吉野 八重

Background: In the early stages of Pandemic (H1N1) 2009, border control measures were taken by quarantine stations to block the entry of infected individuals into Japan and community containment measures were implemented to prevent the spreading. The objectives of this study were to describe these measures and the characteristics of infected individuals, and to assess the measures' effectiveness. Methodology/Principal Findings: Border control and community containment measures implemented from April to June (Period I: April 28-May 21, Period II: May 22-June 18) 2009 were described. Number of individuals identified and disease characteristics were analyzed. For entry screening, a health declaration form and an infrared thermoscanner were used to detect symptomatic passengers. Passengers indicated for the rapid influenza test underwent the test followed by RT-PCR. Patients positive for H1N1 were isolated, and close contacts were quarantined. Entry cards were handed out to all asymptomatic passengers informing them about how to contact a health center in case they developed symptoms. Nine individuals were identified by entry screening and 1 during quarantine to have Pandemic (H1N1) 2009. Health monitoring by health centers was performed in period I for passengers arriving from affected countries and in period II for those who had come into contact with the individuals identified by entry screening. Health monitoring identified 3 infected individuals among 129,546 in Period I and 5 among 746 in Period II. Enhanced surveillance, which included mandatory reporting of details of the infected individuals, identified 812 individuals, 141 (18%) of whom had a history of international travel. Twenty-four of these 141 passengers picked up by enhanced surveillance had been developing symptoms on entry and were missed at screening. Conclusion/Significance: Symptomatic passengers were detected by the various entry screening measures put in place. Enhanced surveillance provided data for the improvement of public health measures in future pandemics.

Prolonged fatigue among elementary and junior high school teachers not only damages their health but also affects the quality of education. The aim of this study was to determine the factors of working conditions associated with prolonged fatigue among teachers at public elementary and junior high schools. We distributed a self-reported, anonymous questionnaire to 3,154 teachers (1,983 in elementary schools, 1,171 in junior high schools) working in public schools in a city in Japan. They were asked to assess 18 aspects of their working conditions using a seven-point Likert scale. Prolonged fatigue was measured using the Japanese version of the checklist individual strength questionnaire. Multiple regression analysis was used to examine the association between working conditions and prolonged fatigue. Gender, age, and school type were introduced as confounders. In all, 2,167 teachers participated in this study. Results showed that qualitative and quantitative workload (time pressure due to heavy workload, interruptions, physically demanding job, extra work at home), communication with colleagues (poor communication, lack of support), and career factors (underestimation of performance by the board of education or supervisors, occupational position not reflecting training, lack of prospects for work, job insecurity) were associated with prolonged fatigue.

Despite long-standing concerns regarding the effects of working hours on the performance and health of medical residents, and the patients' safety, prior studies have not shown an association of excessive sleepiness with the number of sleeping hours and days of overnight work among medical residents. In August 2005, a questionnaire was mailed to 227 eligible participants at 16 teaching hospitals. The total number of sleeping hours in the last 30 d was estimated from the average number of sleeping hours during regular days and during days with overnight work, and the number of days of overnight work. Multiple logistic regression analysis was used to adjust for potentially associated variables. A total of 149 men and 47 women participated in this study. The participation rate was 86.3%. Among the participants, 55 (28.1%) suffered from excessive sleepiness. Excessive sleepiness was associated with sleeping for less than 150 h in the last 30 d (corrected odds ratio [cOR]=1.57; 95% confidence interval [CI], 1.02-2.16). The number of days of overnight work in the last 30 d showed no association with excessive sleepiness. Excessive sleepiness was also associated with smoking (cOR, 1.65; 95%CI, 1.01-2.32). Medical residents who slept for less than 150 h in the last 30 d and smoked had a significantly higher risk of excessive sleepiness on duty.

国際医療協力委託事業「開発途上国における看護技術移転教育プログラムの開発に関する研究」(平成14年〜16年度)における過去2年間の成果を共有し,海外の看護専門家3名から助言を得るため,2日間にわたるワークショップを開催した。研究の目的は,開発途上各国へ日本の看護技術移転活動に関わる人材育成のための教育プログラムを開発することであった。研究は3班で分担され,2つの班は国際看護コラボレーター養成プログラムと,基礎看護教育コラボレーター養成プログラム開発に焦点をおき,1つの班は看護技術移転のための現任教育用のガイドライン(協働基準)の作成を目標に,成果を発表した。研究の最終年度に向けて,このワークショップでの海外看護専門家からの助言と,研究班間のディスカッションから,貴重な示唆を得ることができた。