Strategy for Building Healthy Communities in Rural Areas in Japan and Supportive Activities by the Japanese Association of Rural Medicine / 日本農村医学会雑誌

In the health and welfare policy of the 21st century, the building of healthy communities in rural areas has become an urgent task. The working out of an effective strategy and supportive activities by the Japanese Association of Rural Medicine have become important. We analyzed the situation, outcome, and problems of the health projects which have been continued for the past 40-50 years in Takasu?cho in Hokkaido, Masuda-cho in Akita, Matsumoto City in Nagano and Izumo City in Shimane Prefectures. The supportive actions by hospitals and universities were assessed as a model of community-academia collaboration.

Long-Term Changes in Body Mass Index and Anemia in Rural Inhabitants in Central Hokkaido / 日本農村医学会雑誌

Based on the community health examination data (1980-1996) for inhabitants of Takasu, a rural town in Central Hokkaido, long-term changes in body mass index and prevalence of anemia were studied.<BR>The results were as follows:<BR>1) Median BMIs increased gradually during the observation period in all age groups in males, whereas in females median BMI did not clearly change in their 50's to 70's and decreased gradually in their 30's and 40's.<BR>2) Median BMIs increased gradually with age in both sexes.<BR>3) Median blood hemoglobin levels did not clearly change during the observation period in both sexes.<BR>4) The rate of iron-deficiency anemia was supposed to increase gradually during the observation period in females in their 30's and 40's.

Erythema Gyratum Repens Unassoicated with Visceral Cancers / 日本農村医学会雑誌

Erythema gyratum repens (EGR) is characterized by peculiar clinical features of a wood-grain or zebra-like appearance and rapid migration of concentric erythematous bands as a skin manifestation.<BR>Since Gammel reported in 1952 the first case of this condition as a complication in a 60-year-old man with breast carcinoma, a large number of cases with underlying malignancies have been recorded in medical literature throughout the world. Therefore, ERG has been considered an absolute form of the paraneoplastic skin syndrome.However, Barber et al. reported a case of EGR resulting from pulmonary tuberculosis and unassociated with visceral neoplasm in 1978. Many recent studies also suggests that not all the EGR cases are definitely linked to underlying malignancies.<BR>In this article, we describe a case of a 51-year-old man with EGR in whom no internal malignancies could be detected. We also discuss distinctions between EGR and erythema annulare centrifugum (EAC) and more complex clinical and immunopatholigic aspects of EGR, which have come to the attention of medical researchers recently.

Regional Care System for Ill or Disabled Old People at Home in a Rural Area. The Case of Takasu Town / 日本農村医学会雑誌

Takasu Town has instituted a health and medical information system based on the residents' registry since 1985. Recently, information about home care information was added to this in order to promote the efficiency of home care support.

Morale Scale of the Aged / 日本農村医学会雑誌

A PGC morale scale survey was taken on the aged people in a town of Takasu. No difference was observed in the final score between sexes, but responses to some questions differed significantly between men and women. The disparities were considered due to such factors as respondents' conjugal relations, family make-up and health conditions. When compared with healthy persons, those who see doctors regularly for treatment of high blood pressure and cardiovascular disease got poor scores. Especially the scores for the woman outpatients were significantly lower than those for the healthy women. A similar tendency was noted in the results of activity analysis using the ability indexes of a geriatric research institute. Also worthy of note here is the fact that an individual ability score and moral score significantly correlated.<BR>Therefore, in order to help raise their moral scores, it is very important to help raise their ability to do something in everyday life after due consideration of the quality of life of the aged.

Studies of Facility Care and Home Care for the Aged in a Rural Community / 日本農村医学会雑誌

A survey was made of the state of home care for healthy old folks and those elderly patients who have been disabled by illness or injury, and the care provided by institutions in six areas throughout the nation.<BR>The number of healthy old people was larger in women than in men. However, men had the edgeon women in Activity Daily Living (ADL). Compared to the healthy aged people, many ill or disabled elderly patients receiving home care were found to be suffering from anemia, low cholesterol level, hypoproteinemia, and poor glucose-tolerance. The major cause of disability was cerebral apoplexy. Recently, the cases of cerebral hemorrhage have decreased in number, and the rate of death in acute stage has notability declined ; however, the incidence of cerebral infarction is on the increase among the aged.<BR>There are limits to care for disabled elderly patients at home by the family because of the aging of their spouses and the increasing trend toward the nuclear family. Many of those who look after the sick persons are crying for expert help and services capable of coping with a sudden change in the patient's condition. Hence the need to establish a 24-hour home care providing system. It is desirable to establish old people's homes, as residential care institusion, in alignment with hospitals. This system would facilitate hospitalization in case of emergency. To execute care programs more effectively, close collaboration will be necessary among hospital, home care services, clinics, local governments, agricultural cooperatives, and neighborhood associations.

Introduction of a mass screening program into a rural community: An approach to the development of a primary health care system / 日本農村医学会雑誌

Takasu-machi is a small rural community (population: about 7, 500) adjacent to Asahikawa, one of the largest cities in Hokkaido, Japan's nothernmost major island. Its economy is largely based on agriculture dominated by paddy rice growing. The only medical institution available here is a bedless clinic. To meet total health needs of the inhabitants, we have implemented a total health control program since 1975, with multiphasic screening as its main component. The objectives of of the program are prevention of disease by means of education, early detection and early treatment of disease, and establishment of a primary health care system.<BR>Recently we have conducted a survey of the outcome of the program. The survey found that significant results have been obtained during the past decade.<BR>(1) The number of untreated cases has fallen.<BR>(2) The costs of medical care have been beld down.<BR>(3) The relations between the hospital and practicing physicians have become closer.<BR>(4) People have become health-conscious and aware of the significance of symptoms.<BR>These findings suggest that the establishment of a primary health care system emphasising health screening will be conductive to the health of the medically underserved rural populace.

Epidemiological and clinical studies of hepatocirrhosis and cancer of the liver / 日本農村医学会雑誌

Studies were performed on 44 cases of hepatocirrhosis found by laparoscopy and 75 cases resulting in death from hepatocirrhosis in order to shed light on the etiology of this disease.<BR>Thanks to progress in radiographic diagnosis, it has become possible to detect minute tumors in the liver. In our hospital, six patients have been diagnosed as having less than 5 cm tumors in the liver. The diagnositic procedures that had led to the detection of the lesions were reviewed.<BR>Furthermore, the treatment methods of liver cancer were analyzed using the ten cases.

A health status of women in a diary farming community of Hokkaido:survey findings / 日本農村医学会雑誌

Located in the northernmost part of Hokkaido, Tenpoku is one of the representative dairy farming districts in the prefecture. Official data for fiscal 1983 show that the size of grassland per dairy farm household is 35 ha and that the number of milch cows averages 48 head.<BR>Between 1981 and 1984, investigation was made on the health of women on dairy farms by means of a questionnaire, consultation and multi-programmed health examination. The survey project was actually under-taken during the spring and summer months. The effective number of subjects were 350.<BR>The results of the investigation was compared with those of another health survey which was conducted in the same period on a total of 960 women engaged in paddy rice farming.<BR>The comparison revealed that there are marked differences in health conditions between the two groups.<BR>(1) The frequency of complaints such as associated with the “farmers' syndrome” is higher among the dairy farmers than the rice growers.<BR>(2) The incidence of anemia is also higher in the former group than the latter.<BR>Dairy farming in the district mostly is a family business.The larger the ranch becomes, the harder women, particularly housewives, have to work.<BR>In order to improve health standards, changes in eating habits and implementation of preventive measures against stiffness in the shoulders, low back pain and other lifestyle-related maladies.<BR>To lessen the work load, cooperation among neighbors in a larger part of work should be encouraged.