Evaluation of Four Predictive Models for Identifying Malignancy of Solitary Pulmonary Nodules in Health Check-up Population / 肿瘤防治研究

Objective To compare and validate the efficiency of four models predicting the malignancy of solitary pulmonary nodules (SPN). Methods Patients diagnosed with SPN during health check-up were selected as the research subjects. Risk assessment was conducted using four predictive models. Outcomes were obtained through prospective follow-up. Statistical description and univariate analysis were performed for all risk factors of the four models. ROC curve was applied to compare the efficiency of the four predictive models. Results A total of 479 cases were included in this study. Among these patients, 82 were diagnosed with lung tumor, and the malignant rate was 17.12%. Age, nodule diameter, smoking, family history of tumor, history of extrapulmonary tumor ≥5 years, upper lobe site, unclear boundary, and spiculation rates were higher in the malignancy group than those in the benign group (P < 0.05). The efficiency of Brock model was the best. Its AUC was 0.833, sensitivity was 80.49%, and specificity was 74.31%. Its Youden index, positive likelihood ratio, positive predictive value, and negative predictive value were the highest, and its negative likelihood ratio was the lowest. The AUC, sensitivity, and specificity of Mayo model were 0.815, 81.71%, and 67.51%, respectively; those of PKUPH model were 0.754, 69.51%, and 73.55%, respectively; and those of VA model were 0.738, 68.29%, and 67.55%, respectively. Conclusion The Brock model might be the most appropriate predictive model for the risk assessment of SPN among the health check-up population, and the VA model is the worst. The combination of Brock, Mayo, and PKUPH models requires further study.

Current status and research progress of occupational health monitoring in welding fume operations / 中华劳动卫生职业病杂志

Welding operations are widely present in the manufacturing production process, involving a large number of occupational groups, and are the key occupations where work injuries and occupational diseases occur in China. For different welding processes and welding materials, the content and focus of occupational health monitoring are different. At present, the item of occupational health examination in welding operation is in poor consistency with the on-site exposure of occupational hazard factors, and it is mainly concentrated in the stage of disease development, which can not reflect the early health damage caused by welding dust exposure in time. The emergence of biomarkers of welding dust can make up for this defect. Therefore, it is of great significance to describe the current situation of occupational health monitoring of welding dust and summarize the research progress of related biomarkers for the early prevention of diseases caused by welding dust and the practice of occupational health monitoring.

Development trend of physical examination volume and revenue in health-checkup institutions in China from 2010 to 2019 / 中华健康管理学杂志

Objective:To investigate the development trend of physical examination volume and revenue in health-checkup institutions in China from 2010 to 2019.Methods:In this longitudinal study, the annual income, annual physical examination volume and other indicators reflecting institutional size were collected with questionnaire from 374 health-checkup institutions in the year of 2010, 2015 and 2019. The geometric mean method is used to calculate the compound annual growth rate (CAGR) of the annual physical examination volume, annual income, mean per capita cost from 2010 to 2015 and 2015 to 2019.Results:The annual physical examination volume of health-checkup institutions increased from 1.81 (1.00, 3.20) ×10 4 person times in 2010 to 5.08(3.50, 7.28)×10 4 person times in 2019; the CAGR of the physical examination volume from 2010 to 2015 was 14.04%(8.14%, 23.78%), and it was 9.49%(3.39%, 19.07%) from 2015 to 2019. The annual revenue increased from 768.73 (350.00, 1 623.75) ×10 4 yuan in 2010 to 3 500.00 (1 997.73, 6 818.54) ×10 4 yuan in 2019; the CAGR of annual revenue from 2010 to 2015 was 25.75% (15.17%, 35.09%), and it was 15.67% (8.78%, 26.11%) from 2015 to 2019. The mean per capita cost increased from 434.26 (278.82, 666.66) yuan in 2010 to 755.80 (506.90, 1 005.42) yuan in 2019; the CAGR of the mean per capita cost was 9.82% (1.71%, 17.10%) from 2010 to 2015, and it was 5.37% (0.95%, 10.46%) from 2015 to 2019. Conclusion:From 2010 to 2019, health-checkup institutions in China developed rapidly, and the CAGR of the annual physical examination volume, annual revenue, mean per capita cost are high.

Analysis of factors influencing the frequency of health check-up and health check-up behavior in healthy population / 中华行为医学与脑科学杂志

Objective:To analyze the relevant factors affecting the frequency and behavior of health check-up among the population of medical examinees.Methods:From January to June 2022, 491 health examinees who had health check-ups at the Second Affiliated Hospital of Shandong First Medical University were included.Basic information of the check-up population and their needs for check-up services (form of check-up, content of check-up, cost of check-up, form of feedback on check-up results, and needs for check-up providers) were obtained based on a questionnaire survey.According to the frequency of previous medical check-up, the examinees were divided into never-check-up group (frequency of check-up was 0, n=45), the irregular check-up group (the interval between two physical examinations >1 year, n=49) and the regular check-up group (frequency of check-up=1 year, n=347). The frequency of previous medical check-up was used as the dependent variable, and the age, gender, education level, income, form of medical check-up and cost of medical check-up were used as independent variables to analyse the relevant factors affecting the frequency of their medical check-ups.The above count data were analyzed by one-way analysis using chi-square test, and the count data with statistically significant differences in one-way analysis were analyzed by binary logistic regression.The statistical software was SPSS 21.0. Results:The study included 491 medical examinees, of which 9.16%(45/491) were in the never-check-up group, 20.16%(99/491) in the irregular check-up group and 70.68%(347/491) in the regular check-up group. The impact of demography characteristics of physical examinees on the frequency of health check-up, and there were statistically significant differences in the frequency of health check-up in terms of gender, job, education, and income ( χ2=21.826, 157.113, 104.764, 45.486, all P<0.05). The understanding of health check-up and the attention paid to one's own health were influencing factors that affected the frequency of health check-up. There were statistically significant differences in the frequency of health check-up in necessity of health check-up, attention to one's own health, health check-up forms, health check-up institutions, health check-up price and health check-up contents ( χ2=9.277, 25.863188.239, 59.115, 39.250, 28.314, all P<0.05). Logistic regression analysis showed gender, job type, monthly income, necessity of health check-up, concerns for items of check-up, forms and institutions of check-up were influencing factor of health check-up frequency(all P<0.05). Conclusion:The health check-up behavior of the population and the frequency of regular medical check-ups are influenced by the factors such as gender, education, occupation, income, form of medical check-up, price of medical check-up, choice of medical check-up institution and the degree of concern for one’s own health. The popularisation of health check-ups for special groups such as men, low-income people, low literacy and insufficient awareness of the importance of one’s own health will help improve the overall health awareness of the population.

Iodine nutrition status thyroid nodule detection and influencing factors in 450 health check-up residents in Chengdu / 公共卫生与预防医学

Objective To study the iodine nutrition status and analyze the detection of thyroid nodules and its related influencing factors in 450 health check-up residents in Chengdu area and to provide evidence for the prevention of thyroid nodules. Methods A total of 450 residents who underwent health check-up in the Western Theater General Hospital from January 2019 to January 2022 were selected as the research subjects. The gender, age, weight and other basic conditions of the subjects were investigated, and their urinary iodine levels and occurrence of thyroid nodules were examined. Univariate and multivariate methods were used to analyze the influencing factors of occurrence of thyroid nodules. Results The overall urinary iodine level of the 450 health check-up people in Chengdu area was (96.89 -212.38) μg/L, with an average of (164.86±42.58) μg/L. The urinary iodine level of males was significantly higher than that of females (P60 years old (P60 years old , people in rural areas and people with history of diabetes mellitus in the thyroid nodule group were higher than that in the non-thyroid nodule group, and thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) were higher than those in the non-thyroid nodule group (P60 years old, history of diabetes mellitus and high levels of TGAb and TPOAb were risk factors for the occurrence of thyroid nodules (P<0.05). Conclusion The overall iodine nutrition level of 450 health check-up people in Chengdu is in the appropriate range, and the detection rate of thyroid nodules is high. It is necessary to strengthen the examination of thyroid nodules in key populations (women , history of diabetes mellitus, the elderly, etc.), and provide early detection and active intervention to prevent the occurrence and progression of thyroid nodules.

Combined association of oral and skeletal muscle health with type 2 diabetes mellitus among community-dwelling older adults in Japan: a cross-sectional study / Journal of Rural Medicine

Objective: Although oral health and skeletal muscle status are known to be risk factors for type 2 diabetes mellitus (T2DM), there is limited information on their combined effects among community-dwelling older adults. The purpose of this study was to investigate the association between oral health and skeletal muscle status among older adults with T2DM in Japan.Participants and Methods: This cross-sectional study included data from individuals aged ≥60 years. T2DM was defined as a glycosylated hemoglobin A1c level ≥48 mmol/mol (≥6.5%) or the use of hypoglycemic agents. For oral health status, dental hygienists assessed the number of teeth (NT) and masticatory function (MF). Skeletal muscle status was assessed using skeletal muscle mass index (SMI) and handgrip strength (HGS). Logistic regression analysis examined T2DM in nine-category combinations of oral health status (each of the three categories in NT and MF) and skeletal status (each of the three categories in SMI and HGS).Results: T2DM was prevalent in 83 participants (16.4%) and was significantly associated with low NT and SMI (odds ratio [OR] = 5.93, 95% confidence interval [CI]: 1.37–25.73) and low MF and SMI (OR = 4.48, 95% CI: 1.23–16.35) compared to high NT and SMI and high MF and SMI, respectively.Conclusion: Our findings indicate that low muscle mass with tooth loss or masticatory dysfunction is associated with T2DM among community-dwelling older adults. This suggests that maintaining oral health and muscle mass may be an effective strategy for the prevention of T2DM.

Bibliometrics and visualization analysis of quality control research of health checkup / 中华健康管理学杂志

Objective:To understand the research status, research hotspots and research frontiers of quality control of health checkup in the past 15 years.Methods:Journal literatures with the theme of "Health checkup and Quality control" from China National Knowledge Infrastructure (CNKI) database from 2006 to 2020 were retrieved and analyzed. Excel was used to analyze the time and sequence and discipline distribution of literatures. CiteSpace V software was used for visual analysis of institutions and keywords.Results:A total of 306 literatures were obtained, and the number of literatures published in the past 15 years showed an overall growth trend, with the highest number of literatures published in 2019 (36). They mainly focused on the research of medical and health policies and laws and regulations, clinical medicine, preventive medicine and hygiene and other disciplines, with a few literatures belonging to interdisciplinary disciplines. The top three institutions were Physical Examination Center of Naval General Hospital, Health Management Center of the General Hospital of Tianjin Medical University, Health Management Research Institute of PLA General Hospital. The institutions with high centrality were Physical Examination Center of Naval General Hospital, Editorial Board of Chinese Journal of Health Management, and Chinese Health Management Association and so on. There were fewer cooperative links between institutions. The high-frequency keywords found in 306 literatures were"quality control","health checkup","quality management","health management","physical examination center","Deming Cycle (Plan-Do-Check-Action Cycle, PDCA Cycle)","quality of health checkup", etc."Health management"was the key emergence word in the recent three years.Conclusions:In the past 15 years, the attention on the quality control of health checkup in China has gradually increased, but there is less cross-connection between disciplines and institutions. The research focuses on the internal quality control and the application of advanced management theories in health examination institutions. The transformation from simple health checkup to health management service is the research frontier.

Health check-up guide for rural residents (T/CHAA 005-2019) / 中华预防医学杂志

This standard stipulates the principles, institutional requirements, inspection items, service modes, data management and utilization requirements for carrying out the health check-up for rural residents. It is applicable to the standardized management of the health check-up for rural residents aged 15 years old and above under the relevant national laws and regulations.

Interpretation for the group standard of Health check-up guide for rural residents / 中华预防医学杂志

With the acceleration of the population aging in China, the health problems and the demands of health services such as health check-up for rural residents should attract the attention of the whole society. The group standard entitled Health check-up guide for rural residents (T/CHAA 005-2019), was written by experienced researchers from Chinese Center for Disease Control and Prevention and other professional institutes coordinated by Chinese Health Association. The standard aims to establish a service model that takes health information collection as a means, health risk assessment, health risk intervention and information services as the core, improving the health of rural residents as the target.

Smoking status and unruptured intracranial aneurysm among brain health check-up examinees: a cross-sectional study in Japan / Journal of Rural Medicine

Objective: Although it is well known that smoking is a risk factor for subarachnoid hemorrhage, the association between smoking and unruptured intracranial aneurysms remains unclear. The aim of the present study was to investigate whether smoking status was associated with unruptured intracranial aneurysms among Japanese brain health check-up examinees.Materials and Methods: We conducted a cross-sectional study of 1,496 adults (aged 26–90 years) undergoing brain health check-ups at a single community medical support hospital in Akita, Japan between 2009 and 2013. In Japan, people can discretionarily undergo a brain health check-up for early detection of unruptured intracranial aneurysms or subarachnoid hemorrhages. Participants responded to a questionnaire on lifestyle, such as smoking status, and were classified into three groups: never, former, and current smoker. The evaluation of unruptured intracranial aneurysms detected by magnetic resonance angiography was performed by an expert physician. Multiple logistic regression models were used to estimate the odds ratio for unruptured intracranial aneurysms. We performed statistical analyses by age, sex, and family history of stroke.Results: The number of participants with unruptured intracranial aneurysms was 43 (2.9%). The mean age (standard deviation) and proportion of males was 55.8 (9.5) years and 53.3%, respectively. The adjusted odds ratios (95% confidence intervals) for unruptured intracranial aneurysms of 1.21 (0.48–3.08) among former smokers and 2.88 (1.10–7.50) among current smokers were compared to those of never smokers (p-trend = 0.041). After stratifying by age, sex, and family history of stroke, no interactions were found.Conclusion: This cross-sectional study conducted in Japan showed that smoking was positively associated with unruptured intracranial aneurysms among brain health check-up examinees.

The incidence of diabetes among the non-diabetic residents in Kawauchi village, Fukushima, who experienced evacuation after the 2011 Fukushima Daiichi nuclear power plant disaster

OBJECTIVES@#After the Fukushima Daiichi nuclear power plant disaster in 2011, residents of Kawauchi village who experienced evacuation had a high risk of suffering from diabetes and metabolic syndrome compared with non-evacuees. In addition to evacuation, lifestyle characteristics can be important factors influencing the development and prognosis of diabetes or glucose tolerance. The current study aimed to evaluate the effects of evacuation (i.e., lifestyle changes) on the incidence of diabetes among the non-diabetic residents of Kawauchi village.@*METHODS@#Design is retrospective cohort study. Annual health examination data of residents of Kawauchi village and control area (Ono town) in Fukushima prefecture from 2008 to 2017, as available from the Japanese National Health Insurance system. Participants were classified into three groups: "Diabetes (DM)" (FBG ≥ 126 mg/dL or HbA1c ≥ 6.5% or hospital visit for DM or usage of diabetic medication), "Borderline DM" (126 mg/dL > FBG ≥ 110 mg/dL or 6.5% > HbA1c ≥ 6.0%, and without hospital visit, and without diabetic medication), and "Normoglycemic" (FBG < 110 mg/dL and HbA1c < 6.0%, and without hospital visit, and without diabetic medication). New onset of diabetes was evaluated and the events or missing data were occurred at health checkup. For this survival analysis, 339 residents in Kawauchi and 598 residents in Ono were included. Average follow-up periods after 2010 were 3.9 years in Kawauchi village and 3.6 years in Ono town.@*RESULTS@#Compared with the normoglycemic group, incidence of DM was much greater in the borderline DM group, where DM occurred among 38.2% of the group in 2012 and increased to over 60% cumulatively through 2017 in Kawauchi village. DM had a prevalence of 16.3% in 2012, and below 30% in 2017 in borderline DM group of Ono town. Cox proportional hazard regression analysis was applied to non-DM groups at both study sites separately to evaluate the effects of lifestyle changes at each site. While BMI, BMI change, and the lack of regular exercise (HR = 1.29, 1.72, and 5.04, respectively) showed significant associations with the onset of diabetes in Ono town, only BMI and late-night dinner (HR = 1.21 and 4.86, respectively) showed significant associations with diabetes onset in Kawauchi village.@*CONCLUSIONS@#The current results confirmed that diabetes incidence was increased 6 years after the Daiichi nuclear power plant disaster in Kawauchi. We also found changes in lifestyle habits, suggesting that diabetes prevention with promotion of healthy lifestyle behaviors is an urgent priority.

Prevalence and Profile of Non-Alcoholic Fatty Liver Disease among Adults Undergoing Master Health Checkup, A Hospital based Cross Sectional Study

Introduction: Non-alcoholic fatty liver disease (NAFLD) hasemerged as a major public health problem in recent times. Itis one of the neglected conditions in developing nations likeIndia, due to scarcity of studies on the subject. Study objectivewas to assess the prevalence of NAFLD among patientsundergoing master health check-up in a tertiary care teachinghospital and to analyze the profile of NAFLD cases.Material and materials: The study was a hospital basedanalytical cross-sectional study. Conducted in a tertiary careteaching hospital in south India. People attending the masterhealth checkup in the study setting from June 2015 to July2018 were included. Chi square test was used to test statisticalsignificance.Results: A total of 818 patients were included, out of whom130(15.89%) had NAFLD. The proportion of grade 1, 2 and3 fatty liver was 79.23%, 13.84% and 6.92% respectively.The difference in waist circumference and HDL valueswere statistically significant between male & female (Pvalue <0.001 and 0.007 respectively). No other componentsof Metabolic syndrome had shown statistically significantdifference between males and females. The difference in gradeof NAFLD across the age group is found to be significant witha P- value of 0.035. Grade of NAFLD was not associated withany other diet or lifestyle related parameters.Conclusions: Significant proportion of healthy subjects areaffected by NAFLD, some of them with severe grades, withkey gender differences in some of the factors associatedwith NAFLD. Patients and clinicians needs to be sensitizedregarding NAFLD

Study on determinants of nutritional status of a school going children in a village of Tumakuru taluk

Background: Children (0-14 years) contribute to 26% of world population and 28.4% of India’s population. School going age is a formative period, physically as well as mentally, transferring child into a promising adult. Malnourishment in this age group compromises both physical and mental growth. The objective of the study was to assess the nutritional status and morbidity status among school going children.Methods: A cross sectional descriptive study was conducted at Greenberg international school Kannenahalli, Tumkur. After inclusion and exclusion criteria, which comprised children between 3-12 years of age, total 123 students were included in the study. A pre structured and pre tested proforma was used to collect the data on general information of the child, anthropometric measurements, physical examination, personal hygiene and clinical examination and blood grouping was done.Results: Out of 123 study participants, 30.9% were found to be malnourished and 35.77% had various morbidity conditions. Out of the 39 students who had malnutrition, 20 students (51.3%) were having grade 1 malnutrition, 15 students (38.5%) were having grade 2 malnutrition and 4 students (10.3%) were having grade 3 malnutrition.Conclusions: It concluded that, balanced diet for all the malnourished children to improve their nutritional status and also for healthy children to maintain their health and nutrition. Grade 3 malnourished children were referred to NRC (nutritional rehabilitation center) to improve their nutritional status.

Effects of health check-up feedback style (HCFS) on blood glucose and weight in type 2 diabetes patients aged 75 years and older: a randomized controlled study / 中华临床营养杂志

Objective To analyze the effect of health check-up feedback style (HCFS) on the blood glucose level and weight of type 2 diabetes patients aged 75 years and older.Methods 120 consecutive patients with type 2 diabetes and aged 75 and older who were taking annual health check-up and receiving paper-based medical examination reports at Peking Union Medical College Hospital were enrolled into this study.The patients were randomly divided into two groups (control group and study group).All patients received annual health check-up between November 2014 and October 2015 (baseline health check-up).Patients in control group were given paperbased feedback as usual,while those in study group received feedback via face-to-face or telephone conversations.All patients received their second annual health check-up between November 2015 and October 2016.The patients' blood glucose and weight at the second health check-up were compared between the two groups.Results In baseline health check-up,the levels of HbA1c and BMI showed no difference between the two groups.In the second health check-up,HbA1c and BMI of study group were lower than control group [(7.17±0.58)％ vs.(7.44±0.72)％,P=0.027;(24.3±3.8) kg/m2 vs.(25.0±4.2) kg/m2,P=0.049].Fast blood glucose and waist circumference showed no difference between the two groups.Conclusions Combination of paper-based reports and face-to-face or telephone conversations to feedback on health check-up results led to better blood glucose and BMI control in old aged type 2 diabetes patients.HCFS is of vital importance.

A cohort study on elderly individuals newly certified as requiring long-term care: comparison of rates of care-needs certifications between basic checklist respondents/specific health examinees and non-respondents/non-examinees of 37,000 elderlies in a city / Journal of Rural Medicine

Objective: The rates of care-needs certification were mainly compared between two cohorts: 7,820 specific health checkup examinees/basic checklist respondents and 29,234 non-examinees/non-respondents.Subjects and Methods: Among approximately 37,000 elderly citizens of X City, the number of individuals newly certified as requiring long-term care were observed from the date of the first specific health checkup in 2008 to March 31, 2013. The aggregated totals of these individuals and associated factors were evaluated.Results: 1. Support Required 1, Support Required 2, and Long-term Care Required (level 1) certified individuals accounted for approximately 80% of newly certified individuals aged 65–74 years. Newly certified individuals aged 75 years and over had similar results with 37.2% of them being certified Support Required 1, 19.4% certified Support Required 2, and 22.9% certified Long-term Care Required (level 1). 2. The primary factors for care-needs certification in individuals aged 65–74 years were arthritic disorder in 27.6%, falls and bone fractures in 11.3%, and malignant neoplasm and cerebrovascular disease, among others. This was similar for individuals aged 75 years or over. 3. Of the 7,820 specific health checkup examinees/basic checklist respondents, 1,280 were newly certified as requiring long-term care (16.4%) compared to 7,878 (26.9%) of the 29,234 non-examinees/non-respondents. Therefore, the latter cohort had a significantly higher rate of individuals who were newly certified as requiring long-term care.Conclusion: Both specific health checkups and basic checklists are effective health policies to protect frailty in community elderlies.

Resultados del Examen Periódico de Salud en el Policlínico Universitario Pedro Borrás Astorga / Results of the periodical health check-up in Pedro Borrás Astorga University Polyclinic

Introducción: el examen periódico de salud constituye una herramienta que emplea el médico de familia para iniciar el proceso de evaluación en adultos mayores. Objetivo: describir los resultados del examen periódico de salud. Métodos: se realizó un estudio descriptivo, transversal y retrospectivo en el Policlínico Universitario Pedro Borrás Astorga de Pinar del Río, durante el año 2015, a través de variables seleccionadas. La muestra de estudio estuvo constituida por 7 337 adultos mayores pertenecientes a dicha área de salud y los resultados se expresaron en tablas y gráficos para su mejor comprensión. Resultados: predominó el sexo femenino con 54,6 por ciento, así como el grupo de edad de 65 y más años con 68,6 por ciento. Prevaleció el grupo dispensarial III con 82,6 por ciento fundamentalmente en féminas. El número de exámenes periódicos de salud fueron superiores en el 2015 con 3 806 respecto a años anteriores, donde las afectaciones según escala geriátrica se evidenciaron en el uso de fármacos con 52,2 por ciento. El estado global funcional fue superior al frágil en un 72,6 por ciento. Conclusiones: se caracterizaron los resultados del Examen Periódico de Salud en el Policlínico universitario Pedro Borrás Astorga. El estudio enriquece y amplía el trabajo asistencial, docente, investigativo y gerencial en adultos mayores de dicha área de salud(AU)

Introduction: The periodic health check-up is a tool used by the family doctor to start the evaluation process in aged adults. Objective: To describe the results of the periodic health check-up. Methods: A descriptive, cross-sectional and retrospective study was carried out in Pedro Borrás Astorga University Polyclinic of Pinar del Río, during the year 2015, through selected variables. The study's sample consisted of 7 337 aged adults belonging to the mentioned health area and the results were expressed in tables and graphs for better understanding.Results: The female sex prevailed, with 54.6 percent, as well as the age group of 65 and over, with 68.6 percent. The dispensary group III prevailed, with 82.6 percent, mainly among females. The number of periodic health check-ups was higher in 2015, with 3 806, compared to previous years, in which the effects, according to the geriatric scale, were evidenced in the use of drugs, with 52.2 percent. The global functional state was higher than the fragile one in 72.6 percent. Conclusions: We characterized the results of the periodic health check-up in Pedro Borrás Astorga University Polyclinic. The study enriches and broadens the care, teaching, research and management work in aged adults in this health area(AU)

A retrospective cohort study on the risk assessment of newly certificated long-term care need of elderly individuals in a community: Basic checklist and specific health checkup / Journal of Rural Medicine

<p><b>Objective:</b> This study aimed to examine the factors influencing the requirement of a certificate of long-term care using a basic checklist and items listed in the Special Health Checkup.</p><p><b>Method:</b> This study included 7,820 individuals living in Uji city, who were selected from among 8,000 elderly individuals who, in 2008, underwent a specific health checkup (hereafter referred to as the ‘specific health checkup for the old-old elderly individuals’) for those aged 75 years and above. They answered questions from basic checklists at the time, and 180 individuals were excluded as they had already qualified for requiring the certificate of long-term care at the time of the checkup. The follow-up period extended from the day of the specific health checkup for the old-old elderly individuals to March 31, 2013. The data were analyzed using the certificate of needing long-term care as the response variable. The explanatory variables were the basic attributes, items listed in the specific health checkup for the old-old elderly individuals, interview sheets, and basic checklists. Cox proportional hazards regression analysis was conducted.</p><p><b>Results:</b> In total, 1,280 elderly individuals qualified for requiring the certificate of needing long-term care. The risk factors for the young-old elderly individuals aged 65 to 74 years were as follows: hepatic dysfunction (hazard ratio {HR}=1.69), the presence of subjective symptoms (HR=1.41), an above-normal abdominal circumference (HR=1.36), old age (HR=1.13), a reduced frequency of going out since the previous year (HR=1.87), the use of support for standing up after being seated on a chair (HR=1.86), no deposit or withdrawals made (HR=1.84), the anxiety of falling down (HR=1.50), an inability to climb stairs without holding a railing or wall (HR=1.49), as well as an increased difficulty in eating tough food items compared with 6 months prior (HR=1.44). The risk factors for the old-old elderly individuals were as follows: a positive reaction on proteinuria (HR=1.27), anemia (HR=1.18), old age (HR=1.10), inability to travel on a bus or train by themselves (HR=1.53), the inability to climb stairs without holding a railing or wall (HR=1.48), weight loss (HR=1.36), a reduced sense of appreciation of the activities they had previously participated in, over a span of 2 weeks (HR=1.30), the use of support for standing up after being seated on a chair (HR=1.23), and the anxiety of falling down (HR=1.20).</p><p><b>Conclusion:</b> The items listed in the specific medical checkup as well as the basic checklists were found to be risk factors for both the young-old elderly individuals and the old-old elderly individuals, indicating the need to utilize these lists for the prevention of nursing even in the late stages of life. Moreover, these results suggest the importance of screening elderly individuals suffering from hyperkinesis using the basic checklist and conducting preventive interventions in order to maintain and improve their physical functions.</p>

Equations to estimate visceral adipose tissue volume by a single-slice method / 体力科学

<p>Although it is common to assess visceral adipose tissue (VAT) by CT and MRI with a single slice at the umbilicus or the fourth and fifth lumbar vertebrae (L4-L5), recent studies reported that this single-slice method for determining an individual’s VAT may be inaccurate. Therefore, VAT accumulation should be based on total volume and determined with multiple slices rather than by cross-sectional area. However, obtaining multiple slices is burdensome for both subjects and analysts and lacks versatility despite its accuracy. The purpose of this study was to develop a new equation model for predicting VAT volume while maintaining the measurement accuracy of the multiple-slice method. We analyzed data from 214 Japanese male adults (48.5±9.3 years) and developed multiple, stepwise, linear regressions with VAT volume as a dependent variable and age, BMI, waist circumference and VAT areas (the standard L4-L5 measurement site 0 cm, +5 cm, +10 cm) as independent variables. From these results, we determined the best prediction equation for VAT volume as follows: VAT volume = (30.4×BMI) + (17.9×VAT area at L4-L5+10 cm) – 501.5. The model explained 93.1% of VAT variance and the predicted VAT volume significantly correlated with the measured VAT volume (r=0.97). This study developed a new VAT assessment method with a high level of accuracy. The method is significantly less burdensome in measurement and analysis than the multiple-slice method. Researchers can use this equation when they require an accurate evaluation of VAT accumulation. However, they should bear in mind that this equation was derived from data acquired from middle-aged, overweight and obese male subjects.</p>

Prevalence of impaired fasting blood glucose and its relationship with health check-ups in medical staff in Beijing, 2009-2015 / 中华健康管理学杂志

Objective To explore the fasting blood glucose (FBG) variation trends and the prevalence of impaired fasting blood glucose(IFG)among medical staff in Beijing, 2009-2015.Methods A prospective cohort study, using seven years of follow-up data, was conducted in a large-scale tertiary hospital in Beijing.A total of 1 284 medical staff aged 35 to 60 years were recruited.We divided them into 4 groups according to age and occupational categories,and the level of FBG was tested at the same time each year. Results The number of medical staff who completed all 7 annual FBG tests was 403. There was a stepwise increase in the levels of FBG (4.92 mmol/L, 5.26 mmol/L, and 5.60 mmol/L in the years 2009, 2012,and 2015,respectively;F=100.643,P<0.001).An increasing trend in the prevalence of IFG was also evident (3.7%, 7.7%, and 13.4% in the years 2009, 2012, and 2015, respectively; χ2=39.099, P<0.001). Compared with baseline levels(in 2009),the average levels of FBG and the prevalence of IFG in men and women, as well as in all occupational classes (doctors, nurses, technicians, and other medical employees), were significantly elevated by the year 2015 (all P<0.05). The levels of FBG in male medical staff were higher than that in female medical staff,in both 2009 and 2015(both P<0.001).Conclusion The trend of increasing FBG levels and IFG cases in medical staff,especially in men,has been a problem for hospitals. Health policy action is urgently needed to deflate the IFG bubbles.

Clinical trial for introduction of the preventive measures against Lifestyle-related diseases with Specific Health checkups and Specific counseling guidance in Brunei Darussalam / 国際保健医療

  In Brunei Darussalam, obesity and diabetes mellitus are serious national health challenges, and there is an urgent, nationwide need to develop measures against these diseases. This project provides training in various efforts unique to Japan aimed at preventing lifestyle-related diseases mainly through specific medical check-ups and health guidance. The objective of this project is to form a basis for introducing a Japanese-style system in Brunei Darussalam.  In this training program, the Bruneian staff learned specific medical check-ups, strategies for applying the results of these check-ups, actual and detailed contents of the specific counselling guidance, and so forth. We can reasonably expect that implementation of these practices and the skills acquired in Brunei will enable the Bruneian staff to more effectively prevent and control diabetes and obesity.  Moreover, this project not only contributes to health promotion for Bruneian citizens, but can also be expected to have a spillover effect on neighboring Muslim countries with similar problems (e.g., Malaysia and Indonesia). The prevalence of obesity and diabetes mellitus is increasing globally in both developed and developing countries, and preventive measures are urgently needed worldwide. It seems that recognition and introduction of the efforts made in Japan are extremely meaningful and important for solving international issues.