Education and household income and carotid intima-media thickness in Japan: baseline data from the Aidai Cohort Study in Yawatahama, Uchiko, Seiyo, and Ainan

BACKGROUND@#Epidemiological evidence for the relationship between education and income and carotid intima-media thickness (CIMT) has been limited and inconsistent. The present cross-sectional study investigated this issue using baseline data from the Aidai Cohort Study.@*METHODS@#Study subjects were 2012 Japanese men and women aged 34-88 years. Right and left CIMT were measured at the common carotid artery using an automated carotid ultrasonography device. Maximum CIMT was defined as the largest CIMT value in either the left or right common carotid artery. Carotid wall thickening was defined as a maximum CIMT value > 1.0 mm.@*RESULTS@#The prevalence of carotid wall thickening was 13.0%. In participants under 60 years of age (n = 703) and in those aged 60 to 69 years (n = 837), neither education nor household income was associated with carotid wall thickening or with maximum CIMT. Among those aged 70 years or older (n = 472), however, higher educational level, but not household income, was independently related to a lower prevalence of carotid wall thickening: the multivariate-adjusted odds ratio for high vs. low educational level was 0.43 (95% confidence interval 0.21-0.83, p for trend = 0.01). A significant inverse association was observed between education, but not household income, and maximum CIMT (p for trend = 0.006).@*CONCLUSIONS@#Higher educational level may be associated with a lower prevalence of carotid wall thickening and a decrease in maximum CIMT only in participants aged 70 years or older.

Implementation and Effects of an Interprofessional Collaborative Workshop by Students / 社会薬学

The dawn of Japan’s super-aged society is accompanied by various problems, including increased social security expenditures and greater nursing care burden as well as reduced labor force. Targeting 2025, when Japan’s baby-boomer generation will be aged ≥75 years, the government’s Ministry of Health, Labour and Welfare is promoting the establishment of local comprehensive support and service provision systems (Comprehensive Community Care Systems). Although such comprehensive community care systems will require medical professionals to provide treatment through collaborative interprofessional cooperation with colleagues in other fields, effective cooperation has currently not been established because of a lack of understanding regarding the roles and functions of other occupations. Considering that the promotion of interprofessional-based collaborative learning prior to university graduation will be important for resolving this problem, we organized a workshop for medical students based in Ehime Prefecture and evaluated its usefulness based on questionnaire surveys administered before and after the workshop. Consequently, it was ascertained that pharmacy, medical, and nursing students had a heightened awareness of “the importance of interprofessional collaboration” after the workshop as against before the workshop. Students’ degree of comprehension of the nature of the work in each category increased significantly. These results demonstrate the importance and effectiveness of students familiarizing themselves with the learning and work content of other fields by working with colleagues in different medical fields as observed in this workshop. They also expect that student-led study groups will contribute to promote the comprehensive community care systems.

Effects of background factors on subjective health and survival rate among community-dwelling persons / 日本プライマリ・ケア連合学会誌

<b>Background</b> : With the recent progression of the aging society in Japan, what is now seen as important is not simply treatment of disease alone, but also increased quality of life. We have investigated the correlation between the feeling of subjective health and mortality after mean 3.8 year among local residents.<br><b>Methods</b> : In fiscal 2008, a self-recording questionnaire survey was conducted by mailing the questionnaire to 2,657 local residents. Correlation with deaths after mean 3.8 years was investigated based on the Resident Register. With regard to the evaluation items, as background factors related to death, social life conditions (gender·age), health conditions (history of cardiovascular disease, state of depression, subjective happiness, subjective health)and basic activities of daily living (BADL : walking, diet, excretion, bathing, dressing, and ambulation)were evaluated using a 4-point scale ranging from total assistance to completely independent. The Tokyo Metropolitan Institute of Gerontology (TMIG : instrumental independence, intellectual activity, and social role)was used to evaluate the lifestyle factors.<br><b>Results</b> : Of 1825 subjects, 767 males (mean age : 67±13 years)and 1058 females (mean age : 68±11 years), could be analyzed. There were 91 deaths from 2008 to 2012. Investigation of factors that increased subjective health revealed that age, cardiovascular disease, state of depression, intellectual activities, and subjective happiness were items that showed significant correlation. Multivariate logistic regression analysis revealed that subjective health was a significant explanatory variable of death.<br><b>Conclusion</b> : How one personally feels about one's state of health and how one recognizes that, are important. Though not seen physically, they can be considered as important parameters that predict prognosis.