日足P&Fの状況：（04月21日）～（04月25日）

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.

Background Psychological, social, and environmental factors are important determinants for physical activity promotion. There are numerous studies of the direct effects of these factors on physical activity. However, only a few studies have been examined the direct and mediated effects of these factors on physical activity.Purpose The purpose of the present study was to examine the direct and indirect influences of psychological, social, and environmental factors on physical activity among Japanese adults.Methods An internet-based cross-sectional survey was conducted to 2,000 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, and marital status), self-efficacy, pros and cons, social support for exercise and environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetics, seeing others exercising) were assessed by a self-administered questionnaire. The physical activity was estimated from the Japanese version of the short form of the International Physical Activity Questionnaire. Data were analyzed using structural equation modeling by gender.Results The respondents' mean (SD) age was 43.6(13.0). Environmental factors had indirect effects on physical activity through self-efficacy, social support and pros and cons. On both gender, the strongest indirect effects was the path of environmental factors on physical activity through pros to self-efficacy. The total effects of environmental factors on physical activity were 0.06 of males and 0.04 of females.Conclusion The results indicate that environmental factors had indirect effects on physical activity through psychological and social factors among Japanese adults. These results could contribute to the development of physical activity promotion strategies in Japan.

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: Inconsistent associations of neighbourhood walkability with adults' body weight have been reported. Most studies examining the relationships of walkability and adiposity are cross-sectional in design. We examined the longitudinal relationships of two walkability indices - conventional walkability and space syntax walkability, and their individual components, with weight change among adults over four years. Methods: Data were from the Physical Activity in Localities and Community study in Adelaide, Australia. In 2003-2004, 2650 adults living in 154 Census Collection Districts (CCDs) returned baseline questionnaires in 2007-2008, the follow-up survey was completed by 1098. Participants reported their weight at baseline and at follow-up. Neighbourhood walkability indices were calculated using geographic information systems and space syntax software. Linear marginal models using generalized estimating equations with robust standard errors were fitted to examine associations of the two walkability indices and their individual components with the weight at follow-up, adjusting for baseline weight, socio-demographic variables, and spatial clustering at the level of CCD. Results: The overall mean weight gain over four years was 1.5 kg. The two walkability indices were closely correlated (r = 0.76, p < 0.01). No significant associations were found between the overall neighbourhood walkability indices and weight change. Among walkability components, there was a marginally significant negative association between space syntax measure of street integration and weight change: one standard deviation increment in street integration was associated with 0.31 kg less weight gain (p = 0.09). Conclusions: Using a prospective study design and a novel space-syntax based measure of walkability, we were not able to identify relationships between neighbourhood walkability with weight gain. This is consistent with other inconclusive findings on the built environment and obesity. Research on the built environment and adults' weight gain may need to consider not just local environments but also a larger scale environment within a city or workplace environment in order to capture multiple behaviours relevant to weight gain.

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.

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.

Purpose Environmental initiatives to support walking are keys to noncommunicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance. Methods Data were from the Australian Diabetes, Obesity and Lifestyle study collected in 2004-2005 (baseline) and in 2011-2012 (follow-up). Participants who did not move residence during the study period (n = 2684, age range: 30-77 yr at baseline) were categorized as regular walkers (walked five times per week or more) or not at baseline. Regular walkers were divided into those who stopped and those who maintained regular walking at follow-up. Regression analyses examined relationships of regular walking and walking maintenance with perceived attributes of neighborhood destinations and pedestrian environments. Results Regular walking at baseline was significantly associated with availability of shops (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.04-1.22), many alternative routes (OR = 1.12, 95% CI = 1.01-1.23), park or nature reserve (OR = 1.13, 95% CI = 1.02-1.26), bicycle or walking tracks (OR = 1.08, 95% CI = 1.00-1.17), and feeling safe to walk (OR = 1.18, 95% CI = 1.01-1.38). Maintenance of regular walking was associated with the availability of multiple alternative routes (OR = 1.19, 95% CI = 1.03-1.38). Having many alternative routes and walking tracks was associated with walking maintenance among those who were not or had stopped working. Conclusions Neighborhood destinations (shops and parks) and pedestrian environments (alternative routes, walking trails, and safety from crime) were found to be associated with regular walking, but only pedestrian environment attributes were found to be related to the maintenance of regular walking. Further evidence from prospective studies is required to identify other neighborhood environmental attributes that might support walking maintenance.

Background: It is still not known whether overweight men have different patterns and socio-demographic correlates of self-reported physical activity (PA) compared with normal-weight men. Thus, this study examined the perceived PA patterns and associated socio-demographic factors among normal-weight and overweight Japanese men.Methods: Data were analyzed for 1,420 men (aged 44.4 +/- 8.3 years) who responded to an Internet-based cross-sectional survey relating to socio-demographic variables, BMI status, and a short version of the International Physical Activity Questionnaire. Mann-Whitney, chi-square, and binary logistic regression analyses were employed.Results: Normal-weight men were significantly more likely to attain 150 minutes per week of moderate-to-vigorous PA than overweight men (26.6 % vs. 21.3 %; p = 0.035), whereas there were no significant proportional differences in total PA and walking between the two BMI subgroups. With PA, a significant interaction was observed between BMI status and household income (p = 0.004 for total PA; p = 0.02 for walking). In the subgroup analyses, having a lower household income (odds ratio, 0.63; 95 % confidence interval, 0.41-0.96) was negatively associated with attaining 150 minutes of walking per week among normal-weight men. No significant associations between household income and attaining 150 minutes per week of total PA and walking were found among overweight men.Conclusions: The results revealed that patterns and socio-demographic correlates of self-reported PA in overweight men are different from those in normal-weight men. This finding suggests the necessity of developing specific strategies for PA intervention among overweight men. Socio-demographic correlates of PA may be more important for normal-weight than overweight men.

【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.

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.

The purpose of this cross-sectional study is to investigate the difference in physical activity among elderly living in different areas in Japan ("Bunkyo Ward in Tokyo" (Bunkyo) and "Fuchu City in Tokyo" (Fuchu) as urban areas, and "Oyama Town in Shizuoka" (Oyama) as a non-urban area). Participants were 1859 community-dwelling residents aged 65-74 years, randomly selected from the residential registry (response rate: 68.9%). A mail survey using self-administered questionnaires was conducted. Multivariate logistic regression analyses were used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) of various types of physical activity (eg, walking (Walking), going out (Going-out), bicycling (Bicycling), exercise habits (Exercise)), according to residential areas (reference category: Fuchu), stratified by gender, adjusting for socio-demographic variables. There was a significant difference in Going-out (ORs = 0.61 (95% CI: 0.44-0.86) for men, 0.48 (0.33-0.69) for women)), and Bicycling (0.04 (0.03-0.07) for men, 0.04 (0.02-0.07) for women) in Oyama compared to Fuchu. Furthermore, for women, there was a significant difference in Walking (0.56 (0.38-0.81)) and Exercise (0.59 (0.41-0.85)) in Oyama compared to Fuchu. There was a significant difference in Bicycling and Going-out for men in Bunkyo compared to Fuchu, but there was not a significant difference in other items. Low physical activity levels were observed in the elderly in the non-urban area compared to urban areas. The association was stronger in women. Regional difference might need to be taken into account for an effective physical activity intervention.

Background: In the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users.Objective: The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan.Methods: The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N= 10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses.Results: We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth literacy were significantly more likely to exhibit the good health behaviors of physical exercise (adjusted odds ratio [AOR] 1.377, 95% CI 1.131-1.678) and eating a balanced diet (AOR 1.572, 95% CI 1.274-1.940) than individuals with low eHealth literacy.Conclusions: We found that some health behaviors, including exercise and balanced nutrition, were independently associated with eHealth literacy among Japanese adult Internet users.

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.

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.