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Objective: To clarify the knowledge and practical skills needed for cancer pain management among nurses on remote islands in Japan and related factors nationwide., Setting: Due to geographical factors, nurses working on remote islands in Japan have few opportunities to attend training programs, which makes it difficult to acquire the knowledge and practical skills needed to provide pain management for patients with cancer., Methods: We conducted a self-administered questionnaire survey regarding knowledge and practical skills in pain management for patients with cancer., Design: Cross-sectional study., Participants: Nurses working in cancer pain care in medical facilities and home care on remote islands throughout Japan., Results: We analysed 128 responses. Regarding knowledge, the average accuracy level was 49.1%. Items with a low accuracy rate included selecting medicine according to the type of pain and the patient's condition. Regarding practice, the items with low scores included analgesics appropriate for the type of pain and relating physical pain to mental, social and spiritual aspects. The most common significant factor in both knowledge and practice was related to postgraduate training., Conclusions: These findings suggest that to improve the knowledge and practical skills for cancer pain management among nurses on remote islands in Japan, it is necessary to incorporate clinical reasoning into basic education and establish remote education systems and consultation systems with other facilities., (© 2024 The Author(s). Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Background: Although it is known that resilience is negatively associated with burnout, and that certain interventions can effectively increase resilience, little is known about online resilience-enhancing interventions during the COVID-19 crisis. The aim of this study was to identify the association between an online resilience-enhancing intervention and workplace social support, and burnout among nurses working in the mainland and remote islands of Japan during the COVID-19 crisis., Methods: Pretest-posttest was conducted between April 2020 and February 2021, and the questionnaire survey included the bidimensional resilience scale, the Japanese version of Pine's Burnout Measure, and the workplace social support scale. Changes in burnout, resilience, and social support and the associations with nursing discussions as intervention were analyzed. Participants were 98 Nurses with 1 to 10 years of experience from Japan's mainland and remote island hospitals of Kagoshima Prefecture participated in a baseline survey in April 2020. Of these, 76 participated in a secondary survey in September 2020, and 69 participated in the intervention program and a third survey in February 2021. The online intervention over Zoom consisted of small-group nursing discussions based on the broaden-and-build theory., Results: Changes in burnout showed a significant negative association with change in workplace social support (Coef. = -0.019, 95% CI -0.035- -0.003), as did the interaction between change in acquired resilience and intervention (Coef. = -0.088, 95% CI -0.164- -0.011)., Conclusion: Change in workplace social support was significantly negatively associated with changes in burnout, as was the interaction of intervention and acquired resilience. Promotion of this intervention and making workplace social support more accessible may contribute to reduce burnout in nurses., Competing Interests: The authors declare no conflict of interest., (©2023 Tottori University Medical Press.)

Background: Burnout, due to extreme mental and physical fatigue, and emotional exhaustion, leads to decreased nursing quality and turnover. However, not all nurses are observed as burnouts in the same work environment, and resilience and related factors may have effects on the development of burnouts. Therefore, we conducted a cross-sectional study to examine the effects of resilience and related factors on the burnout in clinical nurses, Kagoshima, Japan., Methods: Data for this cross-sectional study involving nurses ( n = 98) was collected using the following questionnaire surveys: the Bidimensional Resilience Scale, The Workplace Social Support Scale, and the Japanese version of the Pine's Burnout Scale. Using burnout as a dependent variable, analyses were conducted using one-way analysis of variance and multiple regression analysis after adjusted for related factors., Results: The prevalence of burnouts was 19.6% on the mainland and 36.1% on remote island. Innate resilience, acquired resilience, workplace social support, and burnout showed no significant difference between nurses on the mainland and remote island. In the mainland participants, innate resilience (β = -0.492, P < 0.001) and acquired resilience (β = -0.325, P = 0.007) showed a negative association with burnout, and similar associations were observed innate resilience (β = -0.520, P = 0.004) and acquired resilience (β = -0.336, P = 0.057) in the remote island participants. For all participants, innate resilience (β = -0.443, P = 0.001) and workplace social support (β = -0.204, P = 0.031) showed a negative association with burnout, and turnover intention was positively associated (β = 0.025, P = 0.021)., Conclusion: A negative association between burnout and innate resilience factors was observed in the mainland and remote island. Further evaluation of innate resilience is necessary for burnout prevention in clinical nurses., Competing Interests: The authors declare no conflict of interest., (©2022 Tottori University Medical Press.)

Background: Food preferences and oral health of older adults greatly affect their nutritional intake, and old-age-related increase in food neophobia may consequently reduce food intake in older adults. This study aimed to determine the impact of food neophobia and oral health on nutritional risk in community-dwelling older adults., Methods: This cross-sectional study included 238 independent adults aged ≥ 65 years (mean, 76.3 ± 7.3 years). The survey items included a Food Neophobia Scale, frequency of protein intake, oral-health-related quality of life (QOL) assessment, and oral diadochokinesis (ODK; /pa/, /ta/, /ka/) as an index of oral function. Nutritional status was assessed using the Mini Nutritional Assessment®, and based on a cutoff value of 24 points, respondents were categorized as well-nourished (≥ 24 points, Group 1) or at risk of malnutrition (< 24 points, Group 2). A logistic regression model was used to calculate the adjusted odds ratio (adj-OR) with 95% confidence interval (CI) to identify risks factors for malnutrition associated with food neophobia and oral health., Results: Factors associated with the risk of malnutrition in the older population were higher food neophobia (adj-OR = 1.036, 95% CI: 1.007-1.067) and lower oral function (OR = 0.992, 95% CI: 0.985-0.999) and lower oral-health-related QOL (adj-OR = 0.963, 95% CI: 0.929-0.999)., Conclusions: Older adults at risk of developing malnutrition may have higher food neophobia and lower oral function and oral-health-related QOL. Factors contributing to preventing malnutrition include predicting the risk of malnutrition based on the oral health indicators that older people are aware of, signs appearing in the oral cavity, minor deterioration, and providing dietary guidance about food neophobia. Notably, these approaches represent novel strategies for nutrition support that can be implemented based on a multifaceted understanding of the eating habits of older adults., (© 2022. The Author(s).)

We performed a retrospective survey and verification of the medical records of death cases of children (and adolescents; aged <18 years) between 2014 and 2016 in pediatric specialty training facilities in Japan. Of the 2,827 registered cases at 163 facilities, 2,348 cases were included. The rate of identified deaths compared with the demographic survey, was 18.2%-21.0% by age group. The breakdown of deaths was determined as follows: 638 cases (27.2%) were due to external factors or unknown causes, 118 (5.0%) were suspected to involve child maltreatment, 932 (39.7%) were of moderate or high preventability or were indeterminable. Further detailed verification was required for 1,333 cases (56.8%). Comparison of the three prefectures with high rates of identified deaths in Japan revealed no significant differences, such as in the distribution of diseases, suggesting that there was little selection bias. The autopsy rate of deaths of unknown cause was 43.4%, indicating a high ratio of forensic autopsies. However, sufficient clinical information was not collected; therefore, thorough evaluations were difficult to perform. Cases with a moderate or high possibility of involvement of child maltreatment accounted for 5%, similar to previous studies. However, more objective evaluation is necessary. Preventable death cases including potentially preventable deaths accounted for 25%, indicating that proposals need to be made for specific preventive measures. Individual primary verification followed by secondary verification by multiple organizations is effective. It is anticipated that a child death review (CDR) system with such a multi-layered structure will be established; however, the following challenges were revealed: The subjects of CDR are all child deaths. Even if natural death cases are entrusted to medical organizations, and complicated cases to other special panels, the numbers are very high. Procedures need to be established to sufficiently verify these cases. Although demographic statistics are useful for identifying all deaths, care must be taken when interpreting such data. Detailed verification of the cause of death will affect the determination of subsequent preventability. Verification based only on clinical information is difficult, so a procedure that collates non-medical information sources should be established. It is necessary to organize the procedures to evaluate the involvement of child maltreatment objectively and raise awareness among practitioners. To propose specific preventive measures, a mechanism to ensure multiprofessional diverse perspectives is crucial, in addition to fostering the foundation of individual practitioners. To implement the proposed measures, it is also necessary to discuss the responsibilities and authority of each organization. Once the CDR system is implemented, verification of the system should be repeated. Efforts to learn from child deaths and prevent deaths that are preventable as much as possible are essential duties of pediatricians. Pediatricians are expected to undertake the identified challenges and promote and lead the implementation of the CDR system. This is a word-for-word translation of the report in J. Jpn. Pediatr. Soc. 2019; 123 (11): 1736-1750, which is available only in the Japanese language., (© 2021 The Authors. Pediatrics International published by John Wiley & Sons Australia, Ltd on behalf of Japan Pediatric Society.)