Depressive symptoms among Thai male seafarers during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Prevalence of depressive symptoms among seafarers is higher than the general population because of their unique work conditions. Factors that can be changed must be considered and promptly addressed in order to decrease the prevalence of depression. This study aims to clarify the prevalence of depressive symptoms and its related factors among Thai seafarers in an effort to contribute to policies and to prevent depression among Thai seafarers. METHODS: This cross-sectional study was conducted among 381 male seafarers working onboard ocean-going vessels of five Thai shipping companies. The questionnaire items comprised of personal factors, working factors and depressive symptoms. Depressive symptoms were assessed using the Thai version of the Patient Health Questionnaire-9. First, the chi-square test was used for univariate analysis. Then, variables significantly associated by the chi-square test were used for multivariate logistic regression analysis (employing the stepwise method) as independent variables. RESULTS: The average age of participants in this study was 36.4 years. Prevalence of depressive symptoms was 19.5%. One half of the participants (58.3%) reported subjective sleep problems, and most (75.1%) experienced poor coping behaviors. Two thirds (67.5%) were officers, and 10.1% of participants reported that they sometimes or never performed occupational safety behaviors. Regarding work environments, 62.2% reported that their work was disturbed from performing repetitive tasks. Multivariate logistic regression analysis showed two personal factors; sleep problems (Adjusted Odds Ratio (AOR) = 7.97, 95% Confidence interval (CI) = 3.52-18.05) and poor coping behaviors (AOR = 4.46, 95%CI = 1.61-12.34), and three working factors; job assignment (AOR = 2.50, 95%CI = 1.33-4.70), inadequate occupational safety behaviors (AOR = 4.51, 95%CI = 1.85-11.01) and performing repetitive task (AOR = 2.27, 95%CI = 1.16-4.45), were significantly associated with depression. CONCLUSION: During COVID-19 pandemic, 19.5% of Thai male seafarers had depressive symptoms. Personal and working factors including subjective sleep problems, poor coping behaviors, job assignment, performing inadequate occupational safety behaviors and performing repetitive tasks were risk factors of depressive symptoms among Thai male seafarers. Monitoring work environment rigorously and coping with work-related stress of the occupational safety behaviors program should be suggested.

[Development of a scale to evaluate the rest levels of male workers].

Objectives　"Rest" has two aspects: "repose," to recover from physical or mental fatigue, and "restore," to re-establish physical, mental, and social health. Many male workers work for prolonged hours, and despite stress, they do not apply coping behaviors, unlike female workers. Consequently, taking sufficient rest is difficult for male workers. The aim of this study was to develop a scale incorporating multiple factors to evaluate the state in which male workers take rest.Methods　A questionnaire survey was conducted involving 330 male workers aged 20-59 years who had been engaged in two manufacturing industries. The questionnaire items were created with reference to an interview survey of male workers in the literature. After discussing with industrial hygiene experts and conducting a pretest to obtain surface validity, 70 items were used for analyses. In the exploratory factor analysis, promax rotation was used with the maximum likelihood method. In the confirmatory factor analysis, goodness of fit was confirmed with the covariance structure analysis. Health-related quality of life, job stress, work engagement, sleep, and self-assessment of rest were used to examine concurrent validity.Results　With the exploratory factor analysis, we introduced a scale containing 15 items, including three subscales: filling with spirit, enthusiasm for work, and recovery from fatigue. The reliability coefficient (Cronbach's alpha) of the three subscales and the overall scale ranged from 0.79 to 0.88 and 0.89, ensuring internal consistency. The confirmatory factor analysis showed a generally good fit. Their scores were correlated with many items of the health-related quality of life, job stress, work engagement, sleep, and self-assessment of rest.Conclusions　A 15-item "Rest Evaluation Scale" was created to evaluate the state in which male workers in the manufacturing industries take rest. Since the validity, reliability, and concurrent validity of this scale were satisfactory, this scale was considered to be an index evaluating the state of rest of male workers.

Mental health problems and their related factors among seafarers: a scoping review.

BACKGROUND: Seafarers are often reported to be engaged in a dangerous physical and psychosocial work environment. However, mental health status among seafarers has not been focused on compared with physical health issues. Systematic, comprehensive reviews of mental health problems and their relevant factors are lacking. This review aimed to clarify beneficial approaches to the mental health problems faced among seafarers using a scoping review to systematically map the evidence regarding mental health issues and their related factors. METHODS: Studies were searched on MEDLINE/PubMed, Science Direct, Academic search complete using EBSCOhost databases, SCOPUS, EMBASE, and Web of science on 20, August 2020. This scoping review was conducted based on the framework of Arksey and O'Malley and Preferred Reporting items for Scoping Reviews flow diagram. The inclusion criteria were studies which determined the relationship between factors relevant to working conditions or working environment, and mental health in seafarers, and etc. Data were narratively summarized and reported. RESULTS: Twenty-four were included in this review while two major findings were clarified. Firstly, the prevalence of stress, depressive symptoms, and burnout have been mentioned for decades. Secondly, factors related to mental health and psychological issues can be categorized as individual and work environmental factors. The individual factors include experience, age, health status (high BMI, poor sleep, and diabetics), and resilience. The work environmental factors consist of two parts. Job demands comprise pressure from contractors/customers/time, working hours, ship department, job title, voyage episodes, period of seafaring, noise, and vibration. The job resources included instrumental support, team cohesion, shipboard caring and effort-reward imbalance. CONCLUSIONS: A beneficial approach to mental health problems faced among seafarers is necessary to understand comprehensively at individual and organization levels. Promoting health behaviors, training resilience, and managing obesity and chronic diseases comprise individual level strategies. Providing seafarers with adequate instrumental support, and practical support to communicate with customers, managing their distinct work-rest hours and adequate effort-reward balance comprise organization level methods.

[The associations of Japan's specific medical checkup with a health promotion lifestyle, health literacy, and social capital by healthcare coverage type].

Objectives　The goal of this study was to determine whether experiencing Japan's specific medical checkup is associated with a health promotion lifestyle, health literacy (HL), and social capital (SC) by type of healthcare coverage.Methods　The subjects were 1,048 residents of A City aged 40 through 74 years. Individuals who had experienced more than one medical checkup during the past two years were categorized as "Consultation." Individuals without that experience were categorized as "No consultation." Data were collected via an anonymous self-administered mail questionnaire survey. Health promotion lifestyles were assessed using a Japanese version of the Health-Promoting Lifestyle Profile (HPLP II). HL was measured with the 14-item Health Literacy Scale. The SC was measured following Hanibuchi's six-item scale.Results　The response rates were 34.4% for males and 39.6% for females. Of the males covered by National Health Insurance (NHI), 68.8% were Consultation. Of the females covered by NHI, 79.4% were Consultation. Of the males covered by social insurance, 91.7% were Consultation, and 72.6% of the females covered by social insurance were Consultation. The consultation ratio of males covered by NHI was significantly lower among those without a co-residential spouse than among those living with a spouse. The physical activity score (a HPLP II subscale) of the females covered by NHI was significantly lower among those without compared to those with consultation. Among the males covered by social insurance, the nutrition score (a HPLP II subscale) was significantly higher among those without compared to those with consultation, and the number of neighbors providing companionship (an item in the SC scale) was larger. Among the females covered by social insurance, the health responsibility score (a HPLP II subscale) was significantly lower among those without than among those with consultation.Conclusion　There were significant relationships between experiencing more than one medical checkup during the past two years and health promotion lifestyles and between that experience and social capital, except for males covered by NHI. Policies based on these results are encouraged to increase participation in medical checkups. Regarding males covered by NHI, support of their participation in medical checkups by people close to them would be an effective way to increase participation.

[Characteristics of health literacy, social capital, and health behavior acquired through experiences by health promotion volunteers].

Objectives　In order to promote health in the community, collaborative activities with community organizations are, in addition to individual health guidance, considered to be effective. Health promotion volunteers (HPVs) are now gaining attention as one such community organization. The purposes of this research were to clarify the characteristics of health literacy, social capital, and health behavior acquired through experience by HPVs and to obtain findings with which to examine ways to foster HPVs.Methods　An anonymous, self-administered questionnaire survey was conducted through the postal system in a town with 87 currently active HPVs, 158 former HPVs who served between April 2009 and March 2015, and 299 people with no experience as HPVs. The respondents were 54 active HPVs (response rate, 62.1%); 69 former HPVs (43.7%); and 136 people with no experience (45.5%). Participants were asked about their sociodemographic characteristics; activity status as an HPV; self-rated health; whether they had undergone a medical examination (recently) or not; health literacy; social capital; health behaviors; etc.Results　Health literacy, social capital, and health behavior scores of active HPVs showed no significant difference among the three groups. Many of the active HPVs felt that the work was "of help to the local government." The number of participants who tried to encourage others and who self-rated their health statuses as healthy in the active HPV group were significantly higher compared with the former HPVs and the group with no experience.Conclusion　In fostering HPVs, it is necessary to support them in order to ensure that they proactively engage in activities promoting health.

Health-Related Quality of Life and Sleep Disorders in Patients With a Urostomy: Is There a Relationship?

PURPOSE: The purpose of this study was to evaluate the relationship between health-related quality of life (HRQOL) and sleep disorders in persons living with a urostomy. DESIGN: A cross-sectional descriptive study. SUBJECTS AND SETTINGS: Eighty-six adults with a urostomy who were cared for in a stoma outpatient clinic of a hospital in Osaka, Japan, for at least 1 month before data collection, and who were attending support group meetings comprised the sample. The majority of participants (n= 68; 79.1%) were diagnosed with bladder cancer; the median time since ostomy surgery was 3.7 years. METHODS: Participants were queried about demographic and pertinent clinical data; they also completed 2 instruments that measured HRQOL and sleep quality. All data were collected via interview. HRQOL was assessed using a Japanese language version of the World Health Organization Quality of Life (WHOQOL). Sleep quality was evaluated using a Japanese language version of the Pittsburgh Sleep Quality Index (PSQI-J). Demographic and clinical data were collected via a questionnaire designed for this study. RESULTS: WHOQOL scores among persons living with a urostomy were significantly (P < .001) lower than scores among the general population in Japan. Forty-six participants (53.5%) had scores that were higher than 5.5, the cut-off point on the PSQI-J indicating reduced sleep quality. Scores on the PSQI-J were significantly negatively associated with the cumulative scores for WHOQOL scores (standardized partial regression coefficient -0.504, P < .001) even after adjustment based on all other variables. CONCLUSIONS: Study findings suggest that persons with a urostomy have lower HRQOL and sleep quality than adults in the general population.

Potential use of sludge cake from paper mill wastewater treatment as degradable flower pot.

OBJECTIVES: Sludge cake produced in paper mill industries is disposed into a landfill and may cause the environmental and health problems. Now many researchers have tried to recycle rigid materials from it for the purpose of decreasing its volume. The aims of this study were to clarify three hypotheses: (1) whether a flower pot would be economically made from sludge cake, (2) whether it would be safe for environment, and (3) when vegetables would grow enough in it, whether they would be safe for human consumption. METHODS: Sludge cake was mixed with soil (soil texture: heavy clay). The circular plaster mold was used as a fixed mold. As the toxicological testing, leaching test and seed germination test were used. Heavy metal concentrations in vegetables grown in the flower pot were measured. RESULTS: The flower pot was sufficiently formed by drying in natural open air. The results of leaching test showed three heavy metals, lead, nickel and copper, were lower than the standard in Thailand. The seed germination test suggested no negative effects of the flower pot on the germination of Chinese kale. Lead concentrations in the Chinese kale were higher than the recommended maximum level in leafy vegetables. CONCLUSION: The new flower pot can be made from sludge cake with soil. It has the possibility to have no negative effect on the environment. Although the vegetables grown in this flower pot are not suitable to eat, this flower pot has the possibility to solve the environmental and health problems.

Construction technique of disposable bin from sludge cake and its environmental risk.

OBJECTIVES: Now, a lot of researchers have tried to make recycled rigid materials from the sludge cake produced in paper mill industries for the purpose of decreasing its volume. In this study, the researchers tried to make economically a disposable bin and to examine whether it is toxic or not to the outside environment. METHODS: To make a disposable bin, the researchers used the sludge cake, a plastic basket, as a fixed mold, white cloth or newspaper, as a removable supporter for wrapping around the mold, and latex or plaster, as a binder. The strength of the samples was measured by tensile-stress testing. The water absorption was evaluated by Cobb test. As toxicological tests, leaching test and seed germination test were selected. RESULTS: It was possible to form the disposal bin from the cleaned sludge cake. They seemed safe to carry garbage in the industry judging from the results of tensile-stress testing. Some of them showed less water absorptiveness (higher water resistance) in the results of Cobb test. The results of leaching test showed small values of three heavy metals, lead, nickel and copper, in the leachate. The seed germination test suggested no adverse effects of the bins in the clay and sand on the tomato growth. CONCLUSIONS: The results of these tests suggest that the bins have good strength, sufficient water resistance and no toxicological effect on the environment. This new recycled bin has the possibility to solve the environmental and health problems at disposing the sludge cake.

Association between teaching and support skills and subjective effectiveness of nutritional guidance of registered dietitians at hospitals in a Japanese prefecture.

OBJECTIVE: The aim of this study is to clarify the association between teaching and support skills and the subjective effectiveness of nutritional guidance of registered dietitians working at hospitals. METHODS: We carried out a questionnaire survey of registered dietitians at hospitals in a Japanese prefecture. The utilization of nutritional teaching skills in nutritional guidance was investigated using a self-produced 36-item questionnaire that was designed to be mainly used for diabetic patients in 4 settings: first guidance, first assessment, contemplation stage, and preparation stage. The support skills were evaluated by Kikuchi's Scale of Social Skills: 18 items. The subjective effectiveness of nutritional guidance was defined by the behavioral change of the patients after nutritional guidance as evaluated by a registered dietitian. RESULTS: There were 75 respondents (response rate 46.6 %). Among the teaching skills, basic skills in an interview were often used, but some related to coaching skills were not in common use in nutritional guidance. Based on the results of principal component analysis, we created a scale for scoring the utilization of nutritional teaching skills in each setting. Multiple linear regression analysis illustrated that high subjective effectiveness of nutritional guidance was associated with high score of teaching skills in the preparation stage setting and high score of support skills. CONCLUSIONS: These results show that, in addition to frequent use of nutritional teaching skills, improvement of support skills is also necessary to enhance the effectiveness of nutritional guidance.

Strengths within the Community Perceived by Older Adults Living Alone in a Semi-Mountainous Rural Region: A Qualitative Study.

It is recommended that health promotion activities in the community focus on residents' strengths. Hence, this study explored the community strengths perceived by older adults living alone in a semi-mountainous rural region of Japan. A qualitative, descriptive approach was used. Content analysis was performed using data obtained through face-to-face interviews. Interview data were coded; codes were classified based on similarity to create subcategories and categories. The strengths within the community, as perceived by older adults living alone in a semi-mountainous rural region, were revealed in four categories related to ten subcategories: "loose connections with others", "active community participation", "close relationships with community professionals", and "familiarity with the living environment". Strengths within the community perceived by older adults living alone in a semi-mountainous rural region were cultivated in an environment formed by their past lives. Utilizing these resources may help support community-based societies in semi-mountainous rural regions where depopulation and aging are expected to continue in the future. This study was not registered.

[Development of an exercise program for sedentary behavior in desk workers].

PURPOSE: The effects of lacking exercise due to increased sedentary behavior on physical and mental health are attracting attention. We developed an exercise program for sedentary behavior in desk workers and verified whether decreased body pain and weakness and improved subjective health are short-term effects. SUBJECTS AND METHODS: We developed a 3-min exercise program comprising three among four types of exercises; standing on one leg (1 min on each side), squats (1 min), stretching (1 min), and deep breathing with eyes closed (1 min). The exercise program was performed in the morning and afternoon for 2 months (41 days) (3 types × twice daily × 41 days = 246 times) by 94 employees of University A. For easier implementation, radio exercises (part 1), widely recognized in Japan, were performed in the morning and afternoon before work. Participants were asked about their attributes, work situation, physical and mental conditions before and after implementation, and evaluation of the exercise program after implementation. RESULTS: Exercise records and questionnaire responses were collected from 87 participants. The median number of exercises was 83 (interquartile range; 16-128). The participants were divided into two groups based on the median values. The level of lower back pain and friendship scores had an interaction and improved in the group that performed the exercise more frequently. A receiver operating characteristic curve was drawn based on the relationship between the group whose level of lower back pain was reduced by at least 2 of 11 points and that who did not, and the number of exercises. The cutoff value was 70 times, suggesting that performing exercise ≥ 70 times for 41 days decreased lower back pain. To continue implementing the exercise program, it was necessary to use free time, maintain motivation, and create a sense of unity in the workplace. CONCLUSIONS: We created an exercise program comprising four types of exercise for sedentary behavior in desk workers, which is performed in the morning and afternoon for 2 months. Improvements were seen in the degree of lower back pain and friendship score.

A Review of the Literature on the Regional Strengths Perceived by Older People Living in Local Japanese Communities.

As a super-aging society, health promotion activities in local Japanese communities are increasingly essential. Developing the health-promotion programs must include the perspective of older people residing in these communities and what they believe to be their regional strengths. This study aimed to clarify the elements of regional strengths perceived by older people living in local Japanese communities from the literature review. Using the internet edition of the Japan Medical Abstracts Society (Ichu-shi), the authors examined papers on Japanese regional residents using relevant keywords. Of 342 considered papers, 14 papers were extracted in this study. As a result, the contents related to the regional strengths perceived by the older people living in the local Japanese community were extracted, classified based on the similarity of the meanings and contents, and then summarized into the elements of the strengths. As the regional strengths, three categories were cited for individual elements: "Actions or behaviors underpinned by experience," "Continuing to live with positivity and vigor," and "Extensive support for the subject and their family." Three categories were cited for environmental elements: "A comfortable environment," "Maintaining intimate and friendly interpersonal relations," and "Support that meets the regional characteristics." Along with individual and environmental elements, support from experts in the region was cited. Hence, it was concluded that the active participation of experts is essential for promoting activities in local communities, and that deepening relationship with older people has the potential to improve their quality of life.

[Business continuity capabilities for disaster preparedness: A comparative study of different industries in Wakayama Prefecture].

OBJECTIVES: This study aimed to elucidate the status of business continuity plan (BCP) formulation in businesses, focusing on different industries. It examined their preparation for natural disasters, such as earthquakes and tsunamis, and crisis events, such as emerging infectious diseases. METHODS: A total of 1,583 businesses in Wakayama Prefecture, Japan, were randomly selected from the Wakayama Occupational Health Support Center workplace list. Anonymous self-administered questionnaires were distributed by mail. The questionnaire comprised questions on the business, awareness and formulation status of BCP, and business continuity capabilities in preparation for natural disasters and crisis events. It also explored reasons for the lack of progress in BCP formulation. Businesses were categorized into three groups based on the type of industry: manufacturing (114 companies), lifeline (66 companies), and others (207 companies). RESULTS: Questionnaires were collected from 412 businesses, and 387 of those that responded to the type of industry were analyzed (valid response rate: 24.3%). More than 50% of businesses in all industries were aware of BCP. Regarding the status of BCP formulation, 39.5% of the manufacturing, 34.8% of the lifeline, and 41.5% of others had already formulated or were formulating a BCP. Many lifeline businesses had not taken any measures to prepare facilities and allocate funds for emergencies. Additionally, 49% were at high risk of being forced to close down due to disasters. As the background to the lack of progress in formulating a BCP, 60.9% of lifeline businesses did not know what to develop or how to consider it. In addition, 44.2% of others had to secure the time and human resources necessary for formulation. CONCLUSIONS: Although awareness of BCPs is increasing, their formulation has not progressed significantly. In particular, BCP formulation has been delayed in lifeline industries, resulting in low business continuity capabilities. Given that many businesses do not know the contents or methods of formulating BCPs, it is suggested that educating relevant parties about using templates is necessary. This approach can reduce the time required for formulation and enable the creation of a BCP even without detailed human resources.

Health-related quality of life and its relevant factors in Japanese patients with a urostomy.

PURPOSE: The purpose of this study was to measure health-related quality of life (HRQOL) in a group of community-dwelling persons with urostomies. SUBJECTS AND SETTINGS: The study sample comprised 60 people with urostomies who had been discharged for at least 1 month prior to participation and attended an ostomy outpatient clinic at a municipal hospital in Osaka, Japan. METHODS: Data were collected via interview. Health-related quality of life was assessed using a Japanese language version of the Medical Outcomes Research Short Form 36, version 2. Demographic and clinical data were collected via questionnaire designed for this study that queried age, cancer diagnosis, time since surgery, type of urostomy, job status, presence of visual disorders, peristomal skin problem, information about caregivers in the home, and participation in a support group. Health-related quality of life scores were adjusted by gender and age distribution from standard scores among the general population in Japan. RESULTS: The majority of participants (85.0%) were diagnosed with bladder cancer, and the median time since surgery was 3.4 years. Health-related quality of life scores among those who had surgery during the past 4 years were significantly lower than scores of participants living with an ostomy for more than 4 years. Ostomy surgery associated with an underlying cause other than bladder cancer was associated with a significantly lower score on the social function domain of the Medical Outcomes Research Short Form 36, version 2. Presence of a support person at home was associated with significantly lower scores on the mental health domain. Participation in a support group for persons with ostomies significantly lowered the body pain domain score. CONCLUSION: This study shows the factors relevant to the HRQOL of the participants with urostomies. We recommend that WOC nurses should pay particular attention to people who had ostomy surgery and had such factors, because of the higher likelihood for lower HRQOL.

Social development conditions and related factors for children in Japanese kindergarten in Shanghai, China.

OBJECTIVE: The aim of this study is to clarify the social development conditions and related factors for children in Japanese kindergarten in Shanghai, China. METHODS: The target schools were three Japanese kindergartens in Shanghai, three in Wakayama, Japan, and three in Osaka, Japan. The target kindergarten children were all 5- or 6-year-olds. We used an anonymous questionnaire to the guardian of the child. The question items related to social development, lifestyle and daily activities of the child, and rearing awareness and conditions of the guardian. Social development was scored by Strength and Difficulties Questionnaires (SDQ). RESULTS: The number of respondents was 246 (Shanghai group 72, Wakayama group 86, Osaka group 88). The median value of the score of total difficulties and prosocial behavior, SDQ subscale, and the proportion of children judged as low need showed no significant difference. Results of multiple logistic regression analysis showed that the frequency of eating fast-foods and the rearing condition "I become anxious or lose enthusiasm for childrearing when the child is recalcitrant" were the factors relevant to prosocial behavior in the Shanghai group. In the Wakayama group, the hours spent daily watching TV was designated as the relevant factor. In the Osaka group, hours spent daily playing outdoors was found to be the relevant factor. CONCLUSIONS: Social development of children in Japanese kindergarten in Shanghai was the same as that of those living in Japan. The factors relevant to prosocial behavior in the Shanghai group were different from those in the two cities in Japan. This study may show the important points to keep in mind for childrearing abroad.

Factors Related to Nutritional Status of Single Older Residents in Semi-Mountainous Rural Regions of Japan: A Cross-Sectional Study.

Japan's notably high aging rate presents the risk of malnutrition. This study aimed to clarify the nutritional status and factors related to the nutritional status of single older residents in a semi-mountainous rural region of Japan. Using a cross-sectional study design, surveys were administered to older adults in the semi-mountainous rural region in the area of Kochi Prefecture, Japan. Factors associated with a risk of malnutrition were identified using binomial logistic regression analysis. In addition, nutritional status was evaluated using the Mini Nutritional Assessment-Short Form (MNA-SF). Among 53 participants, the MNA-SF score was 12.1 ± 1.5 (mean ± standard deviation), and 71.7% had a normal nutritional status. We observed that participation in local residents' association gatherings (odds ratio [OR]: 7.42, 95% confidence interval [CI]: 1.17-47.01) and risk of depression/anxiety (OR: 12.77, 95% CI: 1.99-81.94) were associated with an increased risk of malnutrition, whereas social interaction with friends (OR: 0.11, 95% CI: 0.02-0.76) were associated with a decreased risk. The nutritional status was normal overall. Community health workers should share information on the health of residents and promote social events to enable older residents living alone to continue leading healthy lifestyles.

[Factors Related to Work Engagement in Occupational Health Nurses: From both Aspects of Work Environmental and Individual Factors].

OBJECTIVES: The Ministry of Health, Labour and Welfare (MHLW) states that it is an important issue to realize a work environment where people find their job worth doing, and the MHLW utilizes work engagement as the concept of a job worth doing. In this study, we aimed to clarify the factors related to work engagement in occupational health nurses from both aspects of work environmental and individual factors. METHODS: An anonymous self-administered questionnaire was mailed to 2,172 occupational health nurses who belonged to the Japan Society for Occupational Health and were in charge of practical work. Among them, 720 responded and their responses were analyzed (valid response rate: 33.1%). The Japanese version of the Utrecht Work Engagement Scale (UWES-J) was used to measure their feelings on whether their job is worth doing. Question items at three levels, namely, work level, department level, and workplace level, were selected from the new brief job stress questionnaire as the work environmental factors. Three scales, namely, professional identity, self-management skills, and out-of-work resources, were used as the individual factors. Multiple linear regression analysis was performed to examine the factors related to work engagement. RESULTS: The mean total score of UWES-J was 57.0 points, and the mean item score was 3.4 points. Among attributes, age, having children, and the position of chief or above were positively correlated to the total score, but the number of occupational health nurses in the workplace was negatively correlated to the total score. Among work environmental factors, work-self balance (positive), which is a subscale at the workplace level, and suitable jobs and opportunities to grow up, which are the subscales at the work level, were positively correlated to the total score. Among individual factors, self-esteem as a professional and self-improvement to be professional, which are the subscales of the professional identity, and problem resolution, which is a subscale of self-management skills, were positively correlated to the total score. CONCLUSIONS: In order for occupational health nurses to find their job worth doing, it is desirable that they will have options to choose diverse and flexible work styles, and that their employers will establish a work-life balance for the entire organization. It is preferable that the occupational health nurses can self-improve, and that their employers will provide opportunities for them to develop professionally. The employers should also establish a personnel evaluation system that allows for promotion. Results also suggest that the occupational health nurses need to improve their self-management skills, and that the employers should assign them to positions suitable to their abilities.

[Efforts to improve workplaces considering for older workers: A questionnaire survey focusing on company size in Wakayama Prefecture, Japan].

OBJECTIVES: The "Guidelines for Ensuring the Safety and Health of Older Workers (hereafter referred to as "Guidelines")," formulated in 2021, require employers to implement measures that proactively prevent occupational accidents among older workers. This study aimed to clarify the status of awareness of the Guidelines and workplace improvement efforts with consideration of older workers, focusing on company size. METHODS: Overall, 780 businesses in Wakayama Prefecture, Japan, were randomly selected from a Wakayama Occupational Health Support Center workplace list. Anonymous self-administered questionnaires were distributed by mail. The questionnaires comprised questions about the workplace, status of awareness of the Guidelines, comprehensive management of safety and health, considerations for working conditions, workers, workload reduction, work posture, work environment, and safety and health. RESULTS: One hundred and seventy-one businesses (effective response rate: 21.9%) provided questionnaires with complete responses. For the Guidelines, 39.0% of small-sized (less than 50 employees) businesses answered, "never even heard of the name," while many medium-sized (50-99 employees) and large-sized (100 or more employees) businesses answered that they had heard of the name but did not exactly know about it (33.3% of medium-sized businesses and 47.8% of large-sized businesses). Regarding the system that subsidizes the expenses required for the improvement of a working environment for older workers to work safely and securely (hereinafter referred to as the subsidy system), many businesses of all sizes answered that they had "never even heard of the name." In the comprehensive management of safety and health, half of the businesses of all sizes had developed a system that made it easy to consult about the risk against occupational accidents of older workers. Regardless of size, more than half of businesses were able to consider working conditions and workers. However, there were only a few items where more than half of the businesses considered workload reduction, work posture, work environment, and safety and health, regardless of business size. It became clear that workplace improvement had not progressed very much. CONCLUSIONS: These results suggest that to promote workplace improvement that considers older workers, it is necessary to disseminate the Guidelines and proactively take on workplace improvement by utilizing the subsidy system.

[Support for a balance between work schedules and treatment regimens among workers with illness: A questionnaire survey focusing on company size in Wakayama Prefecture, Japan].

OBJECTIVES: The support from businesses to create a balance between work schedules and treatment regimens among employees suffering from illnesses, such as cancer and diabetes, seems to be insufficient. This study aimed to investigate efforts of businesses to support the balance of work schedules and treatment regimens among employees with illness, focusing on company size and to identify potential workplace improvements for such employees. METHODS: Overall, 789 businesses in Wakayama Prefecture, Japan were randomly selected from a workplace list of the Wakayama Occupational Health Support Center. Anonymous questionnaires were distributed by mail. The questionnaires consisted of question items on workplace, current employees who had suffered or were suffering from cancer (employees with cancer), employees with illnesses (diseases such as cancer and diabetes), and support for businesses and employees. RESULTS: Questionnaires with complete responses were collected from 187 businesses (response rate: 23.7%). The ratios of businesses where employees with cancer were engaged or had been engaged were 43.4% for small-sized (less than 50 employees), 70.9% for medium-sized (50-99 employees), and 83.1% for large-sized (100 and more employees) businesses. In all business sizes, the most common support in reinstatement or hiring employees with cancer was "absenteeism for treatment." The most common difficulty that occurred in the workplace due to the presence of employees with cancer was "the insufficient number of workers." The information from the attending physician, etc. necessary for deciding the reinstatement was mostly "the current health condition and physical strength." Additionally, in all business sizes, the most common support for employees with illness to balance work schedule and treatment regimens was "considering measures suitable to the situation such as hospital visits and physical condition." The most common challenge was "securing alternative personnel." The information from the attending physician, etc. necessary for deciding the reinstatement was "the current health condition and physical strength," similar to that for employees with cancer. More than 60% of the businesses of varying sizes reported being unaware of the work-treatment balance support coordinator. CONCLUSIONS: Considering measures suitable to the situation, such as hospital visits and physical condition, securing alternative personnel, and actively disseminating information regarding work-treatment balance support coordinators are recommended as workplace improvements for employees with illnesses.

Development of a new instrument for evaluating leg motions using acceleration sensors (II).

OBJECTIVE: The purpose of this study was to investigate the characteristics of the average acceleration of elderly people during walking. METHOD: The subject cohort comprised nine men and 21 women aged ≥63 years. Subjects walked a 10-m straight course (walk test) which required stepping over six obstacles (hurdle walk test). The average acceleration was calculated from the accelerograms. Functional reach test scores and the Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence, fall risk assessment, fall experience within the last year, and carelessness were used as standard indices to estimate the dynamic postural movement and fall risk. RESULTS: The average acceleration during the walk test was not significantly correlated with the standard indices. The average accelerations at the lumbar and knee positions clustered with fall experience and carelessness, while those at the ankle and toe positions clustered with the hurdle walk test, TMIG index of competence, and fall risk assessment. Between the high- and low-risk groups classified by the conventional indices, there was a significant difference in the average acceleration at some measurement positions. The receiver operating characteristic analysis showed the possibility to discriminate the high-risk group according to the standard indices with average acceleration. CONCLUSIONS: The average acceleration during walking may be a composite index that encompasses standard indices and discriminate the high-risk group. As such, it may be a useful tool to estimate the dynamic postural movement and fall risk at all measurement positions.