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Aim: In order to understand the digital divide among older adults during the coronavirus disease 2019 (COVID‐19) pandemic, we investigated the association between internet use and compliance with COVID‐19 preventive behaviors during the first state of emergency in Japan. Methods: A total of 8952 community‐dwelling citizens aged 75 years and above were asked about their preventive behaviors during the first state of emergency using a paper‐based questionnaire. Among them, 51% responded and were divided into internet users and non‐users. We used multivariable logistic regression models to estimate the adjusted odds ratios and 95% confidence intervals of internet use for compliance with preventive behaviors. Results: Approximately 40% of the respondents used the internet, and 9.29% used social media to collect COVID‐19‐related information. Internet usage was independently associated with compliance with using hand sanitizers, avoiding going out, avoiding eating out, avoiding traveling, getting vaccinated, and getting tested for COVID‐19; the adjusted odds ratios (95% confidence intervals) were 1.21 (1.05–1.38), 1.19 (1.04–1.37), 1.20 (1.05–1.38), 1.32 (1.15–1.52), 1.30 (1.11–1.53), and 1.23 (1.07–1.41), respectively. Exploratory subgroup analyses demonstrated that social media users might have shown early adaptation to newly recommended preventive behaviors during the first state of emergency. Conclusions: Results suggest that a digital divide exists, as evidenced by the varied compliance with preventive behaviors depending on internet use. Additionally, social media use may be associated with early adaptation to newly recommended preventive behaviors. Therefore, future studies regarding the digital divide among older adults should investigate differences depending on the types and content of internet resources. Geriatr Gerontol Int 2023; 23: 289–296. [ABSTRACT FROM AUTHOR]

Objective: Two percent of the Japanese population is comprised of foreign residents with further increase expected due to immigration policy revisions. The purpose of this paper is to examine the healthcare needs and difficulties experienced by foreign residents in Japan by level of their Japanese language fluency. Design: A quantitative, descriptive design was used. Sample: We surveyed foreign residents in the greater Tokyo area (N = 209). Measurements: The research team created the survey questions and the contents of the survey include foreign residents' experiences during their visits or stays at medical and public health facilities in Japan. Results: More than 90% of the participants or their families visited medical facilities in Japan regardless of Japanese language fluency; however, those with less Japanese language fluency experienced statistically significant uneasiness or inconvenience concerning communication compared to those with native Japanese language fluency (p =.000). Conclusions: Nurses in Japan may benefit from additional training related to use of interpreters as well as education about diversity and cultural humility. Through better understanding of the specific communication barriers of foreign residents, nurses will be able to better anticipate difficulties and address them. [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]

Aim: To examine the relationship between general self‐efficacy and nursing practice competence for nurses in the second year of employment. Design: A cross‐sectional design was used. Data Sources: The study included 596 nurses in their second year of employment at 75 medical facilities across Japan and used an online questionnaire survey for data collection. Results: The covariance structure analysis showed the path from general self‐efficacy (latent variable) to nursing practice competence. Positive correlations were found between all factors on both scales. Multiple regression analysis results showed that the general self‐efficacy factors of 'positivity in behavior' and 'confidence in social competence' affect nursing practice competence. Conclusion: This study emphasizes the importance of enhancing the general self‐efficacy of second‐year nurses to improve their nursing practice competence. To achieve this, it suggests developing strategies from the perspective of the factors that comprise general self‐efficacy. Implications for the Profession and Patient Care: The findings suggest that improving general self‐efficacy can enhance nursing practice competence, which could inform the development of interventions to support nurses in improving their competence. The study provides basic data for improving nurses' practice competence. Impact: This study is the first to establish a relationship between general self‐efficacy and nursing practice competence among second‐year nurses. It demonstrates the significance of general self‐efficacy in enhancing nursing practice competence, particularly for second‐year nurses worldwide who may be struggling with their nursing practice competence and considering leaving the profession. The findings offer practical implications for stakeholders involved in nursing education and training programs, with potential applications in professional development. Reporting Method: This manuscript adheres to the STROBE guidelines for the reporting of cross‐sectional studies. Patient or Public Contribution: There was no patient or public contribution. [ABSTRACT FROM AUTHOR]

We administered a paper-and-pencil questionnaire to 133 female and 99 male Japanese high school students 13-18 years old ( M = 15.9, SD = 1.57) from the Kansai area to examine cultural influences on their body image and body change behaviours. Our aim was to ascertain the independent and combined influences from traditional Japanese, modern Japanese, and Western values. Cluster analyses identified four 'acculturative' groups: 'anti-modern', 'traditional', 'pro-modern/anti-traditional', and 'pro- Western/anti- Japanese'. Pro-modern and pro- Western adolescents were most dissatisfied with their bodies, and pro-Western adolescents were also most likely to attempt weight loss. The results demonstrate the value of assessing cultural interactions in Japan along three dimensions. [ABSTRACT FROM AUTHOR]

Background: The number of patients with cognitive disorders is rapidly increasing in the world, becoming not only a medical problem, but also a social problem. There have been many reports that various factors are associated with cognitive dysfunction, but the factors have not yet been fully identified. This was a community‐based complete enumeration study which aimed to identify risk and protective factors for dementia. Methods: The first phase included all residents aged 65 years or older in a town in Japan. They completed many examinations, such as living conditions questionnaires, physical examination, Mini‐Mental State Examination, and brain magnetic resonance imaging. The participants with suspected cognitive impairment underwent additional examinations for detailed evaluation in the second phase. Statistical analysis was performed to identify risk and protective factors for dementia after all participants were diagnosed. Results: There were 927 participants in the baseline evaluation; 611 (65.9%) were healthy, 165 (17.8%) had mild cognitive impairment (MCI), and 151 (16.3%) had dementia. The age‐standardised prevalence of dementia was 9.5%. Statistical analyses for amnestic MCI and Alzheimer's disease showed that risk factors for cognitive decline were diabetes mellitus, low activities of daily living, and living alone, and that protective factors were history of exercise and drinking habit. Conclusion: The present findings suggest that several lifestyle‐related diseases and factors are associated with cognitive decline. These results support similar findings from previous studies and will be helpful for preventing dementia in the future. [ABSTRACT FROM AUTHOR]

Background: Suicidal ideation is closely related to severe suicidal behaviour and is an important predictor of suicide attempt and completion, including in older people. Older people tend to have many opportunities to be conscious of death, and may have vague suicidal ideation because of various loss experiences, even if they are not depressed. We hypothesised that suicidal ideation among older people might be a risk factor for later transition to depression. The present study aimed to clarify risk factors that predict the incidence of depression in older people 3 years post‐baseline in a rural area of Japan, and to examine the subsequent course of depression among non‐depressed older people with suicidal ideation. Methods: In 2015 and 2018, survey questionnaires were mailed to residents aged 65 years and over living in a rural area in Japan. Participants were divided into a depression group and a non‐depression group using 15‐item Geriatric Depression Scale scores 3 years post‐baseline. Logistic regression analysis was used to identify predictive factors of late‐life depression 3 years post‐baseline. Results: We received 597 valid responses, with a 3‐year follow‐up rate of 78.8%. Regarding suicidal ideation, 6.7% of non‐depressed older people exhibited suicidal ideation at baseline. Of these, 9.8% exhibited depression after 3 years post‐baseline. Logistic regression analysis indicated that development of late‐life depression is significantly associated with suicidal ideation, being female, and poor health‐related quality of life (HRQOL). Conclusions: The results revealed that suicidal ideation, being female, and poor HRQOL were predictive factors of the development of late‐life depression 3 years post‐baseline in a rural area of Japan. These findings provide novel information regarding the transition to depression among community‐dwelling older people who are not depressed but have suicidal ideation. Whereas suicidal ideation is considered to be a symptom of depression, the current results suggest that suicidal ideation may precede depression in some older people. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to develop a scale to screen for eating disorders in female athletes. Methods: Preliminary survey: A total of 275 female athletes (mean age: 19.4 ± 1.0 years) and 7 female athletes diagnosed with eating disorders (mean age: 20.1 ± 2.5 years) were administered screening items prepared based on an existing scale, followed by exploratory factor analysis. Main survey: Six items, relating to three factors, were extracted, and 201 female athletes (mean age: 22.3 ± 4.8 years) and 6 female athletes diagnosed with current or a history of eating disorders (mean age: 18.8 ± 2.9 years) were queried. The diagnostic validity of the scale was then evaluated. Results: Preliminary survey: Questions (α = 0.71) were extracted from six items, relating to three factors, and collectively termed the University of Tokyo's eating disorders inventory in female athletes (TEDIFA). To determine the scale cut‐off score, ROC analysis was performed with the total score, and the cut‐off and gray zone scores were set at 13 and 11, respectively. Main survey: At the cut‐off score of 13, AUC, sensitivity, and specificity were 0.83 (p < 0.05), 75%, and 90%, respectively. Conclusions: The scale that was developed, TEDIFA, consisted of six items. The cut‐off scores were set at 11 for the gray zone (sensitivity: 75%; specificity: 56%; accurate diagnosis rate: 60%), and 13 for positivity (sensitivity: 75%; specificity: 90%; accurate diagnosis rate: 87%), demonstrating the reliability and validity of the scale. [ABSTRACT FROM AUTHOR]

Aim: To test a modified team‐based learning approach on undergraduate learning outcomes in an acute‐care nursing course in Japan. Design: Mixed‐methods. Methods: Students worked on three simulated cases, engaged in pre‐class preparation, completed a quiz and engaged in group work. We collected data on team approach, critical‐thinking disposition and time spent in self‐learning at four time‐points: before the intervention and after each simulated case. Data were analysed using a linear mixed model, a Kruskal–Wallis test and a content analysis. Data sources: We recruited nursing students attending a mandatory course in acute‐care nursing at University A. Data were collected at four time‐points between April and July 2018. Data from 73 of 93 respondents were analysed. Results: Team approach, critical thinking and self‐learning all increased significantly across the time‐points. Four categories emerged from students' comments: 'achievement of teamwork', 'sense of learning efficacy', 'satisfaction with course approach' and 'issues related to course approach'. The modified team‐based learning approach led to improvements in team approach and critical‐thinking disposition across the course. Conclusion: Incorporating team‐based learning into the curriculum not only contributes to team building but is also effective as a teaching method to improve student learning. Implications for the profession and/or patient care: The intervention led to improvements in team approach and critical‐thinking disposition across the course. The educational intervention also led to more time for self‐learning. Future studies should include participants from various universities and evaluate the outcomes over a longer period. [ABSTRACT FROM AUTHOR]

Aim: Work performance of nurses is a critical aspect that concerns the safety of both nurses and patients, but also secondarily influences nurses' turnover due to serious fatigue and burnout. Monitoring nursing performance as well as fatigue is important for appropriate safety management of patients and nurses, and the development of a monitoring tool is essential. The Nursing Performance Instrument (NPI) can provide comprehensive and brief monitoring of nursing performance. This study aimed to verify the validity and reliability of a Japanese version of the NPI (NPI‐J). Methods: A cross‐sectional study was conducted on nurses who work in inpatient care across five Japanese hospitals. We considered appropriate factor numbers with parallel analysis and the Velicer's minimum average partial test. The construct validity was evaluated using exploratory factor analysis, confirmatory factor analysis (CFA), and Pearson's correlation analysis. Cronbach's alpha was calculated for the internal consistency. Results: A three‐factor model eventually showed acceptable fit indices in the CFA. Moreover, the correlation results among the three factors indicated discriminant validity comparable to the original NPI. The correlation results with acute fatigue, chronic fatigue, and burnout verified convergent validity. Internal consistency was insufficient. Conclusion: The NPI‐J demonstrated acceptable construct validity. This instrument can assess nurses' perceptions of their performance by measuring each item. Future work on the reliability of the sub‐concepts will require additional items or reliability testing based on generalizability theory and item response theory. [ABSTRACT FROM AUTHOR]

Aim Subjective memory complaints scales are expected to be useful for the prediction of future cognitive decline. In Japan, the 'Kihon Checklist-Cognitive Function' (KCL-CF), which consists of three items, is used for primary screening of high-risk older adults. However, the predictive validity of the KCL-CF remains unknown. The aim of the present cohort study was to examine whether the KCL-CF can predict the incidence of dementia. Methods Information on the KCL-CF score (0-3 points) was collected from community-dwelling older adults (≥65 years) through a questionnaire. Data on incident dementia were retrieved from the Long-term Care Insurance database. The Cox model and receiver operating characteristic curve analysis were used. Results Among 13 974 participants, the 5.7-year rate of incident dementia was 8.8%. All KCL-CF items significantly predicted the risk of incident dementia even after adjustment for age and sex ( P-trend < 0.0001). A higher KCL-CF score was associated with a higher risk of dementia; the age- and sex-adjusted hazard ratios (95% confidence interval) were 1.00 (reference) for a KCL-CF score of 0 points, 1.89 (1.65-2.15) for 1 point, 3.01 (2.59-3.50) for 2 points, and 6.20 (4.87-7.90) for 3 points ( P-trend < 0.0001). A cut-off score of ≥1 points had a specificity of 65.1% and a sensitivity of 60.2%, and the area under the receiver operating characteristic curve was 0.65 (95% confidence interval 0.63-0.66). Conclusions The KCL-CF was able to predict incident dementia. However, because a false-negativity rate of approximately 40% would be expected, the KCL-CF score alone might not be sufficient for screening of dementia incidence. Geriatr Gerontol Int 2017; 17: 1300-1305. [ABSTRACT FROM AUTHOR]

Over the last decade, the importance of Advanced Care Planning has been recognized in Japan. However, it is still difficult for healthcare providers and patients to verbalize how they want to spend the last days of their lives and what unfinished business they have left to accomplish. This study aimed to clarify how nurses intervened to assist patients with cancer at the end of life to express their thoughts and concerns. Twenty‐four nurses were interviewed regarding how they intervened for patients' thoughts and concerns, and data were analyzed qualitatively using a modified grounded theory approach. A 25‐item scale was selected, and the questionnaires, which included the scale, were distributed to nurses in general wards, palliative care units, and home visiting nurse services. A total of 1864 responses were analyzed. Factor analysis and structural equation model analysis were used, and three factors were identified: "assessment and intervention," "basic care," and "knowledge and communication," which led to the formulation of an intervention structure model for uncovering thoughts and concerns. These results indicate the importance of basic care and communication during interventions for patients. [ABSTRACT FROM AUTHOR]

Background: In Japan there are limited opportunities for pediatricians to learn gastrointestinal (GI) endoscopy. This study investigated whether a short‐term intensive training for 2 weeks in an adult GI setting enabled pediatricians to acquire basic technical competence for pediatric GI endoscopic procedures. Methods: This was a retrospective case series of pediatricians who underwent 2 weeks of intensive endoscopy training at an adult endoscopy unit in a community hospital. The numbers of esophagogastroduodenoscopy (EGD) and ileocolonoscopy procedures each pediatrician performed were evaluated. All enrolled pediatricians were asked to answer questionnaires regarding the 2 week intensive GI endoscopy training program. Results: There were 17 enrolled pediatricians, of whom 13 were men; average age 32 years (range 27–54). The median (range) numbers of EGDs and ileocolonoscopies performed by each pediatrician during the 2‐week training period were 102 (66–144) and 14 (1–48), respectively. Fifteen out of 17 pediatricians experienced more than 100 GI endoscopies during the 2 weeks. All pediatricians performed biopsies as part of some EGD procedures. All 17 pediatricians found this program satisfactory. All pediatricians became cable of performing pediatric EGD (i.e., for children ≤15 years) after this training program. Sixteen pediatricians have continued to perform pediatric GI endoscopy since this training program. Conclusions: A short‐term intensive training program for 2 weeks in an adult GI setting enabled pediatricians to acquire basic technical competence for pediatric endoscopic procedures. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the developmental outcomes of Japanese babies conceived through assisted reproductive technology (ART), born at ages 48 and 60 months. Methods: Data were collected from 725 children in a hospital‐based cohort study conducted in Japan. The children's level of development was assessed using the Kinder Infant Development Scale, a parent‐rated questionnaire that consists of nine developmental domains. We compared the development between children conceived through ART (N = 189) and those conceived naturally (N = 536) by conducting analyses of covariance. For the analyses, we controlled for the effects of maternal age, family income, parental education, and multiple births. Results: At 48 months, no significant difference was found between children conceived through ART and those conceived naturally, except for the development of receptive language (F(1, 718) = 4.869, p = 0.028)), which was found only for boys. The mean developmental age of receptive language was 60.1 for the children conceived through ART and 57.5 for those conceived naturally. At 60 months, no significant difference was found between children conceived through ART and those conceived naturally, in all domains. Conclusion: At ages 48 and 60 months, no significant difference was found between the children conceived through ART and those conceived naturally in nine developmental domains, except for boys' receptive language at 48 months. [ABSTRACT FROM AUTHOR]

Objectives: Effective daily oral hygiene behaviour will prevent periodontal disease. This study aimed to examine the oral symptoms, oral hygiene behaviours and factors contributing to oral hygiene behaviours among patients with type 2 diabetes in a hospital in Japan. Methods: A cross‐sectional survey was conducted with 198 patients with type 2 diabetes. Oral symptoms were assessed using a dichotomous scale based on clinical guidelines. Oral hygiene behaviours were assessed based on the frequency of daily tooth brushing and the use of interdental cleaning aids. Chi‐square tests and logistic regression analyses were also performed. Results: Overall, 71.2% of the participants had oral symptoms. Of the participants, 80.3% performed twice daily tooth brushing and 61.1% did not perform interdental cleaning on a daily basis. Logistic regression analysis revealed that tooth brushing behaviour was negatively associated with male patients (odds ratio [OR] = 0.45, 95% confidence interval [CI]: 0.25–0.80), difficulty with mastication (OR = 0.63, CI: 0.43–0.92) and tooth loss (OR = 0.68, CI: 0.46–1.00) and positively associated with periodontal disease (OR = 1.73, CI: 1.10–2.72). There were no significant variables related to the use of interdental cleaning aids. Conclusions: Patients need to learn about the necessity for regular oral hygiene behaviours and the appropriate way. In particular, support for male patients, those who have difficulty with mastication, those who have experienced natural tooth loss, and those who have not been diagnosed with periodontal disease are needed. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

Despite increasing research into connections between adverse childhood experiences (ACEs) and health problems, the impact of parental ACEs on parenting practices has not been sufficiently clear. The objective of the study was to consider whether the association between maternal ACEs and child maltreatment is affected by three mediating factors: socio‐economic status (SES), social support and maternal psychological distress in adulthood. The Kochi Child Health Impact of Living Difficulty (K‐CHILD) study (2016) provided the data for this study. Mothers who had children in the first, fifth, eighth and eleventh grade and who lived in the Kochi Prefecture of Japan participated. A pool of 11,954 completed child and caregiver questionnaires was used for analysis. We found that a large number of maternal ACEs was connected to higher risk of physical abuse, psychological abuse and neglect. Maternal psychological distress had the greatest mediating effect. Maternal ACEs can be a risk factor for maltreatment of children. This study suggests that care for mothers with psychological distress will be a key intervention to break the cycle of childhood adversity. [ABSTRACT FROM AUTHOR]

Aim: To explore the unclear association between temporary discharge home from the palliative care unit and achievement of good death, in the background of increases in discharge from the palliative care unit. Association between experiences and circumstances of patient and family and duration of temporary discharge was also examined. Methods: This study was a secondary analysis of data from a nationwide post‐bereavement survey. Results: Among 571 patients, 16% experienced temporary discharge home from the palliative care unit. The total good death inventory score (p <.05) and sum of 10 core attributes (p <.05) were significantly higher in the temporarily discharged and stayed home ≥2 weeks group. Among all attributes, "Independent in daily activities" (p <.001) was significantly better in the temporarily discharged and stayed home ≥2 weeks group. Regarding the experience and circumstance of patient and family, improvement of patient's appetite (p <.05), and sleep (p <.05) and peacefulness (p <.05) of family caregivers, compared to the patient being hospitalized, were associated with longer stay at home after discharge. Conclusions: Patient's achievement of good death was better in the temporarily discharged and stayed home longer group, but this seemed to be affected by high levels of independence of the patient. Temporary discharge from the palliative care unit and staying home longer was associated with improvement of appetite of patients and better sleep and mental health status of family caregivers. Discharging home from palliative care unit is worth being considered even if it is temporary. [ABSTRACT FROM AUTHOR]

Aim: The actual status of fertility preservation treatments in the startup phase in Japan was investigated as a basis for discussing future directions. Methods: This study was conducted as "Research project to promote support of children and parenting 2016" which was supported by Ministry of Health in Japan with the approval of the institutional review board at St. Marianna University. Subjects of the survey were facilities registered with the Japan Society of Obstetrics and Gynecology as fertility preservation facilities, and facilities belonging to the Japan Association of Private Assisted Reproductive Technology Clinics and Laboratories. We provided questionnaires to survey both the medical care system and cases for which fertility preservation was implemented between 2006 and 2016. Results: Responses were obtained from 68 facilities (of the 64, 59 [92.2%] responded to the questionnaire and 9 clinics cooperated). Many facilities limited the cryopreservation of oocytes and ovaries to patients 40–41 years old and the use of eggs to patients 44–45 years old. In the patient survey, 812 cases of oocyte cryopreservation and 201 cases of ovarian tissue cryopreservation were performed during study period. Breast cancer was the most indicated disease, with oocyte cryopreservation in the late 30s and ovarian tissue cryopreservation in the early 30s. Very few babies were born from fertility preservation, and no live birth cases of ovarian tissue cryopreservation were identified. Conclusions: Even from the early days, fertility preservation was implemented according to certain standards in Japan, but was characterized by a large variety of facilities. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan. Methods: The study implemented a cross‐sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K‐clustering and structural equation modeling were used for data analysis. Results: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring. Conclusion: Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses. [ABSTRACT FROM AUTHOR]

Background: The number of individuals who are diagnosed with attention‐deficit hyperactivity disorder (ADHD) during adulthood has increased in recent years. However, there is still no decision aid (DA) to help adults newly diagnosed with ADHD make decisions regarding further treatments. Objective: This study aimed to describe the development process of a DA for adults newly diagnosed with ADHD and its field testing during the shared decision‐making (SDM) process in a clinical setting. Methods: The development process involved the creation of a DA prototype using the International Patient Decision Aid Standards criteria and revision of the prototype through the stakeholders' reviews. The field testing of the DA compared scores before and after the SDM process on the service users' knowledge scale, decisional conflict scale and the Conners Adult ADHD Rating Scales. Results: The developed DA contained options of watchful waiting with own coping skills and pharmacological treatment, which consisted of several kinds of drug options. Fifteen adults newly diagnosed with ADHD participated in the field testing. The participant decision‐making quality outcomes such as their knowledge and decisional conflict improved after the SDM process. ADHD severity did not change. Conclusion: A DA for adults with ADHD was systematically developed following the international criteria. Field testing indicated that the DA could serve as a tool to facilitate the SDM process. Further research on this DA is necessary before its routine implementation. Patient or Public Contribution: During the development process of the DA, the service users who had already been diagnosed with ADHD reviewed the DA prototype and provided feedback, which improved the final version of the DA. [ABSTRACT FROM AUTHOR]

Aim: Maintaining ≥20 teeth is a public health goal worldwide. Healthy aging, which includes psychological and social well‐being, as well as physical indicators, has attracted a great deal of attention with the progression of aging societies. However, no studies have examined the association between the number of remaining teeth and healthy aging. This study aimed to investigate the association between the number of remaining teeth and healthy aging. Methods: This community‐based longitudinal cohort study included 8300 Japanese people aged ≥65 years who were free of disability and depression in the baseline survey in 2006. The participants were categorized into four groups according to the number of remaining teeth at baseline: 0–9, 10–19, 20–24 and ≥25. The primary outcome was healthy aging (defined as meeting all four of the following criteria: free of disability, free of depression, high health‐related quality of life and high life satisfaction), as assessed by a questionnaire survey carried out in 2017. Multiple logistic regression was used to calculate the corresponding odds ratios and 95% confidence intervals. Results: During about 11 years of follow‐up, 621 (7.5%) participants attained healthy aging. Participants with ≥20 remaining teeth showed a higher healthy aging rate. Compared with participants with 0–9 teeth, the multivariate‐adjusted odds ratios (95% confidence intervals) for 10–19, 20–24 and ≥25 teeth were 0.98 (0.77–1.26), 1.28 (1.01–1.63) and 1.59 (1.24–2.03), respectively. Conclusions: These findings suggest that maintaining ≥20 teeth was associated with healthy aging. Geriatr Gerontol Int 2022; 22: 68–74. [ABSTRACT FROM AUTHOR]

Aim: To investigate how nursing faculties' perceived time devoted to research changed during the first wave of the pandemic in Japan (April–June 2020) compared to pre‐pandemic. Methods: This cross‐sectional study was conducted online from July 1 to August 10, 2020 and involved 1,023 nursing faculties in Japan. Participants were asked to respond to a questionnaire based on their experiences from April to June 2020. We calculated descriptive statistics for several measures and examined associations between professional/personal demographic factors and declines in overall research time. Results: Of the 1,023 participants, 71.1% were spending less time on overall research activity; 79.6% spent less time attending academic events/conferences, and 77.4% spent less time conducting experiments/surveys. In contrast, 81.2% spent more time teaching, a much greater proportion than the global scientific community in a previous survey. As for work time allocation during the pandemic, teaching was by far the one activity that participants spent the most time on. Logistic regression analysis revealed that declines in overall research time were associated with several professional demographic factors, such as type of university, current academic position, and acquisition status of Japan's major research grant (KAKENHI) (all p <.05). Conclusions: Nursing faculties in Japan clearly spent less time on research, and more time on teaching during the first wave of the pandemic compared to pre‐pandemic. The initial impact of the pandemic on nursing faculties revealed through this study is an eye‐opener and a start for addressing the long‐term impact on the nursing scientific community. [ABSTRACT FROM AUTHOR]

Approximately 20% of Japanese women in their reproductive years are smokers. Therefore, in the present study, we report the behavioral changes of woman who undertook a 3 month stop-smoking program. Sixty-six pregnant smokers in the first trimester of pregnancy participated in this study from two hospitals and an obstetric clinic in Japan. Our newly-developed e-learning program uses a cell phone Internet connection service to support pregnant women who want to quit smoking. Using this, service participants were given guidance concerning smoking, and were breath tested for their carbon monoxide levels every 4 weeks for 3 months. An e-learning cessation smoking-support program was maintained throughout the same period. Consequently, 52 of 66 pregnant smokers from three settings began the program, and 48 of 52 eventually completed it. The achievement rate of non-smoking was 71.1% (37/48), and their carbon monoxide exhalation levels significantly decreased from 6.43 ± 4.5 ppm at the beginning to 0.7 ± 1.0 ppm in 1 month, to 0.29 ± 1.08 in 3 months ( P < 0.001). These results suggest the effectiveness of our e-leaning program. This paper reports the results of the study. [ABSTRACT FROM AUTHOR]

Aim: A feeling of isolation childcare mothers' face is a serious social problem in Japan because the relationships with mothers and local communities have grown sparser. The purpose of this study was to clarify the feelings of isolation of mothers during childcare and the factors related to it. Methods: We conducted a questionnaire survey in Yao City, Osaka. We mailed out a questionnaire survey of 1293 mothers with infants who had either a 4‐month or 42‐month routine health checkup during the period from September to December of 2018. Results: There was no association between "feeling lonely while raising my child" and the absence of "people who helped raise my children." On the other hand, it was found that the mothers' inner feelings, such as "I wasn't satisfied with my childcare environment" (OR: 2.55, 95% CI: 1.32–4.91, p = 0.0052) or "I lacked confidence in my own childcare abilities" (OR: 6.21, 95% CI: 4.31–8.95, p < 0.0001), were associated with their sense of loneliness. Conclusions: Mothers' "sense of loneliness" was shown to be best correlated with their dissatisfaction with the environment of their childcare and with their lack of confidence in raising their own children. [ABSTRACT FROM AUTHOR]

To date, there has been no systematic examination of cross‐cultural differences in group‐based shame, guilt, and regret following wrongdoing. Using a community sample (N = 1358), we examined people's reported experiences of shame, guilt, and regret following transgressions by themselves and by different identity groups (i.e., family, community, country) in Burkina Faso, Costa Rica, Indonesia, Japan, Jordan, the Netherlands, Poland, and the United States. We assessed whether any variation in this regard can be explained by the relative endorsement of individualistic or collectivistic values at the individual level and at the country level. Our findings suggest that people's reported experience of these emotions mostly depends on the transgression level. We also observe some variation across individuals and countries, which can be partially explained by the endorsement of collectivistic and individualistic values. The results highlight the importance of taking into account individual and cultural values when studying group‐based emotions, as well as the identity groups involved in the transgression. [ABSTRACT FROM AUTHOR]

Objectives Coffee, green tea, and caffeine are potential preventive factors for dementia, but the underlying evidence is insufficient. This study aimed to examine associations between the consumption of coffee, green tea, and caffeine and dementia risk in middle‐aged and older people. Methods: This was a cohort study with an 8.0‐year follow‐up. Participants were community‐dwelling individuals (n = 13,757) aged 40–74 years. A self‐administered questionnaire survey was conducted in 2011–2013. Predictors were the consumption of coffee/green tea, from which caffeine consumption was estimated. The outcome was incident dementia obtained from the long‐term care insurance database. Covariates were demographic factors, body mass index, physical activity, energy, smoking, drinking, and disease history. Adjusted hazard ratios (HRs) were calculated using Cox proportional hazards models. HRs were also calculated using a Cox model with delayed entry. Results: The number of dementia cases during the study period was 309. Participants with higher coffee consumption had lower HRs (adjusted p for trend = 0.0014), with the fifth quintile (≥326 ml/day) having a significantly lower HR (0.49, 95% confidence interval [CI]: 0.30–0.79) than the first quintile (<26 ml/day, reference). Similarly, participants with higher caffeine consumption had a significantly lower HR (adjusted p for trend = 0.0004) than the reference. The Cox model with delayed entry yielded similar results. These associations were significant in men, but not in women. Moreover, participants who consumed 2–2.9 cups/day and ≥3 cups/day of coffee had lower HRs (0.69, 95% CI: 0.48–0.98 and 0.53, 95% CI: 0.31–0.89, respectively) than those who consumed 0 cup/day. The association between green tea consumption and reduced dementia risk was significant (adjusted p for trend = 0.0146) only in the 60–69 years age subgroup. Conclusions: High levels of coffee and caffeine consumption were significantly associated with a reduced dementia risk in a dose‐dependent manner, especially in men. Moreover, coffee consumption of ≥3 cups/day was associated with a 50% reduction in dementia risk. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the vitamin D status among healthy pregnant women in Japan, and to evaluate the effectiveness of the antenatal health guidance intervention for the pregnant women who were informed about their low vitamin D levels. Methods: We measured the level of 25‐hydroxyvitamin D (25[OH]D) using chemiluminescent immunoassay among the singleton pregnant women who received at antenatal routine check‐up (8–24 weeks of gestation) with written consent during September 2017–September 2018. The measurement values were informed by the concerned physician and health guidance intervention was given to the pregnant women with inadequate Vitamin D status (25[OH]D < 30 ng/mL). At around 36 weeks of gestation, the measurement of 25(OH)D and a questionnaire regarding behavioral changes after the guidance was conducted. Results: The average value of 25(OH)D of 1192 pregnant women before the guidance was 14.89 ± 4.85 ng/mL, and the prevalence of sufficient vitamin D status (25(OH)D ≥ 30 ng/mL) was 0.67% (8/1192). Nine hundred eighty‐two pregnant women who had inadequate vitamin D status were followed, thereafter‐guidance prevalence of sufficiency was 1.02% (10/982); insufficiency, 14.66% (144/982); and deficiency, 84.32% (828/982), respectively. Although the prevalence of deficiency was decreased after guidance intervention significantly, the prevalence was still high and the effect on behavioral changes was a little. Conclusion: The prevalence of vitamin D sufficient status among pregnant women in Japan was extremely low, which is a serious condition. It was also revealed the effectiveness of the antenatal health guidance intervention for pregnant women was not enough. [ABSTRACT FROM AUTHOR]

Aim: To investigate the management of obstetrical disseminated intravascular coagulation (DIC) in Japan. Methods: We sent a surveillance questionnaire to 2299 institutions to collect details about the deliveries they performed in 2018. We investigated differences in the management of obstetrical DIC among three types of institutions: perinatal medical centers (PMCs), general hospitals with obstetrical facilities (GHs), and maternal clinics with beds (MCs). Results: We received responses from 703 institutions (30.6% of the total mailed) with results of 306 799 women who gave birth in 2018. In Japan, the potential to treat postpartum hemorrhage and obstetrical DIC was high in the PMC group, moderate in the GH group, and low in the MC group. The incidence of obstetrical DIC in the PMC group (0.44%) was significantly higher than that in the GH (0.21%) and MC (0.06%) groups. The mortality of women with obstetrical DIC in PMCs (1.3%) was similar to that in GHs (0.6%) and MCs (0.0%). The percentages of PMCs that always or sometimes transfused fresh frozen plasma or fibrinogen concentrates (100% and 42.2%, respectively) were significantly higher than those in the GH (88.2% and 29.5%, respectively) and MC groups (29.4% and 5.3%, respectively). Furthermore, institutions whose internal protocols mandated that replacement therapy be always administered in women with obstetrical DIC scores of ≥8 had similar protocols to those for women with fibrinogen levels of ≤1.5 g/L. Conclusions: The capacity to provide therapy for postpartum hemorrhage and obstetrical DIC varied widely among the three groups of institutions. [ABSTRACT FROM AUTHOR]

Aim: Although poor childhood rearing environment is known to negatively impact late‐life cognitive function, there is a scarcity of evidence on the contribution of positive parenting behaviors. The present study investigates the association between parental involvement in childhood and late‐life cognitive function. Methods: A total of 266 older adults aged between 65 and 88 years living in Wakuya City, Miyagi Prefecture, Japan, without indication of mild cognitive impairment or dementia, participated in a survey. Parental involvement in childhood was assessed by a questionnaire, and late‐life cognitive function was measured by the Japanese version of the Quick Mild Cognitive Impairment (QMCI) screening test (range: 0–100). Multiple regression analysis was performed to investigate the association, adjusting for potential confounders and mediators. Results: After adjusting for age, sex, other child‐rearing environment, and academic performance in grade 6, older adults with a high level of positive parental involvement in childhood scored 6.00 (95% CI: 2.39, 9.61) points higher for the QMCI total score than those without. Parental involvement in childhood showed significant dose–response positive associations with the QMCI total score (P < 0.001), clock‐drawing test score (P < 0.05), and verbal fluency score (P < 0.001). Among the six types of positive parental involvement, book reading showed a significant independent positive association with QMCI total score (P < 0.01) and logical memory score (P < 0.01). Conclusions: Greater parental involvement in childhood, particularly book reading, was associated with better late‐life cognitive function. Geriatr Gerontol Int 2021; 21: 794–801. [ABSTRACT FROM AUTHOR]

Objectives Weight loss is a critical health issue in older adults. Oral function is essential for nutrient intake and can be restored using dental prosthetic treatments in patients with tooth loss. This study aimed to investigate the relationship between tooth loss and weight loss among the older adults and to evaluate the magnitude of its risk reduction by dental prosthetic treatment. Design Three‐year follow‐up longitudinal study based on a self‐reported questionnaire. Setting Community‐dwelling older adults in Japan. Participants Adults aged 65 and older (n = 53,690). Measurements We used >10% weight loss during follow‐up, the number of remaining teeth, and the use of dental prostheses as the outcome variable, exposure variable, and mediator, respectively. We fitted the logistic regression model including possible confounders and calculated the odds ratios (ORs) and 95% confidence intervals (95% CIs) of the controlled direct effect (CDE) at the level of use or nonuse of the dental prosthesis based on a causal mediation analysis framework. Additionally, we calculated the proportion eliminated by the dental prosthesis. Results: The mean age of participants was 72.6 years (1 SD = 5.5), and 47.4% were males. About 5.8% (n = 3132) of them experienced >10% weight loss during the follow‐up. Weight loss was observed in 6.8% of the participants with 0–19 remaining teeth and in 4.3% of them with ≥20 remaining teeth. The CDE of 0–19 remaining teeth was greater when no one used dental prosthesis (OR = 1.41; 95% CI = 1.26–1.59) compared with that when all participants used dental prosthesis (OR = 1.26; 95% CI = 1.08–1.46). This indicated that dental prosthesis decreased the risk of weight loss by 37.3%. Conclusion: Our study revealed that tooth loss increased the risk of clinically critical levels of weight loss among community‐dwelling older adults. However, this risk was reduced by dental prosthetic treatment. [ABSTRACT FROM AUTHOR]

The purpose of this cross‐sectional study was to examine factors associated with nurses' resilience during the COVID‐19 pandemic. Data were collected in the latter half of 2020 from 904 nurses across Japan, Republic of Korea, Republic of Turkey, and the United States. The questionnaire included the Connor‐Davidson Resilience Scale 10, plus demographics and 20 questions about practice environment, workplace safety concerning infection control, COVID‐related experience, and organizational support. Fear of becoming infected, intention to leave nursing, and having had a positive COVID‐19 test were inversely associated with resilience (p < 0.05). Regression analysis indicated that U.S. nurses had significantly greater resilience than nurses in the other countries examined (p < 0.001). Nurses reporting organization support and those who participated in policy and procedure development had higher resilience scores (p < 0.01). Organizational support, involving nurses in policy development, and country of practice were found to be important resilience factors in our research, which aligns with other findings. Further research is recommended to determine the optimal practice environment to support nurse resilience. [ABSTRACT FROM AUTHOR]

Objectives: Ultrasonic scalers often cause an uncomfortable feeling to patients during the procedure. This study was conducted to compare patient complaint levels between magnetostrictive (M‐USSC) and piezoelectric ultrasonic scalers (P‐USSC) during supragingival scaling. Methods: This study enrolled 82 subjects who received supportive periodontal therapy for at least 2 years. At each recall visit, probing pocket depth (PPD), bleeding on probing (BOP) and O'Leary plaque control record (O'PCR) were recorded. Then, supragingival scaling was performed using P‐USSC (Varios or Petit Piezo) at the first visit and M‐USSC (Cavitron) at the second visit. After each treatment, a questionnaire survey was performed using the Wong‐Baker Faces Pain Scale for six items, which included the typical complaints occurring during ultrasonic scaling. Results: The scores for all the six items related to patient complaints were greater for P‐USSC than for M‐USSC (p < 0.001). Patient complaints such as discomfort, pain, sound, vibration, hyperesthesia and length of treatment time were ameliorated in 74%, 65%, 80%, 67%, 57% and 53% of subjects using M‐USSC, respectively. On the other hand, only <5% of subjects showed deterioration in terms of each complaint. Conclusion: This study suggested that M‐USSC causes fewer patient complaints during supragingival scaling than P‐USSC. M‐USSC may improve patient motivation and compliance and may contribute towards achieving successful treatment outcomes. However, this result could differ depending on the shape of the tip and the insert and treatment site. Further research will be required under various conditions. [ABSTRACT FROM AUTHOR]

Background: In Japanese high schools, understanding of school non‐attendance and students with developmental disabilities, including autism spectrum disorder (ASD), is gradually improving. On the other hand, few people recognize social anxiety disorder (SAD), the onset of which commences during youth. Social anxiety disorder and ASD share various overlapping characteristics but have different diagnostic criteria. The anxiety caused by these disorders sometimes appears as school non‐attendance. This study examines the relationship between SAD, ASD, and history of school non‐attendance in high school students. Methods: One hundred and fifty‐eight students at one Japanese high school that accepts school non‐ attending students were investigated. To understand the features of ASD and how it relates to SAD tendencies, the Liebowitz Social Anxiety Scale – Japanese (LSAS‐J) and Autism‐Spectrum Quotient – Japanese (AQ‐J) were used. Based on the LSAS‐J cutoff point, participants were divided into high and low anxiety groups and then data were compared between the two groups. Potential factors associated with a high‐SAD trend were evaluated using multivariate logistic regression. Results: The results showed that students with high ASD scores were more likely to have SAD and that a lack of "social skill," a subscale of ASD, was closely associated with a social anxiety trend. However, the relationship between school non‐attendance and social anxiety could not be confirmed. Conclusions: Focusing on the lack of social skills in ASD may provide an opportunity to identify students with high SAD tendencies. This study will contribute to the understanding of high school students with high SAD tendencies in Japan. [ABSTRACT FROM AUTHOR]

Background: Many trace elements are essential for infant growth and development during early life. Their concentrations in breast milk vary depending on social and economic factors. Nonetheless, the present available values in Japan were derived from lactating mothers approximately 15 years ago. Methods: Healthy mothers who gave birth to a single infant after 37 weeks of gestation at Teikyo University Hospital were recruited between July 2016 and December 2017. They were encouraged to collect breast milk samples and a self‐administered food frequency questionnaire at 1 and 3 months postpartum. Anthropometric data for the mothers and their infants were also collected. Overall, 79 subjects were analyzed after excluding subjects with inadequate data in the food frequency questionnaire, insufficient breast milk samples, and medication that could affect dietary intakes. Trace element concentrations were determined by inductively coupled plasma mass spectrometry, and their correlation with several factors were investigated. Results: Trace element concentrations were widely distributed as previously reported. Median concentrations of Cr, Mn, Fe, Cu, Zn, Se, and Mo were 0.8, 0.8, 98, 50, 272, 2.2, and 0.7 µg/dL at 1 month postpartum and 0.6, 0.7, 55, 33, 177, 2.1, and 0.7 µg/dL at 3 months postpartum, respectively. There were no correlations between trace element concentrations and either mothers' intakes or infants' growth. In contrast, there were significant correlations between several trace elements and macronutrients in addition to inter‐element correlations among almost all trace elements. Conclusions: Trace element concentrations in mature breast milk were determined from recently lactating mothers in Japan. [ABSTRACT FROM AUTHOR]

Aim: The Ministry of Health, Labour, and Welfare of Japan proposed a regulation of overtime work as a reform in work style. However, the regulation may deteriorate the quality of medical services due to the reduction in training time. Thus, the study aimed to reveal perceptions in terms of generation gaps in views on self‐training and overtime work, among members of the Japan Society of Obstetrics and Gynecology (JSOG). Methods: A web‐based, self‐administered questionnaire survey was conducted among members of the JSOG. In total, 1256 respondents were included in the analysis. Data were collected on age, sex, experience as a medical doctor, location of workplace, work style, the type of main workplace, and number of full‐time doctors in the main workplace. The study examined the attitudes of the respondents toward overtime work and self‐training. The respondents were categorized based on experience as a medical doctor. Results: According to years of experience, 112 (8.9%), 226 (18.0%), 383 (30.5%), 535 (42.6%) doctors have been working for ≤5, 6–10, 11–19, and ≥ 20 years, respectively. Although 54.5% of doctors with ≤5 years of experience expected the regulation on working hours to improve the quality of medical services, those with ≥20 years of experience expressed potential deterioration. After adjusting for covariates, more years of experience were significantly related with the expectation of deterioration in the quality of medical services. Conclusions: The study revealed a generation gap in the views about self‐training and overtime work among obstetricians and gynecologists in Japan. [ABSTRACT FROM AUTHOR]

Aim: We developed and psychometrically tested the Japanese version of the Professional Attitude Scale for Nurses (PASN‐J). Background: Nurses must recognize the importance of their professionalism; therefore, it is critical to quantitatively measure nurses' professional attitudes. Introduction: This instrument validation study was designed to generate an itemized scale and examine its content validity/psychometric testing using a sample of Japanese nurses. Methods: Based on a trait approach focusing on the characteristic traits of the nursing profession, a 59‐item draft scale was generated. During November 2017, 2657 nurses from 29 facilities in Japan were surveyed. The questionnaire included demographics, the 59‐item draft scale, and a self‐report scale of nurses' professional behaviour and nursing practice ability. Using exploratory and confirmatory factor analyses, we evaluated the construct, criterion‐related, concurrent, and known‐groups validity, and reliability of the PASN‐J. Results: Data from 1716 participants were analysed. The analyses yielded a 38‐item, 3‐factor scale that adequately fit the data. PASN‐J scores were positively correlated with nurses' professional behaviour and nursing practice ability. Conclusion: The 38‐item PASN‐J has good reliability and validity, making it useful for measuring the current condition of nursing professionalism and evaluating nursing education. Implications for Nursing and Health Policy: This scale can evaluate nursing education and promote nurses' professionalism. The PASN‐J will help identifying the elements of undergraduate nursing education that require further emphasis. Additionally, the PASN‐J could facilitate the development of nursing policies to promote professional development in nurses. Ultimately, evaluating nursing education with the PASN‐J enhances nurses' professional attitudes and subsequently improves their quality of nursing, nursing efficiency and patient outcomes. [ABSTRACT FROM AUTHOR]

The most significant influence on nurses' professional growth is through work under direct guidance in clinical settings. Associate nurse unit managers perform direct patient care with the staff, as well as assist management work of nurse unit managers. They can be excellent role models for the staff. We examined their behaviors that help promote staff development, aimed to identify effective behaviors, and created a self‐checklist to evaluate them. We created 53 items to assess staff development behaviors, which were evaluated via a Delphi survey with 252 experts and a questionnaire survey with 124 associate nurse unit managers in Japan to evaluate whether the created item was appropriate. The results of the Delphi survey showed an agreement rate of over 90%, and associate nurse unit managers showed an acceptance rate of 82.6–99.2% for 40 of 53 items. Consequently, we created 40‐item self‐checklist of staff development behaviors for associate nurse unit managers with adequate validity. This checklist would be helpful for them to promote staff development while working in clinical settings and would contribute to enhancing the quality of nursing. [ABSTRACT FROM AUTHOR]

High graduation of nurses and limited job opportunities in Indonesia may lead to the emigration of nurses particularly through facilitated migration. This study aimed at identifying the prevalence of Indonesian nursing students with intention to work in Japan and predictors of their intention to migrate as well as having a definite plan to work in Japan. The study adopted cross‐sectional design with a sample of 1,407 Indonesian nursing students. Factors associated with having migration intention, as well as a definite plan to work in Japan, were age, residence, and overseas experience. Other factors related to a definite plan to work abroad were family income, mastering a foreign language, knowledge about the nurse migration related to Indonesia‐Japan cooperation, and their motivations to migrate to Japan. Sustainability of this international recruitment of nurses is possible by understanding the context of both source and destination countries. Maximizing benefits of migration of nurses for Indonesia and Japan requires structured policies targeting the educational sector and addressing the sustainability issues. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to develop and evaluate the effectiveness of using e‐learning on smartphones to provide dental hygiene education on dental treatment procedures. Methods: This was a randomized controlled trial. Two‐hundred ninety‐three dental hygiene students in four universities, one junior college and one technical school took a preliminary examination, and based on the results, participants in each school were randomly divided into two groups, a test or control group. Both groups took pre‐ and post‐examinations at a 4‐week interval. The test groups learned dental treatment procedures and four‐handed techniques with interactive learning materials using smartphones. The learning materials allowed them to watch videos of dental treatments. The control groups were not provided any learning material. Results: Results of all schools combined showed that the changes from pre‐ to post‐examination scores in the test groups were significantly higher than those of the control groups (p <.05). Post‐examination scores were significantly higher than pre‐examination scores in the test groups in all schools (p <.05). Also, post‐examination scores of the test groups were significantly higher than those of the control groups (p <.05). The changes from pre‐ to post‐examination scores in the test groups of two schools were significantly higher than those of control groups (p <.05). Post‐examination scores of the control groups in two schools were significantly higher than pre‐examination scores (p <.05). Conclusions: Learning dental treatment procedures through e‐learning on a smartphone was effective in developing participants' understanding of dental treatment procedures and four‐handed techniques. [ABSTRACT FROM AUTHOR]

Background: There are growing concerns about the increasing rate of caesarean section (CS) worldwide. Various strategies have been implemented to reduce the proportion of CS to a reasonable level. Most research on medical indications for CS focuses on nationwide evaluations. Comparative research between different countries is sparse. The aim of this study was to evaluate differences in the rate and indications for CS between Japan and Germany in 2012 and 2013. Methods: Comparison of the overall rate and medical indications for CS in two cohort studies from Germany and Japan. We used data from the German Perinatal Survey and the Japan Environment and Children's Study (JECS). Results: We analyzed data of 1 335 150 participants from the German perinatal survey and of 62 533 participants from JECS and found significant differences between the two countries in CS rate (30.6% vs 20.6%) and main medical indications: cephalopelvic disproportion (3.2% vs 1.3%; OR: 2.4 [95% CI: 2.2–2.6]), fetal distress (7.3% vs 2.3%; OR: 3.4 [95%‐CI: 3.2–3.6]), and past uterine surgery/repeat CS (8.4% vs 8.8%; OR: 0.9 [95%‐CI: 0.9–1]). Conclusion: There are differences in the rate and medical indications for CS between Germany and Japan at the population level. Fetal distress was identified as a medical indication for CS more often Germany than in Japan. Considering the substantial diagnostic uncertainty of electronic fetal monitoring (EFM) as the major indicator for fetal distress, it would seem to be reasonable to rethink CS decision algorithms. [ABSTRACT FROM AUTHOR]

Aims and design: Various healthcare services in Japan provide self‐management interventions for older people with chronic obstructive pulmonary disease (COPD). To examine the influence of healthcare service utilisation on self‐management activities, we conducted a cross‐sectional survey of older people with COPD who received care through outpatient clinics (OC), outpatient rehabilitation centres (OR) or home care (HC) services. Methods: The survey consisted of 34 originally developed self‐report questions about three types of self‐management activities: (a) strategies to minimise dyspnoea, (b) appropriate activities to maintain physical and mental health status and (c) communication with healthcare professionals or family members. We compared self‐management activities in each setting (OC, OR and HC) using logistic regression analyses, controlling for dyspnoea level and age, which we chose as representative variables of disease severity. Results: Among the total sample (n = 81; mean age: 78.2 years old), participants in the HC group (n = 25) had the most severe level of COPD, followed by those in the OR (n = 31) and OC (n = 12) groups. Compared with participants from the OC group, more participants from the OR and HC groups reported self‐management activities, such as "moving body corresponding to breathing" (OR: adjusted odds ratio [AOR], 6.71; HC: AOR, 6.98), "trying not to move quickly" (OR: AOR, 5.46), "avoiding suffocating movements" (HC: AOR, 7.37), "getting an influenza vaccination"(OR: AOR, 8.12; HC: AOR, 7.81), "stretching exercise" (OR: AOR, 6.42; HC: AOR, 16.76), "muscle training" (OR: AOR, 8.49; HC: AOR, 9.73) and "discussing lifestyle goals with healthcare professionals" (HC: AOR, 5.75) after controlling for dyspnoea level and age. Conclusions: Some self‐management activities (such as breathing techniques and home exercise) were associated with the use of OR or HC services, an effect persisting after adjusting for degree of breathlessness and age. Implications for practice: Findings suggest that we should provide additional services such as OR and HC besides OC to older people with COPD who are unable to practice self‐management activities. We need to consider strategies to provide effective self‐management intervention in each healthcare service setting according to the unique characteristics of each setting. [ABSTRACT FROM AUTHOR]

Background: The dietary variety score (DVS), a simple dietary survey method for older adults, investigates the weekly frequency of consumption of the 10 food groups in Japan. The DVS is also associated with nutritional status. The original scoring method applied only to community‐dwelling older adults, not to older patients receiving home care, who have little dietary variety. Aim: Using three different scoring methods for the DVS, we examined which method was most likely to reflect the nutritional status of older patients receiving home care. Methods: This cross‐sectional study was carried out on older patients receiving home care. Participant characteristics, the DVS (evaluated using three different scoring methods), and the Mini Nutritional Assessment‐Short Form (MNA®‐SF) survey were researched. A receiver operating characteristic (ROC) analysis was performed to find the cut‐off value for the DVS. Multivariate analysis was performed, with malnutrition as the outcome, to investigate the extent to which the DVS is associated with malnutrition. Results: We studied 317 participants. The DVS could produce significant ROC curves using modified scoring methods A and B (p =.028 and.042) with nutritional status as the outcome. Cut‐off value, sensitivity and specificity were 30 points, 60.9% and 55.9% in modified scoring method A and 5 points, 79.1%, and 35.6% in modified scoring method B. Results of the multivariate logistic regression analysis, in Model 1 dysphagia (odds ratio [95% confidence interval]: 3.85 [1.70–8.71]) and the DVS of modified scoring method A (2.00 [1.11–3.62]) were significant independent factors. In Model 2, dysphagia (3.57 [1.58–8.07]) and the DVS based on modified scoring method B (2.36 [1.24–4.47]) were significant independent factors. Conclusions: Modified scoring method B was found to be most suitable for the dietary assessment of older patients receiving home care. Implications for practice: Even in the absence of registered dietitians, any care staff member who is involved in providing nursing services during home‐visits is capable of administering a dietary survey, when using the easy DVS scoring method. [ABSTRACT FROM AUTHOR]

Aim: Nurses are expected to have a role in the transition of care from pediatric to adult medical practices for adolescents and young adults with childhood‐onset chronic diseases. This study compares the experience, knowledge, and perceptions regarding the ideal care among adult unit and pediatric nurses regarding the transition to adult care for those with childhood‐onset chronic diseases. Methods: A cross‐sectional study using self‐report questionnaires was conducted with nurses in a tertiary hospital in Tokyo. Questions were generated based on a literature review and expert discussion. Data from 1,064 participants were analyzed (adult unit nurses: n = 959, 90.1%; pediatric nurses: n = 105, 9.9%). Results: Among 623 adult unit nurses who had care experience for adult patients with a childhood‐onset chronic disease, 458 nurses (73.6%) were unaware of the concept of transitional care. As the obstructive factors for transition, pediatric nurses recognized problems in healthcare providers' attitudes and lack of transitional care coordinators, while the adult unit nurses emphasized the patients' wishes to continue to receive pediatric healthcare. Most adult unit nurses expected pediatric nurses to function as transitional care coordinators. Conclusion: Adult unit and pediatric nurses had different perceptions of the barriers in transitioning children with chronic diseases to adult care. It is important to have educational programs focusing on transitional care for all nurses, both to enable pediatric nurses to improve transition readiness of children with chronic diseases and to offer adult patients with a childhood‐onset chronic disease continuing support through adult unit nurses. [ABSTRACT FROM AUTHOR]

Aim: To clarify the actual condition and examine the effects of differences in wiping pressure applied by clinical nurses during daily bed baths on skin barrier function, cleanliness, and subjective evaluations. Methods: For the purposes of the present quasi‐experimental interventional study, "wiping pressure" was defined as the "force applied vertically to the skin surface during bed baths." Two types of bed baths, one using ordinary wiping (pressure: 23–25 mmHg) and the other using weak wiping (pressure: 12–14 mmHg), were performed on the forearms (right and left) of 30 healthy adult men and women, and the effects on transepidermal water loss, stratum corneum hydration, cleanliness, and subjective evaluations were examined. Results: The results showed no differences between ordinary and weak wiping pressure in regard to the effects on skin barrier function and cleanliness. In terms of subjective evaluations, a significant association was seen between wiping pressure and the "sensation of having dirt removed" (P =.036). Regarding "degree of pain," some participants reported that the wiping pressure felt "slightly painful" under both conditions (ordinary: 31.1%; weak: 10.7%), while some with sensitive skin reported feeling pain even during weak wiping pressure. Conclusions: The results of the present study suggest that skin assessments should be performed before and after bed baths, and that wiping pressure should be controlled and evaluated while considering the patient's feelings. [ABSTRACT FROM AUTHOR]

Background: Sleep shortage has been pervasive among pupils. Methods: Multiple regression analysis was used to analyze 2,722 questionnaires obtained from grade 5 to 12 pupils, to determine factors associated with sleep duration. Results: Significant regression formulae for sleep duration were obtained for all school types: adjusted R2/ P value were 0.14/<0.001 for elementary school; 0.11/<0.001 for junior high school; 0.06/<0.001 for high school. Longer after‐school activities (standardized regression coefficient/ P value were −0.22/<0.001 for elementary school; −0.10/<0.01 for junior high school; −0.18/<0.001 for high school) and more sleepiness (−0.09/<0.001 for elementary school; −0.07/<0.05 for junior high school; −0.07/<0.05 for high school) were significantly associated with reduced sleep duration for all school types. In both elementary and junior high schools, the higher grade (−0.53/<0.001 for elementary school; −0.10/<0.01 for junior high school), and longer weekday screen time (−0.15/<0.001 for elementary school; −0.19/<0.001 for junior high school) were also significantly associated with sleep loss. In elementary school, irregular dinner (−0.07/<0.05), breakfast skipping (−0.11/<0.001), longer weekend screen time (−0.09/<0.05) and better self‐reported academic performance (0.07/<0.05) also revealed significant associations with sleep loss. In high school, reduction of sleep duration was also significantly associated with higher standardized body mass index (−0.08/<0.05). Conclusions: Excessive after‐school activity might be considered in association with pupils' sleep reduction. [ABSTRACT FROM AUTHOR]

Nurses need to be appropriately trained in genetics to provide clinical care based on best practice for patients and families. This exploratory study describes an educational intervention using authentic stimulus material centered on a clinical case study of a family with a baby with Down syndrome. Quantitative and qualitative data were collected from a sample of 15 nurses and 27 students from three universities in Japan before and after completing an entry‐level workshop on competency‐based genetics nursing. Participants reported increased perceived genetics knowledge and clinical confidence. Despite more than 90% of the participants reporting that they understood the underlying genetics knowledge, their confidence and the ethical aspects of genetics nursing had not been promoted after the seminar. In contrast, the reflections, coded into three categories, showed they recognized families' needs for psychological support, family decision making, and protection and privacy and suggested that nurses had undergone a profound shift in understanding about these issues. Although indicating that a single seminar was insufficient, the study findings will be useful to develop educational materials on genetics for both students and nurses. [ABSTRACT FROM AUTHOR]

Aim: Critical thinking is vital in implementing evidence‐based practice. However, little is known about factors related to critical thinking among nurses in Japan. This study aims to comprehensively explore the organizational and personal factors related to critical thinking disposition among hospital nurses in Japan. Methods: We conducted a cross‐sectional, self‐administered questionnaire survey. Critical thinking was measured using the 33‐item Japanese Critical Thinking Disposition Scale. We asked nurse managers about organizational characteristics of hospitals/units and about their critical thinking disposition. We questioned staff nurses regarding personal characteristics, cultural construal of self, self‐esteem, perception of their work environment and workload, experiences of nursing research, and critical thinking disposition. We conducted multiple regression analysis to identify factors associated with staff nurses' critical thinking. Results: We analyzed data from 68 nurse managers and 986 staff nurses. The staff nurses' mean age was 37.6 years and 91% of the participants were female. Factors related to higher critical thinking were working in an emergency unit (β =.07, p =.040); having a bachelor's degree or higher qualification (β =.07, p =.030); having higher independent view of self (β =.22, p <.001), self‐esteem (β =.24, p <.001), and perceived workload (β =.10, p =.002); and training experience of nursing research in post‐licensure education (β =.15, p <.001). Conclusions: The factors influencing critical thinking disposition are mainly related to personal characteristics or experiences. Providing research training for nurses may contribute to fostering critical thinking. [ABSTRACT FROM AUTHOR]

Aim: To explore what factors may influence recovery knowledge and attitudes among professionals in mental health. Methods: We utilized an existing dataset from a study that surveyed 331 subjects among 475 eligible professionals. We used data from 289 participants without missing values for the analyses (valid response rate = 60.8%). The questionnaire included three psychometrically tested scales: (a) Recovery Knowledge Inventory (RKI); (b) Recovery Attitudes Questionnaire (RAQ); and (c) Internal Work Motivation, as well as other variables. Mean‐based comparisons of the RKI and RAQ scores between several subgroups were examined. We also examined the correlation between RKI and RAQ scores and the continuous variables. Multiple linear regression was implemented to examine the simultaneous effects of the factors on RKI and RAQ scores. The mean age of participants was 39.9 years and 69.2% were female and 44.0% were nursing professionals. Results: Multiple linear regression analyses showed that the internal work motivation and the experience of discharging patients after a lengthy hospitalization were significantly and positively associated with recovery attitude. Working at community facilities and being young were significantly and weakly correlated with recovery knowledge. The experience of participation in self‐help groups exhibited positive relationships with RKI and RAQ scores, while education exhibited positive but weak relationships with RKI and RAQ scores. No significant relationship was observed in the regression analyses. Conclusions: Internal work motivation, the experience of discharging patients after a lengthy hospitalization, working at community facilities, and being young may positively contribute to better recovery knowledge and attitudes. Future research using a longitudinal design will explore other factors. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between use of assisted reproductive technology (ART) and mother‐to‐infant bonding. Methods: Using nationwide birth cohort study with periodical follow‐ups for mothers and children during pregnancy and at 1 year after delivery, mothers were classified following three groups; infertility group with ART: 2792 mothers; infertility group with non‐ART treatment (ovulation induction and intrauterine insemination): 3835 mothers and unaided pregnancy group: 78 726 mothers. Data on maternal and child health as well as basic characteristics were collected via medical records and self‐administered questionnaires. The Japanese version of Mother‐to‐Infant Bonding Scale was used to evaluate maternal bonding style. To evaluate the association between ART and maternal bonding toward babies, multivariate analysis was used with adjustment for potential confounders such as babies' sex, socio‐economic status and history of maternal mental disorders. Results: Multivariate logistic regression analysis indicated that ART was slightly but significantly associated with an increased risk of maternal lack of affection toward their newborn (adjusted odds ratio 1.10, 95% confidence interval 1.02–1.20), while non‐ART was significantly associated with both maternal lack of affection and anger/rejection toward the newborn. No substantial association was observed between ART and overall Mother‐to‐Infant Bonding Scale score (adjusted odds ratio 1.03, 95% confidence interval 0.94–1.12). Very slight negative correlations were observed between poor mother‐to‐infant bonding and good infant mental and physical development at both 6 months and 1 year. Conclusion: ART may exert a negative influence on maternal emotion after delivery, but this does not have strong correlation with child development evaluated by mothers. [ABSTRACT FROM AUTHOR]