Influence of new coronavirus pandemic on behavior and awareness of young nurses and nursing students in Japan.

BACKGROUND: Although mental health disorders of health care workers in the coronavirus disease 2019 (COVID-19) pandemic have been focused, little is known about the psychological impact on nurses and the influence on their behavior and awareness, such as professionalism and views on life and death, in Japan where there are fewer cases of infection and deaths than in other countries. Moreover, the influence of the pandemic on nursing students is still unclear. METHODS: An online questionnaire survey was conducted among nurses and nursing students. Feelings during the state of emergency (at the peak of the pandemic) in Japan, changes in behavior and awareness after the rise of COVID-19, and the associated factors influencing these changes were analyzed, comparing nurses with nursing students. RESULTS: Significantly increased scores of anxiety/fear (p < .005) and voluntary restraint (p < .005) and significantly decreased score of motivation (p < .005) were observed during the state of emergency in both nurses and students. Scores of experience of discrimination (p < .005) and consideration of premature retirement (p < .01) were significantly increased in nurses. Moreover, preventive behavior (p < .005), lifestyle (p < .005), anxiety about nursing (p < .005) and views on life and death (p < .005) significantly changed after the rise of COVID-19 in both nurses and students. Only nurses reported significant damage to their professionalism (p < .01). Anxiety/fear and/or voluntary restraint and/or decreased motivation during the state of emergency were major factors associated with these changes. Also, the type of hospital, experience of care of infected patients and sex affected some of the changes. Voluntary restraint (p = .008), increased preventive behavior (p = .021) and decreased motivation (p = .005) were more marked in nurses than in students, while change in views on life and death was greater in students than in nurses (p = .002). CONCLUSION: The COVID-19 pandemic has had a psychological impact on nurses and nursing students, associated with changes in behavior and awareness even in Japan. Of note, the COVID-19 pandemic has affected nurses' professionalism and views on life and death. This study demonstrates the importance of having a coping strategy for anxiety and damaged professionalism in nurses, and education on life and death in nursing students.

Model Comparisons of the Cost Effectiveness of Rubella Vaccination Method in Japanese Adults.

The number of rubella cases has increased in Japan, especially among adults. Rubella infection in pregnant females can lead to congenital rubella syndrome (CRS). The Japanese government is promoting vaccination to prevent CRS. This study performs a cost-effectiveness analysis of the following four methods: (1) females who wished to become pregnant and partners, with an antibody-titer test; (2) females only, with an antibody-titer test; (3) females and males, without an antibody-titer test; (4) females only, without an antibody-titer test. A decision tree model with a hypothetical cohort of 500 males and 500 females was used for the analysis, and the parameters were obtained from previous studies. The number of avoidances of CRS was defined as the effect. Compared to the case where methods were not implemented, the number of CRS cases that can be prevented by implementing the methods was 0.0115589 by (1) and (3) and 0.0147891 by (2) and (4). The cost effectiveness of (1) to (4) was 287,413,677 JPY, 135,050,529 JPY, 388,524,974 JPY, and 197,744,219 JPY, respectively (1 JPY = 0.00963247 USD). Method (2) was the most cost-effective and did not change by sensitivity analysis. We conclude that the vaccination for females only with an antibody-titer test is recommended.

Factors associated with smoking cessation and relapse in the Japanese smoking cessation treatment program: A prospective cohort study based on financial support in Suita City, Japan.

INTRODUCTION: The purpose of this study is to clarify the effect of providing financial support and factors associated with smoking cessation and relapse in the Japanese smoking cessation treatment (SCT) program based on financial support. METHODS: A prospective cohort study was conducted at the smoking cessation outpatients of hospitals or clinics in Suita City, Japan from May 2017 to September 2018. In all, 153 participants were recruited and received standardized treatment based on the SCT program. Participants were required to answer four questionnaires and register for the financial support program. Chi-squared test, Fisher's exact test, non-paired t-test and log-binomial regression analysis were used to analyze the data. RESULTS: Of the 153 participants, 140 participants completed a 12-week treatment and the completion rate was 91.5%. There were no factors significantly associated with smoking cessation and relapse (p<0.05). However, male, cigarettes smoked per day, having present diseases, having previous abstinence, living with family, cohabitation with smokers, desire to smoke at the start of treatment, self-efficacy at the start of treatment, desire to smoke at 4 weeks and self-efficacy at 4 weeks showed statistically significant odds ratio for success of smoking cessation. Similarly at 12 weeks, male, age at smoking initiation, cigarettes smoked per day, having previous abstinence, living with family, cohabitation with smokers, desire to smoke, self-efficacy and depression disorders showed statistically significant odds ratio for smoking relapse. In addition, the rate of abstainers using varenicline was 68.60%, which was higher than abstainers using nicotine patch (55.60%) and the relapse rate of participants using nicotine patch was 100.00%, significantly higher than for relapsers using varenicline (45.80%). CONCLUSIONS: Further study is expected to clarify the effect of providing financial support and the factors associated with smoking cessation and relapse in the SCT program based on financial support.

Using GIS to simulate tsunami evacuation guidance signs for the hearing impaired.

The Nankai Trough in Japan has been identified as a geological feature that could cause extensive damage in the event of a major earthquake. In this study, we investigated the impact of effective guidance signs for hearing-impaired individuals requiring special care when escaping to a tsunami evacuation building (emergency evacuation location) using geographical information system (GIS) and viewshed analysis. We selected an area we considered would suffer severe damage following a major earthquake and tsunami; we identified difficulties in the provision of escape routes. Using GIS, we determined the time required for escape and tsunami arrival time if effective signs were installed; we undertook such analysis using the height data of buildings in the target area. With effectively installed guidance signs, the average required evacuation time was 36.88 minutes; without such signs (which is currently the case in the target area), the average time was 47.10 minutes: that would result in citizens getting caught by the tsunami. Installing effective guidance signs would allow hearing-impaired individuals to escape to an evacuation building before being hit by the tsunami.

[Survey on the Actual Situation of Home Care Support by Outpatient Nursing Managers and on the Awareness of Regional Cooperation].

Shortened hospitalization periods result in an increase in discharged patients with a lack ofself -care agency and families with lower caring ability. The role ofoutpatient nurses becomes more important in such situations. In this study, to clarify the role played by outpatient nurses, we surveyed them about their actual situation ofhome care support and awareness of regional cooperation. Subjects included outpatient nursing managers ofgeneral hospitals with inpatient facilities publicized in Osaka Prefecture; for the survey, questionnaires were sent to them via mail. The questionnaire collection rate was 16.5%. Regarding issues related to outpatient nursing, insufficient manpower was the most frequent response. Although efforts to provide nursing care have been made, such as the use ofmedical professionals and the arrangement ofcertif ied nurses and specialized nurses, the actual situation was clarified with difficulty to ensure nursing quality such as working shifts of the staffs and arrangement standard. Reasons why nursing quality cannot be ensured included the following: readiness of the patient cannot be understood, time cannot be ensured because ofthe large non-nursing workload, and nursing volume cannot be determined. Although efforts such as arrangement of certified nurses and establishment of outpatient sections for nursing were found to ensure nursing quality, insufficient regional cooperation was clarified with issue of nursing cooperation inside hospitals. This situation was considered to be influenced by large nursing-related workload, such as shortened waiting time, concentrated treatments, and smooth functioning.

[Effect of Sterilized Water on the Removal of Staphylococcus Aureus Attached to the Inner Surface of the Enteral Nutrition Tubes].

OBJECTIVE: The purpose ofthis study is to determine whether Staphylococcus aureus(S. aureus)can be removed completely from the inner surface of the enteral nutrition tubes using sterilized water. METHODS: A bacterial solution of S. aureus in saline was prepared. The enteral nutrition tubes were later soaked in this solution for 1 hour. After the solution was drained, bacterial count ofthe tube was determined. The inner surfaces ofthe tubes were later flushed 10 times with sterilized water. The bacterial load of the tubes was determined after flushing. After 18 hours, the viable bacteria on the insides of the tubes were enumerated. RESULTS: One hour after the initial inoculation, 62.6±26.0% oft he S. aureus survived. Some bacteria remained viable on the tubes after 10 flushes with sterilized water. Eighteen hours after the flushes, viable bacteria could be detected on the inside ofthe tubes. CONCLUSION: To ensure the safe use ofthe enteral nutrition tubes, it is important not to recycle the tubes or to disinfect the tubes after every meal.

[An Investigation into the Geographical Characteristics of Difficult Areas of Food Access in Mountainous Regions Using a Geographic Information System].

We performed this study with the aim of clarifying the geographical features of areas of difficult-to-access foods in mountainous regions, using GIS, altitude data, and future population projections. With QGIS, we mapped altitude data, future estimates of the old age population(mesh), and retail store data, and we extracted the altitude at the mesh center point. We also draw straight lines connecting the retail stores and the mesh center point. Meshes located in areas with high altitudes had significantly more meshes not occupied by humans than meshes located in low-lyingareas (p<0.01). At least 95% of the retail shops and mesh center points were separated by more than 500 meters, and thus are considered difficult to access. The number of non-residential areas increases in mountainous regions because of the sharp gradient and the long distance to retail stores. By visualizingusingGIS, future resources can be considered more realistically.

[Identifying the Regional Features in the Visiting Nursing Station Trade Area Using GIS].

In order to clarify the characteristics of the area where the visiting nursing station is located, we conducted a study to identify the regional characteristics of the visiting nursing station in Ishikawa Prefecture, using geographical information system(GIS). We mapped the elderly population, aging rate, and location data for the visiting nursing station using QGIS, and created trade areas(Voronoi diagrams). The aging rate for each trade area is 22.4%(min 8.8% to max 44.6%), about 5 times. The difference in area is about 850 times as large as the central value of 9.2 km2(min 0.5 km2 to max 423.2 km2). In addition, there was a tendency for stations with a large trade area to have a higher aging rate than that of smaller stations. Understanding the characteristics of the area surrounding visiting nursing stations using GIS facilitates the clarification of potential needs and opportunities for providing visiting nursing services that are suitable for each area.

Salivary melatonin levels and sleep-wake rhythms in pregnant women with hypertensive and glucose metabolic disorders: A prospective analysis.

In preeclampsia and gestational diabetes, the sympathetic nerves are activated, leading to disrupted sleep. Melatonin, which transmits information to regulate the sleep-wake rhythm and other such biorhythms, has been implicated in insulin resistance, antioxidant behaviors, and metabolic syndrome. In addition, its reduced secretion increases the risk of hypertension and diabetes. The aim of this study was to elucidate the features of melatonin secretion, sleep quality, and sleep-wake rhythms in pregnant women with complications. Fifty-eight pregnant women with pregnancy complications (hypertensive or glucose metabolic disorders) and 40 healthy pregnant women completed questionnaires, including sleep logs and the Pittsburgh Sleep Quality Index (PSQI), during the second to third trimesters. Their salivary melatonin levels were also measured. Pregnant women with complications had significantly lower morning (p < 0.001), daytime (p < 0.01), evening (p < 0.001), night (p < 0.01), daily mean (p < 0.001), peak (p < 0.001), and bottom (p < 0.01) melatonin values than healthy pregnant women. Pregnant women with complications also had significantly smaller melatonin amplitudes than healthy pregnant women (p < 0.001). Among pregnant women with complications, the duration (p < 0.05) and frequency (p < 0.01) of wake after sleep-onset were significantly greater in the poor sleep group than in the favorable sleep group which was divided by PSQI cutoff value. Pregnant women with hypertensive or glucose metabolic disorder complications had smaller circadian variation in salivary melatonin secretion, and their values were lower throughout the day than healthy pregnant women.

Distinctive bacteria-binding property of cloth materials.

BACKGROUND: Nosocomial infections may be caused by pathogens that are transmitted from the hands or clothes of hospital personnel. Handwashing has been evaluated as effective against the spread of pathogens, but transmission through clothes has been little investigated. Evaluation of bacterial adherence to clothes is difficult because of the nonuniform amount of water absorbance by cloth. Therefore, we measured binding of bacteria to cloth fibers made of cotton, nylon, polyester, acrylic, or sheep's wool and tried to characterize bacterial binding to cloth. METHODS: We chose to study the opportunistic pathogens Staphylococcus aureus and Pseudomonas aeruginosa. Cloth fibers were incubated with bacterial suspensions in silicone-coated tubes. We evaluated the reduction of numbers of bacteria in solutions incubated with the fibers and calculated binding ratios of bacteria to the fibers. RESULTS: Polyester or acrylic fibers bound S aureus and P aeruginosa at high ratios (>80%), but cotton fibers bound them at low ratios (<10%). Nylon fibers bound S aureus at low ratios, but P aeruginosa at intermediate ratios. CONCLUSION: The results suggested that polyester, acrylic, or wool clothes could be good carriers of S aureus and P aeruginosa and thus should be covered with cotton clothes to minimize the spread of the pathogens.