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Chronic constipation (CC), which can cause behavioral and psychiatric symptoms of dementia and related caregiver distress, is common in older adults admitted to care facilities with dementia. This study aimed to examine the effect of defecation care on CC and related problems.This study compared bowel training and defecation posture intervention (intervention group) with general care (control group) as the treatment of CC among older adults with dementia in 6 long-term care facilities. The primary outcomes were the number of spontaneous bowel movements (SBMs) and complete SBMs. The secondary outcomes were Patient Assessment of Constipation Quality of Life Questionnaire, Constipation Scoring System, constipation symptoms, and Neuropsychiatric Inventory Nursing Home Version scores. The differences were analyzed using 2-way ANOVA with repeated measures.The data of 30 patients (14 in the intervention group, 16 in the control group) were analyzed. Weekly mean complete SBMs increased from 0.53 times at baseline to 1.58 times at 8 weeks in the intervention group compared with a change from 0.56 to 0.43 times in the control group (interaction P0.001). The Patient Assessment of Constipation Quality of Life Questionnaire, Constipation Scoring System, behavioral and psychiatric symptoms of dementia, and caregiver distress scores showed significant improvement after 8 weeks of defecation care intervention.Defecation care, including bowel training and appropriate defecation posture, is effective for CC among older adults with dementia, improving patient mental health and reducing burden on caregivers.

Wheat (Triticum aestivum L.) is one of the most important crops in the world. In the Central-West region of Brazil, there wheat cultivation has increased greatly; however, diseases such as tan spot (Pyrenophora tritici-repentis) are a concern. Silicon is known to act on the plant's defense process; therefore, the objective of this work was to evaluate the efficiency of silicon associated with fungicides in reducing the severity of wheat tan spot in the State of Goiás. The experiment was carried out in the field, with two wheat cultivars and two plots, where one received four applications of silicon + fungicides and the other only fungicide. The severity was evaluated through a scale of points that varied between 1 (small spots) and 5 (large necrotic and chlorotic areas coalescing) and the hectoliter weight was calculated. Based on the experiment, it was observed that the silicon associated with fungicides reduced the severity of the tan spot in both cultivars and also resulted in higher grain quality. It was concluded that the application of silicon reduces the severity of tan spot in wheat, indicating the effect of the micronutrient as an inducer of resistance in plants under the conditions of the Goiás Cerrado.

ObjectivesClassifying individuals into multimorbidity patterns can be useful to identify the target population with poorer clinical outcomes. Self-rated health (SRH) is one of the core outcomes in multimorbidity patients. Although studies have reported that multimorbidity is associated with poor SRH, whether certain patterns have stronger associations remains unknown. Therefore, this study aimed to identify the prevalence and patterns of multimorbidity and investigate the association between multimorbidity patterns and SRH in an older Japanese population.DesignCross-sectional study.SettingData were obtained from the 2013 Comprehensive Survey of Living Conditions, a nationally representative survey of the general Japanese population.ParticipantsThis study mainly examined 23 730 participants aged ≥65 years who were not hospitalised or institutionalised.Primary outcome measurePoor SRH was defined as choosing ‘not very good’ or ‘bad’ from five options: ‘excellent’, ‘fairly good’, ‘average’, ‘not very good’ and ‘bad’.ResultsThe prevalence of multimorbidity was 40.9% and that of poor SRH was 23.8%. Three multimorbidity patterns were identified by exploratory factor analysis: (1) degenerative/mental health, (3) malignant/digestive/urological/haematological and (3) cardiovascular/metabolic. Multivariable modified Poisson regression analysis revealed that high malignant/digestive/urological/haematological, degenerative/mental health and cardiovascular/metabolic pattern scores, corresponding to the number of affected body systems in each pattern, were significantly associated with poor SRH (adjusted risk ratio (aRR)=1.68, 95% CI: 1.60 to 1.76; aRR=1.63, 95% CI: 1.58 to 1.69; and aRR=1.31, 95% CI: 1.26 to 1.36, respectively). When including the Kessler 6 score, a screening scale for psychological distress, in the analysis, the association between each multimorbidity pattern score and poor SRH decreased.ConclusionsMalignant/digestive/urological/haematological and degenerative/mental health patterns may be associated with a high risk for poor SRH. Further research should focus on interventions to improve SRH in multimorbidity patients.

The effects of the regular consumption of soy, barley, and green tea in a real-life setting are unclear. This longitudinal observational study showed the associations of their intake with cardiometabolic health when employees freely selected these foods in the workplace cafeteria of an industrial company in Japan. The consumption was objectively assessed by an electronic purchase system using integrated circuit chip-equipped tableware and personal identification cards. The associations between the cumulative number of servings of each food during the 12 weeks prior to a health examination and changes in cardiometabolic measurements were examined among Japanese male workers (

Previous studies of occupational health services (OHS) during the coronavirus infection disease (COVID-19) pandemic have focused on either occupational physicians (OPs) or enterprises mainly in the metropolitan areas. This survey aimed to assess OHS in some local cities during the pandemic and different perceptions of OPs and small- and medium- sized enterprises, which could contribute to efficient OHS in the future.From July to October 2021, we conducted a questionnaire survey targeting 196 OHS officers and 42 OPs in Shizuoka prefecture. We mailed 196 questionnaires (anonymous) to the OHS officers, with self-addressed postcards requesting their OP's cooperation for a similar survey. Based on the postcards replies, we mailed 149 questionnaires to 36 OPs. The survey was consisted of five categories; demographic characteristics, changes in OHS during the pandemic, infection countermeasures, infection status of employees, and free descriptions.The effective responses included 155 and 124 questionnaires from officers and 29 OPs, respectively. Regarding demographic characteristics, manufacturing and processing industries comprised the most frequent office types, whereas fewer than 100 employees comprised the most common office size. Regarding the changes in OHS, 8.4% of enterprises had OP's remote participation in health committees, and 14.5% of enterprises had stopped workplace patrols. Regarding infection countermeasures, approximately 90% of enterprises received advice and support from OPs and perceived health committees as the most helpful in receiving it. Whereas, OPs primarily gave it in workplace patrols. Many enterprises have implemented various infection countermeasures; however, they feel that promoting smoking cessation is difficult. They believed that the following advice and support was useful for the countermeasures; promoting awareness-raising activities to prevent infection, ventilation methods, and infection control while eating. Approximately 6.6% of enterprises were reluctant to share information about infection status among employees with OPs, and 34.5% of OPs were reluctant to share it with OHS officers. Moreover, about the ratio of enterprises whose employees had COVID-19, we found a difference between enterprises (39.4%)and OPs (28.2%). In free descriptions, some enterprises complained that OPs focused on COVID-19-related OHS and neglected conventional OHS.The survey revealed the OHS during the pandemic in some local cities and different perceptions about infection status between enterprises and OPs. To prepare for future pandemics, official organizations and academic conferences should provide guidelines for sharing information between OPs and enterprises. We believe this survey will lead to further cooperation between the two and better OHS combining COVID-19-related and conventional OHS.

Recent randomized controlled trials have demonstrated a protective association between carotenoids and inflammation; however, the basis of this association on lifestyle factors remains unclear. This study aimed to clarify the associations between carotenoids and inflammatory markers stratified by lifestyle factors, using baseline data from the Mikkabi Study. Serum carotenoid and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Multivariable adjusted odds ratios (ORs) for a high hs-CRP level (≥2.0 mg/dL) were obtained using logistic regression analysis. The data of 882 individuals were analyzed; 11.7% had high hs-CRP levels. The highest tertile of lutein (OR: 0.44; 95% confidence interval [CI]: 0.25–0.76), zeaxanthin (OR: 0.36; 95% CI: 0.21–0.64), total carotenoid (OR: 0.57; 95% CI: 0.32–0.9997), and oxygenated carotenoid concentration (OR: 0.50; 95% CI: 0.28–0.90), with the lowest tertile as reference, was inversely associated with a high hs-CRP level. The interaction between lutein, but not other carotenoids, and current smoking was significant. The inverse association between lutein and a high hs-CRP level was significant in non-smokers (OR: 0.41; 95% CI: 0.22–0.76) but not in smokers. These results further support the anti-inflammatory effect of carotenoids; nevertheless, further studies should clarify the interaction of smoking with the association between lutein and inflammation.

Background Untreated caries is the most prevalent disease in the world. A sense of coherence (SOC) contributes to oral health. However, little is known about the association between guardians' SOC and children’s oral health. We aimed to clarify the association between guardians’ SOC and their children’s caries based on socioeconomic status in Japan. Methods This study’s subjects were Japanese public junior high schoolers, aged 12-15, and their guardians. We administered a questionnaire survey among guardians in 2016 to assess their SOC and family environment. With their students’ consent, public junior high schools shared the results of the dental examinations. Multivariate logistic regression was conducted to clarify the association between guardians’ SOC and their children’s untreated decayed permanent teeth. We also conducted a stratified analysis according to a relative poverty line. Furthermore, we included interaction term of annual equivalent incomes, educational attainment with guardians’ SOC in analysis. Results We observed a significant inverse association between children’s untreated decay and their guardians’ SOC (OR 0.93). Equivalent annual income had a significant marginal association with decayed teeth (OR 0.14). The association of SOC was stronger in the low economic group (OR 0.64). In the high economic group, educational attainment was significantly associated with decayed teeth (OR 0.50). Conclusions Guardians with higher SOC were associated with children having fewer caries. Guardians’ SOC is a preventive factor for children’s caries, especially among children with low economic status. Key messages This result suggests that guardians’ SOC is one of the psychosocial determinant of children’s oral health.

As a result of the coronavirus disease 2019 (COVID-19) pandemic-related restrictions, food systems have undergone unprecedented changes, with the potential to affect dietary behavior. We aimed to investigate workers’ dietary changes resulting from the introduction of regulations to combat COVID-19 in a Japanese factory cafeteria. Objective data on daytime dietary intake were automatically collected from electronic purchase system records. The dataset included the weekly data of 890 men from 1 July 2019 to 30 September 2020. The cafeteria regulations came into effect on 10 April 2020, in this context, the purchase of dishes and estimated dietary intake were monitored. The number of cafeteria visits decreased slightly after the introduction of the regulations. The purchase of main and side dishes also decreased, but the purchase of grain dishes was less affected. When compared with summer 2019 (pre-pandemic, no regulations: 1 July to 29 September 2019), in summer 2020 (during the pandemic and with regulations: 29 June to 30 September 2020), the estimated mean grain, meat, fish, and total energy intake was stable, however, vegetable intake decreased by 11%. As the COVID-19 pandemic continues, workplace cafeteria regulations need to be monitored to avoid unfavorable dietary changes in employees.

BACKGROUND:The trend of association between overweight and high serum total cholesterol (TC)among the elderly is unclear. In addition, there is little evidence of risk of underweightfor high TC. Therefore, we examined the trend of association of overweight or underweight with high TC among Japanese elderly people using nationwide population-based data., METHODS:Data of the National Survey on Circulatory Disorders and National Health and NutritionSurvey for 1980, 1990, 2000, and 2010 were used in the analysis. High TC was definedas 220 mg/dL and above. For participants aged ≥50 years, sex-specific odds ratios (ORs)of overweight or underweight compared with normal body mass index participants forhigh TC were calculated using a logistic regression model adjusted for age, smoking, drinking, exercise, food, and treatment of hyperlipidemia., RESULTS:A total of 5,014, 4,673, 5,059, and 2,105 participants enrolled in these surveys in 1980,1990, 2000, and 2010, respectively. Although overweight was positively and significantlyassociated with high TC in 1980, the association has gradually weakened since (ORs in 1980 and 2010 were 2.44; 95% confidence interval [CI], 1.83-3.24 and 0.92; 95% CI, 0.66-1.27 among men and 1.43; 95% CI, 1.18-1.72 and 1.08; 95% CI, 0.81-1.44 among women, respectively). While underweight was inversely and significantlyassociated with high TC in 1980, the association also gradually weakened among women(ORs in 1980 and 2010 were 0.28; 95% CI, 0.12-0.60 and 0.37; 95% CI, 0.10-1.28 among men and 0.39; 95% CI, 0.26-0.57 and 0.96; 95% CI, 0.58-1.57 among women,respectively)., CONCLUSIONS:These findings provide evidence that high TC prevention efforts must expand the target to not only overweight but also to normal and underweight people.

[Purpose] This study aimed to determine the coping behaviors of elderly Japanese community-dwelling persons toward their skeletal muscle injuries and disorders. [Participants and Methods] A mail-in, self-administered questionnaire survey was administered to 1,084 community-dwelling adults aged 70 years and older. Information was obtained regarding their coping behaviors when dealing with bone fractures, dislocations, sprains, bruising, stiff shoulders, low back pain, acute muscle/joint pain, chronic muscle/joint pain, and daily fatigue. [Results] Visits to hospitals or general clinics were the most popular coping behavior for bone fractures, dislocations, sprains, bruising, low back pain, acute muscle/joint pain, and chronic muscle/joint pain; visits to a Judo therapist’s office were the second most popular coping behavior for these conditions. Acupuncture, as well as chiropractic and massage clinics, were less frequently visited. For stiff shoulders and daily fatigue, many participants did not visit any medical facility. [Conclusion] Among the elderly, visits to hospitals or general clinics were the most used coping behavior for many types of skeletal muscle injuries and disorders. Visits to a Judo therapist’s office were the second most used coping behavior. Visits to acupuncture, chiropractic, and massage clinics were less frequent. With these data, therapists could improve their care skills upon consideration of the coping preferences among community-dwelling elderly persons.

Background Oral health is thought to be associated with diet quality, and socioeconomic status (SES) affects both oral health and diet. The aim of this study was to investigate the association between the number of teeth and dietary intake as well as nutritional biomarker, considering the subjects’ SES. Methods We conducted a cross-sectional analysis of data from 2049 individuals aged ≥ 50 years from the National Integrated Project for Prospective Observation of Non-communicable Disease and its Trends in the Aged 2010. The number of remaining teeth was categorized into age-specific quartiles (Q1 to Q4). We assessed the adjusted means and 95% confidence intervals for dietary variables by the number of teeth using analysis of covariance. Stratified analyses by SES were also conducted. Results The intake of grain products was 31 g higher, and those of vegetables and meat were 30 g and 8 g lower, respectively, in Q1 (fewer teeth) than in Q4 (more teeth). Carbohydrate intake was higher whereas protein, minerals (potassium, magnesium, and zinc), vitamins (vitamins A, E, B1, B6, β-carotene, and folic acid), and dietary fiber intakes were lower among individuals with fewer teeth. Adjusted mean serum albumin levels were low in Q1. The associations between the number of teeth and dietary intake were more evident in individuals with a low SES. Conclusions Having few remaining teeth was associated with a low nutrient intake and low serum albumin levels in middle-aged and older Japanese adults, and these associations were more evident in individuals with low SES. Electronic supplementary material The online version of this article (10.1186/s12199-018-0752-x) contains supplementary material, which is available to authorized users.

Objectives Shift workers are at an increased risk of diet-related chronic conditions. We aimed to investigate dietary intake and dinner timing among shift workers. Methods A questionnaire survey was administered to the employees of 43 companies in Japan between December 2013 and February 2014. The dietary intake of workers was assessed through a validated food frequency questionnaire (FFQ). Nutrient intake was evaluated by adjusting the total energy intake using a nutrient residual model. Analysis of covariance was used to obtain the means of total energy and nutrient intake by the work schedule (shift or daytime), and the means of total energy and nutrient intake by dinner timing (regular or irregular). Results Valid responses were obtained from 2,062 daytime and 302 shift workers. A valid response rate to the FFQ was slightly but significantly lower among shift workers than among daytime workers (87.1% and 91.8 %). When compared to daytime workers, shift workers were more likely to eat dinner at irregular times (46.7% vs. 3.6%). Shift work was associated with a higher mean body mass index (23.4 kg/m2 vs. 22.3 kg/m2), a higher proportion of being overweight (27.7% and 18.8%), higher total energy intake, and lower intakes of dietary fiber, vitamin B2, folic acid, vitamin C, potassium, calcium, magnesium and iron. Moreover, irregular dinner timing was associated with lower intakes of protein, folic acid, and zinc in daytime workers, and lower intakes of carbohydrate and copper in shift workers. Conclusions These findings indicate a need to improve the diet of shift workers.

People often make judgements irrationally. For example, people tend to underestimate the completion time of tasks and be overly confident in their estimations. Previous research shows that unpacking tasks into a series of required steps reduced the underestimation of completion times. The purpose of this research was to examine the phenomenon of overconfidence in simulation and gaming situations and study the relationship between unpacking and overconfidence. For this research, a production management game, the “OPT SCHEDULING GAME,” was used. Two different questionnaires were distributed before game run to examine whether some informative questions improved the quality of estimations by participants; the results for this were affirmative. A post-game questionnaire assessed the attitudes of participants regarding their understanding of the process, result prediction, etc. The results of this questionnaire showed that their attitudes remained the same whether they were provided with informative questions or not before game run. This was consistent with the results of previous research that showed unpacking did not improve the overall quality of performance on a task, even though unpacking does improve the quality of estimations on the time needed to complete that task. One reason would be those who have an incorrect understanding of the situation tend to be overconfident and convincing and those who have a correct understanding of the situation tend to be less confident and silent. If we could assist those with an incorrect understanding and a sense of overconfidence to become good listeners and support those with a correct understanding and a feeling of uncertainty to become more open and outspoken, then the effect of overconfidence would be reduced. If simulation and gaming can assist people to learn from each other, people can make better judgements as a team.

[Purpose] Three complementary and alternative medicine (CAM) therapies: "Judo therapy", "acupuncture and moxibustion", and "Japanese traditional massage and finger pressure" have been partially covered by the national health insurance in Japan. The lifetime prevalence of the use of these CAM therapies is not well known. The aim of the present study was to report the prevalence of the lifetime use of these CAM therapies. [Participants and Methods] We conducted a mailed self-administered questionnaire survey among community-dwelling older people in Japan in 2015. They were asked whether they had undergone any treatments with the 3 CAM therapies. The answers obtained were classified into 3 categories: current, ever, or never. We defined lifetime prevalence as the proportion of individuals who are currently using or have ever used any of these 3 therapies in the population. [Results] Overall, we approached 1051 individuals and 983 agreed to participate. Lifetime prevalence of Judo therapy, acupuncture and moxibustion, and Japanese traditional massage and finger pressure use was 28.0%, 17.8% and 15.8%, respectively, among males, and 44.5%, 18.4%, and 27.3%, respectively, among females. [Conclusion] These results showed that not only Western medicine but also CAM therapies are common among older people in Japan.

Background Most studies on socioeconomic inequalities in oral health have not considered the effects of behavioral and biological factors and age differences. Furthermore, the nationwide status of inequalities remains unclear in Japan. Methods We analyzed data from 2,089 residents aged ≥40 years throughout Japan. The lowest quartile of the number of remaining teeth for each 10-year age category was defined as poor oral health. Behavioral and biological factors included smoking status, obesity, diabetes mellitus, high-sensitivity C-reactive protein, and the use of dental devices. Multiple logistic regression analyses were conducted to examine the associations of educational attainment and equivalent household expenditure (EHE) with oral health, and stratified analyses by age category were also conducted (40-64 years and ≥65 years). Results Lower education and lower EHE were significantly associated with an increased risk of poor oral health after adjusting for age, sex, employment status, marital and living statuses, and EHE/education; the odds ratio for junior high school education compared with ≥college education was 1.84 (95% confidence interval [CI], 1.36-2.49), and the odds ratio of the lowest compared with the highest EHE quartile was 1.91 (95% CI, 1.43-2.56). Further adjustments for behavioral and biological factors attenuated but did not eliminate these associations. EHE was significantly associated with oral health among elderly adults only, with a significant interaction by age category. Conclusions Those with a lower education and those with lower EHE had a significantly higher risk of poor oral health, even after adjustments for behavioral and biological factors.

Background Food access is important for maintaining dietary variety, which predicts underweight. The aim of this study was to examine the association of food access and neighbor relationships with eating and underweight. Methods We analyzed cross-sectional data from 102,869 Japanese individuals aged 65 years or older. The perceived availability of food was assessed using the presence or absence of food stores within 1 km of the home. Level of relationships with neighbors was also assessed. The odds ratios (ORs) and 95% confidence intervals (CIs) for infrequent food intake and underweight were determined using logistic regression analysis. Results The proportion of men and women having low access to food was 25–30%. Having low food access (OR 1.18; 95% CI, 1.12–1.25 for men and OR 1.26; 95% CI, 1.19–1.33 for women) and a low level of relationship with neighbors (OR 1.38; 95% CI, 1.31–1.45 for men and OR 1.57; 95% CI, 1.48–1.67 for women) was associated with infrequent intake of fruits and vegetables in both sexes. Association between low food access and infrequent intake of fruits and vegetables was higher among men with low levels of neighbor relationship (OR 1.34; 95% CI, 1.23–1.46) than among men with high levels of relationship (OR 1.10; 95% CI, 1.03–1.18). Conclusions Low perceived availability of food is a risk factor for low dietary variety among older people. Furthermore, high levels of relationship with neighbors may relieve the harmful effect of low food access., Highlights • Low food access was associated with infrequent eating of foods in older Japanese. • Low level of relationship with neighbors was also associated with infrequent eating. • Interaction between food access and neighbor relationships was significant in men.

Aim To examine the association between the types of involvement in bullying and the time perspective among Japanese adolescents. Methods A questionnaire was conducted among Japanese junior high school students at eight public schools that were located in two cities in Shizuoka Prefecture, Japan. Shirai's Experiential Time Perspective Scale was used, which comprises four subscales: goal-directedness, hopefulness, self-fulfillment, and acceptance of the past. An analysis of covariance was applied, with the time-perspective subscales as the objective variable, type of involvement in bullying as a fixed factor, and grade, family structure, and economic status as the covariates. Results The analysis sample included 2630 adolescents (valid response rate: 88.6%). The bullying rate of the boys was 10.8% and 4.1% for the girls, for the male victims it was 10.1% and 14.5% for the female victims, and for both the bully and the victim, it was 8.5% and 5.4%, respectively. The students who were not involved in bullying had the highest scores of hopefulness, self-fulfillment, and acceptance of the past. For both sexes, bullying was significantly associated with hopefulness, self-fulfillment, and acceptance of the past. Goal-directedness was not associated with the type of involvement in bullying. Conclusions The victims of bullying had low time perspectives of hopefulness, self-fulfillment, and acceptance of the past. Providing support that increases hopefulness, self-fulfillment, and acceptance of the past might help to prevent pessimistic decision-making, such as that seen in cases of suicide.

Background and Aims Cohort studies in Japan indicate that citrus fruit and β-cryptoxanthin–rich Satsuma mandarin are candidate foods for lowering cardiovascular risk; however, there have been few intervention studies of β-cryptoxanthin and Satsuma mandarin supplementation. Methods and Results A randomized, placebo-controlled, double-blind parallel trial was performed. Apparently healthy men and women were randomly assigned to two groups: one receiving concentrated β-cryptoxanthin–rich Satsuma mandarin juice (β-cryptoxanthin 4 mg per 125 mL/day: active group) and one receiving β-cryptoxanthin–deprived Satsuma mandarin juice (β-cryptoxanthin 0 mg per 125 mL/day: control group) for 12 weeks. The primary outcome was brachial-ankle pulse wave velocity (baPWV), which assesses arterial stiffness. An oxidative stress biomarker and clinical outcomes were also evaluated. Effect of the intervention on the outcome variables was analyzed using generalized linear mixed models. After the trial, a prespecified 8-month follow-up examination was conducted. One hundred eighteen subjects were randomly assigned, and 117 completed the intervention. Serum β-cryptoxanthin concentration was increased among the active group after β-cryptoxanthin–rich Satsuma mandarin juice supplementation. Both supplementations lowered baPWV and oxidative stress biomarker levels; however, there was no additional effect in the active group compared with the control group. At the 8-month examination, the increase in baPWV among the active group was smaller than that among the control group. Conclusion Satsuma mandarin juice supplementation is potentially beneficial for reducing cardiovascular risk; however, additional β-cryptoxanthin supplementation did not enhance this effect. Further study is needed to evaluate the long-term effect of β-cryptoxanthin supplementation. Registration UMIN-CTR, UMIN000013579.

Untreated caries is the most prevalent disease in the world. A sense of coherence (SOC) is believed to contribute to oral health. We aimed to clarify the association between guardians&rsquo, SOC and their children&rsquo, s caries based on socioeconomic status (SES) in Japan. This study&rsquo, s subjects were Japanese public junior high schoolers (N = 1730), aged 12&ndash, 15, and their guardians in Kosai City. We administered a questionnaire survey among guardians in 2016 to assess their SOC and family environment. With their students&rsquo, consent, public junior high schools shared the results of the dental examinations that were part of their school physicals. Multivariate logistic regression was conducted to clarify the association between guardians&rsquo, s untreated decayed permanent teeth. We also conducted a stratified analysis according to a relative poverty line. We observed in the multivariate regression a significant inverse association between children&rsquo, s untreated decay and their guardians&rsquo, SOC (OR 0.93, 95%CI 0.87&ndash, 1.00). The association of SOC was stronger in the low economic group (OR 0.64, 95%CI 0.43&ndash, 0.95). Guardians with higher SOC were associated with children having fewer caries. Guardians&rsquo, SOC is a factor for the prevalence of caries and access to dental care, especially among children with low economic status.

Background Recent advances in medicine and an increasingly demanding healthcare environment are causing various complicated ethical problems. Nursing students need to prepare to deal with ethical issues in their future roles. Ethical sensitivity is a key aspect of the ethical decision-making process; however, there is no scale to measure nursing students’ ethical sensitivity. Therefore, we developed a scale and verified its reliability and validity. Methods The Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) was developed in three phases. First, questionnaire items were formulated after a literature review and interviews with nursing students. Next, its face and content validity were examined by an expert panel and piloted among nursing university graduates. Then, a final draft questionnaire survey was administered to nursing university students from 10 Japanese universities in 2015 and an exploratory factor analysis was performed. Criteria-related relevance was examined to compare established scales (i.e. the Japanese version of the Moral Sensitivity Test (JMST) and the Japanese version of the revised Moral Sensitivity Questionnaire (JMSQ)) using single regression analysis. A second questionnaire survey was conducted in one of the 10 universities to examine reliability. Results Initially, 48 items including ethical conflict in clinical nursing practice were formulated, and 47 items were approved by the expert panel. Five-hundred and twenty-eight nursing students responded to the final draft questionnaire. Participants’ mean age was 20.4 (standard deviation = 3.1) years. The questionnaire was reduced to 13 items and three factor structures were determined by exploratory factor analysis: ‘respect for individuals’, ‘distributive justice’, and ‘maintaining patients’ confidentiality’. The Cronbach’s alpha values for items in each domain ranged from 0.77–0.81, and the Cronbach’s alpha for the entire ESQ-NS was 0.82. The ESQ-NS was significantly associated with specific domains: ‛Judgment of the care conflict’ from the JMST and ‘Sense of Moral Burden’ from the JMSQ. Pearson’s correlation coefficient of the ESQ-NS between the first and second survey was 0.42 (p

Epidemiological studies have suggested that there is an association between diet and mental health. The aim of this study was to investigate the association between the intake of six minerals and mental disorders in a cross-sectional study. We used data from the Eating Habit and Well-being study in Japanese workers. Kessler&rsquo, s six-item psychological distress scale was used to detect mental disorders, with a cut-off score of 12/13, and a validated food frequency questionnaire was used to estimate dietary mineral intake. A total of 2089 participants with no history of depression were included. The prevalence of mental disorders was 6.9%. The lowest quartiles of zinc, copper, and manganese intakes were associated with mental disorders, whereas the lowest quartiles of calcium, magnesium, and iron intake were not associated with mental disorders. Combination analysis of high (&ge, median) or low (&lt, median) intake of zinc, copper, and manganese showed that low zinc and low copper intake, even with low or high manganese intake (odds ratio (OR), 2.71, 95% confidence interval (CI), 1.29&ndash, 5.73, and OR, 3.06, 95% CI, 1.41&ndash, 6.61, respectively) showed a higher OR than that of high zinc, high copper, and high manganese intake. Further studies are required to investigate the impact of dietary mineral intake on mental health.