Objectives　At the beginning of the COVID-19 pandemic, the number of infected children was lower than that of adults. Most cases were transmitted in the family, asymptomatic, and severe cases were rare. In the sixth wave in Japan the number of infected children increased sharply after the Omicron variant had been replaced in December 2021, which had a substantial influence in maintaining social and medical functions. Furthermore, few reports on child death in the country have raised concerns among parents. However, no literature has elucidated the epidemiological characteristics of the Omicron variant in children. In this study, we aimed to clarify them during the sixth wave in Japan.

Methods　We analyzed the data of 28,086 COVID-19-infected patients those were registered in the Yamashirokita Public Health Center between January 15, 2022 and May 31, 2022. The cumulative incidence and hospitalization rate were compared between the age groups <15 and those >15 years based on the databases compiled by our public health center and the Kyoto prefecture government. In addition, we analyzed the background, length of hospitalization, and clinical symptoms of 24 patients based on active epidemiological investigation, health observations, and discharge reports submitted from medical facilities.

Results　Of the 52,897 residents <15 years (pediatric population is 12.3%), 15.1% (7,980 cases) were infected, and children accounted for 28.4% of all-age infected patients. Among them, 24 were hospitalized (0.3% of children with COVID-19, 0.04% of the child population). Conversely, of the 377,093 residents aged ≥15 years, 5.3% (20,106 patients) were infected. Among them, 1,088 were hospitalized (5.4% of COVID-19 patients, 0.28% of the adult population). For 24 hospitalized children, 22 (91.6%) had mild cases and 2 (8.3%) had moderate cases, and no severe case was noted based on the criteria of severity in Japan's COVID-19 medical care guidelines. Two patients (8.3%) were hospitalized for treatment of other diseases. The median of hospital stay was 3.5 days, and 20 patients (83.3%) were discharged home during the recuperation period.

Conclusions　The cumulative incidence of children with COVID-19 in the sixth wave was 15.1%, approximately three times higher than that of the older patients; however, no severe case was observed in children.

Objectives　This study aimed to develop scales for evaluating the level of implementation of community practices and explore the perception of public health nurses in municipalities regarding their community practices.

Methods　Draft scales were developed based on a literature review and interviews with municipal public health nurses. Subsequently, a questionnaire survey was conducted with municipal public health nurses across Japan in response to these draft scales. Respondents were recruited based on the municipality population size. Questionnaires were distributed to 2,074 individuals from 52 municipalities ensuring representation from diverse municipalities. Exploratory factor analysis was performed to determine the number of factors, while confirmatory factor analysis was performed to determine the factor structure. The reliability of the scales was assessed by calculating Cronbach's alpha coefficients, and their validity was tested by examining correlations with existing scales, namely the Moral Competence Scale for Public Health Nurses and the Professional Identity Scale for Public Health Nurses, and years of experience as a public health nurse.

Results　A total of 721 (34.8%) valid respondents were included in the analysis. Three scales, methods of community practices (three factors, nine items), perceptions of public health nurses toward community residents through community practices (three factors, 10 items), and organizational environment supporting community practices (two factors, 11 items) were developed as indicators of the implementation of public health nurses' community practices. Cronbach's alpha coefficients for the three scales were 0.896, 0.913, and 0.868, respectively. As hypothesized, each subfactor exhibited a positive correlation with the existing scales. However, certain subfactors did not demonstrate any correlation with years of experience.

Conclusion　The three scales developed in this study were individually examined for reliability and validity. These scales can be used independently or in combination, allowing public health nurses to select the most suitable scale(s) based on their objective.

　A notable contribution of this study is the establishment of concrete indicators for evaluating community practices, addressing the previously vague nature of this evaluation. By incorporating the scale items into daily health practices, we anticipate that these indicators can be employed to evaluate community practices at the organizational and individual levels.

Objectives　“Rest” has two aspects: “repose,” to recover from physical or mental fatigue, and “restore,” to re-establish physical, mental, and social health. Many male workers work for prolonged hours, and despite stress, they do not apply coping behaviors, unlike female workers. Consequently, taking sufficient rest is difficult for male workers. The aim of this study was to develop a scale incorporating multiple factors to evaluate the state in which male workers take rest.

Methods　A questionnaire survey was conducted involving 330 male workers aged 20–59 years who had been engaged in two manufacturing industries. The questionnaire items were created with reference to an interview survey of male workers in the literature. After discussing with industrial hygiene experts and conducting a pretest to obtain surface validity, 70 items were used for analyses. In the exploratory factor analysis, promax rotation was used with the maximum likelihood method. In the confirmatory factor analysis, goodness of fit was confirmed with the covariance structure analysis. Health-related quality of life, job stress, work engagement, sleep, and self-assessment of rest were used to examine concurrent validity.

Results　With the exploratory factor analysis, we introduced a scale containing 15 items, including three subscales: filling with spirit, enthusiasm for work, and recovery from fatigue. The reliability coefficient (Cronbach's alpha) of the three subscales and the overall scale ranged from 0.79 to 0.88 and 0.89, ensuring internal consistency. The confirmatory factor analysis showed a generally good fit. Their scores were correlated with many items of the health-related quality of life, job stress, work engagement, sleep, and self-assessment of rest.

Conclusions　A 15-item “Rest Evaluation Scale” was created to evaluate the state in which male workers in the manufacturing industries take rest. Since the validity, reliability, and concurrent validity of this scale were satisfactory, this scale was considered to be an index evaluating the state of rest of male workers.

Objectives　Policies promoting community integration of individuals with mental disabilities have increased the need for community advocacy. This study aimed to identify situations in which individuals with mental disabilities perceive the need for advocacy support and how to deal with them.

Methods　In this qualitative descriptive study, group interviews were conducted with 13 peer advocates and 12 individuals with mental disabilities. A verbatim transcript of the interviews was created. Categories were generated by raising the level of abstraction from the perspective of “Situations where individuals with mental disabilities require advocacy support and how to address them.”

Results　Situations requiring advocacy support occurred in outpatient psychiatry settings, psychiatric hospitalizations, welfare facilities, schools, neighborhoods, and places of employment; among family and relatives; and at consultation services. In outpatient psychiatry, “difficulties in accessing medical care” were reported. In psychiatric hospitalizations, participants felt “pressured and unable to escape the environment.” In welfare facilities, “romantic relationships between users were discouraged.” Regarding familial difficulties, “limited understanding and acceptance of the disease,” “relationship deterioration due to poor hospitalization conditions and forced hospitalization,” and “marital difficulties due to mental illness” were prevalent. Participants in schools experienced “isolation due to their illness,” and in the local community, there were “problems related to reasonable accommodation of individuals with disabilities in neighborhood association activities.” Employed participants faced “inadequate consideration despite disclosing their illness to co-workers.” At counseling institutions, participants felt “forced to endure without resolution when consulting.” Individuals with disabilities coped with these situations by “transferring to a different clinic” or “changing facilities,” but in the case of psychiatric hospitalization, they gave up and “did not go against the staff.”

Conclusion　Individuals with mental disabilities need advocacy support for psychiatric care and diverse situations such as family, school, and community engagement. Efforts should be made to introduce an advocacy system in psychiatric hospitals and to disseminate accurate information about mental illness to high-risk age groups. Moreover, it is necessary to disseminate knowledge of reasonable accommodation and appropriate responses to individuals with mental illness. Peer advocates should educate individuals with disabilities about their rights and encourage proactive measures.