Comparative evaluation of the sleep quality metrics between a cardboard bed and a camp cot: a randomized controlled crossover study.

Background: Health-beneficial emergency bedding has become increasingly important for dealing with natural disasters such as the anticipated Nankai Trough earthquake in Japan. When the Great East Japan Earthquake occurred, cardboard beds were provided to evacuees. However, there were concerns about lower back pain and sleep disturbances, as cardboard beds offer insufficient pressure distribution. This study aimed to compare the effects of cardboard beds with those of foldable camp cots on sleep quality. Methods: A randomized controlled crossover study involving 20 healthy participants aged 18-45 years was conducted between June 2022 and January 2023. Participants were asked to sleep for one night on a camp cot and for another night on a cardboard bed, with a minimum three-day washout period between the two nights. Body pressure distribution and sleep metrics obtained from polysomnography (PSG) and questionnaires were compared between the two-bed types (P < 0.05). Results: The camp cot exhibited better body pressure distribution than a cardboard bed, leading to improved sleep satisfaction, bedding comfort, and reduced morning sleepiness. Nevertheless, polysomnography revealed no notable differences in sleep metrics or sleep architecture between the two types of beds. Conclusions: Our findings indicate that cardboard beds have lower pressure dispersion capabilities than camp cots, leading to an increased number of position changes during sleep. Additionally, subjective sleep quality, such as alertness on waking, sleep comfort, and sleep satisfaction, was lower for cardboard beds, suggesting that camp cots might offer a more comfortable bedding option for evacuees. However, there were no discernible differences between the two-bed types in terms of objective sleep metrics derived from PSG. The potential for sleep disturbances caused by lower back pain from a hard mattress has been noted, and it is possible that a single night's experience in healthy individuals might not be enough for sleep issues to manifest.

Comparison of body pressure distribution in healthy subjects between bubble wrap and an emergency mattress laid on a cardboard bed: a randomized controlled crossover trial.

Background: It has been pointed out that the poor environment of evacuation shelters causes health problems and disaster-related deaths among evacuees, and we are concerned that their environment will deteriorate, particularly during a large-scale disaster due to a shortage of daily necessities. In Japan, evacuees usually slept on floors with futons until the Great East Japan Earthquake, but cardboard beds were installed in evacuation shelters. Previous studies have suggested that cardboard beds can reduce cold air transmission from the floor. We have reported that a cardboard bed can have a low-contact pressure dispersion capacity and cannot reduce musculoskeletal strain, unlike a futon or mattress. In the Great East Japan Earthquake, 33% of disaster-related deaths were reported to have been caused by physical or mental fatigue due to living in evacuation shelters. When a large-scale disaster such as the Nankai Trough Earthquake generates huge numbers of evacuees, the supply of mattresses for evacuees will be very difficult. Therefore, we considered potential alternatives that could be produced in large quantities over a short period. Bubble wrap, with very lightweight and waterproofing, could be a good candidate for mattress replacement. This study aimed to investigate the improvement in body pressure distribution and pressure-sensing area when using bubble wrap. Methods: Twenty-seven healthy subjects allocated to sequences A and B with different intervention order were laid in supine and lateral positions on a cardboard bed without a mattress, bubble wrap, or air mattress: the mattress-body contact pressure and contour areas were measured, and subjective firmness and comfort during these conditions were also investigated using the visual analog scale (VAS). Acquired data were analyzed using a linear mixed-effects model and Bonferroni's post-hoc test, and P < 0.05 was considered statistically significant. Results: The mattress-body contact pressure and contour area showed significant differences with and without air mattresses. With the air mattresses, the pressure in the supine position decreased by 34%, and that in the lateral position decreased by 13%. However, the four-fold bubble wrap did not improve the mattress-body contact pressure and contour area; the change ratios were within 5% compared to the cardboard bed. However, there were significant differences in subjective firmness and comfort using the VAS among all experimental positions. Conclusion: Our study showed that bubble wrap could not significantly improve body pressure concentration and may not be a satisfactory substitute for air mattresses. Because of the improvement in subjective firmness and comfort with the bubble wrap, using it for an extended period may affect the incidence of back pain in evacuees. Finally, we hypothesize that the body pressure dispersion of the bubble wrap may be improved by changing the air-filling rate and the size of the air bubbles.

How has the COVID-19 pandemic influenced nursing students' academic experience and career choices? A qualitative descriptive analysis.

COVID-19 control measures influenced education and training environments and profoundly impacted nursing students' career prospects and academic lives. This study intends to elucidate the impact of the COVID-19 pandemic on nursing students' academic experience and career choices. A qualitative descriptive study was conducted at a 4-year university in Japan, using semi-structured interviews with 14 nursing students. Sandelowski's qualitative descriptive analysis was conducted. We identified 11 categories that summarize COVID-19's influence on students' academic experience and career choices: "Forced change to a new learning system," "Difficult learning thoroughly with restricted face-to-face interactions," "Worries regarding teacher evaluations when face-to-face interactions are restricted," "Adapting to changes in the learning environment," "Finding new ways to learn due to the different learning environment," "Worries regarding career decision-making after losing opportunities to obtain career information," "Fully utilizing limited information resources in deciding where to work while being influenced by others," "Coping with a confusing new job hunting system," "Worries about becoming a nurse without enough practical experience," "Conscious of working as a nurse while facing infections," and "Support from those around me is helpful in an unfamiliar environment." The categories comprised four elements: academic impact, employment/career impact, future impact on working as a nurse, and environmental support. Building an online education/training program, ensuring the availability of regular psychological support, providing abundant information on employment, installing an information desk, and providing regular feedback were considered imperative for supporting nursing students.

Impact of the COVID-19 pandemic on the mental health of nursing students in Japan: a cross-sectional study.

BACKGROUND: The effect of the prolonged coronavirus disease (COVID-19) pandemic on the mental health of nursing students is unclear. This study assesses the prevalence of anxiety, depression, and insomnia among nursing students in Japan during the pandemic and determines the risk factors associated with such symptoms. METHODS: An online survey-based cross-sectional study was conducted from August 16 to October 16, 2021. Participants were first- to fourth-year nursing students enrolled in undergraduate programs at the eight universities in Japan. Anxiety, depression, and insomnia were assessed using the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index-7, respectively. We calculated descriptive statistics for each measurement item and performed univariate and logistic regression analyses to evaluate the potential risk factors. RESULTS: We received responses from 1,222 of 3,056 nursing students (response rate: 40.0%). After 25 participants were excluded due to missing outcome values, 1,197 students (valid response rate: 98.0%) were included in the analysis. The prevalence of anxiety, depression, and insomnia was 4.8%, 12.4%, and 18.0%, respectively. The risk of anxiety was lower among participants who did not have any relatives or friends who had been infected with SARS-CoV-2 than among those who did (aOR 0.36, 95% CI 0.14-0.94). The risk of depression was higher among participants whose financial status had worsened during the pandemic than among those whose financial status had not changed (aOR 3.44; 95% CI 1.98-5.96). Common factors that increased the risk of anxiety, depression, and insomnia were life satisfaction and fear of COVID-19. CONCLUSION: Mental health-related symptoms among nursing students in Japan have not necessarily worsened with the spread of COVID-19 but were exacerbated by the intensity of changes in daily living and fear, which are psychosocial effects associated with the pandemic.

Cardboard Bed Without Mattress Is Ineffective in Improving the body Contact Pressure-a Preliminary Study Using a Dummy Model.

OBJECTIVE: This study aimed to describe and evaluate the dispersion of body-mattress contact pressure on a cardboard bed and investigate whether the cardboard bed has a positive effect on evacuees' musculoskeletal burden. MATERIALS AND METHODS: A high-performance nursing simulator was used to measure the contact pressure and the body surface contour area of the bed, and these values were collected with the patient in the supine position using the Body Pressure Measurement System. Data of each test were acquired 10 times and were compared among 4 conditions (plastic sheet, cardboard bed, cardboard bed with a blanket, and cardboard bed with a mattress-topper). The data analysis for body-mattress contacts pressure and the surface contour area of the whole body, head, chest, and buttocks were conducted by one-way repeated analysis of variance and Bonferroni post-hoc test. RESULTS: The average body-contact pressure on the cardboard bed did not decrease compared with that on the floor with plastic sheets. In contrast, the body surface contour area was significantly different among any other conditions, but the gap was only approximately 16%. However, the body-contact pressure and the body surface contour area were improved when a mattress-topper was added on the cardboard bed. When a blanket was laid on the cardboard bed, the contact area was increased. CONCLUSION: Our results indicate that the pressure dispersion ability of the cardboard bed was not sufficient; however, adding the mattress-topper or the blanket could contribute to an improvement in the evacuees' musculoskeletal burden. Many evacuees lay a mattress topper or futon on a cardboard bed after installing cardboard beds. Our findings may also support the scientific validity of the evacuees' actual sleeping style in Japan. This preliminary study provides the basis for future research on exploring an appropriate sleeping bed condition in evacuee shelters.

Impact of the COVID-19 pandemic on mental health of nursing students in Japan: protocol for a cross-sectional study.

INTRODUCTION: The COVID-19 pandemic is spreading globally with a high risk of mortality. It is also significantly affecting mental health. For nursing students, the impact of COVID-19 on mental health is predicted to be significant; however, sufficient data have not been obtained. Therefore, this study will aim to assess the mental health of nursing students and evaluate the related factors. METHODS AND ANALYSIS: This proposed study is a cross-sectional survey using a self-report questionnaire. An online questionnaire will be distributed among all nursing students of eight universities in Japan. The survey questionnaire will consist of questions related to demography, life satisfaction, fear of COVID-19, mental health and physical activities. The target sample size is 1300 nursing students. We will calculate descriptive statistics for each measurement item and perform univariate and logistic regression analyses to evaluate the potential risk factors for anxiety, depression and insomnia symptoms in nursing students. The strength of association will be assessed using the OR and its 95% CIs. Statistical significance will be set at a p<0.05. ETHICS AND DISSEMINATION: The protocol was approved by the Institutional Review Board (IRB) of the University of Hyogo on 22 March 2021 (ID: 2020F29). In addition, all of the participating facilities required ethical approval from their local IRBs. The findings will be disseminated through peer-reviewed publications and conference presentations. We believe that the proposed large-scale investigation of the mental health of nursing students during the COVID-19 pandemic and the relationship between mental health and fear of COVID-19 are novel and will be a strength of this study.

Head cooling during sleep improves sleep quality in the luteal phase in female university students: A randomized crossover-controlled pilot study.

Although selective head-cooling has been reported to decrease scalp and tympanic temperature and improve sleep quality, whether head-cooling during sleep can improve sleep quality in women during the luteal phase has not been elucidated. This randomized, controlled crossover open trial aimed to investigate the effect of head cooling during sleep on sleep quality in women during the luteal phase. Female university students aged 19-25 years with increased daytime sleepiness during the luteal phase were recruited by poster advertisement at their university from May to June 2016 and from May to June 2017. Fourteen women aged 19-22 years participated in this study. The temperature-controllable cooling sheet containing tubes filled with circulating water was used for head-cooling, and the head-cooling and the controlled temperature were set at 25°C and 35°C, respectively. Electroencephalogram data were obtained using a single-channel portable electroencephalogram device. The difference in sleep-related variables and tympanic temperature between head-cooling and control were analyzed using a linear mixed model. The proportion of arousal was lower with head cooling than with the control. In contrast, the proportion of non-REM3 and the delta power were higher with head cooling than with the control. The proportion of non-REM2 and non-REM3 among sleep EEG stages were positively and negatively correlated with the mean tympanic temperature during sleep, respectively. However, arousal and REM were not correlated with tympanic temperature. We considered the reduction of arousal time by head-cooling might be related to scalp temperature rather than tympanic temperature. Further, our results suggested that head-cooling also improved subjective sleep comfort. In conclusion, head-cooling during sleep could improve sleep quality in young women during the luteal phase.

Direct inhibition of arginase attenuated airway allergic reactions and inflammation in a Dermatophagoides farinae-induced NC/Nga mouse model.

The expression of arginase I has been a focus of research into the pathogenesis of experimental asthma, because arginase deprives nitric oxide synthase (NOS) of arginine and therefore participates in the attenuation of bronchodilators such as nitric oxide (NO). The present study used an intranasal mite-induced NC/Nga mouse model of asthma to investigate the contribution of arginase to the asthma pathogenesis, using an arginase inhibitor, N(omega)-hydroxy-nor-l-arginine (nor-NOHA). The treatment with nor-NOHA inhibited the increase in airway hyperresponsiveness (AHR) and the number of eosinophils in bronchoalveolar lavage fluid. NOx levels in the lung were elevated despite suppressed NOS2 mRNA expression. Accompanied by the attenuated activity of arginase, the expression of arginase I at both the mRNA and protein level was downregulated. The levels of mRNA for T helper 2 cytokines such as IL-4, IL-5, and IL-13, and for chemotactants such as eotaxin-1 and eotaxin-2, were reduced. Moreover, the accumulation of inflammatory cells and the ratio of goblet cells in the bronchiole were decreased. The study concluded that the depletion of NO caused by arginase contributes to AHR and inflammation, and direct administration of an arginase inhibitor to the airway may be beneficial and could be of use in treating asthma due to its anti-inflammatory and airway-relaxing effects, although it is not clear whether the anti-inflammatory effect is direct or indirect.