新潟県立大学

Objective　Children's homes provide a stable living environment for children without guardians or those who have experienced abuse. In Japan, there is a movement toward smaller-scale residential care facilities to realize "a more homelike environment." This study considered meal provision within children's daily living spaces as a component of the home environment, aimed to classify children's homes into four residential types and examined the characteristics and challenges of their meal provision systems.Methods　In January 2022, a nationwide questionnaire survey was conducted in 606 children's homes (500 responses, 82.5%). The analysis focused on directly operated facilities in which in-house staff were responsible for meal provision. Facilities were categorized into four residential types based on their configuration;(a) no unit,(b) large unit (>8 children), (c) small unit (≤8 children), and(d) branch-type small-scale group care (located outside the main facility).　The classification considered meal preparation location and method ("centralized cooking in one kitchen" or "unit-based cooking") and occupations involved in meal provision. In facilities with unit kitchens, their use was categorized ("cooked from all raw ingredients" or "partially cooked such as only rice"), and compared by cooking style.Results　Data from 420 directly operated facilities, (680 residential units; 99 no-units, 78 large units, 296 small units, and 207 branch-type units) were analyzed. Facilities that used centralized cooking were common in no-unit (100.0%) and large unit (83.3%) types, but less common in branch-type units (23.2%). Contrastingly, unit-based cooking was most prevalent in branch-type units (74.9%). Facilities using unit kitchens to cook all meals from raw ingredients were significantly more common among those using unit-based cooking than among those using centralized cooking (P < .001). Childcare workers and nursery teachers were significantly more involved in meal provision in branch-type units, whereas registered dietitians/dietitians were significantly less involved (P < .001).Conclusion　Meal provision systems differed by residential type. Branch-type small-scale group care units, which provide a more home-like environment, relied heavily on childcare workers and nursery teachers for meal provision, whereas the involvement of dietitians is limited. These findings highlight the need for meal support systems that balance homelike environments with trained professional support.

Objectives　Various personal health record (PHR) services have been developed over recent years. However, academic evidence concerning PHR system use and its effects on behavioral change remains scarce. This umbrella review aimed to summarize current evidence regarding the factors associated with PHR service use and their association with patient outcomes.Methods　We searched PubMed, PsycInfo, and CINAHL databases and extracted review articles that reported factors associated with PHR service use and their association with patient outcomes. Three independent reviewers screened the titles and abstracts; one reviewer performed a primary assessment of the full texts, and two others confirmed the results.Results　Twelve studies were ultimately included in this review. A tethered PHR, or patient portal, represents an online tool that is connected to electronic medical records, whereas an untethered PHR represents a collection of health or wellness data concerning an individual's health. The former function includes viewing electronic medical records, contacting healthcare providers via messaging, refilling prescriptions, and scheduling appointments. In contrast, the monitoring and sharing of health statuses represent the primary functions of the latter. Male sex, younger age, higher education, higher income, Caucasian lineage, and insurance coverage were reported to represent the personal attributes associated with PHR service usage. Familiarity with the Internet and information was also associated with using PHR services. Some studies on tethered PHRs showed improved disease control and communication with healthcare providers, whereas others found no such association. Messaging with healthcare providers was associated with medication management, regular visits, and improved control of blood glucose and low-density lipoprotein levels. The associations among medication refilling with adherence, and health status monitoring/sharing with improved glycemic control and self-management were also reported. Certain PHR services have been specifically designed to support self-monitoring and disease control.Conclusion　We identified the concept of PHRs and the key terms that correspond to it. Few studies have examined the functions of untethered PHRs and their associations with patient outcomes compared with those of a tethered PHR. Further research is therefore warranted to clarify the effects of untethered PHR services.

BACKGROUND AND OBJECTIVES:In Japan, there are no official dietary guidelines for young children and nutrients may be insufficient on weekends, compared to weekdays at nursery schools. To ensure adequate nutrition, an appropriate dietary evaluation method is required. This study used the Healthy Eating Index (HEI)-2020, which is based on the Dietary Guidelines for Americans, to evaluate the diet quality of Japanese children, examine its validity through associations with nutrient and food group intake, and compare dietary characteristics on weekdays and weekends. METHODS AND STUDY DESIGN:The participants were 669 children aged 3 to 5 years attending nursery schools across Japan. Relationships of HEI-2020 scores with nutrient and food group intake, and comparisons between weekdays and weekends were evaluated. RESULTS:The median HEI-2020 score was 50/100, with almost maximum scores for Total Protein Foods, Seafood and Plant Pro-teins, and Added Sugars, while Whole Grains and Refined Grains scored zero. Additionally, the largest score differences between weekdays and weekends were found in Dairy and Greens and Beans. Higher HEI-2020 scores correlated with lower saturated fatty acids intake and higher intakes of dietary fiber, vitamins, and minerals. Weekday scores were significantly higher and less varied than weekend scores. CONCLUSIONS:HEI-2020 can identify nutrient intake challenges in Japanese children. Greater consumption of Dairy and Greens and Beans-components that showed large weekday-weekend differences-may improve diet quality.