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Shinya Matsuda

Publications and source records attributed to Shinya Matsuda.

17 recordsLinked to original sources
PubMed2006

Prospective study of vegetable consumption and liver cancer in Japan.

We examined the relationship between vegetable consumption and the risk of death from liver cancer in a cohort study in Japan. This analysis is based on data from 6,049 subjects aged 40 to 79 years enrolled in a cohort study conducted in Fukuoka Prefecture, Japan. The follow-up period was from 1986 to 1999. All liver cancer deaths were recorded. The vegetable consumption was classified into 3 groups: "once per week or less," "2-4 times per week" and "daily intake." The Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence interval (95% CI). A total of 51 male and 22 female liver cancer deaths were recorded during 62,343 person-years of follow-up. The "once per week or less" group was considered the referent group. In males, the multivariate HRs of liver cancer deaths were 0.61 (95% CI: 0.33-1.14) and 0.25 (95% CI: 0.11-0.59) in the "2-4 times per week" and "daily intake" groups, respectively. In females, the multivariate HRs were 0.44 (95% CI: 0.13-1.51) and 0.51 (95% CI: 0.16-1.69), respectively. The multivariate HRs were also reported by history of hepatitis and cirrhosis. In those without a history of these conditions, the multivariate HRs were 0.54 (95% CI: 0.27-1.09) and 0.36 (95% CI: 0.16-0.83). In those with a history of these conditions, the multivariate HRs were 0.58 (95% CI: 0.22-1.56) and 0.37 (95% CI: 0.13-1.06), respectively. Our study reveals an inverse association between vegetable consumption and the risk of death from liver cancer. These results provide further evidence of the protective effect of vegetables against liver cancer.

Adult↗
PubMed2006

[Functional improvement program of musculoskeletal system of the elderly in an isolated island of Kagoshima prefecture].

Under the coming amendment of long term care insurance (LTCI), the preventive activities will be more strengthened in order to ameliorate the quality of life (QOL) levels of the slightly frail elderly and then to rationalize the LTCI expenditures. The functional training of the musculoskeletal system is regarded as especially important. In order to validate its effectiveness and availability in a rural setting, we organized a physical fitness program for the slightly frail elderly in an isolated island of Kagoshima prefecture. According to the results of our preliminary study, statistically significant improvement was observed for some items of the physical fitness level, but not for life style, activities of daily living (ADL), instrumental activities of daily living (IADL) levels or Frenchay Activities Index. In addition to the relatively small number of participants, it is thought that physical fitness training alone cannot increase the elderly activity volume. Further studies are necessary to clarify the usefulness of physical training on the ADL/IADL level of the elderly.

Activities of Daily Living↗
PubMed2005

Profiling of resource use variation among six diseases treated at 82 Japanese special functioning hospitals, based on administrative data.

BACKGROUND: Profiling treatment in Japanese hospitals has rarely been conducted systematically with an administrative database. The study aims to present descriptive statistics of medical profiling and to examine the sources of variation in resource used for six common diseases. METHODS: Administrative records for 266,677 patients were analyzed to examine variation in length of stay (LOS) and total charge (TC) by hierarchical multiple linear regression for cases of ischemic stroke, ischemic heart disease (IHD), great vessel disease (GVD), respiratory neoplasm, gastric neoplasm and colonic neoplasm. RESULTS: Average LOS and TC increased with disease severity and invasiveness of surgical procedure. The coefficient of determination of the full model was highest for LOS in IHD (0.432), and for TC that was highest in GVD (0.702). Among various variable sets examined, surgical procedures explained largest variance in resource use. CONCLUSION: With a standardized database derived from claims data, wide audience of stakeholders in Japanese healthcare will be able to access the profiling of practice or disease variation concerned.

Aged↗
PubMed2005

[The effects of an exercise program for the female elderly in the community].

In Mizumaki-cho, Fukuoka, a "School of muscle-building for the elderly" was held by the self-help group "MIZUMAKI Iki-iki senior club" once a week from Sep. 2002 to Mar. 2004. This school program included stretching, aerobics and resistance exercises. In this study, we clarified the effect of exercise for the 38 elderly females in this school. Their average age was 65.8 years old. Blood pressure, BMI, body %Fat, VO2 max, grasping power, time of standing on one leg with eyes open, anteflexion while sitting, time of walking for 10 m and time of standing up from sitting on a chair were measured before starting school, after 6 months, 12 months and 18 months. Every measured value except BMI and VO2 max was improved, and these improvements continued for 18 months. Especially, it was shown that time of standing on one leg with eyes open, time of standing up from sitting on a chair and time of walking for 10 m improved by 121.6%, 112.7%, 30.4%, respectively, compared with each measured value at the start. These improvements might produce the effect of fall prevention for the elderly. From the results of this study, it was clarified that regular exercise builds up the muscles of the female elderly, and continuation of exercise also extends the effect of exercise for the female elderly.

Accidental Falls↗
PubMed2005

[Sudden difficulty in ventilation due to massive subcutaneous emphysema during laparoscopic cholecystectomy].

A 56-year-old woman with cholecystolithiasis was scheduled for laparoscopic cholecystectomy. Anesthesia was induced with fentanyl and propofol IV, and the trachea was intubated using vecuronium IV. Anesthesia was maintained with 60% nitrous oxide and propofol intravenously, and vecuronium was used for muscle relaxation. Following induction of carbon dioxide pneumoperitoneum, PETCO2 slightly increased. During pneumoperitoneum PETCO2 as easily controlled by increasing minute volume of ventilation. Fifty minutes after the start of pneumoperitoneum, suddenly the peak airway pressure increased and PETCO2 reached 70 mmHg continuously. At this time, severe massive subcutaneous emphysema from the anterior thorax to the head and neck was noted, and the manual lung ventilation was very difficult. After discontinuation of pneumoperitoneum, PETCO2 gradually decreased with improvement of the neck subcutaneous emphysema. At the same time the lung ventilation improved. We speculate that major causes of difficulty in ventilation were the decreased compliance and the tracheal tube comppression, which were due to massive subcutaneous emphysema. Our findings show that we have to stop pneumoperitoneum immediately, when we find a sudden increase of the peak airway pressure or PETCO2 with subcutaneous emphysema during laparoscopic cholecystectomy.

Carbon Dioxide↗
PubMed2005

[Effect of DPC based payment and its future].

Since 2003, the DPC based bundle type payment scheme has been applied for the acute care hospitals, including the special function hospitals. The DPC scientific committee under the Central Social Insurance Medical Council has examined the change in hospital services after the introduction of DPC based payment. It has been observed the reduction of ALOS, resource uses such as laboratory test radiological examination, drugs and supplies. The under treatment due to strong incentive for cost containment has not been observed up to now.

Cost Control↗
PubMed2004

[Case mix based payment and DPC from an international perspective].

The basic principle of Diagnosis Related Groups (DRG) is to classify patients according to the combination of diagnosis and procedures. The first DRG developed by research at Yale University was adopted for the per-case-payment American Medicare scheme for hospital fees under a DRG/PPS (prospective payment system). This scheme has been refined continuously and adopted as payment systems in other countries. The DPC-based reimbursement scheme in Japan consists of two components; a DPC component and a Fee-For-Service (FFS) component. The DPC component corresponds to the "so-called" hospital fee, includes the hospital basic charge, the pharmaceuticals and supplies used in wards, lab-test, radiological examination, and any procedures costing less than 10,000 yen. The FFS component corresponds to the charges for surgical procedures, pharmaceuticals and supplies used in operation rooms, and procedures costing more than 10,000 yen. For the DPC component, a per diem payment schedule is set for each DPC group. One of the most important objectives in introducing the DPC scheme is to ameliorate the transparency of hospital activities in Japan. The DPC system is expected to make hospital services measurable, and then to provide a common ground for discussion among interest groups over the optimal policy to maintain a sustainable Japanese medical care system. However, in order to keep DPC more reliable, much must be done to refine the DPC version 3. For example, development of CCP (Co-morbidity-Complication-Procedure) matrix is now ongoing to more properly describe the resource consumption of each DPC group. It is also important how to evaluate nursing services, ICU services and expensive drugs and materials within the DPC sheme.

Austria↗
PubMed2002

[Peer education by medical students in a public health course].

Sex education by peers is becoming popular in Japan. To improve youth's reproductive health by continuous peer education and to encourage medical students to obtain the methodology necessary for health promotion, we started peer sex education by medical students in the annual public health course. One junior high school and one senior high school in Kitakyushu City in Japan asked medical students to conduct peer sex education classes at their schools. Medical students planned and carried out these classes based on the results of a questionnaire that they gave to the junior high school and senior high school students before the peer education. After the class, the students' responses to the class were investigated by another questionnaire. In this questionnaire, over 90% of the students answered that they were interested in talking about sexual issues with medical students. As for the medical students, they said that they could understand better the methodology of health promotion and also gained confidence by this experience. We will continue to carry out peer education in the medical school's public health course, and we intend to research further how junior high school and senior high school students' sexual behavior may change in the future.

Adolescent↗
PubMed2002

The health and social system for the aged in Japan.

Japan implemented a new social insurance scheme for the frail and elderly, Long-Term-Care Insurance (LTCI) on 1 April 2000. This was an époque-making event in the history of the Japanese public health policy, because it meant that in modifying its tradition of family care for the elderly, Japan had moved toward socialization of care. One of the main ideas behind the establishment of LTCI was to "de-medicalize" and rationalize the care of elderly persons with disabilities characteristic of the aging process. Because of the aging of the society, the Japanese social insurance system required a fundamental reform. The implementation of LTCI constitutes the first step in the future health reform in Japan. The LTCI scheme requires each citizen to take more responsibility for finance and decision-making in the social security system. The introduction of LTCI is also bringing in fundamental structural changes in the Japanese health system. With the development of the Integrated Delivery System (IDS), alternative care services such as assisted living are on-going. Another important social change is a community movement for the healthy longevity. For example, a variety of public health and social programs are organized in order to keep the elderly healthy and active as long as possible. In this article, the author explains on-going structural changes in the Japanese health system. Analyses are focused on the current debate for the reorganization of the health insurance scheme for the aged in Japan and community public health services for them.

Aged↗
PubMed2002

[A sexual health study of high school students at the 3 high schools in Kitakyushu City].

OBJECTIVES: The purpose of this study was to clarify the actual sexual behavior and attitudes of high school students in Kitakyushu city, Fukuoka and then to develop effective sex education methods for high school students in this region. METHODS: This study investigated the sexual behavior and attitudes of 1,297 high school students in Kitakyushu by self-administered questionnaire. The differences in their answers by sex, prevalence of sexual intercourse and change in sexual behavior and attitude before and after the sex education lecture were examined. RESULT: 39.3% of the students had had sexual intercourse and 74.1% answered that they might have sex, if it were with a partner whom they loved. However, they did not have enough knowledge about contraception and sexually transmitted diseases. This result shows that they did not recognize the risks accompanying sexual intercourse. There are significant differences between male and female students in their sexual attitudes. Male students tend to permit premarital sexual intercourse, unfaithfulness, prostitution, hiring a prostitute and abortion. Male students tend to give more approval to the following opinions: both men and women should agree to sexual contact if the partner wants it; men should take the initiative in sexual contact; women should not talk about sex. Many female students answered that women should make their own decisions to have or not to have sex, however a considerable number of female students answered that for their first intercourse, they just agreed with their partner even though they really did not want to do so. After the sex education lecture, the students have more knowledge about contraception and STDs. However, there is no significant difference in their sexual attitudes before and after the lecture. CONCLUSION: In order to facilitate more desirable and safer sexual behavior among the younger generation, it is not enough to simply give them knowledge about contraception or STDs, etc. To organize more comprehensive sex education, it is also important to pay enough attention to gender problems and other social factors such as family background or regional background, etc.

Adolescent↗