[Vitalizing public health activities through community assessment: A report of the Committee on Public Health Nursing 2014-2017].

Objectives　This report aims to present the community assessment model developed by the Committee on Public Health Nursing (6th term) of the Japanese Association of Public Health. This new model was designed such that it could be applied to a broad range of public health activities. It aims at theorizing public health nurses' practice-based knowledge and sharing it among other public health professionals.Methods　The model was developed during seven committee meetings held from October 2014 to September 2017. In the first step, we brainstormed the definition and methods of community assessment and constructed a framework for a literature review. In the second step, information on theories, research, and practice relevant to community assessment was reviewed based on this framework. In the third step, the community assessment model was developed based on the results of the literature review and the practice experience of the committee members. In the last step, we examined the applicability of this model to the practice of occupational health and public health administration.Project activities　We defined community assessment as the "skills and methods based on applied science that drive Plan-Do-Check-Action (PDCA) cycles in every activity that aims at achieving a better quality of life (QOL)." We further classified community assessment into two types; comprehensive assessment and targeted assessment. The model underlined that community assessment was a continuous and developmental process that occurs throughout every stage of the PDCA cycle, and that it was oriented toward improving the QOL of community residents. This model also purported that the empirical and scientific intuition, and ethical sensitivity of assessors were among the key determinants of assessment quality.Conclusion　The model on community assessment developed in the present study based on the empirical knowledge of public health nurses could be applied to all types of public health activities in communities.

Job Demand and Job Resources related to the turnover intention of public health nurses: An analysis using a Job Demands-Resources model.

Objectives The purpose of this study was to investigate the job demands and job resources of public health nurses based on the Job Demands-Resources (JD-R) model, and to build a model that can estimate turnover intention based on job demands and job resources.Method By adding 12 items to the existing questionnaire, the author created a questionnaire consisting of 10 factors and 167 items, and used statistical analysis to examine job demands and job resources in relation to turnover intention.Results Out of 2,668 questionnaires sent, 1993 (72.5%) were returned. Considering sex-based differences in occupational stress, I analyzed women's answers in 1766 (66.2%) mails among the 1798 valid responses. The average age of respondents was 41.0±9.8 years, and the mean service duration was 17.0±10.0 years. For public health nurses, there was a turnover intention of 9.2%. The "job demands" section consisted of 29 items and 10 factors, while the "job resources" section consisted of 54 items and 22 factors. The result of examining the structure of job demands and job resources, leading to turnover intention was supported by the JD-R model. Turnover intention was strong and the Mental Component Summary (MCS) is low in those who had many job demands and few job resources (experiencing 'burn-out'). Enhancement of work engagement and turnover intention was weak in those who had many job resources. This explained approximately 60% of the dispersion to "burn-out", and approximately 40% to "work engagement", with four factors: work suitability, work significance, positive work self-balance, and growth opportunity of job resources.Conclusion This study revealed that turnover intention is strong in those who are burned out because of many job demands. Enhancement of work engagement and turnover intention is weak in those with many job resources. This suggests that suitable staffing and organized efforts to raise awareness of job significance are effective in reducing turnover intention.

Expression of interferon gamma and proinflammatory cytokines in the cecal mucosa of rats experimentally infected with Blastocystis sp. strain RN94-9.

Blastocystis hominis is a zoonotic intestinal protozoan parasite whose pathogenic potential is still controversial. The aim of the present study was to clarify the pathogenicity of Blastocystis parasites in rats. Oral inoculation with 1 x 10(5) cysts of Blastocystis sp. strain RN94-9 in rats resulted in chronic infection in the cecum at least until 4 weeks after infection. Histological examination revealed neither mucosal sloughing nor inflammatory cell infiltration but showed a slight but significant increase in goblet cell numbers in the cecal mucosa 1-3 weeks post-infection. Differential staining of acidic and neutral mucins by the alcian blue-periodic acid-Schiff method showed that the predominantly increased cells were neutral mucin(+) but not acidic mucin(+) goblet cells. Reverse transcription real-time polymerase chain reaction studies demonstrated significant upregulation of the expression of interferon-gamma, interleukin (IL)-12, and tumor necrosis factor alpha, but not IL-6 or granulocyte-macrophage colony-stimulating factor, in the cecal mucosa at 2 and/or 3 weeks post-infection. The induction of local host responses, including mild goblet cell hyperplasia, and significant upregulation of type-1 and proinflammatory cytokines, suggest that Blastocystis sp. strain RN94-9 is a weakly pathogenic organism that could elicit proinflammatory as well as protective responses in local tissues.

Infectivity of different genotypes of human Blastocystis hominis isolates in chickens and rats.

Most Blastocystis hominis isolates from humans are believed to be potentially zoonotic. This is because B. hominis isolates found in a variety of other host species have been found to have identical or relatively similar genotypes to those found in human isolates. However, the transmission of human B. hominis isolates to other animals has not been confirmed experimentally. In this study, the infectivity associated with several unique human Blastocystis genotypes (subtypes 2, 3, 4 and 7) was therefore investigated by infecting chickens and rats with two isolates of each subtype experimentally. The results showed that one isolate of subtype 4 and one isolate of subtype 7 was capable of infecting both chickens and rats, while two isolates of subtype 2, another isolate of subtype 4, and another isolate of subtype 7 could only infect chickens. Conversely, two isolates of subtype 3 failed to infect either of the animals. These results confirmed that several genotypes from human isolates could infect chickens and/or rats, indicating that chickens and rats are suitable experimental animal models for studying the zoonotic potential of human Blastocystis isolates.

High-frequency ultrasonographic imaging in suprachoroidal hemorrhage after filtering surgery.

A 64-year-old woman with glaucoma had suprachoroidal hemorrhage approximately 6 hours after trabeculectomy. High-frequency ultrasonography revealed high reflectivity in the inner space of a kissing choroidal detachment, which facilitated the differential diagnosis of suprachoroidal hemorrhage resulting from serous choroidal detachment. The ciliary process and iris were anteriorly displaced due to the ciliary detachment and forward pressure of the anterior vitreous. On the basis of the diagnosis, transscleral choroidal drainage was performed without delay and the patient's vision was preserved. After surgery, suprachoroidal hemorrhage disappeared clinically, but high-frequency ultrasonography detected persistence of the choroidal detachment in the peripheral area.