第55回日本社会医学会総会 -...
TRANSCRIPT
第 55回日本社会医学会総会
「地域から、職場から、我が国の社会医学を考える」
2014 年 7月 12 日（土）～ 13 日（日）
名古屋大学東山キャンパス
i
ii
iii
iv
v
10:00 11:00
11:00 11:10
11:10 12:00
12:00 13:00
13:00 13:50
14:00 14:50
15:00 15:50
"
16:00 18:00
3 -
18:15 20:00
vi
14:00 15:00 1-3
1. :2
2.
3. ( ) ( )
( )
15:00 16:004-6
4.
5.
6.
16:00 17:007-9
7.
8.
9.
17:00 18:0010-11
10.
11.
12.
18:15 20:00
vii
14:00 15:001-3
1. GGT CVD
2.
3.
( )
15:00 16:004-6
4.
5. 60( )
6. 36 JAGES
JAGES
16:00 17:007-9
7.
8. PTA
9.
17:00 18:0010-12
10.
11.
12.
18:15 20:00
viii
15:00 16:30
HPV
16:40 18:00C1-4
1.
2.
NTT docomoHIVHIV
3. 41
4.
18:15 20:00
ix
9:00 12:00
( NPO )
/
12:00 12:50
13:00 14:25
14:30 16:30
16:30 18:00
x
9:00 10:001-3
1. 40 2
2.
3.
10:00 11:004-6
4.
5. CO
6.
11:00 12:007-9
7. 2006 2010
8. Sense of Coherence (SOC)
9. QOL
12:00 12:50
xi
12:00 12:50
13:00 14:00
(
14:00 15:00
15:00 16:2010-13
10. ,
11.
12. K6
13.
xii
12:00 12:50
13:00 14:00 10-12
10.
11.
12.
14:00 15:00
13-15 13. Case Report
14. A
15.
15:00 16:40 16-19 HEALTH SUPPORT OSAKA
16.
17.
HEALTH SUPPORT OSAKANPO
HEALTH SUPPORT OSAKA HEALTH SUPPORT OSAKA
18.
19.
20.
16:40 18:00
xiii
12:00 12:50
xiv
xv
xvi
xvii
xviii
2005
2007
47
1
50
50
2
1Sv47
20mSv
5
CT10mSv
3 1000mSv 3006
2010mSv
3
mSv
1mSv
3
4 CT
1mSv0.67mSv
1.67mSv
1mSv
4
3
5
5050mSv
25
25 1002500 1
3000 1
=1:1.1 1.61:2.5
6.2
1:1.6 2.01:0.6 1.0
110
1000/
4
5
24 2072,670
1193 9827
12
24 667014
3630 10 2
3 DV
DV
7
100
8
19801989
GTGT
GT
GTGT
GT
GT CVD
GT CVDGT
19801990
GTCVD
GT
GT
GTGT CVD 1990 2000
GTDM CVD
GTCVD
52007 GT
CHDGT
1 e=2.72 U/L CHDHR 1.20 1.54
GT DMGT 1 U/L
DM HR 1.92Liu GT
GT
RR 1.94MetS
GT
MetS RR 1.632013 Du GT
9
CVDGT 4
RR 1.56 CVD RR 1.52
3
GSHGT
GTDM
MetSCVD CVD
GTGSH
GSH
GT
Lee GTCVD
GT
GT LDL
GT GSHLDL
CHD
GT
GT HMG-CoA
CVD
GT 40 60 U/L 10 15 U/L CVD 1.5
CVDDM MetS
GT4 2 1.5
GT
CVD
GT
CVDGT
CVDGT 40~60U/L
1/4
10
11
12
1960
Dead Finger
1970
610 1975
6081975
EU(98/37/EC) EU(2002/44/EC)
EUANSI
S2.70-2006 Guideline for Measurement and Evaluation of Human Exposure to Vibration Transmitted to the Hand)
2006 5
2009 910
2003 2007
2006 3
35
21 710 0710 3
21 7 100710 1
21 7 100710 2
ISO
13
2 1A(8)
5.0m/s2
EU
14
1
2011 1412
98.5 7.0
7.6 0.5
20104147 679
5
2012 64.627171 4.2
18886 52323035153
2
201073
184 68 10
2.3 1.5
3032006
815 19 1297 18
200067
75 1002004
15
122013 17
12
3
38-47, 2011
16
3 43 61 65 61 23 4
5 6
1 23 45 61 61 31 31 31 3
1 3
1 31 31 31 3
1 31 3
1 3
1 31 3
1 31 31 3
2008 2009
17
2010
2012
2043 20002007 153
38.2 2.7
SOHO
1
10
3
2012
18
2012
49.6%64.0%
60.3% 2010
20121
1
2012 1
MSW
23 43 722013
65 2538
11 77
40 60 7465
40 691
226 45%
3 23 32 11
439 67.2
131 21 36.2 1 3
22 37.96 6 10.3
5
1111 23.4
622 (38%) 4
(7 ) 13 (22 )67
19
77 44 77
44 773 5.2
8
1246 2
42 4477
50
3
2
20
21
3
5
2014 4 1310 572
870 228
0 11
3
13 553 7167
55
55
16 25 63
60 70
28
22
24
25
26
19
20
20
20National Health Service
NHS1980
New Public Health
212004
Health Protection Agency2013 Public Health
England
19
150
27
safety promotion, SP
SPWHO Community Safety
Promotion
Safe Community, SC
SCSC 1989 WHO 1
Stockholm ManifestoSC
safety
social inclusion SCSC
SC
SC
SC2004
SP/SC2004
29
60 68.7
10080
71
NPO2013 10
11
800 90
32
60
2001
DOTS NPO
33
/
(Health in All Policies )
(health inequality) (health inequity)
EU
34
2013 2001.7
20134
JICA
2500
36
NPO/NGO
AA
7A
BB
6
37
A
B
2012 A
A B
2013
B
http://www.pref.aichi.jp/0000059106.html 2014.6.9
http://www.moj.go.jp/housei/toukei/toukei_ichiran_touroku.html 2014.6.9
2011
3 46 512012
27117.
2012
Vol.27 N04 349361
38
)
e-Stat 1,74223
2
51,000 497 432 71 )
1,000
201312 2014 2
()
334 ( 33.4%)329
93(28.3%) 236(71.7%)172(72.9%)
1.06%( 1.33 0.98%)( )
( 2)
HPHP
645459
)) )
))
39
NPO
NPOMICA
1998 2
2002NPO
1
MICA
MICAMICA
23200,696
2.713
24
24365 5
2 3,0005,000
1 2MICAMICA
2013
41
MICA
1998
10
2000 MICA
20082012
MICA
2013
2014
NPO
NPO
42
1978
2013 721%
20093
93
8 ( 8.6 )
4 ( 4.3 )
1 ( 1.1 )
14 ( 15.1 )
4 ( 4.3 )
5 ( 5.4 )
28 ( 30.1 )
7 ( 7.5 )
4 ( 4.3 )
5 ( 5.4 )
1 ( 1.1 )
1 ( 1.1 )
15 ( 16.1 )
12 ( 12.9 )
3 ( 3.2 )
1 ( 1.1 )
1 ( 1.1 )
1 ( 1.1 )
3 ( 3.2 )
1 ( 1.1 )
43
9 40
, , , , , , 2011.
21 232012
, 67(5)., , 2012
, 67(4).Ippei Mori, Toyoki Nakao, Hiroatsu Narita (2012) Migrant workers in Japan, Experiences of participatory action-orientedoccupational safety and health training. Asian-Pacific Newsletter on OccupationalSafety and Health 19 (1).
44
2013 54
34,700 4,828165 2,320538 3
2013 4
6
72 825
45
CC) 20 30CC
19502000 HPV
DNA HPV06 FDA
09 12 2CER 11 8 4
GAR13 4
13 6
HPVCC
CER HPV16 18 GAR 611 16 18
CER
100 ,GAR 2.568.9 100
2
HPV
CC
CER 9.4 GAR6
CC
2013 9[
] CER 1,910 100271.3 [
415(58.9)] GAR 410 100219.6 [ 123(65.9 )]2,320 260.4 [
538 60.4 ]
1
10 213 10 28 CER
31
14 434,700 6,977
46
4,828 165 CC78Adverse Event Vaers
SaneVax14 1 20
Adjuvant lTomljenovic 2011
l Adjuvant
14 2 5
CCHPV
CCPap test HPV-DNA
sensitivity 1002007 Maryland
20 30
HPV-DNA
1
2014/4/15http://www.mhlw.go.jp/file/05-Shingikai-10601000-Daijinkanboukouseikagakuka-Kouseikagakuka/0000033853.pdfhttp://www.mhlw.go.jp/stf/shingi/2r98520000034g8f-att/2r98520000034hsc_1.pdf
2
2
10
1 59 26 85 0.92 67 9 76 0.93 28 3 31 0.34 16 5 21 0.25 15 5 20 0.26 13 4 17 0.27 14 0 14 0.28 10 4 14 0.29 8 5 13 0.110 7 5 12 0.1
2014/4/15http://www.mhlw.go.jp/file/05-Shingikai-10601000-Dai
jinkanboukouseikagakuka-Kouseikagakuka/0000033882.pdf
47
25 9 30
48
2013.3.31 2014.4.30
2014.4.30 5.2914.6.11
1 2 23 4
5PMDA http://www.pmda.go.jp/kenkouhigai/help/information.html
> > >16 26 4
14.5.31
49
2007 886760
10 197517.5 1990
2007 11.71970 5000 1990
30002000
20 4020 30
GLOBOCAN200810
15.2 9.117.1 EU 9.0 5.7
9.840
EU
OECD 2009
24.5 6085.9
78.7
7010
19705
2006 23.1
human papillomavirus HPV 16 18
HPV
HPVHPV
HPV5
10HPV 16 18
HPV90 80
HPV70 80
50
HPV
51
24365
1975
602011 3 (2
1 ) 7921
70% 702005 388
46851 66
4
2004777 10 2010
1338 17
1970
( 503 ) 1975
( 71 ) 1994
( 547 )
4024
18(1986 )
30kg 20kg
201319
52
8 50
23
53
2013 8 11 2 62145
154072% 1354
1262 8957.9
46.1 30.0%34.1%
175.0 62.9
1)
90 8.4%9 11.5% 23.0
17.8
568.9 64.1
58.758.6 58.0
41.6%36.5%
34.5% 31.5%30.1%
6.0%
47.6%44.2%36.1% 4.1%
1) ..
, 31, 28-32, 2007.
54
2013 6 19
ISO
55
200727 2011
282015 4
28 15
2012
7015
29 2015
2012iPS
731
70
2015
2014 1 12
2015
(URL: http://15-jikko.jimdo.com)katsunishi aol.com
56
1932 1945
57
58
1943 8 25,26
92
194311 26
12 6
104
18
1943 12 17
12
59
BCG( )
19
17
1941 6 14
1 4
1942 3 144
5 1,2,3
5
60
61
1932 3 31933 13 3 161934 9 5 141935 9 1 101936 14 12 261937 15 11 261938 13 14 271939 24 16 401940 27 27 541941 22 17 391942 30 23 8 611943 21 21 15 571944 10 13 17 401945/ 8/15 7 25 6 381945/9/8 89 891945/9/21 3 31945/9/24 1 1 21945/10/2 3 31945/10/16 18 181945/11/1 14 141945/11/7 1 11945/11/8 19 191945/11/9 9 91945/11/12 1 11946/4/28 123 941946/6/17 123 123
217 188 46 451136 109 22 267
15.5 14.5 11.5 32.2154 124 128 40682 95 35 212
10572) 11642) 2662) 2487
( )
731
: . . 2014 15
2014 3 231945 3 28
16
() 1(
1985)
(2009)
1
2)
( )
( ): 16(30) (
): 15(27) (
63
): 12(17)
1 10
89
123
123
(1920 7 6
200 )
1
katsunishi outlook.com
64
2
( AR) AR
(1, p.9)(2)
(CBPR) (3)AR
ARAR
2009 2(
172
( I )
( M) M I
M
2012I
•
G
G 2
3
•
GG
(
2
4
2013I
(52013 3 )
MAR
11 1 2
65
11 ( CP)
(2014 2)
MI CP 11
MSW( SW)
(2014)
M
I M SWCP I
MI
MSW
M
CPI
CP
CPCP
M
I
CP
SW CP
CP
AR CP
CP
2013/1425590148
1) Stringer, ET.(2012)
2) Greenwood, DJ., Levin, M. (2006)
1 pp.63-85E-mail: [email protected]
66
2 3 9
2014
28252% 48% 10 30
9% 40~50 26% 6032% 70 21% 80 12%
73% 2735% 25%
17% 12%11%
28% 72%13% 59%
15% 1% 12%57%
13% 7% 22%1%
13%12% 10% 8%
5% 4%2% 18% 25%
100% 58.8% 130% 94%10 94.4% 5
4.6% 1%
200019% 2000 3999 16% 40005999 7% 6000 9999 4% 10000
3%3 4.6% 5
11.4% 10 35.5% 1569.4% 15 30.6%
67
40~60
COPD
1.
2.
3.
4.
5.
68
( ) ( )( )
2014 13
3
( )
IC
164 53 ( )2
(SW)3
2
(
)
69
11.
[ ] [] [ ] [
] [ ][ ] [
]
[ ]
[]
[ ]
[] (DV)
[ ]
2. [
] [ ][ ] [
] [ ] [] [ ]
[ ] [] [
] [ ] []
[ ] []
[] [ ]
SW[
][ ]
2013/14 25590148
70
25 5 20 6 820 59
500
238 45.71 2 4084.438.2 17.2 8.4
70 1
82.8
56.531.9 6.1 40.6
3.5 26.1
46.1 59.4
60.9
6053.4
72.4
5060
38.6 14.2
55.946.5
9.433.3
51.353.3
100 299 44.2 300
71
51.3
53.3100 299 44.2 300
38.354.6
22.585.4
72.453.0
20
46.7
45.034.6
59.748.9 49.4
32.514.6
70
7047.5
22
25
72
147 30
2013 412 7
142 96.6%63 42
29.6% 9768.3%
55 38.7%24 16.9%
6344.4%
39 27.5%42 29.6%
4632.4% 2215.5% 7351.4%
61 25 41.0%
536 i)
ii)
73
i)29.6% 36.4% 5
27.5% 29.1%26.1% 21.8%
20.4% 25.5%14.8%
20.0% 9.9% 10.9%3.5%
7.3% 3.5% 5.5%
ii)
4
57.7%
67.1%45.1%
19.5% 11.0%
hiroty@ belle.shiga-med.ac.jp
31 ( 21.8 ) 13 ( 9.2 )17 ( 12.0 ) 30 ( 21.1 )16 ( 11.3 ) 46 ( 32.4 )
7 ( 4.9 ) 17 ( 12.0 )17 ( 12.0 ) 34 ( 23.9 )21 ( 14.8 ) 40 ( 28.2 )
8 ( 5.6 ) 8 ( 5.6 )2 ( 1.4 ) 31 ( 21.8 )5 ( 3.5 ) 34 ( 23.9 )
13 ( 9.2 ) 20 ( 14.1 )27 ( 19.0 ) 24 ( 16.9 )43 ( 30.3 ) 38 ( 26.8 )
9 ( 6.3 ) 18 ( 12.7 )29 ( 20.4 ) 20 ( 14.1 )48 ( 33.8 ) 37 ( 26.1 )29 ( 20.4 ) 8 ( 5.6 )
8 ( 5.6 ) 14 ( 9.9 )14 ( 9.9 ) 33 ( 23.2 )18 ( 12.7 ) 0 ( 0.0 )
9 ( 6.3 ) 1 ( 0.7 )37 ( 26.1 ) 5 ( 3.5 )12 ( 8.5 ) 2 ( 1.4 )10 ( 7.0 ) 2 ( 1.4 )29 ( 20.4 ) 14 ( 9.9 )
2 ( 1.4 ) 2 ( 1.4 )27 ( 19.0 ) 10 ( 7.0 )81 ( 57.0 ) 42 ( 29.6 )
2 ( 1.4 ) 3 ( 2.1 )34 ( 23.9 ) 7 ( 4.9 )71 ( 50.0 ) 25 ( 17.6 )
3 ( 2.1 ) 6 ( 4.2 )9 ( 6.3 ) 9 ( 6.3 )
39 ( 27.5 ) 26 ( 18.3 )41 ( 28.9 ) 1 ( 0.7 )14 ( 9.9 ) 3 ( 2.1 )32 ( 22.5 ) 68 ( 47.9 )
*
* *
74
75
76
2004
49,867
1997
1.4 1.6( )
7575 2
75 4
35.4 477.6 2.2
75
23.0 74.6 2.2
2
4
2
103
77
79
80
7
7 2012 112013 4
( )
2
( )2
81
83
85
0.02.04.06.08.0
10.012.014.016.018.020.0
6:00 15:00 am3:00 15 00
18.9 1.612.0 1.4 15.8 4.2
pgm
l
86
SC
SC
3,000
SC
23
71.1 24
21
SC
SC
SC
25
SC
87
-glutamyltransferase(GGT)-GTP 1989 AST
ALT
GGT(CVD)
GGTCVD
6
2003 2009
40 64 2,603
1,924GGT 4 CVD
GGT6
140/90mmHg
126mg/dL HbA1c 6.5%NGSP 150mg/dL
220mg/dL40mg/dL
HDL- 7.0mg/dL6.0mg/dL1+
GGT4 ( ) 6 CVD
ORa (95% C.I.) p ORa (95% C.I.) p ORa (95% C.I.) p ORa (95% C.I.) p ORa (95% C.I.) p
GGT4 1.22 (0.89 1.67) - 1.45 (0.76 2.77) - 1.54 (0.99 2.38) - 1.65 (1.07 2.55) * 1.61 (0.70 3.70) -1.72 (1.27 2.34) ** 2.47 (1.36 4.48) ** 1.75 (1.12 2.71) * 1.60 (1.03 2.49) * 1.60 (0.70 3.69) -2.53 (1.86 3.44) *** 4.13 (2.35 7.26) *** 1.88 (1.20 2.96) ** 1.84 (1.18 2.87) ** 2.29 (1.04 5.04) *
GGT4 1.07 (0.77 1.48) - 1.37 (0.71 2.66) - 1.46 (0.94 2.29) - 1.37 (0.88 2.14) - 1.64 (0.70 3.85) -1.36 (0.98 1.89) - 2.33 (1.24 4.35) ** 1.65 (1.04 2.63) * 1.18 (0.74 1.87) - 1.60 (0.66 3.86) -1.85 (1.32 2.59) *** 4.39 (2.35 8.20) *** 1.72 (1.04 2.84) * 1.15 (0.70 1.86) - 2.46 (1.01 6.00) *
GGT4 1.03 (0.65 1.61) - 2.15 (0.39 11.80) - 0.78 (0.31 1.95) - 0.98 (0.41 2.34) - 2.16 (0.39 11.82) - 1.19 (0.77 1.82) - 4.07 (0.88 18.95) - 2.07 (1.00 4.27) - 1.68 (0.80 3.55) - 1.34 (0.22 8.07) - 1.73 (1.14 2.62) ** 10.43 (2.43 44.75) ** 2.90 (1.44 5.85) ** 2.88 (1.43 5.79) ** 3.27 (0.68 15.80) -
GGT4 1.01 (0.64 1.60) - 1.99 (0.36 10.99) - 0.78 (0.31 1.96) - 0.96 (0.40 2.30) - 2.18 (0.39 12.06) - 0.96 (0.61 1.51) - 3.14 (0.66 14.96) - 1.92 (0.91 4.02) - 1.49 (0.69 3.20) - 1.32 (0.22 8.15) - 1.26 (0.81 1.96) - 7.23 (1.62 32.34) * 2.62 (1.26 5.46) * 2.37 (1.14 4.95) * 3.50 (0.68 18.11) -
GGT4 : (-26) (27-41) (42-72) (72-) GGT4 : (-13) (14-16) (17-23) (24-)a OR GGT4 p : ***(0.1% ) **(1% ) *(5% ) -(5% )b ,BMI, ,
89
GGT46 CVD
BMI
GGT4 6CVD
BMI
1989GGT
GGT
CVD
GGTCVD
GGT4 ( ) 6 CVD
ORa (95% C.I.) p ORa (95% C.I.) p ORa (95% C.I.) p ORa (95% C.I.) p ORa (95% C.I.) p
GGT4 1.53 (1.16 2.01) ** 3.80 (1.67 8.65) ** 3.02 (1.84 4.94) *** 2.28 (1.42 3.64) ** 1.50 (0.64 3.56) -2.12 (1.62 2.79) *** 6.12 (2.74 13.64) *** 4.78 (2.95 7.75) *** 3.90 (2.48 6.14) *** 2.56 (1.14 5.74) *3.79 (2.91 4.95) *** 13.03 (6.01 28.26) *** 4.95 (3.03 8.09) *** 4.77 (3.03 7.51) *** 3.32 (1.52 7.29) **
b
GGT4 1.24 (0.93 1.65) - 2.98 (1.30 6.86) * 2.74 (1.65 4.54) *** 1.87 (0.88 2.14) * 1.00 (0.41 2.43) -1.45 (1.07 1.96) * 4.26 (1.85 9.80) ** 3.95 (2.35 6.63) *** 2.60 (0.74 1.87) *** 1.37 (0.56 3.33) -2.12 (1.54 2.93) *** 8.87 (3.84 20.48) *** 3.76 (2.15 6.57) *** 2.53 (0.70 1.86) ** 1.56 (0.61 3.97) -
c
d 0.73 (0.55 0.98) * 0.74 (0.44 1.26) - 0.74 (0.49 1.11) - 0.63 (0.42 0.95) * 0.88 (0.39 2.02) -
GGT4 1.16 (0.86 1.55) - 2.78 (1.19 6.46) * 2.55 (1.52 4.27) *** 1.68 (1.02 2.75) * 0.96 (0.38 2.42) - 1.13 (0.93 1.78) - 3.76 (1.58 8.91) ** 3.51 (2.04 6.04) *** 2.15 (1.27 3.63) ** 1.30 (0.50 3.38) - 1.86 (1.32 2.62) *** 7.74 (3.23 18.51) *** 3.31 (1.85 5.94) *** 2.07 (1.18 3.62) * 1.48 (0.54 4.02) -
GGT4 : (-16) (17-27) (28-50) (51-) p : ***(0.1% ) **(1% ) *(5% ) -(5% )a OR GGT4 b ,BMI, ,c , ,BMI, , d OR
90
1 1 2
1 2
201275
S
75Pearson
R 0.334
HDI
R0.350
p<0.05 SPSS Statistics22
=0.357P=0.007 =0.444P=0.001 = 0.313 P=0.016
=-0.350P=0.017
Yorifuji T. et al, 2013
91
( )
3 3
200116,462
13,19580.2 3 2004
2001 265 84 7,810
3
3
SPSS19.0 J for Windows Amos19.0 for windows
1.
1
2
3 IADL BADL4
55
54.9
92
3
65 84
0488 0.481
3
-0.009 0.062 -0.048 -0.0393
0.661 0.746 0.3780.569
0.310 0.645
0.133 0.0740.098 0087
0.362 0.439 0.091 0.439
30.658 0.557
0.401 -0.557NFI=0.865 CFI=0.885
RMSEA=0.025 3
16 53
33
3
93
24
6
24
25
1
225 11 30
12 22 2 25
12 7 1 26 1 122 26 1
11 1 1 19 226 1 18 1 1
26 2 4 183 4 2
54
118 17 24
24 83 1460 9
20 2.4 2410.3 30 8.4 20.0 408.4 15.4 50 20.5 20.560 60.2 33.3
42.2 2422.5 57.8 77.5
24 1.9
23 10 27.716 12
31 37.324 14
12 17
94
25771 97.8
24 97.4 2
98.1 1.996.2
3.8 1298.1 1.9
25 2424
25 12 96
83 74
[ ]
1
2
E-Mail [email protected]
95
A
60 3
60
22 522 6
IC
IC
(2011)(1992:271)
60
(1992)
60A 40 X
60 B 30Y
60C 30 Z
74 47 19 3
1 29.5% 2 23.93 27.3%
3.420
3
96
1) 2) 1) 2) 3)
JAGES 4)
JAGES
Y 136
36
/
361 2
3 45 6
7 8)IADL 910
11 1213
14 1516 17
18 19
2021 22
2324) 25)26 27)
2829 30
31 3233)
34 3536
98
36136
715.3%
31.4% 4.0% 1.8%10.0% 0.0%15.5% 27.9% 5.5%
3.3% 11.1% 0.0%33.6% 56.0% 17.9%3.0% 10.8% 0.0%
24.3% 44.4% 6.8%
Y
36 136
25
H25 003
99
Interdependence
JSPS
B 2528
5170
2013
14
40
9,099
4
BMI
SPSS Statistics22(IBM) HA
LBAU7( )
( 2013-095)
3,143 34.5
40 58
63.4( 12.3)
1
95 1.490
(1.133 1.960) 1.938 (1.466 2.563)
2.022 (1.351 3.024)
100
PPTA
1) 1) 2) 3)
1 2
3
PTA
A
PTA 5
2013 7 11
PTA
PTA
PTA
PTA
PTA
2
P1-P2 1)
P1 PTA
PTA
PTA
P2 PTA
PTA
PTA PTA
PTA
PTA
PTA
P1 P2
PTA
PTA
101
15 16 824 65
21 3 28.2% 15181
21
97
26 1 25 13 14
28
103
2011 2 310 (
) PTA1645
666 ( 40%)( )
124482 606
GHQ12(4 0-0-1-1 )
SC6 (5 )
PPC 10(5 ) Sense of Coherence
(SOC) SOC 13 (5) (4 )
(5 ) (4 )3
( )2
(
18.7% 33.3% p<0.001)(
16.6%
23.2% (p<0.05) ( 1-1) (
)(p<0.001) GHQ (
p<0.05) PPC SC( p<0.05) ( 1-2) SOC
(p<0.01)( )(p<0.001)
44.8%
16.5%(p<0.001) GHQ (4)
54.5%( )
50
( )
105
2012 i
6.5 20026.3%
ii
7
9 6
65
5
M-GTA
Richard S. Smith Jonathan Sharp
iii
Unusual Sensory Experiences USEs
15
/ /
107
//
Smith Sharp
USEs
iv
Smith
SmithSharp
M-GTA
25 26(
25590150 )
i 2012
ii 2012 /
iii Richard S. Smith Jonathan Sharp 2013 Fascination and Isolation: A Grounded Theory Exploration of Unusual Sensory Experiencesin Adults with Asperger Syndrome, Journal of Autism And Developmental
Disorders,43:891-910. iv 2008
59 287-310
108
109
1999 10
2002 32010 4
1.2010.7.23 1
2013.10.1 122.
2011
3. 2013
2014
4. 2013
1 500 2300
A)
1999.10.23
B)
2000.10.14 2
C)
2002.3.25
D)
2003.10.18 46
7E) 2004.8.24
110
1
2
2004.8.24
2004.8.24
F) 2010.4.28 C
2010.4.28
(1)
307 2013.7
111
NTT docomoHIV
HIV
presence of wellness
HIVHIV
HIV/AIDS
HIV
HIV
HIV
HIVHIV
HIV
Sense of Coherence SOC
Perceived Positive Change PPC
HIV 20137 -2014 2
HIV Futures Japan21 HIV
NGOHIV
1,095 913
95.9% 3.7% 20 -7038.1 30 41.2% 40 34.3%
46SOC Sense of Coherence 13
7
2Ryff
3Perceived Positive Change PPC
HIV 115
112
1)Sense of Coherence SOC51.0 12.9
24 2548.3 16.2 25 34 282 49.6
11.7 35 44 416 50.9 12.845 54 161 52.4 13.8 55
21 62.3 13.2
, 2014 59.0(12.2)25~34 54.6 11.7 35 44 56.7
11.6 45 54 57.2 11.3 55~6461.7 11.82)20.8 4.0 13.2 4.5
, 2005 22.0 (3.7)14.4 (4.3)
3) 4.4 (1.1)
3.4(1.3) 3.8(1.0)
, 2000 25 344.9 (0.6)
4.2 (1.0) 4.3 (0.7)35~44 4.9 (0.7)
4.6 (0.7) 4.3 (0.6)4) Perceived Positive Change PPC
1 375 41.1%% 281
30.8% 2397 43.5% 241 26.4%
3344 37.7 221 24.2%
4212 23.2% 390
42.7% 5346 37.9%
198 21.7% 6
246 26.9%318 34.8% 7
195 21.4%268 29.4% 8
224 24.5% 18720.5% 9
225 24.6% 204 22.3%10
80 8.8% 67073.4% 11
131 14.3%157 17.2%
HIV
2 78
10
HIV 913Sense of
CoherencePerceived Positive Change
Sense of Coherence
HIV
Perceived Positive Change
B24330158
113
2008 2009
2010 10 1
2013 7 54
2010 10 2013
2010 10 2014 41
10 20
13.2 1 29 11.9
30 41 16.4
60
10 40
50
30
30
10
114
2
2001 A65 16,462
13,195 80.2%2004
8,285
2001 2004 2007 3
2001 20078,285
3,887 46.9%4,398 53.1%2001
1,114 13.4%
3
1
n n
2 2001 2004
116
1 2 3 11 4 5
6 11 7 8 9 10 11
1 2 3 45 6
8 9 10 11
117
118
( S56 )
100200
C1
12
A(
52
(S46 )
2 ( ) ( )13
2 2014 1
3 12
2
( S63 )
1
( ) 24 22
119
10
5
I ( H3 ) H
2
3
1~3
()
()
1) .
.2014;Vol.59:2-72)
-. .
2014;Vol.502:45-503)
( 21).
;2014.Vol.21(4) :
120
1996
2000 9
2000 9 2014 314
791 ( 936 )17 (
5112 711
566 90 (
)135
693 1897.5 53.5 (22
81 ) 50 288 (40.5%)40~60 85.1%
208 (29.3%139 (19.5%
115 (16.2% 94
(13.2% 78 11.0%77 10.8%75.7 DT(
)= 4.3 MT()=10.3 FT( ) 3.6
(Gingival Index 1)89.5
9713.8% 443 64.6%
633 22135.0% 237 37.5%
166 26.3%
553218 (39.4%) 1 1 252
(45.6 ) 85.0% 1 15.9
562 76.1
511(71.9%)
121
200 (39.1%) 81.0%15.0%
14 2000 20032004 2008 2009
20136.0 16.5
22.8
0.410.8 19.8
2014
122
19901996
JIS2008 JIS
10
19861
2013 10
44 19891995
20032013 8 19
9 10 20
10 11
83.6 g /dl 20 g/dl- 29.0mg/l
2.2mg/l2
1970
1981
123
1310 40 g/dl
2
56 437 2014
124
125
1
7:12014
7:1
7:1
2 6 2145
2013 8 11
154072%
7:1 7:17:1
7:1SPSS v20 2
2
t 5%
23-49-1
1.7:1 45
549 7:1 7 82
2.1
1 7:1
126
7:139.3 7:1 27.2
(p<0.01)
7:1 34 (6.2%) 19.8672.8 7:1 13 (15.9%)13.2 171.0
3.1
2 7:139.0 50.0 7:1
29.5 39.0
4.3
7:1
7:1
JSPS(C) 24593196
127
2006 2010 -
1 23
( )2006 2010
2006 2010
17,325 (20069,079 2010 8,246 )
2 ( 1 2 )2006 2010 2 (2006
1 2010 2 )
16,818 (2006 87962010 8032 )
1
69.2% 200669.6% 2010 68.8%
2
5 200620061 4
2010 20104
32006 2006
21
2010 2010
21
22006 2006
22010 2010
25
2006 200641
2010 201041
2006 2010
2006 2010
3
128
( )1 N(%)
2006N=8,796
2010N=8022
p
6,121 (69.6) 5,516 (68.8)* p<0.05 (Fisher )
2
2006N=6,121
2006N=2,675
p2010
N=5,5162010
N=2,506p
1. 3,419 (56.0) 1,426 (53.4) * 2,739 (49.8) 1,258 (50.3)
2. 4,111 (67.5) 2,064 (77.5) * 3,548 (64.7) 1,880 (75.3) *
3. 3,572 (58.9) 2,139 (80.6) * 3,101 (56.6) 1,976 (79.5) *
4. 4,274 (70.2) 2,100 (78.8) * 3,748 (68.3) 1,955 (78.2) *
5. 3,302 (54.3) 1,774 (66.8) * 3,262 (59.6) 1,794 (71.9) *
6. 3,394 (55.9) 1,104 (41.5) * 2.817 (51.4) 999 (40.0) *
7. 4,526 (74.7) 1,498 (56.5) * 4,071 (74.4) 1,431 (57.4) *
8. 2,792 (46.1) 1,416 (53.4) * 2,660 (48.6) 1,420 (57.1) *
9. 4,490 (73.7) 1,467 (55.2) * 3,988 (72.6) 1,328 (53.2) *
10. 4,227 (69.6) 1,464 (55.0) * 3,850 (70.2) 1,379 (55.3) *
11. 4,403 (72.3) 1,408 (52.9) * 3,956 (71.9) 1,332 (53.3) *
12. 3,234 (53.3) 966 (36.4) * 2,820 (51.5) 866 (34.7) *
13. 2,714 (44.8) 673 (25.4) * 2,209 (40.4) 576 (23.2) *
14. 4,404 (72.3) 1,066 (40.2) * 3,909 (71.4) 1,028 (41.3) *
15. 2,772 (45.4) 1,776 (66.6) * 2,604 (47.5) 1,736 (69.6) *
* p<0.05 (Fisher ) VS
129
130
Forth-age
60 Forth-age
23~25
54 555 -68
1 2
3 55 59
QOL CASP19GSE(general self-efficacy)
SSE(social self-efficacy)ikigai9
160.2 2 61.3 3 63.2
3QOL CASPGSE ikigai9 3
SSE 3
GSE ikigai9
ikigai9
132
134
135
1.complex system:
.
2.
IT
SEIR
3.
136
SCSN 3
Putnam SCK62011 2012
K6SC
23 18
2,1712085
96.0 245 12 2
16211542
K6 4 52011 2012
SC 4 0 16
12 1312 13
K6 2011 2012
~2011 2012
10
K6 SC1 SC
2011 201212
K665.2% SC
12 12SC
K6
138
1
K6
53.364.0%
2
42.7% 01 2
K64
3
55.7%55.2%
4
K6K6
K6
Mail Address rsuzuki@iwate nurse.ac.jp
139
16
5357
6
21
1948National Health Service NHS
1980 Black Report 1998Independent inquiry into inequalities in health
1998 Saving Lives: Our Healthier Nation The Wanless reports 2003 Tackling Health Inequalities: A Programme for Action 2004 Choosing Health: Making Healthy Choices Easier 2006
Our health, our care, our say: a new direction for community services2013 4
140
1980
NHS
1 Acheson D. Public health in England. Report of the committee of inquiry into the future development of the public health function. London: HMSO. 1988.
2 Acheson D. Independent Inquiry into Inequalities in Health. London: The Stationery Office.1998.
3 Department of Health. Shifting the Balance of Power in England. London: Department of Health. 2001.
4 Donaldson L. Getting Ahead of the Curve. London: Department of Health. 2002.
5 Department of Health. Healthy lives, healthy people white paper: our strategy for public health in England. London: Department of Health. 2010.
6) Black D. Inequalities in Health. Public Health 1991; 105: 23-7.
7 Department of Health. Saving Lives: Our Healthier Nation. London: The Stationery Office. 1999.
8 Department of Health. Tackling Health Inequalities: Summary of the 2002 Cross Cutting Review. Parliamentary Under-Secretary of State for Public Health. 2002:1-63.
9 Department of Health. Tackling Health Inequalities: A Programme for Action. London: Department of Health. 2003:1-73.
10 Department of Health. Choosing Health: Making Healthy Choices Easier. London: Department of Health, 2004:1-207. .
11 D Evans, S Dowling, Developing a multi-disciplinary public health specialist workforce: training implications of current UK policy, J Epidemiol Community Health 2002; 56:744-747.
12 McPherson K, Talor S, Cole E. Far and against; public health does not need to be led by doctors, BMJ 2001; 322:1593-1596.
141
1,000
217 2312 24 1
Text MiningStudio4.1
23-107
5045.7%35.6% 3 10 51.1%
3 543.5% 35.3%
41
1,
2
142
HIV
HIV
HIV chot CAST
HIV
HIV HIV3,739
3,656 97.8
SPSSVo19
71.3 28.5
9844.6
38.5 16.9HIV
HIV
29 18.7
7.5HIV
49.7 50.3
HIV
963.8
22.8 45.8HIV
144
KAKEN
367
2014 3 364
KHCoder
367
66
115
19 64
33 19 29
16
55 29
146
S K H 106 32325 9 25 10
7 43
1
MSW
2-1
2-2
MSW 2-3
FAX
83
MSW3
FAX
1
MSWa 50.0 33.6 66.4
*11.1 0.8 21.4
*a1 8.3 0.0 17.4
*a1
b 88.9 84.7 92.9 56.5 50.0 62.9 b1 24.6 19.0 30.2 b1,b2
147
2-1 7
FAXa 25.5 20.5 30.5 g1 38.4 32.9 43.9 7.6 4.6 10.6 62.9 57.4 68.4 g4b 25.5 20.5 30.5 g1 37.1 31.6 42.6 7.0 4.0 9.9 60.3 54.7 65.8 g4c 24.5 19.6 29.4 g1 37.4 31.9 42.9 6.3 3.5 9.1 59.9 54.4 65.5 g4d 27.8 22.7 32.9 39.7 33.2 44.3 6.3 3.5 9.1 58.3 52.7 63.9
e 29.1 24.0 34.3 40.4 34.8 46.0 6.6 3.8 9.5 55.0 49.3 60.6
f IVH 31.1 25.9 36.4 41.1 35.5 46.7 5.3 2.7 7.9 51.3 45.6 57.0
g 37.1 31.6 42.6 48.0 42.3 53.7 5.6 3.0 8.3 48.3 42.7 54.0
2-2 7
FAXa 29.8 24.6 35.0 g1 83.1 78.8 87.4 4.0 1.7 6.2 31.5 26.2 36.7
b 32.8 27.4 38.1 83.8 79.6 88.0 3.3 1.2. 5.4 31.5 26.2 36.7
c 34.4 29.0 39.8 81.8 77.4 86.2 3.3 1.3 5.4 28.8 23.7 34.0
d 33.4 28.1 38.8 78.8 74.1 83.5 3.6 1.5 5.8 30.4 25.2 35.7
e 35.4 30.0 40.9 79.5 74.9 84.1 4.0 1.7 6.2 29.1 24.0 34.3
f IVH 34.1 28.7 39.5 77.8 73.1 82.6 3.3 1.2 5.4 28.5 23.3 33.6
g 41.1 35.5 46.7 76.8 72.0 81.6 3.3 1.2 5.4 29.5 24.3 34.7
2-3 MSW 7
FAXa 30.8 25.5 36.1 87.4 83.6 91.2 f2 3.6 1.5 5.8 32.1 26.8 37.4
b 29.1 24.0 34.3 83.1 78.8 87.4 3.6 1.5 5.8 31.1 25.9 36.4
c 32.8 27.4 38.1 82.5 78.1 86.8 3.6 1.5 5.8 30.8 25.5 36.1
d 30.1 24.9 35.4 82.1 77.7 86.5 4.0 1.7 6.2 28.1 23.0 33.3
e 30.5 25.2 35.7 81.5 77.0 85.9 4.0 1.7 6.2 29.5 24.3 34.7
f IVH 30.5 25.2 35.7 78.8 74.1 83.5 3.0 1.0 4.9 26.2 21.2 31.2
g 35.8 30.3 41.2 79.5 74.9 84.1 3.6 1.5 5.8 28.8 23.7 34.0
148
149
150
24
7
151
1981
1 23
45
2
1 234 5
61991 2010
279
29
54 3
1981 2102012 225
1 380
21
1982 201214.9 12.311.9 8.38.6 20.17.5 01.0 8.0
152
1
2
153
A 40
IQ52
ADL
B
B 50
B B
IQ50
B
C 60 20
IQ28
A
IQ
IQ
154
DMD3~5
9 1520
ADL QOL
1.Y
6 K 2 8
2.2013 3 9
20142 25 28 OT
62
2013 3 2014 4
3.
55
8 20 SMA
10 4020
8
156
1945
VAVA The Vietnam Association for Victims of Agent Orange/Dioxin
200026
2004 120 2005
3
VAVA
158
VAVA
VAVA
25
25
25 74
3390 45 (4000 2000 )/
481 (20,000 )/
1
1995 12
T.T.H.Thu
25
159
53
AB
B
B
3 2011 6 1 20145 31 retrospective
160
PTSD
3DPC
13
4
5
6
161
1
1 31 39
2004
2006/5/29
2
4
3
15 1
2013
162
10
254 59
20032007
2009/04/15
2010/4/1
354 59
20073
2008 102009/9/11
2008 10
PEG
163
Case Report
2007 9
Case Report
Case Report
2 3
Blumberg McBurney
MRI
1
MRI4
164
A
A 2011
2012 2013
2012
2012 2013
166
167
168
NPO 11 11
2003 2005 3
20131410 805
201317 1
4
1. 2013
2.
1617 76.6
160mmHg 1/3110mmHg 1/4
237mmHg 140mmHg
32013 4
14104 17
169
170
A B C
172
1 2013 8 9NPO
2 2013 4 20142 4
1
A B C D
80 90 60 40
17 17 18 12 7
2007 6 2008 1 2010 10CR
2011 11
2007 62007 12
2008 12008 3
2010 122011 5
2011 112011 11
DOTS 2007 122009 7
2008 32009 2
2011 72011 12
2011 122012 7
1 11 2
173
3 NPO
2 1 A
2 B
3 C
1
4 D
44
4
174
2012
597
2
84.3 ,
15.7
175
1
23
ICF
1 ICF International Classification of Functioning, Disability and Health
2001 WHO
ICF
Generic Set , Brief ICF Set , Enlarged Brief Set , (Comprehensive Set)
1.2.
3.
1
100
1. 2 3 4 5
ICF
177
