The Mental Health of Young Return Migrants with Ancestral Roots in Their Destination Country: A Cross-Sectional Study Focusing on the Ethnic Identities of Japanese-Brazilian High School Students Living in Japan.

BACKGROUND: The number of young Japanese Brazilians, who are return migrants with Japanese ancestral roots, is increasing rapidly in Japan. However, the characteristics of their mental health and the relation between mental health and a complex ethnic identity remains unclear. METHODS: This cross-sectional study compared 25 Japanese-Brazilian high school students with 62 Japanese high school students living in the same area. Research using self-report questionnaires on mental health, help-seeking behavior tendencies, and ethnic identity was conducted. The Japanese-Brazilian group was also divided into high and low ethnic identity groups, and their mental health conditions were compared. RESULTS: The Japanese-Brazilian group had significantly poorer mental health conditions and lower ethnic identities than the Japanese group and were less likely to seek help from family members and close relatives. Among the Japanese Brazilians, those with low ethnic identity had significantly poorer mental health than those with high ethnic identity. CONCLUSIONS: Young Japanese Brazilians may face conflicts of ethnic identity that can disturb their mental health. To build an inclusive society, the establishment of community services to support mental health and to help return migrants develop their ethnic identity is essential.

Demographic and clinical characteristics of foreign nationals accessing psychiatric services in Japan: a multicentre study in a metropolitan area.

BACKGROUND: International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognised as a risk factor for multiple mental-health related issues, there are few regional reports on foreign nationals accessing the psychiatric services in Japan. We aimed to reveal their current status and provide information to develop an optimal service system. METHODS: A multicentre retrospective document review research was conducted. The subjects were foreign nationals who resided in Japan and presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of 3 years. We investigated the patients' demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals and outcome. RESULTS: The percentage of foreign patients among all patients (1.4%) was quite low. Their age distribution (45.8 years on average) was dissociated from the age distribution of foreign nationals who resided in Japan. Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines, Korea and Brazil. Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic and stress-related disorders were the most common diagnosis (24.4%). The proportion of psychoactive substance use was higher than that for Japanese national data as immigrants are known to be at risk for it. CONCLUSIONS: The results suggest that foreign nationals who reside in Japan are less likely to contact appropriate services for mental illness, especially young people at relatively high risk of mental illness do not access services. Furthermore, lack of medical interpreters may impede the mental health conditions of foreign nationals. The development of a community-based integrated care system accessible to foreign nationals seems to be indispensable.

Factors related to the burnout of Japanese female nurses with children under 3 years old.

AIM: Burnout is a common feature among healthcare professionals; however, little systematic research exists on burnout among nurses who are raising children. The burnout-related factors among female nurses with children under the age of 3 years were identified in order to ascertain potential burnout prevention methods. METHODS: In total, 1681 nurses with children who worked at nine city hospitals in Kanagawa Prefecture, Japan, were sent the Maslach Burnout Inventory-Human Services Survey; 1173 nurses responded in June 2014. They were divided according to their sex and children's ages. A data analysis was undertaken for those female nurses with children who were aged under 3 years who provided valid responses (n = 158). RESULTS: A number of factors related to burnout in female nurses with children aged under 3 years was found via a multiple regression analysis: irritation at being unable to attend to their own affairs, over 4-6 h of overtime work per week, having a child aged under 3 years as the first or second child, little sense of work fulfillment, using a childcare facility outside the workplace, dissatisfaction with their salary, feeling ill-qualified as a parent, and a sense of inadequate support. CONCLUSIONS: Child care occurs during a limited period and appropriate support is needed. A workplace environment with no overtime work, a childcare facility in the workplace, and mental health support to reduce "feelings of irritation" and "feeling ill-qualified as a parent" could help to prevent burnout in female nurses with toddlers and infants.

Modal variety of microsatellite instability in human endometrial carcinomas.

PURPOSE: Microsatellite instability (MSI) in human endometrial cancer (EC) was analysed using a unique fluorescent technique. MSI is associated with various human neoplasms. However, the reported frequency of MSI differs widely in each malignancy. Methodological difficulties have in fact been pointed out in its assay techniques. METHODS: We previously established a sensitive fluorescent technique in which the major methodological problems are overcome. Application of this technique has revealed two distinct modes of microsatellite alterations, i.e. Type A and Type B. In the present study, we have applied this technique to 94 ECs. RESULTS: Significant microsatellite alterations were observed in 38 (40.4%) tumours of the panel. The two modes, Type A and Type B, were indeed observed in this malignancy. More importantly, we found that the modes more closely correlated with the molecular and clinicopathological backgrounds of the tumours than the established and widely used MSI grades, MSI-H and MSI-L. Type B MSI widely correlated with family history of hereditary non-polyposis colorectal cancer-associated cancers, whereas MSI-H only did with that of colorectal cancer. Furthermore, mutation in the KRAS oncogene, which has been regarded as generally infrequent in microsatellite-unstable tumours, was clearly associated with Type A MSI. CONCLUSIONS: Our observations may suggest a biological relevance and a potential utility of the modal classification of MSI and, furthermore, added complexities to genomic instability underlying tumourigenesis in human endometrium.

Factors affecting burnout in female nurses who have preschool-age children.

AIM: This prospective cohort study aims to clarify the factors affecting burnout in female nurses who have preschool-age children. METHODS: The subjects were 2151 female nurses who have preschool-age children and work at 70 city hospitals across Japan. The questionnaires were completed by 1644 female nurses with preschool-age children in October 2010, and they were divided into a cohort to observe the incidence of burnout, which was investigated in October 2011. RESULTS: At the baseline, the authors obtained responses from 1802 subjects (83.8%) who had agreed to join the study. The subjects the authors were able to investigate totaled 523, of whom 117 (22.4%) had experienced burnout. Multiple logistic regression analysis showed that influencing or predictive factors in burnout were years at the present workplace, will to continue work, assertiveness, overtime work, and spanking children. CONCLUSION: Female nurses who have preschool-age children tend to burnout easily if they have been at their present workplace for less than 3 years, wish to quit working, respond to a child's misbehavior with spanking, are "very low" in assertiveness, or work 4-6 h of overtime per week.

In vitro antibiotic susceptibility profile of Clostridium difficile excluding PCR ribotype 027 outbreak strain in Hungary.

Our study showed the antibiotic susceptibility profile of toxigenic Clostridium difficile isolated from nosocomial and community-acquired CDI between 2008 and 2010. MICs of 200 C. difficile strains were determined using E®test method in the case of erythromycin, clindamycin, moxifloxacin, rifampicin, and metronidazole. All strains were susceptible to metronidazole in the study period. Resistance rates to erythromycin, clindamycin and moxifloxacin were 31%, 29.5%, and 21.5%, respectively. In the case of rifampicin, the MIC range was quite wide, 11.5% of the tested strains proved to be highly resistant (MIC≥32 µg/ml) to rifampicin. When we compared these results with our earlier findings from 2006 to 2007, only minor changes in susceptibility over the time-periods could be observed in the case of erythromycin, clindamycin, moxifloxacin, and rifampicin, but metronidazole susceptibility did not show changes.

Relationship between assertiveness and burnout among nurse managers.

AIM: We aimed to clarify the relationship between assertiveness and burnout among nurse managers at university hospitals. METHODS: The directors at three university hospitals agreed to cooperate with our study. During a one-month period from May to June 2007, a self-administered questionnaire was distributed to 203 nurse managers (head and sub-head nurses). The Japanese version of the Rathus Assertiveness Schedule (J-RAS) and the Japanese version of the Maslach Burnout Inventory (MBI) were used as scales. Burnout was operationally defined as a total MBI score in the highest tertile. RESULTS: Valid responses were obtained from 172 nurse managers. The mean J-RAS score of the burnout group (-14.3) was significantly lower than that of the non-burnout group (-3.3). Responses about work experience and age showed no significant group difference. Total MBI score was inversely correlated with J-RAS score (R = -0.30, P < 0.01). Multiple logistic regression analyses indicated a decrease in the risk of burnout by 26% (0.74 times) for every 10 point increase in the J-RAS score, and by 60% (0.40 times) for greater satisfaction with own care provision. CONCLUSIONS: The results suggest that increasing assertiveness and satisfaction with own care provision contributes to preventing burnout among Japanese nurse managers.

Relationship of working mothers' parenting style and consistency to early childhood development: a longitudinal investigation.

AIM: This paper is a report of a longitudinal study of the relationship of working mothers' parenting style to their children's social competence and vocabulary/ motor/intellectual development. BACKGROUND: With an increasing number of women choosing to remain in the workforce after starting a family, there has been a concomitant increase in use of non-parental childcare facilities to help look after the child while the mother is at work. This increase in non-parental care has led to a dramatic change in the traditional child-rearing environment. METHODS: Long-term investigations were conducted over a period of 2 years in 41 Japanese government-licensed childcare facilities. Child development was evaluated by childcare professionals and parenting style was assessed by questionnaire. A total of 504 children and their mothers participated in the study. Data collection was carried out in 2004 and 2006. FINDINGS: We found that the changes in parenting style were statistically significantly related to children's development after 2 years. For instance, changes in the parent-child playing routine contributed to the child's social competence (odds ratio = 11.088). Variation in working mothers' disciplinary practices was also associated with children's vocabulary development after 2 years (odds ratio = 2246). CONCLUSION: Working mothers should increase interactions with their children in their free time to reduce the risk of developmental delay. Daily childcare support provided by family members or social organizations for long-term working mothers is helpful in mediating the negative relationship of mothers' working with children's development.