Analysis of salivary cortisol levels to determine the association between depression level and differences in circadian rhythms of shift-working nurses.

OBJECTIVE: The aim of this study was to clarify whether there are differences in the circadian rhythms of shift-working nurses by assessing depression, fatigue and salivary cortisol levels. METHODS: Forty nurses working in a two-shift system at "Hospital A", Fukuoka City, Japan, used a self-rated depression scale (SDS) to assess their depression levels. Fatigue levels were measured with the visual analogue scale for fatigue (VAS-F); saliva was collected before and during shifts for three days. Results were analyzed with analysis of variance (ANOVA). RESULTS: Thirty-six valid records were obtained, and subjects were classified according to SDS scores into a normal group (NG), moderate group (MG) and severe group (SG). There were no significant differences in the day shift salivary cortisol values of the three groups. However, the night shift salivary cortisol value for the SG was 0.132 µg/dl at 16:00, before starting the shift, and decreased to 0.036 µg/dl at 20:00. It increased slightly up to 0.057 µg/dl by 24:00 and formed a peak between 5:00 and 7:00, with the levels being 0.322 µg/dl and 0.305 µg/dl respectively. Meanwhile, the NG cortisol value was 0.154 µg/dl before the shift, decreased to 0.034 µg/dl by 20:00, slightly increased up to 0.093 µg/dl by 5:00 and presented its peak value, 0.253 µg/dl, at 7:00 next morning. CONCLUSIONS: SG nurses presented significantly increased salivary cortisol levels early in the morning during night shifts, showing a phase deviation in the circadian rhythm. Because subjective fatigue levels did not differ with time, SG nurses should understand and deal with physical changes in the early morning. This approach may reduce medical accidents and malpractice in the early morning.

Retrospective longitudinal study on the relationship between 8-year weight change and current eating speed.

Most of the studies that have examined the relationship between the speed of eating and obesity have been cross-sectional. We investigated 529 male workers who received health check-ups provided by the employer in 2000 and 2008. We obtained information on the subjects' alcohol consumption, smoking status, self-reported speed of eating, and exercise in 2008, and height and weight in both 2000 and 2008. We compared weight change from 2000 to 2008 between 2 groups classified according to the speed of eating: a group of fast eaters, and a combined group of medium and slow eaters. The fast-eating group had a higher average weight gain (1.9 kg) than the medium and slow eating group (0.7 kg). Although statistically significant only for the 20-29-year age group, weight gain was greater in the fast-eating group for all age groups and was statistically significant when the age groups were combined. The relationship between eating fast and weight change was statistically significant even after adjusting for age and body mass index in 2000, drinking, smoking, and exercise. Our results suggested that the speed of eating is related to the rate of weight gain.

Predictors of recognition and practice of family nursing among healthcare professionals in Japan.

BACKGROUND: Although many nurses have become aware of the importance of family-centered nursing, very little is known about the advanced knowledge and intervention skills of family nursing in Japan. OBJECTIVES: We examined the characteristics of their recognition of family nursing and factors related to the practice of family nursing. METHODS: The subjects were nursing staff at a large hospital in Fukuoka, Japan (n=596). A study using self-administered questionnaires was conducted in October 2002. Factor analysis and multiple linear regression analysis were used to analyse the data. RESULTS: Of 596 nurses, 376 returned questionnaires (63.6%). The study achieved the following findings. (1) The nurse's recognition of family nursing had four subscales: skills required to interview family members to construct a trusted relationship; assessment of family structure and family functioning; interventional skills of family nursing; and skills to collect information on family members. (2) The predictors of family nursing recognition were 'gender', 'job position in hospital', 'individual experience of caring for their family members', 'length of clinical experience' and 'types of wards where they work'. (3) The predictors of practice of family nursing were 'interventional skills of family nursing', 'skills to collect information on family members' and the 'total of four skills'. CONCLUSIONS: It is implied that the acquisition of knowledge and skills of family nursing in hospital settings are invaluable to consciousness-raising and practice of family nursing. RELEVANCE TO CLINICAL PRACTICE: As the factors related to practice or recognition of family nursing have been identified, the present findings are useful for hospital administrators who want to promote family nursing in their hospitals.

[An epidemiological study of the relationship between the number of remaining teeth and the disabled elderly receiving long-term care].

This study attempts to clarify the relationship between the long-term care of the elderly and the number of remaining teeth by comparing the remaining teeth of the healthy with that of the disabled elderly. A survey was conducted in a town, Fukuoka Prefecture. The disabled group consisted of 62 persons with level of disability of 4-5 according to the Long-term Care Insurance categorization. Controls were selected randomly from healthy elderly residents, one for each in the disabled group, matching gender and age (less than +/- 1 year old). Public health nurses conducted interviews using a questionnaire to determine the cause of disease, medical history, lifestyle and period of long-term care, and counted the remaining teeth. The mean number of remaining teeth presented a significant difference with 3.7 for the disabled group and 9.1 for the control group (p < 0.01). A logistic regression analysis revealed that the odds ratio for long-term care to that of the reference with 20 or more teeth was 7.03 (95% CI: 1.15-42.85) for 10 to 19 teeth, 15.61 (2.89-84.26) for 1 to 9 teeth, and 15.11 (2.84-80.48) for no teeth. The age group of 65-69 years and 70-79 years in the disabled group had significantly smaller mean numbers of remaining teeth than their control group counterparts by approximately 14 and 12 respectively, but in the age group of 80 years or more, no significant difference was observed between the two groups. In conclusion, our results suggested that elderly people with fewer remaining teeth have a high risk for long-term care. Especially, the risk was thought to be strongly associated with the loss of some teeth in middle age.