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Aim: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. Background: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. Design: This is a single‐centre retrospective descriptive study. Methods: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors. Results: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non‐surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non‐malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. Conclusions: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care. Summary statement: What is already known about this topic? Although the characteristics of patients at high risk of rehospitalization include malignancy, heart failure, conditions such as chronic obstructive pulmonary disease and other diseases prone to recurrence, old age, reduced activities of daily living and emergency hospitalization, few studies have reported on cases with multiple risks. What this paper adds? The most frequent risk types for unplanned readmissions within a month were emergency admissions for malignant tumours, emergency admissions for non‐malignant tumours with a hospital stay of 2 weeks or more and scheduled admissions for non‐surgical purposes with a length of stay of 2 weeks or more. The implications of this paper: The risk of unplanned readmission within 1 month of discharge increased due to a combination of multiple risks.This study helps us identify patients who are at high risk for readmission early in the hospitalization process and in providing nursing support for transition to their homes. [ABSTRACT FROM AUTHOR]

Purpose. This study aims to elucidate the gender gaps in the strategies for maintaining the social participation and interaction of older adults with people in a local community. Methods. The subjects were 130 older adults aged 65 years or older and independently living in their homes in Saitama, Saitama Prefecture, Japan. The authors conducted an anonymous questionnaire survey on paper and performed multiple regression analysis for men and women separately using the Lubben Social Network Scale-6 (LSNS-6) as the dependent variable. Results. Among the independent variables used for the analysis, those that significantly influenced LSNS-6 in men were social activities related to the daily life satisfaction of the elderly (SARDS). The independent variables that significantly influenced LSNS-6 in women were SARDS, sense of coherence-13 (SOC-13), and the number of family members living with the subjects. Discussion. Health promotion is not associated with interaction with people in men compared with women. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the risk factors for household transmission of the omicron variant of SARS‐CoV‐2. Background: The household infection rate has been reported to be higher for the omicron variant than for non‐omicron variants of SARS‐CoV‐2. Determination of the risk factors for household transmission of the omicron variant is therefore important. Design: A Retrospective Cohort Study was conducted. Methods: When family members of health care workers (HCWs) were found to be infected with SARS‐CoV‐2, the HCWs had to receive two nucleic acid amplification tests for SARS‐CoV‐2: immediately after and 5 to 10 days after the onset of COVID‐19 in the family members. Risk factors of household transmission were analysed by comparing cases (HCWs infected with SARS‐CoV‐2) and controls (HCWs not infected with SARS‐CoV‐2) using multivariable analysis. Results: Unvaccinated status (OR: 3.97), age of index cases (≤6 years) (OR: 1.94) and staying at home with index cases (OR: 10.18) were risk factors for household transmission. Conclusion: If there is a strong desire to avoid household infection, family members infected with SARS‐CoV‐2 should live separately during the period of viral shedding. Summary statement: What is already known about this topic? During the COVID‐19 pandemic, nurses have been exposed to SARS‐CoV‐2 not only from COVID‐19 patients but also from family members infected with SARS‐CoV‐2 but prevention of SARS‐CoV‐2 infection to nurses is important to maintain health services function.The household infection rate was reported to be higher for the omicron variant (42.7%) than for non‐omicron variants (36.4% for Alpha, 29.7% for Delta and 22.5% for Beta). Determination of the risk factors for household transmission of the omicron variant is therefore important. What this paper adds? Unvaccinated HCWs had higher transmission rates (OR: 3.97, 95% CI: 1.22–12.88) than those of HCWs who received more than two doses of BNT162b2 or mRNA‐1273 mRNA COVID‐19 vaccines.Index cases aged 6 years or younger had higher transmission rates (OR: 1.94, 95% CI: 1.13–3.35) than those of index cases aged 7 years or older.The odds of transmitting to HCWs was higher (OR: 10.18, 95% CI: 2.98–34.72) for HCWs who stayed at home with the index cases than for HCWs who spent time in a different building from the index cases. The implications of this paper: If there is a strong desire to avoid household infection, family members infected with SARS‐CoV‐2 should live separately during the period of viral shedding. [ABSTRACT FROM AUTHOR]

Background: Preoperative education can improve postoperative quality of life in patients undergoing stoma surgery. However, the prevalence and when, where, and how preoperative education is implemented are unclear. Therefore, this study aimed to assess the current status of outpatient preoperative education for patients undergoing stoma surgery for rectal cancer as perceived by nurses. Additionally, it sought to identify the information provided by Japanese healthcare providers as a part of preoperative education. Methods: This cross-sectional study included 1,716 wound, ostomy, and continence nurses (WOCNs) in charge of stoma clinics at Japanese hospitals. Unsigned self-administered survey forms were mailed to the participants, and paper- or web-based responses were obtained. The main questions included: overview of the participants and their facilities, provision of outpatient preoperative education, status of implementation, and preoperative education components. To examine the factors associated with preoperative education, the independent variable was the presence or absence of preoperative education in the clinic, and the explanatory variables were the years of experience as a nurse, years of experience as a WOCN, type of hospital, number of beds, and number of intestinal stoma surgeries per year. Regression analysis was performed. Results: We received 773 valid responses (valid response rate: 45%). Duration of experience as a nurse and as a WOCN were 24.6 and 10.9 years, respectively. Outpatient preoperative education was provided by 24% of the participants. Most preoperative education sessions were conducted for patients or caregivers. Preoperative education took 31–60 min per patient, and one to five patients received preoperative education each month. Booklets, ostomy appliances, and stoma models/dolls were used as supplementary materials for preoperative education. The most frequently mentioned components of preoperative education were stoma care, daily life, social security, stoma clinic, traveling and going out, quality of life after stoma surgery, and precautions for medical treatment. In addition, education on the use of restrooms on the go, disaster preparedness, defecation disorders after restorative proctectomy, and complications after stoma closure were considered necessary. Conclusions: The implementation rate of outpatient preoperative education was low (24%). Future challenges include the development of specific educational content and procedures suitable for the Japanese medical environment and the establishment of preoperative medical care teams for stoma surgery to promote the provision of outpatient preoperative education. [ABSTRACT FROM AUTHOR]

Background: No study has investigated sleep‐related environmental factors in patients according to their functional independence measure (FIM) cognitive scores. Aims: The aim of this study is to examine the associations between environmental factors such as noise and sleep latency according to the FIM cognitive scores among inpatients in rehabilitation wards. Design This is a prospective longitudinal study. Methods: This study measured the sleep state using a bed‐based actigraphy, environmental data from Environmental Sensor®, and medical record information of 33 inpatients in the rehabilitation wards during 2018. A linear mixed‐effect model was used to analyse the associations between sleep latency and environmental factors. Participants were grouped according to high or low FIM cognitive scores. Results: The average patient age was 77.2 ± 10.9 years, and 48.5% were male. In the high FIM cognitive score group, the loudness and frequency of noise exceeding 40 dB during sleep latency were significantly associated with sleep latency. In the low FIM cognitive score group, only the noise frequency was associated with sleep latency, and intra‐individual variance was larger than that of the high group. Conclusion: These findings suggest that providing night care with attention to subdued noise is important, particularly for patients with low cognitive functional independence levels measured by the FIM cognitive score. Summary statement: What is already known about this topic? Many elderly individuals have sleep disorders, such as difficulties falling and staying asleep.Environmental factors, like light and noise, influence inpatients' sleep. What this paper adds? Patients with high functional independence measure (FIM) cognitive scores had longer sleep latency when both the loudness and frequency of noise exceeded 40 dB.Patients with low FIM cognitive scores had longer sleep latency with frequent noise, regardless of loudness.Nurses should provide care with more caution, taking into consideration the frequency of noise produced, regardless of loudness, particularly for patients with a low cognitive functional independence level measured by the FIM cognitive score. The implications of this paper For elderly inpatients with a lower cognitive functional independence level measured by the FIM cognitive score, the number of nurses' visits at night should be minimized to avoid disturbing the patients' sleep by using devices such as nonwearable sleep monitoring sensors, which can also contribute to reducing nurses' burden. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to examine the effects of a learning programme for nurse managers on connecting learning with their own experiences and fostering competence. Background: In Japan, second‐level programmes for certified nurse administrators represent the main opportunity for formal training for nurse managers. However, it is difficult for nurse managers to transfer second‐level programme learning to their workplace. Methods: This quasi‐experimental study used a two‐group pretest–posttest design with purposive sampling and non‐random assignment of 29 consenting Japanese nurse managers who were participating in a second‐level programme through a prefectural nursing association. The programme provided reflection papers and feedback from a researcher, as well as reflective group sessions. The outcome measure was the Japanese First‐Line Nurse Managers Competence Inventory (JNMCI) score. Results: The intervention group showed significant improvement in JNMCI scores after participating in the programme. A significant difference in JNMCI scores was also observed between the intervention and comparison groups. Conclusion: This learning programme led to improved competency among nurse managers. Implications for Nursing Management: Nurse manager development programmes should include reflection papers and feedback, as well as reflective group sessions, to improve competency among nurse managers. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the relationship between family caregivers' health‐related quality of life and health outcomes in care recipients. Methods: A total of 160 female caregivers in Japan were initially assessed using self‐reported baseline questionnaires to determine physical and mental aspects of their health‐related quality of life. Based on these scores, they were divided into three groups: lower, middle, and higher quality of life. We followed up with the 133 participants (after excluding those that did not respond) 6 years later to assess the health of their care recipients; 36 caregivers continued to provide home care, while 97 reported that their care recipient had died or been admitted into institutionalized care. Results: Statistically, a higher risk for care recipients' health deterioration was strongly associated with the mental component score in the lower caregivers' quality of life group of than for the middle group, after adjusting for the care recipients' age, health status, and caregivers' age at baseline. There was no significant association between deterioration of health of care recipients and physical component scores of the caregivers. Conclusion: Caregivers' poor health‐related quality of life, particularly poor mental health, may be linked to the deterioration of care recipients' health. Summary statement: What is already known about this topic? Family caregivers reportedly have lower quality of life than noncaregivers.While factors associated with decreased quality of life of caregivers such as high caregiving burden and longer care duration are being identified, they remain difficult to prevent.Lower caregiver quality of life may negatively influence the care recipients. What this paper adds? Poor mental health in caregivers, calculated with health‐related quality of life scores, is associated with health deterioration of care recipients.Physical health in caregivers is not associated with health deterioration of care recipients. The implications of this paper: Support for improving the health‐related quality of life of caregivers is necessary, especially in relation to their mental health, from the viewpoint of maintaining the health status of care recipients. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the organization and developmental sequences of macro-structure components of the written narratives of 44 students aged 7-11 years old in Japan who are deaf or hard of hearing (DHH). Based on the results, the students successfully completed the elements of action, sequence, orientation and climax of their oral paper puppet plays. Also cited is the definition of narrative as an extension of discourse.

Aims: The aims of this paper are to (a) outline the design and implementation of an evidence‐based assertiveness communication workshop for Japanese nursing students; and (b) report on the evaluation of nursing students' satisfaction with the workshop using the Satisfaction with Assertiveness Communication Training Program Survey. Background: A body of research attests to the relationship between assertive communication and patient safety. This paper reports the design and evaluation of an assertiveness communication training programme designed to enhance students' ability to communicate safety in clinical practice. Design: A culturally appropriate and evidence‐based assertiveness communication workshop, informed by Gagne's instructional design principles, was implemented for third‐year nursing students in two Japanese higher educational institutions in December 2017. A descriptive study design was used to evaluate the workshop. Methods: Students' perceptions of the workshop were evaluated using the Satisfaction with Assertiveness Communication Training Program Survey, which includes ten items that are rated using a 5‐point Likert scale from strongly disagree [1] to strongly agree [5]. Data were analysed using descriptive statistics. The Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guidelines were used in the reporting of this study. Results: A total of 111 students from a population of 150 participated in the study giving a response rate of 74%. The overall mean satisfaction score was 4.12 indicating a high level of agreement with each of the survey items. With the exception of two items, the mean scores were above 4.0. "Confidence in using assertiveness communication skills" and "Utilising role‐plays to practice learnt skills" received mean scores of 3.71 and 3.90, respectively. Conclusion: Given the compelling research about the importance of assertive communication in health care, the results from this study support continuing investment in assertiveness communication training programmes for nursing students. Relevance to clinical practice: Assertive communication is an essential communication skill for safe nursing practice. Culturally appropriate assertiveness communication training programmes are of particular relevance in hierarchical healthcare contexts. [ABSTRACT FROM AUTHOR]

Objectives: In this paper and prospective study, we examine the number of healthy behaviors and the incidence of disability in community-dwelling older adults aged 65 years and older. Methods: Participants (N = 4483) were residents of Obu, Japan who were asked about regular exercise, smoking status, and sleep duration. Demographic variables, history of disease, physical function, and cognitive function were measured as confounders. Information about disability was obtained from the Obu City Office. Results: At 24 months after baseline assessment, 165 participants (3.7%) were certified as having disability. Participants with 2 healthy behaviors had a 1.61-fold increased risk of disability (95% CI: 1.08 -2.42) compared with those with 3 healthy behaviors; those with one or no healthy behaviors had a 2.01-fold risk (95% CI: 1.26-3.19) even though adjusting for confounders. Conclusions: The number of healthy behaviors was associated with the incidence of disability, with the hazard ratios increasing progressively as the number of healthy behaviors decreased. [ABSTRACT FROM AUTHOR]

Accessible summary What is known about the subject? Loneliness among people diagnosed with schizophrenia is a serious problem. Recent studies have focused on the loneliness; however, no study has examined the relationships between loneliness and both individual and environmental factors comprehensively., What this paper adds to existing knowledge? The main results indicated that the community-dwelling people diagnosed with schizophrenia in Japan as well as in other countries experienced higher levels of loneliness. Both individual and environmental factors were related to loneliness. Increasing the self-efficacy for community life and self-esteem of individual factors, and not being socially isolated and increasing community integration of environmental factors would improve their loneliness., What are the implications for practice? Health practitioners, in particular, public health nurses in mental health care, should work to develop a partnership with people diagnosed with schizophrenia, their family members, friends and other community-dwelling people in order to decrease and prevent loneliness. For individuals diagnosed with schizophrenia, interventions by cooperating with community resources and using the technique of nurses to assist them with continuous community activity could be useful. For environmental interventions, population approach such as developing daily programmes which family members can participate in, and cooperating with educational institutions and community events could have a positive effects., Abstract Introduction Loneliness among people diagnosed with schizophrenia living in communities can decrease quality of life and may contribute to suicide. Aim The aim of this study was to examine the levels of loneliness among Japanese people diagnosed with schizophrenia and to identify individual and environmental factors related to their loneliness. Method A cross-sectional survey was conducted with 264 people diagnosed with schizophrenia who use local activity support centres in urban areas. The self-administered questionnaires included questions on loneliness, demographic characteristics, individual factors including self-efficacy for community life and self-esteem, and environmental factors including social isolation, community integration and service use. Results The study results indicated that people diagnosed with schizophrenia in Japan experience higher levels of loneliness, corroborating results from other countries. Multiple regression analysis showed that a lower level of self-efficacy for community life, self-esteem, community integration and social isolation predicted a higher level of loneliness, accounting for 55.3% of variance. Implications for Practice Public health nurses in mental health care in Japan can work with individuals diagnosed with schizophrenia and communities using the technique to assist them with continuous activity and cooperating with community resources and educational institutions in order to decrease and prevent loneliness. [ABSTRACT FROM AUTHOR]

Background: An innovative measurement system using a computerized adaptive testing technique based on the item response theory (CAT) has been expanding to measure mental health status. However, little is known about details in its measurement properties based on the empirical data. Moreover, the response time (RT) data, which are not available by a paper-and-pencil measurement but available by a computerized measurement, would be worth investigating for exploring the response behavior. Purpose: We aimed at constructing the CAT to measure depressive symptomatology in a community population and exploring its measurement properties. Also, we examined the relationships between RTs, individual item responses, and depressive levels. Method: For constructing the CAT system, responses of 2061 workers and university students to 24 depression scale plus four negatively revised positive affect items were subjected to a polytomous IRT analysis. The stopping rule was set for standard error of estimation < 0.30 or the maximum 15 items displayed. The CAT and non-adaptive computer-based test (CBT) were administered to 209 undergraduates, and 168 of them administered again after 1 week. Results: On average, the CAT was converged by 10.4 items. The θ values estimated by CAT and CBT were highly correlated ( r = 0.94 and 0.95 for the 1st and 2nd measurements) and with the traditional scoring procedures ( r's > 0.90). The test-retest reliability was at a satisfactory level ( r = 0.86). RTs to some items significantly correlated with the θ estimates. The mean RT varied by the item contents and wording, i.e., the RT to positive affect items required additional 2 s or longer than the other subscale items. Conclusion: The CAT would be a reliable and practical measurement tool for various purposes including stress check at workplace. [ABSTRACT FROM AUTHOR]

Purpose: Our previous work proposed a rehabilitation robot to support bimanual-coordinated training not only in active-assisted and passive-driven modes but also in active-resisted mode. However, assessment of training effect was only focused on the improvements of subjects' motion-tracking precisions. This paper presents an evaluation strategy based on variations in both cerebral activation level (CAL) and motion-tracking precision. Method:Fourteen healthy subjects participated in motion-tracking training in bimanual active-assisted and active-resisted modes, and in single right-limb and left-limb modes, with haemoglobin concentration and motion-tracking errors being measured simultaneously. Analyses of variance (ANOVA) of the CAL and motion-tracking errors were performed to investigate bimanual training effect and the difference between bimanual and single-limb trainings in activating the brain. Results: In the bimanual modes, both the CAL and motion-tracking precision significantly increased after training. And the CAL induced in the bimanual trainings were significantly greater than in the single-limb trainings. Conclusions:Significant enhancement of the CAL and motion-tracking precision confirmed a positive training effect on enhancing the bimanual-coordination capability of healthy subjects. Compared to the single-limb modes, the higher CAL in the bimanual modes demonstrated the potential of the proposed bimanual training for improving the functional integrity of the two hemispheres. [ABSTRACT FROM AUTHOR]

This paper aims to determine via responses to three questionnaire surveys how sexuality education programs are conducted at junior high schools in Japan. Study 1 examined the practice of sexuality education in schools, Study 2 investigated junior high school students' (age 12–13 and 14–15 years) knowledge of sexuality, and Study 3 examined parents'/guardians' views on sexuality education. For Study 1, 703 principals of 5158 junior high schools returned an original questionnaire (13.6% recovery rate), and for Studies 2 and 3, 9492 students and 5374 parents returned questionnaires (86.2% and 60.3% recovery rate, respectively). In Study 1, an average of 9.19 hours of instruction was allocated to sexuality education over three grades. In Study 2, the average correct response rate was as low as 34.5% for boys and 39.4% for girls, with many answering ‘I don't know.’ Approximately one-half of the boys indicated there was nothing in particular they wanted to know about sex and no-one they wanted to consult. In Study 3, parents viewed school as a more appropriate setting than home for teaching physiological aspects of sexuality and providing accurate information. From the results of the three studies, we discuss the current situation and future challenges for sexuality education in Japan. [ABSTRACT FROM PUBLISHER]

Abstract: The aim of the present study is to examine job role quality relating to intention to leave current facility and to leave profession among direct care workers in residential facilities for elderly in Japan. Direct care workers completed a paper questionnaire on October 2009. From 746 facilities in three prefectures (Tokyo, Shizuoka, and Yamagata) 6428 direct care workers with complete data were included in the analyses. The Job Role Quality (JRQ) scale was translated into Japanese language to assess job role quality. Hierarchical multiple regression analysis showed that intention to leave current facility was primarily associated with job role quality: poor skill discretion, high job demand, and poor relationship with supervisor. Intention to leave profession was primarily associated with poor skill discretion. The results of the present study imply the strategies to direct care worker retention for each facility and policy efforts. Each facility can implement specific strategies such as enhanced variety of work and opportunity for use of skills, adequate job allocation, and improvement of supervisor–employee relationship in work place. Policy efforts should enhance broader career opportunities in care working such as advanced specialization and authorized medical practice. [Copyright &y& Elsevier]

A recent paper reported that Aβ oligomer causes neuronal cell death through the phosphatidylinositol-3-OH kinase (PI3K)- Akt-mTOR signaling pathway. Intraneuronal A&beta, a main pathological finding of Alzheimer's disease (AD), is also known as inhibiting activation of Akt. This study aims to investigate whether single nucleotide polymorphisms (SNPs) of the Akt1 gene are associated with AD. SNPs genotyped using TaqMan technology was analyzed using a case-control study design. Our case-control dataset consisted of 180 AD patients and 130 age-matched controls. Although two SNPs showed superficial positive, Hardy-Weinberg equilibrium (HWE) tests, and linkage disequilibrium (LD) analyses suggested that genetic regions of the gene are highly polymorphic. We failed to detect any synergetic association among Akt1 polymorphisms, Apolipoprotein E (APO E), and AD. Further genetic studies are needed to clarify the relationship between the Akt1 and AD. [ABSTRACT FROM AUTHOR]