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Background: Although disparities in socioeconomic status in health behaviors have been highlighted globally, they are not well understood in Japanese adolescents. The purpose of this study was to clarify the changes in socioeconomic disparities in adolescents’ fundamental health behaviors, such as physical activity, screen time (ST), sleep, breakfast intake, and bowel movement before and during COVID-19. Methods: This was a repeated cross-sectional study which used data from the 2019 and 2021 National Sports-Life Survey of Children and Young in Japan. Data of 766 and 725 participants in 2019 and 2021, respectively, were analyzed. Favorable health behaviors were defined as daily moderate to vigorous physical activity (MVPA) of at least 60 minutes, ST of less than 2 hours, sleep of 8 to 10 hours, daily breakfast intake, and bowel movement frequency of at least once in every 3 days. We calculated the slope index of inequality and relative index of inequality in each health behavior for equivalent household income levels for assessing absolute and relative economic inequalities. Results: Compliance with MVPA and ST recommendation significantly declined from 20.1% and 23.0% in 2019 to 11.7% and 14.9% in 2021, respectively. The slope index of inequality and relative index of inequality increased in MVPA for income levels, but decreased in daily breakfast in 2019 to 2021. Although the widening and narrowing of the disparity were inconclusive for ST, it exacerbated for the higher-income groups. Conclusions: Our study revealed widening of economic disparities in the achievement of recommended MVPA and narrowing of it in breakfast intake among adolescents before and during COVID-19.

This study aimed to explore the socio-economic inequalities in physical activity (PA) based on domains of daily life, such as work, transport, recreation and sedentary life, among Japanese adults during the COVID-19 pandemic.This was a cross-sectional study.This study used data from the 2020 National Sport and Lifestyle Survey, conducted by the Sasakawa Sports Foundation. Data of 2,296 (1,103 women) participants were analysed. PAs were assessed using the Global Physical Activity Questionnaire. Educational level and household income were used as indicators of socio-economic status. We calculated the slope index of inequality (SII) and relative index of inequality (RII).We detected absolute and relative inequalities for household income in all PA domains, except for work-related PA. The higher the participants' income, the longer they engaged in transport- and recreation-related PA and sedentary behaviour. Recreation-related PA had a larger disparity than other domains, with SII at 20.8% (95% confidence interval [CI] -28.4 to -13.1) and RII at 0.58 (95% CI 0.47-0.71). At the educational level, each inequality was observed in work- and recreation-related PA and sedentary behaviour. The higher the participants' educational level, the longer they engaged in recreation-related PA and sedentary behaviour. However, work-related PA was longer at lower educational levels, with RII at 1.90 (95% CI 1.48-2.44). The inequality in recreation-related PA was also relatively large (SII 23.3%, 95% CI -30.9 to -15.7; RII 0.54, 95% CI 0.45-0.66).Our study revealed significant socio-economic disparities in each PA domain, particularly in recreational PA. These results suggest a widening gap because of the COVID-19 pandemic.

BackgroundAlthough disparities in socioeconomic status in health behaviors have been highlighted globally, they are not well understood in Japanese adolescents. The purpose of this study was to clarify the changes in socioeconomic disparities in adolescents’ fundamental health behaviors, such as physical activity, screen time (ST), sleep, breakfast intake, and bowel movement before and during COVID-19.MethodsThis was a repeated cross-sectional study which used data from the 2019 and 2021 National Sports-Life Survey of Children and Young in Japan. Data of 766 and 725 participants in 2019 and 2021, respectively, were analyzed. Favorable health behaviors were defined as daily moderate-to-vigorous physical activity (MVPA) of at least 60 minutes, ST of less than 2 hours, sleep of 8 to 10 hours, daily breakfast intake, and bowel movement frequency of at least once in every 3 days. We calculated the slope index of inequality (SII) and relative index of inequality (RII) in each health behavior for equivalent household income levels for assessing absolute and relative economic inequalities.ResultsCompliance with MVPA and ST recommendation significantly declined from 20.1% and 23.0% in 2019 to 11.7% and 14.9% in 2021, respectively. The SII and RII increased in MVPA for income levels, but decreased in daily breakfast in 2019 to 2021. Although the widening and narrowing of the disparity was inconclusive for ST, it exacerbated for the higher income groups.ConclusionsOur study revealed widening of economic disparities in the achievement of recommended MVPA and narrowing of it in breakfast intake among adolescents before and during COVID-19.

Background: An international physical activity (PA) questionnaire is beneficial to make cross-country comparisons among children and adolescents. This study assesses the validity of the PA questions in the World Health Organization Health Behavior in School-Aged Children (WHO HBSC) survey in Japanese children and adolescents. Methods: Participants were fifth- to sixth-grade Japanese primary school students (67 students aged 10.8 [0.5] y) and first- to third-grade junior high school students (108 students aged 13.0 [0.7] y). The Japanese version of the PA questions in the WHO HBSC (WHO HBSC-J) was used. To assess the validity of the PA questions, the authors used a partial correlation adjusted for sex, age, and relative weight between the answers to the survey questions and objectively measured moderate to vigorous PA (MVPA) by an accelerometer. Results: A significant positive correlation was found between accelerometer-measured MVPA and the number of reported days with at least 60 minutes/day of MVPA in primary school students (r = .39, P = .002) and junior high school students (r = .32, P Conclusion: The HBSC-J has moderate validity for evaluating MVPA in Japanese primary school and junior high school students.

Background It is unclear whether either neighborhood collective efficacy or school collective efficacy is associated with adolescent alcohol use. This study aimed to examine the relative contributions of collective efficacy, both in school and in the neighborhood contexts, to alcohol use among Japanese adolescents. Methods A cross-sectional study was conducted in public high schools across Okinawa and Ibaraki Prefectures in Japan in 2016. The study participants consisted of 3,291 students in grades 10 through 12 cross-nested in 51 schools and 107 neighborhoods. Alcohol use was measured as current alcohol drinking, which was defined as self-reported drinking on at least 1 day in the past 30 days. Collective efficacy was measured using scales of social cohesion and informal social control in school and the neighborhood. Contextual-level collective efficacy was measured using aggregated school-level and neighborhood-level individual responses, respectively. We used non-hierarchical multilevel models to fit the cross-nested data. Results Significant variation in alcohol use was shown between schools but not between neighborhoods. After adjusting for covariates, school collective efficacy at individual- and contextual-levels was protectively associated with alcohol drinking (odds ratio [OR] for the increase of one standard deviation from the mean 0.72; 95% confidence interval [CI], 0.63-0.82 and OR 0.61; 95% CI, 0.49-0.75, respectively), whereas neighborhood collective efficacy at individual- and contextual-levels was not associated with alcohol consumption. Conclusion The school-level associations of collective efficacy with adolescent alcohol use may have the greater impact than the neighborhood-level associations. Adolescent drinking prevention efforts should include enhancing school collective efficacy.

In Asia and the Pacific Island region, strengthening of school health activities and measures is urgently recommended to deal with the impact of the increasing risk of potential school closures due to continuation of the coronavirus disease 2019 (COVID-19) pandemic in 2021. As the incidence of COVID-19 in 2020 was relatively low in these regions, many of the countries were able to avoid prolonged school closures. However, even if vaccination is expanded in the future and the pandemic tends to come to an end, the risk of SARS-CoV-2 variants spreading among children will also increase, and the possibility of having to close schools again will also increase.

Background:Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016.\nMethods:We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated.\nResults:Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time.\nConclusions:Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools., 論文

Background There are numerous reports that social and emotional skills in early childhood have profound influence on lifelong health. The aim of this research is to determine the relation between the lifestyle and the social and emotional skills among children in present day Japan. Methods The object of analysis was a total of 110 parents of kindergarten students (56 boys, 48 girls,6 gender unknown) from 3 kindergartens in central Okinawa Island. The survey was conducted in mid-December 2019. Regarding the content of the survey, parents were asked to answer on a five-point scale, based on their subjective opinion, how good is their child, as compared to other children, in each of the 9 sub-scales of the social and emotional skills proposed in the 2015 OECD report, namely “perseverance,” “self-control,” “passion for goals,” “sociability,” “respect,” “caring,” “self-esteem,” “optimism,” “confidence.” Additionally, other question items were set, mainly to ask about the child's own lifestyle. Results The results of multivariate logistic regression analysis are following. As for “achieving goals:” 3 items for perseverance - “there are few likes and dislikes about food (OR:2.67, 95％CI:1.03～6.94, p=.043),” “Time for playing games on smartphone is determined (OR:3.21, 95％CI:1.19～8.68, p=.021),” “Eat more fruits (OR:3.03, 95％CI:1.24～8.26, p=.016),” are statistically significant. [Other results are omitted in this abstract] Conclusions It became clear that the acquisition of social and emotional skills during early childhood generally involves regular lifestyle and “discipline” at home as a whole. Besides, it is important for parent and child to do various activities together, including those aiming to increase cognitive skills. This study is considered to be a powerful evidence for the development of future intervention programme, aimed at acquiring social and emotional skills in early childhood. Key messages In early childhood family and kindergarten have to cooperate to foster social and emotional skills, important for lifelong health. This study is considered to be a powerful evidence for the development of future intervention programme, aimed at acquiring social and emotional skills in early childhood.

The purpose of this study was to examine the potential role of aerobic fitness (AF) as a mediator of the association between physical activity (PA) and academic achievement (AA) among Japanese junior high school students. A cross-sectional data was collected from 608 7th grade students enrolled at five public junior high schools in two suburban municipalities in Okinawa, Japan. Self-reported PA was assessed using the Patient-Centred Assessment and Counselling for Exercise plus Nutrition questionnaire. The 20-meter shuttle run test was performed to determine AF. AA was evaluated using the overall grade point average. Family structure, parental education level, and achievement motives were the self-reported covariates. The results of the bootstrapped mediation analysis indicated that PA had a direct effect on AF, which in turn influenced the AA among boys. After adjusting for AF, the association between PA and AA disappeared while the association of AF with AA still remained. However, neither PA nor AF was associated with the AA of girls. Therefore, the hypothesis that AF might mediate the relationship between PA and AA was supported for boys. Promoting AF, as a result of engaging to PA could positively influence AA particularly in boys.

Positive association between physical fitness and academic achievement in adolescents has been suggested yet the causal effect of physical fitness on academic achievement remains unclear. This study examined if longitudinal changes in physical fitness were associated with changes in academic achievement among junior high school students. Analyses were based on a two-year with three time-point data of 567 students (aged 12&ndash, 13 years old at the baseline-point, 303 boys) who entered in five Japanese junior high schools in 2015. Academic achievement was evaluated using the student&rsquo, s overall grade point average. Comprehensive physical fitness score was summed up from eight fitness tests: 50-m sprint, standing broad jump, repeated side-steps, sit and reach, sit-ups, hand-grip strength, handball throw, and 20-m shuttle run or endurance run. The hybrid regression model was applied to examine the impact of change in physical fitness on change in academic achievement using multiple imputation to account for non-response at follow-up. The changes in fitness score within-person and the differences in average of fitness score of three-time points between-person were associated with change in overall grade point average for boys. No significant association between fitness score and overall grade point average was observed in girls. Opportunities for increased physical fitness may be important to support academic achievement, particularly in junior high school boys.

This cross-sectional study examined the effect of school-level structural social capital on smoking and drinking among Japanese youth. Self-administered anonymous questionnaires were distributed to 3248 students at 29 high schools across Okinawa, Japan in 2008. Structural social capital was measured by students’ participation in organized activities: student council, extracurricular activities, volunteer activities, community sports clubs, and youth associations. Contextual-level social capital was measured by aggregated school-level individual responses. At the individual level, extracurricular activity participation was negatively associated with smoking and drinking, whereas participation in youth associations was positively associated with smoking and drinking. School-level extracurricular activity participation was negatively associated with smoking among boys, whereas school-level participation in youth associations was positively associated with smoking among boys and girls and drinking among boys. This study suggests that structural social capital measured by participation in organized activities, especially extracurricular activities, might be an important way for youths to attain good health. This study also supports the idea that particular type of activities, such as youth associations, can lead to the so-called “dark side of social capital”.

This study investigated the reliability and validity of the Multidimensional Scale of Life Skills in Late Childhood, an instrument designed to measure a concept similar to “zest for living” in late childhood. A total of 1,888 elementary school students in the 4th, 5th, and 6th grades residing in urban and suburban areas as well as in remote islands of 3 prefectures (Okinawa, Kagoshima, and Nagasaki) were surveyed. On the basis of our analysis, 24 items and seven factors were extracted. These factors are problem-solving/synthesis, relationship with friends, personal manners, decision-making and future planning, self-learning, collecting and using information, and leadership. Cronbach’s alpha reliability coefficients were computed for each subscale and ranged from 0.71 to 0.87. Test-retest reliability coefficient values ranged from 0.68 to 0.79. To examine the construct validity of the scales, a goodness-of-fit model was determined by confirmatory factor analysis, and satisfactory values were found (GFI = 0.952, AGFI = 0.937, CFI = 0.966, RMSEA = 0.016). The validity of the goodness-of-fit model and the reliability of the scales indicate that the Multidimensional Scale of Life Skills in Late Childhood is an effective assessment tool.

Background Physical activity is important for human health even from childhood years. Physical education (PE) class has traditionally played a central role in developing physical activity habits among children in Japan. Although PE teaching methods may vary according to age, in 2000, Japan has implemented critical-thinking and decision-making skills as essential abilities to be attained in school education, …

BACKGROUND: The importance of school contextual effects on health and well-being among young people is currently recognized. This study examines the contextual effects of school satisfaction as well as the effects of individual-level school satisfaction on health-risk behaviors in Japanese high school students. METHODS: Self-administered questionnaires were distributed to 3248 students in grades 10 through 12 at 29 public high schools throughout Okinawa, Japan. Using multilevel logistic regression models, the effects of individual- and contextual-level school satisfactions on health-risk behaviors were analyzed. The contextual-level school satisfaction was defined as satisfaction at the school level and was measured using aggregated individual scores. Behaviors studied included current smoking, current drinking, and sexual activity. RESULTS: Approximately 15%, 6%, and 5% of the total individual differences in smoking, drinking, and sexual behaviors, respectively, occurred at the school level. Students with lower school satisfaction were more likely to engage in health-risk behaviors compared with those with higher school satisfaction. After adjustment for individual-level school satisfaction and other covariates, the odds of smoking and drinking increased with decreasing contextual-level school satisfaction. However, the association of contextual school satisfaction with sexual activity did not reach statistical significance. CONCLUSIONS: This study showed that individual- and contextual-level school satisfactions affected smoking and drinking behaviors in Japanese high school students. However, no significant association between contextual-level school satisfaction and sexual activity was observed. Language: en

This study examined whether subjective health complaints were associated with school-related stress and physical activity among Japanese 6th grade school children and determined the influence of physical activity on the relationship between school-related stress and health complaints. In addition, other health practices were examined as moderators of the association between stress and health complaints. A self-administered questionnaire was conducted for 1,978 pupils at 25 public elementary schools throughout Okinawa, Japan. As a result of two-way analysis of variance, school-related stress showed a significant main effect on health complaints among both boys and girls. However, physical activity did not show a main effect on health complaints among either boys or girls. There was also no observed interaction between school-related stress and physical activity on health complaints. Other health practices had significant main effects on health complaints in this age group. Pupils who slept for 7-8 hours, ate breakfast everyday, watched TV for less than 4 hours a day, or played video games for less than 4 hours a week were less likely to report health complaints. However, there was no observed interaction between school-related stress and each health practice on health complaints. This study suggests that physical activity in this age group has no direct or buffering effects on health outcomes.

The purpose of this study was the examination of nursing home care staff's knowledge, attitudes, and image of elderly sexuality and the determination of a possible relationship among them. Nurses and care workers from five nursing homes in Okinawa, Japan volunteered to participate the study. One hundred fifty-two care staff answered and returned the self-administered packet for a response rate of 74.5%, with 126 of the respondents completing the questions appropriately. The packet included questionnaires containing demographic characteristics, institutional factors, the Japanese version of Aging Sexuality Attitudes and Knowledge Scale (ASKASJ) and a Semantic Differential (SD) technique for assessment of respondents' image of elderly sexuality. A computer software package, the SPSS, statistically examined average scores of knowledge, attitudes, and image on elderly sexuality. Additionally, a multiple regression analysis examined variables related to the knowledge, attitudes, and image. Pearson's correlation coefficient was utilized for further assessment of the relationship among them. The study found that "experience of learning elderly sexuality " was significantly related to knowledge, attitudes, and image of elderly sexuality. In addition, there were significant positive correlations between knowledge and attitude scores (r=0.51), knowledge and image (r=0.48), and attitude and image (r=0.38). These findings indicate that education is a key to increasing care staff's knowledge, positive image and attitudes on elderly sexuality. However, only 31.7% of the respondents received education related to elderly sexuality, mostly from sources outside the school setting. We point out the importance of incorporating the topic of elderly sexuality in educational programs. Japanese gerontological nursing educators need to encourage formal inservice programs for care staff and develop school curriculums for nursing students on sexuality in the aged.

Objectives: This study aims to examine regional differences in relationships between depressive symptoms and psychosocial factors among Japanese high school students in Okinawa and Saga prefectures in Japan.Methods: The study sample was 3, 234 students from 14 public high schools in Okinawa and 2, 503 students from 12 public high schools in Saga. The students completed a self administered questionnaire between September and November 2000. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). The psychosocial factors examined were participation in community events, life stress, self-esteem, perceived social support, and life environment.Results: There was no difference in depressive symptoms by region. Students in Saga had higher levels of stress in the academic, teachers' and friends' domains compared to students in Okinawa. Students in Saga also evaluated their natural environment better than their counterparts in Okinawa. On the other hand, students in Okinawa were more likely to participate in community events than those in Saga. After controlling for sociodemographic variables, depressive symptoms were found to be significantly associated with life stress, self-esteem, and social support among students in both Okinawa and Saga. Only among students in Okinawa, however, were depressive symptoms significantly related to participation in community events. The psychosocial factors accounted for the same amount of variance in depressive symptoms for Okinawa and Saga students. Additionally, life stress in the teachers' domain had stronger associations with depressive symptoms among students in Saga than among those in Okinawa. The depressive symptom levels of Okinawa students seemed to be more strongly associated with self-esteem than those affecting their counterparts in the Saga prefecture.Conclusion: These findings show that there is similar pattern of associations between depressive symptoms and psychosocial factors among high school students in Okinawa and Saga, except for participation in community events. Life stress, self-esteem, and social support may be common factors associated with depressive symptoms among high school students regardless of region. Overall, the magnitude of the relationship between depressive symptoms and psychosocial factors was similar across Okinawa and Saga students.

Focusing attention on gender differences in stress and stress coping behavior in school teachers, attempts were made to clarify their relationship to awareness of duties, the Type A behavior and depression which presents problems with respect to adaptation to their duties. Twelve elementary and 12 junior high schools in Okinawa Prefecture were selected at random, and was performed in 331 teachers (128 male and 203 female) who answered all questions listed in the coping inventory for stressful situations (CISS). 1) Task-oriented coping showed a significant positive correlation with age in both male and female. It was higher in married persons than in unmarried persons in both male and female, and was highest in married male. Emotion-oriented coping was significantly higher in female than in male and also in female elementary school teachers than female junior high school teachers. Avoidance-oriented coping was significant higher in female than in male, and showed a significant negative correlation with age regardless of gender. It was higher in unmarried female, class teachers, and female in good health. 2) The factors of busyness and disharmony related to awareness of duties were significantly higher in female. 3) Multiple regression analysis by sex was performed using factors showing a significant correlation with coping behavior as independent variables and each coping behavior as dependent variables. On each coping behavior, it may be related to some factors in both male and female, while it is shown by the results stress-coping behavior shows gender differences. The results of the present study suggest it is necessary to cope with health problems in teachers in consideration of their gender differences and that social support strategies, including those at workplace, are important to prevent or solve mental and physical health problems.

The purpose of this study was to examine the relationships between risk factors and smoking status among high school students in Okinawa, Japan. We also examined if there is a dose-response relation between the number of risk factors and smoking status. Self-reported questionnaires including smoking status and potential risk factors were conducted using a sample of 1,029 students of a public senior high school in Okinawa. The percentage of smokers was 40.0% for males and 10.6% for females, and it was significantly higher for males than females. As a result of multivariate analysis, we identified four significant risk factors; peer smoking, attitude of peer toward subject smoking, intention to smoke at the age 20, and alcohol drinking. The number of these risk factors was linearly associated with increased percentage of smokers, and a linear trend was significant for both gender students. Additionally, magnitude of risk for smoking among females became considerably great compared with those of males as the number of risk factors increased. In conclusion, this study was the first study in Japan to indicate a significant dose-response relationship between the number of risk factors and smoking status among high school students. We also found that females with many risk factors had extremely increased vulnerability to smoking compared to male counterpart. These findings may be useful to identify high-risk students who need more intensive smoking prevention programs and to develop the content of effective interventions.

This study employed a longitudinal design to examine the psychosocial correlates and risk factors for depressive Symptomatology among undergraduate students. We determined the cross-sectional relation of the psychosocial variables to depressive symptoms at Time 1, and also identified the psychosocial risk factors for the emergence of depressive symptoms at Time 2. Self reported questionnaires were conducted using a sample of 532 students of a university in Okinawa, Japan. We assessed depressive symptomatology by the Center for Epidemiologic Studies Depression Scale (CES-D) at two different times 3 month apart. The psychosocial variables examined were life stressors, type A behavior, self-esteem, locus of control, coping style, perceived social support, and health practices. Multiple logistic regression analyses were conducted to examine the relation of the psychosocial variables to depressive symptoms. After controlling for the effects of demographic and other variables, many psychosocial variables such as life stressors, self-esteem, locus of control, coping style including accepting responsibility and planful problem-solving, father support, and mother support were associated with current depressive symptoms. Life stressors also acted as risk factors for future depressive symptoms. Students experienced high level on life stressors had a 10-fold increased risk for the onset of depression as compared with those had low stressors. These findings may be useful to identify high-risk students who need more intensive prevention programs for depression.

To examine the relationship between stress and perceived social support among high school students, we asked 3, 254 students in Okinawa to respond to questionnaires pertaining to depressive symptoms, daily hassles, and social support. We measured depressive symptomsas stresses by using the Zung Self-rating Depressive Scale (SDS). A junior high school version of the Scale of Expectancy for Social Support (SESS) was used to measure the expectancy of social support. As a result, females showed significantly higher scores on depressive symptoms, and support from mother, siblings and friends than males, while males reported significantly higher scores on support form father and teachers than females. There were no gender differences in daily hassles. Daily hassles and each support resource had significant main effects on depressive symptoms, but no interaction was found between them in both males and females. In other words, social support had direct effects on depressive symptoms, and it was highly probable that the expectancies of social supports reduce the depressive symptoms, regardless of intensity of daily hassles. When the expectancies of other support resources were adjusted, we found that supports only from father and friends reduce depressive symptoms in males, while supports from father, mother, siblings, and friends do in females. These findings demonstrate that daily hassles and social support are independently related to depressive symptoms of high school students, and that depressive symptoms could be reduced directly by the expectancy of social support such as support from father and friends in both males and females, and support from mother and siblings in females only. In conclusion, these findings support the direct effect hypothesis of social support for high school students.

This study examined the individual and contextual effects of cognitive social capital at school on cigarette smoking and alcohol drinking in Japanese high school students. Self-administered questionnaires were distributed to 3248 students in grades 10-12 (aged 15-18 years) at 29 public high schools across Okinawa, Japan in 2008. The individual-level cognitive social capital studied was generalized trust. Using multi-level logistic regression models, the effects of individual- and contextual-level cognitive social capital on smoking and drinking were analyzed. Contextual-level cognitive social capital was measured on the basis of aggregated individual responses to the trust question at school level. After adjustment for the covariates, individual-level trust was negatively associated with smoking and drinking among boys and girls. Similarly, after adjustment for the covariates, school-level trust showed an inverse association with smoking for girls. A similar but not statistically significant association was observed for boys. On the other hand, school-level trust was not associated with drinking among boys or girls. After adjustment for individual-level trust and the covariates, these findings were in the same direction, but the school-level trust for girls no longer had a significant contextual effect on smoking. The findings suggest evidence of the individual effect of cognitive social capital on adolescents' smoking and drinking, and that the contextual effect of social capital on smoking was inconclusive. In addition, no association of contextual-level social capital with drinking was observed.

This study examines relationships between condom use and age at initiation of sex, the number of sexual partners, and alcohol or drug use before sex among a convenience sample of 2852 Japanese adolescents. We found that nonuse of condoms is related to early initiation of sex, having multiple sexual partners and alcohol or drug use before sex.

Anopheline mosquitos and their relation to malaria transmission were studied 3 times: in July and August, 1999; in December, 1999; and in August and September, 2000. The studies took place in the malaria endemic villages of Khammouane Province, southeast of Lao PDR. A total of 28 species were collected using human and animal bait. Human bait attracted predominantly Anopheles dirus and An. minimus, which were identified as vectors by the detection of sporozoites by dissection, PCR, and enzyme-linked immunosorbent assays for Plasmodium falciparum and P. vivax. The vectorial capacity of An. dirus was 0.009-0.428, while that of An. minimus was 0.048-0.186. The inoculation rate of An. dirus was 0.052-0.137 (Boualapha; August, 2000). An. nivipes and its sister species, An. philippinensis, were principally zoophilic, although a considerable number of the females were also attracted to human bait in the villages of the paddy field areas. An. philippinensis infected with oocysts of P. vivax was detected in a specimen collected by animal bait. These two species were considered as vectors in Khammouane Province. Four species, An. notanandai, An. sawadwongporni, An. willmori, and An. hodgkini, had not been recored before in Lao PDR. Information is provided on host preference and the nocturnal biting activities of common species and the incidence of malaria in the study areas.

This study aims to examine regional differences in relationships between depressive symptoms and psychosocial factors among Japanese high school students in Okinawa and Saga prefectures in Japan.The study sample was 3,234 students from 14 public high schools in Okinawa and 2,503 students from 12 public high schools in Saga. The students completed a self-administered questionnaire between September and November 2000. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). The psychosocial factors examined were participation in community events, life stress, self-esteem, perceived social support, and life environment.There was no difference in depressive symptoms by region. Students in Saga had higher levels of stress in the academic, teachers' and friends' domains compared to students in Okinawa. Students in Saga also evaluated their natural environment better than their counterparts in Okinawa. On the other hand, students in Okinawa were more likely to participate in community events than those in Saga. After controlling for sociodemographic variables, depressive symptoms were found to be significantly associated with life stress, self-esteem, and social support among students in both Okinawa and Saga. Only among students in Okinawa, however, were depressive symptoms significantly related to participation in community events. The psychosocial factors accounted for the same amount of variance in depressive symptoms for Okinawa and Saga students. Additionally, life stress in the teachers' domain had stronger associations with depressive symptoms among students in Saga than among those in Okinawa. The depressive symptom levels of Okinawa students seemed to be more strongly associated with self-esteem than those affecting their counterparts in the Saga prefecture.These findings show that there is similar pattern of associations between depressive symptoms and psychosocial factors among high school students in Okinawa and Saga, except for participation in community events. Life stress, self-esteem, and social support may be common factors associated with depressive symptoms among high school students regardless of region. Overall, the magnitude of the relationship between depressive symptoms and psychosocial factors was similar across Okinawa and Saga students.

In order to provide basic data for evaluation of malaria control measures, a study on the knowledge and behavior of people regarding prevention of malaria was carried out in 8 malaria endemic villages in Khammouane Province of Lao PDR from 1999 to 2000. The total valid questionnaire respondents were 932, with a mean age of 32.3 +/- 14.9. 43.7% of the respondents were illiterate. About 44% of the respondents suffered from malaria in the past. About 55% of the illiterate group slept in mosquito nets, compared to 75.4% for the educated group. About 29% of the illiterate respondents had knowledge of malaria transmission by mosquito bites, compared to 48.8% for the educated groups. Out of 167 non-impregnated mosquito nets examined in two villages, 13 were in bad condition having holes or leaks and 39 female mosquitos including Anopheles spp were collected in these nets by early morning catches. Knowledge of malaria and behavior in relation to the prevention of malaria were significantly related to educational level. Health education as well as general education must be taken into account for communities in malaria endemic areas to become more involved in malaria control strategies.

To investigate factorial construct validity of a measurement scale of fatigue symptoms in junior high school students, a questionnaire which consisted of Cumulative Fatigue Symptoms Index (CFSI) and Psychological Condition Test (PCT) was administered on 289 students in Okinawa. Reliability coefficients were 0.607-0.811 for CFSI scales. A principal factor analysis with varimax rotation was applied to CFSI. In boys, 4 factors were extracted; general psychological symptoms, fatigue, emotional instability, and decreased morale and vitality. In girls, 4 factors were extracted; depression and anxiety, decreased morale and vitality, fatigue, and irritability. The same procedure was applied to PCT. In boys, 4 factors were extracted; negative feeling, vigor, inferiority complex, and fatigue. In girls, 4 factors were extracted; negative feeling, anger, vigor, and fatigue. Among factors derived from CFSI and PCT, the fatigue factor of CFSI was correlated with that of PCT. The factors concerning psychological symptoms of CFSI were correlated with those of PCT. However, the vigor factor of PCT was not correlated with any other factors. These results suggest that CFSI in junior high school students had factorial construct validity.

In the previous papers the temperature rise due to throttling was applied as a starting aid for a four stroke cycle diesel engine and a crankcase scavenged two stroke cycle diesel engine. In the present paper the same process has been applied to a two stroke cycle diesel engine with a scavenging blower. By releasing the cylinder pressure on the compression stroke with an automatic valve, pressure drop under the ambient can be obtained at the end of an expansion stroke. When the exhaust ports open, the air rushes into the cylinder with a considerable temperature rise. After scavenging, the charge temperature is lowerd, being, however, higher than the scavenge air temperature at the beginning of compression. The calculated temperature rise reached 80°C before scavenging. However, when the delivery ratio was unity in the scavenging process, it was reduced to 24°C at the beginning of compression, while the observed one was 19°C. In the starting test the minimum cooling water temperature at which the engine can start can be lowered by 30°C in the range of small delivery ratio.

Audiometric findings of traumatic deafness caused by explosion were discussed in 18 cases. All subjects complained of tinnitus immediately after exposure to explosion and audiometric examination revealed hearing impairment in 15 cases. About four days after explosion tinnitus faded away in all cases, and after two weeks the hearing impairment was restored in most cases.In order to measure, the difference of sound pressure level in the room, the pistol shot was employed as a sound source. The data obtained in this experiment suggested that individual hearing loss was not always proportioned to the intensity of the sound. As a result, the authors deduced that individual difference of susceptibitily played an important role in the occurrence of the traumatic deafness.

By using Image Intensifier and general anaesthesia, the authors have recently succeed easily and safely in removing an artificial tooth from the esophagus of 47-years old man who swallowed it by accident.

It is absolutely necessary to know the condition of the ossicular chain preoperatively in tympanoplastic surgery.In addition to pure tone audiometry, patch test (covering test), Tsunoda's liquid conduction test, Onchi's bone conduction test on the pinna, and acoustic probe hearing test have been done for this purpose. Among these hearing tests, Tsunoda's and Onchi's methods are supposed to be the best way to know the condition of the ossicular chain and stapedial foot plate and can be done as a routine preoperative examination with simple equipments.On this paper, these two tests were reconsidere on the ground of experimental and clinical studies.The patient was placed in the lateral position with the examined ear upward and acoustic probe (10mm in diameter) was put on the cavitas conchae and another ear was masked with white noise.The following results and conclusions were obtained;1) The sound conduction route and its testing method based on the present experiment were termed “Meatus Conduction (M.C.) and its test”.2) M.C. may be different from ordinary bone conduction (B.C.) in quality. When the meatus was filled with water, threshold of M.C. and B.C. were decreased; on the other hand, with mercury of the same gravity of the water, threshold of M.C. was elevated in 15db, in contrast to the fact that threshold of B.C. was decreased.3) In this method, the vibratory sound is conducted from the bone conduction receiver to the cochlea via the bony wall of meatus and the ossicular chain in tympanic cavity, independent of condition of the tympanic membrane.4) The result that the threshold of M.C was variable according to the pathological changes of the ossicular chain was different from Tsunoda's theory that the degree of ossicular chain disturbance was parallel to the difference between thresholdof M.C. and that of Liquid Conduction (L.C.).5) The degree of M.C. loss and that of L.C. loss depend on the function of the ossicular chain and that of stapedial foot plate in the perforated ears respectively. Therefore, the cases with M.C. loss and normal L.C. have sound conduction disturbances in the ossicular chain with intact stapedial foot plate, and if there are both M.C. and L.C. loss, some changes around the oval window may be found.6) The diagnostic standards obtained by analysis of 32 cases were available for differential diagnosis of conductive hearing loss.