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application/pdf, 論文(Article), 特定健康診査（以下、「特定健診」という。）は多くの対象者を把握でき、保健指導を着実に行える絶好の機会であるが、減塩指導を受ける観点からは十分な機会になっておらず、特定健診時に使用される標準的な質問票には食塩摂取量に関する項目もない。そこで本研究の目的は標準的な質問票の項目と新潟県版塩分チェックリストによる推定食塩摂取量との関連を明らかにすることである。方法は胎内市の国民健康保険加入者のうち、2017年度の特定健康診査受診者1,139人（男性454人、女性685人）の性別、年齢、BMI、腹囲、収縮期血圧、拡張期血圧と、標準的な質問票20項目のデータを用いた。推定食塩摂取量は新潟県民の高食塩摂取に関連する10の食習慣から開発された新潟県版塩分チェックリストを用いた。本研究はハイリスク者にアプローチするため、目的変数は推定食塩摂取量の第3 四分位を基準に、男性12g以上、女性10g以上を食塩摂取量の高値の者とし、説明変数は基本属性と標準的な質問票20項目を用いて、二項ロジスティック回帰分析を男女別に行った。結果は男女とも年齢が若いこと、腹囲が大きいこと、遅い夕食をとることが、また男性のみ歩く速度が遅いこと、女性のみ夕食後の間食・夜食をとることが食塩摂取量の高値の者と有意な関連があった。今後それらの項目に該当する者は保健指導時に減塩指導が必要であることが示唆された。, Specific health checkups are a great opportunity to grasp many subjects and steadily provide health guidance. However, they are not sufficient from the viewpoint of reducing salt intake and none of the standard question items used in special health checkups ask about salt intake. This study aimed to elucidate relation between items on the standard questionnaire and estimated salt intake based on the salinity checklist（ Niigata prefecture version）. The participants were 1,139 Tainai City residents （454 male, 685 female） covered by Japan’s National Health Insurance, who had undergone specific health checkups in 2017. Their gender, age, BMI, waist circumference, systolic pressure, diastolic pressure, and responses to the 20 standard questions constituted the data used in this study. The salinity checklist（ Niigata prefecture version）, developed based on 10 dietary habits correlated with high salt intake among the prefecture’s residents, was used to estimate salt intake. To limit the scope to high-risk participants, the baseline for target variables was set at the 3rd quartile of estimated salt intake, i.e., 12 g or more for men and 10 g or more for women, defined as high salt takers. The explanatory variables consisted of basic attributes and 20 items of the standard questionnaire. Binomial logistic regression analysis was performed separately on the male and female data. The results showed that high salt intake was significantly associated in both men and women with younger age, larger abdominal girth, having late dinners, eat; further, walking speed was slower only among the male participants, and eating snacks and dinner after supper among the female participants. It is suggested that people with these items in the future need to be instructed to reduce their salt intake in health guidance.

application/pdf, 論文(Article), わが国においてメタボリックシンドローム（以下、MSとする）は重要な問題である。新潟県では2001年に平均寿命・健康寿命の延伸と生活の質の向上を目指した新潟県健康づくり指針「健康にいがた21」を策定し、2009年にはMSに着目した計画内容の見直しと改訂が行われ、新潟県においてもMSは重要な課題である。本研究の目的は新潟県の特定健康診査のデータ（男性50,122名、女性51,659名、計101,781名）を男女別に分析し、MSに関連する要因を明らかにすることである。目的変数にMS該当を1 、MS予備群該当・非該当を0とするダミー変数を置き、説明変数には「年代」「BMI」「収縮期血圧」「拡張期血圧」の基本属性4 項目と問診項目の15項目を用いて、男女別に二項ロジスティック回帰分析を行った。男女ともに「年代」「BMI」「収縮期血圧」「拡張期血圧」「血圧を下げる薬」「血糖を下げる薬」「コレステロールを下げる薬」「20歳からの体重増加」「喫煙」「歩行又は身体活動」「歩行速度」の項目で有意差があった。男性のみ「30分以上の軽い運動」「食べる速度」「飲酒」「睡眠」、女性のみ「1 年間の体重変化」の項目でそれぞれ有意差があった。, Metabolic syndrome is an important problem in Japan today. In Niigata, the Niigata Prefecture Health Promotion Guidelines “Healthy Niigata 21”, which aim to extend life expectancy and healthy life years and to improve quality of life, were formulated in 2001. In 2009, the prefecture also reviewed and revised the contents of the plan to focus on metabolic syndrome. This study aimed to analyze data concerning specific health examinations in Niigata Prefecture（ total 101781, male 50122, female 51659） by gender and to clarify factors related to metabolic syndrome. Items related to the objective variable of metabolic syndrome were 1, and the potential metabolic syndrome group and unrelated items were 0. Using the four basic characteristics of “age”, “BMI”, “systolic blood pressure”, and “diastolic blood pressure” as explanatory variables, a binomial logistic regression analysis was conducted by gender using 15 questionnaire items. Both men and women exhibited significant differences in terms of “age”, “BMI”, “systolic blood pressure”, “diastolic blood pressure”, “medication to lower blood pressure”, “medication to lower blood glucose”, “medication to lower cholesterol”, “use of tobacco”, “weight gain during 20s” “walking or physical activity”, and “walking speed”. Men-only items included “light exercise for periods longer than 30 minutes”, “eating speed”, “alcohol consumption”, and “sleep” while women-only items included “annual change in body weight”., 症例・事例・調査報告

application/pdf, 論文(Article), 相談支援専門員は障害者の自立支援に大きく寄与しているが、相談支援専門員のメンタルヘルスに関する先行研究は深められていない現状にある。そこで職業性ストレス簡易調査票を用いて相談支援専門員のストレスの評価を行った。本研究の目的は相談支援専門員のストレス状態を検討し、そして高ストレス者となる要因を明らかにすることである。調査は全国180事業所416名の相談支援専門員を対象とし、計275名を分析対象とした（有効回答率66.1％）。その結果、相談支援専門員は職業性ストレス簡易調査票の標準集団と比較して「心理的な仕事の負担（量）」「心理的な仕事の負担（質）」「自覚的な身体的負担度」「疲労感」「不安感」「家族・友人からのサポート」の点数が高く悪い状態であった。また男性のみ「抑うつ感」「身体愁訴」の点数が高く悪い状態であった。高ストレス者となる要因は、基本属性では常勤の勤務形態の方が、職業性ストレス簡易調査票の項目では「同僚からのサポート」「上司からのサポート」「抑うつ感」「仕事のコントロール度」「自覚的な身体的負担度」「家族・友人からのサポート」「心理的な仕事の負担（量）」の点数が高く悪くなるほど高ストレス者となる結果であった。事業所として一次予防の観点から上述した項目について取り組みが必要であり、二次予防の観点では「抑うつ感」を感じている者のケアを検討する必要性が明らかになった。, Although consultation support specialists（ CSSs） have been making major contributions toward promoting independence among persons with disabilities, in-depth studies regarding the mental health of such workers are few. Therefore, the present study attempts to evaluate stress among CSSs using the Brief Job Stress Questionnaire（ BJSQ）. It aims to examine the stress levels among CSSs and identify factors that can lead to high stress in individuals. From a population of 416 CSSs working in 180 consultation offices nationwide, data from 275 individuals were analyzed （valid response rate, 66.1%）. Compared to a control group that also completed the BJSQ, CSSs scored higher, and were thus worse off in quantitative workload, qualitative workload, physical burden, fatigue, anxiety, and support from family/friends. Male CSSs scored higher, and were thus worse off, in depression and physical complaints. Factors associated with high stress were as follows : in terms of basic attributes, full-time employment status; and in terms of items on the BJSQ, high scores on support from colleagues, support from superiors, depression, job control, physical burden, support from family/friends, and quantitative workload. The results indicate that consultation offices should address the items mentioned above from the perspective of primary prevention, and that care for CSSs experiencing depression should be considered from the perspective of secondary prevention.

application/pdf, 論文(Article), Although the field of consultation support has contributed substantially toward promoting independence among persons with disabilities, indepth studies regarding the mental health of consultation support specialists (CSSs) have been lacking. The present study examined tendency toward burnout among CSSs, and determined factors that aggravate and mitigate any such tendency that was detected. The Maslach Burnout Inventory (Japanese version) (MBI-JV) was used to analyze data from 297 of 416 CSSs (71.4% survey response rate) from 180 agencies nationwide. The results showed that 37.4% of CSSs required attention for burnout. The MBI-JV scores were converted into an objective variable by designating subjects scoring at or above the first quartile to the high burnout group and subjects scoring at or below the third quartile to the low burnout group. Multiple regression with a factor analysis model was applied to 19 items (12 items from basic subject characteristics and seven items related to workplace conditions and job duties from the Human Resource Management (HRM) checklist compiled by the Japan Institute for Labour Policy and Training); these were adopted as explanatory variables. The number of CSSs working at a given agency (p < 0.05) and age (p < 0.05) were found to be aggravating factors,while relationships with consultees (p < 0.05), personal life considerations (p < 0.01), and career path (p < 0.001) were found to be mitigating factors. These findings suggest that development of countermeasures against burnout among CSSs might be needed. Furthermore, the study verified that burnout prevention not only combats career stagnation and turnover, but also can improve service quality.

application/pdf, 学位論文(Thesis), Niigata Journal of Health and Welfare. 2017, 17(1), 12-24., 33111甲第42号

The serum and urinary ferritin levels in 52 RA patients were measured by the 2-site immunoradiometric assay method. Serum ferritin levels in RA patients correlated with C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) but not with serum iron levels and hemoglobin concentrations, although they were within the normal range. High serum ferritin levels were associated with sera with hyper gamma-globulin and rheumatoid factors. In sequential studies, serum ferritin changed in parallel with ESR, CRP and disease activity in a majority of the patients. The urinary ferritin levels and u/s ratios in some RA patients were higher than control values. Higher values were found particularly in the group of patients under gold therapy but not in groups under other treatments.

Human peripheral blood mononuclear cells (PBM) were separated into sheep erythrocyte rosette-forming (Es+) and non Es+ cells by the Ficoll-Hypaque gradient sedimentation method. Thirty-eight percent of the Es+ cells formed rosettes with dog erythrocytes and were designated as Es+Ed+ cells. The remaining Es+ cells were designated as Es+Ed- cells. Only a few non Es+ cells formed rosettes with dog erythrocytes. Among Es+Ed+ cells, T4 antigen-positive cells were observed approximately 1.7 times as often as T8 antigen-positive cells, when measured by staining with OKT4 or OKT8 monoclonal antibody. Among Es+Ed- cells, however, T4 and T8 antigen-positive cells were observed in almost equal proportion. Preincubation of PBM with OKT11 monoclonal antibody, but not with OKT4 monoclonal antibody, inhibited the rosette formation with dog as well as sheep erythrocytes. These results indicated that Es+Ed+ cells were a subpopulation of T-cells in which a majority of the cells were T4 antigen-positive, and that the binding sites of dog erythrocytes on human T-cells was closely linked with that of sheep erythrocytes.