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Certain types of community-based social activities improve the health issues of older adults; however, the present patterns of participation in community activities remain unknown. This study aims 1) to identify community-dwelling older adults' patterns of participation in community-based activities and 2) to evaluate the relationships between social support, self-efficacy, self-rated health, and the patterns of participation in community activities. This cross-sectional study used data collected from 146 older adults aged ≥65 years who participated in community events in Japan in 2018. Cluster analysis was used to identify subjects' patterns of participation in community activities. In the multinomial logistic regression model, the participation pattern (dependent variable), and social support and self-efficacy (independent variables), were included, adjusting for age, sex, and years of residency. Three participation pattern clusters were identified: diverse activities (58%), municipal events (30%), and senior citizen club (12%). The proportion of participants reported themselves healthy were 93%, 88%, and 78% for diverse activities, municipal events, and senior citizen club clusters, respectively. Compared to those in the senior citizen club cluster, older adults in the diverse activities cluster were more likely to have self-efficacy (adjusted odds ratio (aOR): 1.19, p = .041) and social support (aOR: 2.35, p = .018), while participants in the municipal events cluster were associated with only social support (aOR: 3.29, p = .022). Increasing social support and self-efficacy may promote seniors' participation in diverse community activities, which would be beneficial for their healthy aging. Further studies are needed to evaluate the causal relationships.

Despite a clinical need, only a few studies have provided information concerning visual estimation training for raters to improve the validity of their evaluations. This study aims to describe the differences in the characteristics of raters who evaluated patients' dietary intake in hospitals using the visual estimation method based on their training experiences.We collected data from three hospitals in Tokyo from August to September 2016. The participants were 199 nursing staff members, and they completed a self-administered questionnaire on demographic data; working career; training in the visual estimation method; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity of and skills of visual estimation. We classified participants into two groups, experienced and inexperienced, based on whether they had received training. Square test, Mann-Whitney U test, and univariable and multivariable logistic regression analysis were used to describe the differences between these two groups in terms of their characteristics; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity and tips used in the visual estimation method.Of the 158 staff members (79.4%) (118 nurses and 40 nursing assistants) who agreed to participate in the analysis, thirty-three participants (20.9%) were trained in the visual estimation method. Participants who had received training had better knowledge (2.70 ± 0.81, score range was 1-5) than those who had not received any training (2.34 ± 0.74, p = 0.03). Score of self-evaluation of method validity of the visual estimation method was higher in the experienced group (3.78 ± 0.61, score range was 1-5) than the inexperienced group (3.40 ± 0.66, p 0.01). Mean total scores of using tips in the visual estimation method in the experienced and inexperienced groups were 19.6 ± 1.76 and 17.9 ± 2.28, respectively (score range was 6-24), differing significantly between the two groups (p 0.01). Multivariable logistic regression revealed that participants who had been trained had adequate knowledge (OR: 2.78, 95% CI: 1.05-7.35) and frequently used tips in visual estimation (OR: 1.85, 95% CI: 1.26-2.73).Trained participants had more required knowledge and they used visual estimation tips more frequently than participants who had not been trained in the visual estimation method. This study provides new evidence for the importance of training clinical staff members to use the visual estimation method appropriately and makes suggestions to improve the validity of the visual estimation method.

The aim of this study was to examine differences in the validity of a visual estimation method for determining patients' meal intake between various meal types and supplied food items in hospitals and to find factors influencing the validity of a visual estimation method.There are two procedures by which we obtained the information on dietary intake of the patients in these hospitals. These are both by visual assessment from the meal trays at the time of their clearing, by the attending nursing staff and by weighing conducted by researchers. The following criteria are set for the target trays: A) standard or therapeutic meals, which are monitored by a doctor, for energy and/or protein and/or sodium; B) regular, bite-sized, minced and pureed meal texture, and C) half-portion meals. Visual assessment results were tested for their validity by comparing with the corresponding results of weighing. Differences between these two methods indicated the estimated and absolute values of nutrient intake.A total of 255 (76.1%) trays were included in the analysis out of the 335 possible trays and the results indicated that the energy consumption estimates by visual or weighing procedures are not significantly different (412 ± 173 kcal, p = 0.15). However, the mean protein consumption was significantly different (16.3 ± 6.7 g/tray, p 0.01) between the two procedures. Compared with standard meals (38 ± 45 kcal, 1.9 ± 2.5 g/tray), raters significantly misestimated the energy and protein intake of half-portion meals (78 ± 65 kcal, 2.8 ± 2.2 g/tray, p = 0.01) but accurately estimated the protein intake of protein controlled meals (0.5 ± 0.6 g/tray, p = 0.03). Trays adding supplied food items were significantly misestimated for energy intake (66 ± 58 kcal/tray) compared to trays with no additions (32 ± 39 kcal/tray, p 0.01). Moreover, the results of multivariable analysis demonstrated that supplied food items were significantly associated with increased odds of a difference between the two methods (OR: 3.84; 95% confidence interval [CI]: 1.07-13.85).There were high correlations between the visual estimation method and the weighing method measuring patients' dietary intake for various meal types and textures, except for meals with added supplied food items. Nursing staff need to be attentive to supplied food items.

Nursing staff have an important role in patients’ nutritional care. The aim of this study was to demonstrate how the practice of sharing a patient’s nutritional status with colleagues was affected by the nursing staff’s attitude, knowledge and their priority to provide nutritional care. The participants were 492 nursing staff. We obtained participants’ demographic data, the practice of sharing patients’ nutritional information and information about participants’ knowledge, attitude and priority of providing nutritional care by the questionnaire. We performed partial correlation analyses and linear regression analyses to describe the relationship between the total scores of the practice of sharing patients’ nutritional information based on their knowledge, attitude and priority to provide nutritional care. Among the 492 participants, 396 nursing staff (80.5%) completed the questionnaire and were included in analyses. Mean±s.d. of total score of the 396 participants was 8.4±3.1. Nursing staff shared information when they had a high nutritional knowledge (r=0.36, P

This study aimed to identify dietary and fluid behaviors associated with relative interdialytic weight gain (RIDWG) (divided by the respective dry weight [DW]) by stratifying the patients according to body mass index (BMI).This was a cross-sectional, multicenter investigation. Between July 2016 and March 2017, data were collected from 4 Japanese dialysis centers in 3 cities. The patients (n = 577) were asked to reply to a self-completed questionnaire, including questions on perception about DW and dietary and fluid behaviors. The differences in perception about DW and dietary and fluid behaviors were compared between RIDWG nonadherence (average RIDWG ≥5％ a month) and adherence subgroups.The 360 participants were stratified into thin (20; 28.6%), normal low (≥20 and 22; 22.5%), normal high (≥22 and 25; 31.7%), and overweight (≥25; 17.2%) groups on the basis of BMI. In the thin and normal low BMI groups, the RIDWG nonadherent patients were more likely to identify their DW as "looking to increase." Although the difference was less prominent between the adherence subgroups in the thin BMI group, the RIDWG nonadherent patients in normal low BMI group seemed to generally take less care to intentionally regulate their behaviors as a representative of sodium-intake/fluid management. Although patients with a larger body size (overweight and normal high BMI groups) were not associated with this perception about DW, they were associated with some demographic characteristics; regarding the normal high BMI group, a higher proportion of RIDWG nonadherent patients worked full-time, and they more frequently reported an irregular eating pattern.Dietary and fluid behaviors associated with RIDWG differed according to the BMI group. Assessing more specific types of patient behaviors, focusing on the underlying factors associated with dietary and fluid behaviors, and taking BMI into consideration are required.

Rationale, aims and objectives: To determine more effective intervention, this qualitative study explores the specific behaviors of adult patients undergoing hemodialysis with regard to dietary and fluid restrictions. Additionally, to understand their characteristics, identified behaviors were categorized as being either intentional or unintentional.Methods: This study employed a descriptive exploratory design comprising individual semi-structured interviews. It was conducted from July to September 2014 in one private dialysis facility treating 73 outpatients in Tokyo, Japan. Forty-three patients receiving hemodialysis treatment consented to participate. Behaviors identified in the interviews were categorized by considering “the motivation behind them (intentional/unintentional)” and their “adequacy (if the behavior seems to lead adherence or not).”Results: This study identified 32 categories of “intentional behaviors” and 14 categories of “unintentional behaviors”. Intentional behaviors included general behaviors of “making adjustments in diet” and non-adherence behaviors of “taking halfway measures” and “abandonment”. Unintentional behaviors comprised general behaviors practiced after the initiation of HD therapy, in addition to non-adherence behaviors due to “habituation” and “dietary environments”.Conclusions: A total of 46 categories of specific behaviors regarding dietary and fluid restrictions in patients receiving HD were identified. Categories were then divided into two different types: intentional and unintentional. Though certain characteristics were similar to other adherence behaviors such as those toward medication, the current study also proposes some unique aspects of dietary behaviors with respect to diversity and habitual strength. Understanding the characteristics of different types of non-adherence behaviors, such as whether they are intentional or unintentional, could be a potentially important contribution to interventions.

目的：フォーマティブ・リサーチに基づいた体重管理プログラムを職域において実施し，プログラムのプロセス評価およびプログラム実施後の対象者の行動，BMIの変化を検討する。方法：都内にある運送業者の一営業所（社員317名）で実施した。プログラムの計画のため，環境調査と社員18名を対象にインタビュー調査を実施した（研究1）。フォーマティブ・リサーチの結果からプログラムを計画し，約6カ月間プログラムを実施した。BMI，体重管理における誘惑場面におけるセルフエフィカシーおよび対策行動，体重管理に関する知識などの変化をプログラム実施前後で比較した（研究2）。結果：フォーマティブ・リサーチの結果，勤務時間内に社員がプログラムに参加する時間を確保することが難しいことがわかり，食生活調査の個人結果返却と社内の休憩室の掲示板を用いたプログラムを実施した。その結果，対象者の36.3％（115名）が事前事後調査に回答し，21.5％（68名）が個人結果を受け取りかつポスターを利用したと回答した。後者では，体重管理の知識も増え（p＝0.021），体重管理の誘惑場面における対策行動を実行する者が増える傾向にあった（p＝0.064）。また，一日の菓子・嗜好飲料の回数も減っていた（p＝0.001）。考察：本研究の解析対象者は，事前事後調査に回答した者であり，かつ本研究ではコントロール群を設定していないため，プログラムの効果は評価できない。本稿は，対象者のニーズをもとにプログラムを開発した点において先進性があり，職域での体重管理プログラムの事例として紹介するものである。（オンラインのみ掲載）

application/pdf, 学術雑誌論文, Objective: The purpose of the present study was to develop scales to measure the strategies used ofr coping with the temptations experienced during weight control.\Methods: The subjects for this study consisted of 994 consenting adults who anonymously responded to a selfadministered\questionnaire. The questions focused on the frequency with which the subjects used various strategies to cope with the temptations experienced during weight control, their stage of change, their knowledge about weight control, their self-efficacy, their perceptions of their current weight, and their demographic characteristics. Data were analyzed in terms of the item selection, exploratory and confirmatory factor analyses, and assessment of the reliability (Cronbach's alpha) and validity of the scales.\Results: There were 752 respondents for subsequent analyses (518 males, 210 females, nad 42 missing data). Five scales comprising 44 items concerning coping strategies were extracted from the data: counter- conditioning (11 items), eating style (12 items), stimulus ocntrol (5 teims), social support (4 items), and cognitive coping (12 items). The internal consistency (Cronbach’s alpha) of these scales were 0.68~0.87. More advanced stages of change and greater knowledge weight control were associated with significantly higher scores for the scales measuring coping\strategies.\Conclusions: The validity and reliability of these five new scales were confirmed for subjects who were in weight control. Since this study used cross-sectional survey methodology, a longitudinal study will be necessary to examine the relationship between coping strategies and self-efficacy for dealing with temptation during about weight control.

application/pdf, 学術雑誌論文, The strategies were qualitatively examined for coping with temptation during a weight-loss program. Selfresponse questionnaires were distributed to 65 adults (22 males and 43 females) in October 2007, 6 months after they had articipated in a weight-management program in Shizuoka Prefecture, Japan. Each subject answered open-ended questions about the strategy for coping with temptation regarding weight control, and the answers were categorized by two researchers. The respondents provided 461 items which were assigned to 61 sub-categories in five categories. These categories were counter-conditioning (188 items), eating style (98 items), stimulus control (78 items), cognitive coping (70 items), and social support (27 items). Most coping strategies were similar to the process of change that constitutes the transtheoretical model (TTM). The results of this study suggest that cognitive coping strategies, which are presumed in TTM to be common during the early stage of behavior change, can also be employed during the action and maintenance stages, and that eating style, which is not included in the process of change, may be an important coping strategy for changing eating behavior.

A new preparation method of porous CaSiO3 with relatively high surface area and a property as a catalyst support were investigated. The CaSiO3 was prepared by mechanical grinding of SiO2 with CaO in a wet state and the obtained homogeneous mixture was calcined at 523 K. The prepared CaSiO3 was stable up to 1023 K under heating in air, had porous shape, and showed a relatively high surface area (260 m2/g). Pt and Ni supported CaSiO3 were prepared, and its property as a catalyst support was evaluated by the observation of adsorbed CO by infrared spectroscopy.