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Aim: Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer‐to‐peer learning and assessment can help improve nurses' skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE). Methods: A pre‐ and post‐survey of 97 nursing students from a nursing school in Japan was conducted as a peer‐to‐peer oral health education training program that included an assessment and performance checklist. Results: Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0–25) of the first, second, third, and fourth participants in the four‐student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (p <.01). Fifty‐two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills. Conclusions: This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE‐style delivery. [ABSTRACT FROM AUTHOR]

Objective: This study sought to investigate the current status and faculty members' perceptions of oral care education in Bachelor of Nursing curriculums in Japan. Method: Data were gathered through a questionnaire survey of 196 participants, who were faculty members in charge of oral care education in the basic, adult, gerontological, and home nursing fields, from 295 nursing schools that offered Bachelor degrees in nursing across Japan. Results: The quantitative data showed that 38.5% of the participants worked for less than 5 years as oral care educators, only 15.5% taught oral care in perioperative wards, only 62.2% used an oral care training simulator, and less than 30% believed that training in the prevention of oral diseases should be enhanced. From the descriptive responses, this study identified such problems as the inability of students to perform student‐on‐student and patient‐based oral care training owing to the risk of SARS‐CoV‐2 transmission, and the lack of teaching materials, time, and human resources, and cooperation with other nursing fields and health professionals. Conclusions: This study revealed several problems in oral care education in the Bachelor of Nursing curriculums in Japan. To tackle these challenges, this study suggests the development of an interdisciplinary course that unifies oral care education in nursing fields, in order to promote collaborative oral care education and to improve nursing students' knowledge and skills of oral care. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups in order to develop an educational oral health checkup training programme for nurses.Materials and Methods: A cross-sectional questionnaire survey was distributed to nurses (n = 184) who worked in a hospital and an affiliated long-term care facility in Japan from September to October in 2016. The questionnaire survey investigated their practices, attitudes and confidence in the performance of oral health checkups for elderly patients who were in their care and the factors that were associated with the performance of oral health checkups.Results: A total of 143 (77.7%) nurses participated in this study. Almost half (51.7%) performed oral health checkups for elderly patients. More than 60% examined the lip, tongue and tongue coating, gingiva and oral mucosa, and oral cleanliness; however only 32.4% examined the present teeth and 8.1% examined the saliva. Approximately 90% of the nurses felt that all health professionals should perform oral health checkups for elderly patients who were in their care. Their confidence of the oral examination was statistically significantly associated with their performance of oral health checkups for elderly patients.Conclusions: This is the first survey to investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups. These findings will contribute to the development of a training programme for nurses who perform oral health checkups in elderly patients. [ABSTRACT FROM AUTHOR]

Background: The relationship between oral and cognitive functions among older people is highly debated. Objective: To examine whether oral functions are related to changes in the levels of mild cognitive impairment (MCI) biomarkers in older Japanese outpatients. Methods: This observational study included 52 outpatients aged ≥65 years who underwent dental examinations at the Fukuoka Dental College Hospital. The Mini‐Mental State Examination (MMSE) was performed, and MCI blood biomarker levels were assessed at baseline and after 2 years. The present dental and periodontal conditions and the oral functions (tongue pressure and masticatory performance) were evaluated. Changes in parameters from baseline to follow‐up were compared using the Wilcoxon signed‐rank test, McNemar test or chi‐squared test. Associations among changes in the parameters were analysed using Spearman's rank correlation coefficient. Results: The follow‐up rate in this study was 67%. The masticatory performance was improved (p < 0.001), whereas gingival inflammation was decreased (p < 0.001) over the 2‐year period. A significant increase in the MMSE score (p < 0.001) and a decrease in MCI risk (p < 0.001) were noted. The decrease in MCI risk was correlated with the increase in both masticatory performance (ρ = −0.34; p < 0.05) and MMSE score (ρ = −0.56; p < 0.01). Conclusion: A decrease in MCI risk, as demonstrated by the levels of the blood biomarkers, was correlated with an increase in the masticatory performance in Japanese outpatients. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the effects of a study course in oral health care on the perceptions of nursing students. The course was designed and evaluated by a multi-professional team at a Japanese nursing school.Method: The subjects were 119 nursing students. They participated in the oral health course that comprised 45h of training in 4 years. These were designed and taught by oral health professionals, a certified speech-hearing therapist, and nurses. Questionnaires were distributed to subjects to compare their perceptions and awareness about oral health care before, in between, and after the courses. A chi-square test was used to compare the data.Results: After completing the courses, more than 95% of the participants were interested in the oral health care practice and expected to collaborate with oral health professionals after getting qualified. Additionally, they understood the effectiveness of oral health care for the prevention of aspiration pneumonia and perceived that oral health care should be provided to hospitalized patients and community-dwelling older adults. Their awareness of the need to learn techniques for tooth brushing support, salivary gland massage, oral management, swallowing training, removing tongue coating, and gargling, both in theory and practice, was significantly improved.Conclusion: Multi-professional education has the potential to improve the awareness of nursing students of oral health care and promote collaborative oral health care in the future. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate the effect of interprofessional educational programmes on the improvement of nursing students' oral assessment performances by comparing their attitudes, confidence, abilities, and self‐performance before and after the education. Materials and methods: The subjects included 112 first‐year nursing students in a Japanese nursing school. They participated in the oral assessment educational programmes, which were supported by dentists and introduced into the 1‐year curriculum. The first programme was a 1.5‐hr lecture with a self‐oral assessment training in May 2018, and the second was a 1‐hr oral assessment training in October 2018. The questionnaire surveys investigating nursing students' attitudes, confidence, and self‐performance regarding oral assessment and the tests measuring their oral assessment abilities were conducted before and after the programmes. The total scores on the tests were 0–9 points. Results: A total of 101 (90.2%) nursing students responded to all the questionnaires and tests. Their attitudes and confidence regarding oral assessment were significantly improved after the programmes. The total average scores on the tests were significantly increased from 6.8 points at baseline to 7.9 points after the programmes. The percentage of their performance of self‐oral assessment every day significantly increased from 15.8% at baseline to 32.7% after the programmes. Conclusions: These results suggested that the educational programme might be effective in improving not only the students' attitudes and confidence regarding oral assessment but also their oral assessment abilities and self‐oral assessment performance. Therefore, future programmes must focus on training them to improve oral health care referrals. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing faculty members' perceptions of oral care and to identify the effects of an educational environment on their perceptions. Methods: A cross‐sectional questionnaire regarding oral care was conducted at eight nursing schools in Japan. A total of 156 (71.6%) faculty members participated in this study. Their perceptions of oral care practice were compared by using a statistical analysis according to the length of work experience, teaching field, school, and facility setting (defined as whether the school had an affiliated hospital with a dental department). Results: Almost all of the faculty members were nurses and most were female. Almost all perceived that oral care was effective in the prevention of aspiration pneumonia and frailty. There were significant differences by teaching field in the nurses' perceptions regarding with whom they should collaborate to conduct oral care and there were significant differences by school in the nurses' perceptions regarding who should provide oral care, where it should be provided, and what kinds of knowledge are important for practice. Perceptions of low involvement in oral care were significantly associated with the schools having an affiliated university hospital with a dental department. Conclusion: There were different perceptions regarding oral care among nursing faculty members and their perceptions might have been affected by their educational environment. Therefore, it is suggested that oral care education should be standardized and nursing faculty members should standardize the curriculum regarding oral care for nursing students. [ABSTRACT FROM AUTHOR]

Objective: The aim was to investigate the relationships between subjective well-being and the existence of primary care dentists in community-dwelling elderly people.Background: Some studies have reported subjective well-being focusing on oral health, but no studies have examined the relationship between subjective well-being and primary care dentists.Methods: This cross-sectional study used data from community-dwelling elderly people aged ≥70 years (n = 624). The Philadelphia Geriatric Center Morale Scale (PGCMS; range = 0 [low morale]-17) was used to assess subjective well-being. Additional information regarding age group, sex, medical consulting situation (ambulatory care/home care), primary care dentists, family structure, economic status, health status was collected via questionnaire.Results: The average PGCMS score in ambulatory care patients (ACP) group who have primary care dentists was highest among community-dwelling elderly people. In a logistic regression model, a low PGCMS score (0-11) was independently correlated to 80-89 age group (OR = 1.70; 95% CI, 1.13-2.54; P = 0.008), ≥90 age group (OR = 3.86; 95% CI, 1.83-8.18; P < 0.001), unsatisfied for economic status (OR = 2.68; 95% CI, 1.59-4.53; P < 0.001), unsatisfied for health status (OR = 3.94; 95% CI, 2.60-5.98; P < 0.001) and having no primary care dentists (OR = 1.81; 95% CI, 1.09-3.01; P = 0.021) in ACP group.Conclusions: The subjective well-being of ACP who have primary care dentists was higher than in other people. Primary dentists contributed to the subjective well-being of elderly people. [ABSTRACT FROM AUTHOR]

Background: We have started clinical application of 8K ultra-high definition (UHD; 7680 × 4320 pixels) imaging technology, which is a 16-fold higher resolution than the current 2K high-definition (HD; 1920 × 1080 pixels) technology, to an endoscope for advanced laparoscopic surgery. Results: Based on preliminary testing experience and with subsequent technical and system improvements, we then proceeded to perform two cases of cholecystectomy and were able to achieve clinical success with an 8K UHD endoscopic system, which consisted of an 8K camera, a 30-degrees angled rigid endoscope with a lens adapter, a pair of 300-W xenon light sources, an 85-inch 8K LCD and an 8K video recorder. These experimental and clinical studies revealed the engineering and clinical feasibility of the 8K UHD endoscope, enabling us to have a positive outlook on its prospective use in clinical practice. Conclusions: The 8K UHD endoscopy promises to open up new possibilities for intricate procedures including anastomoses of thin nerves and blood vessels as well as more confident surgical resections of a diversity of cancer tissues. 8K endoscopic imaging, compared to imaging by the current 2K imaging technology, is very likely to lead to major changes in the future of medical practice. [ABSTRACT FROM AUTHOR]

In recent years, the design of nursing uniforms, employing a variety of colors and patterns, has placed emphasis on their impression of being the least intimidating and forbidding to patients as well as their functionality and hygiene. The present study, including a survey of 469 hospitals nationwide, aimed to identify the optimal design of nursing uniforms for both patients and nurses, focusing on nursing uniforms as a medium of expression. A total of 87.8% of the surveyed hospitals had nursing uniforms, and 89.5% viewed them as one of the elements that add to the appeal of a hospital. "Combination of a white tunic and pants" and "white one-piece type" were the most common uniforms. When adopting new uniforms, 90.3% of the hospitals incorporated the opinions of nurses, selecting opaque, stretch material with a soft texture and a combination of tunic tops of appropriate length and pants so that they could move freely. Whereas some hospitals favored white, which conveys an image of cleanliness and reliability, others chose subtle, warm, and soft non-white colors; opinions were divided over the color of white. A total of 65.7% of the hospitals were planning to introduce new nursing uniforms. Based on the results of the current study it is important to select designs and colors that help reduce patients' anxiety and strain while presenting an image of trust and cleanliness. [ABSTRACT FROM AUTHOR]

A survey was conducted to examine the images of nursing uniforms, involving patients (patient group), nurses and dental hygienists (hospital group). The present study focused on differences in their impressions of six types of uniform worn by nurses and dental hygienists. (1) The combination of a flower-patterned tunic and white pants was favored by both patient and hospital groups. However the combination of dark-redpurple scrub and white pants was considered inappropriate by both groups, especially patients concerned over their disorders and treatment. (2) Factor analyses were conducted on the two groups' impressions of the six types of uniform. The results were as follows: "compassion", "trust/responsibility", "aggressiveness", and "activeness" were extracted in the patient group, and "compassion", "trust/responsibility", "activeness", and "sophistication" in the hospital group. The factor score for "compassion" was high in "flower-patterned tunics and scrubs", and the score for "trust/responsibility" was high in "the white one-piece type and the combination of a white tunic and white pants". As people have different impressions of nursing uniforms depending on their style and color, it is important to pay attention to the designs when a selection is made. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the usefulness of a newly developed oral simulator for nursing students' oral assessment education on oral diseases and symptoms., Materials and Methods: The participants were first-year students (n=105) at a nursing school in Japan. Ten identical oral simulators with angular cheilitis, missing teeth, dental caries, calculus, periodontitis, hypoglossal induration, food debris, and crust formation were created by a team of dentists. After a 45-minute lecture programme for oral assessment performance with the Oral Health Assessment Tool (OHAT), the ability test with the simulators and the OHAT as well as test feedback were conducted in a 30-minute practical programme. To evaluate the effectiveness of the programmes, questionnaires and ability tests with slides of oral images were conducted at baseline and after the programme., Results: Ninety-nine students (94.3%) participated in this study. The results of the ability test with the simulators and the OHAT in the practical programme showed that the correct answer rates of assessing tongue, gingiva, present teeth, and oral pain were less than 40%. Their levels of confidence, perception, and oral assessment performance were statistically significantly higher after the programmes than they were at baseline. Their level of confidence in assessing the need for dental referral had the largest increase in scores compared to the lowest scores at baseline in the nine post-programme assessment categories., Conclusions: This study identified several problems with nursing students' oral assessment skills and improvements of their oral assessment confidence, perceptions and performance.

Objective: This study aimed to investigate nurses' perceptions of oral health care provision to inpatients in Japanese hospitals and the infection control measures taken by them after the coronavirus disease 2019 (COVID-19) lockdown to promote collaborative oral health care., Method: The participants were 1037 nurses working in inpatient wards at 4 hospitals in Fukuoka Prefecture, Japan. Data were collected through a questionnaire survey approximately 6 months after the first COVID-19 lockdown., Results: More than 90% of the 734 nurses participating in this study positively perceived the preventive effect of oral health care on aspiration pneumonia, ventilator-associated pneumonia, and viral infection. However, approximately half of them had negative perceptions about their knowledge and confidence regarding the control of COVID-19 with oral health care provision, and 84.7% expected to be provided with the necessary information by oral health professionals. Further, 537 nurses (73.2%) provided oral health care to their patients; 9 nurses (1.7%) responded that those patients who received oral health care decreased after the lockdown; and 12 (2.4%) responded that they could no longer collaborate with oral health professionals because of the lockdown. Additionally, 41.7% of them used neither protective glasses nor face shields even after the lockdown began., Conclusions: This study showed that almost all the nurses perceived the benefcial effect of oral health care for the prevention of viral infection and pneumonia. However, some nurses perceived that their oral health care provision and collaborative oral health care were negatively affected. It also showed that most nurses' knowledge, confidence, and use of infection control measures were insufficient. The results indicate that oral health professionals should support nurses in providing oral health care by providing them with information on COVID-19 infection control measures to prevent infection transmission., Competing Interests: Conflict of interest None disclosed., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

A female in her forties was diagnosed with rectal cancer involving the uterus and bladder and with multiple lymph node metastasis. Chemotherapy was successful and resulted in complete clinical response 1 year and 2 months after commencement. She continues chemotherapy without resection of the primary tumor. The complete response has been maintained for 8 years and 11 months.

Objective: Collaborative oral health care among health-care workers (HCWs) is important to prevent oral and systemic diseases. The purpose of this study was to investigate the perceptions, attitudes and performance of HCWs regarding collaborative oral health care and to compare them among HCWs., Method: The subjects were dentists (DTs), dental hygienists (DHs), hospital nurses (HNs), speech-language-hearing therapists (STs) and certified care workers (CCWs) in Fukuoka Prefecture, Japan. DTs were members of the Fukuoka Dental Association, and DHs worked in dental clinics. HNs worked in hospitals without dental departments. STs and CCWs were members of professional associations. Data were collected by a mail survey. The chi-square test and Kruskal-Wallis test were used to compare the data among HCWs., Results: A total of 119 DTs, 91 DHs, 229 HNs, 119 STs and 121 CCWs participated in this study. The total response rate was 20.6%. There were significant differences in perceptions of what should be performed as part of oral health care among HCWs. Only 20%-60% of HCWs performed collaborative oral health care, while more than 75% were willing to perform such care. Levels of collaborative oral health care with other types of professionals and positive willingness to perform such care were lower among HNs than among the other HCWs., Conclusions: It is suggested that oral health professionals should recognise the presence of differences in the perceptions, attitudes and performance among other types of HCW and try to improve these to promote interprofessional collaboration of oral health care in hospitals., (© 2020 World Dental Federation. Published by John Wiley & Sons Ltd.)

A 56-year-old man was diagnosed with advanced adenocarcinoma of the esophagogastric junction. He received 1 course of neoadjuvant chemotherapy with S-1. After neoadjuvant chemotherapy, the primary tumor showed a remarkable decrease in size. Subtotalesophagectomy, D2 lymph node dissection, and reconstruction with a gastric tube through the posterior mediastinal route were performed. Pathological examination showed that most of the cancer cells had been destroyed, with a part where adenocarcinoma mucosa was seen. We successfully treated a case of advanced adenocarcinoma of the esophagogastric junction, with neoadjuvant S-1 chemotherapy and surgicalresection.

Purpose: To investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups in order to develop an educational oral health checkup training programme for nurses., Materials and Methods: A cross-sectional questionnaire survey was distributed to nurses (n = 184) who worked in a hospital and an affiliated long-term care facility in Japan from September to October in 2016. The questionnaire survey investigated their practices, attitudes and confidence in the performance of oral health checkups for elderly patients who were in their care and the factors that were associated with the performance of oral health checkups., Results: A total of 143 (77.7%) nurses participated in this study. Almost half (51.7%) performed oral health checkups for elderly patients. More than 60% examined the lip, tongue and tongue coating, gingiva and oral mucosa, and oral cleanliness; however only 32.4% examined the present teeth and 8.1% examined the saliva. Approximately 90% of the nurses felt that all health professionals should perform oral health checkups for elderly patients who were in their care. Their confidence of the oral examination was statistically significantly associated with their performance of oral health checkups for elderly patients., Conclusions: This is the first survey to investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups. These findings will contribute to the development of a training programme for nurses who perform oral health checkups in elderly patients.

Obtaining access to the peritoneal cavity in laparoscopic surgery is more difficult in morbidly obese people. The aim of this study was to examine the safety and efficacy of accessing the peritoneal cavity using an optical, bladeless trocar without previous pneumoperitoneum in morbidly obese patients. The patients' characteristics and outcomes with consecutive and preferential use of an optical, bladeless, first trocar insertion without previous pneumoperitoneum in morbidly obese patients (body mass index > 35 kg/m2) was reviewed. A total of 208 morbidly obese patients were included. The trocar insertion technique was used in 196 patients. No bowel or major abdominal vessel injuries occurred. Ninety-eight patients (50%) had previous abdominal operations. Trocar-related injuries occurred in 3 patients: a superficial mesenteric laceration in 2 and a laceration of a greater omentum vessel in 1. The direct first trocar insertion technique provides safe entry into the peritoneal cavity in morbidly obese patients.