Quality of Life in Hand Eczema Questionnaire: Validation of the Japanese version of a disease-specific measure of quality of life for hand eczema patients.

Hand eczema (HE) is a common skin disease that impairs health-related quality of life (HRQOL). Impairments in HRQOL have already been reported in Japanese HE patients using the Skindex-16. Recently, an instrument to measure disease-specific HRQOL in HE patients was developed by an international expert group, consisting of domains for: (i) symptoms; (ii) emotions; (iii) functioning; and (iv) treatment and prevention. The objective of this study is to translate the English-language version of the Quality of Life Hand Eczema Questionnaire (QOLHEQ) to Japanese and then to validate the Japanese version. The Japanese version of the QOLHEQ, the Dermatological Life Quality Index (DLQI) and a questionnaire regarding basic demographic information, including patient ratings of HE severity, were distributed to Japanese HE patients. Additionally, a dermatologist evaluated patients' HE severity using the Physician Global Assessment. A total of 124 patients with a mean age of 43.7 years were included in the analysis, and 78% of the sample was female. Cronbach's alphas for the domains symptoms, emotions, functioning, and treatment and prevention were 0.76, 0.89, 0.88 and 0.81, respectively. The total QOLHEQ score showed a strong correlation with the DLQI, a moderate correlation with patient-rated severity and weak correlations with dermatologist-rated severity and the number of consultations. The Japanese version of the QOLHEQ showed excellent reliability and high validity. The Japanese version of the QOLHEQ is ready for use in epidemiological studies to evaluate HRQOL impairments in HE patients.

Cross-Cultural Validation of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ).

The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is the only instrument assessing disease-specific health-related quality of life in patients with hand eczema. It is available in eight language versions. In this study we assessed if the items of different language versions of the QOLHEQ yield comparable values across countries. An international multicenter study was conducted with participating centers in Finland, Germany, Japan, The Netherlands, Sweden, and Turkey. Methods of item response theory were applied to each subscale to assess differential item functioning for items among countries. Overall, 662 hand eczema patients were recruited into the study. Single items were removed or split according to the item response theory model by country to resolve differential item functioning. After this adjustment, none of the four subscales of the QOLHEQ showed significant misfit to the item response theory model (P < 0.01), and a Person Separation Index of greater than 0.7 showed good internal consistency for each subscale. By adapting the scoring of the QOLHEQ using the methods of item response theory, it was possible to obtain QOLHEQ values that are comparable across countries. Cross-cultural variations in the interpretation of single items were resolved. The QOLHEQ is now ready to be used in international studies assessing the health-related quality of life impact of hand eczema.

Self-reported hand eczema among dental workers in Japan - a cross-sectional study.

BACKGROUND: Dental workers are considered to have a high risk of developing occupational hand eczema. OBJECTIVES: To estimate the prevalence of work-related hand eczema and associated risk factors in dental workers in Japan. METHODS: A self-administered questionnaire was sent by mail to all dental clinics of Kumamoto City, Japan. In addition, patch testing with 24 dentistry-related allergens was offered. RESULTS: In total, 46.4% of dental workers (n = 528: response 31.4%, based on 97 clinics) reported a lifetime history of chronic hand eczema. The 1-year prevalence was 36.2%. According to logistic regression analysis, the most important risk factors for the 1-year prevalence were a personal history of atopic dermatitis [odds ratio (OR) 4.7, 95% confidence interval (CI): 2.2-8.8], asthma and/or allergic rhinitis (OR 2.0, 95%CI: 1.3-3.0), dry skin (OR 1.7, 95%CI: 1.1-2.7), shorter duration of work (OR 2.0, 95%CI: 1.2-3.5 for up to 10 years versus >20 years), and washing hands >10 times per day (OR 1.6, 95%CI: 1.0-2.5). Fifty-four workers were patch tested. Rubber chemicals and acrylates were the most frequent occupationally relevant contact allergens. CONCLUSIONS: Dental workers in Japan have a high prevalence of hand eczema. Health education to prevent hand eczema and more frequent patch testing are needed.

Allergic contact dermatitis from two-component acrylic resin in a manicurist and a dental hygienist.

BACKGROUNDS: Two-component acrylic resin used in nail art and dentistry can cause allergic contact dermatitis (ACD), but only a few reports from Japan have been published. CASES: A 35-year-old female manicurist (case 1) and 30-year-old female dental hygienist (case 2) were diagnosed with ACD caused by ethyl methacrylate and methyl methacrylate in a liquid monomer of two-component acrylic resin respectively. Case 1 was sensitized from direct skin contact with nail art acrylic products, which could have been avoided, and gave up both being a manicurist and a user. Onset in case 2 occurred when she started to work as an apprentice. She had believed that the cause of her symptoms was use of disposable natural rubber gloves, not a liquid monomer penetrating through her gloves, until she was patch tested positive to (meth)acrylates and liquid monomer. CONCLUSIONS: To prevent sensitization, it should be emphasized in occupational training in both specialties that there should be no direct contact with acrylic products and that disposable gloves do not have sufficient protecting properties.

Relationship between lifestyle and lifestyle-related factors in a rural-urban population of Japan.

OBJECTIVE: To clarify the actual state of residents' lifestyle in a mixed rural-urban area in Japan, and to investigate the relationship between residents' lifestyle and lifestyle-related factors. METHODS: The Japanese version of Health Promoting Lifestyle Profile-II (HPLP-II), lifestyle-related factors developed through group work with residents of Town A, and demographic variables were used to evaluate 1176 community residents' lifestyles and associated factors. RESULTS: Factor analysis revealed that there were 4 factors related to healthy lifestyle. Nonparametric analysis revealed that female and elderly groups showed higher overall HPLP-II score than male and young groups. A significant correlation coefficient was seen between scores of overall HPLP-II and lifestyle-related factors (r = 0.611, p < 0.001). Multiple linear regression analysis demonstrated that HPLP-II was significantly associated with each lifestyle-related factor, showing a similar order in both gender and age groups. Finally, covariance structure analysis demonstrated that the score of health cognition and regional factors increased the score of HPLP-II, which then increased the score of self-rated health. CONCLUSIONS: The present research clarified the actual state of residents' lifestyles by age and gender in a mixed rural-urban area in Japan, demonstrating a vector model from health cognition and regional factors to self-rated health, via residents' lifestyle.

Assessment of health-promoting lifestyle profile in Japanese university students.

OBJECTIVES: This descriptive study of 314 students was conducted to determine whether there were any relationships of their demographic variables with a health-promoting lifestyle profile. METHODS: The Japanese version of the Health Promoting Lifestyle Profile II (HPLP-II) questionnaire was used to investigate students' lifestyles. One-way analysis of variance (ANOVA) and multiple comparison procedures using the Scheffe test were conducted to identify significant differences among university year (first, second, etc.) groups. The t-test independent participants was utilized to compare the HPLP-II scores according to gender and living with family (yes/no). Multiple regression analysis was used to analyze the effects of various demographics on the overall HPLP-II score and the six health-promoting lifestyle subscales. RESULTS: The whole cohort of participants had an overall HPLP-II mean score of 2.50 (SD = 0.29), with the highest mean score being for interpersonal relations (3.05 ± 0.44), and the lowest mean score being for health responsibility (2.01 ± 0.53). The overall HPLP-II score of the students during the first university year was 2.59 (SD = 0.29), and this score progressively declined in their second year (2.49 ± 0.29), third year (2.47 ± 0.28), and fourth year (2.45 ± 0.30). Female students practiced significantly better health responsibility, interpersonal relations, and nutrition than males, and male students practiced significantly better physical activity than females. The students who were living with family had significantly higher nutrition scores than those not living with family. CONCLUSIONS: These significant findings linking the HPLP-II, university year level, and living with family (yes/no) in university students will enable healthcare providers to develop interventions to assist students in improving their health lifestyles in the university environment and will help in devising suitable education programs.

A comparative study of health-promoting lifestyles in agricultural and non-agricultural workers in Japan.

OBJECTIVES: To clarify the difference in health-promoting lifestyles between agricultural and non-agricultural workers in Japan, a cross-sectional study was conducted on 627 residents living in a town with a mixed rural-urban population. METHODS: The subjects were divided into 8 groups by job (agricultural and non-agricultural), age (young and old), and gender (male and female). To evaluate the subjects' lifestyles, the Health Promoting Lifestyle Profile II (HPLP-II) was applied. The Bartlett test and the Kendall rank test were performed for statistical analysis. RESULTS: There was no significant difference in the overall score of the HPLP-II between the two job groups. However, for the HPLP-II subscales, a significantly higher score for "spiritual growth" and a significantly lower score for "physical activity" were seen in the agricultural group than in the non-agricultural group. In general, the old and female groups showed higher scores than the corresponding groups, regardless of job type. CONCLUSIONS: It was determined that the major countermeasures to maintain a healthy lifestyle in agricultural workers should be associated with how to introduce daily activities that maintain and enhance "spiritual growth" and improve "physical activity".

Policy framework for formulating environmental management strategy for sustainable development of tanneries in India.

OBJECTIVES: The leather industry is one of the main examples of industries which play an important role in the Indian economy in terms of exports and employment opportunities, while being blamed for environmental pollution. The objective of this study was to find the advances or improvements in the Japanese leather industry which are not found in typical leather industries in developing countries. We examined the Japanese leather industry in this context because Japan is a developed country in which tanning processes have been a traditional business from ancient times, and also the leather industry has played an important role in the process of economic development of Japan. METHODS: The study was based both on information collected from various areas related to the leather industry or leather industry stakeholders, and also on a review of published information. Information was collected through site visits, interviews, questionnaires, and detailed discussions with these stakeholders, as well as from their websites. RESULTS: The framework of a typical leather industry is discussed in three sections: pollution prevention, pollution control, and pollution mitigation related to sources, processes, and impact possibilities, respectively. Eleven basic differences were noted between the Japanese and Indian leather industries. The availability of melting centers is the main important feature of the Japanese leather sector. CONCLUSION: Guidelines are suggested which focus on some changes that are expected to lead to both environmental and economic benefits, with better pollution management, which should lead to continuous improvement of the environmental performance of the industry, and, finally, sustainable development.

Applying the social cognitive perspective to volunteer intention in China: the mediating roles of self-efficacy and motivation.

When predicting volunteer intention, much attention is paid to the volunteer organization environment (VOE). Given that self-efficacy and motivation have emerged as important predictors of volunteer intention, we adopted a combination of ideas of Bandura's social cognitive theory and Ajzen's theory of planned behavior integrating VOE, self-efficacy and motivation to examine their effects on volunteer intention and to determine whether self-efficacy and motivation mediate the relationship between VOE and volunteer intention. The subjects of this study consisted of 198 community health volunteers in Shanghai city, China. Exploratory factor analysis was performed to identify the factor structure using standard principal component analysis. Six new factors were revealed, including two VOE factors, relation with organization and support from government; two motivation factors, personal attitude and social recognition; self-efficacy and volunteer intention. The results of a hierarchical regression analysis indicated that relation with organization accounted for 14.8% of the variance in volunteer intention, and support from government failed to add significantly to variance in volunteer intention; self-efficacy and personal attitude motivation partially mediated the effects of relation with organization on volunteer intention; social recognition motivation did not mediate the relationship between relation with organization and volunteer intention; and relation with organization, self-efficacy and personal attitude motivation accounted for 33.7% of the variance in volunteer intention. These results provide support for self-efficacy and personal attitude motivation as mediators and provide preliminary insight into the potential mechanisms for predicting volunteer intention and improving volunteering by integrating VOE, self-efficacy and motivation factors.

Quality of life associated with perceived stigma and discrimination among the floating population in Shanghai, China: a qualitative study.

The floating population refers to the large and increasing number of migrants without local household registration status and has become a new demographic phenomenon in China. Most of these migrants move from the rural areas of the central and western parts of China to the eastern and coastal metropolitan areas in pursuit of a better life. The floating population of China was composed of 121 million people in 2000, and this number was expected to increase to 300 million by 2010. Quality of life (QOL) studies of the floating population could provide a critical starting point for recognizing the potential of regions, cities and local communities to improve QOL. This study explored the construct of QOL of the floating population in Shanghai, China. We conducted eight focus groups with 58 members of the floating population (24 males and 34 females) and then performed a qualitative thematic analysis of the interviews. The following five QOL domains were identified from the analysis: personal development, jobs and career, family life, social relationships and social security. The results indicated that stigma and discrimination permeate these life domains and influence the framing of life expectations. Proposals were made for reducing stigma and discrimination against the floating population to improve the QOL of this population.