Lifestyle Factors and Health Awareness for Improving Bone Density Acquisition in Adolescent Girls: A Pilot Study With Secondary Data.

OBJECTIVES: Adolescent girls are in an important life stage of peak bone mass (PBM) acquisition. We aimed to examine the provision of health guidance for female high school students and elucidate the factors that can increase bone density. DESIGN: A quantitative, cross-sectional analysis was used in conducting the study. SAMPLE: Sixty Japanese female first-year high school students comprised the study sample. MEASUREMENTS: We included secondary data from a bone mineral density survey conducted among female high school students in August 2016 and analyzed in 2023. RESULTS: Thirty participants each (age, mean±SD, 15.80±0.45 years) were assigned to the high and low bone stiffness groups. The high bone stiffness group had higher health awareness, better lifestyle habits, and higher club activity-related stress than the low bone stiffness group. CONCLUSIONS: Lifestyle factors and health awareness improved bone density in adolescent girls. Items related to exercise were particularly important for improving bone density. Eating habits and health awareness also affected bone density. Adolescent women should recognize that adolescence is a critical period for lifelong health, a period with few opportunities to develop health awareness. Acquiring appropriate lifestyle habits during adolescence can help prevent bone density loss.

Coping With Women's Menstruation-Related Health Issues in Male-Dominated Companies: A Cross-Sectional Study in Japan.

BACKGROUND AND OBJECTIVES: Japanese women face many female-specific health problems in the workplace, especially menstruation-related issues, which can adversely affect their quality of life and productivity. This study aims to examine how female employees in a male-dominated company in Hiroshima, Japan, cope with menstruation-related health issues in the workplace and the factors that influence their coping strategies. MATERIALS AND METHODS: This study used a cross-sectional survey research method. The survey investigated age, health, and menstrual-related issues, as well as women's active participation support and health literacy (HL) levels. The sample population included employees of a manufacturer in Hiroshima prefecture. The data were collected from February 20 to March 10, 2023. The analysis subjects were 171 women who had experienced menstruation-related, women-specific health issues in the workplace. Their attitudes toward menstruation-related issues could influence their experiences. They were categorized into positive and negative groups based on their attitudes toward coping with women's health issues. Chi-square tests and logistic regression analysis were used to compare the two groups. RESULTS: The study found that 50.3% (N = 296) of female employees had experienced women's menstruation-related health issues at work. As many as 62.6% (N = 171) of female employees showed a positive attitude, and the study also found that female employees with a positive attitude toward menstruation-related health issues had higher HL (odds ratio (OR) = 1.216, 95% CI: 1.007-0.1.468) and were more likely to be able to predict menstruations (OR = 4.528, 95% CI: 1.618-12.670).  Conclusions: In male-dominated companies, many female employees are affected by menstruation-related problems in the workplace. A positive attitude toward women's health issues was positively associated with HL and predictive ability. Male-dominated companies should pay attention to women's menstruation-related health issues in the workplace, implement interventions to improve their health literacy and predictive ability, strengthen communication with them, and encourage them to actively participate in women's health initiatives.

Current Situation of Disaster Preparedness for Effective Response in Japanese Special Needs Schools.

OBJECTIVE: Schools may serve as shelters in the event of a disaster, but little is known about the requirements of children with disabilities in such situations. This study, therefore, aimed to investigate disaster preparedness in Japanese special needs schools depending on the designation of welfare shelters. METHODS: A questionnaire was distributed to schools nationwide. The respondents (authorities from 531 schools) answered questions about their jobs, disaster experiences, the school type, its students' disabilities, its designation as a welfare shelter, its evacuation readiness, and the items of a disaster prevention awareness scale. Differences in preparedness among schools and the relationship between preparedness and designation as a welfare shelter were determined. RESULTS: Most respondents had never experienced a natural disaster. Schools had insufficient resources to cope with disasters. While the majority (68.2%) had resources for children to stay overnight, a substantial minority of schools (31.8%) did not. No differences were found in preparedness among schools with different types of children with disabilities. Schools designated as welfare shelters were significantly better prepared than others. CONCLUSIONS: Special needs schools in Japan have limited disaster preparedness. The designation of schools as welfare shelters may increase their preparedness for disasters.

Use of Caffeine-Containing Energy Drinks by Japanese Middle School Students: A Cross-Sectional Study of Related Factors.

Excessive consumption of caffeine negatively affects individuals' health. Therefore, we studied the use of energy drinks and the conditions associated with it among Japanese secondary school students. Participants were 236 students in grades 7-9 who completed anonymous questionnaires at home in July 2018. We measured the basic attributes and dietary, sleeping, and exercise habits. We used Chi-squared tests to compare differences between users and non-users of energy drinks. Logistic regression analyses were used to elucidate the complex association between the variables. The results showed that boys were more willing to consume energy drinks than girls. The reasons were 'feeling fatigued', 'needing to stay awake', 'for curiosity', and 'to quench one's thirst'. Among boys, the following were associated with the use of EDs. Buying their own snacks , not understanding nutritional labels on foods, high caffeinated beverage intake, late bed-times on weekdays, always waking up at about the same time, and weight. Health guidance is needed to prevent overconsumption and dependence on energy drinks. The cooperation of parents and teachers is needed to achieve these goals.

Distress of Educators Teaching Nursing Students with Potential Learning Disabilities: A Qualitative Analysis.

Clinical training at Japanese nursing universities has an increasing need for individualized learning support for students with potential learning disabilities. Despite a high interest in student support, educators' difficulties are neglected. This study clarified the difficulties encountered by practical training instructors in delivering clinical training to nursing students with potential learning disabilities. In this descriptive, qualitative study, online focus group interviews were conducted. Participants were nine Japanese nursing university graduates with over five years of clinical education experience. A total of five categories were extracted: searching for measures tailored to students in a short period of time during training; resistance to individualized responses that significantly differ from traditional Japanese collectivist education; conflict over support being perceived as favoring a particular student; hesitation to identify students' limits; and barriers in the process of supporting difficulties due to the nature of learning disabilities. Practical training instructors experience difficulties and hesitation when teaching students with potential learning disabilities. The practical training instructors need support and educational opportunities as well as students who need help. To overcome these difficulties, university educational staff, as well as students and families, must be educated on the existence and value of support tailored to the characteristics of an individual's learning disability.

Breast Cancer Screening and Perceptions of Harm among Young Adults in Japan: Results of a Cross-Sectional Online Survey.

Breast cancer is the most commonly diagnosed female cancer and the leading cause of cancer death. Early detection and treatment are important to reduce the number of deaths. Japan recommends mammography every two years for women over 40 years of age. However, in recent years, an increasing number of younger women have been undergoing breast cancer screening (BCS). To reduce the harms of BCS among young adults, our study extracted data from an online survey conducted in 2018 and applied χ2 tests and logistic analysis to identify the influencing factors regarding interest in undergoing BCS. The results of our analysis support the need for a reduction in the BCS rate through awareness regarding the harms of health screening among young people. In particular, for those who receive BCS through occupational screening, we believe that improving education on breast awareness, the accuracy of occupational screening, and breast self-examination methods could reduce the harms from BCS in younger age groups.

Exploring mutual support awareness in Japanese communities: A pilot study.

OBJECTIVE: The study aimed to examine life situations and perceptions related to the recognition of mutual support among Japanese people. DESIGN: A quantitative, correlational, cross-sectional analysis. SAMPLE: Nine hundred and nine participants who provided complete questionnaire responses. MEASUREMENTS: As a disaster prevention measure, a community center conducted a "questionnaire survey evaluating the recognition of mutual support and several potentially related factors". In our study, these data from a self-administered questionnaire were used secondarily. RESULTS: The perceptions that differed with regard to the sense of mutual support included family structure; satisfaction with support, security, and disaster prevention in the district; being able to ask for help with shopping; closeness of the relationship with one's neighbors; seeing oneself as providing or needing protection; and recognition of existing worries regarding evacuation. In a logistic regression model, the factors predicting the sense of mutual support included being younger than 70 years, being able to ask for help with shopping, and the closeness of the association with one's neighbors. CONCLUSIONS: The study identified situations that might predict the sense of mutual support in individuals in Japanese communities.

Examining corporate support issues with health literacy as a key factor: The Case of a Hiroshima corporation.

Context: Given the dramatic decline in Japan's labor force, promoting women's participation in the workforce is essential. Aims: We aimed to take a Hiroshima company as an example and analyze the influencing factors of health literacy (HL) to clarify the issues of the active participation of female employees. Methods and Materials: From February to March 2023, a cross-sectional study was conducted by a company in Hiroshima prefecture that contained many male employees. A total of 1,114 valid respondents were received. Employees' demographics, menstrual-related concerns, women's activity promotion support, and HL were investigated in this study. Statistical Analysis Used: The Chi-square test and logistic regression using SPSS statistical software version 25 were used. Results: There were significant differences between high and low HL with age, women's menstrual problems, and women's activity promotion support. The participants who were unaware of women's menstrual-related problems and their company's implementation of women's activity promotion support were more likely to have high HL. In addition, female employees (including female management) and male management have significantly different cognitions about women's activity promotion support. Conclusions: This study found that overall HL among employees in male-dominated companies is low, even among participants who were aware of women's menstruation-related health issues and the company's women's activity promotion support. Increased women's representation in management can bridge policy perception gaps. Male-dominated companies should enhance HL via career programs, health education, and improved communication for active female engagement.

Factors Affecting the Cervical Cancer Screening Behaviors of Japanese Women in Their 20s and 30s Using a Health Belief Model: A Cross-Sectional Study.

In recent years, the incidence and mortality rates of cervical cancer (CC) have increased among young women. Cervical cancer screening (CCS) is crucial to reducing the incidence and mortality of CC in a country such as Japan, where it is challenging to raise HPV vaccination rates. The purpose of this study was to identify psychological and personal characteristics relating to CCS participation among young people by using the Health Belief Model (HBM). For this cross-sectional study, an internet survey was conducted between February-March 2018. Based on HBM and personal characteristics, χ2 tests and logistic analyses were used to identify factors influencing CCS. Responses obtained from 816 women in their 20s and 30s were used in the analysis. For HBM-based psychological characteristics, the odds ratios were significantly higher for "cues to participation in screening" and "barriers to participation at the time of cancer screening", while "barriers to participation before cancer screening" showed significantly lower odds ratios. On the other hand, it was found that the presence of children and having regular health checkups affected the attributes of screening that were significant for decision-making. Therefore, it is important to create proactive measures to encourage younger women to undergo medical examinations.

Nursing Students' Retention of Knowledge by Basic Knowledge Type: An Exploratory Study.

Students' interests help determine their learning effectiveness and knowledge acquisition and retention. It is necessary to confirm whether there is a difference in the way in which content being learned is remembered by the content type. In this study, we examined the characteristics of nursing students' retention of physiological knowledge and environmental knowledge by utilizing scores obtained in class. The participants comprised 57 nursing students who had taken a class twice-once in their second year and once in their third year. Before and after each class, students completed an 11-question survey with human health and comfort items based on nursing core competencies and Sphere standards. The correct answer rate was calculated using a logistic regression model to account for inter- and intra-individual variations. The estimated correct answer rate per individual showed one of three trends: (1) increasing and decreasing depending on the lesson topic (knowledge type), (2) increasing overall after decreasing, and (3) increasing gradually. Physiological knowledge was retained well, whereas knowledge pertaining to the environment was retained poorly. Even with knowledge of the environment, the knowledge that students apply to their daily lives and social events was maintained.

Identification of Factors Influencing Cholesterol Changes in Elementary-School Children: A Longitudinal Study.

Changes in serum cholesterol levels during childhood may affect the risk of cardiovascular disease in adulthood. However, cholesterol level changes in Japanese children and adolescents and the factors that influence them have not been completely elucidated. This study aimed to determine whether cholesterol levels changed due to the effects of growth and identify factors. This cohort study included elementary-school children in the fourth grade (9−10-year-old) who underwent assessments of cholesterol levels and demographic and lifestyle characteristics. The participants were followed up in their first year of junior high school with the same laboratory, demographic, and lifestyle assessments. From the fourth year of elementary school to the first year of junior high school, children's cholesterol levels decreased (p < 0.0001). Regarding bowel movements, cholesterol level reduction was significant in individuals with regular bowel movements but not significant in those with infrequent bowel movements. Weight was the factor that most strongly negatively predicted cholesterol level reduction (p < 0.001). The study demonstrated the significance of lifestyle factors for growth-related changes of total cholesterol levels and identified weight as the factor that most strongly influenced total cholesterol level changes. Guidance regarding lifestyle improvements should be imparted to children from the fourth grade of elementary school.

Managers' awareness of mental health measures for their employees in small and medium-sized enterprises in a depopulated mountainous area in Japan: A qualitative study.

ABSTRACT: The local economy is often supported by small and medium-sized enterprises. There is a need to consider effective promotion methods for mental health measures in these enterprises in depopulated mountainous areas. It is important to understand managers' awareness when considering effective mental health measures in these enterprises. The study's aim is to explore managers' awareness of mental health measures for employees in small and medium-sized enterprises in depopulated mountainous areas in Japan.Qualitative semi-structured interviews were conducted with 6 managers in 2019. The primary issues addressed by the interview were regarding the awareness among managers about mental health promotion measures for employees. These are the primary prevention measures. The interview also addressed issues related to the awareness of measures for mental health problems that are fundamental to the secondary and tertiary prevention measures. A qualitative descriptive analysis was conducted.Three categories and 8 subcategories emerged regarding the managers' awareness of mental health promotion measures for employees. The 3 categories were: "Individual support, including their life's aspect, while taking advantage of formal and informal relationships," "The difficulty of drawing out an employees' motivation to work, due to the changes over time in the work size or in their working relationships," and "Creating a comfortable working environment for employees, by complying with the labor standards and adjusting relationships." Regarding managers' awareness of the measures for mental health problems, four categories and 8 subcategories emerged. The 4 categories were: "Prevention and awareness of the incidence of mental health problems," "Individual support based on the enterprise's or employee's characteristics," "A lack of support for the manager to address employees' mental health problems," and "Employees quitting the job, due to the lack of appropriate support."Though managers in depopulated mountainous areas were well aware of the mental health activities offered, the categories showed the need to foster social capital. It also showed the need to collaborate with external support organizations, and the difficulties faced by small and medium-sized enterprises.

Residents' Concerns Regarding Schools Designated as Evacuation Shelters.

OBJECTIVE: The purpose of this study was to investigate the perceptions of residents who are knowledgeable about the schools used as shelters. METHODS: The target group was comprised of teachers and guardians of children enrolled in 4 schools, which were selected in the vicinity of District B, which was severely damaged by heavy rain in 2014. A qualitative descriptive study design was used. RESULTS: The number of surveys collected was 1702 (collection rate 62.2%). A total of 1017 clauses were entered, and 85 codes were generated for 7 categories. The guardians and teachers believed that there was a discrepancy between shelter capacity and the real situation; citing a lack of information, and ill preparedness of the schools for disasters as some of the problems. Based on the knowledge and experiences from previous disasters, they responded that there was inadequate management, and evacuees faced difficulty living comfortably in the shelters. CONCLUSION: In order to use school facilities during any disaster, it is important for residents to recognize the need to solve problems, and to work with local governments to support improvements. This realization reveals a sense of ownership of emergency shelters and prevents confusion among residents. Also, this will help people to prepare for disasters and prevent disruption during evacuation.

Developing a Hybrid Platform for Emergency Remote Education of Nursing Students in the Context of COVID-19.

Due to the COVID-19 pandemic, many nursing students are being taught remotely. Remote learning has drawbacks, such as decreased motivation for learning and difficulties conveying the instructor's intentions. Strategies that compensate for the shortcomings of remote learning should be identified. This study aimed to evaluate the understanding of the knowledge use and awareness of negotiation methods through cases and teaching tools in nursing student classes on environmental assessment and daily life support, and to examine whether supplementary assistance can compensate for the drawbacks of remote learning. This study used a mixed-method design, and included 59 second-year nursing students attending an environmental assessment course in 2021. Students' knowledge use and awareness of negotiation methods were evaluated using self-assessment worksheets before and after the class. The pre- and post-class scores were compared using the Wilcoxon signed-rank test. The mean knowledge score increased significantly during the study period (p < 0.001). Students acquired awareness of how to use the knowledge gained during class and negotiation awareness by observing role play, factors that strengthen motivation when learning alone. This study provides insight into the potential of class supplements to compensate for the deficits of remote learning. Supplementing the shortcomings of remote learning should be a priority and may be a focal point of hybrid learning.

Does Behavior Pattern Influence Blood Pressure in the Current Cultural Context of Japan?

BACKGROUND: Type A behavior pattern has been presented as a risk for coronary heart disease and defined as a psychological-behavioral construct. This study aimed to identify the influence of type A behavior pattern on blood pressure in the current cultural context of Japan. METHODS: This study utilized a cross-sectional design. Self-administered questionnaires were distributed to community residents aged 40-59 yr in western Japan from Aug to Sep 2017. The data included participant's demographic information (including socioeconomic variables); information related to blood pressure, type A behavior pattern, psychological factors, and health-related behaviors. Logistic regression was used to identify the influence of type A behavior pattern on systolic blood pressure after adjusting for behavioral, psychological, and socioeconomic factors. RESULTS: The sample included 362 participants with a mean age of 51.5 years (SD = 5.96); 148 (41.2%) men. A logistic regression demonstrated that type A behavior pattern was negatively associated with systolic blood pressure (OR = 0.43, 95% CI [0.22, 0.83]) after adjusting for sex and age. Similar results were observed after adjusting for other covariates. CONCLUSION: There may be a negative association between type A behavior pattern and systolic blood pressure among adults living in the current cultural context of Japan.

Comprehensive analysis of depression-related factors among middle-aged residents in Japan, an Eastern culture: A cross-sectional study.

ABSTRACT: There is a need to comprehensively identify depression-related factors, including individual and socioeconomic factors, in each country or cultural area, to consider effective measures to address depression within communities. However, there are not enough studies on middle-aged residents in Japan or other Eastern countries to currently achieve this. Thus, the aim of this study was to comprehensively identify factors related to depression in middle-aged residents in Japan, an Eastern country.The study design was cross-sectional. A questionnaire survey was conducted among all community residents aged 40 to 59 in a rural municipality in Western Japan. The questionnaire contained items on demographic characteristics, psychological factors, health-related behaviors, and socioeconomic factors. A Chi-Squared test or Fisher exact test was used to analyze the relationships between depression and each assessed factor. Next, a logistic regression analysis was performed to identify comprehensive relationships between depression and its related factors.Data from 362 participants were analyzed. The average age was 51.5 years; 148 were male. A Chi-Squared test or Fisher exact test demonstrated that many psychological factors, health-related behaviors, and socioeconomic factors ware significantly related to depression. A logistic regression analysis showed that depression was significantly associated with male gender, low sense of coherence, high cognitive stress levels, low help-seeking behavior, poor quality sleep, and a lack of hobbies. Nagelkerke R2 was 51%.This study revealed through multivariate analysis that depression was primarily associated with personal behavioral and psychological factors in Japan, an Eastern country with a holistic cultural background. This result is consistent with findings from Western countries. This study can contribute the promotion and evaluation of preventive measures for depression in Eastern culture that focus on individual behavioral and psychological factors.

Remote Teaching Due to COVID-19: An Exploration of Its Effectiveness and Issues.

Universities have quickly shifted to remote learning due to the COVID-19 pandemic. This study compared two versions-emergency remote teaching (ERT) and conventional face-to-face class (FFC)-of a course design based on the instructional design ARCS model for effectiveness and issues. The current study comprised 46 third-year nursing students who attended an FFC course in 2019, and 56 third-year students who took the ERT version in 2020. Students' self-rated goal attainment and knowledge of genetics scores were compared before and after taking the courses. Scores between the two class types were compared using the Wilcoxon rank sum test. The students' worksheets were evaluated using keyword frequency and content analyses. Both classes achieved their goals satisfactorily, and this study confirmed that for this course, ERT was as effective as FFC. A comparison of the increase in domain goal attainment scores per student showed that only the psychomotor domain item, "I can fully explain human diversity using genomic information", was significantly different, as it was significantly higher for ERT (p = 0.003). This higher item in the ERT group suggests that ERT can pose a lack of practice caution in acquiring nursing skills.

Genetics education program to help public health nurses improve their knowledge and enhance communities' genetic literacy: a pilot study.

BACKGROUND: As human genetics knowledge develops, public genetic literacy needs to be increased, though the educational capacity for this purpose has not yet been fully developed. Under this circumstance, the daily work of public health nurses can be viewed as an opportunity to enhance public genetic literacy. However, in Japan, there is not only a lack of public knowledge of human genomics but also a lack of public health nurses' recognition about genomic literacy. A short-term education program was implemented as a pilot study. This study aimed to examine the effectiveness of the program to support public health nurses' activity aimed at promoting health services-related genetic literacy. METHODS: The genetics education program was implemented in December 2019, in Kagoshima, Japan. Twenty-three public health nurses cooperated with the research. The program was composed of a case study on consultation, a lecture on hereditary diseases, and a discussion on the role of public health nurses. Familial hypercholesterolemia was used as the topic of the case study. We evaluated scores for cognition, affect, and psychomotor characteristics related to their learning goals before and after the program using Wilcoxon signed-rank tests. Answers in the consultation were qualitatively analyzed. RESULTS: The mean cognitive score, capturing provision of explanations of hereditary disease, was 6.3 before the program but increased significantly to 9.3 after the program (p < 0.001). For the affective score, the goal of which was deepening interest in human genetics, the mean score increased significantly from 8.5 before to 11.0 after (p < 0.001). For the psychomotor score, addressing the need for genetic consultation, the mean score increased significantly from 4.4 before to 8.1 after (p < 0.001). Prominent themes extracted from descriptions on the worksheet post training included, "providing advice and accurate information on genetic disorders" and "referral to a specialized organization." CONCLUSIONS: Our findings indicated that this education program helps public health nurses be positively involved in human genetic disorders. Thus, they may connect to their local community to provide accurate genetics knowledge and advice for health management and promoting genetic literacy.

Identifying the challenges to successfully teaching about genetic diversity among Japanese junior high school students.

OBJECTIVES: Creating a diverse and inclusive symbiotic society is specified in the sustainable development goals. In a symbiotic society, support for those who need, it is called "reasonable support." However, it is unclear in the classroom that many children understand "reasonable" as a consideration to support children with special needs. The aim of this study is to identify the actual understanding of junior high school students and the challenges related to genetic diversity through school health teachers in readiness for developing a symbiotic society. METHODS: A focus group interview was conducted for five school health teachers working in public junior high schools to identify the perspectives of their feeling about the current understanding of children in regard to genetics and diversity. Participants were recruited who agreed to engage voluntarily in this research. A qualitative descriptive design was used in this study. RESULTS: The results of the analysis revealed three categories consisting of 67 codes and 10 subcategories. Three categories were identified: I-understanding the heterogeneity and diversity of children's ambivalent minds; II-limitation of school health teachers' involvement in genetics and diversity-related issues; and III-importance for children to understand heterogeneity and diversity to build life skills. CONCLUSIONS: School health teachers remarked on the limitations of learning and teaching genetics and diversity. They paid attention to the flexibility of a child. It suggests that the purpose of genetic education is to develop children's life skills with the flexibility to live in the future. There is a need to consider new genetic education for school health teachers and students to learn about diversity.

Analysis of the Training Effect of a Nursing Undergraduate Course on the Management of Radiation-Related Health Concerns-A Single Group Experiment.

After the 2011 Fukushima Daiichi accident, demands regarding nursing staff's management of nuclear disasters have increased. This study aimed to evaluate a basic training program to teach undergraduate nursing students on how to deal with public anxiety following a nuclear disaster. We analyzed the data of 111 third-year nursing students attending a Japanese university. We set attainment goals in three domains (cognitive, affective, psychomotor) regarding their acquisition of consultation techniques for radiation-related health concerns. We compared pre- and post-class response scores on a knowledge test and calculated word frequencies in health consultation scenarios. The pre-class mean score was 12.2 out of 27 points and the post-class mean score (directly after the course) was 21.0, a significant increase (p < 0.001). The mean level of attainment in each of the three domains increased significantly from pre-test to post-test (p < 0.001). The variety and number of words in the health consultations also increased. Students attained the program goals for radiation-related health concerns in all domains. During disasters, there is a great need for nursing staff to administer physical and mental care to the public. This program was evaluated to be one wherein nursing staff can acquire fundamental knowledge about radiation in a short time.