Associations between self-assessed masticatory disability and health of community-residing elderly people. Community Dent Oral Epidemiol 1999; 27: 366-71. C Munksgaard, 1999 Abstract -Objective: To examine the relationship between the self-assessed masticatory disability and the health of community-residing older people. Methods: Of 1473 randomly selected people aged 65 years and older living in Settsu, Osaka Prefecture, in October 1992, data on general health status, history of health management, psychosocial conditions, and dental conditions were obtained from 1405 people by interviews made during home visits. Follow-up for 54 months was completed for 1306 subjects (93.0%; 1072 living, 234 deceased). Results: Being over 75 years of age, having poor general health and poor dental status, not using dental health checks, not using general health checks, not participating in social activities, not feeling that life is worth living (no ''ikigai''), and feeling anxious about the future were univariately and significantly associated with self-assessed masticatory disability. Logistic regression analyses indicated that being older than 75 years, having poor general health and poor dental status, not using dental health checks, and not participating in social activities were independently associated with self-assessed masticatory disability. The Cox proportional hazards model

A large outbreak of Escherichia coli O157 infections via school lunches occurred at primary schools in 1996 in Sakai City, Japan. As many as 10,000 patients suffered from diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome (HUS). Using data on 288 inpatient school children affected by this outbreak, of whom 36 presented complete HUS and the remaining 252 tested positive for E. coli O157 culture, we attempted to identify predictors for the progression to HUS. Within the first 5 days of illness, clinical features associated with inpatients who developed HUS compared with those without HUS included a C reactive protein (CRP) level higher than 1.2 mg/dl (OR 44.26; 95% CI 5.83-336.23), a white blood cell (WBC) count greater than 11.0 x 10(9)/l (OR 5.03; 95% CI 2.13-11.87) and a temperature higher than 38.0 degrees C (OR 5.00; 95% CI 2.25-11.08). It can be concluded that these three factors are predictive factors for the development of HUS in patients with E. coli O157 infection, and patients who have two or all of these factors should be observed closely.

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Certain health and psychosocial factors are closely associated with self-assessed masticatory disability among older people. Further investigations are needed to determine whether masticatory disability is a significant risk factor for mortality.

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The purpose of this study was to establish the relationship between the will of bedridden elderly people to be self-reliant and their life prognosis, and to darify the factors related to the will to be self-reliant of such persons.The cohort consisted of 274 bedridden elderly persons aged 65 years and over who lived at home and were observed continually over ten years. Data were obtained from observation records done by four public health nurses who visited the subjects at least once a year and assessed their state of health. The variables studied were demographic variables, activities of daily living, the cause of being bedridden, the strength of the will to be self-reliant and the date of having become bedridden. Cox's proportional hazard model, the Kaplan-Meier method and discriminant analysis were used for statistical analysis.Of the 274 subjects, 107 subjects (39.1%) were male and 167 (60.9%) female, with a mean age of 82 years. The subjects who lived with their families accounted for 96.7%. The mortality hazard ratio for subjects with a weak will to be self-reliant to those with a strong will was 1.64, which was statistically significant. Discriminant analysis demonstrated that the will to be self-reliant showed a significant relationship with age, level of activities of daily living and refraining from expressing one's own feelings in consideration of the family's feelings.Bedridden elderly persons with a strong will to be self-reliant had a significandy better life prognosis than those with a weak one. A strong will to be self-reliant among the elderly is related to age, level of activities of daily living, and refraining from expressing one's own feelings in consideration of the family's feelings.This study clearly points out the need for home care service personnel to work in cooperation with families to emphasize encouragement to build the will to be self-reliant for the elderly in Japan.