Interprofessional Team Collaboration as a Mediator Between Workplace Social Capital and Patient Safety Climate: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Patient-safety climate is one of the most important organizational factors contributing to health care quality. We hypothesized that a patient safety climate is fostered by the willingness to collaborate and trust among members as well as by daily collaborative practices. This study aimed to clarify the effect of workplace social capital on patient safety climate. We also sought to investigate the mediating effect of interprofessional team collaboration on the relationship between workplace social capital and patient safety climate. METHODS: This cross-sectional survey was conducted from November 2021 to January 2022 using anonymous web-based questionnaires. The survey was distributed to 1495 employees working in a hospital in Tokyo, Japan. The questionnaire included the patient safety climate scale, workplace social capital scale, Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II-J), and demographic items. Structural equation modeling was performed to verify the associations among the 3 variables. In addition, a significance test for indirect effects was conducted using the bootstrap method to confirm the mediating effect of AITCS-II-J. RESULTS: A total of 725 employees participated in this survey, and 632 data items were analyzed. Nurses were the highest number of respondents (68.2%), followed by physicians (13.3%). Workplace social capital and patient safety were directly and significantly associated (ß = .309, P < .01). Furthermore, the partially indirect effect of the AITCS-II-J on the association between workplace social capital and patient safety climate was also significant (ß = .430, P < .01). CONCLUSIONS: Workplace social capital was significantly and directly related to patient safety climate and was also significantly related to patient safety climate partially mediated by interprofessional team collaboration. Our findings suggest the importance of workplace social capital and routine multidisciplinary collaboration for a patient safety climate to manage health care quality.

[The relationship between parenting anxiety in mothers and the resources from which they routinely sought advice: The final "Healthy Parents and Children 21" survey].

Objectives　This study aimed to examine the relationship between parenting anxiety in mothers and the resources from which they routinely sought advice.Methods　Data consisted of the 75,662 survey responses from parents of children who had undergone health checkups between April and August of 2013. A logistic regression analysis was performed using parenting anxiety (computed using the responses to the two survey items "I don't feel confident as a parent" and "I wonder if I'm mistreating my child") as the response variable. The people or resources from which the mothers sought parenting advice and the number of such resources were used as the explanatory variables.Results　Across all ages, the percentage of mothers selecting "husband" as a parenting resource was the largest, and most mothers indicated they had three resources. Common across all ages, mothers who indicated that they had their husband or the child's grandmother or grandfather as resources had a significantly lower odds ratio of having parenting anxiety than mothers who did not. In contrast, mothers who selected "nursery school or kindergarten teachers" or "the Internet" as resources had a significantly higher odds ratio of having parenting anxiety than mothers who did not select these resources. Across all ages, no significant relationship was found between mothers' parenting anxiety and the number of resources they used for parenting advice. There was a significantly higher odds ratio of mothers of children aged 18 and 36 months who indicated that they wondered if they were mistreating their child if they had nobody to talk to than if they had one resource. When the number of resources increased to three, four, or five, the odds ratio was significantly reduced.Conclusion　For mothers of children of all ages, results showed that those who routinely sought advice from their husband or their child's grandparents had a significantly lower probability of experiencing parenting anxiety. On the other hand, this probability was significantly higher when their resources were nursery school or kindergarten teachers or the Internet. This study also suggests that, for mothers of young children, having a larger number of people from whom to routinely seek advice may reduce their anxiety about their parenting ability.

Awareness of cardiopulmonary resuscitation among parents of 3-year-old children.

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) in infants or toddlers mainly occurs at home. Therefore, parents should be able to perform immediate cardiopulmonary resuscitation (CPR) when they witness OHCA. The status of knowledge regarding CPR among parents, however, remains unclear. The aim of the present study was therefore to determine the factors associated with awareness of CPR in parents of 3-year-old children. METHODS: We analyzed a subset of data from a population-based, cross-sectional survey that served as an evaluation of a national campaign for maternal and child health in Japan. The questionnaire was distributed to 32 897 parents who visited public health centers for medical check-ups for their children in 2013. Multivariate logistic regression analysis was carried out using the obtained demographic data. RESULTS: Overall, 26 971 parents (82.0%) responded to the questionnaire. On multivariate logistic regression analysis, birth order of the child, age of the mother at delivery, awareness of medical facilities for emergency services at night or during the weekend, current occupation status of the mother, and current economic status were independently associated with CPR awareness. When the mother was employed but the parents felt economically insufficient, the probability of having CPR knowledge decreased by 19%. Regardless of the parents' economic stability, the probability of having CPR knowledge declined by >35% when the mother was unemployed. CONCLUSIONS: The current occupation status of mothers and the current parent economic status should be considered when planning educational strategies regarding CPR training for parents.

Informative three-dimensional survey of cell/tissue architectures in thick paraffin sections by simple low-vacuum scanning electron microscopy.

Recent advances in bio-medical research, such as the production of regenerative organs from stem cells, require three-dimensional analysis of cell/tissue architectures. High-resolution imaging by electron microscopy is the best way to elucidate complex cell/tissue architectures, but the conventional method requires a skillful and time-consuming preparation. The present study developed a three-dimensional survey method for assessing cell/tissue architectures in 30-µm-thick paraffin sections by taking advantage of backscattered electron imaging in a low-vacuum scanning electron microscope. As a result, in the kidney, the podocytes and their processes were clearly observed to cover the glomerulus. The 30 µm thickness facilitated an investigation on face-side (instead of sectioned) images of the epithelium and endothelium, which are rarely seen within conventional thin sections. In the testis, differentiated spermatozoa were three-dimensionally assembled in the middle of the seminiferous tubule. Further application to vascular-injury thrombus formation revealed the distinctive networks of fibrin fibres and platelets, capturing the erythrocytes into the thrombus. The four-segmented BSE detector provided topographic bird's-eye images that allowed a three-dimensional understanding of the cell/tissue architectures at the electron-microscopic level. Here, we describe the precise procedures of this imaging method and provide representative electron micrographs of normal rat organs, experimental thrombus formation, and three-dimensionally cultured tumour cells.

Current situation and issues using maternal and child health-related information in the "Healthy parents and children 21" campaign across municipalities in Japan.

Objectives The use of maternal and child health-related information is an issue faced by the "Healthy parents and children 21" campaign, a national campaign to improve the health standards of mothers and children in Japan. This study described the current situation and issues faced by municipalities across Japan that use this information.Methods Data across municipalities selected for the current survey of promoting the "Healthy parents and children 21" campaign in 2013 were analyzed in this study. First, we chose prefectures where collected and analyzed maternal and child health-related information was provided by the municipalities. Then, we divided the municipalities according to those prefectures where the municipalities regularly reported the maternal and child health-related information and those that did not report it regularly. Finally, the characteristics about maternal and child health in those municipalities were investigated.Results Of the 47 prefectures analyzed, 35 prefectures (74.5%) collected and analyzed maternal and child health-related information provided by the municipalities. The 35 prefectures included 1,242 municipalities, of which 700 (56.4%) regularly reported maternal and child health-related information, and 542 (43.6%) did not report it regularly. The proportion of municipalities, where information about smoking during pregnancy, immunization, or low birth weight in infants was positively used, was significantly lower among municipalities that did not regularly report maternal and child health-related information than among those that regularly reported it (P<0.001). The proportion of municipalities that coordinated projects on prevention of child abuse or low birth weight in infants with the prefectures was significantly lower among municipalities that did not regularly report maternal and child health-related information than among those that regularly reported it.Conclusion Among municipalities that did not regularly report maternal and child health-related information, coordinating projects about child abuse with the prefectures might be associated with an increase in using the information. In addition to collecting and analyzing maternal and child health-related information provided by municipalities, prefectures should help municipalities coordinate projects about those issues to increase the use of the information in municipalities.

Glomerular basement membrane injuries in IgA nephropathy evaluated by double immunostaining for α5(IV) and α2(IV) chains of type IV collagen and low-vacuum scanning electron microscopy.

BACKGROUND: The glomerulus contains well-developed capillaries, which are at risk of injury due to high hydrostatic pressure, hyperfiltration, hypertension and inflammation. However, the pathological alterations of the injured glomerular basement membrane (GBM), the main component of the glomerular filtration barrier, are still uncertain in cases of glomerulonephritis. METHODS: We examined the alterations of the GBM in 50 renal biopsy cases with IgA nephropathy (31.8 ± 17.6 years old) using double immunostaining for the α2(IV) and α5(IV) chains of type IV collagen, and examining the ultrastructural alterations by transmission electron microscopy (TEM) and low-vacuum scanning electron microscopy (LV-SEM). RESULTS: The GBM of IgA nephropathy cases showed various morphological and qualitative alterations. In the TEM findings, thinning, gaps, rupture, thickening with a lamellar and reticular structure and double contours were detected in the GBM. Double immunostaining for α5(IV) and α2(IV) showed thickening of the GBM with reduced α5(IV) and increased α2(IV), or mosaic images of α5(IV) and α2(IV), and holes, fractures, spiny projections and rupture of α5(IV) in the GBM. In addition, LV-SEM showed an etched image and multiple holes in a widening and wavy GBM. These findings might be associated with the development of a brittle GBM in IgA nephropathy. CONCLUSION: Glomerular basement membrane alterations were frequently noted in IgA nephropathy, and were easily evaluated by double immunostaining for α2(IV) and α5(IV) of type IV collagen and LV-SEM. The application of these analyses to human renal biopsy specimens may enhance our understanding of the alterations of the GBM that occur in human glomerular diseases.