In advance care planning (ACP), there are cases where it is difficult for patients to express their intentions for various reasons. In this study, we discussed the difficulties and countermeasures for the implementation of ACP in the cases of children and the elderly, involuntary hospitalization for psychiatric care, and the choice of end-of-life nutrition, as cases in which it is difficult for the patients to express their intentions. Internal difficulties caused by the individual, external difficulties such as non-provision of appropriate information and social difficulties such as the absence of significant others were considered to be the factors that make ACP implementation difficult. It is important for supporters to understand these difficulties and to implement ACP according to the individual patients. It is hoped that discussions on the promotion of ACP will be further enhanced in the future.

Excessive use of social networking services (SNS) is known to have a significant negative impact on mental health in university students. In this study, we conducted an online questionnaire survey of university students and analyzed 146 responses in order to clarify the relation between SNS addiction and self-compassion among university students. As a result, it was found that there was a significant negative relationship between SNS addiction and self-compassion in the university students. In addition, the subscales of "self-judgment," "isolation," and "over-identification" were significantly associated with SNS addiction. These results suggest that selfcompassion education may help reduce the deterioration of mental health caused by SNS addiction.

We developed a lifestyle reflection sheet for preventing and treating metabolic syndrome. Our tool aimed to help local residents identify their risk factors for metabolic syndrome, recognize areas for improvement in their lifestyle habits, and proactively engage in health promotion. We enrolled 1,146 patients, consisting of 715 men and 431 women, aged 18 to 92 years. Inclusion criteria were those who underwent health checkups at Mine City Hospital and answered a lifestyle questionnaire. We hypothesized that individuals with conditions related to metabolic syndrome have undesirable lifestyle habits. To test this hypothesis, we conducted logistic regression analysis to examine the probabilities of metabolic syndrome, hypertension, hyperglycemia, and dyslipidemia. The results were displayed as similarity percentages, reflecting how closely the daily behaviors of individuals with these conditions aligned with the behaviors of those who had these specific health issues. Eight specific behaviors were selected for preventing and improving metabolic syndrome: diet-related (eating behaviors that do not lead to obesity, avoid snacking, consume vegetables, reduce salt), physical activity-related (physical activity/ exercise, avoiding prolonged sitting), health-related (maintaining a sense of coherence), and alcohol-related (amount of alcohol consumed). The scores for these factors were calculated using a validated factor analysis. Each item was visualized by displaying a graph showing the standard deviation for all survey subjects. The lifestyle reflection sheet was printed on special paper and returned to individuals after their health check. The sheet served as a reference tool for health guidance. By utilizing this sheet, individuals could be individually notified of their risk of developing metabolic syndrome and the benefits of healthy behaviors. Behavioral changes for health were encouraged through a review of lifestyle habits.

The dissemination of knowledge and awareness regarding mental health promotion is an important issue in the mental health and welfare policies of local governments. In order to clarify the relationship between the social life situation of local residents and their mental health, we analyzed 1,139 people who underwent health checkups at Mine City Hospital and answered a lifestyle questionnaire about their psychological state (Kessler 6 Scale [K6]), social interaction (Lubben Social Network Scale-6 [LSNS6]), sleep (Athens Insomnia Scale [AIS]), economic situation, household composition, and residential area by sex and age group (youth: 20-39 years old, middle age: 40-64 years old, elderly: 65 years old or older). In men, K6 score decreased as the age group increased; however, there was no change in women across all age groups. Furthermore, when comparing by age group and sex, elderly men had the lowest K6 score. Analysis of the data for all subjects revealed that K6 score was negatively correlated with LSNS6 score (r = -0.219, P < 0.01) but had a significant positive correlation with AIS score (r = 0.495, P < 0.01). The "difficult" economic situation group had higher K6 scores than the "average" and "affordable" groups. These findings suggest that people with a poor psychological state have less human interaction and tend to suffer from insomnia and that improving one's subjective economic situation may contribute to a good psychological state.

The purpose of this study was to examine the advantages and problems of the mutual nomination method from the viewpoints of both teachers and children, in order to introduce the method more appropriately and effectively in the classroom. In order to understand from the children's standpoint, we asked university students to reflect on their classroom situations at elementary, junior high, and high schools, and conducted a questionnaire survey using both face-to-face and web-based surveys. The subjects consisted of 138 university students. To understand from the position of the teachers, elementary, junior high, and high school teachers were interviewed. Eleven teachers were elementary school teachers, nine were junior high school teachers, and five were high school teachers. The method of analysis was content analysis for both the children's and the teachers' standpoints. The results are presented initially from the children's perspective, followed by the teachers' perspective. First, from the children's perspective. Regarding experience with the mutual nomination method, in elementary school, the number of respondents with and without experience was 88 and 29, respectively, in middle school, 37 and 77, and in high school, 28 and 102, respectively. Five categories of advantages of the mutual nomination method were obtained, including [active and motivated participation in class], [ease of raising hands and speaking up], and [bright and peaceful atmosphere]. On the other hand, four categories were obtained for problems such as [bias and fixation of nominated/non-nominated students], [classroom relationships revealed by bias of nominated/non-nominated students], and [creation of rules for effective implementation of the mutual nomination method]. Next, from the teachers’ perspectives, regarding their experience with the Mutual Nomination Method, elementary school teachers implemented the method according to the subject matter and learning objectives, and according to the condition of the children and the classroom. Junior High and high school teachers implemented the method only slightly. Five categories of advantages of the mutual nomination method were obtained, including [active and motivated participation in class], [deepening of learning], [ease of raising hands and speaking up, and confidence gained from the experience of giving presentations]. Six categories were obtained as problems and innovations of the mutual nomination method, including [introduction of the method in consideration of the situation of the children and the classroom], [bias and fixation of those who are nominated/not nominated], and [creation of rules for effective implementation of the mutual nomination method]. Based on the above results, and considering both the children's and teachers' standpoints, the mutual nomination method seems to have the advantage of making it easier for children to actively and enthusiastically learn, raise their hands, and speak up. However, there are also problems such as the bias of children who speak up, the fact that some children experience not being nominated even if they raise their hands, and the fact that relationships in such classes become more visible. To introduce the mutual nomination method, it is necessary to have a supportive classroom climate and good classroom discipline as a foundation. It was shown that it is important for teachers to fully assess the classroom situation and implement the method under management, such as by applying rules according to the situation.