論文 - 岡村　智教

地域，職域におけるアルコール摂取と身体所見の関連についての疫学的検討．

Kitamura A., Iso H., Sato S., Iida M., Naito Y., Kiyama M., Okamura T., Nakagawa Y., Shimamoto T., Sankai T., Imano H., Komachi Y.

[Nippon kōshū eisei zasshi] Japanese journal of public health 43 （ 2 ） 86 - 101 1996年02月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0546-1766

　概要を見る

<p>To investigate associations of alcohol intake to constitutional and biochemical variables, cross-sectional studies of men aged 40-59 years from six geographical and occupational populations with varied lifestyles were conducted in the 1990's. Systolic and diastolic blood pressures, glutamic oxaloacetic transaminase, gamma glutamyl transpeptidase, HDL-cholesterol, and uric acid were linearly associated with alcohol intake in all six populations. Drinkers of 2+ drinks (46 g ethanol or more) per day showed higher levels of triglyceride, glutamic pyruvic transaminase than never-drinkers. In two urban occupational populations, men who mainly drank beer had higher uric acid levels; men mainly drinking sake had higher blood pressures and lower serum total cholesterol; men mainly drinking whiskey had higher obesity indices. These differences in constitutional and biochemical variables related to type of alcoholic beverage consumed may be due to differences in lifestyles such as diet and physical activity.</p>

老人保健事業における機能訓練事業参加者の実態と日常生活自立度に関する研究．

Okamura T., Nakagawa Y., Ishikawa Y., Kitamura A., Kiyama M., Sato S., Naito Y., Iida M., Iso H., Shimamoto T.

[Nippon kōshū eisei zasshi] Japanese journal of public health 42 （ 10 ） 878 - 887 1995年10月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0546-1766

　概要を見る

<p>To clarify characteristics of participants in community-based rehabilitation programs provided by local municipalities (cities, towns, and villages) and effect of the program on their levels of independence in activities of daily living (ADL), a cross-sectional study was performed on 422 participants in 49 municipalities in Kochi Prefecture. 1. Mean age of participants was 68.3 +/- 9.0, and 77.7% of them were stroke patients. 2. The mean interval between disease onset and program participation was 40.4 months, and the mean duration of program participation was 54.5 months. 3. At the start of rehabilitation programs and at the time of the investigation (December 1993), about 90% of the participants had good levels of independence in ADL (Rank A and over according to the standard of the Ministry of Health and Welfare). 4. The frequency of rehabilitation programs and the presence of occupational therapists were positively associated with the improvement of levels of independence in ADL. In particular, the frequency of rehabilitation programs was associated with improvement of quality of life in self-supporting participants (Rank J2), and the presence of occupational therapists was associated with the improvement of ADL in semi-bed-ridden participants (Rank A). 5. After adjusting for age and sex, using multiple logistic regression analysis, type of diseases (non-stroke), hospital rehabilitation immediately after onset, higher levels of independence in ADL at the start of rehabilitation programs, and higher frequency of rehabilitation programs were significantly associated with improvements in levels of independence in ADL. Shorter interval between disease onset and program participation, and the presence of occupational therapists were also associated with improvements in levels of independence in ADL, although the relation did not reach statistical significance.</p>

入院受療率に関連する家族要因－高知県と島根県の比較と高知県N町における検討．

Okamura T., Iida M., Tanigaki M., Doi M., Iso H., Shimamoto T., Komachi Y.

[Nippon koshu eisei zasshi] Japanese journal of public health 41 （ 4 ） 352 - 361 1994年04月

研究論文（学術雑誌）, 共著, 査読有り,  ISSN  0546-1766

　概要を見る

<p>Kochi Prefecture had a higher admission rate for patients with cardiovascular disease, particularly for stroke, than Shimane Prefecture which has a similar socio-economic level. Kochi Prefecture had a smaller average number of persons in a household, a lower proportion of three generation households, and a lower proportion of households with six persons or more than Shimane Prefecture. The decline in number of persons in a household was greater in Kochi Prefecture than in Shimane Prefecture from 1960 to 1985, especially between 1970 and 1975. The association between family make-up and hospital discharge one year after stroke was examined in a rural community in Kochi Prefecture. Two hundred forty nine patients aged 40 years and older who were admitted immediately after stroke events were registered between 1969 and 1988, and they were followed for one year. According to family make-up, the subjects were divided into four groups: 1) persons who lived with spouse and daughter-in-law, 2) persons who lived with spouse, 3) persons who lived with daughter-in-law, 4) persons who lived without spouse and daughter-in-law. Although mean age and the proportion of serious cases were not different between group 1 and group 4, the proportion of admitted patients of group 1 was significantly lower than that of group 4. About 60% of group 1 had households with six persons or more. Group 2 had the lowest proportion of admitted patients, but this group was significantly younger than other groups. Within group 3, the proportion of admitted patients was higher in households in which the daughter-in-law had a job than in households in which she did not. These results suggest that the high admission rate in Kochi Prefecture is attributable to households which are short of personnel for home care.</p>

長期的な予防対策を実施した地域における脳卒中発生状況と予後の推移に関する研究

Okamura T.

[Nippon koshu eisei zasshi] Japanese journal of public health 41 （ 1 ） 56 - 66 1994年01月

研究論文（学術雑誌）, 単著, 査読有り,  ISSN  0546-1766

　概要を見る

<p>Trends for stroke incidence and prognosis were investigated in a southwest rural town in Japan, where a community-based stroke prevention program has been conducted since 1969. Four hundred forty-nine stroke patients aged 40 years and older were registered from 1969 to 1988. From among these, 405 (90%) were followed for 3 years to examine prognosis. 1. Age-adjusted stroke incidence in each 5 year interval decreased from 1969 to 1988 with stroke incidence decreasing in almost all age groups 40 years and older for both men and women. A small increase in incidence was observed for women aged 70 years and older between 1979-1983 and 1984-1988. 2. While there was a 46% increase in the population aged 40 years and older, the number of stroke patients decreased between 1969-1973 and 1984-1988. 3. Mortality rates between one week and three years after a stroke have shown a decrease from 1969-1978 to 1979-1988. The proportion of those not requiring nursing care between one week years after stroke has increased. The proportion of all patients requiring nursing care however did not change. 4. After adjusting for age, sex, type of stroke, and loss of consciousness, the blood pressure level within 5 years prior to the stroke was positively associated with death between one week and three years after the event, and was negatively associated with the proportion of those not requiring nursing care. 5. Despite a 31% increase in the census population of all ages between 1969-1978 and 1979-1988, the number of those requiring nursing care has increased only 6% at one year after stroke. If the population had remained constant, the number of those requiring nursing care would have decreased by 10% at one year after the event. These results suggest that a long-term community-based stroke prevention program can decrease both the number of those requiring nursing care and mortality after stroke, as well as stroke incidence and the number of stroke patients.</p>