.

Conclusions: GVS current signals induced body sway and increased the width of body sway synergistically. It was also suggested that a time delay structure occurred between the GVS current signal and body sway.

Objectives: Recent legislative changes in the wake of the novel coronavirus pandemic have placed an increased emphasis on the research activities of Local Public Health Institutes (PHIs) in Japanese municipalities. However, few studies have examined the ethical review processes of these institutes.

Methods: We analyzed information on (a) the status and year of establishment of “Ethics Review Committees” (and equivalent committees), (b) the number of review cases for each year, (c) the status of public disclosure of committee activities, and (d) the composition of committee members for 85 PHIs across Japan. Publicly available information from each PHI and the Ministry of Health, Labour and Welfare was used for the analysis.

Results: Out of 85 PHIs nationwide, about half of them publicly disclosed the establishment of their committees (41 committees, 48.2%). The number of review cases handled by the committees varied, with some committees having no cases or only one case. Among the committees, approximately 20% still maintained adherence to outdated national research ethics guidelines, and approximately 15% did not specify any guidelines they followed. Furthermore, we identified committees without external members (at least two committees) and those lacking public representation (four committees).

Conclusion: There are differences in the operational performance of ethics review committees at PHIs, possibly owing to varying levels of understanding of the guidelines, the degree of proactive engagement in academic research, and the emphasis on human subject research. There is a crucial need to accumulate and share experiences that support the review functions of the committees.

Objectives: The objectives of this study were to develop a Japanese version of the Pediatric Epilepsy Medication Self-Management Questionnaire Caregiver Version (PEMSQ-J) and to examine its reliability and validity.

Methods: A quantitative cross-sectional study was conducted among primary caregivers (N=309) of children under the age of 18 taking epilepsy medication. The PEMSQ-J was the main instrument used to collect information such as basic demographics.

Cronbach’s α was calculated to determine internal consistency, and the intraclass correlation coefficient was calculated to assess reproducibility. In addition, confirmatory factor analysis with covariance structure analysis was performed to confirm the goodness of fit of the model. Finally, criterion-related validity was confirmed.

Results: Analysis of responses to items on the PEMSQ-J revealed no ceiling or floor effects, and there was no marked bias in distributions in terms of skewness or kurtosis. Internal consistency assessed with Cronbach’s α ranged from 0.847 to 0.935. A test of reproducibility revealed that the intraclass correlation for the total score was 0.730. Exploratory factor analysis identified two factors, which differed from the four factors in the original version. When their details and structure were examined, however, the two were interpreted as having a similar structure. Similarly to those of the original version, the goodness-of-fit indices for the four factors according to confirmatory factor analysis were close to the standard values.

Conclusion: The PEMSQ-J, which consists of 27 items with a four-factor structure, was statistically acceptable, and it was found to have a certain degree of reliability and validity.

What is health? We all have a goal that we aspire for in our life—our “reason to live”. Health is a pillar necessary for achieving our goal in life and I believe that altruism is the basic principle of this pillar. In this paper, I first discuss altruism in health from biological and economic perspectives, and then review the history of the concept of health. Next, I introduce the keywords necessary for understanding health and then present the points necessary for determining good health and for the role of each individual in issues concerning health. In conclusion, I would like to define health as a state of physical, mental and social well-being necessary for people to achieve self-achievement and happiness while living in society. Health is an attitude, and the very process of striving to achieve good health is itself “good health”. In addition, altruism is fundamental to good health. The spirit of respect and empathy for not only humans health but also “planetary health” is important.

Drs. Futatsuka, Eto, and Uchino expressed their opinions in the Journal of the Japanese Society for Hygiene in the form of a review of my book, “Minamata Disease and the Responsibility of Medicine.” (The reviewers translated it as “Responsibility of Medical Authorities,” but for my purposes in writing this book, I believe it should be translated as “Responsibility of Medicine.”) The nine major comments of the three reviewers described in this book review were reviewed from the basic perspective of toxicology, epidemiology, and neuroscience. This book review is fraught with either medical, logical, or ethical problems in all the nine points as follows: (1) the inadequate way in which exposure and health hazards are considered from the toxicological perspective, (2) problems in interpreting epidemiological information, (3) the failure to consider recent achievements in methylmercury toxicosis studies, (4) presenting the reviewers’ own theories without regard to the content of my book while calling it a “book review,” (5) presenting and criticizing what Takaoka does not claim as if he does, and (6) making claims that are inconsistent with the three reviewers’ own views. The problems with this book review will become even clearer when you read “Minamata Disease and the Responsibility of Medicine” itself.

Objectives: To understand the actual situation and needs of young researchers and to provide reference for the management of Young Researchers Association (YRA) and the Japanese Society for Hygiene activities in the future.

Methods: An Internet survey was conducted on 67 members registered in YRA of the Japanese Society for Hygiene. The questions included those on basic information, research content and impressions about the activities of the society.

Results: Although members of YRA differ in backgrounds, research method used, and years of research experience, the respondents rated the organization as highly useful and participated continuously. In particular, they considered that participation in the planning of academic conferences and summer gatherings of YRA not only helped improve interpersonal relationships and expertise, but also provided opportunities to consult regarding educational activities and collect information. Regarding the format of conferences, it was shown that the majority of requests were for a hybrid format. It was also shown that most of the respondents expected opportunities for collaboration and joint research through participation in YRA.

Conclusion: Through YRA, we would like to contribute to the further revitalization of young researchers and the Japanese Society for Hygiene by understanding and responding to the needs of diverse young researchers.

Objective: In this study, we aimed to develop a comprehensive health literacy (HL) scale for Japanese workers (CHLS-J) and to investigate the relationship between HL and health-related behaviors.

Methods: We conducted a cross-sectional study by a questionnaire survey of Japanese workers aged 18 years and older (N=313). The HL scale we previously developed was slightly modified on the basis of the pre-examination and used for developing CHLS-J. Self-reported data on demographic variables, socioeconomic status, health-related behaviors, present illness, past illness, and HL were collected. To determine the factor structure of the HL scale, an exploratory factor analysis was conducted, and the internal consistency of the scale was assessed using Cronbach’s coefficient alpha. The criterion-related validity was evaluated using the Pearson product-moment correlation coefficient.

Results: From the results of factor analysis, 30 HL items were extracted and the structure was based on three factors (the knowledge and competencies for collecting health information, decision-making and communication, and the motivation for utilizing health information). High CHLS-J scores were significantly associated with food purchasing behaviors based on food labeling and maintaining a well-balanced diet. Furthermore, patients with present or past illness were more likely to have high CHLS-J scores.

Conclusions: The results show that CHLS-J is mostly a validated and reliable scale, and that the high-HL group had a healthy eating lifestyle. This study suggests that CHLS-J can be used to measure HL and educate Japanese workers on the necessity of health behavioral changes.