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While previous studies found that origami, when used for cognitive training and education, can improve spatial ability, the underlying mechanisms of this change, presumably associated with the origami folding process, remain unclear. In the present study, we focused on origami imagery in which participants imagined the process of folding paper to create a work of art; and we examined the cognitive factors involved in the imagery process and their association with mental transformations and the extent to which visual imagery was vivid. We identified four specific relevant cognitive factors in origami imagery: (a) controllability of origami transformations, (b) visual imagery of shapes, (c) hand sensations, and (d) visual imagery of colors. We associated the first two of these with non-rigid transformations: the controllability of origami transformations and the visual imagery of shapes. Moreover, vividness of visual imagery was related to all four cognitive factors. We propose this cognitive model of origami as one that considers the key relationships between origami imagery, mental transformations, and vividness of visual imagery. [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]

Introduction: Mental health is a serious concern among novice school nurses in Japan. Numerous novice school nurses with various health problems experience high stress levels, affecting their mental health. They may be experiencing reality shock, a known risk factor for burnout and turnover, or its factor, the "reality gap." Objective: This study aimed to examine the hypothetical model by which the reality gap affects the mental health of novice school nurses. Methods: This cross-sectional study conducted a self-administered questionnaire survey, and responses were obtained from 102 novice school nurses. A path model was created based on a hypothetical model. Results: After several revisions on the hypothesis model, a modified path model was generated (CFI =.98, TLI =.93, RMSEA =.06). The path model showed that reality gaps negatively affected work engagement, work engagement positively affected intention to stay, and intention to stay positively affected mental health. Reality gap was also directly negatively associated with mental health. Having various support networks reduced the effects of reality gaps on mental health. Additionally, social support in the workplace boosted work engagement. Conclusion: Unique from other studies, this study contributed to understanding the effects of reality gaps on mental health. School managers and administrators should establish a support system that enables school nurses to receive various supports from within and outside the school. In addition, novice school nurses should take advantage of networks and support inside and outside school to reduce reality gaps and grow as professionals. [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: Culturally appropriate communication training programs for a wide range of professions that can be used during infection epidemics are crucial for advance care planning implementation. Starting in 2018, the Japanese Ministry of Health, Labour and Welfare made a major policy change, and doctors, nurses, and social workers, and care managers were identified in the guidelines as the professions that promote advance care planning. Motivated by the lack of online programs for Japanese care managers, we proposed a new one-day program. Objectives: This study aimed to determine the changes in the positive attitude of care managers toward dying patients compared to that of nurses, which has been used in past literature as an outcome of advance care planning educational interventions, after administering the program in Japan. Design: Before-after comparison study. Methods: Care managers were recruited through our website, ACP-Piece, http://plaza.umin.ac.jp/~acp-piece/piece.html. A questionnaire survey concerning positive attitudes toward dying patients was administered before and after the program on 28 August 2021. Sixty-six subjects participated in the training and 60 participants, including 14 care managers, consented to the study and completed the questionnaire surveys before and after the program. Results: The Frommelt attitude toward care of the dying scores for care managers increased after the program (p -values, confidence intervals, and effect sizes: p < 0.001, −11.90 to −4.388, −1.252). After training, care managers had a significantly higher maximum score occurrence than nurses. Older care managers with advance care planning experience may have had a higher maximum score occurrence compared to younger, inexperienced participants. Conclusion: To our knowledge, this is the first to demonstrate the increased positive attitude scores toward dying patients after online communication training for Japanese care managers. The limitations of this study include the lack of evidence regarding reasons for score changes, long-term score changes, and effectiveness for patients and their families. [ABSTRACT FROM AUTHOR]

Background: Little League elbow, including humeral epicondylitis and osteochondritis dissecans, is a severe throwing injury in school-aged pitchers. Recent rule revisions have been implemented, and thus, prevention awareness may have increased. Purpose: To compare the incidence of elbow injury in 2011 from a previous study with that in 2021 and examine changes in the incidence and characteristics of players with elbow injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A survey based on the 2011 survey was conducted from September 1 to December 31, 2021, among 4060 third- to sixth-grade Little League players belonging to 203 teams in Kyoto, Japan. This survey included a 23-item checklist on physical condition and injury. The participants were classified into 2 groups according to the presence or absence of an elbow injury in the dominant arm during the season. The Wilcoxon rank-sum test was conducted to compare differences in basic information between the 2 groups. We also compared the differences in the 23 checklist items between the 2 groups using the chi-square or Fisher exact probability test. Results: Overall, 98 teams (1335 players; age range, 8-12 years) returned the questionnaires (collection rate, 32.9%). The final analysis population (excluding incomplete questionnaires) was 678 (mean age, 10.6 ± 1.1 years). Elbow injuries accounted for 30.7% of all injury sites in the players. Overall, 61 players (9.0%) reported elbow injuries in 2021 compared with 19.1% of the players in the 2011 survey (P <.01) A significantly higher percentage of players with elbow injuries had elbow pain in extension (item 2 on the survey checklist, P <.001) and flexion (item 4, P <.0024), were regular players (item 5, P =.0288), played baseball under fatigue (item 8, P =.0028), and had lower and upper limb inflexibility (item 17, P =.0379; item 18, P =.0146; and item 22, P =.0085). Conclusion: Study findings indicated that the incidence of elbow injuries has decreased significantly over the past 10 years, although the elbow joint still accounted for almost one-third of all injuries in Japanese youth baseball players. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Japanese version of the Life Skills Scale for Adolescents and Adults (LSSAA) into Chinese, English, and Korean, simplify it, and assess its reliability and validity. Validation was performed using individual data of 9941 high-school students from China, Japan, Korea, and the United States collected by the 2021 "Survey on Experiences and Attitudes Related to the Corona Crisis" conducted by the National Institution For Youth Education. Confirmatory factor analysis showed that the four-factor model of the LSSAA fit the data for all four countries. Testing of the measurement invariance of the four-factor model among the four countries supported the adoption of a weak invariance model, and the LSSAA scores were comparable across all four countries. These results suggest that the LSSAA has good reliability and validity and applies to adolescents in English-speaking countries and some Asian counties. [ABSTRACT FROM AUTHOR]

This study aims to analyze associations between lifestyle-related factors and body mass index (BMI) and blood pressure (BP) in middle-aged and older people in Japan. An association analysis using a multilevel model with demographic and lifestyle-related factors as variables and with BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) as outcomes was conducted. Among the modifiable lifestyle factors, we found a significant dose-response association for BMI and slower eating (fast: reference; normal: −0.123 kg/m2 and slow: −0.256 kg/m2). Consuming >60 g/d ethanol was significantly associated, before and after adjustment for BMI, with an increase in SBP of 3.109 and 2.893 mm Hg, respectively. These findings suggested that health guidance should focus on factors such as the eating rate and drinking habits. [ABSTRACT FROM AUTHOR]

Increasing numbers of older workers continue to work after being eligible to claim a state pension, yet little is known about the quality of these jobs. We examine how psychosocial and physical job quality as well as job satisfaction vary over the late career in three contrasting national settings: Sweden, Japan and the United States. Analyses using random effects modelling drew on data from the Swedish Longitudinal Occupational Survey of Health (n = 13,936-15,520), Japanese Study of Ageing and Retirement (n = 3704) and the Health and Retirement Study (n = 6239 and 8002). Age was modelled with spline functions in which two knots were placed at ages indicating eligibility for pensions claiming or mandatory retirement. In each country, post-pensionable-age jobs were generally less stressful, freer and more satisfying than jobs held by younger workers, results that held irrespective of gender or education level. [ABSTRACT FROM AUTHOR]

Background: Nurses are expected to make and implement autonomous decisions to provide patients with excellent quality nursing while practicing complex, high-level care. However, studies have shown that nursing practice based on autonomous decision-making is difficult, and a gap exists between decision-making and implementation. Research question/aim/objectives: This study aims to clarify trends among nursing professionals who recognize they are practicing ethical behavior in their nursing practice. Research design/Participants and research context: We surveyed the basic attributes of and used the Ode's Ethical Behavior Scale for Nurses with 3467 nursing professionals working at 34 hospitals in suburban cities of Japan and investigated the relationships among these factors. Ethical considerations: This study was approved by the appropriate research ethics committee. The Ethical Behavior Scale for Nurses was used with the authors' permission. Findings/results: Significant differences were found in the mean "ethical behavior" scores between nurses and licensed practical nurses and midwives and licensed practical nurses. Mean scores for the "justice" subscale differed significantly between the low experience group and mid-level experience group and between the high experience group and mid-level experience group. Significant differences were also found in the mean scores between those with ethics education experience and those without, those with ethics training experience and those without, and those with ethics conference experience and those without. Discussion: Midwives and nurses had higher ethical behaviors than licensed practical nurses. Nursing professionals with low and high experience had higher justice scores than those with mid-level experience. Finally, nursing professionals with ethics education, training, or conference experience had higher ethical behavior than those without such experience. Conclusion: Nursing professionals who recognize they are practicing ethical behavior tend to be midwives or nurses with low or high levels of experience who attended ethics education, training, or conferences. [ABSTRACT FROM AUTHOR]

Background: Hikikomori, a clinical condition widely studied in Japan, is receiving increasing attention in Western Countries. Aims: This study aimed to create a new instrument for evaluating the risk of Hikikomori in both Eastern and Western countries. Methods: Through two studies on Italian adolescents, youths, and adults (n = 1,285) and a study on Japanese youths and adults (n = 392), we analyzed the psychometric properties of the Hikikomori Risk Inventory (HRI-24). Results: We found support, in both the Italian and Japanese samples, for the good and stable factor structure of the scale (CFI = 0.94, RMSEA = 0.057 for both the adult samples), as well as for its convergent and divergent validity. Conclusions: The HRI-24 might be used in future studies in both Western and Eastern countries to shed light on the features of this clinical disorder in different cultures. This will allow the development of culture-sensitive preventive and clinical interventions. [ABSTRACT FROM AUTHOR]

Introduction: This pilot randomized controlled trial assessed the effectiveness of a nurse–occupational therapist meeting on improving motor and social-cognitive functions, as well as motivation, in a subacute hospital setting. Methods: Participants were randomized to a weekly multidisciplinary team meeting group ('control', n = 20) or a nurse–occupational therapist meeting group ('intervention', n = 18). Medical care plans in both groups were discussed in the weekly meeting. In addition, the details of daily life problems for the intervention patients were discussed in the nurse–occupational therapist meeting. Outcome measures included motor and social-cognitive functions assessed by the Functional Independence Measure and motivation assessed by the Vitality Index. Assessment time points were at admission and discharge. Results: In the intervention group, additional improvements were found in the Functional Independence Measure cognitive (p = 0.048, r = 0.32) and the Vitality Index (p = 0.027, r = 0.36), whereas the Functional Independence Measure motor was improved in both groups (p ≤ 0.018, r ≥ 0.52). Conclusion: We found significant improvement in motor function in both groups and additional improvements in social-cognitive function and motivation in the intervention group. These observations suggest that collaborative practice between nurses and occupational therapists could improve functions underlying independent daily life in hospitalized elderly patients. [ABSTRACT FROM AUTHOR]

Background: Distrust in authorities has negative effects on mental health. Aims: In this study, we aimed to explore whether the impact of distrust in government on mental health became stronger in the area heavily affected by the 2011 Fukushima nuclear power plant accident. Methods: We examined the effects of distrust in the national government on depressive symptoms three years after the accident among community residents in Fukushima prefecture using those in the Kanto area (the area surrounding Tokyo) as a control. A questionnaire survey was administered to a random sample of 1000 residents in Fukushima prefecture and 1650 residents in the Kanto area. Distrust in the national government was assessed using a four-point single-item scale. Depressive symptoms were measured using the Patient Health Questionnaire-9. The associations of residential area (i.e. living in Fukushima prefecture or in the Kanto area) and distrust in the national government with depressive symptoms were examined, controlling for socio-demographic characteristics and disaster-related experiences using multivariate linear regression analyses. We used the interaction term of residential area and distrust in the government to explore the difference in the association between the respondents in Fukushima prefecture and those in the Kanto area. Results: Valid responses were obtained from 976 (36.8%) residents. Distrust in the government was associated with depressive symptoms and the association was stronger in Fukushima prefecture than in the Kanto area. Conclusion: The deleterious effects of distrust in the government on mental health may become more serious after a nuclear power plant accident and require careful attention during support activities in an affected area. [ABSTRACT FROM AUTHOR]

How do authoritarian leaders in modern organizations influence work team emotional climate and performance? Defining authoritarian leadership as an ambient, demanding, and controlling leadership style, we conducted a survey study of 252 leaders and 765 subordinates matched in 227 work teams in three large public Japanese organizations. The results indicate that authoritarian leaders are more likely to create a team climate of emotion suppression, which induces a higher level of team emotional exhaustion that negatively impacts team performance. Furthermore, we found that authoritarian leaders' own emotion suppression enhances the above sequential mediation effects, i.e. the more emotion suppression the authoritarian leader him/herself exercises, the stronger the team climate of emotion suppression, the higher the level of team emotional exhaustion, and the lower the team performance. These findings suggest that leadership effectiveness may be improved if leaders can reduce their authoritarian behaviors and identify appropriate channels for employees to release emotions in the workplace. [ABSTRACT FROM AUTHOR]

Objective: To compare the 1-year outcomes of patients with lumbar spinal stenosis treated with supervised physical therapy or unsupervised exercise. Design: A single-center randomized controlled trial with concealed allocation, blinded assessor and intention-to-treat analysis. Setting: Spine care center. Subjects: A total of 86 patients presenting with symptoms of neurogenic claudication caused by lumbar spinal stenosis. Interventions: The physical therapy group received supervised physical therapy sessions twice a week for 6 weeks and home exercise program. The home exercise group received 6-week home exercise program only. Main measures: The primary outcome was symptom severity on the Zurich claudication questionnaire at 1 year. Secondary outcomes included physical function, pain, health-related quality of life and the surgery rate after 1 year. Results: At 1 year, more patients in the physical therapy group than in the home exercise group achieved minimum clinically important differences in Zurich claudication questionnaire symptom severity (60.5% vs 32.6%; adjusted odds ratio [AOR] 4.3, [95% CI [1.5–12.3], P = 0.01); Zurich claudication questionnaire physical function (55.8% vs 32.6%; AOR 3.0 [1.1–8.1], P = 0.03); SF-36 bodily pain (48.8% vs 25.6%; AOR 2.8 [1.1–7.3], P = 0.03), and SF-36 general health (20.9% vs 7.0%; AOR 6.1 [1.1–33.0], P = 0.04). The surgery rate at 1 year was lower in the physical therapy than in the home exercise group (7.0% vs 23.3%; AOR 0.2 [0.04–0.9] P = 0.04). Conclusions: Supervised physical therapy produced greater improvements in symptom severity and physical function than unsupervised exercise and was associated with lower likelihood of receiving surgery within 1 year. [ABSTRACT FROM AUTHOR]

Background: Although advance care planning discussions are increasingly accepted worldwide, their ideal timing is uncertain and cultural factors may pertain. Aim: To evaluate timing and factors affecting initiation of advance care planning discussions for adult patients in Japan and Taiwan. Design: Mixed-methods questionnaire survey to quantitatively determine percentages of patients willing to initiate advance care planning discussions at four stages of illness trajectory ranging from healthy to undeniably ill, and to identify qualitative perceptions underlying preferred timing. Setting/participants: Patients aged 40–75 years visiting outpatient departments at four Japanese and two Taiwanese hospitals were randomly recruited. Results: Overall (of 700 respondents), 72% (of 365) in Japan and 84% (of 335) in Taiwan (p < 0.001) accepted discussion before illness. In Japan, factors associated with willingness before illness were younger age and rejection of life-sustaining treatments; in Taiwan, older age, stronger social support, and rejection of life-sustaining treatments. Four main categories of attitudes were extracted: the most common welcomed discussion as a wise precaution, responses in this first category outnumbered preference for postponement of discussion until imminent end of life, acceptance of the universal inevitability of death, and preference for discussion at healthcare providers' initiative. Conclusion: The majority of patients are willing to begin discussion before their health is severely compromised; about one out of five patients are unwilling to begin until clearly facing death. To promote advance care planning, healthcare providers must be mindful of patients' preferences and factors associated with acceptance and reluctance to initiate advance care planning. [ABSTRACT FROM AUTHOR]

Background: Protecting the dignity of elderly residents of facilities and providing dignified care can be difficult. Although attempts have been made from several aspects, dignity is considered an area in which less real impact has been made in both theory and practice. Objective: The objective of this study is to characterize the concept of dignity in care for elderly subjects in residential facilities from a practical perspective through concept synthesis. Research design: This study includes in-depth interviews with residents of elderly facilities and a literature review. Participants and research context: A total of 12 residents of seven facilities in three prefectures in Japan were recruited via purposive sampling, and 27 interviews were conducted. Each digitally recorded interview was transcribed verbatim. The interview data were analyzed based on hermeneutic phenomenological research. The literature was searched using PubMed, CINAHL, and Web of Science with combinations of terms such as dignity, elderly, and residential facilities and then selected according to the predefined inclusion criteria. The descriptions about dignity in the included studies were divided into codes and compared with the results of the interviews. Ethical considerations: This study was approved by the institutional review board of Nagoya University's Graduate School of Medicine. Findings and discussion: There were 1728 data codes for the interviews from which four themes were generated. In the literature review, 3716 titles were searched, and 28 articles were selected. Combining these results, five following themes and a conceptual matrix were obtained: individual dignity not affected by others ; dignified care in a narrow sense ; elements of the staff side ; dignity in relation to family members, friends, society, and other residents ; and dignity in relation to nursing care facilities and the nursing care system. Conclusion: According to the established matrix, we must consider the role of the care system, facility, family, and society in providing care with dignity and the individual dignity to residents and dignity in daily care. [ABSTRACT FROM AUTHOR]

This study examined the assessment criteria based on which care managers (CMs) decide to commence home-visit nursing to develop a common assessment scale to guide CMs in making sound decisions about whether to commence home-visit nursing. For this purpose, we conducted a postal survey of 200 CMs. After removing 17 items from the questionnaire based on item analysis, we analyzed the remaining factors to confirm construct validity. This factor analysis identified 96 items comprising the following four factors: (1) the daily life condition of users and the support required by them, (2) strengthening medical support, (3) scheduling medical treatment/management or recuperation, and (4) preparing for users' mental and physical changes and preventing the deterioration of the situation. The results of the study indicate the first step in the process of developing a common assessment scale; in this study, we clarified the general factors that underpin a decision to commence home-visit nursing and the relationships among the items for each factor. [ABSTRACT FROM AUTHOR]

Background: Moral distress occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Moral distress was found to cause negative feelings, burnout, and/or resignation. Not only external factors such as lack of staff but also internal ones affect moral distress. Moral sensitivity, which is thought of as an advantage of nurses, could effect moral distress, as nurses being unaware of existing ethical problems must feel little distress. Objectives: To examine the impact of moral sensitivity on moral distress among psychiatric nurses, and affirm the hypothesis that nurses with higher moral sensitivity will suffer moral distress more than nurses with less moral sensitivity in two different samples. Ethical consideration: The study obtained ethical approval from the Research Ethics Committee of the Faculty of Medicine at Mie University (# 1111, 20.4.2010), and by the Turku University Ethics Board (29.5.2012). Permissions to undertake the study was obtained from the in two hospital districts and in one city (§ 48/4.10.2012, § 63/4.9.2012, 51/2012 27.8.2012). Informed consent was not formally obtained, because the questionnaire was anonymously reported by the participants who volunteered to answer. The participants responded voluntarily and anonymously. Methods: An anonymous questionnaire containing the Revised Moral Sensitivity Questionnaire and the Moral Distress Scale for Psychiatric nurses was conducted to 997 nurses in 12 hospitals in Japan, and 974 nurses in 10 hospitals in Finland after obtaining of approval by research ethics committees. Data were analyzed using a multi-group structural equation model analysis. Findings: A set of analyses imply that the association of moral sensitivity with moral distress is significant and similar between Japan and Finland, whereas the factor structures of moral sensitivity and moral distress may be partially different. Discussion: The result of this study may indicate that nurses with high moral sensitivity can sense and identify moral problems, but not resolve them. Therefore, supporting nurses to solve ethical problems, not benumbing them, can be important for better nursing care and prevention of nurses' resignation. Conclusion: Moral sensitivity and moral distress were positively correlated among psychiatric nurses in both Japan and Finland, although the participating nurses from the two countries were different in qualification, age, and cultural background. Nurses with high moral sensitivity suffer from moral distress. [ABSTRACT FROM AUTHOR]

Several reports have indicated that grief and mental health outcomes of people bereaved by suicide vary by their relationship to the deceased. Parents who have lost offspring experience higher levels of distress than those with other relationships to the deceased. However, there are limited studies investigating the experience of parental bereavement by suicide, and further research is needed. The present study aimed to clarify the differences in grief reactions between bereaved parents and those with other relationships to the deceased in Japan and explore a statistical model of adaptation to the loss. In total, 105 bereaved participants completed a questionnaire covering grief reaction, meaning reconstruction, mental health, social context, and demographic variables. Parents scored higher on several grief reaction items and lower in sense-making than those with other relationships. In addition, path analysis showed that sense-making acted as a moderator in the experience of loss of offspring and grief reaction. [ABSTRACT FROM AUTHOR]

Background: Limited data regarding knowledge and factors related to understanding the adverse drug reaction (ADR) reporting system of health care professionals are available in Japan. Objective: The objective of this study was to identify factors related to understanding the ADR reporting system in Miyagi Cancer Center and to find ways to increase the number and quality of ADR reports. Methods: Self-administered questionnaire surveys were administered before and after the educational meeting among health care professionals who were working in our hospital during the study period. Subanalyses restricted to nurses were also performed. Main Outcome Measure: Understanding ADR reporting system among healthcare professionals. Results: The percentage of respondents who understood the ADR reporting system in the questionnaire after the educational meeting was significantly higher than that in the questionnaire before the educational meeting. In the questionnaire after the educational meeting, multivariate logistic regression analysis found that having over 30 years of practical experience (odds ratio [OR], 3.852; 95% confidence interval [CI], 1.228-12.081 for 20-29 years, 7.695; 1.650-35.881 for over 30 years), being a physician (8.071; 1.923-33.878), being a pharmacist (18.357; 3.847-87.585), and participating in the educational meeting (5.111; 1.700-15.365) were factors associated with understanding the ADR reporting system. Multivariate logistic regression analysis of the questionnaire results before the educational meeting among nurses showed that working at outpatient departments (8.330; 3.008-23.069) was significantly and independently associated with understanding the ADR reporting system. Conclusions: The present study demonstrated that many years of practical experience, profession (physicians, pharmacists), and educational interventions were associated with good understanding of the ADR reporting system among health care professionals. [ABSTRACT FROM AUTHOR]

In this study, we translated the Adolescent Time Inventory–Time Attitudes (ATI-TA) scale into Japanese and examined the internal consistency and structural and convergent validity of ATI-TA scores in a sample of 383 Japanese high school students aged 15 to 18 years. The ATI-TA consists of six subscales assessing two valences (positive and negative) for each of three time periods (past, present, and future). Internal consistency estimates for scores on the ATI-TA were over .79. Confirmatory factor analysis indicated that a six-factor model yielded the best fit to scores. Correlations among ATI-TA scores, time attitudes assessed by the semantic differential method, educational career planning, and self-esteem were consistent with our hypotheses. Our results provide evidence that scores on the Japanese version of the ATI-TA are reliable and valid, and thus potentially useful for research in this cultural context. [ABSTRACT FROM AUTHOR]

The present qualitative study aims to shed light on the job satisfaction of home-visit care workers in Japan. A total of 19 participants were recruited from two rural, three suburban, and one urban area in and around Nagoya city. The qualitative data were collected through individual or group interviews from May to August of 2017. The interviews were conducted using an open-ended questionnaire concerning job satisfaction. Qualitative content analysis was used to systematically identify ideas and patterns emerging from the interview data. Three main themes emerged from the analysis: client–worker conflict, public opinion about the profession, and changing but rewarding work. Home-visit care workers enjoy working in an environment where communication is highly valued, and appreciate the diversity of their clients' personalities. [ABSTRACT FROM AUTHOR]

The present study aimed to explore how different health-related domains of health literacy, as measured by the European Health Literacy Survey Questionnaire, were associated with health-related behaviors among a general population in Japan. We conducted a cross-sectional observational study of 1002 Japanese residents. Our questionnaire addressed socioeconomic status, health status, health-related behaviors, and health literacy. Among the 3 health-related domains of health literacy (health care, disease prevention, and health promotion), a multivariate model revealed that the disease prevention domain was associated with exercise behavior and alcohol consumption. The health promotion domain was associated with dietary behavior and exercise behavior. There were strong correlations among all health-related domains of health literacy; however, there were different associations between health literacy and health-related behaviors depending on those domains. Additional research is needed to determine how and to what extent each domain of health literacy is related to what health behaviors and outcomes. [ABSTRACT FROM AUTHOR]

Objective Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders and is characterized by recurrent abdominal pain or abnormal defecation. This investigation evaluated the relationship between IBS and self-reported quality of life in a community-dwelling population in Japan. Methods For this cross-sectional survey, we enrolled 1002 volunteers who participated in the Iwaki Health Promotion Project in 2013. IBS symptoms were evaluated using the criteria from the Japanese version of the Rome III Questionnaire. The assessments included an interview to obtain sociodemographic data, the second version of the Short-Form Health Survey (SF-36), and the Center for Epidemiologic Studies Depression Scale. Multiple regression analysis was used to assess the relationship between IBS symptoms and scores on the SF-36. Results A total of 59 subjects (5.9%) were classified as having IBS. Scores for all eight domains of the SF-36, the physical component summary, and the mental component summary were significantly and negatively associated with the Center for Epidemiologic Studies Depression scores. Physical functioning, role physical, vitality, mental health, and physical component summary scores were significantly and negatively associated with IBS. Conclusions The burden of IBS symptoms affects both physical and mental wellbeing, even after adjusting for confounders. Our findings suggest that screening for IBS symptoms and evaluating the need for medical care is important for community health workers. [ABSTRACT FROM AUTHOR]

Japanese communication relies heavily on nonverbal cues and context. The purpose of this study was to examine the impact of video-mediated communication (VMC) on communication satisfaction and marital relationships in young couples separated during the perinatal period as they honor the Japanese tradition of Satogaeri Bunben. Couples were assigned to the VMC treatment group (n = 14) or control group (n = 13). A mixed-methods approach to data collection and analysis was used. Longitudinal quantitative analysis from the Primary Communication Inventory and Intimate Bond Measure revealed significant differences between the Husband groups. Primary Communication Inventory and Intimate Bond Measure were strongly correlated regardless of group. Qualitative analysis of participant diaries revealed the addition of visual cues helped create a sense of “virtual co-presence,” which was both positive and negative. In conclusion, VMC appears to improve communication in the separated Japanese perinatal couples, especially through the addition of visual cues provided with VMC. [ABSTRACT FROM AUTHOR]

With the growing focus on continuous professional development, demands placed on nurses to uphold nursing competence have been increasing. This study examined how nurses with different lengths of clinical experience perceived the relationship between their actual competence and the competence they felt was demanded of them, and how this relationship was related to their turnover intentions. Survey questionnaires were distributed to 1,377 nurses, of whom 765 returned usable completed forms. The results showed that across all the groups of clinical experience, nurses perceived the demanded competence levels to be higher than their actual competence levels. However, turnover intentions were not related to nurses’ perceptions of demanded competence and were negatively related to perceptions of actual competence. The levels of competence demanded should not be considered as threats for nurses. Improving nurses’ competence may reduce their turnover intentions. [ABSTRACT FROM AUTHOR]

Background: The number of HIV-infected patients who require palliative or end-of-life care is increasing, and the status of end-of-life care for HIV patients with malignancies is unclear. Aim: This study aimed to evaluate the end-of-life care provided to HIV patients with malignancies in Japan. Design: National cross-sectional questionnaire-based survey. Setting/participants: Questionnaires were delivered to the medical staff of 378 regional core hospitals/core hospitals for AIDS and 285 palliative care units in Japan. Data were collected between August and October 2013. Results: Overall, 226 regional core hospitals/core hospitals for AIDS (59.8%) responded. A total of 55 institutions (24.3%) provided end-of-life care to HIV patients with malignancies. Regarding the place of death of the patients, 69.1% died at the institution whereas 18.2% were transferred to palliative care units. The requests of 16 (29.1%) institutions to transfer patients to palliative care units were rejected. Of the 378 palliative care units, 179 (62.8%) responded. While 13 palliative care units (4.6%) provided care to hospitalized HIV patients with malignancies, 20 (11.2%) refused to accept these patients for treatment because of a lack of experience in treating these patients and a lack of knowledge regarding HIV infection. Conclusion: Our findings suggest that in Japan, HIV patients with malignancies have difficulties obtaining hospitalization at a palliative care unit, which is likely due to a lack of experience among the professionals in treating such patients as well as a lack of knowledge about HIV. [ABSTRACT FROM AUTHOR]

Background: Chief nurses are most likely to take the lead in discussing and working to resolve ethical dilemmas, creating an ethical culture within their organization that results in effective ethics training. As the first step in this process, there is a need to define the kinds of ethical dilemmas that chief nurses grapple with on a regular basis as a target for future study. Research design: Anonymous written questionnaires and semi-structured interviews. Ethical considerations: All research procedures were approved by the Chubu University Ethics Review Board, the research institution to which the authors belong (authorization no. 250016). Findings and discussion: Responses from four chief nurses indicated that ethical dilemmas could be categorized as either those related to patient dignity or those related to management (unique to their roles as administrators). It was also learned that chief nurses struggle with the fact that although they consult with their superiors and others, these efforts do not lead to resolution. The expectation is that going forward, chief nurses will play a central role in acting as coordinators with physicians to promote better communication as well as lead group discussions aimed at providing care that respects patient dignity. [ABSTRACT FROM AUTHOR]

This study measured implicit and explicit attitudes toward major nursing safety violations using the Implicit Association Test (IAT) and self-reported questionnaires, respectively. Experiment 1 sampled nursing students (n = 71), and Experiment 2 sampled patient safety nurses (n = 38). Although reaction time to IAT stimuli of major nursing safety violations was quicker than of general nursing behaviors, error trials did not reveal a significant difference between IAT stimuli of major nursing safety violations and of general nursing behaviors in Experiment 1. Explicit attitude was related with intention to violate safety protocols in Experiment 1. In Experiment 2, both reaction time and error trials showed significant differences between IAT stimuli of major nursing safety violations and of general nursing behaviors. This was interpreted in that patient safety nurses had formed a firm implicit attitude, unlike the nursing students; however, the findings suggested that attitudes were not related to violations in nursing. [ABSTRACT FROM AUTHOR]

Using a sample of 116 Japanese men who had been placed under parole/probationary supervision or released from prison, the present study examined standardization, reliability, and validation of the Japanese Criminal Thinking Inventory (JCTI) that was based on the short form of the Psychological Inventory of Criminal Thinking Styles (PICTS), a self-rating instrument designed to evaluate cognitive patterns specific to criminal conduct. An exploratory factor analysis revealed that four dimensions adequately captured the structure of the JCTI, and the resultant 17-item JCTI demonstrated high internal consistency. Compared with the Japanese version of the Buss-Perry Aggression Questionnaire (BAQ), the JCTI showed a favorable pattern of criterion-related validity. Prior criminal environment and drug abuse as the most recent offense also significantly correlated with the JCTI total score. Overall, the JCTI possesses an important implication for offender rehabilitation as it identifies relevant cognitive targets and assesses offender progress. [ABSTRACT FROM AUTHOR]

We test the Spiral of Silence theory about Internet use in Japanese Internet society. We looked at Twitter and analyzed whether the Spiral of Silence theory would hold for it. Twitter's speed and scope of information dissemination is fast and extremely wide ranging. For these reasons, Twitter is an appropriate field for analyzing the influences of the Internet on the formation of public opinion. By integrating social investigation and behavioral log analysis, we test a model that incorporates an individual's attitudes (measured via a questionnaire) and an individual's communication network structure and actual communication behavior (measured via behavior log analysis). The results from our analysis show a positive correlation between individuals' perception that their opinion represents the majority view and the number of times they have spoken out. Moreover, while homogeneity of opinions of a personal network on Twitter influenced speaking out by a majority group, homogeneity of opinions does not influence speaking out by a minority group. [ABSTRACT FROM AUTHOR]

Japan is facing an unprecedented aging society. In 2013, 25.1% of the total population in Japan was 65 years old and over. One third of the population in Japan will be at least 65 years old in 2035; healthy aging is crucial for public health and society in Japan. Under the budget limitations of social security, policies and frequent policy changes have created great uncertainty and concern for the elderly population. Given these circumstances, we conducted questionnaire surveys in 2010 to examine concerns in this age-group. In 2010, we sent questionnaires to university graduates 65 years old and older, randomly selected from a list of an alumni association of 11 universities. The questionnaires were open-ended and asked them to write any concerns that they had about health care, health policy, health systems, and their future. We received 344 responses. Among those who responded, 271 (78.8%) respondents said that they had concerns. We conducted a text analysis (Trend Search–Keyword Associator 2008) and extracted the keywords from their responses. The keywords that were extracted frequently included hospitals, doctors, health-care system, health care, Japanese government policies, government, medical insurance system for the elderly, support, increase, copayment, health (their own), scarcities, and burdens. In this study, many elderly people in Japan are concerned about health-care expenditures, health-care systems, and health policies. This may be caused by frequent health policy changes and uncertainty due to frequent administration changes such as the lack of clarity concerning raising the out of pocket payment rate from 10% to 20% for elderly people under budget constraints in Japan. Correct policy making and determination to eliminate the concerns from this vulnerable population in Japan are necessary for healthy aging. [ABSTRACT FROM AUTHOR]

The article discusses a study which assessed whether the Daily Cognition and Behavior for Alzheimer's Disease (DCB-AD) scale might help in monitoring changes in cognition and behavior among patients with Alzheimer's disease. Topics covered include the prevalence of AD in Japan which accounted for the greatest morbidity rate among older people with dementia, methods used in the study, and the scores for the DCB-AD scale which indicated a declining pattern similar to those for the other scales.

Using 2002 International Social Survey Programme data, this study examines the association between women’s economic resources (full-time employment, educational attainment, and income) and their attitudes toward marriage across 31 countries (N = 14,827). The focus of this study is to test whether state policy to reduce work–family conflict (shorter working hour schedules and enhancement of public child care services and parental leave) explains cross-national differences in the association between women’s economic independence and their attitudes toward marriage. The results show that highly educated women have negative attitudes toward marriage only in countries with long average working hours. Also, in countries with generous public child care services, the positive effect of educational attainment is stronger. These findings suggest that it is not women’s economic independence per se that reduces attractiveness of marriage; instead, it is the incompatibility between work and family life that lowers women’s marriage aspirations. [ABSTRACT FROM PUBLISHER]

OBJECTIVE: To examine the educational effects of a tailored leaflet on current drinking behavior, thoughts about drinking alcohol during pregnancy, and knowledge of fetal alcohol syndrome (FAS) among pregnant women. DESIGN: Intervention. PARTICIPANTS: We recruited pregnant women who were participating in maternity classes held at five municipal health centers in Saitama Prefecture and Tokyo in Japan. METHODS: Questionnaires were administered before and after distribution of either a tailored or a non-tailored leaflet and again after the women delivered their babies. RESULTS: More women read the non-tailored leaflet than the tailored one; this was because they felt they could read the non-tailored leaflet immediately. As for educational effects, the tailored leaflet was not superior to the non-tailored one in changing the women's behavior, thoughts, or knowledge. CONCLUSION: It is more important for health education leaflets to seem easy to read in terms of volume than to be tailored. [ABSTRACT FROM AUTHOR]

The article presents a study on various factors of social workers' positions towards suicide. It states that the study mailed a self-administered questionnaire to participants who are registered with the Japanese Association of Certified Social Workers in Tokyo. It used Attitudes Toward Suicide Scale (ATTS) and multivariate analysis of covariance (MANCOVA). Results show that those who have a history of suicidal behavior had firm stands towards the right to suicide.

The article discusses a study to evaluate the cross-cultural development of a stand-alone European Organization for Research and Treatment of Cancer (EORTC) measure of spiritual well being for palliative care patients with cancer. The study found that a provisional 36-item measure ready for Phase IV field-testing, the EORTC QLQ-SWB36 has been developed, with the items are comprehensible across languages and cultures. The need for Phase IV testing is highlighted.

The current article describes the results of posttraumatic stress educational outreach and screening offered to 141 citizens of Japan who attended a public-service mental health training regarding post-disaster coping 40 days after a 6.8 Richter Scale earthquake, local and regional deaths, and an ongoing nuclear radiation threat. Attendees were given access to anonymous questionnaires that were integrated into the training as a tool to help enhance mental health literacy and bridge communication gaps. Questionnaires were turned in by a third of those in attendance. Among respondents, multiple exposures to potentially-traumatic events were common. More than a quarter of respondents met criteria for probable PTSD. Physical health and loss of sense of community were related to PTSD symptoms. Associations and diagnosis rates represented in these data are not generalizable to the population as a whole or intended for epidemiological purposes; rather, they are evidence of a potentially useful approach to post-disaster clinical screening, education, and engagement. Results are presented in the context of previous findings in Japan and ecologically-supportive post-disaster field research is discussed. [ABSTRACT FROM AUTHOR]

Previous studies mainly examined individual and family factors affecting Japanese fathers’ involvement in child care. Along with these factors, we examine how work-related factors such as father-friendly environment at work, workplace’s accommodation of parental needs, job stress, and autonomy are associated with Japanese men’s participation in child care. Using 2010 data collected from Japanese fathers with preschool children (N = 1,317), a theoretical model is tested on men who work for large or small/medium companies. We find that company’s accommodation of parental needs and job autonomy increase child care involvement of fathers in medium/small companies, and job stress reduces such involvement among men in large companies. Implications of these findings are discussed in light of recent public attention on child caring fathers in Japan. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to examine factors influencing attitudes toward sexual activity among early adolescents in Japan. A total of 1,551 students aged 12 to 14 years at 4 junior high schools were divided into either a conservative or liberal group. Results of chi-square tests showed that the liberal group had higher percentages of students with drinking, smoking, and sexual activity than the conservative group. The liberal group also had more dating partners and friends with sexual experiences than the conservative group. Unpaired t test indicated that the liberal group rated lower than the conservative group in talking to their parents about life and AIDS and teachers listening to their opinions. Furthermore, a multiple regression analysis showed that smoking, experience with sex, talking to parents about AIDS, teachers listening to participants’ opinion, older dating partners, and friends with sexual experiences were all significant predictors of attitude toward sexual activity. [ABSTRACT FROM AUTHOR]

BACKGROUND: A relevant relationship exists between the upper and lower airway, indicating the concept of a unified airway. This study aimed to evaluate whether rhinitis has an association with asthma in children. METHODS: A cross-sectional nationwide survey was performed among children 6-7, 13-14, and 16-17 years old, using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire in Japan. According to the responses to the ISAAC core questions, a child who had experienced nasal symptoms in the past 12 months in the absence of a cold was defined as having current rhinitis. RESULTS: After excluding 11,475 children because of incomplete data, 136,506 children were analyzed. Even after adjusting for demographics, sex, and obesity, children with current rhinitis were more likely to have asthma (adjusted odds ratio [OR], 3.10 [95% CI, 2.92-3.30] in children aged 6-7 years; OR, 3.76 [95% CI, 3.45-4.10] in children aged 13-14 years; and OR, 3.59 [95% CI, 3.33-3.88] in children aged 16-17 years). Children whose daily activities were more impaired by rhinitis symptoms had a significantly higher prevalence of severe asthma. The adjusted ORs for severe asthma among asthmatic children whose daily activities were severely impaired by rhinitis symptoms were 3.66 (95% CI, 2.29-5.85) in children aged 6-7 years, 2.55 (95% CI, 1.64-3.96) in children aged 13-14 years, and 1.87 (95% CI, 1.24-2.82) in children aged 16-17 years compared with asthmatic children whose daily activities were not impaired at all. CONCLUSION: There was a close association between rhinitis and asthma in young children to adolescents. Asthma should be examined in children with rhinitis symptoms. [ABSTRACT FROM AUTHOR]

The psychosocial outcomes of individuals with high-functioning autism spectrum disorder (HFASD) appear to be diverse and are often poor relative to their intellectual or language level. To identify predictive variables that are potentially ameliorable by therapeutic intervention, this study investigated self-reported psychosocial quality of life and associated factors for adults with HFASD. All participants (n = 154) had a diagnosis of autism spectrum disorder, were over 18 years of age, lived in the community, and had used one or more support services during the survey period. The results demonstrated that psychosocial quality of life was lower than that of the general Japanese adult population. Environmental factors, such as mother’s support and early diagnosis, were associated with better quality of life, and aggressive behaviors were associated with poorer quality of life, while expressive language level at preschool years, a conventional outcome predictor, did not predict quality of life. These results emphasize that quality of life measures should be included as outcome indicators in treating individuals with HFASD. [ABSTRACT FROM PUBLISHER]

To validate a Japanese version of Power of Food Scale (PFS-J), and to describe characteristics in appetitive motives among current Japanese young adults, the original English PFS was translated into Japanese and translated back into English, to confirm conceptual and linguistic equivalence, and administered to university students. Test-retest reliability of the PFS-J was evaluated in additional experiments. The PFS-J demonstrated good internal consistency and stability over time. Confirmatory factor analyses demonstrated that the PFS-J has acceptable factor structure. Criterion validity was suggested, in that the relationship between the original PFS and Three-Factor Eating Questionnaire Revised-21 was similar to that between the Japanese versions of the scales. While no association was observed between the scores of PFS-J and Body Mass Index, the scores were higher in women than in men. Characteristics of the appetitive motives in Japan might be different from those in western countries. [ABSTRACT FROM AUTHOR]

Background: Although researchers have suggested that consumer art can help reduce the stigma of mental illness, there is little evidence of the attitudes of the Japanese public towards such artwork.Material: A total of 277 Japanese visitors attending an exhibition of visual arts by people with mental illness completed a short questionnaire.Discussion: After their visit, approximately 87% of the participants reported being strongly or fairly impressed by the creative art. Word frequency analysis implied generally positive attitudes towards the works.Conclusions: The Japanese public might generally have positive and empathetic attitudes towards artwork by people with mental illness. [ABSTRACT FROM AUTHOR]

The psychometric properties of scores from the Achievement Goal Questionnaire were examined in samples of Japanese (N =326) and Canadian (N =307) postsecondary students. Previous research found evidence of a four-factor structure of achievement goals in U.S. samples. Using confirmatory factor-analytic techniques, the authors found strong evidence for the four-factor structure of achievement goals in both the Canadian and Japanese populations. Subsequent multigroup structural equation modeling indicated the metric invariance of this four-factor structure across the two populations. [ABSTRACT FROM AUTHOR]

A cross-sectional study was conducted with a national epidemiological survey to investigate the prevalence and demographic distribution of adult survivors of child abuse in Japan. A self-administered questionnaire was used to measure the history of child abuse and the demographic characteristics. The participants reported the following 4 types of child abuse: physical abuse (3%), sexual abuse (0.6%), neglect (0.8%), and psychological abuse (4%). Significant unequal distribution of child abuse was found to be associated with sex, living region, marital status, job status, and educational status. We determined the prevalence of adult survivors of child abuse in Japan and found that their demographic characteristics were unequally distributed. Policy makers and public health providers should take these demographic disparities into account in considering effective public health interventions for survivors of child abuse. [ABSTRACT FROM PUBLISHER]