[Developing scales to evaluate community practices among municipal public health nurses: content, perceptions of public health nurses, and organizational environment].

Objectives　This study aimed to develop scales for evaluating the level of implementation of community practices and explore the perception of public health nurses in municipalities regarding their community practices.Methods　Draft scales were developed based on a literature review and interviews with municipal public health nurses. Subsequently, a questionnaire survey was conducted with municipal public health nurses across Japan in response to these draft scales. Respondents were recruited based on the municipality population size. Questionnaires were distributed to 2,074 individuals from 52 municipalities ensuring representation from diverse municipalities. Exploratory factor analysis was performed to determine the number of factors, while confirmatory factor analysis was performed to determine the factor structure. The reliability of the scales was assessed by calculating Cronbach's alpha coefficients, and their validity was tested by examining correlations with existing scales, namely the Moral Competence Scale for Public Health Nurses and the Professional Identity Scale for Public Health Nurses, and years of experience as a public health nurse.Results　A total of 721 (34.8%) valid respondents were included in the analysis. Three scales, methods of community practices (three factors, nine items), perceptions of public health nurses toward community residents through community practices (three factors, 10 items), and organizational environment supporting community practices (two factors, 11 items) were developed as indicators of the implementation of public health nurses' community practices. Cronbach's alpha coefficients for the three scales were 0.896, 0.913, and 0.868, respectively. As hypothesized, each subfactor exhibited a positive correlation with the existing scales. However, certain subfactors did not demonstrate any correlation with years of experience.Conclusion　The three scales developed in this study were individually examined for reliability and validity. These scales can be used independently or in combination, allowing public health nurses to select the most suitable scale(s) based on their objective.　A notable contribution of this study is the establishment of concrete indicators for evaluating community practices, addressing the previously vague nature of this evaluation. By incorporating the scale items into daily health practices, we anticipate that these indicators can be employed to evaluate community practices at the organizational and individual levels.

[Gaining consensus on key terms in community health activities: A national survey using the Delphi method].

Objectives　The purpose of this study was to define the terminology used in community health activities by systematically establishing agreement among public health nurses and related professionals, to aid them in effectively cooperating with other professionals.Methods　We extracted the major terms described in "Guidelines for Public Health Nurses' Activities in the Region," which was issued by the Director of Health Bureau, Ministry of Health, Labor and Welfare; and conducted 2 iterations on the proposed definition of the terms using the Delphi method. The survey targeted 800 stakeholders from the following 4 professions: public health nurses in managerial positions in local governments, clerical staff in local governments, public health nursing professors at educational institutions, and social welfare council staff. Respondents indicated their degree of agreement with the definition of the terms using a 4-point Likert scale. We tallied the answers indicating "I agree" or "Mostly agree." A 70% term agreement was considered "conformed." A free text box for each proposed definition was also available so that respondents could share their opinions and offer alternatives.Results　The first survey received 231 responses. The conformity of their definitions ranged from 83.9%-96.9% (mean=91.5%). Although all definitions exceeded the consensus level, we examined their adequacy with reference to the definitions and opinions from the free text. Various opinions were obtained from those engaged in each occupation. The second round included 117 consenting stakeholders from the first survey, yielding 90 responses. Their degree of conformity ranged from 86.7%-98.9% (mean=94.6%). Therefore, we determined the definitions had reached a robust agreement. We revised the definitions of some terms with reference to the opinions from the free texts and finalized the definitions. Finally, we defined 23 terms-such as region, community diagnosis, and policy.Conclusion　All terms had a conformity of more than 85%, thus bringing into alignment those community health terms that had varying interpretations among related occupations earlier. By including the opinions of those from the related occupations who collaborate with public health nurses, the definitions of these terms could be established and shared. These definitions can be used in public health nursing practice, education, service, and research-among those in involved these related occupations.

An experiential approach to developing radiological content for public health nursing: Lessons from a nuclear disaster.

OBJECTIVE: This study identified the radiological content required for PHNs and public health nursing students based on PHNs' experiences caring for people affected by the 2011 Fukushima Daiichi nuclear power plant accident. DESIGN: We used qualitative research, interviews, and content analysis. SAMPLE: Participants were eight PHNs employed by local governments in Fukushima and neighboring prefectures. RESULTS: Six content themes regarding the nuclear disaster were identified: (a) basic knowledge about radiation, (b) public health nursing activities in emergency exposure situations, (c) management in emergency exposure situations, (d) consultation to support residents affected by the nuclear disaster, (e) activities in the existing exposure situations, and (f) disaster preparedness in the planned exposure situations. Necessary content shifted depending on the phase of the nuclear disaster recovery. CONCLUSIONS: The use of the experiences of PHNs after the nuclear power plant accident to inform PHNs and public health nursing students will enable PHNs to respond appropriately and support people without difficulties. Comprehensive radiation content is needed to address the range of situations caused by nuclear disaster.

[Correlation between community activity functions and the antecedent factors of mothers and activity forms].

Objectives This study aimed to validate the function of community activities for mothers and examine the constructions of these functions. The relationships between these functions and the antecedent factors of mothers and community activity forms were investigated as well.Method Several items were selected, in accordance with a conceptual framework determined by a preliminary investigation, to measure the function of community activities, mothers' antecedent factors, and community activity forms. The target group was mothers of infants living in metropolitan areas who participated in community activities. The validity and reliability of the Community Activity Function Evaluation Scale for Mothers (CAFES), which includes five subscales, were examined by confirmatory factor analysis and Cronbach's reliability coefficient. Covariance structure analysis was also carried out. The construction of the five subscales was examined, and the relationships between the five functions, mothers' antecedent factors, and community activity forms were validated.Results Of the 405 responses (36.8% response rate), 379 (93.5%) were eligible for analysis. Confirmatory factor analysis confirmed the goodness of fit and reliability of the five subscales model. The five functions were correlated, per covariance structure analysis (CFI=0.858, RMSEA=0.060). Multiple regression analysis validated the relationships between the activity functions and mothers' antecedent factors and activity forms.Conclusion The community activities measured by CAFES worked mutually and were interrelated. The five activity functions showed relationships with mothers' antecedent factors (participation>10 times) and activity forms (mothers participate in half-day activities as administrators). Further studies are required in diverse community groups to refine CAFES for generalized use.

Public Health Nurses' Experiences in Caring for the Fukushima Community in the Wake of the 2011 Fukushima Nuclear Accident.

OBJECTIVE: This study described public health nurses' (PHNs) experiences in caring for people in their communities during the recovery stage of the Fukushima nuclear accident. DESIGN AND SAMPLE: Forty-four PHNs responded to an open-ended questionnaire administered before a radiation protection workshop and participated in interviews after the workshop. Data were qualitatively analyzed. RESULTS: Two major themes were identified: (1) profound powerlessness and (2) compelling sense of mission. The participants cared for people driven by their compelling sense of mission, despite not having the correct information or sufficient knowledge. They spoke of being heart-broken and barely able to face the reality of the impact of the accident. CONCLUSIONS: PHNs supported people because of a compelling sense of mission yet it was a great burden. Education about radiation and radiation protection for nursing students and PHNs, two-way communication between PHNs and radiation specialists, long-term support by specialists, and the opportunity for PHNs to share their feelings and experiences is necessary.

Phosphatidylinositol 3-kinase-binding protein, PI3KAP/XB130, is required for cAMP-induced amplification of IGF mitogenic activity in FRTL-5 thyroid cells.

We previously demonstrated that long-term pretreatment of rat FRTL-5 thyroid cells with TSH or cAMP-generating reagents potentiated IGF-I-dependent DNA synthesis. Under these conditions, cAMP treatment increased tyrosine phosphorylation of a 125-kDa protein (p125) and its association with a p85 regulatory subunit of phosphatidylinositol 3-kinase (p85 PI3K), which were suggested to mediate potentiation of DNA synthesis. This study was undertaken to identify p125 and to elucidate its roles in potentiation of DNA synthesis induced by IGF-I. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis revealed p125 to be a rat ortholog of human XB130, which we named PI3K-associated protein (PI3KAP). cAMP treatment elevated PI3KAP/XB130 mRNA and protein levels as well as tyrosine phosphorylation and interaction with p85 PI3K leading to increased PI3K activities associated with PI3KAP/XB130, supporting the role of PI3KAP/XB130 in DNA synthesis potentiation. Importantly, PI3KAP/XB130 knockdown attenuated cAMP-dependent potentiation of IGF-I-induced DNA synthesis. Furthermore, c-Src was associated with PI3KAP/XB130 and was activated in response to cAMP. Addition of Src family kinase inhibitors, PP1 or PP2, during cAMP treatment abolished tyrosine phosphorylation of PI3KAP/XB130 and its interaction with p85 PI3K. Finally, introduction of PI3KAP/XB130 into NIH3T3 fibroblasts lacking endogenous PI3KAP/XB130 enhanced IGF-I-induced DNA synthesis; however, a mutant Y72F incapable of binding to p85 PI3K did not show this response. Together, these data indicate that cAMP-dependent induction of PI3KAP/XB130, which is associated with PI3K, is required for enhancement of IGF mitogenic activities.

[Making the system which confirms a discharge adjustment--a practical use and the effect of the tool by multi-occupational cooperation].

In order for a patient and a family to be able to return to the region comfortably and to lead the life of their own, ascertaining and multi-occupational participation of the support to the patient and family needs to be inquired (joint conference) at the early stage of hospitalization. Before discharged from the hospital, it is essential for the patient and family to know a key person and have useful social resources, so that we can pull out their self care abilities at home and eventually link to a comfortable homecare support. By our intervention in the early stage of hospitalization, a family's uneasiness of taking care of the patient at home has changed to a confidence and led to shortening of hospital stay. Sharing the information with the staffs of many occupational disciplines and to have a homecare support that meets the patient and his family's needs will lead to an elevation of the services and staff motivation.

[Migration of bisphenol A and benzophenones from paper and paperboard products used in contact with food].

Migration of bisphenol A (BPA) and benzophenones, i.e., benzophenone (BZ), 4-(dimethylamino)benzophenone (DMAB), Michler's ketone (MK) and 4,4'-bis(diethylamino)benzophenone (DEAB), from 21 paper and paperboard products (15 recycled paperboard boxes and 6 virgin paper products) used in contact with food was examined. Migration levels of compounds from recycled paperboard were compared under various food-simulating conditions. BPA showed the highest migration into 20% ethanol and benzophenones into 95% ethanol. No compounds migrated from virgin paper products, but compounds did migrate into food simulants from recycled paperboard food boxes. BPA migrated into 20% ethanol from all recycled paperboard food boxes between 1.0 and 18.7 ng/mL. Into 95% ethanol, migration of BZ was observed in 8 samples (1.0-18.9 ng/mL), DMAB in 12 samples (1.2-3.7 ng/mL), MK in 13 samples (1.9-9.0 ng/mL), and DEAB in 13 samples (1.0-10.6 ng/mL). The highest migration level was 27.2 ng/mL and most of the migration levels were below 10 ng/mL. These values are sufficiently low compared with the TDI and NOAEL levels. Moreover, the amount of food in daily meals that comes into contact with paperboard products is relatively small. Consequently, it was concluded that there was no safety concern regarding the tested compounds in recycled paperboard food boxes.

[Contents of eight harmful elements in baby toys and their migration tests].

Levels of eight harmful elements, i.e., antimony, arsenic, barium, cadmium, chromium, lead, mercury and selenium, were investigated in 45 baby toys and 10 paints, which were mainly made of polyvinyl chloride. All samples contained barium at levels of 0.3-3,700 mg/kg, several samples contained cadmium (0.2-26 mg/kg), chromium (0.5-280 mg/kg) and lead (1.5-1,300 mg/kg), and one sample contained antimony (5.3 mg/kg). They might have been used as colorants of the toy materials and paints. They were then evaluated using the migration test of ISO 8124-3, in which samples were ground up, and then soaked in 0.07 mol/L HCl at 37 degrees C for two hours. Barium, cadmium, chromium and lead migrated from some of the samples, but at levels lower than the migration limits required by ISO 8124-3. Compared with the Japanese official method, the ISO method resulted in higher migration, but there are significant differences in the migration limits, test method, and so on between them. Further investigation is needed in this area.

Heart rate variability with repetitive exposure to music.

Previous studies of physiological responses to music showed inconsistent results, which might be attributable to methodological differences. Heart rate variability has been used to assess activation of the sympathetic and the parasympathetic nervous systems. The present study aimed to examine heart rate variability with repetitive exposure to sedative or excitative music. The participants were 13 undergraduate or graduate students who were each exposed to three conditions sedative music (SM), excitative music (EM), and no music (NM) on different days. Each participant underwent four sessions of one condition in a day. Sedative music and no music each induced both high relaxation and low tension subjectively. However, excitative music decreased perceived tension and increased perceived relaxation as the number of sessions increased. The low-frequency (LF) component of heart rate variability (HRV) and the LF/HF (high-frequency) ratio increased during SM and EM sessions but decreased during NM sessions. The HF component of HRV during SM was higher than that during EM but the same as that during NM. These findings suggest that excitative music decreased the activation of the parasympathetic nervous system.