Ryoji Shinohara

Association Between Maternal Smoking During Pregnancy and Birth Weight: An Appropriately Adjusted Model From the Japan Environment and Children’s Study

Background There has been no large nationwide population-based study to examine the effects of maternal smoking status during pregnancy on birth weight that simultaneously controlled for clinical information, socioeconomic status, and maternal weight. Thus, this study aimed to determine the association between maternal smoking status during pregnancy and birth weight, while taking these confounding factors into consideration. Methods This study examined the first-year fixed dataset from a large nationwide birth cohort study that commenced in 2011. The dataset consisted of information on 9369 singleton infants born before December 31, 2011. Children were divided into 4 groups for statistical analysis: those born to mothers who did not smoke (NS), who quit smoking before pregnancy, who quit smoking during early pregnancy, and who smoked (SM). Multiple linear regression models were conducted for each sex to examine the association between maternal smoking status during early pregnancy and fetal growth. Birth weight was estimated using the least-squares method after controlling for covariates. Results After controlling for potential confounding factors, maternal smoking status during pregnancy was significantly associated with birth weight. There was a significant difference in birth weight between NS and SM for both male and female infants (male infants, 3096.2 g [NS] vs 2959.8 g [SM], P < 0.001; female infants, 3018.2 g [NS] vs 2893.7 g [SM], P < 0.001). Conclusions Using data from a large nationwide birth cohort study in Japan, we have shown that maternal smoking during pregnancy may reduce birth weight by 125–136 g.

A Pilot Study of Social Competence Assessment Using Interaction Rating Scale Advanced

Purpose. The purpose of this paper is to clarify the validity of the Interaction Rating Scale Advanced (IRSA) as an evidence-based practical index of social skills. Methods. The participants in our study were 17 high school students. The participants completed the five-minute interaction session and were observed using the IRSA. Their teacher evaluated their social competence based on regular observation in school. Results. The results indicated the high correlation between IRSA scores and teachers practical evaluation. IRSA can measure social competence with high validity. Conclusion. The IRSA provides further evidence of the fact that in order to study social competence development, it is important to evaluate various features of the interaction like IRSA subscales.

Interaction Rating Scale (IRS) as an Evidence-Based Practical Index of Children’s Social Skills and Parenting

Background The purpose of this paper is to describe the features of the Interaction Rating Scale (IRS) as an evidence-based practical index of children’s social skills and parenting. Methods The participants in our study, which was conducted as part of a Japan Science and Technology Agency (JST) project, were 370 dyads of children (aged 18, 30, and 42 month) and 81 dyads of 7-year-old children with their caregivers. The participants completed the five minute interaction session and were observed using the IRS. Results The results indicated that the IRS can measure children’s social skill development and parenting with high validity. Along with the discriminate validity for pervasive development disorder (PDD), attention-deficit/hyperactivity disorder (ADHD), abuse and maltreatment, a high correlation with the SDQ (Strength and Difficulties Questionnaire), and high reliability, the IRS is effective in describing features of social skill development. Conclusions The IRS provides further evidence of the fact that in order to study children’s social skill development, it is important to evaluate various features of the caregiver-child interaction as a predictor of social skills.

Evaluation of the associations between changes in intraocular pressure and metabolic syndrome parameters: a retrospective cohort study in Japan

Objective The contributions of highly correlated cardiovascular risk factors to intraocular pressure (IOP) are not clear due to underlying confounding problems. The present study aimed to determine which metabolic syndrome parameters contribute to elevating IOP and to what extent. Design Retrospective cohort study. Setting A private healthcare centre in Japan. Participants Individuals who visited a private healthcare centre and underwent comprehensive medical check-ups between April 1999 and March 2009 were included (20 007 in the cross-sectional study and 15 747 in the longitudinal study). Primary and secondary outcome measures Changes in IOP were evaluated in terms of ageing and changes in metabolic syndrome parameters. Pearsons correlation coefficients and mixed-effects models were used to examine the relationship of changes in IOP with ageing and changes in metabolic syndrome parameters in cross-sectional and longitudinal studies, respectively. Results In the cross-sectional study, IOP was negatively correlated with age and positively correlated with waist circumference, high-density lipoprotein cholesterol (HDL-C) levels, triglyceride levels, systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting plasma glucose (FPG) levels. In the longitudinal multivariate analysis, the associated IOP changes were −0.12 (p<0.0001) mm Hg with male sex; −0.59 (p<0.0001) mm Hg with 10 years of ageing; +0.42 (p<0.0001) mm Hg with 1 mmol/L increase in HDL-C levels; +0.092 (p<0.0001) mm Hg with 1 mmol/L increase in triglyceride levels; +0.090 (p<0.0001) mm Hg with 10 mm Hg increase in SBP; +0.085 (p<0.0001) mm Hg with 10 mm Hg increase in DBP; and+0.091 (p<0.0001) mm Hg with 1 mmol/L increase in FPG levels. Conclusions Elevation of IOP was related to longitudinal worsening of serum triglyceride levels, blood pressure and FPG and improvement in serum HDL-C levels.

Maternal Smoking During Pregnancy and Growth in Infancy: a Covariance Structure Analysis

Background Smoking during pregnancy is related to fetal constraint and accelerated postnatal growth. However, the pathways between these factors have not been clarified. Pathway analyses that link these factors can help us better understand the mechanisms involved in this association. Therefore, this study aimed to examine pathways between maternal smoking during pregnancy and growth in infancy. Methods Participants were singletons born between 1993 and 2006 in rural Japan. The outcome was the change in weight z-score between birth and 3 years of age. Pathways from maternal smoking and other maternal factors (such as maternal body mass index and work status) to growth in infancy via birth factors (such as birth weight and gestational age) and breastfeeding were examined using structural equation modeling. Results Complete data were available for 1524 children (775 boys and 749 girls). The model fit appeared adequate. Lower birth weight and non-exclusive breastfeeding mediated the association between maternal smoking during pregnancy and rapid growth in infancy. Maternal smoking was also directly linked to rapid growth in infancy (standardized direct effects 0.06, P = 0.002). Taking all pathways into account, the standardized total effect of maternal smoking on growth in infancy was 0.11. Conclusions Maternal smoking during pregnancy may both indirectly, through birth weight and breastfeeding status, and directly influence growth during infancy; however, there may be other pathways that have not yet been identified.

Factors Associated With Health Service Utilization in Ulaanbaatar, Mongolia: A Population-Based Survey

Background Understanding patterns of health service utilization can improve health care and increase use of health services. We examined patterns of health service utilization among residents of Ulaanbaatar, Mongolia. Methods A total of 500 adults were surveyed using paper-based questionnaires. The χ2 test and multiple logistic regression were used to identify associations between factors. Results 44.1% of respondents had visited a physician during the previous 12 months. After controlling for determinants, the significant predictors of utilization of health service were attention to health examinations (OR = 3.6, CI: 1.93–6.76), being married (OR = 2.7, CI: 1.50–4.72), being satisfied with the overall cleanliness of the hospital (OR = 2.4, CI: 1.12–5.19), being a nonsmoker (OR = 2.2, CI: 1.21–3.98), having periodic physical examinations (OR = 2.2, CI: 1.25–3.71), not being a hospital patient during the previous 3 years (OR = 2.1, CI: 1.22–3.73), having proper documentation (OR = 1.9, CI: 1.10–3.43), having medical insurance (OR = 1.9, CI: 1.96–3.28), not wanting to receive information on food and nutrition (OR = 0.6, CI: 0.36–0.96), having more than 5 household members (OR = 0.5, CI: 0.50–0.85), low income (OR = 0.5, CI: 0.30–0.85), lack of concern for food and nutrition (OR = 0.5, CI: 0.28–0.84), self-medication during the past 12 months (OR = 0.4, CI: 0.24–0.69), and desire for treatment abroad (OR = 0.4, CI: 0.20–0.60). Conclusions A number of health-related behaviors and sociodemographic factors were important predictors of health service utilization.

Perceiving active listening activates the reward system and improves the impression of relevant experiences

Although active listening is an influential behavior, which can affect the social responses of others, the neural correlates underlying its perception have remained unclear. Sensing active listening in social interactions is accompanied by an improvement in the recollected impressions of relevant experiences and is thought to arouse positive feelings. We therefore hypothesized that the recognition of active listening activates the reward system, and that the emotional appraisal of experiences that had been subject to active listening would be improved. To test these hypotheses, we conducted functional magnetic resonance imaging (fMRI) on participants viewing assessments of their own personal experiences made by evaluators with or without active listening attitude. Subjects rated evaluators who showed active listening more positively. Furthermore, they rated episodes more positively when they were evaluated by individuals showing active listening. Neural activation in the ventral striatum was enhanced by perceiving active listening, suggesting that this was processed as rewarding. It also activated the right anterior insula, representing positive emotional reappraisal processes. Furthermore, the mentalizing network was activated when participants were being evaluated, irrespective of active listening behavior. Therefore, perceiving active listening appeared to result in positive emotional appraisal and to invoke mental state attribution to the active listener.

Childhood Growth Trajectories According to Combinations of Pregestational Weight Status and Maternal Smoking during Pregnancy: A Multilevel Analysis

Pregestational weight status and maternal smoking during pregnancy are significantly associated with fetal and childhood growth. However, few studies have examined associations between childhood growth and combinations of these factors using multilevel analysis. This study aimed to describe differences in childhood growth trajectories according to these combinations, using data from a prospective cohort study in Japan. The study participants were 1,973 women and their singletons, who were born between April 1, 1991 and March 31, 2003. Children were categorized according to whether they were born to normal-weight, nonsmoking mothers (NN); normal-weight, smoking mothers (NS); underweight, nonsmoking mothers (UN); underweight, smoking mothers (US); overweight, nonsmoking mothers (ON); or overweight, smoking mothers (OS). Birth weight and anthropometric data were collected from 1,965 children at birth (99.6%), 1,655 aged 3 (83.9%), 1,527 aged 5 (77.4%), 1,497 aged 7–8 (75.9%), and 1,501 aged 9–10 (76.1%). Multilevel analysis examining both individual and age as different level variables according to sex was used to describe the trajectories of body mass index z scores for statistical analyses. Although children of the OS group were the leanest at birth, their body mass indices had increased rapidly by 3 years of age. Moreover, body mass index was also likely to increase in boys in the NS and ON groups. A different trend was observed in girls. Body mass index decreased from 5 years of age in girls in the US group. There were no remarkable differences in body mass index trajectories between children in the other groups. In conclusion, childhood growth trajectories differed according to combinations of pregestational weight status and maternal smoking during pregnancy. Further, there were sex-related differences in the associations between childhood growth and factor combinations.

Adolescent growth in overweight and non-overweight children in Japan: a multilevel analysis.

BACKGROUND A trend towards earlier pubertal growth has been identified along with an increase in childhood obesity rates. The study aimed to identify the differences in growth patterns during adolescence between overweight/obese and non-overweight children in Japan. METHODS The participants were children from a prospective cohort study called Project Koshu, who were born between 1991 and 1998, in Japan. They were classified as overweight/obese or non-overweight according to their body mass index (BMI) in the first grade of elementary school (6-7 years of age) and were followed until graduation from junior high school (14-15 years of age). Anthropometric data were collected at an annual medical check-up in their school. Height gain trajectories were constructed by BMI categories using multilevel analyses. This analysis was stratified by gender. RESULTS Overall, 111/850 (13.1%) girls and 109/911(12%) boys were defined as overweight/obese at baseline. Approximately 80% of the children were followed until the third grades of junior high school. Overweight/obese girls gained more height in the first half period, reached their peak height gain about a year earlier than non-overweight girls, and experienced an earlier decline in height gain. Similarly, overweight/obese boys gained more height than non-overweight boys initially. Additionally, non-overweight boys maintained a higher rate of height gain from the age at peak height gain, although the age at peak height gain did not differ between the two groups. CONCLUSIONS The overweight/obese children grew faster than the non-overweight children in the early pubertal stages, and the non-overweight children caught up and exceeded in height gain at a later stage.

The Trajectory of Children's Social Competence from 18 Months to 30 Months of Age and Their Mother's Attitude towards the Praise

Background Praise from caregivers has been shown as an important influence on the development of social competence in early adolescence. However, the effects of praise in younger children have not been investigated. We examined how the trajectory of children’s social competence from 18 months to 30 months of age was related to their caregiver’s attitude towards the importance of praise at times when their child was 4 months and 9 months old. Methods We studied 155 mother-child dyads, whose interactions during play were observed both when the child was 18 months and 30 months old, which was conducted as part of a Japan Science and Technology Agency (JST) project. The child’s social competence was assessed using the Interaction Rating Scale (IRS). Demographic data was obtained when the child was 4 months old, and the caregiver’s attitude towards the importance of praise when the child was both 4 months and 9 months old. A logistic regression analysis controlling for the effects of demographic variables was performed. Results We found that children who had received continuous praise from their mother when they were 4–9 months of age had a decreased risk of low social competence at 18–30 months of age. Conclusions A mother’s attitude towards the importance of praise at early stages of her child’s development has an important influence on the later trajectory of social competence.