Toshio Kobayashi

Year-round high physical activity levels in agropastoralists of Bolivian Andes: results from repeated measurements of DLW method in peak and slack seasons of agricultural activities.

By the repeated use of the doubly labeled water method (DLW), this study aimed to investigate (1) the extent of changes in energy expenditure and physical activity level (PAL) in response to increased agricultural work demands, and (2) whether the seasonal work demands induce the changes in the fairly equitable division of work and similarity of energy needs between men and women observed in our previous study (Phase 1 study; Kashiwazaki et al., 1995 : Am J Clin Nutr 62: 901–910). In a rural small agropastoral community of the Bolivian Andes, we made the follow‐up study (Phase 2, 14 adults; a time of high agricultural activity) of the Phase 1 study (12 adults; a time of low agricultural activity). In the Phase 2 study, both men and women showed very high PAL (mean±SD), but there was no significant difference by sex (men; 2.18 ± 0.23 (age; 64 ± 11 years, n = 7), women; 2.26 ± 0.25 (63 ± 10 years, n = 7)). The increase of PAL by 11% (P = 0.023) in the Phase 2 was equally occurred in both men and women. The factorial approach underestimated PAL significantly by ≈15% (P < 0.05). High PAL throughout the year ranging on average 2.0 and 2.2 was attributable to everyday tasks for subsistence and domestic works undertaking over 9–11 h (men spent 2.7 h on agricultural work and 4.7 h on animal herding, whereas women spent 7.3 h almost exclusively on animal herding). The seasonal increase in PAL was statistically significant, but it was smaller than those anticipated from published reports. A flexible division of labor played an important role in the equitable energetic increase in both men and women. Am. J. Hum. Biol., 2009.

Effects of Web-based Career Identity Training for Stress Management among Japanese Nurses: A Randomized Control Trial

Job stress among hospital nurses is often high because of the high quantitative and qualitative nature of their workload. One of the main reasons is negative career identity (CI). Indeed, CI and the degree of role conflict in nurses has been found to be worse than in other occupations . CI is defined as the cognitive representation of self, derived from past work experiences, beliefs, values, attributes, and motives that define individuals in terms of their work roles . The reason for a relatively bad CI among Japanese nurses may be the low flexibility of the work style in Japanese hospitals. Many nurses desire to develop their professional skills and want their own careers to be compatible with their daily life-cycle . Methods reported for improving CI are similar to the methods used in career counseling, and should also be effective for use with Japanese nurses. Web-based training is comparatively low-cost and accessible compared to traditional classroom training. In fact, the effectiveness has been found to be the same as that of classroom training . In this study, to examine the effects of a web-based CI training program on nurses, changes in career identity and levels of job stress were examined among Japanese hospital nurses.

Effects of Two 15-min Naps on the Subjective Sleepiness, Fatigue and Heart Rate Variability of Night Shift Nurses

The purpose of this study was to examine the effects of two 15-min naps on nurses who work at night in a three-shift system. Of the 15 nurses who were included as study subjects on a night shift, eight took two short naps (the Nap condition), and seven worked without taking a nap (the No-nap condition) during the night shift. We measured sublingual temperature and the bispectral index (BIS), obtained heart rate and heart rate variability measures from an electrocardiogram (ECG), and evaluated sleepiness and fatigue levels every hour using the Visual Analog Scale (VAS). Both subjective sleepiness and fatigue increased between 4:00 and 5:00, with no significant differences observed between the two groups. However, the low- to high-frequency ratio (LF/HF) in the Nap condition group was found to be significantly lower than in the No-nap condition group. Furthermore, a sudden, brief increase in HF values was observed in the No-nap condition group in the morning. The results of this study suggest that taking two short naps may effectively reduce tension and prevent a brief increase in HF values by suppressing sympathetic nervous activity in the morning.

Short-term behavioral changes in pregnant women after a quit-smoking program via e-learning: A descriptive study from Japan

Approximately 20% of Japanese women in their reproductive years are smokers. Therefore, in the present study, we report the behavioral changes of woman who undertook a 3 month stop-smoking program. Sixty-six pregnant smokers in the first trimester of pregnancy participated in this study from two hospitals and an obstetric clinic in Japan. Our newly-developed e-learning program uses a cell phone Internet connection service to support pregnant women who want to quit smoking. Using this, service participants were given guidance concerning smoking, and were breath tested for their carbon monoxide levels every 4 weeks for 3 months. An e-learning cessation smoking-support program was maintained throughout the same period. Consequently, 52 of 66 pregnant smokers from three settings began the program, and 48 of 52 eventually completed it. The achievement rate of non-smoking was 71.1% (37/48), and their carbon monoxide exhalation levels significantly decreased from 6.43 ± 4.5 ppm at the beginning to 0.7 ± 1.0 ppm in 1 month, to 0.29 ± 1.08 in 3 months (P < 0.001). These results suggest the effectiveness of our e-leaning program. This paper reports the results of the study.

In the Nepalese context, can a husband’s attendance during childbirth help his wife feel more in control of labour?

BackgroundA husband’s support during childbirth is vital to a parturient woman’s emotional well-being. Evidence suggests that this type of support enables a woman to feel more in control during labour by reducing maternal anxiety during childbirth. However, in Nepal, where childbearing is considered an essential element of a marital relationship, the husband’s role in this process has not been explored. Therefore, we examined whether a woman in Nepal feels more in control during labour when her husband is present, compared to when another woman accompanies her or when she has no support person.MethodsThe study participants were low risk primigravida women in the following categories: women who gave birth with their husband present (n = 97), with a female friend present (n = 96), with mixed support (n = 11), and finally, a control group (n = 105). The study was conducted in the public maternity hospital in Kathmandu in 2011. The Labour Agentry Scale (LAS) was used to measure the extent to which women felt in control during labour. The study outcome was compared using an F-test from a one-way analysis of variance, and multiple regression analyses.ResultsThe women who gave birth with their husband’s support reported higher mean LAS scores (47.92 ± 6.95) than the women who gave birth with a female friend’s support (39.91 ± 8.27) and the women in the control group (36.68 ± 8.31). The extent to which the women felt in control during labour was found to be positively associated with having their husband’s company during childbirth (β = 0.54; p < 0.001) even after adjusting for background variables. In addition, having a female friend’s company during childbirth was related to the women’s feeling of being in control during labour (β = 0.19; p < 0.001) but the effect size was smaller than for a husband’s company.ConclusionThe results show that when a woman’s husband is present at the birth, she feels more in control during labour. This finding has strong implications for maternity practices in Nepal, where maternity wards rarely encourage a woman to bring her husband to a pregnancy appointment and to be present during childbirth.

Changes in Health Habits of Female Shift Workers

Changes in Health Habits of Female Shift Workers: Shin‐ya Kaneko, et al. Department of Hygiene & Preventive Medicine, School of Medicine, Fukushima Medical University—This paper examines the effects of shift work on the lifestyles of female factory workers. As an indicator of healthy lifestyle habits, we used a scoring system (referred to below as the ‘health score’) based on Lester Breslows health habits. The ‘health score’ of the women was higher than that of the men, but the shift workers’ score was lower than that of the non‐shift workers (p<0.01). In addition, the score of workers who had changed from non‐shift work to double‐shift work was remarkably low (p<0.01). These results suggest that, while the female shift workers manage to maintain relatively healthy lifestyles in comparison with the males, they have more difficulty maintaining these habits than do female workers who do not perform shift work. It can be concluded that, in addition to heightening womens consciousness of their own health, surrounding entities such as the work environment, the home, and the community in general need to pay due care to Japans female shift workers.

Evaluating educational media using traditional folk songs (‘lam’) in Laos: a health message combined with oral tradition

In the Lao Peoples Democratic Republic (Laos), health education is clearly a core aspect of the health service and is vital in improving peoples lives through good health. However, there are many obstacles to conducting effective health education. The development of effective educational media is one solution to these problems. In Laos, traditional folk songs (lam) are preserved as part of the local communication media, and recently this communication medium has been used for health education. The aim of this study is to evaluate the effectiveness of educational media using lam. For this purpose, we conducted focus group discussions with 48 participants. The reactions of the participants towards a lam, developed for preventing HIV/AIDS, were analysed using the KJ (Kawakita Jiro) method. The analysis showed there were eight areas of concern: (1) interest in a lam talking about HIV/AIDS; (2) knowledge and perception related to HIV infection routes; (3) expressing a willingness for preventing HIV/AIDS; (4) togetherness with people living with HIV/AIDS; (5) HIV/AIDS education for children; (6) improving educational methods; (7) characteristics and effectiveness of the lam and (8) song preferences. The reactions of the participants, such as gaining knowledge and expressing individual attitudes and community actions for preventing HIV/AIDS, were promoted by the characteristics and effectiveness of the lam such as oral tradition, artistry and cultural values. In particular, the oral tradition represented by lam is useful for the Lao people in memorizing and communicating information.

Impact on perceived postnatal support maternal anxiety and symptoms of depression in new mothers in Nepal when their husbands provide continuous support during labour.

BACKGROUND when a husband provides continuous support during his wifes labour, his presence is considered effective in reducing her dissatisfaction with the childbirth process. The impact of this on the postnatal well-being of a new mother, however, is not clear. OBJECTIVE to examine the impact on postnatal support, maternal anxiety and symptoms of depression experienced by new mothers in Nepal when their husband supported them continuously during labour. METHOD the study involved 231 Nepali women, of whom 77 were supported continuously by their husbands, 75 by female friends, and 79 were not supported by any companion during childbirth. They were contacted at six to eight weeks post partum, when postpartum support questionnaires, a state-trait anxiety inventory and the Edinburgh postnatal depression scale were administered. Structural equation modelling was conducted. FINDINGS observations showed that continuous support from a husband during his wifes labour was related to a greater degree of postnatal support than those who were not supported by their husband during labour (β=0.23, p<0.001). Similarly, the more the women considered they were being supported, the less likely they were to experience maternal anxiety (β=-0.52, p<0.001), which in turn was associated with a lower level of depression (β=0.43, p<0.001). These findings were consistent, even after adjustments for the effect of female support during the postnatal period. CONCLUSION the study suggests that continuous support from husbands during labour has a direct impact on the perceived postnatal support, and an indirect impact on anxiety and depression in new mothers in Nepal.

Seasonal differences in physiological and psychological responses to hot and cold environments in the elderly and young males

Abstract Oral and skin temperatures, blood pressure, heart rate, thermal sensation, and the comfort of seven healthy elderly and seven healthy young males were measured in order to evaluate the difference in thermore gulation with aging in summer and winter by exposure to relatively mild hot and cold environments. The subjects, who wore T-shirts and short pants, and were exposed to three different thermal conditions (20, 28, and 36°C) for 90 min, including sitting at rest for 50 min and a head-up-tilt test for 40 min (supine (0°): 25 min, upright (80°): 15 min). The oral temperature in the cold was significantly lower in the summer than in the winter in both groups. The oral temperature of the elderly subjects significantly declined from that of the young subjects after 30 min in winter, and also before 30 min and after 60 min in summer. The systolic blood pressure (SBP) of the elderly subjects was significantly decreased by the head-up-tilt test in all conditions, but this was not the case in the young subjects. The reduction in SBP in the elderly subjects was significantly greater in the summer than in the winter. The elderly subjects were subjected to higher thermal and cardiovascular stresses by cold in summer and by heat in winter than the young, and their core temperature changed more widely. We found that their thermoregulatory responses were delayed, which was caused by the degradation of the vascular regulation ability with aging.

Possible effects of diets on serum lipids, fatty acids and blood pressure levels in male and female Japanese university students.

ObjectivesTo prepare a dietary recommendation for young Japanese for the prevention of coronary heart disease, we surveyed the dietary habits, serum lipids, serum fatty acids and blood pressure levels among male and female students.MethodsIn this study, 175 male and 246 female university students were interviewed for the frequency of consumption of selected food items and the habit of skipping breakfast. Serum fatty acids were analyzed by gas chromatography.ResultsThe frequencies of consumption of dishes cooked with oil and intake of vegetables were higher in female students than in male students. Serum n-6 polyunsaturated fatty acids were slightly higher in females students than in male students while that of serum n-3 polyunsaturated fatty acids was 6.4% in both sexes. For both males and females, those who skipped breakfast at least once a week were less likely to consume vegetables and fruits than those who did not. Female students who skipped breakfast were also less likely to consume fish and had lower composition of n-3 polyunsaturated fatty acid and higher systolic and diastolic blood pressure levels than males. For female, the intake of milk and dairy products correlated inversely with systolic blood pressure levels and the intake of n-3 polyunsaturated fatty acids correlated inversely with diastolic blood pressure levels. For males, the intake of fruits and consumption of dishes cooked with oil correlated inversely with systolic and diastolic blood pressure levels.ConclusionOur findings suggest that increased intake of fish, milk and dairy products, fruits and vegetables from early adulthood and a regular dietary pattern are important to reduce the risk factors for coronary heart disease.