Objective: The study aimed to develop and validate the Japanese version of the Staff Attitudes to Nutritional Nursing Geriatric Care Scale (Japanese SANN-G).

Methods: A total of 493 nurses, nursing assistants, and caregivers participated in an anonymous questionnaire survey that included the 18-item SANN-G translated into Japanese. A month after the survey was conducted, 108 of 493 participants were asked to complete the 18-item SANN-G once again. Construct and criterion validity, internal consistency, and test-retest reliability were confirmed using exploratory and confirmatory factor analysis, Spearman's correlation analysis, and Cronbach's alpha, respectively.

Results: Data from 490 participants were used in this study (eligibility rate = 99.4%). The factor structure included a total of ten items under the two following subscales: 1) resistance to increased workload (5 items) and 2) misestimation of risk and skills of malnutrition care (5 items). The model fit indices were fairly good (GFI: 0.968, AGFI: 0.949, CFI: 0.938, RMSEA: 0.052). Cronbach's alpha and test-retest correlation of the 10-item Japanese SANN-G were α = 0.733 and ρ = 0.628 (p < 0.001), respectively. Regarding criterion validity, the correlation coefficients of SANN-G of the participants' knowledge, priority of nutritional care, and sharing information about patients' nutritional status were ρ = -0.021 (p = 0.639), 0.158 (p < 0.001), and 0.176 (p < 0.001), respectively.

Conclusion: We confirmed the reliability and validity of the Japanese SANN-G although its factor structure differed from the original version.

Objective: This study aims to elucidate the effects of childhood food-related pickiness, the experience of overcoming it, and the intention to overcome it on stress-coping ability during adulthood.

Methods: Subjects were recruited through an online survey company for a retrospective study. The questionnaires were distributed to nearly 700,000 monitors (20~39 years old); responses were collected until a sample of 400 responses was achieved. The questionnaire included items on food pickiness during childhood, the experience of overcoming it, and the intention to overcome it. We used the Japanese version of the Sense of Coherence (SOC) 13-item questionnaire to assess stress-coping ability during adulthood. This scale consists of three subscales measuring comprehensibility, manageability, and meaningfulness.

Results: The effective response rate was 94.8% (n = 379 of 400). In the sample, 95 subjects (25.1%) considered themselves to have exhibited no food-related pickiness during childhood. Those who did not display pickiness had significantly higher manageability scores than those who did. The SOC scores were notably higher among those who had an intention to overcome their pickiness, compared with those who did not. Moreover, those who intended to overcome their pickiness had significantly higher total SOC scores than those who did not, independent of their experience of overcoming pickiness.

Conclusion: Food pickiness and the intention to overcome it during childhood affect stress-coping ability in adulthood.

Objective: The study aimed to examine the characteristics of the students of dietetics regarding their intention to participate in international activities and their competency in dietetics.

Methods: A total of 489 students from five universities in the Kanto, Kansai, Chugoku, and Kyushu regions completed a questionnaire survey in December, 2018. After excluding respondents with missing answers, we analyzed the answers of 399 respondents (valid response rate: 81.6%).

Results: An exploratory factor analysis was performed on the dietetics students' intention to participate in international activities. As a result, seven items and two factors were extracted, and the factor contribution rate was 62.3%, which indicated significant "intention to acquire basic international knowledge" and "intention to establish professional practice for foreign nationals." The third-year students' intentions to participate in international activities were classified into four clusters according to whether they scored high or low on the two factors. In addition, we examined the relationship between the competency scores of registered dietitians and their attitudes toward foreign language learning in each cluster. The competency of the cluster that scored high on both factors was significantly higher than those of the other three groups, and this was also found to be related to their attitudes toward foreign language learning and foreigners.

Conclusions: Third-year students of the registered dietitian training course who scored high on "intention to acquire basic international knowledge" and "intention to establish professional practice for foreign nationals" had high competency scores, positive experiences involving international exchange, and a good attitude toward dealing with foreigners.

Objective: The study aims to verify the effectiveness of early introductory education for first-year students with an emphasis on providing them with a clear picture of their future as registered dietitians.

Methods: The study involved 214 students under the Department of Nutritional Science at N University. In the first semester, introductory education was conducted through three 90-minute sessions and one 180-minute session. A total of 17 questionnaires were administered before and after receiving education to evaluate its effects, including goal setting, understanding of the significance of the learning, motivation to work as a registered dietitian, and the degree of effort to achieve the goal.

Results: The students scored significantly higher across all effects after completing the introductory education. These improvements varied, depending on the stage at which an individual was to set their future goals. Motivation to be a registered dietitian increased among students who were able to identify their desired occupation but could not give a reason, and among those who could not visualize their career after graduation. For students who had a clear reason to pursue their desired occupation, and for those who desired a motivational experience, the education improved them in terms of striving for their goal.

Conclusions: This early introductory educational program has beneficial effects and appropriate educational content in response to various stages of future goal setting. Although further enhancement is necessary, the effects of this program comprehensively foster the students' desire to become registered dietitians.

Objective: Health Japan 21 (the second term) promotes an "increase in the number of corporations in the food industry that supply food products low in salt and fat." However, the status of its implementation is not evident as the specific criteria for registration have not been questioned. A survey was conducted by local governments throughout Japan to determine the implementation rate of the system to improve healthy food environments in restaurants and other settings and criteria for registration of stores to understand the criterion combination and quantitative criteria for nutrients and food groups.

Methods: The study comprised 154 local governments, including prefectures, cities with public health centers, and special wards throughout Japan. In October 2019, a web search was conducted on local government websites regarding the system to improve a healthy food environment in restaurants, and the registration criteria were dichotomized into access to information and food. Criterion combination patterns of nutrients and food groups for access to food were categorized and the presence of quantitative criteria was identified.

Results: Among the surveyed local governments, 80% confirmed to have implemented the system to improve healthy food environments in restaurants. More than 80% of the local governments that implemented these systems included access to information or food as registration criteria. The most commonly registered items under the criteria for access to food were "lots of vegetables" (approximately 90%) and "low salt" (approximately 80%), and a combination of "lots of vegetables" and "low salt" was confirmed in 29 cases. The items which more than half of the local governments required the quantitative criteria were "lots of vegetables," "lots of calcium," and "lots of iron."

Conclusions: The most commonly registered items under access to food were "lots of vegetables" and "low salt." A limited number of local governments set criterion combination, and the quantitative criteria for which "low salt" was essential was also low at approximately 30%.

Objective: We systematically reviewed the association between the currently reported dietary scores and non-communicable diseases (NCDs).

Methods: We assessed NCDs according to dietary scores in adults and systematically reviewed the relationship between dietary scores and NCDs. We selected English and Japanese articles published in PubMed from January 2000 to May 2017 according to the acceptance criteria, categorized them according to dietary scores, and summarized them in an evidence table on a Mediterranean diet score (MDS).

Results: Of the 2,036 selected articles, 574, 902, and 323 articles were excluded by title, abstract, and full-text review, respectively. Finally, we selected 237 articles and sorted them according to their dietary scores. Further, 142, 65 and 34 articles were related to Healthy Eating Index, MDS, Diet Quality Index, respectively. MDS-related articles were further classified as MDS articles (n = 17), alternate MDS (aMed) articles (n = 23), and 5 MedDietScore articles (n = 5). MDS and aMed are relative scores and, therefore, depend on the target population, while MedDietScore is an absolute value. All MDSs were significantly associations with cancer, cardiovascular disease, and obesity.

Conclusions: Our findings suggest different target populations and study purposes require different methods of MDS scoring. We suggest accumulating more evidence to examine the relationship between the MDS and NCDs on a global scale.

Objective: This study aimed to understand the status and actual employment conditions of registered dietitians (RDs) and dietitians working in insurance pharmacies and drugstores and to clarify employment issues.

Methods: A self-administered questionnaire survey was conducted with 153 RDs and dietitians (67 companies) who participated in the 14th Study Group on Pharmacy RDs on November 19, 2019. The valid response rate was 96.1% (RDs: 96.0%, dietitians: 100%), and the valid response rate from each representative of the participating companies was 100%. We conducted a qualitative analysis of the employment issues.

Results: A majority of the respondents were RDs (98.6%) who worked in the Kanto region (65.3%), were in their 20s (74.8%), had been certified for less than 5 years (69.4%), and had been working for their companies for less than 3 years (64.0%). They were engaged in nutritional counseling and seminars while working as medical clerks. Through qualitative analysis, employment issues were classified into "dedication and time to work," "understanding and cooperation with the insurance pharmacy and patients," and "lack of knowledge and experience," and further categorized into the perspectives of "work balance," "expertise and job content (business skills)," "work productivity," "relationships with other professions," and "relationships with the insurance pharmacy."

Conclusions: To address employment problems, it is necessary to enable collaboration with others in the same industry, improve the educational environment, and expand support from the government and other organizations.