Health-related word recognition and pronunciation by patients in Gauteng, South Africa in English and native languages.

BACKGROUND:  Low health literacy has been found to affect people's ability to take care of their own health and follow the principles of disease prevention. Incomprehension of health education and healthcare instructions may lead to poor health outcomes. AIM:  The aim of the study was to describe and compare a sample of primary healthcare patient's ability to recognise and pronounce health-related words in English and in his or her native language. SETTING:  The study was conducted in 12 primary healthcare (PHC) clinics in Gauteng, South Africa. METHODS:  A prospective, quantitative, comparative research design using a survey method was used to assess the ability to recognise and pronounce health-related words of 401 respondents using the REALM-R (SA) tool. RESULTS:  Most respondents were 18-29 years (32%) and 30-49 years (53%) old. More than half (54%) of the respondents have completed grade 12 schooling. Adequate English health-related word recognition and pronunciation levels were at 19.5%, while native health-related word recognition and pronunciation levels were far better, ranging between 55.6% and 97.0%. CONCLUSION:  Respondents showed better word recognition and pronunciation of the health-related words in their native language than in English. Providing health information in the patient's native language and on their level of understanding may therefore improve patient health outcomes.Contribution: The study is the first of its kind to determine word recognition and pronunciation of health-related words in English and a native language of South African PHC patients. Knowing this may assist healthcare professionals to give health education and instructions on the patient's level of understanding.

Pedigree analysis of Korean native chickens: unraveling inbreeding and genetic diversity.

This study assessed the trends in inbreeding, effective population size, and genetic diversity across six Korean native chicken lines using pedigree records from 54,383 chickens. Understanding these genetic parameters is significantly important for maintaining healthy and viable chicken populations. The primary objective was to analyze the pedigree data to assess the levels of inbreeding and genetic diversity and to evaluate the effective population size across the different lines. Pedigree analysis revealed that pedigree completeness peaked in the first generation and declined in subsequent generations for all lines. Line A exhibited a mean inbreeding coefficient of 0.0201, whereas the other lines displayed lower mean values ranging from 0.0009 to 0.0098, indicating that inbreeding levels were within an acceptable range and considered safe from extinction. Average relatedness consistently increased with time. Individual increases in inbreeding were the highest in Line A (0.62%), with smaller increases in the other lines ranging from 0.02 to 0.23%. Effective population sizes varied from 81 to 2500, with average coancestry within parental populations ranging from 0.0032 to 0.0290. The fe/fa ratio between 1.00 and 1.69 in the 6 lines suggested a moderate impact during bottleneck events, with subsequent populations recovering well. The genetic diversity loss due to genetic drift and unequal founder contributions ranged from 0.66-3.15%, indicating that considerable genetic variability remains within the populations. The results of this study have practical applications in the management and conservation of genetic resources in poultry breeding programs. By highlighting the importance of monitoring inbreeding and maintaining genetic diversity, the findings can help develop strategies to ensure the long-term sustainability of these chicken lines. This study provides valuable insights into the genetic management of Korean native chicken lines, emphasizing the need for strategic breeding practices to preserve genetic health and diversity.

Impacts of invasion on a freshwater cleaning symbiosis.

Organismal invasions have repeatedly been cited as a driving force behind the loss of biodiversity. Unlike many other impacts of invasion, the effect of invasion on native symbiont communities has received less attention. The introduction of invasive hosts presents a potential opportunity to native symbionts; invasive hosts could benefit native symbionts through providing a novel host environment that improves symbiont fitness relative to their fitness on native hosts. Alternatively, invasive hosts could noncompetent hosts for native symbionts, resulting in negative impacts on native symbiont abundance and diversity. Crayfish in the northern hemisphere host diverse assemblages of obligate annelid symbionts (P: Anellida, O: Branchiobdellida). Two invasive crayfish hosts in the genus Faxonius have been introduced and are interacting with the native crayfish hosts and their symbionts in three watersheds in western Virginia, USA. Previous studies suggest that the invasive host F. cristavarius is a less competent host for symbionts compared to native hosts in the genus Cambarus. We carried out an extensive survey in these watersheds to determine impacts of varying degrees of invasion on branchiobdellidan abundance and diversity. We also conducted a complementary host replacement experiment to investigate how increases in the relative abundance of invasive hosts contributes to observed patterns of symbiont abundance and diversity in the field. In our survey, as the proportion of invasive hosts at a site increased, branchiobdellidan abundance and diversity declined significantly. In the experiment, the worms dispersed onto both native and invasive hosts. As the percentage of noncompetent F. cristavarius hosts increased, the survival of branchiobdellidans declined. Both symbiont survival and opportunities for successful dispersal are reduced as this noncompetent invasive host progressively displaces native hosts, which imperils the integrity of native host-symbiont systems. Given that many native hosts accrue significant fitness benefits from their relationships with native symbionts, including hosts in our study system, losses of beneficial symbionts may produce a positive feedback loop that decreases invasion resistance of native species, exacerbates the effects of invasions, and presents a major conservation issue in invaded systems.

Brazilian stingless bee honey: A pioneer study on the in vitro bioaccessibility of phenolic compounds.

In this study, the effect of in vitro gastrointestinal digestion of phenolic compounds, the total phenolic content, and the antioxidant potential of stingless bee honey were investigated. Among the 33 phenolic compounds investigated, 25 were quantified, and only eight were not bioaccessible (p-aminobenzoic acid, sinapic acid, pinobanksin, isorhamnetin, quercetin-3-glucoside, syringaldehyde, coumarin, and coniferaldehyde). Benzoic acid was predominant in most undigested samples (21.3 to 2414 µg 100 g-1), but its bioaccessibility varied widely (2.5 to 534%). Rutin, a glycosylated flavonoid, was quantified in all samples and might have been deglycosylated during digestion, increasing the bioaccessibility of quercetin in a few samples. Overall, the concentration of phenolic compounds prior digestion and their bioaccessibility varied greatly among samples. Nevertheless, higher concentrations before digestion were not correlated to greater bioaccessibility. This study is the first to assess the in vitro bioaccessibility of phenolic compounds in SBH, providing novel insights into SBH research.

Endovascular Aortic Repair of an Infective Native Aortic Aneurysm.

An infective native aortic aneurysm (INAA) is a rare, life-threatening, and complex disease. Therefore, the diagnosis and treatment of INAA remain uncertain. We describe the case of a 64-year-old man who had abdominal pain and a fever for more than one week. We diagnosed him with INAA on the basis of the clinical presentation, laboratory findings, and computed tomography (CT) images. After administering preoperative antibiotic therapy for four weeks, we performed endovascular aortic repair (EVAR). He then received antibiotic treatment for 12 months postoperatively. After successful treatment of an INAA with endovascular aortic repair, the patient had no recurrence for more than six years after the end of antibiotic therapy.

Unequal Effect of Educational Attainment on Reducing Poverty and Welfare; Diminished Returns of American Indian/Alaska Native Populations.

Background: American Indian and Alaska Native (AIAN) communities face pronounced economic and health disparities compared to White Americans, a situation rooted in long-standing historical injustices and segregation. The theory of Minorities' Diminished Returns (MDR) provides insight beyond the traditional focus on socioeconomic status (SES) disparities, such as educational attainment. It suggests that the beneficial outcomes of educational achievements on health and economic status are less substantial for marginalized and racially non-White groups compared to White Americans. Aims: This study investigates the applicability of the MDR theory to AIAN populations by examining whether the positive effects of education on poverty reduction and the decreased risk of disability benefit dependency are weaker for AIAN adults relative to their White counterparts. Methods: Utilizing data from the 2022 National Health Interview Survey (NHIS), this cross-sectional study analyzed a cohort of 20,743 adults, comprising 20,474 White and 269 AIAN individuals. We assessed the relationships between educational attainment, poverty level, and the likelihood of receiving disability benefits. A structural equation model was employed, with receipt of disability benefits as a latent factor influenced by racial background (AIAN) as a potential moderator, education as the main predictor, and poverty level and self-rated health as mediators. Gender, age, employment status, marital status, and Hispanic ethnicity served as additional covariates. Results: Findings indicate that higher educational levels are generally associated with a lower likelihood of receiving disability benefits, mediated by improved health and economic status. Nonetheless, the interaction between race (AIAN) and education significantly influenced economic outcomes, subsequently affecting the risk of receiving disability benefits. This suggests that Whites benefit more economically from education than AIAN individuals do. Conclusion: The study underscores the MDR theory's relevance to the disparities in educational outcomes related to poverty risk and receiving disability benefits among AIAN populations. The challenges AIAN individuals face in leveraging their educational achievements for economic gain relative to Whites may be attributed to pervasive racism and discrimination within various sectors, including employment and education. Addressing these disparities necessitates policy interventions that ensure educational returns are equitable across racial groups, with a focus on equal access to resources and opportunities.

Prenatal intention to human milk feed in the native Hawaiian population: predictors of any human milk feeding from birth to six months postpartum.

BACKGROUND: Rates of non-communicable diseases are disproportionately high among Native Hawaiian (NH) people, and the proportion of NH infants being fed human milk (HM) is the lowest among all ethnicities within the state of Hawai'i. The aim of this study was to explore biological, socio-economic, and psychosocial determinants of the initiation and duration of human milk feeding (HMF) among a study of NH mothers and infants. METHODS: A sample of 85 NH mother-infant dyads who were participating in a larger prospective study were involved in this research. Recruitment for the parent was delayed due to the COVID-19 pandemic. Recruitment started in November 2020 and continued until April 2022. Questionnaires were distributed at birth, two-months, four-months, and six-months postpartum. Questionnaires addressed topics relating to maternal and infant characteristics and infant feeding practices. Descriptive statistics, comparative analysis, and multivariate logistic regression tests were conducted. RESULTS: The majority of participating mothers were aged between 31 and 35 years, had some college education or more, were employed, and multiparous. The majority of infants were receiving HM at each timepoint (94% at birth, 78% at two-months postpartum, and 76% at four and six-months postpartum). Factors found to be significantly associated with HMF initiation and duration were prenatal intention to HMF, maternal educational attainment, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) recipiency. A prenatal intention to HMF was found to be a strong predictor of HMF at birth (aOR = 64.18, 95% CI 2.94, 1400.28) and at two-months postpartum (aOR = 231.55, 95% CI 2.18, 2418.3). Participants not involved with WIC were more likely to be HMF at four-months postpartum (aOR = 6.83, 95% CI 1.01, 46.23). CONCLUSION: This research supports existing evidence that prenatal intention to HMF and higher maternal educational attainment are positive predictors of HMF. WIC participation and being a SNAP recipient were found to be negatively associated with HMF which suggests a need for more culturally tailored support. Further research is required to reduce the gap in knowledge related to the determinants of HMF in NH.

Actinomyces neuii Causing Right-Sided Infective Endocarditis: A Case-Based Literature Review.

Actinomyces neuii (also known as Winkia neuii nowadays), quite different from its genus,is a facultatively anaerobic organism that rarely causes human infections.Like the rest of its genus, it usually has a good prognosis. In this case report, we present an interesting case of a middle-aged female who presented to the emergency department (ED) with fever and dyspnea, eventually diagnosed with infective endocarditis (IE) caused by A. neuii. To the best of our knowledge, it is the first reported case of A. neuii causing right-sided infective endocarditis in a middle-aged female with no residual or prosthetic valvular disease.

Understanding determinants of lung cancer preventive care in at-risk urban American Indians and Alaska Natives: A mixed-methods study.

Introduction: Lung cancer is the leading cause of cancer death among American Indian and Alaska Native (AI/AN) people, and AI/AN people have the highest rate of smoking of any racial or ethnic group in the US. There is limited research to inform culturally-relevant strategies for lung cancer prevention inclusive of lung cancer screening (LCS). The objective of this study was to understand determinants of LCS and tobacco cessation care in at-risk urban-dwelling AI/ANs. Materials and Methods: This was a mixed-methods community-based participatory research study including complimentary qualitative discussions and surveys conducted in Seattle, Washington, USA from 2022 to 2023. The study measures and analytic approach integrated the Consolidated Framework for Implementation Research and Tribal Critical Race Theory and qualitative transcripts were analyzed using thematic analysis. Participants were self-identified AI/AN people who were age ≥ 40 and had ≥ 10-year history of commercial cigarette smoking. Results: Forty-five participants completed surveys and participated in discussions, 48% were female, the median age was 58 and median smoking history was 24 pack-years of commercial cigarette use. Themes revealed prominent barriers to LCS care including access, costs, awareness, and fear. Many reported previous negative and discriminatory encounters within and outside the health system which may also serve as barriers. Most participants endorsed cancer screening and increased education, recommending Indigenous-centered, delivered, and tailored programs, as well barrier-directed support. Conclusions: In a broad sample of at-risk urban-dwelling AI/AN people, our findings suggest enthusiasm for preventive care but several complex barriers. Participants endorsed culturally-tailored programs which could provide relevant education and address barriers.

Long-lines for research monitoring and efficient population regulation of an invasive apex predator, European catfish (Silurus glanis).

European catfish is a large-bodied apex predator, a key species in native areas, but invasive in others where it negatively impacts local aquatic fauna necessitates catfish regulation. However, traditional ichthyological methods face challenges in capturing it. The study presents a detailed description of the efficient long-line method, refined through 48 sampling campaigns across twelve European water bodies. This method proves cost-effective and technically undemanding, requiring an average of 5.6 bait fish to catch one European catfish per day. The long-lines outperform other techniques, with the highest Biomass per unit effort (BPUE) of 6.205 kg of catfish per man-hour and minimal by-catch (0.276 kg per man-hour). In contrast, fyke nets, the second most efficient method, achieve a BPUE of 0.621 kg of catfish per man-hour with 3.953 kg of by-catch per man-hour. To optimize long-line catches, a 15 m distance between branch lines and regular relocation is recommended. Live fish is the most effective bait with no significant differences observed among species. However, earthworms, a less controversial alternative, are also efficient, especially for smaller catfish. Our recapture approach using various ichthyological methods revealed no hook avoidance behavior by catfish after a previous catch or avoidance by a certain part of the population. The long-line method is suitable for population regulation, scientific research, and conservation efforts and is the most effective means of capturing live European catfish.

The Medicine Wheel as a public health approach to lifestyle management interventions for indigenous populations in North America.

This analytic essay intends to elevate Medicine Wheel, or generally "four directions" teachings, to encourage a more comprehensive alignment of lifestyle intervention components with traditional ecological knowledge systems of Indigenous cultures in North America. North American Medicine Wheels provided people with a way to orient themselves both within their traditional belief systems and to the seasonal changes in their areas, improving survivability. The wheel or circle is a sacred symbol, indicating the continuity and perpetuity of all of life. The four directions are iconized in many Indigenous cultures across North America with different directions representing different aspects of our world and of ourselves, different seasons of the year and of our lives, different beings of the earth and tribes of humans with a balance among those necessary for health and wellbeing. In the context of public health, teachings of the four directions warn that a lack of balance limits our ability to achieve optimal health. While there is much public health success in lifestyle interventions, existing practice is limited by a siloed and one size fits all approach. Medicine Wheel teachings lay out a path toward more holistic and Indigenous-based lifestyle intervention that is modifiable depending on tribal teachings and needs, may appeal to a variety of Indigenous communities and is in alignment with health behavior change theory. It is a public health imperative that lifestyle management interventions are fully optimized to rigorously determine what can be achieved when interventions are implemented in a holistic and Indigenous-based manner, and in alignment with an Indigenous model of health. This more complete alignment would allow for a stronger foundation to further explore and develop social determinants (i.e., housing, employment, etc.) and structural intervention enhancements to inform public health practice and promote health equity.

Study Protocol for the Opioid and Pain Treatment in Indigenous Communities Trial: A Systems Level Intervention for Enhanced Screening and Brief Intervention and Referral for Co-Occurring Chronic Pain and Opioid Use Disorder.

American Indian/Alaska Native (AI/AN) individuals have the highest rates of opioid overdose mortality and chronic pain (CP) compared to other racial/ethnic groups in the United States. These individuals also report higher rates of pain anxiety and pain catastrophizing, which are both associated with poorer outcomes and risk for opioid misuse (OM) and opioid use disorder (OUD) among individuals with CP. Yet, no prior studies have examined rates of comorbid pain and OUD among AI/AN adults. This commentary describes an implementation research partnership of 3 AI/AN-serving clinics and a university team that utilizes an implementation hybrid type III design to examine the impact of implementation strategies on adoption and sustainability of evidence-based screening and brief intervention for CP and OM/OUD among AI/AN clients. As part of our community-engaged approach, we embrace both AI/AN models and Western models, and a collaborative board of 10 individuals guided the research throughout. We hypothesize that our culturally centered approach will increase rates of screening and brief intervention and improve identification of and outcomes among AI/AN clients with CP and OUD who receive treatment at participating sites. Each site convenes a workgroup to evaluate and set goals to culturally center screening and brief interventions for CP and OM/OUD. Data collected include deidentified electronic health records to track screening and brief interventions and rates of CP and OUD; provider and staff surveys beginning prior to implementation and every 6 months for 2 years; and a subset of clients will be recruited (N = 225) and assessed at baseline, 6, and 12 months to examine biopsychosocial and spiritual factors and their experiences with culturally centered screening and brief intervention. Cultural adaptations to the measures and screening and brief intervention as well as barriers and facilitators will be addressed. Recommendations for successful Tribal health clinic-university partnerships are offered.

Phytoremediation as a viable ecological and socioeconomic management strategy.

Phytoremediation is an environmentally friendly alternative to traditional remediation technologies, notably for soil restoration and agricultural sustainability. This strategy makes use of marginal areas, incorporates biofortification processes, and expands crop alternatives. The ecological and economic benefits of phytoremediation are highlighted in this review. Native plant species provide cost-effective advantages and lower risks, while using invasive species to purify pollutants might be a potential solution to the dilemma of not removing them from the new habitat. Thus, strict management measures should be used to prevent the overgrowth of invasive species. The superior advantages of phytoremediation, including psychological and social improvements, make it a powerful tool for both successful cleanup and community well-being. Its ability to generate renewable biomass and adapt to a variety of uses strengthens its position in developing the bio-based economy. However, phytoremediation faces severe difficulties such as complex site circumstances and stakeholder doubts. Overcoming these challenges necessitates a comprehensive approach that balances economic viability, environmental protection, and community welfare. Incorporating regulatory standards such as ASTM and ISO demonstrates a commitment to long-term environmental sustainability, while also providing advice for unique nation-specific requirements. Finally, phytoremediation may contribute to a pleasant coexistence of human activity and the environment by navigating hurdles and embracing innovation.

Characterization of a Monoclonal Antibody by Native and Denaturing Top-Down Mass Spectrometry.

Established in recent years as an important approach to unraveling the heterogeneity of intact monoclonal antibodies, native mass spectrometry has been rarely utilized for sequencing these complex biomolecules via tandem mass spectrometry. Typically, top-down mass spectrometry has been performed starting from highly charged precursor ions obtained via electrospray ionization under denaturing conditions (i.e., in the presence of organic solvents and acidic pH). Here we systematically benchmark four distinct ion dissociation methods─namely, higher-energy collisional dissociation, electron transfer dissociation, electron transfer dissociation/higher-energy collisional dissociation, and 213 nm ultraviolet photodissociation─in their capability to characterize a therapeutic monoclonal antibody, trastuzumab, starting from denatured and native-like precursor ions. Interestingly, native top-down mass spectrometry results in higher sequence coverage than the experiments carried out under denaturing conditions, with the exception of ultraviolet photodissociation. Globally, electron transfer dissociation followed by collision-based activation of product ions generates the largest number of backbone cleavages in disulfide protected regions, including the complementarity determining regions, regardless of electrospray ionization conditions. Overall, these findings suggest that native mass spectrometry can certainly be used for the gas-phase sequencing of whole monoclonal antibodies, although the dissociation of denatured precursor ions still returns a few backbone cleavages not identified in native experiments. Finally, a comparison of the fragmentation maps obtained under denaturing and native conditions strongly points toward disulfide bonds as the primary reason behind the largely overlapping dissociation patterns.

Addressing emerging issues in entomology: 2023 student debates.

The Entomological Society of America (ESA) Student Debates is an annual student competition at the ESA Annual Meeting organized by Student Debates Subcommittee (SDS) members of the ESA Student Affairs Committee. In conjunction with the 2023 ESA Annual Meeting theme, 'Insects and influence: Advancing entomology's impact on people and policy', the theme of this year's student debate was 'Addressing emerging issues in entomology'. With the aid of ESA membership, the SDS selected the following debate topics: (1) Should disclosure of artificial intelligence large language models in scientific writing always be required? and (2) Is it more important to prioritize honey bee or native pollinator health for long-term food security within North America? Four student teams from across the nation, composed of 3-5 student members and a professional advisor, were assigned a topic and stance. Over the course of 5 months, all team members researched and prepared for their assigned topic before debating live with an opposing team at the 2023 ESA Annual Meeting in National Harbor, Maryland. SDS members additionally prepared and presented introductions for each debate topic to provide unbiased backgrounds to the judges and audience for context in assessing teams' arguments. The result was an engaging discussion between our teams, judges, and audience members on emerging issues facing entomology and its impact on people and policy, such as scientific communication and food security, that brought attention to the complexities involved when debating topics concerning insects and influence.

A Modified McCall Culdoplasty in Pelvic Organ Prolapse Surgery: Anatomical and Functional Outcomes.

INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate anatomical and functional outcomes of a modified McCall culdoplasty compared with the traditional technique for pelvic organ prolapse. METHODS: This prospective clinical observational study was conducted in a secondary referral urogynecological center between October 2021 and October 2022. A modified McCall culdoplasty was performed in 85 patients (group A). It was characterized by dissection of uterosacral ligaments up to the ischial spines, their shortening and attachment to the vaginal apex and both the rectovaginal and the vesicovaginal fascia. Outcomes were compared with those of a group of 86 patients (group B) who underwent the traditional culdoplasty between September 2020 and September 2021. Primary outcome was prolapse recurrence. Secondary endpoints included subjective outcomes, vaginal length, quality of life, and urinary and anal incontinence. Statistical analysis was conducted using Fisher's exact, Mann-Whitney U, and Student's t tests. RESULTS: At 12 months, prolapse recurrence occurred in 2.5% (CI 0.7-8.8%) of patients in group A and in 6.7% (CI 2.9-14.7%) in group B. Postoperative vaginal length was 8.3 ± 0.78 cm in group A and 6.4 ± 1.1 cm in group B (p < 0.001). The Patient Global Impression of Improvement questionnaire revealed that 76 patients (96.2%) in group A versus 64 (85%) in group B were very satisfied (p < 0.03). Both groups showed an improvement in urinary symptoms and quality of life. CONCLUSIONS: The modified McCall culdoplasty showed successful anatomical and functional outcomes, with a tendency towards lower recurrence rates than the traditional McCall procedure. Further long-term studies are needed to confirm our data.

Dental anxiety and oral health in American Indian and Alaska natives.

OBJECTIVE: American Indian and Alaska native (AI/AN) individuals report distrust of the healthcare system. This study explored associations between having either high levels of dental distrust or high levels of dental care-related fear and anxiety ("dental anxiety") and oral health outcomes in AI/AN adults. METHODS: The 2022 State of Oral Health Equity in America survey included the Modified Dental Anxiety Scale and asked to what extent respondents agreed with the statement, "At my last oral health visit, I trusted the oral health provider I saw", and asked about self-rated oral health and presence of a dental home. RESULTS: AI/AN individuals (N = 564) who reported low dental trust (n = 110) or with high dental anxiety (MDAS≥19; n = 113) reported significantly worse overall and oral health and were significantly less likely to have a dental home (p < 0.05 used for each analysis). CONCLUSION: Dental distrust and dental anxiety can significantly impact oral health and dental utilization in AI/AN communities and are important intervention targets to improve AI/AN oral health.

Death on the permafrost: Revisiting the 1918-20 influenza pandemic in Alaska using death certificates.

The 1918-20 influenza pandemic devastated Alaska's Indigenous populations. We report on quantitative analyses of pandemic deaths due to pneumonia and influenza (P&I) using information from Alaska death certificates dating between 1915 and 1921 (n=7,147). Goals include a reassessment of pandemic death numbers, analysis of P&I deaths beyond 1919, estimates of excess mortality patterns overall and by age using intercensal population estimates based on Alaska's demographic history, and comparisons between Alaska Native (AN) and non-AN residents. Results indicate that ANs experienced 83% of all P&I deaths and 87% of all-cause excess deaths during the pandemic. AN mortality was 8.1 times higher than non-AN mortality. Analyses also uncovered previously unknown mortality peaks in 1920. Both subpopulations showed characteristically high mortality of young adults, possibly due to imprinting with the 1889-90 pandemic virus, but their age-specific mortality patterns were different: non-AN mortality declined after age 25-29 and stayed relatively low for the elderly, while AN mortality increased after age 25-29, peaked at age 40-44, and remained high up to age 64. This suggests a relative lack of exposure to H1-type viruses pre-1889 among AN persons. In contrast, non-AN persons, often temporary residents, may have gained immunity before moving to Alaska.

Language confidence and job satisfaction among foreign-born nurses in Japan: mediating effect of workplace discrimination and moderating effect of immigration duration.

AIM: This study explored the relationship between language confidence and job satisfaction, the mediating role of workplace discrimination, and the moderating role of immigration duration among foreign-born nurses in Japan. INTRODUCTION: Job satisfaction is an important factor in preventing migrant nurses' turnover intentions; however, the relationships among language confidence, immigration duration, workplace discrimination, and job satisfaction among foreign-born nurses remain unclear. METHODS: A cross-sectional study was conducted. Data were collected between June and August 2022 through an online survey of nurses who were born outside of Japan but were currently working as registered nurses in Japan. PROCESS v4.0 Macro for SPSS 28.0 was applied to analyze the effect of language confidence on job satisfaction, the mediator effect of workplace discrimination (model 4), and the moderator effect of immigration duration (model 15). RESULTS: Data from 187 participants were analyzed. The results showed that 1) foreign-born nurses' language confidence was negatively correlated with workplace discrimination and positively correlated with job satisfaction; 2) workplace discrimination played a partially mediating role between language confidence and job satisfaction; and 3) immigration duration positively moderated the relationship between language confidence and job satisfaction. CONCLUSION: Foreign-born nurses with stronger confidence in their proficiency in Japanese perceived less workplace discrimination and higher job satisfaction. Workplace discrimination acted as a mediator in the relationship between language confidence and job satisfaction, and this relationship was strengthened with longer migration periods. Managers and policymakers should implement policies and strategies to combat workplace discrimination and provide tailored support to improve foreign-born nurses' job satisfaction, which may contribute to their retention in Japan.