Hokkaido Welfare Federation Hospitals: Their Role to Play in Improving Regional Medical Care / 日本農村医学会雑誌

The Hokkaido Welfare Federation of Agricultural Cooperatives runs a total of 15 hospitals including six general hospitals. Each hospital constitutes a nucleus of medical care facilities for people in each region of Hokkaido, Japan's largest prefecture. In addition to daily medical consultation, examination and treatment, they are carrying out extensive programs associated with health control for inhabitants in agricultural districts and care for the aged, whose number is increasing at a fast clip. In this paper, the author will review their activities in the past and present, and dwell on the future.

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.

Respiratory Troubles and Diseases caused by Farm Work / 日本農村医学会雑誌

One is inclined to imagine that the incidence of respiratory diseases will be negligible among rural people who live and work in fresh and clean air. On the contrary, however, we have reports on the high incidence of chronic obstructive pulmonary diseases and on the existence of a variety of specific respiratory diseases which are incidental to farm work. To clarify this situation, the Japanese Association of Rural Medicine organized a special study group and carried out various studies with grants from the Ministry of Health and Welfare. This is the study group's summary report of the four year research project prepared in conclusion of the project.<BR>The actual state of respiratory diseases among rural people, as investigated by the present study group, can be summarized as follows:<BR>1) In rural districts, in spite of its freedom air-pollution, there exist in high percentages people suffering from respiratory symptoms and patients of obstructive pulmonary diseases. As the important cause of this phenomenon, farm operations, especially thrashing, rice-hulling, compost preparation, scattering of agricultural chemicals can bementioned, which invite the development of symptoms and their aggravation.<BR>2) Pathologically, farmer's pneumoconiosis attributable to farm operation dust was evidenced, crying for the necessity of dust prevention measure during farm operations.<BR>3) In connection with atopic asthma the study group proved the antigenicity of rice-straw, wheat-straw, celiae of tea-sprout, young leaves, and chrysanthemum leaves. There are also anumber of already known antigens. It is necessary to establish measures for its prevention and treatment.<BR>4) In rural districts of Japan, esp. in stock-raising farm houses, there are in comparatively high percentages those who react positive to fungous antigens which are the causes of farmer's lung. However, there have hitherto been reported only two cases, and the study group added one more. In the future, more extensive practice of immunological tests and clinical follow-ups of the positive cases will be necessary.<BR>5) In view of the results reported above, it is considered that there are numerous questions concerning respiratory troubles and diseases in rural districts which are awaiting further study.

Respiratory Troubles and Diseases caused by Farm Work (Farmer's Lung, etc.) / 日本農村医学会雑誌

It is to be noted that in rural districts where they live and work in fresh and clean air the incidence of chronic obstructive pulmonary diseases is as high as in the districts of air-pollution. Besides, there are a variety of respiratory diseases particularly incidental to life-environment and farm work. To be more informed of their actual conditions, the Japanese Association of Rural Medicine organized a special study group and has carried out various studies for four consecutive years with grants from the Ministry of Health and Welfare. The major results obtained are as follows:<BR>(1) There were a variety of farm operations which produced or increased respiratory symptoms, including thrashing and scatteringof agricultural chemicals;<BR>(2) It became clear that there existed in an advanced age group certain cases of “agricultural pneumoconiosis” which could be regarded as the terminal of the so-called “thrash-bronchitis”<BR>(3) Among the cultivators of rush, raw material for Tatami, there existed cases of pneumoconiosis;<BR>(4) There were a variety of agents to produce bronchial asthma, such as rice straw, chaff, tea-leaves and chrysanthemum-leaves;<BR>(5) In Japan only two cases of farmer's lung were reported prior to this study. One more case was added to the list by this study group. Besides, cases positive to fungous agents were found among farmers in considerably high percentage.

Respiratory Troubles and Diseases caused by Farm Work / 日本農村医学会雑誌

It is to be noted that in rural districts where they live and work in fresh and clean air the incidence of chronic obstructive pulmonary diseases is as high as in the districts of air-pollution. Besides, there are a variety of respiratory diseases particularly incidental to life-environment and farm work. To be more informed of their actual conditions, the Japanese Association of Rural Medicine organized a special study group and has carried out various studies for four consecutive years with grants from the Ministry of Health and Welfare. The major results obtained are as follows<BR>(1) There were a variety of farm operations which produced or increased respiratory symptoms, including thrashing and scattering of agricultural chemicals;<BR>(2) It became clear that there existed in an advanced age group certain cases of “agricultural pneumoconiosis” which could be regarded as the terminal of the so-called “thrash-bronchitis”<BR>(3) Among the cultivators of rush, raw material for Tatami, There existed cases of pneumoconiosis;<BR>(4) There were a variety of agents to produce bronchial asthma, such as rice straw, chaff, tea-leaves and chrysanthemum-leaves;<BR>(5) In Japan only two cases of farmer's lung were reported prior to this study. One more case was added to the list by this study group. Besides, cases positive to fungous agents were found among farmers in considerably high percentage.