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Background: A recent epidemiological study showed that air pollution is closely involved in the prognosis of ischemic stroke. We and others have reported that microglial activation in ischemic stroke plays an important role in neuronal damage. In this study, we investigated the effects of urban aerosol exposure on neuroinflammation and the prognosis of ischemic stroke using a mouse photothrombotic model., Results: When mice were intranasally exposed to CRM28, urban aerosols collected in Beijing, China, for 7 days, microglial activation was observed in the olfactory bulb and cerebral cortex. Mice exposed to CRM28 showed increased microglial activity and exacerbation of movement disorder after ischemic stroke induction. Administration of core particles stripped of attached chemicals from CRM28 by washing showed less microglial activation and suppression of movement disorder compared with CRM28-treated groups. CRM28 exposure did not affect the prognosis of ischemic stroke in null mice for aryl hydrocarbon receptor, a polycyclic aromatic hydrocarbon (PAH) receptor. Exposure to PM2.5 collected at Yokohama, Japan also exacerbated movement disorder after ischemic stroke., Conclusion: Particle matter in the air is involved in neuroinflammation and aggravation of the prognosis of ischemic stroke; furthermore, PAHs in the particle matter could be responsible for the prognosis exacerbation., (© 2023. The Author(s).)

Objectives: To explore essential characteristics of healthcare employee satisfaction by comparing Japan and China in terms of job satisfaction model, satisfaction level, and the crucial factors predicting overall job satisfaction., Methods: A questionnaire was developed with 35 facet-specific job-related satisfaction and 10 general satisfaction items. The Japanese survey collected 474 responses (74% response rate). Two additional items were added in the Chinese survey and 429 responses were collected (69%)., Results: The same five-factor satisfaction model was acquired from both countries with an additional factor labelled "relationship with patients" for China. Applying these factors, a moderate satisfaction level was observed for all professional groups in China, whereas it varied in Japan. A moderate-to-high satisfaction was seen for physicians, a moderate level for pharmacists and technologists, and a low level for nurses. Japanese physicians were significantly more satisfied than Chinese physicians, whereas Japanese nurses were less satisfied than Chinese nurses. Both countries shared crucial predictors of overall job satisfaction that were reputation, growth and development, and work demands and workload. Additionally, financial rewards and relationship with patients were critically important for the Chinese., Conclusions: Japanese and Chinese healthcare employees shared the job satisfaction model with an extra factor for Chinese. Satisfaction levels were similar for pharmacists and technologists in the two countries, but largely different for physicians and nurses. Because crucial satisfaction factors differed, it is suggested that strategies to improve job satisfaction should be specific to culture and profession, eg, in Chinese hospitals, management should support more to employees especially physicians for dealing with conflicts and medical disputes with patients., (© 2019 John Wiley & Sons, Ltd.)

Objectives: To explore Chinese patients' views on physician disclosure actions after an adverse event and their acceptance of different types of apologies from the physician who caused the event., Methods: A questionnaire survey was conducted in 2009, collecting 934 valid responses (52% response rate) from inpatients and families in 3 Chinese hospitals. Respondents' views on and attitudes toward physician actions after a medical error were elicited as responses to 2 fictitious adverse events (vignettes) with different levels of outcome severity., Results: Chinese patients were more skeptical of physician disclosure actions after a case with a severe outcome than with a mild outcome. Recent experiences of suffering due to medical errors deteriorated patients' trust in physician disclosure actions. Chinese patients would prefer to receive a "full" apology, which included explicit words of apology and an undertaking of hospital responsibility. The results revealed the most effective apology, which was a full apology with the hospital's promise of taking preventive actions, and the least effective apology, a so-called "partial" apology in which the physician merely expresses sympathy for the event. Patient refusal of a physician's apology became stronger with an increase in the level of outcome-mild versus severe., Conclusions: Chinese patients' suspicion about health-care staff disclosure actions is rather strong. In addition, a large difference was identified in the level of patient acceptance between a physician's "full" or "partial" apology. Therefore, it is suggested that Chinese hospitals should adopt an "open" policy, which should include a "sincere" apology to the patient who experienced a medical error to maintain mutual trusts between the staff and patients.

Japanese and Chinese share virtually identical morphographic characters invented in ancient China. Whereas modern Chinese retained the original morphographic functionality of these characters (hanzi), modern Japanese utilizes these characters (kanji) as complex syllabograms. This divergence provides a unique opportunity to systematically investigate brain strategies for sentence reading in Japanese-Chinese bi-literates. Accordingly, we investigated brain activation associated with Japanese and Chinese reading in 14 native Japanese speakers literate in Mandarin and 14 native Mandarin speakers literate in Japanese using functional magnetic resonance imaging performed on a 3T system. The activation pattern exhibited clearly distinct features specific for each language. Regardless of the subject's native language literacy, Chinese reading activated an area significantly larger than Japanese reading, suggesting that brain processes involved in Chinese reading were much more complex than Japanese reading. Significant recruitment of corresponding cortical areas in the right hemisphere with Chinese reading was also apparent. The activation patterns associated with Japanese reading by native Japanese literates was highly consistent with previous reports, and included the left inferior frontal gyrus (IFG), left posterior temporal lobe (PTL), and left ventral premotor cortex (PMv). The activation pattern associated with Chinese reading by native Chinese literates was also highly consistent with previous reports, namely the left IFG, left PTL, left PMv, left anterior temporal lobe (ATL), and bilateral parieto occipital lobes (LPOL). The activation pattern associated with Chinese reading by native Japanese literates was virtually identical to that by native Chinese literates, whereas the activation pattern associated with Japanese reading by native Chinese literates was signified by additional activation of LPOL compared to that by native Japanese literate. The study indicated that IFG and PTL are universal language areas, while PMv is the area for decoding complex syllabograms. LPOL is the "Chinese language area," while ATL is essential for languages with analytic morphosyntax., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objectives: The present paper has 2 primary objectives as a pilot study on health-care safety climate in China: to develop its prototypical model well fit to the country's current hospital situations and validated external reliability and to elicit essential characteristics of safety climate for hypothetical general features in Chinese health care., Methods: A safety climate survey was carried out in 2008 at a university hospital in Shanghai, using an Operating Room Management Attitudes Questionnaire. We collected 1056 valid responses from doctors and nurses with 81% of overall response rate., Results: A 9-dimension model of safety climate was developed by applying principal component analysis to the entire sample with 44% of cumulative variance accounted for. Compared with the Japanese sample, safety climate in the Chinese hospital was characterized as strong awareness of own competence, positive attitudes to organization, but large power distance and unrealistic staff recognition of human error. Criterion validity of the construct was in part assured by significant correlations of 4 dimensions with self-reported staff behavior of accident reporting., Conclusions: Safety climate has been not yet mature in the hospital surveyed that might be partly tied with blame culture. Considering health-care policies, procedures, and management styles shared with many other health-care organizations as well as Chinese culture, we would hypothesize that the immature nature is common in Chinese health care as overall characteristics of safety climate. From these results, we would suggest that a nonpunitive health-care culture should be fostered to improve patient safety in China.