BACKGROUND: The demand for aged-care services in Japan has surged due to the country's aging population. Furthermore, nationwide survey on the current state of aged-care services revealed that the primary reason for the resignation of women working in these sectors was poor interpersonal relationships. Moreover, given that women working in aged-care services work in shifts around the clock to manage the health and safety of the people in their care, they are at high risk of health-related issues including insomnia symptoms. Thus, we aim to examine the association between levels of satisfaction with interpersonal relationships (LSIR) and insomnia symptoms for women working in aged-care services in Japan, as well as the effect of work-life imbalance on the association between LSIR and insomnia symptoms. METHODS: In this cross-sectional study, the participants were 472 women aged 18-60 years who worked in aged-care services in Japan in 2014-2016. Insomnia symptoms were measured using the Athens Insomnia Scale, and scores of 6 or greater indicated the presence of insomnia. LSIR were assessed through self-administered questionnaires and evaluated at three levels. The association between LSIR and insomnia symptoms was evaluated using a multinominal logistic regression model. Path analysis was used to examine the potential effects of LSIR on insomnia symptoms by incorporating covariates such as work-family conflict, marital status, and depressive symptoms. RESULTS: Compared to high LSIR, the multivariable-adjusted odds ratios (95% confidence interval) of insomnia symptoms were respectively 1.36 (0.81-2.30) and 2.42 (1.11-5.23) for medium and low LSIR. The path analysis showed that low LSIR were significantly associated with having high work-to-family (W-to-F) conflict and being single. CONCLUSIONS Low LSIR were significantly associated with insomnia symptoms among women working in aged-care services in Japan. High W-to-F conflict exacerbated this relationship. Therefore, enhancing interpersonal relationships may be necessary for preventing insomnia. However, due to the cross-sectional nature of our study, causality cannot be inferred. Further longitudinal research is needed to better understand these associations.
Humans ; Japan/epidemiology* ; Sleep Initiation and Maintenance Disorders/psychology* ; Female ; Middle Aged ; Adult ; Cross-Sectional Studies ; Interpersonal Relations ; Young Adult ; Adolescent ; Personal Satisfaction ; Health Services for the Aged/statistics & numerical data*

  A look at the reports of accidents or near accidents in our hospital revealed that the incidence of falls or stumbles in children was at the top of the list in frequency. In the past five years, our pediatric ward has experienced an average of about 10 such cases annually. Regarding the risk of falling, advice is given by nurses to parents during the orientation session when their babies and little children are hospitalized. However,the advice was entirely subjective - not going by any rule or guidelines. Recently, an assessment score sheet for the risk factors for falling and a preventive measure against falls was drafted and trial used, with the result that changes were observed in the way the nurses in their 20s watch and take care of the little patients. Moreover, they became able to look after the infants according to their age, developmental stage and disposition. The use of the common pamphlet helped the young nurses gain selfconfidence even though they are inexperienced in child-rearing and nursing.  From these results, we concluded that the uniform guideline and order of priority led to the improvement of the quality of nursing in the nurses in their 20s.

The efect of some types of exercise on systolic pressure was studied. The results were as follows.
1. Increased rate of systolic pressure immediately after run of eight distances was greatest in 100 meter run. Such a high level was also observed in both 400 and 1, 500 meter runs.
Further prolongation of the distance, however, induced a sharp reduction of increased rate to 5, 000 meters and in a run of still longer distance the above tendency was weakened.
2. If these results are applicable to the change of systolic pressure during a prolonged exercise, Edward's graphic representation seems to be true. Some of our experiments, however, indicated that Edward's curve was not the only case.
Some features often expected were the following.
a) Generally, the final rise was low if the initial rise was low.
b) However, the final rise would be high in the cases with a faster finish even if the initial rise was low.
c) In general, the final rise was high if the initial rise was high.
d) However, the final rise would be lowering as development of exhaustion even if the initial rise was high, and only this form was considered to analogize with Edward's curve.
3. Blood pressure was determined during short interruption of exercise in 10, 000meter run. The lap time was estimated immediately before the determination of pressure.
Since there was a strong statistical correlation between the increased rate of systolic pressure and the lap time (r=0.698, P<0.01), the fall in systolic pressure increased at early stage in a long continued exercise was supposed to be induced by decreased pace.
Therefore, decreased severity of exercise may be a major factor inhibiting increase of pressure during prolonged exercise. It is undeniable that this type brought about by in-hibiting pressor effect is angmented by some nervous or humoral factors.
4. The longer the distance, the earlier the subnormal phase after exercise tends to start and the deeper the drop of systolic pressure will become.
In all of the four prolonged runs over 5, 000 meters was observed average drop below normal of about 20 per cent and the lowest value of 28 per cent except two cases indicating marked fall. Futhermore, average fall below normal in mean arterial pressure induced after increased pressure by epinephrine was 30 per cent in rabbits. These data showed that in subnormal phase there may be a certain lower limit to sink and that the existense of this protective line of defence would prevent deterioration of the circulation.
5. The systolic pressure rised in the trained higher than in the untrained immediately after a short and sharp effort, but in the former the reduction of the rise with longer distance of run was more slight than the latter.