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BACKGROUND: In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching-learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings. METHODS: This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays. RESULTS: First, the quantitative and qualitative findings confirmed each other 's CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students' academic satisfaction with the programme. CONCLUSIONS: The finding of CBL experiences in a group and students' satisfaction with faculty members' and preceptors' teaching improved nursing students' competency development. Meanwhile, students' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.
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BACKGROUND: Occurrence of hypersensitivity reaction (HSR) in patients having received multiple doses of carboplatin has been reported. Several studies demonstrated reduction of carboplatin-associated HSR with in combination with pegylated liposomal doxorubicin (PLD). The objective of this study was to determine the suppressive effect on carboplatin-induced HSR via combined treatment with PLD within clinical practice. METHODS: We reviewed the medical records of women with primary or recurrent ovarian, fallopian tube, or peritoneal cancer treated with carboplatin containing regimen at our hospital between January 2009 and March 2019. We compared the incidence of carboplatin-induced HSR among patients who received more than one cycle of PLD plus carboplatin (PLD-C) therapy (i.e., PLD-C group) versus patients who never received PLD-C therapy (non-PLD-C group). RESULTS: A total of 414 women were included in this study (48: PLD-C group, 366: non-PLD-C group). Carboplatin-induced HSR occurred in 34 total patients (8.2%) [1/48 (2.1%) in the PLD-C group and 33/366 (9.0%) in the non-PLD-C group], with a median cycle number of carboplatin administration at onset of HSR being 9. Incidences of carboplatin-induced HSR within the PLD-C versus non-PLD-C group at the 8th, 12th, and 16th cycles of carboplatin administration were 2.2% vs 11.2%, 2.2% vs 28.6%, and 2.2% vs 39.1%, respectively [hazard ratio: 19.2 (95% confidence interval: 9.82-39.4), p < 0.0001]. CONCLUSION: Based on the data analyzed here, a suppressive effect on carboplatin-induced HSR via combination therapy with PLD was confirmed within clinical practice.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carboplatina/efeitos adversos , Neoplasias das Tubas Uterinas/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Peritoneais/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carboplatina/administração & dosagem , Doxorrubicina/administração & dosagem , Doxorrubicina/análogos & derivados , Neoplasias das Tubas Uterinas/mortalidade , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/mortalidade , Neoplasias Peritoneais/mortalidade , Polietilenoglicóis/administração & dosagem , Adulto JovemRESUMO
BACKGROUND: In 2006, the countries of the Association of Southeast Asian Nations (ASEAN) signed the Mutual Recognition Arrangements (MRA) in relation to nursing services in the region. This agreement was part of a set of policies to promote the free flow of skilled labor among ASEAN members and required mutually acceptable professional regulatory frameworks. This paper presents a narrative review of the literature to (1) describe progress in the development of the regulatory framework for nursing professionals in Cambodia and Vietnam since 2000 and (2) identify key factors, including the MRA, that affect these processes. METHODS: For document review, policy documents, laws, regulations, and published peer-reviewed and gray literature were reviewed. Data were triangulated and analyzed using a tool developed by adapting McCarthy et al.'s regulatory function framework and covering eight functions (legislation, accreditation of preservice education, competency assessment, registration and licensing system, tools and data flow of registration, scope of practice, continuing professional development, professional misconduct and disciplinary powers). RESULTS: Cambodia and Vietnam have made remarkable progress in developing their regulatory frameworks for nursing. A number of key influences contributed to the development of nursing regulations, including the signing of the MRA in 2006 and the establishment of the Joint Coordinating Committee on Nursing (AJCCN) in 2007 as key milestones. Macroeconomic and political factors affecting the process were economic growth and an emerging private sector, social demand for quality care and professionalism, global attention to health workforce competencies, the role of development partners, and regular monitoring and mutual learning through AJCCN. A period of incubation enabled countries to develop consensus among stakeholders regarding regulatory arrangements; this trend accelerated after 2010 by bringing national regulatory schemes into conformity with the regional framework. Some similarities in the process (e.g., preservice education first, legislation later) and differences in key actors (e.g., professional councils and the capacity of nursing leaders) were observed in two countries. CONCLUSION: Further development of the regulatory framework will require strong nursing leadership to sustain achievements and drive continued progress. The adapted tool to assess regulatory capacity works well and may be of value in assessing the development of regulations in the nursing profession.
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Enfermeiras e Enfermeiros/legislação & jurisprudência , Enfermeiras e Enfermeiros/provisão & distribuição , Camboja , Desenvolvimento Econômico , Regulamentação Governamental , Política de Saúde , Humanos , Licenciamento em Enfermagem , Qualidade da Assistência à Saúde , VietnãRESUMO
To upgrade nursing instruction capacity in Cambodia, two bridging programmes were opened for the Bachelor of Science in Nursing simultaneously in-country and out-of-country (Thailand). A descriptive qualitative study was conducted to assess effectiveness of both programmes jointly and to explore needs concerning the further development of nursing education. This study included interviews with 34 current or previous programme participants (nursing instructors or hospital preceptors) and 10 managers of collaborating institutions. New learning content, personal outcomes, challenges and obstacles and future needs were qualitatively coded to create categories and subcategories of data. Findings show that programme participants were most influenced by the new content areas (e.g. nursing theory and professionalism), active teaching-learning strategies and the full-time educational immersion afforded by the out-of-country programme. Programme participants who had returned to their workplaces also identified on-going needs for employing new active teaching-learning approaches, curriculum revision, national standardization of nursing curricula and improvements in the teaching-learning infrastructure. Another outcome of this study is the development of a theoretical model for Nursing Capacity Building in Developing Countries that describes the need for intermediate and long-term planning as well as using both Bottom-Up and Edge-Pulling strategies.
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Currículo , Países em Desenvolvimento , Educação em Enfermagem , Capacitação de Professores , Adulto , Camboja , Docentes de Enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Pessoal , TailândiaRESUMO
The establishment of epithelial polarity is tightly linked to the dramatic reorganization of microtubules (MTs) from a radial array to a vertical alignment of non-centrosomal MT bundles along the lateral membrane, and a meshwork under the apical and basal membranes. However, little is known about the underlying molecular mechanism of this polarity-dependent MT remodeling. The evolutionarily conserved cell polarity-regulating kinase PAR-1 (known as MARK in mammals), whose activity is essential for maintaining the dynamic state of MTs, has indispensable roles in promoting this process. Here, we identify a novel PAR-1-binding protein, which we call microtubule crosslinking factor 1 (MTCL1), that crosslinks MTs through its N-terminal MT-binding region and subsequent coiled-coil motifs. MTCL1 colocalized with the apicobasal MT bundles in epithelial cells, and its knockdown impaired the development of these MT bundles and the epithelial-cell-specific columnar shape. Rescue experiments revealed that the N-terminal MT-binding region was indispensable for restoring these defects of the knockdown cells. MT regrowth assays indicated that MTCL1 was not required for the initial radial growth of MTs from the apical centrosome but was essential for the accumulation of non-centrosomal MTs to the sublateral regions. Interestingly, MTCL1 recruited a subpopulation of PAR-1b (known as MARK2 in mammals) to the apicobasal MT bundles, and its interaction with PAR-1b was required for MTCL1-dependent development of the apicobasal MT bundles. These results suggest that MTCL1 mediates the epithelial-cell-specific reorganization of non-centrosomal MTs through its MT-crosslinking activity, and cooperates with PAR-1b to maintain the correct temporal balance between dynamic and stable MTs within the apicobasal MT bundles.
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Células Epiteliais/citologia , Células Epiteliais/metabolismo , Proteínas Associadas aos Microtúbulos/metabolismo , Microtúbulos/metabolismo , Proteínas Serina-Treonina Quinases/metabolismo , Animais , Polaridade Celular/fisiologia , Células Cultivadas , Cães , Células Epiteliais/enzimologia , Células HEK293 , Células HeLa , Humanos , Imunoprecipitação , Células Madin Darby de Rim Canino , Camundongos , Morfogênese , Ligação Proteica , TransfecçãoRESUMO
Cytomegalovirus (CMV) is associated with congenital infections. We aimed to validate the revised CMV immunoglobulin (Ig) M titer cutoff for IgG avidity measurements as a reflex test in maternal screening to identify women with primary CMV infection and newborn congenital cytomegalovirus (cCMV). We screened maternal CMV antibodies (the Denka assay) in Japan, from 2017 to 2019, using a revised IgM cutoff (≥4.00 index). Participants were tested for IgG and IgM antibodies, and for IgG avidity if IgM levels exceeded the cutoff. We compared these with corresponding results from 2013 to 2017 based on the original cutoff (≥1.21) and recalculated using the revised cutoff. Newborn urine CMV DNA tests were performed for women with low avidity (≤35.0%). Among 12,832 women screened in 2017-2019, 127 (1.0%) had IgM above the revised cutoff. Thirty-five exhibited low avidity, and seven infants developed cCMV. Of 19,435 women screened in 2013-2017, 184 (1.0%) had IgM above the revised cutoff, 67 had low avidity, and 1 had cCMV. The 2017-2019 results were not significantly different from the 2013-2017 results. The revised IgM cutoff improves maternal screening in identifying primary infection and newborn cCMV; however, further study related to other assays than Denka is required.
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Infecções por Citomegalovirus , Complicações Infecciosas na Gravidez , Recém-Nascido , Feminino , Humanos , Gravidez , Citomegalovirus/genética , Gestantes , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Japão/epidemiologia , Imunoglobulina G , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/epidemiologia , Anticorpos Antivirais , Imunoglobulina M , Afinidade de AnticorposRESUMO
Strengthening nursing leadership in health systems has been identified as a priority for achieving Universal Health Coverage (UHC). We aimed to analyse the characteristics of Japanese technical assistance projects for nursing human resource development in Lao People's Democratic Republic (Lao PDR) and suggest directions for future assistance. An upgrading program, as part of human resource development, was initiated in the 1990s; it has contributed to the development of nursing leaders. Moreover, technical assistance from development partners has had synergistic effects by consistently promoting the involvement of nursing leaders in administration, education, and clinical practice to establish a functional regulatory system. In resource-limited settings, the application of both edge-pulling (leadership development) and bottom-up (quality improvement of the mass population) strategies are required. From a long-term perspective, development partners should continue to invest in increasing the number and quality of nursing leaders by upgrading the courses and leadership training programs, starting from the younger generation.
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OBJECTIVES: This study examined the effectiveness of a newly developed work-family life support program on the work-family interface and mental health indicators among Japanese dual-earner couples with a preschool child(/ren) using a randomized controlled trial with a waitlist. METHODS: Participants who met the inclusion criteria were randomly allocated to the intervention or the control groups (n = 79 and n = 85, respectively). The program comprised two 3-h sessions with a 1-month interval between them and provided comprehensive skills by including self-management, couple management, and parenting management components. The program sessions were conducted on weekends in a community center room with 3-10 participants. Outcomes were assessed at baseline, 1-month, and 3-month follow-ups. Primary outcomes were work-family balance self-efficacy (WFBSE), four types of work-family spillovers (i.e., work-to-family conflict, family-to-work conflict, work-to-family facilitation, and family-to-work facilitation), psychological distress, and work engagement reported by the participants. RESULTS: The program had significantly pooled intervention effects on WFBSE (P = .031) and psychological distress (P = .014). The effect sizes (Cohen's d) were small, with values of 0.22 at the 1-month follow-up and 0.24 at the 3-month follow-up for WFBSE, and -0.36 at the 3-month follow-up for psychological distress. However, the program had nonsignificant pooled effects on four types of work-family spillovers and work engagement. CONCLUSIONS: The program effectively increased WFBSE and decreased psychological distress among Japanese dual-earner couples with a preschool child(/ren).
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Saúde Mental , Angústia Psicológica , Equilíbrio Trabalho-Vida , Humanos , População do Leste Asiático , Apoio Familiar , Pais , EmpregoRESUMO
OBJECTIVES: This study aimed to examine the reliability and validity of the Japanese version of the eight-item CREW Civility Scale which measures workplace civility norms and compare the civility scores among various occupations. METHODS: A longitudinal study included all employees in a social care organization (N = 658) and a cross-sectional study included all civil servants in one city (N = 3242) in Japan. Structural validity was tested through confirmatory factor analyses (CFA). Construct validity was assessed through Pearson's correlations of civility with other variables. Internal consistency was assessed by Cronbach's alpha and 1-year test-retest reliability was assessed by the Intraclass Correlation Coefficient (ICC). RESULTS: The results of CFA showed an acceptable level of model fit (TLI =0.929; CFI =0.949; and SRMR =0.034). CREW Civility Scale scores were significantly positively correlated with supervisor support, co-worker support, and work engagement, while significantly negatively correlated with incivility, workplace bullying, intention to leave, and psychological distress, which were consistent with our hypotheses. Cronbach's alpha coefficient was 0.93 and ICC was 0.52. Younger, high-educated, and managerial employees and, childminder/nursery staff reported higher civility. High school graduates and respondents who did not graduate from high school, part-time employees, nurses, paramedical staff, and care workers reported lower civility. CONCLUSIONS: The Japanese version of the CREW Civility scale is a reliable, valid measure of civility, appropriate for Japanese workplaces as well as for use in multi-national studies alongside other existing versions of this scale in English, Portuguese and Farsi.
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Local de Trabalho , Estudos Transversais , Humanos , Japão , Estudos Longitudinais , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Local de Trabalho/psicologiaRESUMO
The coronavirus disease 2019 (COVID-19) pandemic has triggered the implementation of public health measures globally. The health department of local governments has played a critical role in confronting COVID-19. In Japan, public health centers (PHCs) are focal points for COVID-19 response. Understanding the response to COVID-19 in local areas is critical to ensure adequate preparation for future emergencies. Therefore, the purpose of this study is to clarify how the COVID-19 operations by PHCs in Japan were managed and facilitated at the beginning of the infection spread, and their future challenges. We designed a case study that included two PHCs with a population of approximately 400,000 in Japan. Semi-structured focus group interviews with public health nurses from these two PHCs were conducted in September and October 2020. The data were analyzed using chronological time-series analysis. The switch to crisis response was encouraged by the business continuity plan. Their operations for the prevention of COVID-19 in the community were facilitated by the existing network. Further, strengthening the knowledge and skill regarding infectious disease control and management skills during infectious disease-related health emergencies were recommended. It is important to ensure that the environment facilitates emergency response and that people-and-community-centered health promotion activities are conducted, during an emergency situation, with more innovative action and leadership.
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COVID-19 , COVID-19/epidemiologia , Previsões , Humanos , Japão/epidemiologia , Governo Local , Saúde PúblicaRESUMO
Continuous professional development is important for improving professional competencies, such as cognitive knowledge, technical skills, behaviors, and attitudes. Trainees who complete training programs can have a positive influence on their workplaces. However, it is challenging to establish a process that can facilitate individual learning and help achieve training outcomes in educational and clinical workplaces. In Cambodia, a tumultuous history has played a part in the deficit of adequately prepared nursing faculty. Since the faculty development is vital to ensuring the quality of education, the application of upgraded nursing programs has started in 2011. After the completion of upgraded program, an immediate post-training study was conducted in 2014. Results showed that some faculty members did not accept trainees because they lacked an understanding about nursing concepts. The current study aimed to evaluate the medium-term outcomes of an established program that can improve nursing education and to identify relevant factors in light of the institutional development of educational and clinical facilities in Cambodia. A qualitative study incorporating focus group discussions, key-informant interviews, and teaching document reviews was performed with a thematic analysis using the four-level training evaluation model of Kirkpatrick. Finally, factors influencing outcomes were assessed based on the Bronfenbrenner's ecological system theory. Five themes for behavior and three themes for results were identified as medium-term outcomes from an institutional development aspect. The major enabling factors for the above-mentioned themes were the support of institutional managers, continuous networking among trainees, and supportive national policy. Compared with the immediate post-training study findings, the perceived medium-term outcomes became more strategically focused. Then, the impact of training at a considerably broader scale within the workplace was discussed. The findings highlighted the importance of medium-term program delivery and monitoring if one understands the role played in stimulating outcomes. Moreover, the importance of contextual factors including the influence of managers and policy environment were emphasized.
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Educação em Enfermagem , Docentes de Enfermagem , Camboja , Humanos , Aprendizagem , Pesquisa QualitativaRESUMO
Migrants face several challenges in their daily lives in the host country due to limited knowledge about the language, culture, and social system of the host country. Their vulnerability increases in a time of crisis. During the COVID-19 pandemic, migrant communities were severely affected. Evidence on migrants' access to COVID-19-related information and services is limited. We conducted a qualitative, descriptive study among migrants from Vietnam, Myanmar, and Nepal living in Japan to explore the barriers and promoting factors for their access to health-related information, health services, and welfare services during the first wave of COVID-19. We used a thematic analysis to identify key themes according to the study's objectives. Further, these themes were assessed using an adapted version of the ecological model. The migrants mainly relied on the information available on social networking sites and were not aware of formal sources of information. Language was a major barrier, followed by cognitive bottlenecks and time constraints for migrants accessing health-related information and services. Social media, short-form information provided using their native language or plain Japanese and illustrations, and supportive people around could help them to access health-related information and services. The findings from this study demonstrate how migrants can represent a vulnerable group in a host country, even more so in a time of crisis.
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COVID-19 , Emigrantes e Imigrantes , Migrantes , COVID-19/epidemiologia , Serviços de Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Japão , Pandemias , Pesquisa QualitativaRESUMO
Robot-assisted extraperitoneal para-aortic lymphadenectomy has been reported to be feasible option for the surgical management of gynecologic malignancy previously (Narducci et al., 2009) (Hudry et al., 2019). We have reported the feasibility of laparoscopic extraperitoneal total para-aortic and pelvic lymphadenectomy (Andou, 2016). This article aims to show the safety of robot-assisted extraperitoneal "total para-aortic and pelvic" lymphadenectomy. The video is the staging surgery for 67-year-old woman suspected clinical stage IA ovarian clear cell carcinoma after abdominal hysterectomy and salpingo-oophorectomy. As abdominal adhesion was predicted, she was treated using robot-assisted extraperitoneal total para-aortic and pelvic lymphadenectomy. The patient was placed in the supine position and tilted 7 degrees to the right. Three robot arms were docked at the patient's left side. The center port was used for the scope. The bipolar cutting method was performed using the surgeon's right hand. An AirSeal® port (ConMed, Utica, NY, USA) was placed on the side near the assistant. After the extraperitoneal space was expanded, lymphadenectomy was performed up to the renal veins and below to the obturator muscles using the bipolar cutting method. This was followed by omentectomy. The operative time were 189 min, and the estimated blood loss was 75 ml. A total of 56 lymph nodes were harvested (22 para-aortic lymph nodes and 34 pelvic lymph nodes). Total extraperitoneal lymphadenectomy by robot-assisted surgery was a feasible procedure for this patient. The procedure, which does not require the Trendelenburg position and is not obstructed by bowel, may be suitable for patients with hypertension, glaucoma, obesity or abdominal adhesion.
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OBJECTIVE: Investigate the characteristics and serology of pregnant women with cytomegalovirus (CMV) immunoglobulin (Ig)G seroconversion during pregnancy to understand the risk factors associated with primary CMV infection and the occurrence of fetal congenital CMV infection. MATERIALS AND METHODS: We retrospectively studied 3202 pregnant women who were CMV IgG-negative in early pregnancy and were retested for IgG in late pregnancy. Characteristics were compared between participants with and without IgG seroconversion, and serological parameters were compared between participants with and without fetal congenital CMV infection. RESULTS: Twenty-six participants showed CMV IgG seroconversion and fifteen showed fetal congenital CMV infection. Seroconversion rates were significantly higher in teens (5.0%) than in older women (20s: 0.8%; 30s and over: 0.6%) (p < 0.001). Titers of CMV IgM at IgG seroconversion were higher in women without (median 8.66) than with (median 6.54) congenital infection (p = 0.045). The congenital infection rate was high when IgM titers at IgG seroconversion were low (47.1% with 4.00-12.00 titers and 100% with 1.21-3.99 IgM titers) (p = 0.048). CONCLUSIONS: Nulliparous pregnant teenagers have a high risk of CMV IgG seroconversion and the CMV IgM titer at IgG seroconversion may help predict the occurrence of fetal congenital CMV infection.
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Citomegalovirus/imunologia , Doenças Fetais/imunologia , Imunoglobulina G/sangue , Imunoglobulinas Intravenosas/sangue , Complicações Infecciosas na Gravidez/virologia , Adulto , Infecções por Citomegalovirus/embriologia , Infecções por Citomegalovirus/imunologia , Infecções por Citomegalovirus/transmissão , Feminino , Doenças Fetais/virologia , Humanos , Imunoglobulina G/imunologia , Imunoglobulinas Intravenosas/imunologia , Japão , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Estudos Retrospectivos , Fatores de Risco , SoroconversãoRESUMO
OBJECTIVE: This study assessed maternal cytomegalovirus antibodies, and the occurrence of primary and congenital cytomegalovirus infections, and risk factors of congenital infection after a maternal primary infection. STUDY DESIGN: We included 19,435 pregnant women in Japan, who were tested for serum cytomegalovirus antibodies before 20 gestational weeks. Immunoglobulin (Ig) G avidity was evaluated in women with both IgG and IgM antibodies; tests were repeated at ≥28 gestational weeks among women without IgG and IgM antibodies. RESULT: Primary and congenital infections were 162 and 23 cases, respectively. The risk ratios for congenital infection were 8.18 (95% confidence interval: 2.44-27.40) in teenage versus older women, and 2.25 (95% confidence interval: 1.28-3.94) in parity ≥ 2 versus parity ≤ 1. Of 22 live birth congenital infection cases, three had abnormal neurological findings. CONCLUSION: We demonstrated teenage and parity ≥ 2 pregnant women as risk factors of post-primary congenital infection.
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Infecções por Citomegalovirus , Complicações Infecciosas na Gravidez , Adolescente , Idoso , Anticorpos Antivirais , Citomegalovirus , Infecções por Citomegalovirus/epidemiologia , Feminino , Humanos , Imunoglobulina M , Relações Mãe-Filho , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Estudos ProspectivosRESUMO
This study examines how working parents' work attitudes (i.e., workaholism and work engagement) are associated with their child's psychological well-being. Based on the Spillover-Crossover model (SCM), we hypothesize that (a) work-to-family spillover (i.e., work-to-family conflict and facilitation) and (b) employee happiness will sequentially mediate the relationship between parents' work attitudes and their child's emotional and behavioral problems. A cross-sectional survey was conducted among Japanese dual-earner couples with pre-school child(ren). On the basis of valid data from 208 families, the hypothesized model was tested using structural equation modeling. For both fathers and mothers simultaneously, workaholism was positively related to work-to-family conflict, which, in turn, was negatively related to happiness. In contrast, work engagement was positively related to work-to-family facilitation, which, in turn, was positively related to happiness. Fathers' and mothers' happiness, in turn, were negatively related to their child's emotional and behavioral problems. Results suggest that parents' workaholism and work engagement are related to their child's emotional and behavioral problems in opposite ways, whereby parents' spillover and happiness mediate this relationship. These findings support the SCM and suggest that decreasing workaholism and improving work engagement may not only improve employees' happiness, but also decrease their child's emotional and behavioral problems.
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Proteção da Criança , Conflito Familiar , Engajamento no Trabalho , Adulto , Criança , Saúde da Criança , Pré-Escolar , Estudos Transversais , Pai , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães , Carga de TrabalhoRESUMO
We have demonstrated that tadalafil facilitates fetal growth in mice with L-NG-nitroarginine methyl ester (L-NAME)-induced preeclampsia (PE) with fetal growth restriction (FGR). Tadalafil is a selective phosphodiesterase 5 inhibitor that dilates the maternal blood sinuses in the placenta, thereby facilitating the growth of the fetus. The purpose of this study was to investigate the effects of tadalafil treatment for PE and FGR on the developing brain in FGR offspring using an L-NAME-induced mouse model of PE with FGR. A control group of dams received carboxymethylcellulose (CMC). L-NAME-treated groups received L-NAME dissolved in CMC from 11 days post coitum (d.p.c.). The L-NAME-treated dams were divided into two subgroups 14 d.p.c. One subgroup continued to receive L-NAME. The other subgroup received L-NAME with tadalafil suspended in CMC. Tadalafil treatment for PE with FGR reduced the expression of hypoxia-inducible factor-2α in the placenta and in the brain of the FGR fetus. Moreover, tadalafil treatment in utero shows improved synaptogenesis and myelination in FGR offspring on postnatal day 15 (P15) and P30. These results suggest that tadalafil treatment for PE with FGR not only facilitates fetal growth, but also has neuroprotective effects on the developing brain of FGR offspring through modulating prenatal hypoxic conditions.
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Retardo do Crescimento Fetal/prevenção & controle , Hipóxia/prevenção & controle , Pré-Eclâmpsia/tratamento farmacológico , Tadalafila/administração & dosagem , Vasodilatadores/administração & dosagem , Animais , Fatores de Transcrição Hélice-Alça-Hélice Básicos/análise , Encéfalo/patologia , Modelos Animais de Doenças , Feminino , Camundongos , Placenta/patologia , Gravidez , Resultado do TratamentoRESUMO
OBJECTIVE: The purpose of this randomized, controlled trial was to examine the effects of a psychoeducational information website on improving work engagement among individual workers with low work engagement, where work engagement was measured as a secondary outcome. METHODS: Participants were recruited from registered members of a web survey site in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to intervention or control groups. Immediately after the baseline survey, the intervention group was invited to study a psychoeducational website called the "UTSMed," which provided general mental health literacy and cognitive behavioral skills. Work engagement was assessed by using the Utrecht Work Engagement Scale at baseline, 1-, and 4-month follow-ups for both intervention and control groups. An exploratory analysis was conducted for a subgroup with low (lower than the median scores) work engagement scores at baseline. RESULTS: A total of 1,236 workers completed the baseline survey. In the low work engagement subgroup, a total of 313 and 300 participants were allocated to an intervention and control group, respectively. In the high work engagement subgroup, 305 and 318 participants were allocated to an intervention and control group, respectively. The program showed a significant effect on work engagement (t = 1.98, P = 0.048) at the 4-month follow-up in the low work engagement subgroup, with a small effect size (d = 0.17). CONCLUSION: A web-based psychoeducation resource of mental health literacy and cognitive behavioral skills may be effective for improving work engagement among individual workers with low work engagement.
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Terapia Cognitivo-Comportamental/métodos , Letramento em Saúde/métodos , Internet , Saúde Mental , Trabalho/psicologia , Adulto , Depressão/psicologia , Feminino , Seguimentos , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Estresse Psicológico/psicologia , Adulto JovemRESUMO
OBJECTIVES: This study of Japanese dual-earner couples examined the impact of family and job demands on one's own and one's partner's fatigue as well as gender differences in these effects. METHODS: A total of 2,502 parents (1,251 couples) were surveyed using a self-administered questionnaire. A crossover model was tested using structural equation modeling. RESULTS: The results of structural equation modeling analyses showed that both job and family demands independently exacerbated fatigue. There was an indirect effect of job and family demands on partner fatigue through one's own fatigue only from husbands to wives. An indirect effect of job demands on partner fatigue through partner's family demands was identified only from wives to husbands. Furthermore, there were gender differences in the crossover of fatigue. CONCLUSIONS: This study shows that job and family demands influence family circumstances. When considering means to reduce employees' fatigue, gender differences in the mechanism of fatigue need to be taken into account.
Assuntos
Emprego/psicologia , Fadiga/psicologia , Renda , Estresse Psicológico , Adulto , Emoções , Feminino , Humanos , Relações Interpessoais , Japão , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Cônjuges/psicologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: Although incivility is a common interpersonal mistreatment and associated with poor mental health, there are few studies about it in Asian countries. The aim of this study was to develop the Japanese version of the modified Work Incivility Scale (J-MWIS), investigate its reliability and validity, and reveal the prevalence of incivility among Japanese employees in comparison with data on Canadian employees. METHODS: A total of 2,191 Japanese and 1,071 Canadian employees were surveyed, using either the J-MWIS or MWIS. Japanese employees additionally answered questions on civility, worksite social support, workplace bullying, psychological distress, intention to leave, and work engagement to investigate construct validity. RESULTS: At least one form of workplace incivility was experienced by both Japanese (52.3%) and Canadian (86.0%) employees in the previous month. Internal consistency reliability of the J-MWIS was acceptable (α=0.71-0.81), and correlation analyses also confirmed its construct validity as expected. Workplace incivility was associated with lower workgroup civility, lower supervisor and coworker support, higher workplace bullying, higher psychological distress, higher intention to leave, and lower work engagement. Confirmatory factor analyses showed that the original three-factor model (supervisor incivility, coworker incivility, and instigated incivility) fitted moderately in both Japan and Canada data, though the privacy/overfamiliarity factor was additionally extracted from exploratory factor analysis for the J-MWIS. CONCLUSIONS: The results of this study suggested that the J-MWIS has moderate internal consistency reliability and good construct validity.