Objective: This study aimed to compare factors facilitating shared decision-making (SDM) in renal replacement therapy decision support between physicians and nurses using text mining analysis. Methods: A web-based survey was conducted among 250 physicians and 299 nurses between December 2024 and March 2025. Free-text responses regarding factors facilitating SDM were collected and analyzed using quantitative text analysis. Results: Valid responses were obtained from 103 physicians and 122 nurses. Both groups identified six factors, with three shared conceptual domains across physicians and nurses, reflected in three physician factors and four nurse factors. Common domains included “promoting patient and family understanding”, “enhancing staff education”, and “strengthening multidisciplinary collaboration”. Physicians emphasized structural and environmental factors, such as “establishing clinical systems”, “inter-institutional collaboration”, and “securing sufficient time”. In contrast, nurses highlighted practical and interpersonal aspects, including “understanding patients’ values and lifestyles”, “supporting patient-centered decision-making”, and “promoting team-based information sharing”. Conclusions: Factors that facilitate SDM in renal replacement therapy include perspectives common to both physicians and nurses, as well as profession-specific perspectives. These findings suggest that integrating organizational support and clinical skills development is crucial for promoting SDM in clinical settings.
Understanding late-onset alcohol use disorder (AUD) requires examining individuals' life histories and their relationship with alcohol. Few studies, however, have detailed the developmental process of late-onset AUD. This multiple case study explored the life stories and cultural influences of four older Japanese adults diagnosed with late-onset AUD. Life story interviews traced their experiences from childhood to the present. Commonalities emerged regarding early drinking and feelings of existential emptiness, while diverse family relationships and patterns of progression of the disorder were observed. These findings have important implications for developing more effective support strategies for older patients, particularly within Japan's unique drinking culture.
This paper attempts to develop an analytic tool for exploring whether dynamic processes in different complex adaptive systems share a common evolutionary mechanism over time. A nonlinear autoregressive integrated (NLARI) model is derived from a class of nonlinear systems with resilience mechanisms by using Newton’s second law to stochastic systems. Whether NLARI effectively models a class of dynamic processes in complex adaptive systems with common evolutionary mechanism depends on whether it can characterize and predict major dynamics of time series data from these systems. This study finds that a relative restoring coefficient controls bifurcation and stability of NLARI’s deterministic system. Unexpectedly, unstable oscillations may be because the relative restoring coefficient is too large or too small due to a weak resilience, while a stable fixed point and stable period-2 cycle only occur in an approximate value of the relative restoring coefficient.
Background: Existing XR simulators for enteral feeding rely mainly on self-reported learning outcomes and procedural checklists. As a result, they offer limited opportunities to capture objective behavioral data or to present dynamic patient reactions. This two-stage pilot study evaluated an XR-based gastrostomy tube-feeding simulator (ESTE-TF) that integrates sensor-derived performance metrics and two biological-reaction presentation modalities (projection mapping and tablet display). Methods: In Experiment 1, nursing students completed pre- and post-experience questionnaires assessing perceived learning across seven domains, alongside sensor-based measurements of feeding-start timing, dosing-rate characteristics, and total procedure time. Experiment 2 employed a tablet-based version with four learning items assessed for students and post-experience evaluations collected from registered nurses. Participants also compared the two XR presentation methods. Results: Students demonstrated perceived learning gains of small-to-large magnitude across both experiments (Experiment 1: d = 0.455–0.974; Experiment 2: d = 0.014–0.886), with wide 95% confidence intervals reflecting the exploratory nature of this pilot work. Sensor-derived data showed greater dosing-rate variability and longer procedure times among students than nurses. Participants reported that projection mapping offered a more embodied experience, whereas tablet displays provided clearer visibility. Conclusions: These findings indicate the feasibility and preliminary educational potential of integrating sensing technologies with XR-based biological-reaction presentation for gastrostomy-feeding training. Given the small samples and non-validated measures, results should be interpreted as exploratory. Future research will refine sensor accuracy, establish standardized performance metrics, and evaluate learning outcomes using validated instruments and controlled study designs.
Background:This study aimed to investigate health-promoting lifestyle behaviors and associated factors among Chinese workers residing in Japan.Methods:A cross-sectional survey was conducted between May and July 2017 among 313 Chinese workers (response rate: 69.4%; 62.6% female), recruited through convenience and snowball sampling in Japanese-language schools in Hiroshima Prefecture. The health-promoting lifestyle profile II revised (HPLP-IIR) was used to assess six dimensions: health responsibility (HR); physical activity (PA); nutrition (NU); spiritual growth (SG); interpersonal relations (IR); and stress management (SM). Demographics, Japanese language proficiency, residence and employment status, and workplace health education were included as independent variables.Results:The mean total HPLP-IIR score was 2.68 (SD = 0.57). The highest subscale scores were for IR (M = 3.02), NU (M = 3.01), and SG (M = 2.99), while the lowest were for HR (M = 2.37), PA (M = 2.42), and SM (M = 2.77). Stepwise multiple regression analysis revealed that higher Japanese language proficiency, participation in workplace health education, and clerical occupations were positively associated with HPLP-IIR scores. In contrast, student status, fixed-term or contract-based employment, current illness, and longer residence in Japan were negatively associated with overall and subscale scores. The model explained 17% of the variance in total HPLP-IIR.Conclusion:Japanese language proficiency, occupational type, and workplace health education are key factors in promoting healthier lifestyles among Chinese workers. Interventions that provide language support and stable employment conditions are essential for improving their health behaviors and integration.
