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Aim: To explore the health beliefs of clinical and academic nurses from Japan, Australia and China regarding wearing paper masks to protect themselves and others, and to identify differences in participants' health beliefs regarding masks. Background: The correct use of face masks and consensus among health professionals across the globe is essential for containing pandemics, and nurses need to act according to policy to protect themselves, educate the public and preserve resources for frontline health workers. Paper masks are worn by health professionals and the general public to avoid the transmission of respiratory infections, such as COVID‐19, but there appear to be differences in health beliefs of nurses within and between countries regarding these. Methods: This qualitative descriptive study used content analysis with a framework approach. Findings: There were major differences in nurse participants' beliefs between and within countries, including how nurses use paper masks and their understanding of their efficacy. In addition, there were cultural differences in the way that nurses use masks in their daily lives and nursing practice contexts. Conclusion: Nurses from different working environments, countries and areas of practice hold a variety of health beliefs about mask wearing at the personal and professional level. Implications for nursing policy and health policy: The COVID‐19 pandemic has sparked much discussion about the critical importance of masks for the safety of health professionals, and there has been considerable discussion and disagreement about health policies regarding mask use by the general public. Improper use of masks may have a role in creating mask shortages or transmitting infections. An evidence‐based global policy on mask use for respiratory illnesses for health professionals, including nurses, and the general public needs to be adopted and supported by a wide‐reaching education campaign. [ABSTRACT FROM AUTHOR]

Studies have indicated that higher numbers of nurses regarding staffing ensure patient safety and a better practice environment. Using citation analysis, this study visualizes the landscape of nurse staffing research over the last two decades to show the overall publication trends, major contributors, and main research topics. We extracted bibliometric information from PubMed from January 2000 to September 2022. After clustering the network, we analyzed each cluster's characteristics by keyword. A total of 2167 papers were considered for analysis, and 14 clusters were created. The analysis showed that the number of papers published per year has been increasing. Researchers from the US, the UK, Canada, Australia, and Belgium have led this field. As the main clusters in nurse staffing research during the past two decades, the following five research settings were identified: nurse outcome and patient outcome research in acute care hospitals, nurse staffing mandate evaluation research, nursing home research, and school nurse research. The first three clusters accounted for more than 80% of the total number of published papers, and this ratio has not changed in the past 20 years. To further develop nurse staffing research globally, evidence from other geographic areas, such as African and Asian countries, and from long-term care or community settings is necessary. [ABSTRACT FROM AUTHOR]

Background: More new randomized controlled trials (RCTs) on acupuncture have been published in Japan since our last updated systematic review (2010). This systematic review aimed to evaluate the quality of RCTs on acupuncture conducted in Japan and understand the decade-wise changes in the methodological characteristics of the relevant RCTs. Methods: The literature search was performed using Ichushi Web, the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and our team's compilation of relevant papers. We included full-length papers reporting RCTs that examined the clinical effects of acupuncture on patients in Japan published in or before 2019. We assessed the risk of bias (RoB), sample size, control setting, negative trial reporting, informed consent, ethics approval, trial registration, and adverse event reporting. Results: A total of 99 articles reporting 108 eligible RCTs were identified. The number of RCTs published in each decade was 1, 6, 9, 5, 40, and 47 in the 1960s, 1970s, 1980s, 1990s, 2000s, and 2010s, respectively. Quality assessment using the Cochrane RoB tool revealed that "sequence generation" improved in and after 1990 (73%–80% of RCTs were rated as "low") and "blinding of outcome assessors" slightly improved in and after the 2000s (40%–50% judged as "low"). However, "high" or "unclear" remained the dominant grades in other domains. Clinical trial registration and adverse events were reported only in 9% and 28% of the included RCTs even in the 2010s, respectively. A different acupuncture method or different point selection (e.g., deep vs. shallow insertion) was the most dominant control setting before 1990, while sham (or "placebo") needling and/or sham acupoints became the most dominant in the 2000s. The proportion of RCTs with positive results was 80% in the 2000s and 69% in the 2010s. Conclusions: The quality of RCTs on acupuncture conducted in Japan did not appear to have improved over the decades except for "sequence generation." While the culture of submitting negative trial reports was prevalent in the Japanese acupuncture research milieu as late as the 1990s, the overall quality of the relevant trials needs to be further improved. [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]

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]

Aims: This work aims to map instruments available in Japanese that have been assessed for reliability or validity for measuring evidence‐based practice (EBP) among clinical nurses. Background: As EBP competencies comprise various domains, many EBP instruments have been developed. However, instruments available in Japanese for measuring EBP have not been reported systematically. Design: We conducted a scoping review. Data sources Two different bibliography databases were searched to identify EBP instruments published until 2019: ICHUSHI (for Japanese articles) and PubMed. Review methods: After relevant studies were screened and identified, study profile characteristics were extracted to identify EBP instruments in Japanese, and the quality of methodology for developing such instruments was evaluated. This information was recorded and the characteristics were descriptively summarized. Results: Ninety potentially relevant articles were identified, of which seven articles and nine instruments were included in this review. All instruments were based on self‐reported self‐efficacy and attitudes. Few Japanese instruments included all the steps required for EBP. The overall reporting quality of each instrument was low. Conclusions: EBP instruments available in Japanese are extremely scarce. The study results show that it is difficult to measure the various aspects of EBP with the existing instruments. Summary statement: What is already known about this topic? A systematic review reported that more than 100 instruments for evaluating evidence‐based practice (EBP) have been developed worldwide.Even if no language restrictions are applied in systematic reviews, international databases often do not cover publications in languages other than English, or those that are from Asia, Africa, or South America.Japanese EBP instruments have not been cited in systematic reviews of EBP. What this paper adds? EBP instruments available in Japanese published until 2019 were extremely scarce.There was little variation in the outcome domains and scale components of EBP instruments available in Japanese.An EBP instrument originally developed in Japan included a subscale on nursing research that considers the cultural characteristics specific to Japan. The implications of this paper: This review could help researchers, educators, and practitioners in choosing EBP instruments available in Japanese to measure nurses' readiness or competencies for EBP.A literature review of non‐English language publications could address the language limitations of previous systematic reviews in mapping EBP instruments. [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]

The quality-assured preparation of crushed and diluted preparations for children is a challenge. In this study, a multicenter study was conducted to validate the preparation method for the quality assurance of baclofen powder, clonidine powder, and hydrocortisone powder prepared from tablets according to a previously established method. In-hospital preparations were prepared at five medical facilities under different crushing and mixing conditions. After storage in closed bottles, in-use bottles, and laminated paper for 120 days, ingredients stability, drug elution, and content uniformity after packaging were evaluated. All three ingredients were maintained at between 90% and 110% of their initial content for 120 days under packaging conditions of 25 ± 2 °C and 60 ± 5% relative humidity, with no change in dissolution in all formulations made at all five facilities. The content uniformity was also acceptable. The established method may contribute to quality-assured pediatric dosage form modification. [ABSTRACT FROM AUTHOR]

Background: While research has explored the risk of periodontal disease in various eye conditions, the link between dry eye and periodontal disease remains underexplored, especially in Japanese adults. This study aims to investigate the association between dry eye and periodontal disease in community-dwelling Japanese adults. Methods: This study is a subset of the Uonuma cohort study, which includes Japanese adults aged 40 years and older residing in the Uonuma area of Niigata Prefecture, Japan. Participants completed a self-administered, paper-based questionnaire. Statistical analyses, including the chi-square test, independent t test, ANOVA test, and logistic regressions, were employed to assess the association of periodontal disease with independent variables. Results: Among 36,488 participants (average age 63.3 years, 47.4% men), 39.3% had a history of periodontal disease, and gender differences were statistically significant (p < 0.001). Significant associations were found between periodontal disease and dry eye diagnosis or symptoms. Univariable logistic regression revealed links between periodontal disease and age, gender, living status, alcohol consumption, remaining teeth, bite molar availability, and history of dry eye disease or symptoms. Multiple-adjusted regression found that doctor-diagnosed dry eye was associated with a higher likelihood of periodontal disease (odds ratio, 1.12; 95% confidence interval, 1.03–1.22). Participants who never experienced dryness or foreign body sensation had lower ORs of periodontal disease than those who always experienced such symptoms across all models. Conclusion: A significant correlation was found between dry eye and periodontal disease in Japanese adults. Regular check-ups, early detection, and effective management of both conditions are strongly recommended. [ABSTRACT FROM AUTHOR]

(1) Background: The increasing older population and demographic shifts highlight the need to understand the digital profiles of older adults, a pivotal factor in developing innovative technologies like the e-VITA virtual coach. This personalized coach provides recommendations for sustainable well-being in a smart home environment. (2) Methods: This study focuses on analyzing the characteristics of older individuals categorized as Internet users (onliners) and non-users (offliners). European Social Survey data from 2021 were utilized for European analysis, determining Internet usage based on frequency. Offliners are defined as users who never use the Internet, and onliners as those who use it, albeit with different frequencies. In Japan, data from the 9th International Comparative Survey on the Lives and Attitudes of the Elderly were employed, based on the responses of 1367 subjects, which defined onliners as individuals using communication devices and offliners as those not utilizing fax machines, cell phones, or the Internet. (3) Results: This paper presents a primary analysis of older end-user context and perspectives, outlining effective strategies for the diffusion of an active and healthy aging coaching system in the market and society. (4) Conclusions: the study emphasizes the importance of analyzing digital behavior in any user-centered design approach to ensure the system's acceptance after deployment. [ABSTRACT FROM AUTHOR]

Political apologies have been argued to contribute to reconciliation among groups and nations but their efficacy has also been questioned. This paper examines the acceptance of political apologies, their content and the protagonists in the victim nation, the perpetrator nation and their subgroups. Guided by studies on the structure of apologies, it distinguishes 10 features of apologies, seven of which concern their content and three of their protagonists. Following the analysis of apology statements by Japan to South Korea, the paper further breaks these features (factors) down into 32 elements (levels). The acceptance of around 70,000 possible apology combinations is examined in a randomized conjoint experiment, which was embedded in online quota‐based surveys in Japan (n = 2700) and South Korea (n = 3000). The analysis reveals that the content of apologies matters, protagonists matter more than content and some subgroups matter more than protagonists. The subgroup analysis showed that some within‐country differences are larger than cross‐country differences, which challenges the SIT. Apology statements that would be acceptable in both nations are summarised. [ABSTRACT FROM AUTHOR]

Purpose: Informed by health activism (Zoller, 2005), the purpose of this paper is to explore the communicative processes of organizations working with women migrants in countries of destination. In particular, it explored the definitions of and explanations for health of organizations, their solutions to disease and illness, as well as, the methods and tactics they use to communicate health. Design/methodology/approach: It employed qualitative approach specifically in-depth interviews with leaders or core members of not-for-profit and faith-based organizations working with Filipina migrants in Japan. Field notes from participant observations in formal meetings and informal gatherings were likewise used as data sources. Findings: While organizations also recognized physical and spiritual health, they placed strong emphasis on mental well-being. Other than translation service, pastoral care, and shelter, coordinating with other not-for-profit and faith-based organizations, international centers, and governments was solution for addressing illness and disease. Together with face-to-face, digital media were used as method and tactic to communicate within and outside organizations. It likewise found that the organizations included were inclusive such that they also worked with other Filipinos in Japan. Originality/value: This paper contributed to migration health literature by discussing the central role of organizations for mental well-being activism, favorable consequences of coordination among organizations to promote access to quality healthcare and information and dual characterization of digital media for organizing publics. Overall, it is one of the few to explore the ways into which organizations communicatively challenge health structures in countries of destination. [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]

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]

Background: Emotional design of multimedia lessons involves adding features that are intended to increase learner enjoyment and promote learning—such as adding narrative, anthropomorphizing non‐human elements, and using warm colours. Objective: The present study extends this work to examine the potential of Japanese animation (anime) for improving science learning. Method: Specifically, 134 English‐speaking students learned about cells in the human body by viewing the popular anime, Cells at Work, either in Japanese with English subtitles or dubbed in English with no subtitles (anime groups), or by viewing a slideshow containing the same information (slideshow group). The anime conditions were vibrant story‐driven lessons that depicted human‐looking cells working to fight off invaders in a human body that looked like a city. The slideshow used very similar wording as the anime groups, and displayed the cells without anthropomorphism or a storyline. Results and Conclusion: The anime groups did not differ significantly from each other on any dependent measures and were therefore combined. The anime groups scored significantly higher than the slideshow group on retention (d = 0.35) and transfer (d = 0.48) tests. The anime groups also had significantly higher ratings of motivation (d = 0.60) and enjoyment (d = 1.13), whereas, the slideshow group had significantly higher ratings of distraction (d = 0.59). These results support the cognitive‐affective theory of learning with media (CATLM) and demonstrate that anime may be an effective learning medium. Takeaways: Anime should be considered as a medium for science learning, especially when students might not otherwise be motivated to learn. Lay Description: What is currently known about this topic: Anime is a form of Japanese animation similar to an animated comic book.Cells at Work is a series of anime lessons on cells in the human bloodstream.Cells are represented with anthropomorphism, colours, and rounded shapes.Emotional design involves using anthropomorphism, colours, and rounded shapes. What does this paper add: Students viewed an anime or an equivalent slideshow on the human bloodstream.The anime group performed better on a post‐test and reported less distraction.Anime can be considered a form of emotional design for science lessons. What are the implications for practitioners: Anime can be used to teach about cells in the human bloodstream.Instructional designers should consider using anime as a medium for science instruction. [ABSTRACT FROM AUTHOR]

To include people with disabilities as equal citizens, CRPD (Convention on the Rights of Persons with Disabilities) promotes direct or supported decision-making by people with disabilities. However, involuntary psychiatry admission is considered in many countries to be necessary for people with psychosocial disabilities. To overcome the tension and implement CRPD, it is essential to understand the experiences and concerns of service users, family members, and medical professionals in each country. To understand the process and the factors that make psychiatrists decide involuntary psychiatric admission in Japan, and explore their attitudes toward direct or supported decision-making by people with psychosocial disabilities. Psychiatrists who had authorized involuntary admission and who were in charge of the service users were recruited at hospitals in Japan. The interviews were individual, peer to peer, and semi-structured. The interviews were audio-recorded, transcribed verbatim, and the analysis followed reflexive thematic analysis using NVIVO 12. Six psychiatrists (five designated psychiatrists and one psychiatric resident) participated in the study at two hospitals in urban Japan. The study found that the psychiatrists assessed symptoms, behaviors, and perceptions of the service users together with supports and wishes of their families. The psychiatrists decided on involuntary admission when they saw self-harm or violence, weak insights and judgment abilities, family's wishes, or when they wanted to avoid the service users leaving the hospital with incomplete treatment. The psychiatrists felt that the service users would not understand any explanations, which made their communications minimal. The psychiatrists thought it was hard to imagine a system other than the current involuntary admission mechanism. If it was to change, they felt the essential things were to avoid abuse, clarify who is responsible, make plans medically valid and feasible, and assess and plan through everyday life, not just in crisis. During a crisis, the psychiatrists were most careful about complying with the Mental Health Act and responded to the family's wish. The psychiatrists justified involuntary admission as they believed that people in a psychiatric crisis cannot decide or understand and need protection. Related protocols, laws, and expectations from family members shapes the values and practices of psychiatrists in Japan. The paper concludes with several recommendations to regard people with psychosocial disabilities as equal citizens, and promoting the aim of reducing or ending involuntary admission. [ABSTRACT FROM AUTHOR]

Support needs for pregnancy-related anxiety among low-risk pregnant women remain unclear. This study aimed to clarify the kinds of support for anxiety that women seek during pregnancy in Japan. Data were collected in a semi-structured focus group interview involving five pregnant women who were not in specific risk groups, recruited from three facilities in Tokyo. We generated themes using inductive thematic analysis. This paper adhered to the consolidated criteria for reporting qualitative research. From the data on support needs for anxiety during pregnancy, three themes were derived: (1) seeking tailored professional support; (2) seeking continuous support within informal relationships; and (3) seeking others' success stories in the same situation. These three types of support gave participants a sense of reassurance or raised concern, depending on the situation. We proposed a model comprising the three derived themes using social cognitive theory. We discussed how these three types of support influenced pregnant women's self-efficacy, which is the core concept of the social cognitive theory. Our findings may help to plan theory-based research and effective interventions to provide support for women's anxiety during pregnancy using a population approach. Our results also demonstrated the importance of collaboration with pregnant women in developing further research and interventions. [ABSTRACT FROM AUTHOR]

The Personal Outcomes Scale is a measurement tool to examine quality of life among persons with intellectual disability. This paper addressed the validity and reliability of the Japanese version of the scale using both self-reports and reports of others. Data were collected from 128 people with intellectual disability (90 men and 38 women; Mage = 37.19 ± 11.90 (range = 19–69) years) and 27 support workers. Reliability was examined by Cronbach's alpha coefficients, inter-respondent reliability coefficients, and test-retest reliability. Validity was examined by construct validity and criteria-related validity. Self- and other-reported versions showed adequate internal consistency (α = 0.79); however, some domains had relatively low internal consistency. Validity tests showed weak to moderate correlations between the total score and the domain scores in both versions. The scale is reliable overall; however, cultural aspects should be considered to bolster its reliability for practical application. [ABSTRACT FROM AUTHOR]

This study reviewed the literature on psycho-social treatments for reducing school absenteeism in Japan, particularly focussing on those featuring a cognitive-behavioural approach. To extract studies, we screened journals published by 52 academic societies that are members of the Union of the Japanese Psychological Association and reviewed relevant peer-reviewed papers. We consequently analysed 31 cases: 21 elementary school students and 10 junior high school students. We found that to effectively address school absenteeism in Japan, cognitive-behavioural approaches should feature a combination of two or more behavioural techniques. These findings may help Japanese practitioners, such as school counsellors, explain to clients the benefits of choosing cognitive-behavioural approaches, as well as the prospects for support. [ABSTRACT FROM AUTHOR]

INTRODUCTION Certain foods and beverages are associated with smoking craving. However, only few studies have explored the relationship between food or beverage-related and taste-associated smoking craving. In this study, we aimed to identify the types of foods related to smoking craving in Japanese individuals who smoke cigarettes or heated tobacco products (HTPs). METHODS A total of 657 individuals (HTP and cigarette smokers and never smokers) participated in this cross-sectional study. Participants were asked what foods/ beverages, tastes, seasonings, cooking methods, and cuisine categories, made them want to smoke and what foods they consumed. RESULTS Alcoholic beverages such as beer, coffee, and fat-rich foods were associated with a higher likelihood of smoking craving. Fruits, dairy products such as milk, and sweet and sour tastes, were associated with a lower likelihood of smoking craving. The daily intake of fruit and dairy products was significantly lower in cigarette and HTP smokers than in non-smokers (median fruit intake: nonsmokers, 46.4 g/1000 kcal/day; cigarette smokers, 22.2 g/1000 kcal/day; HTP smokers, 31.4 g/1000 kcal/day; p<0.001; median dairy product intake: nonsmokers, 76.3 g/day; cigarette smokers, 48.2 g/day; HTP smokers, 57.6 g/day; p<0.001) as assessed using a food frequency questionnaire (BDHQ). CONCLUSIONS Specific foods and beverages such as alcohol, fruits, and dairy products are related to smoking craving, and their intake differs according to smoking status. [ABSTRACT FROM AUTHOR]

Current medical science has not yet found a cure for dementia. The most important measures to combat dementia are to detect the tendency toward cognitive decline as early as possible and to intervene at an early stage. For this reason, screening for dementia based on language ability has attracted much attention in recent years. However, in most of the previous studies, the cohort of people with dementia has been smaller than the control cohort. In this paper, we use a pre-trained Japanese language model for text analysis and evaluate the effectiveness of text augmentation on a dataset consisting of Japanese-speaking healthy older adults and those with mild cognitive impairment (MCI). We also examined what tasks contributed to the results. This experimental setting can also be used to detect other diseases that may affect the language areas of the brain outside of the hospital. [ABSTRACT FROM AUTHOR]

To address the importance of family carers' understanding of care, encompassing their own care as well as the broader care and health social systems, this paper leverages the notion of 'care literacy'. The aim of this study is to understand the variation in care literacy and the impact of care literacy on preventive care. The empirical focus is on working family carers for older relatives in Japan, through a cross-sectional online survey that includes a novel operationalization of care literacy, an established measure of health literacy, the assessment of information used to understand care, and measures of preventive care. The participants' (n = 281) mean age was 53, with 44% women, and an average of 8.3 h per week caring for their parent(s). The measure of care literacy is shown to be correlated, as expected, but distinct to health literacy (correlation 0.60). Based on regression analysis of care literacy, significant explanatory variables are health literacy (p < 0.001), gender (p = 0.044), number of sources of information on care (p = 0.029), and care hours (p < 0.001). In contrast, proximity in living arrangements of the carer and care receiver and severity of care needs were not significant predictors. Turning to the impact of care literacy, care literacy is a significant explanatory variable for use of preventive measures (p = 0.002), in particular as related to nutrition (p < 0.001), frailty (p = 0.028), and general home renovations (p = 0.018). The pattern of results from this cross-sectional analysis indicates the importance of understanding the potential for improved care literacy as an enabler of better care. [ABSTRACT FROM AUTHOR]

Since 1965, Japan has issued numerous apologies to Korea, which however failed to resonate with the Korean public. To investigate this puzzle, this paper analyses the structure of these apologies and empirically examines their reception in Korea. Blatz et al.'s (Political Psychology, 2009, 30, 219) classification of components of political apologies was applied to conduct a qualitative analysis of 63 official apology statements by Japan to Korea and identify the most frequently used components (Study 1). Korean participants (N = 210) were randomly presented with an experimental vignette consisting of a major apology component to examine their psychological responses, and they also ranked the importance of each major apology component (Study 2). Results showed that while Koreans viewed admission of wrongdoing as an essential and the most demanded component of apology, it was paradoxically the least frequent component offered by Japan in reality. [ABSTRACT FROM AUTHOR]

Background The management of the avulsion of deciduous and permanent teeth in children is well outlined in the guidelines of the International Association of Dental Traumatology and the American Academy of Pediatric Dentistry. However, little information is available about the level of knowledge in the management of dental trauma among undergraduate dental students in Japan. The objective of this study is to explore dental students' level of educational knowledge in the management of avulsed teeth. Methods A three-part questionnaire was used to gather demographic data and evaluate the knowledge of students at Kyushu Dental University. Results Questionnaire data were collected from 121 (53 first-year, 68 sixth-year) students. Regarding the immediate emergency management of a case in which a 9-year-old girl had fallen down the stairs and lost a maxillary incisor but remained conscious, 55.9% of sixth year students and 28.3% of first-year students suggested the immediate transportation of the tooth to a dentist. The answer selected by the largest number (50.9%) of first-year respondents was "sideline the injured girl and get her to bite on a tissue paper for several hours". In a case in which a boy had an avulsed tooth after falling down on a road, only 13.2% of first-year students suggested the transportation of the tooth in his mouth to the clinic. Most the largest number of respondents believed that the best way to transport an avulsed tooth to the dental clinic was to "wrap it in dry tissue paper". Conclusions These results suggest that education in first aid for accidents that occur outside dental clinics or hospitals is insufficient. Japanese dentists and dental educations must immediately improve the utilization of the guidelines for dental trauma and the education of undergraduate students and patients in the management of dental trauma using an integrated approach. [ABSTRACT FROM AUTHOR]

Objectives: This study examines the implementation and short-term effects of a Learning Partner Model (LPM)-based educational program on cancer prevention and control information for community health volunteers in Japan. Methods: The program was undertaken by 3 local governments in collaboration with a government initiative and offered a 90-min group workshop to community health volunteers. Community health volunteers (primary participants) recruited in turn friend or family members (secondary participants) with whom they were prepared to share the content of the workshop with the help of printed materials received in the workshop. We conducted self-administered paper and pencil questionnaire surveys before, immediately after, and 3 months after the workshop. The t-test, Fisher's exact test, paired t-test, and McNemar test were used to compare the 2 groups' demographic characteristics and healthy habits at pretest. Repeated measures ANOVA was used to compare cancer prevention knowledge between groups and over time. Results: Of 142 participants, 107 pairs of learning partners (primary and corresponding secondary participant) completed all questionnaires. All primary participants and 37.4% of the secondary participants were women, and 57.9% of the learning partners were spouses. The results showed significantly higher correct answers on the cancer-prevention knowledge questions in the post-workshop and follow-up surveys compared to the pre-workshop survey (P < .001). The increase in knowledge was observed in all learning-partner groups in all 3 sites. Conclusion: The study demonstrates a promising strategy that can be adapted to the health needs of the community beyond cancer prevention and control, building on the efforts of local governments and government health initiatives. [ABSTRACT FROM AUTHOR]

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]

Encouraging students to actively ask questions during lectures is a formidable challenge that can be addressed through innovative use of information technology. We developed a robotic system that allows students in a lecture to collaboratively decide questions to be asked by a humanoid robot. To verify whether the system reduces hesitation to ask questions during lectures, 62 university students were divided into two groups, and each attended two different mock lectures on the Nobel Prize in Physics. Two lectures were conducted with and without the proposed system in counterbalanced order. Results suggested that students who were usually hesitant to ask questions during lectures became less hesitant to ask questions face‐to‐face when they could use the proposed system. Moreover, the perceived activeness in the lectures increased when using the system. Multiple regression analyses revealed that certain student actions, particularly tweeting and showing agreement with the questions posted by others, were correlated with an increase in perceived activeness. Lay Description: What is already known about this topic: In‐class student passivity is a widespread problem at many schools.Information and robot technologies have focused on addressing student passivity.Existing audience response systems are supportive but with limited degrees of freedom.It is unclear how these systems can encourage face‐to‐face student interactions. What this paper adds: We developed a system for in‐class students to ask questions collaboratively via a humanoid robot.Japanese undergraduates attended two experimental mock lectures with and without the proposed system.Hesitant students felt less hesitation asking questions face‐to‐face in the class with our system. The implications of study findings for practitioners: Significant effects of the robotic system on lecture participation are shown.In particular, it can encourage hesitant students to actively participate in class.Lecturer–student supported communication expected to promote experiences without it.Experiments in real educational settings are recommended to verify system usefulness. [ABSTRACT FROM AUTHOR]

The internationalization of science has prompted major science funding agencies to seek to further international cooperation in basic research through the use of outposts based outside of the agency's home country. While these offices are all international in scope, the strategies and utilization of these offices vary. This paper begins by outlining the motivations and theoretical framework for international offices, drawing specifically from a proximity theory of relationships. Subsequently the paper presents a typology of activities that fall under the rubric of international engagement in science. We will then critically examine the international offices of four leading basic research funding agencies and attempt to characterize and describe the distinct models that these agencies employ. Building from the models of organization, the paper closes with a discussion of the impacts of these overseas offices as well as other policy implications from the use of different engagement strategies in fostering international collaboration. [ABSTRACT FROM AUTHOR]

Background: Sleep disorders have an enormous impact on occupational health and are counterproductive from an economic perspective. However, the processes of causing sleep disorders from psychosocial aspects have not yet been known. The purpose of this study was to describe how sleep disorders develop among workers with respect to different psychosocial conditions. Methods: A conventional qualitative content analysis was conducted with a semi-structured interview among twenty-seven workers (14 males and 13 females) who were diagnosed with sleep disorders or had a self-reported history of sleep difficulties. Study participants were recruited from a specialized clinic and communities using snowball sampling. This paper adhered to the Standards for Reporting Qualitative Research (SRQR) checklist. Results: The results showed that there were four steps involved in the sleep disorders development process. Firstly, participants with sleep disorders developed 'early warning signs' with 11 categories of triggers; secondly, 'aggravating factors' on top of these early warning signs; thirdly, workers tried to 'cope with' their sleep disorders in the ways they thought would be effective. Finally, when coping failed to improve the quality of sleep, it led to the onset of sleep disorders. Conclusion: The development of sleep disorders and triggers of psychosocial factors were revealed. An occupational health nurse can bring these findings in practice for preventing worker's sleep disorders. [ABSTRACT FROM AUTHOR]

Research identifies unique challenges for younger women diagnosed with breast cancer at or before 45 years of age. This paper explores the experiences of younger women from diverse cultural backgrounds with breast cancer to see if there are differing healthcare provision needs across cultures. Sandelowski and Barroso's framework for undertaking a meta-synthesis is used in this paper. Initial searches in academic databases returned 42 papers of interest. Re-reading the papers in the context of the research question identified 12 studies which met the inclusion criteria. Five key themes were identified in these 12 studies. The overarching finding is that, irrespective of cultural background, the confrontation with breast cancer transforms the younger woman's life. It seems that healthcare provision needs do not differ substantially across cultures. Health professionals should address the unique psychosocial effects of cancer in the context of the lifestage of the woman. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mood and adjustment disorders are two major causes of long-term sick leave among employees, leading to large social losses. Therefore, a return to work (RTW) intervention was attempted, targeting patients with mood and adjustment disorders. OBJECTIVE: This study aimed to investigate the outcome of an interdisciplinary RTW intervention including occupational therapy implemented within the Japanese healthcare framework. METHODS: An interdisciplinary RTW intervention including occupational therapy was conducted five times a week for approximately three months, targeting individuals with mood and adjustment disorders who took a leave of absence. Their mental symptoms, cognitive functioning, job performance, temperament, social adaptation, psychosocial state, and readiness to RTW before and after the intervention were evaluated. Full-time RTW ratios at 3, 6, 12, 18, and 24 months from baseline were followed up and compared with those of prior studies. RESULTS: A total of 30 individuals completed the intervention. After the intervention, participants' psychological symptoms, cognitive function, vocational aptitude, temperament, social adaptation, psychosocial state, and readiness to RTW improved (p≤0.001–0.0279). The ratios of RTW at 3, 6, 12, 18, and 24 months from the baseline were 6.7%, 46.7%, 73.3%, 77.8%, and 82.6%, respectively, reflecting a higher pattern than prior reports. CONCLUSIONS: The interdisciplinary RTW intervention including occupational therapy has the potential to improve not only depressive symptoms but also cognitive functioning, job performance, social adaptation, and readiness to RTW. They can also raise RTW ratios. [ABSTRACT FROM AUTHOR]

In the UK and Japan, midwives provide health services for women with concerns about a genetic condition or who are considering antenatal screening. In both countries, competences related to genetic health care have been devised but there is little evidence about midwifery competence in practice. A systematic literature review was undertaken to determine the extent to which midwives are achieving the genetic competences that are prescribed for their practice. English and Japanese literature from January 1999 to March 2009 was retrieved. Original studies or reviews, in which an aspect of midwifery practice was related to genetic competences, were eligible for inclusion. After a critical appraisal, six UK and five Japanese papers were eligible for inclusion. The findings indicated that midwives are not achieving the competences, nor are they confident about their genetics knowledge. Moreover, women are not being supported to make informed decisions regarding antenatal screening. We have confirmed that little research is being undertaken in both countries regarding competency achievement in practice. Changes to midwifery curricula and further continuing education are required to ensure that midwives are able to provide effective care regarding genetics. [ABSTRACT FROM AUTHOR]

Aims and objectives: To clarify beliefs linked with depression among older adults with depression in Japan. Background: As a result of global population ageing, caring for older adults with depression has become an important issue worldwide. In this paper, the concept of "beliefs" pertains to phenomena that lead to distress about disease and can be alleviated through talk therapy. While previous studies focused on illness beliefs in people with mental illness and depression, no studies have yet focused on such beliefs among older adults with depression. Design: Qualitative, narrative‐research‐based method. Methods: Observation and 1–5 narrative interviews lasting 60–90 min were conducted with each of 19 older adults with depression in a Japanese psychiatric ward. The resulting narratives were thematically analysed to derive relevant themes and subthemes. Reporting of this research adheres to COREQ guidelines. Results: Four themes and twelve subthemes were revealed. Depression‐linked beliefs among older adults with depression were (1) "guilt and regret," (2) "pessimism," (3) "futility of treatment" and (4) "desire to be needed by loved ones and society." Conclusion: Depression‐linked beliefs among older adults with depression constituted spiritual pain reflecting character tendencies, including experiences of loss and developmental challenges related to ageing as well as subjects' natural diligence and consideration for others. Relevance to clinical practice: (1) Helping nurses better understand distress experienced by older adults with depression, who are prone to feel guilt and regret when reflecting on the past and to alleviate distress through dialogue and providing positive affirmation for patients. (2) To understand and assuage distress over experiences of loss in old age. (3) To help older adults with depression form a more relaxed attitude towards life, so that even if they have experienced loss as a result of old age, they can maintain their self‐esteem and existential sense of self‐worth. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to identify the following two research questions for paternal depression through a meta-analysis of relevant qualitative studies: 1. How has paternal depression been screened for by professionals? 2. What are the coping strategies /support available for paternal depression and the challenges in providing strategies/ support for paternal depression? Methods Relevant articles were identified using the following databases: CINAHL, MEDLINE, and Google Scholar. The search keywords used were 'support' AND 'postpartum depression of father' OR 'paternal depression' OR 'mental health of fathers' AND 'qualitative study' in the database. There were 32 qualitative articles retrieved from the database and through hand searching, of which 5 articles were included in the analysis. Meta-ethnography were utilised in this study. All analysed papers were scored and guaranteed by the Critical Appraisal Skills Program (CASP; 0-10 points) as valuable qualitative studies. The analysis was performed using NVivo 12 for Windows. Results In the present meta-synthesis, the Patient Health Questionnaire -9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire -15 (PHQ-15), and the List of Threatening Events were used to identify depression in fathers. Additionally, one study used the six criteria of the definition of postnatal depression to identify paternal depressive symptoms. As a result of the meta-synthesis, the following eight metaphors were extracted from all analyses articles: 'Triggers of paternal depression'; 'Awareness of paternal depression'; 'The Impact of paternal depression'; 'Coping'; 'Lack/unhelpful of information resources'; 'Barriers to seeking help'; 'Reasons for needing supports'; and 'Helps for paternal depression'. Paternal depression due to a sequence of triggering events and the perceived symptoms varied. Once fathers realized they had depression, they attempted to cope with it. However, there were inadequate therapies and information to cope with depression. Moreover, embarrassment of seeking help due to being male was also a barrier to coping with depression. In contrast, the responsibility to protect the family motivated them to acknowledge their depression and seek social support and professional help. Conclusion Anxiety and general depression scales were used to screen for paternal depression, and no measures for paternal depression were not used. Men who were aware of paternal depression tried to cope with it; however, it is possible that support for paternal depression was not sufficiently available and that masculinity may also be a barrier to seeking help for depression. On the other hand, the responsibility of protecting their families motivated fathers to be proactive in seeking help to overcome depression. [ABSTRACT FROM AUTHOR]

Culture influences the way health‐care professionals communicate with each other and their ability to relate to colleagues in an assertive manner. Cultural barriers can also make it difficult for nurses to speak up even when they have concerns about patient safety. An understanding of the potential impact of cultural factors is therefore needed when developing assertiveness communication training programs. This paper presents the findings from a study that explored Japanese nurses' perceptions of how culture and values impact assertive communication in health care. Semistructured interviews with 23 registered nurses were undertaken, and data were analyzed using directed content analysis. Two major themes were identified: collectivism and hierarchy/power. In the present study, we discuss the cultural values related to collectivism that included four categories of "wa" (harmony), "uchi to soto" (inside and outside), implicit communication/ambiguity, and "nemawashi" (groundwork). The findings highlight the impact of culture on nurses' assertive communication behaviors and can be used to inform the design of culturally‐appropriate assertiveness communication training programs for Japanese nurses working both within their own country or internationally. [ABSTRACT FROM AUTHOR]

This study investigated the different activities and distinctive roles undertaken by the 67 schools for the blind across Japan. A qualitative content analysis based on primary sources, including annual reports published by the Association of Principals of Schools for the Blind from 2011 to 2020 was conducted. From the identified activities, two themes: "activities targeted to individuals with visual impairment" and "activities targeted to environment of individuals with visual impairment," with nine total categories emerged. Several findings of this study corroborated those from previous research. However, this research elucidates how Japanese schools for the blind approach crucial elements needed in ensuring equal access to education and social participation for all students with visual impairment (VI) including those in mainstream classrooms. The findings highlight the complexity of the debate surrounding segregated schools in this era of inclusion and calls on policy makers and school administrators to adopt a more nuanced understanding of the roles these schools play in supporting inclusive education. [ABSTRACT FROM AUTHOR]

Background: Living in rural areas is a major contributor of health inequity. Tackling health inequity is important for primary care physicians. Therefore, it is important to compare the quality of primary care between rural and urban areas. To the best of our knowledge, this is the first study to examine the association between rurality and patient experience (PX) in Japan using validated measures. Methods: This cross-sectional study was conducted using online surveys. Participants were selected using a stratified random sample based on sex and age. The Japanese version of the Person-Centered Primary Care Measure (PCPCM) was used as an indicator of PX. We used the Rurality Index for Japan (RIJ) to measure rurality. Furthermore, we used multivariate linear regression analysis to examine the relationship between the RIJ and PCPCM after adjusting for confounders. Results: Of the 1112 eligible participants, 800 responded to the survey (response rate:71.9%). The mean PCPCM scores were 2.46 (standard deviation: 0.73) and median RIJ was 15 (interquartile range: 6–33). The crude and adjusted coefficients of rurality were − 0.02 (− 0.006–0.001, p = 0.114) and − 0.02 (− 0.005–0.001), respectively, demonstrating that rurality was not significantly associated with the total PCPCM score. Subgroup analyses were similar to the main analyses. Conclusion: We found that PX in primary care did not differ by rurality in the general Japanese population. [ABSTRACT FROM AUTHOR]

Background: The workload of public health nurses (PHNs) working for local governments has been increasing as health issues become more diverse and complicated. Even amidst the ongoing administrative and fiscal reforms, there is an urgent need to ensure how effectively and efficiently public health nurses can practice in health service development. The objective of this research was to clarify the actual conditions of best practice transfer (BPT) and its related factors. Methods: An anonymous postal and self-administered questionnaire survey was conducted among PHNs working at 334 sites, including the local government offices and health centers across Japan, and analysed mainly through logistic regression analysis. Results: One hundred eighty-five of the 334 institutions (55.4%) agreed to participate, and of the 966 questionnaire forms distributed, 709 forms (73.4%) were collected, of which 702 responses (72.7%) were valid. Although less than half (43.2%) have experience in BPT in health service development, more than 80% are willing to perform going forward. Significant factors for both the group with experience in BPT and the group with willingness to perform include an organizational culture that promotes BPT, as well as multiple elements of the workplace environment and facilitating factors related to knowledge and learning. The experienced group recognised the needs for criteria to evaluate the adaptability of best practice, while the willing group, to evaluate the quality of practice. Conclusions: Through a nationwide survey, this research elucidated for the first time the actual conditions of BPT by PHNs in Japan and related factors. The results indicated the importance of developing a system to promote BPT at the workplace level, also highlighted the importance for practitioners and experts, including researchers, to work together to develop practical guidelines to ensure evidence-based practices. Urgent actions are needed for the national and local governments to develop a system to promote BPT from diverse perspectives, building on the findings of this research. [ABSTRACT FROM AUTHOR]

While previous reports have established the anti-inflammatory effects of hangeshashinto, the intracellular signal transduction pathways involved have yet to be elucidated. We aim to employ an experimental system using oral cancer cells to assess the impact of hangeshashinto on intracellular signal transduction pathways in response to stimulation by Porphyromonas gingivalis pathogen-associated molecular patterns (PAMP). Hangeshashinto demonstrated the ability to inhibit the production of interleukin (IL)-6 and IL-8 induced by P. gingivalis PAMP. Furthermore, hangeshashinto suppressed the activation of the IL-6 promoter stimulated by PAMP. Hangeshashinto, like Toll-like receptor (TLR) signaling inhibitors (resatorvid and C29) and an immunosuppressant (dexamethasone), exhibited the ability to suppress TLR-mediated activation of the transcription factor nuclear factor-κB (NF-κB) in response to PAMP stimulation. This study suggests that the anti-inflammatory effects of hangeshashinto may be attributed to the inhibition of TLR signal transduction pathways including NF-κB activation, thereby suppressing NF-κB-dependent gene expression. [ABSTRACT FROM AUTHOR]

Lung cancer (LC) is currently the leading cause of cancer deaths in Japan. Early detection through lung cancer screening (LCS) is important for reducing mortality. Therefore, exploring the factors affecting willingness to undergo LCS, particularly among young people, is important. This study aimed to elucidate the inclination toward LCS and its determining factors among Japanese university students. This cross-sectional study, involving 10,969 Japanese university students, was conducted in April 2023. A Pearson's chi-square test and a binomial logistic regression analysis were used to analyze factors related to the dependent variable, willingness to undergo LCS in the future. Out of the 6779 participants (61.8%) involved in this study, 6504 (95.9%) provided valid responses, and 4609 (70.9%) expressed a willingness to undergo LCS in the future. Analysis revealed current smoking as a barrier to future willingness to undergo LCS. Other barriers included postponing the age of screening, anxiety about the screening content, and concerns about the possibility of having cancer after screening. Addressing barriers, such as current smoking and anxiety about screening, that prevent young people from undergoing LCS in the future is crucial. Therefore, universities should provide opportunities to educate students about LCS and explore various educational methods. [ABSTRACT FROM AUTHOR]

Background: Little information is available on the association between gender nonconformity during adolescence and subsequent mental health. While the distress related to gender nonconformity may be socially produced rather than attributed to individual-level factors, further research is needed to better understand the role of psychosocial factors in this context. Method: We analyzed data from the Tokyo Teen Cohort, obtained through random sampling of adolescents born between 2002 and 2004. We used inverse probability weighting to examine the association of gender nonconformity at ages 12 and 14 as a time-varying variable with subsequent mental health at age 16, while accounting for time-fixed and time-varying confounders. Furthermore, we used a weighting approach to investigate the mediating role of modifiable psychosocial factors in this association, addressing exposure-mediator and mediator–mediator interactions. Results: A total of 3171 participants were analyzed. Persistent gender nonconforming behavior at ages 12 and 14 was associated with subsequent depression (β = 2.02, 95% confidence interval [CI] 0.85 to 3.19) and psychotic experiences (β = 0.33, 95% CI 0.14 to 0.52) at age 16. The results remained robust in sensitivity analyses. Approximately 30% of the association between gender nonconformity and depression was consistently mediated by a set of psychosocial factors, namely loneliness, bullying victimization, and relationships with mother, father, and friends. Conclusions: Persistent gender nonconformity during adolescence is associated with subsequent mental health. Psychosocial factors play a vital mediating role in this association, highlighting the essential need for social intervention and change to reduce stigmatization and ameliorate mental health challenges. [ABSTRACT FROM AUTHOR]

Older adult patients account for 70% of all hospitalized patients in Japan, and intermediate care based on patient-centered care (PCC) that ensures continuity and quality of care at the interface between home services and acute care services and restores patient's independence and confidence is necessary for them to continue living independently. At present, no concept of intermediate care is established in Japan, and the implementation of PCC has been delayed. Thus, in this study, a Japanese version of the intermediate care evaluation index (patient-reported experience measure (PREM)) was created on the basis of the original PREM developed in the UK, and data in wards with intermediate care functions in Japan were collected to confirm internal consistency and validity from 2020 to 2022. The Japanese version of PREM was found to have a factor structure with two potential factors. Given the clear correlation with the shared decision-making evaluation index, which is the pinnacle of PCC, the theoretical validity of the Japanese version of PREM, which is based on PCC as a theoretical basis, was confirmed. [ABSTRACT FROM AUTHOR]

Exercise training integrating physical and cognitive activities is gaining attention because of its potential benefits for brain health. This study focuses on exercise training using a dart game called Wellness Darts. Wellness Darts is a sport involving throwing darts and walking to pull them out of the board, memorizing the score, and subtracting this from the total score, thus requiring the simultaneous performance of two tasks: exercise and calculation. This is expected to maintain and improve cognitive function, and whether this continual darts training affects brain function is of great interest. Before conducting the longitudinal study revealing its effect on brain function, we aimed to cross-sectionally confirm the difference in hemispheric lateralization between expert and non-expert players. Functional near-infrared spectroscopy (fNIRS) was used to measure brain activity for three groups: an expert older group who practiced darts continually, a non-expert older control group, and a non-expert younger control group. Their brain activity patterns were quantified by the lateralization index (LI) and compared between groups. The results showed that the younger and the expert older groups had significantly higher LI values than the non-expert older group, and there was no difference between the expert older and the younger groups. Our results suggest that the Wellness Darts game possibly promotes hemispheric lateralization. [ABSTRACT FROM AUTHOR]

Homicide followed by suicide (HS) is a tragic event with varied characteristics across countries and regions. Compared to Western countries, there are limited studies on HS in Asian countries. Therefore, this study aimed to clarify the characteristics of recent HS cases by examining forensic autopsy records from 2008 to 2020 collected from the Department of Legal Medicine, Chiba University, in Japan. A total of 77 HS cases were identified, involving 77 perpetrators (52 completed suicides, 25 attempted suicides), with 28 perpetrator and 89 victim autopsies. Our findings showed that older adults accounted for nearly half of the victims; victims were mostly females, whereas most perpetrators were male. The most common HS relationship was that between a parent and a child. Autopsy findings showed that the most common cause of death was strangulation, and illegal drugs were detected only in a few cases; however, psychotropic drugs were detected in child victims. No obvious evidence of past child physical abuse by caregivers was found. In contrast, intimate partner violence (IPV) was present, with a history of IPV found in half of HS cases involving adult intimate partner relationships. Notably, gender differences in age and relationship to the victim were identified. Likewise, some perpetrators may have expressed their plans and intentions for HS before the event, which may represent an important sign for HS prevention. However, to accurately reveal the course of HS, nationwide integrated statistics, forensic autopsies, including toxicological analyses of the deceased; and forensic psychiatric perspectives, including psychological autopsy, are required. [ABSTRACT FROM AUTHOR]

Background: The dysphoric milk ejection reflex (D-MER) is a reflex that causes temporary discomfort during milk ejection. D-MER develops due to the effects of hormones involved in lactation, and it has been reported that it is a physiological symptom different from postpartum depression, but the actual situation is unknown in Japan. Methods: This study was conducted using a self-administered, anonymous survey of mothers of children who had undergone health checkups at three years of age at five health centers in Kagoshima city and aimed to clarify the reality and perceptions of mothers regarding D-MER. The survey period was from May to September, 2022. The questionnaires were distributed to 389 mothers, and 216 (55.5% recovery rate) responses were received, of which 202 (valid response rate 93.5%) were included in the analysis. Results: Regarding the experience of D-MER, 202 mothers in the study population had given birth to a total of 403 children and experienced D-MER when breastfeeding 62 children (15.4%). Of the 202 mothers included in the analysis, 47 (23.3%) answered that they had experienced D-MER with at least one child while breastfeeding. Sixty-six mothers (32.7%) knew about D-MER. Compared to those who had not experienced D-MER, those who had experienced D-MER had significantly higher scores on the items related to having had trouble breastfeeding (odds ratio (OR]: 3.78; 95% confidence interval (CI]: 1.57, 9.09) and knowing about D-MER (OR 2.41; 95% CI 1.20, 4.84). Regarding symptoms, irritability (n = 24, 51.1%), anxiety (n = 22, 46.8%), and sadness (n = 18, 38.3%) ranked high. Coping strategies included distraction, focusing on the child, and, in some cases, cessation of breastfeeding. Thirty mothers (63.8%) answered that they did not consult anyone, citing reasons such as a belief that no one would be likely to understand their symptoms, and that they could not sufficiently explain their symptoms. Conclusion: The low level of awareness of D-MER suggests that it is necessary to inform and educate mothers and the public about the physiological symptoms of D-MER. Moreover, it is necessary to listen to the feelings of mothers with D-MER and support them in coping with their symptoms. [ABSTRACT FROM AUTHOR]

Background: This work investigated the differences in the biomechanical properties of open reduction and internal fixation (ORIF) and percutaneous minimally invasive fixation (PMIF) for the fixation of calcaneal fractures (Sanders type II and III calcaneal fractures as examples) through finite element analysis. Methods: Based on CT images of the human foot and ankle, according to the principle of three-point fixation, namely the sustentaculum tali, the anterior process and the calcaneal tuberosity were fixed. Three-dimensional finite element models of Sanders type II and III calcaneal fractures fixed by ORIF and PMIF were established. The proximal surfaces of the tibia, fibula and soft tissue were constrained, and ground reaction force and Achilles tendon force loads were added to simulate balanced standing. Results: The maximum stress was 80.54, 211.59 and 113.88 MPa for the calcaneus, screws and plates in the ORIF group and 70.02 and 209.46 MPa for the calcaneus and screws in the PMIF group, respectively; the maximum displacement was 0.26, 0.21 and 0.12 mm for the calcaneus, screws and plates in the ORIF group and 0.20 and 0.14 mm for the calcaneus and screws in the PMIF group, respectively. The values obtained from the simulation were within the permissible stress and elastic deformation range of the materials used in the model, and there was no significant stress concentration. The maximum stress and displacement of the calcaneus and implants were slightly lower in the PMIF group than in the ORIF group when fixing Sanders type II and III calcaneal fractures. Conclusions: This study may provide a reference for optimising the design of implants, the development of individualised preoperative plans and the choice of clinical surgical approach. [ABSTRACT FROM AUTHOR]

Introduction: The development of cultural sensitivity is essential for health care professionals but there are few tools to measure this quality in Japan. The purpose of this study was to develop a scale of cultural sensitivity for Japanese health care professionals and examine its reliability and validity. Method: A draft scale was created through conceptual analysis and a questionnaire was completed by 515 health care professionals and 1,322 college students. Exploratory and confirmatory factor analyses were used to determine suitable scale items and examine model fitness. Results: The four-factor 18-item scale showed acceptable model fitness. Cronbach's α coefficient exceeded.90 and correlation coefficients for criterion-related validity were over.29. Construct validity was confirmed by the significantly higher score of the cross-culturally experienced groups. The intraclass correlation coefficient was.642 (professionals) and.722 (students). Discussion: This reliable and valid scale for Japanese health professionals and college students may be used to evaluate training programs to increase their cultural sensitivity. [ABSTRACT FROM AUTHOR]

Background Although dysgeusia is a common adverse event in chemotherapy patients; it has not been evaluated using objective methods, and its prevalence and frequency have not been quantified. Methods Salt-impregnated taste strips were used to objectively assess dysgeusia in patients receiving chemotherapy at Akita University (n = 38) and those off chemotherapy (n = 9). Participant characteristics, and ongoing and previous chemotherapies were evaluated, and their associations with dysgeusia analyzed. Results Dysgeusia developed in 38.8% (14/38) of chemotherapy patients, and was most prevalent in patients receiving 5-fluorouracil (5-FU) or its oral analogs (48.1%, 13/27). Particularly, dysgeusia developed in 55.6% (10/18) of patients receiving oral 5-FU analogs; however, prevalence in patients receiving and off chemotherapy was not significantly different. Patients aged ≥70 years also tended to experience dysgeusia (75.0%, 6/8). Conclusions Association with dysgeusia may be higher for some chemotherapeutic drugs. Dysgeusia should be routinely assessed in chemotherapy patients with objective methods such as paper strips; interventions for its prevention may be required. [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]

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.