日足P&Fの状況：（04月14日）～（04月18日）

この日から5日ほど、毎日足の皮が剥け続けた。かかとから始まり、足の指から甲まで、余すところなく一皮剥けた。感動的だがひとつ気になったのが、足の皮が部屋のいたるところに落ちてしまうこと……。剥けている期間は靴下を履くことをオススメする。

Accumulating evidence suggests that the built environment may be associated with cardiovascular disease via its influence on health behaviours. The aim of this study was to estimate the associations between traditional and novel neighbourhood built environment metrics and clinically assessed cardio-metabolic risk factors among a sample of adults in Canada. A total of 7171 participants from Albertas Tomorrow Project living in Alberta, Canada, were included. Cardio-metabolic risk factors were clinically measured. Two composite built environment metrics of traditional walkability and space syntax walkability were calculated. Among men, space syntax walkability was negatively associated with systolic and diastolic blood pressure (b = -0.87, 95% CI -1.43, -0.31 and b = -0.45, 95% CI -0.86, -0.04, respectively). Space syntax walkability was also associated with lower odds of overweight/obese among women and men (OR = 0.93, 95% CI 0.87, 0.99 and OR = 0.88, 95% CI 0.79, 0.97, respectively). No significant associations were observed between traditional walkability and cardio-metabolic outcomes. This study showed that the novel built environment metric based on the space syntax theory was associated with some cardio-metabolic risk factors.

PurposeBoth moderate-to-vigorous physical activity (MVPA) and sedentary behavior can be associated with adult adiposity. Much of the relevant evidence is from cross-sectional studies or from prospective studies with relevant exposure measures at a single time point before weight gain or incident obesity. This study examined whether changes in MVPA and television (TV) viewing time are associated with subsequent changes in waist circumference, using data from three separate observation points in a large population-based prospective study of Australian adults.MethodsData were obtained from the Australian Diabetes, Obesity, and Lifestyle study collected in 1999-2000 (baseline), 2004-2005 (wave 2), and 2011-2012 (wave 3). The study sample consisted of adults age 25 to 74 yr at baseline who also attended site measurement at three time points (n = 3261). Multilevel linear regression analysis examined associations of initial 5-yr changes in MVPA and TV viewing time (from baseline to wave 2) with 12-yr change in waist circumference (from baseline to wave 3), adjusting for well-known confounders.ResultsAs categorical predictors, increases in MVPA significantly attenuated increases in waist circumference (P for trend 0.001). TV viewing time change was not significantly associated with changes in waist circumference (P for trend = 0.06). Combined categories of MVPA and TV viewing time changes were predictive of waist circumference increases; compared with those who increased MVPA and reduced TV viewing time, those who reduced MVPA and increased TV viewing time had a 2-cm greater increase in waist circumference (P = 0.001).ConclusionDecreasing MVPA emerged as a significant predictor of increases in waist circumference. Increasing TV viewing time was also influential, but its impact was much weaker than MVPA.

In order to reduce traffic accidents, it is important to know where traffic accidents occur and how people perceive hazard that is related to traffic. In this study an attempt was made to examine the relationship between actual traffic accident location and people's perception of hazardous location using geographic information system. An extensive questionnaire survey was conducted with regard to the perceived location of traffic hazard. Three types of accident-hazard relationship were identified. Finally potential application of hazard map is discussed. © 2004 ASCE.

2000年 6月に施行された大規模小売店舗立地法では、評価に用いる指針が全国一律の基準であるため、地域都市の特性が反映されていない。これにより多くの地方都市では、大規模小売店舗により生じる問題に悩まされている。特に駐車場容量不足や渋滞など、交通関連の問題である。そこで本研究では、より地域の実情を反映した指針とはどうあるべきなのか考察し、地方都市における地域の実情を反映したの独自基準の策定方法の提案を行った。特に、地域の実情を反映する為に 2000年と 2004年に栃木県の大規模小売店舗に対して実施された調査結果を用いた。これにより、大規模小売店舗立地法に示されている指針に対して、地域性を考慮した独自基準のあり方を提案する事が可能となった。

【目的】先行研究（Izawa et al.,2004,2005）において我々は, 最高酸素摂取量(PVO2)や骨格筋機能などの身体機能指標, 健康関連QOL(HRQOL)およびそれらの媒介変数である身体活動セルフ・エフィカシー(SEPA)に対して, 運動療法を主体とした回復期プログラムがそれらの向上に影響を与えることを報告した. しかし疾患別でのそれら各指標の実態および関連性についての報告は少ない. 本研究の目的は、疾患別の身体機能指標, SEPA,およびHRQOLを比較検討し, HRQOLの関連要因について明らかにすることである.
【方法】 対象は, 当院ハートセンターに急性心筋梗塞(AMI)あるいは心臓外科手術目的で入院後, 急性期プログラムを終了し外来での心肺運動負荷試験（CPX）の依頼があった1924件中, 発症あるいは手術後1か月時点でのCPX, 身体機能指標, SEPAおよびHRQOLの測定を施行した連続600例である. 属性 (年齢, 性別, BMI)に関する情報は診療記録より調査した. 身体機能指標は, 握力, 膝伸展筋力, PVO2を用いた. SEPAはSEPA尺度(2002, 岡)を用い, 上下肢活動に関するSEPAの2項目に分け,その平均値を算出した. HRQOLはSF-36の身体的健康度（PCS）と精神的健康度（MCS）のサマリースコアを用いた. これら各指標について心筋梗塞366例（AMI群）と心臓外科術234例（CS群）の2群間で比較検討し, HRQOLの関連要因を抽出した. 統計学的手法はカイ二乗,t検定および重回帰分析を用いた。統計学的判定の基準は5%未満とした. なお本研究は, 当大学生命倫理委員会の承認を得て施行された.
【結果】結果はAMI群 vs. CS群の順に, 年齢 (61.5 vs. 62.1歳, p=0.55), 性別 (男性の割合, 85 vs. 80% p=0.54), BMI (23.3 vs. 22.1 kg/(m)2, p=0.01), 握力(35.8 vs. 30.6 kg, p=0.01), 膝伸展筋力(1.7 vs. 1.5 Nm/kg, p=0.01), PVO2(24.3 vs. 21.1 ml/kg/min, p=0.01), SEPA (上肢, 64.5 vs. 45.0, 下肢, 69.5 vs. 61.2, p=0.01), PCS (46.7 vs. 43.8, p=0.01), MCS (49.5 vs. 49.1, p=0.52)であった. 重回帰分析の結果, PCSの関連要因としてAMI群は下肢活動のSEPA（R2=0.11, p=0.01）, CS群は上肢活動のSEPA（R2=0.14, p=0.01）が抽出された. 一方, MCSは, AMI群は下肢活動のSEPA（R2=0.12, p=0.01）, CS群は握力と上肢活動のSEPA（R2=0.15, p=0.01）が抽出された.
【考察】CS群はAMI群に比し身体機能, SEPA, PCSは低値を示すことから, 特にCS患者に対するそれらの向上のための配慮が必要であると考えられた. またCS群, AMI群ともにHRQOLの関連要因の一つとして, 媒介変数であるSEPAが少なからず関与することからHRQOLに対するSEPA向上の重要性が示された.

Background–Several non-pharmaceutical policies, which include stay-at-home orders, mobility restrictions, and quarantine, have been implemented to reduce the spread of novel coron-avirus disease 2019 (COVID-19). The present study examines work style changes among company workers after COVID-19 and analyses their effects on workers’ domain-specific sedentary and active behaviours. Methods-We analysed data from a nationwide prospective online survey in Japan. The data were obtained in February 2019 (n = 3200) and in July 2020 (n = 1709) from the registered individuals of a Japanese internet research service company. The participants reported work style patterns before and after the outbreak of COVID-19 in the follow-up survey. Domain-specific sedentary behaviours and physical activities were assessed by questionnaires. Paired t-tests were used to compare work styles before and after the outbreak of COVID-19. Multivariable linear regression models were used to assess the associations between changes in work style and changes in sedentary behaviours and physical activities. Results. Workers had more working from home days and fewer office-based working days after the outbreak of COVID-19 (p < 0.001 and p < 0.001, respectively). The increase in the number of working from home days per week was significantly associated with increases in work-related sitting time and total sitting time (b = 0.16, 95% CI 0.08, 0.24, p < 0.001 and b = 0.23, 95% CI 0.11, 0.36, p < 0.001, respectively). However, it was also associated with a decrease in car sitting time (b = −0.04, 95% CI −0.06,-0.01, p < 0.001). In addition, the increase in the number of working from home days was associated with a decrease in work-related moderate physical activity (b =−0.06, 95% CI −0.10, −0.02, p < 0.001). Conclusions. Our study provided preliminary evidence of an increase in working from home days in response to COVID-19 in Japan and of how this increase in the number of working from home days has affected workers’ sedentary behaviours and physical activities. These findings shed light on the effects of COVID-19 on work styles and workers’ sedentary behaviours and physical activity.

IntroductionThe most effective type of social participation against psychological distress in older adults is not well documented. The aim of this study was to examine whether different types of social participation are associated with changes in psychological distress level in older men and women in Japan.MethodsTwo thousand seven hundred community-dwelling older adults (aged 65-74 years, 50% women) were randomly selected from the resident registry of three cities. Of these, participants who reported social participation and psychological distress level in the baseline survey in 2010 were followed up. Psychological distress was evaluated based on K6 scales at baseline and follow-up (in 2015). Social participation level was examined using question items from the National Health and Nutrition Survey in Japan. Exploratory factor analysis was used to derive the underlying factor structure. Multiple linear regression analysis was used to examine the association between social participation and changes in psychological distress level after adjusting for covariates stratified by both gender and age group or living arrangement.ResultsData from 825 community-dwelling older adults (45.3% women) were analyzed. Social participation was categorized into two types using factor analysis: community involvement (volunteer activities, community events, clubs for the elderly) and individual relationship (friendship, communication with family and friends, hobbies). During the 5-year follow-up, 29.5% of participants reported a deterioration in psychological distress. Higher community involvement was independently associated with lower risk of psychological distress for older women (beta = 0.099, p = 0.047), whereas there were no associations with individual relationship for either gender. Furthermore, in older women living with others, higher community involvement was also associated with lower risk of psychological distress (beta = 0.110, p = 0.048).ConclusionCommunity involvement provides older women with mental health benefits regardless of individual relationship level. Promoting community involvement may be an effective strategy for healthy mental aging.

Purpose: Patients with exercise capacity of 5 metabolic equivalents (METs) are considered to have a high risk of death. The aim of this study was to determine age-related differences in physical activity associated with an exercise capacity of = 5 METs in chronic heart failure (CHF) outpatients. Methods: We enrolled 157 stable CHF patients (79.6% men, age 60.3 +/- 11.5 years). Patients were divided into two age-based groups (middle-aged, 65 years, n = 97) and (older-aged, = 65 years, n = 60). Peak oxygen uptake (peak VO2) was assessed by cardiopulmonary exercise testing. We further divided patients into groups according to exercise capacity: = 5 METs and 5 METs. Physical activity was assessed by measuring the average number of steps/day for 1 week with an electronic pedometer. Results: Receiver-operating characteristic curves were used to select cutoff values for steps associated with an exercise capacity of = 5 METs in the middle- and older-aged patients. Cutoff values of 6045 steps in the middle-aged and 6070 steps in the older-aged patients were determined. Conclusions: Both middle-and older-aged CHF patients with exercise capacity of = 5 METs completed approximately 6000 steps/day. This could become a target amount for minimal physical activity that could contribute to increased exercise capacity in CHF patients.

Background: Although regular physical activity can facilitate healthy aging, improve functional capacity, and prevent chronic diseases in the elderly, many of the Japanese elderly are not sufficiently active. Thus, examining the determinants is an important prerequisite for designing effective programs. The present study investigated the demographic, behavioral, psychosocial, and environmental determinants of meeting the national pedometer-determined physical activity recommendations for the elderly Japanese. Method: Data were analyzed for 137 community-dwelling elderly Japanese aged 70 to 89 years (47% male, mean age = 74.5 years), who completed a questionnaire and wore a pedometer. Demographic (gender, age, marital status), behavioral (BMI, smoking, alcohol consumption), psychosocial (self-efficacy, social support, health professional advice), and environmental (perceived neighborhood environment) variables were self-reported. Averaged daily steps were obtained using 1-year pedometer measurements. Based on the national physical activity recommendations in Japan (males: 6700 steps females: 5900 steps), the participants were divided into two categories-sufficiently active and insufficiently active. An adjusted logistic regression model was utilized. Results: Totally, 47.4% of the participants (males: 51.5% females: 43.8%) met the national recommendations. When adjusting for all other variables, a higher self-efficacy for exercise (AOR = 1.16 95% CI: 1.04-1.28) and positive perception of the neighborhood environment (AOR = 1.43 95% CI: 1.03-1.98) significantly influenced the meeting of the national recommendations. Conclusions: The findings clarified the need to identify effective intervention strategies to promote physical activity and suggest that an intervention design that accounts for these determinants may more effectively promote physical activity among the elderly Japanese. © 12 Bentham Science Publishers.

Studies have shown the potential effects of sedentary behavior and physical activity on not only physical and mental health but also academic performance in children. Nevertheless, studies have only focused on either sedentary behavior or physical activity. Examining the joint effects of both behaviors on academic performance provides detailed insights into the patterns of these behaviors in relation to children's academic achievement. The present study investigated the joint longitudinal associations of physical activity and screen time with academic performance among Japanese children. The screen time and physical activity of 261 children aged 7-10 years were assessed, and their academic performance was evaluated one year later. Multivariate logistic regression analysis was used to examine the joint associations of screen time and physical activity with academic performance adjusted for demographic characteristics. Children with low screen time and physical activity had 2.04 (95% confidence interval: 1.11-3.78) times greater odds of having high academic performance compared to children with high screen time and low physical activity, while children with low screen time and high physical activity had 2.75 (1.17-6.43) times greater odds (boys; 4.12 (1.19-14.24)). Low screen time was related to high academic performance after one year, regardless of the physical activity level.

A rapidly growing body of literature has explored associations between urban design attributes, which are conducive to walking, and social capital. The current study aimed to build on the limitations of previous research. Specifically, this study estimated the associations between traditional and novel walkable built environment metrics and social capital among a sample of adults in Japan. Data (n = 1010) from a randomly selected cross-section of residents (40–69 years old) from two areas in Japan were included. Social capital was assessed by questionnaires. Several objective and perceived walkable built environment attributes were calculated. Covariate-adjusted multivariable linear regression models were used to estimate associations between neighborhood built attributes and the three social capital scores. Street connectivity was negatively associated with activities with neighbors (b = -0.21, 95% CI -0.31, -0.11). Perceived population density was negatively associated with all three social capital scores, including social cohesion, activities with neighbors, and social participation (b = -0.21, 95% CI -0.30, -0.11, b = -0.15, 95% CI -0.24, -0.06, and b = -0.16, 95% CI -0.29, -0.02, respectively). Traditional walkability and Walk Score® were negatively associated with activities with neighbors (b = -0.04, 95% CI -0.07, -0.00 and b = -0.09, 95% CI -0.15, -0.04, respectively). No significant associations were observed between perceived walkability and social capital scores. Space syntax walkability was negatively associated with social cohesion and activities with neighbors (b = -0.12, 95% CI -0.23, -0.01 and b = -0.11, 95% CI -0.21, -0.01, respectively). This study provided unique findings demonstrating that walkable built environments may not necessarily support social capital in ultrahigh-density Asian cities.

Objective:The present study examined physical activity(PA)levels and differences in PA by gender and grades during school recess periods. Method:PA levels of two hundred and thirty children(55% boys, 42%younger)from two elementary schools in Japan were measured with accelerometry for seven consecutive days. Time spent in sedentary, light PA, moderate PA, vigorous PA during break(25 minutes)and lunch recess(15 minutes), and total recess(40 minutes)was determined. Two-way analysis of variance was used to examine differences in PA variables by gender and grades. Results:Data of one hundred and eighty four children(52% boys, 56% younger)was available. Time spent in sedentary, light PA, moderate PA, and vigorous PA was 8.5±4.9, 12.9±3.8, 1.6±1.2, and 2.9±2.8 minutes during break, and 3.5±2.5, 9.5±2.2, 1.4±0.9, and 1.6±1.4 minutes during lunch recess, respectively. There were no significant interactions between gender and grades. Significant main effects of PA variables were found for gender and grades. Boys had fewer sedentary time(p=0.017)and higher vigorous PA time(p<0.001)than girls during total recess. Younger engaged in more sedentary(p=0.045)and less light(p=0.023)and moderate PA(p=0.006)than older at break. On the other hand, at lunch recess, younger had significantly longer light(p=0.015)and vigorous PA(p<0.001)and shorter sedentary time(p<0.001)than older. Conclusion:Overall, boys were less sedentary and engaged in PA at higher intensity levels than girls during school recess. Different pattern in PA was shown between break and lunch recess by grades.

Background Little is known about differences in the risk of poor nutritional status as assessed by the Geriatric Nutritional Risk Index (GNRI) in relation to physical performance in elderly female cardiac inpatients. The present study aimed to determine both differences in physical performance based on the GNRI and physical performance cut-off values according to the GNRI in elderly female cardiac inpatients.Methods We enrolled 105 consecutive female Japanese inpatients aged a parts per thousand yen65 years (mean age, 74.6 years) with cardiac disease in this cross-sectional study. We divided the patients into two groups according to GNRI: high-GNRI group (a parts per thousand yen92 points) (n = 71) and low-GNRI group ( 92 points) (n = 34). Handgrip strength (HG), knee extensor muscle strength (KEMS), gait speed (GS), and one-leg standing time (OLST) were assessed as indices of hospital physical performance and compared between the two groups to determine cut-off values of physical performance.Results After adjustment for age and left ventricular ejection fraction, HG, KEMS, GS, and OLST were significantly lower in the low-GNRI versus high-GNRI group. Cut-off values by ROC curve analysis were 16.2 kgf (AUC = 0.66; p 0.001) for HG, 34.3 % of body weight (AUC = 0.62; p = 0.04) for KEMS, 1.24 m/s (AUC = 0.72; p 0.01) for GS, and 8.28 s (AUC = 0.62; p = 0.04) for OLST.Conclusions The risk of poor nutrition, as indicated by a low GNRI, might be a predictor of lower physical performance. Cut-off values determined in this study might be minimum target goals for physical performance that can be attained by elderly female cardiac inpatients.

Examining the associations of eHealth literacy (eHL) with obtaining health knowledge from websites would help to clarify the causal pathway between eHL and health knowledge. This study aimed to compare the results obtained from Internet users with high or low eHL in accessing a reputable cancer website to obtain colorectal cancer (CRC) knowledge. A total of 105 participants with high eHL and 103 participants with low eHL accessed a reputable CRC website managed by the National Cancer Center and responded to Internet-based surveys before and after accessing a website in 2012. Twelve responses to knowledge statements regarding CRC were selected based on item response theory, and the differences in correct responses of pre- and post-surveys by each eHL group were compared. Two statements showed a significant increase in correct responses in the high eHL group only: "Red meat intake is a risk factor" (p = 0.002), and "Obesity is a risk factor" (p = 0.029), whereas only one response did so in the low eHL group: "Bloody stools are a symptom" (p = 0.004). Low eHL Internet users appeared less capable of obtaining knowledge of CRC by accessing information from a reputable cancer website than high eHL Internet users.