Sexual behavior and condom use among male students in Dar-Es-Salaam, Tanzania with emphasis on contact with barmaids.

OBJECTIVE: The objective of this quantitative study was to identifying factors that influence young men to participate in risky sexual behavior that place them at risk of HIV infection, as young people are at higher risk for HIV infection than adults. METHODS: A cross-sectional study design that employed face-to-face interview questionnaire to identify socio-demographic characteristics, sexual behavior, knowledge of HIV, STD, attitudes towards condoms was administered to 175 sexually active male students between 17 and 24 years old in college settings of Dar-es-Salaam city, Tanzania. RESULTS: In the previous 12 months, 80% of students had at least one steady sex partner (girlfriend), 71% had sex with a barmaid, 33% had sex with a casual partner and 83% had multiple sex partners. Condoms had been used at some time by 83% of students, and in the latest sexual encounter by 56%. However, only 37%, 22%, and 11% consistently used condoms during sex with girlfriends, casual partners and barmaids, respectively. Condom use was least popular during sex with barmaids, and 94% and 91% of students had experienced oral and anal sex with barmaids, respectively. STD infection was reported by 42% of students. Sex with barmaids was associated with alcohol and illicit drug intake, sex under their respective influences, and STD infection. Despite the high prevalence of these risky behaviors, 64% of students replied that they were at low or no risk of HIV infection. CONCLUSION: Our findings suggest that HIV prevention programs for male students should emphasize risks associated with multiple sexual partners, and sex with barmaids and casual partners, to increase the risk perception of HIV/AIDS. Condom use needs to be promoted.

Influence of work duration or physical symptoms on mental health among Japanese visual display terminal users.

The present study examined the relationship of work duration or physical symptoms to the mental health of visual display terminal (VDT) workers in Japan. The mental health status of 2,327 VDT users at an administrative office was investigated using the 12-item General Health Questionnaire (GHQ-12). Subjects were asked about their age, sex, hours of daily VDT use, rest and breaks during VDT work, eyestrain, and musculoskeletal pain. Logistic regression analysis was used to evaluate the associations with mental health status (GHQ-12 scores). The mean age of subjects was 39.5 yr (SD=10.3). Among all subjects, 36.7% could rest during VDT work and 66.9% received breaks during VDT work. The proportion of subjects who reported eyestrain and musculoskeletal pain were 19.6% and 25.7%, respectively. Eighteen percent of subjects were classified into a GHQ-12 high score group. Logistic regression analysis showed that age less than 40 yr, not receiving breaks during VDT work, and the presence of eyestrain and musculoskeletal pain were significantly associated with poor mental health status (high GHQ-12 scores). Using a VDT for more than 5 h/d and being female were also marginally associated with high GHQ scores (p<0.1). In conclusion, the management of physical health as well as work duration is important for good mental health status among VDT users.

The influence of visual display terminal use on the physical and mental conditions of administrative staff in Japan.

Visual display terminals (VDT) are standard equipment for many office workers. Their use, however, may increase the risk of developing adverse conditions related to vision, the musculoskeletal system, and mental health. We carried out a survey among 3070 workers aged 18 to 67 years (mean, 39.9 years) at a prefectural administrative office, in which 76% of subjects were visual display terminal (VDT) users. We examined the relationship between duration of daily VDT use and eyestrain, neck or upper extremity pain, back pain, and mental health, and estimated the effect of breaks and rest during VDT work on these symptoms. The 12-item General Health Questionnaire (GHQ-12: total scores ranged from 0 to 12) was used to identify potential poor mental health status, and subjects with 4 or more were considered to have symptoms of psychological distress. Seventeen percent of subjects reported eyestrain, 19.1% reported upper extremity pain, 11.6% reported back pain, and 17% of subjects had GHQ-12 scores of 4 or higher. Logistic regression analysis showed that duration of daily VDT use and lack of breaks and rest during VDT work were significantly associated with eyestrain, neck or upper extremity pain, back pain, and psychological distress. In order to protect users from the adverse effects associated with VDT work, reducing daily VDT exposure, taking breaks, and rest during VDT work are important.

Determinants of self-rated health among community-dwelling women aged 40 years and over in Japan.

In developed countries, the elderly population is growing rapidly. Self-rated health is an important indicator of health and has been the focus of a number of aging studies. However, little is known about the possible differences in determinants of self-rated health according to age. Self-rated health and its possible determinants were examined in 542 community-dwelling Japanese women aged 40 to 91 years. The proportion of women with poor self-rated health increased with age. Approximately half of the women had poor self-rated health among women aged 80 years and over. We used multiple logistic regression analysis to examine the association with poor self-rated health in women aged 40 to 64 years (n = 248) and 65 years and over (n = 294). Lower physical activity and a greater number of comorbidities were associated with poor self-rated health for ages 40 to 64 and 65 years and over. Furthermore, the risk of poor self-rated health increased by 1.5-fold with every increase in the number of painful joints in the lower extremities for the 40- to 64-year-old age group, and increased by 2-fold with back pain for those 65 years and over. The determinants of self-rated health were similar in both middle-aged and elderly Japanese women. Our results could contribute to effective interventions to improve quality of life among Japanese women.

Relationship between falls and physical performance measures among community-dwelling elderly women in Japan.

BACKGROUND AND AIMS: The relationship between falls and physical performance has focused on the frail elderly who have several health problems, particularly those in nursing homes or care facilities. It is important to clarify the relationship between falls and physical performance among the community-dwelling elderly. METHODS: We examined the relationship between falls and physical performance measures (grip strength, chair stand time, functional reach, usual walking speed) among 402 community-dwelling Japanese elderly women aged 60 years and over. RESULTS: Overall prevalence of falls was 21.1%, and increased with age. In univariate analysis, grip strength and functional reach were not significantly different between women who did and did not fall. Chair stand time of women who fell was longer than that of women who did not (p = 0.05), and the usual walking speed of women who fell was significantly slower than that of women who did not fall (p < 0.0001). Physical functioning significantly decreased with age; grip strength, functional reach and usual walking speed decreased, and chair stand time increased. Logistic regression analysis, adjusting for age and other covariates, showed that slower usual walking speed was significantly associated with falls, but grip strength and functional reach were not. Increased chair stand time had a borderline association (p = 0.1). CONCLUSIONS: Our findings indicate that poor lower extremity function, especially walking ability, is an important risk factor for falls in elderly Japanese community-dwelling women.

Secular trends of sizes at birth in Japanese healthy infants born between 1962 and 1988.

Body sizes at birth are important clinical indicators widely used for evaluation of prenatal growth. Japan had significant socioeconomic improvement around the 1960s, and these environmental changes may influence physiologically prenatal growth. Furthermore, in Japan, measurements of size at birth for birth certificates are weight and height. Thus, we can refer to annual data on weight and height, but not on head and chest circumference at birth. In this study we measured the weight, height, and head and chest circumference at birth among 6,563 Japanese singleton healthy infants, annually in 1962 and 1988, and examined secular trends of these anthropometric measurements. The boys consistently exceeded the girls in all four variables. Birth weight and height increased significantly from the 1960s to '70s, but did not differ between the '70s and '80s in both boys and girls. Secular trends of head and chest circumference were different from them. In both boys and girls, head and chest circumference increased significantly from the '60s to the '70s, but decreased significantly from the '70s to the '80s. No difference of head circumference during the '60s and '80s was found, but the difference of chest circumference was found. Size at birth was likely to increase from the '60s to '70s in Japan. These findings suggest that the environmental changes such as socioeconomic improvements influence the prenatal growth.

Effects of lifestyle factors on stiffness index of calcaneus measured by quantitative ultrasound system among Japanese women aged 40 years and over: the Hizen-Oshima Study.

To explore how the stiffness index of the calcaneus is related to lifestyle factors, we examined the associations of lifestyle factors, age, and years since menopause, with stiffness index of the calcaneus among 573 community-dwelling Japanese women aged 40-89 years. Stiffness index of the calcaneus was obtained from quantitative ultrasound measurement. Body height and weight were measured, from which body mass index (BMI) was calculated. Physical activity index was calculated using a validated questionnaire. Dietary calcium intake and amount of ingested alcohol were estimated by a semiquantitative food frequency questionnaire. Current smoking status was obtained by questionnaire. In univariate analysis, stiffness index was positively related to physical activity index and BMI, and inversely to age and years since menopause, but not to dietary calcium intake. Stiffness index of drinkers and current smokers was not significantly different from that of non-drinkers and non-smokers, respectively. Among the natural menopausal women, multiple regression analysis showed that advancing age and years since menopause were associated with lower stiffness index, while higher physical activity index and greater BMI were associated with higher stiffness index. In conclusion, higher physical activity, in combination with adequate nutrition for weight maintenance, should be emphasized as a part of a healthy lifestyle in order to maintain bone health among middle-aged and elderly Japanese women.

Appendicular bone mass and knee and hand osteoarthritis in Japanese women: a cross-sectional study.

BACKGROUND: It has been reported that there is an inverse association between osteoarthritis (OA) and osteoporosis. However, the relationship of bone mass to OA in a Japanese population whose rates of OA are different from Caucasians remains uncertain. METHODS: We studied the association of appendicular bone mineral density (second metacarpal; mBMD) and quantitative bone ultrasound (calcaneus; stiffness index) with knee and hand OA among 567 Japanese community-dwelling women. Knee and hand radiographs were scored for OA using Kellgren-Lawrence (K/L) scales. In addition, we evaluated the presence of osteophytes and of joint space narrowing. The hand joints were examined at the distal and proximal interphalangeal (DIP, PIP) and first metacarpophalangeal/carpometacarpal (MCP/CMC) joints. RESULTS: After adjusting for age and body mass index (BMI), stiffness index was significantly higher in women with K/L scale, grade 3 at CMC/MCP joint compared with those with no OA. Adjusted means of stiffness index and mBMD were significantly higher in women with definite osteophytes at the CMC/MCP joint compared to those without osteophytes, whereas there were no significant differences for knee, DIP and PIP joints. Stiffness index, but not mBMD, was higher in women with definite joint space narrowing at the CMC/MCP joint compared with those with no joint space narrowing. CONCLUSIONS: Appendicular bone mass was increased with OA at the CMC/MCP joint, especially among women with osteophytes. Our findings suggest that the association of peripheral bone mass with OA for knee, DIP or PIP may be less clearcut in Japanese women than in other populations.

Comparison of the prevalence of radiographic osteoarthritis of the knee and hand between Japan and the United States.

OBJECTIVE: There is no direct international comparison of the prevalence of osteoarthritis (OA) between Japanese and Caucasians. We compared the prevalence of radiographic knee and hand OA between women in Hizen-Oshima, Japan, and in Framingham, Massachusetts, USA. METHODS: A population based cross sectional study among 358 women in Japan and 815 women in the USA aged 63 years or older for knee joints, and 157 women in Japan and 655 women in the USA aged 71 years or older for hands. Radiographs were obtained of knees and hands, and were graded according to the Kellgren-Lawrence (K-L) criteria. Definite OA was defined as K-L grade 2 or higher, present in at least one joint of a given group. A person was defined as having OA or not in a given joint group, and we used logistic regression with the US group as referent to determine the prevalence odds ratio of OA among Japanese. RESULTS: The age adjusted prevalence of knee OA in Japanese women was higher than in Caucasians (OR 1.96, 95% CI 1.50-2.56), while the prevalence of hand OA other than distal interphalangeal joint in Japanese was lower than in Caucasians (OR for proximal interphalangeal joint 0.66, 95% CI 0.46-0.93; OR for metacarpophalangeal joint 0.62, 95% CI 0.42-0.90), especially base of thumb OA (OR 0.15, 95% CI 0.11-0.22). CONCLUSION: These findings suggest site-specific differences in the prevalence of OA that may be attributed to genetic and/or environmental factors.

Metacarpal bone mineral density, body mass index and lifestyle among postmenopausal Japanese women: relationship of body mass index, physical activity, calcium intake, alcohol and smoking to bone mineral density: the Hizen-Oshima study.

The present study was designed to investigate the influence of modifiable risk factors (body weight and lifestyle) for bone loss on bone mineral density (BMD). We examined age-specific changes in metacarpal BMD, and its associations with body mass index and lifestyle among 532 community-dwelling postmenopausal Japanese women. Measurements of the second metacarpal BMD were obtained from the hand radiographs using computer-assisted radiographic absorptiometry. Body height and weight were measured, and body mass index (BMI) was calculated. Physical activity index was calculated using validated questionnaire. Daily calcium intake and amount of ingested alcohol were estimated by semiquantitative food frequency questionnaire. Current smoking status was obtained by questionnaire. Metacarpal BMD decreased significantly with increasing age. Simple correlation analysis indicated that metacarpal BMD correlated significantly with BMI and physical activity index. On the other hand, metacarpal BMD did not correlate with calcium intake and alcohol drinking. Metacarpal BMD in current smokers was not different from that in nonsmokers. Multiple regression analysis showed that increasing age was associated with decreased metacarpal BMD and greater BMI increased metacarpal BMD. However, physical activity, calcium intake, alcohol drinking and current smoking were not significant determinants of metacarpal BMD. Our findings suggest that maintenance of adequate body mass (prevention for leanness) is important for prevention of postmenopausal bone loss.

Body mass index, physical activity, dietary intake, serum lipids and blood pressure of middle-aged Japanese women living in a community in the Goto archipelago.

Mortality in the Goto archipelago region of the Nagasaki prefecture in Japan is higher than the Japanese average. In this study, we investigated dietary intake, habitual physical activities, systolic and diastolic blood pressure, serum total cholesterol and high-density lipoprotein cholesterol of middle-aged women in the Narao community in the Goto archipelago. We compared these parameters with a Japanese sample, and analyzed the results according to body mass index (BMI) and age. The mean BMI of Narao women was higher than that of the Japanese sample. Serum cholesterol and blood pressure of Narao women correlated with BMI. However, dietary intake and physical activities and not differ between normal- and over-weight Narao women. The higher serum total cholesterol and diastolic blood pressure of Narao women, relative to the Japanese sample, could be explained by the presence of over-weight women in the Narao community. However, dietary and behavioral factors associated with higher BMIs could not be clarified in this cross-sectional study.

Association of body mass index with joint pain among community-dwelling women in Japan.

BACKGROUND AND AIMS: To investigate the impact of obesity on joint pain, we examined the association of body mass index (BMI) with joint pain. METHODS: 351 community-dwelling Japanese women aged 40-85 years were asked about joint pain at specific joints, and height and weight were measured. Logistic regression analysis was used to evaluate BMI and other potential predictors of joint pain. RESULTS: BMI was positively associated with knee pain, but not with pain at other specific joints, after adjusting for age. The association of BMI with knee pain remained significant after adjustment for an additional covariate (physical activity). We also examined the associations of age, BMI, and regular physical activity with joint pain at any site, in the arm, in the leg, or in the back. Independently of age and regular physical activity, BMI was positively associated with joint pain in the leg, but not with pain at any site, in the arm or in the back. No significant association of physical activity with joint pain at any site, in the arm, in the leg or in the back was found. CONCLUSIONS: Knee pain was associated with greater BMI. This finding supports previous longitudinal studies, suggesting that some knee pain could be prevented by avoidance of excess weight, if the association is causative. However, the association was not very strong; thus, it is likely that many cases of knee pain cannot be avoided by weight reduction only, and may require other interventions.