Japanese Red Cross College of Nursing

Abstract Background Globally, there is an ongoing shortage of nurses, hindering many countries from achieving their healthcare goals. In response to this issue, Japan’s Ministry of Health, Labour and Welfare introduced the Job Demands-Resources (JD-R) Model in 2019. Although this model has been validated by several researchers, it’s applicability to hospital nurses in Japan has not yet been established. The aim of this study was to test the model fit of the JD-R Model with nurses working in Japanese hospitals. Method The study adopted a cross-sectional, model-testing design using a self-administered questionnaire survey. A total of 3,000 nurses from 48 hospitals were recruited through stratified random sampling. Of the distributed questionnaires, 707 were returned. After excluding responses with more than 10 missing items, 624 valid responses were analyzed using structural equation Modeling. Results The fit indices of the original JD-R Model indicated an acceptable model fit ( χ² = 116.34, RMSEA = .21, AIC = 162.34, and CFI = .91). The model was subsequently modified for hospital nurses based on the results of the Lagrange Multiplier (LM) test, resulting in improved fit indices (χ² = 12.22, RMSEA = .057, AIC = 58.22, CFI = .99). Discussion The modified JD-R Model demonstrated a good fit and proved applicable to hospital nurses. Notably, the model revealed a positive causal relationship between work engagement and health problems, suggesting that excessive engagement may contribute to adverse health outcomes among hospital nurses.

BackgroundThe widespread availability of health information online, coupled with the ease of access to the internet, has led pregnant women to rely heavily on online sources for pregnancy-related guidance. The internet-based information regarding nutrition enabled positive dietary changes for pregnant women. Although there are some important sources for pregnant women to collect their health information, some information increases maternal anxiety and difficulties based on a lack of information. Moreover, some women become confused due to conflicts on the same topics from different websites. However, concerns about the reliability and impact of this information have surfaced, contributing to heightened anxiety among expectant mothers. The importance of the quality of web-based information is increasingly recognized; however, no studies have evaluated the quality of nutrition-related information for pregnant women.ObjectiveThis study aims to bridge this research gap by assessing the quality of online health information concerning prenatal nutrition tailored to pregnant women.MethodsThis cross-sectional descriptive study was conducted through a Google keyword search on February 14, 2023. We used search terms, such as “pregnancy,” “pregnant women,” “diet,” and “nutrition” and conducted an exhaustive search on Google. Using the Quality Evaluation Scoring Tool (QUEST), we meticulously evaluated the quality of the retrieved information.ResultsThe top 20 Google-searched sites were evaluated using the QUEST tool. The average score was 11.7 points, ranging from 6 to 15, with most sites scoring between 11 and 15. Half of the websites lacked clear authorship and most gave weak or no attribution to specific scientific sources. While conflict of interest scored highest overall, with 60% showing no bias, some sites promoted products or specific interventions. Currency was inconsistent—only half were updated within 5 years. Complementarity received the lowest scores, with 70% lacking support for patient-physician relationships. The tone was generally positive, with 95% supporting their claims, though only one site used a balanced, well-reasoned tone. Discrepancies in cited guidelines on nutritional intake and inappropriate expressions about alcohol, weight management, and miscarriage raised concerns about the information’s accuracy and appropriateness.ConclusionsAlthough many websites use cautious language to mitigate commercial influence, deficiencies persist in crucial areas for empowering informed decision-making among pregnant women. From our assessment of the results, it was found that incorrect evidence information is provided at the top of search results, which is easily accessible to users. The inadequacies in attributing authorship, clarifying conflicts of interest, and ensuring the currency of information pose substantial challenges to the reliability and usefulness of online health resources in prenatal nutrition. Since internet-based information is the most accessible, reliable evidence should be provided to protect everyone from misinformation, including shallow health literacy demographics, and from potential physical and psychological harm.

The aim of this study was to explore the characteristics of public health ethics education programs designed for nursing students to inform the development of curricula that produce nurses with a strong ethical compass. The COVID-19 pandemic has highlighted the urgent need for public health ethics education in nursing. While the importance of balancing individual rights and the health of the community is well-recognized, there is a dearth of effective educational programs and materials to equip nursing students with the necessary skills to navigate these complex ethical issues. This study is a scoping review of the literature Data sources: The PubMed, CINAHL and Web of Science databases were searched to identify studies that met the inclusion criteria. A total of 16 studies were obtained within a search period of 2012-2023. Our analysis showed that some of the studies included other faculty members and practitioners. Effective teaching methods included narrative media and gaming methods, while Internet technology posed teaching challenges. Evaluation methods ranged from analyzing student discussions and reports to using specific measurement scales. These findings suggest the need to develop a broader range of evaluation methods and collaborative efforts among educators to ensure the sharing of educational resources.

Lymphatic venous anastomosis is associated with a low incidence of lower extremity lymphoedema-associated cellulitis; however, the exact relationship is unknown. This multicentre RCT evaluated the effect of lymphatic venous anastomosis on prevention of cellulitis. Patients with secondary lower extremity lymphoedema who underwent at least 3 months of non-operative decongestive therapy were assigned randomly to lymphatic venous anastomosis or conservative therapy. The primary and secondary outcomes were cellulitis frequency, and assessments of circumference, hardness, and pain respectively. Overall, 336 patients were divided into two groups: 225 in the full-analysis set (primary outcome 225; secondary outcomes 170) and 156 in the per-protocol set (primary outcome 156; secondary outcomes 110). In both analyses, lymphatic venous anastomosis with non-operative decongestive therapy was more effective in preventing cellulitis than non-operative decongestive therapy alone; the difference between groups in reducing cellulitis frequency over 6 months was -0.35 (95 per cent c.i. -0.62 to -0.09; P = 0.010) in the full-analysis set (FAS) and -0.60 (-0.94 to -0.27; P = 0.001) in the per-protocol set (PPS) Limb circumference and pain were not significantly different, but lymphatic venous anastomosis reduced thigh area hardness (proximal medial and distal and lateral proximal). Four patients experienced contact dermatitis with non-operative decongestive therapy alone. Lymphatic venous anastomosis in combination with non-operative decongestive therapy prevents cellulitis. UMIN00025137, UMIN00031462.

Introduction. The aim of this study was to evaluate the practicality of the signal transducer and activator of transcription (STAT) 3 polymorphisms as a predictive biomarker and sorafenib trough concentration as a monitoring biomarker for hand-foot skin reaction (HFSR) in patients with hepatocellular carcinoma (HCC). Methods. In total, 43 Japanese HCC patients were included. Sorafenib concentrations were measured, if possible, on days 8, 29, 35, and 57. The sorafenib concentration on day 8 (Cday8) was used for the analysis of HFSR occurring up to day 29. The median concentration for each patient (Cmedian) was used for HFSR occurring up to day 57 (study period). The STAT3 single nucleotide polymorphism (SNP) rs4796793 was determined using cell-free DNA extracted from plasma. Result. The Cday8 tended to be higher in the HFSR onset or grade ≥ 2 HFSR severity group than in the non-HFSR or grade ≤ 1 HFSR severity group. The Cmedian was significantly higher in the HFSR onset or grade ≥ 2 group than in the non-HFSR or grade ≤ 1 HFSR group. The Cmedian thresholds for predicting HFSR onset and severity were 3.62 μg/mL and 6.10 μg/mL, respectively. There was no association between STAT3 rs4796793 and HFSR onset or severity. In multivariate analysis, Cmedian values ≥ 3.62 μg/mL and >6.10 μg/mL were associated with the increased risk of HFSR onset (odds ratio: 16.6, p < 0.01) and severity (odds ratio: 15.7, p < 0.01), respectively. Conclusion. Monitoring of the sorafenib trough concentration may be practical for avoiding HFSR.

Polypharmacy, which refers to the situation of a patient taking more medications than is clinically necessary, has become a major problem in recent years. Although the effects of medications on pressure ulcers have been reported, there are no reports on the impact of the total number of medications on pressure ulcers. The purpose of this study was to investigate the effect of number of medications on the severity of pressure ulcers. Participants included 94 patients who were admitted to Chiba University Hospital with pressure ulcers between April 2013 and March 2021. Univariate analysis identified ulcer depth, weight loss and anticoagulant use to be factors that contributed to the severity of pressure ulcers. Multiple regression analysis was performed for six variables, namely, the number of medications, ulcer depth, weight loss and anticoagulant use, as well as diabetes status and total serum protein level, which have been reported to be associated with pressure ulcers in previous studies. The following independent risk factors were identified: weight loss (β 0.207, 95% confidence interval [CI] 0.700-3.193; p = 0.003), anticoagulant use (β 0.161, 95% CI 0.271-3.088; p = 0.020) and ulcer depth (β 0.719, 95% CI 7.172-10.329; p < 0.001). The number of medications was not a significant factor. This study revealed that the number of medications a patient is taking does not affect the severity of pressure ulcers. The findings should provide useful information for the management of pressure ulcers.

Constipation is common in children and can significantly affect quality of life. Prebiotics are reportedly helpful for constipation in adults, but few studies have examined their use in young children. In this study, the effect of 1-kestose (kestose), which has excellent bifidobacterial growth properties, on constipation in kindergarten children (n = 11) was compared with that of maltose (n = 12) in a randomized, double-blind study. Three grams of kestose per day for 8 weeks did not affect stool properties, but significantly increased the number of defecations per week (Median; 3 → 4 times/week, p = 0.017, effect size = 0.53). A significant decrease in Intestinibacter, a trend toward increased bifidobacteria, and a trend toward decreased Clostridium sensu stricto were observed after kestose ingestion, while concentrations of short-chain fatty acids in stools were unchanged.

This single-center observational study aimed to investigate the association between labor neuraxial analgesia (LNA) and neonatal outcomes. We conducted a retrospective cohort study at a tertiary perinatal center and included all vaginal deliveries performed between November 2015 and December 2021. Obstetric and neonatal outcomes were compared between deliveries with LNA (LNA group) and without analgesia (control group). Propensity score (PS) matching was used for statistical analysis. We included 2343 singleton deliveries performed in 1367 nulliparous and 976 multiparous women, in whom LNA was induced in 352 and 178 deliveries, respectively. After PS matching, the nulliparous LNA group had a significantly higher incidence of Apgar scores <7 at 1 (7.1% vs. 3.6%, p=0.0139) and 5 min (2.3% vs. 0.7%, p=0.0397) and meconium staining (29.8% vs. 23.2%, p=0.0272) than the nulliparous control group. Other neonatal outcomes, including umbilical artery pH and neonatal intensive care unit admission rate, were comparable between the nulliparous LNA and control groups. No significant differences in neonatal outcomes were seen in multiparous women. Regarding fetal heart rate abnormalities, severe late deceleration (4.8% vs. 1.7%, p=0.0036) and severe prolonged deceleration (17.0% vs. 11.9%, p=0.0224) were more common in the nulliparous LNA group than in the nulliparous control group, and the multiparous LNA group exhibited more severe variable deceleration (21.3% vs. 14.3%, p=0.0485) than the multiparous control group. Our findings suggest that LNA is associated with short-term adverse neonatal and obstetric outcomes in vaginal deliveries. LNA should be performed with precautionary measures and adequate medical resources.

Ensuring the telecommunication services is one of the key pillars for the disaster response. However, the past studies pointed out that the lack of electricity causes significant negative effect in the service continuity of telecommunication in emergencies. Using the vehicle to establish a mobile and off-grid telecommunication site is one of the solutions in emergencies. Recently, the vehicle with the external power supply functions becomes popular as the progress of the electric vehicles in our society. Therefore, this study aims to assess the practical effectiveness of the application of the fuel cell vehicle to support the telecommunication services in emergencies. The medical fuel cell vehicle with telecommunication functions and the external power supply functions was developed. In the field test, various functions in the M-FCV such as the external power supply, the real-time image sharing, the vehicle management application were tested to support the telecommunication in emergencies. In addition, in a disaster response drill, the M-FCV was utilized to establish the field telecommunication unit by using its functions. To ensure the electricity to support the telecommunication services in emergencies, the application of fuel cell vehicles is considered as an effective solution.