Toshiki Katsura

The effects of coaching on salivary cortisol stress marker in mothers with young children, a randomized controlled trial.

Objectives: The purpose of this study was to evaluate the effects of a coaching program on saliva cortisol sensitivity in normal healthy mothers with young children. Methods: A randomized controlled trial (RCT) was conducted with objective and subjective outcome measurements of the stress indicator. A postal survey to assess emotional intelligence (EI) was administered by random sampling to mothers of young children aged 3 months to 6 years in Japan. A total of 74 mothers with median EI scores or lower were enrolled in a RCT involving the coaching program. The intervention group received a 3-month coaching program. The control group was given the coaching program at follow-up. Stress state outcomes (saliva cortisol level, EI score, and Profile of Mood States (POMS)) were measured at baseline and immediate follow-up, with salivary cortisol measured again at a one-month follow-up. Results: Significant differences were found for saliva cortisol level and the EI score within and between the intervention and control groups. Some POMS subscale scores were significantly different within the intervention and control groups. Conclusion: The participants in the coaching program had significantly reduced saliva cortisol levels and better secondary outcomes than those in the control group.

The development of a town of safety, security and health project in an area with a very high population aging rate: -the activities of a community salon on a shopping street and their assessment-.

Objective: The aim of this study was to assess the “Health Care Town in Kyoto” project designed to promote health and safety for health conscious people in a small community. We conducted a survey involving the users of the salon and local residents to examine the effects of the activities in the salon. Methods: We recorded the activities of salon and conducted semi-structured interviews with ten local residents to ask their opinions about the salon. The data from the interviews were analyzed using the Grounded Theory Approach. We distributed a questionnaire and collected 215 valid responses (valid response rate: 67.8%). Results: 1) Purpose of using the salon was categorized into health consultation, conversation with others, rest and other purpose. 2) The significance of the salon for users was categorized into usability, acquisition of useful information, changes in daily habits and their maintenance, diversion, interaction with other people and acceptance by the shopping center. 3) The results of the questionnaire survey showed marked relations between Well-Being Index (WHO-5), age, employment and family budget, self-rated health and ability to perform daily activities (TMIG), whereas use of the salon was not associated with Well-Being Index (WHO-5). On the other hand, there were marked relations between loneliness (LSO), educational background and use of the salon, demonstrating that the facility helped its users reduce loneliness (LSO). Conclusion: In this town, the salon has served as a place providing effective preventive support for the health of individual users.

Relations of mother’s sense of coherence and childrearing style with child’s social skills in preschoolers

BackgroundWe examined the relationships between mothers’ sense of coherence (SOC) and their child’s social skills development among preschool children, and how this relationship is mediated by mother’s childrearing style.MethodsMothers of 1341 Japanese children, aged 4–5 years, completed a self-report questionnaire on their SOC and childrearing style. The children’s teachers evaluated their social skills using the social skills scale (SSS), which comprises three factors: cooperation, self-control, and assertion.ResultsPath analyses revealed that the mother’s childrearing mediated the positive relationship between mother’s SOC and the cooperation, self-control, and assertiveness aspects of children’s social skills. Additionally, there was a significant direct path from mother’s SOC to the self-control component of social skills.ConclusionsThese findings suggest that mother’s SOC may directly as well as indirectly influence children’s social skills development through the mediating effect of childrearing. The results offer preliminary evidence that focusing on support to improve mothers’ SOC may be an efficient and effective strategy for improving children’s social skills development.

An Analytical Model / Emotional Intelligence Quotient and QOL in Mothers with Infants in Japan.

Objective: The purpose of this study was to examine the relationship between the emotional intelligence quotient and health-related quality of life using structural equation modeling. Methods: A self-administered questionnaire survey was conducted among 1,911 mothers who visited the Health Center for an infant medical examination. A hypothetical model was constructed using variables of the emotional intelligence quotient, social support, coping, parenting stress, and perceived health competence. Result: There were a total of 1,104 valid responses (57.8%). Significant standardized estimates were obtained, confirming the goodness of fit issues with the model. The emotional intelligence quotient had a strong impact on physical and psychological quality of life, and showed the greatest association with coping. This study differed from previous studies in that, due to the inclusion of social support and explanatory variables in coping, an increase in coping strategies was more highly associated with emotional intelligence quotient levels than with social support. Conclusion: An enhanced emotional intelligence quotient should be considered a primary objective to promote the health of mothers with infant children.

Visual recognition of the elderly concerning risks of falling or stumbling indoors in the home: -comparison of visual attention points among elderly, middle aged and young individuals-.

Objective: The objective of this study was to verify the recognition of dangers and obstacles within a house in the elderly when walking based on analyses of gaze point fixation. Materials and Methods: The rate of recognizing indoor dangers was compared among 30 elderly, 14 middle-aged and 11 young individuals using the Eye Mark Recorder. Results: 1) All of the elderly, middle-aged and young individuals showed a high recognition rate of 100% or near 100% when ascending outdoor steps but a low rate of recognizing obstacles placed on the steps. They showed a recognition rate of about 60% when descending steps from residential premises to the street. The rate of recognizing middle steps in the elderly was significantly lower than that in younger and middle-aged individuals. Regarding recognition indoors, when ascending stairs, all of the elderly, middle-aged and young individuals showed a high recognition rate of nearly 100%. When descending stairs, they showed a recognition rate of 70-90%. However, although the recognition rate in the elderly was lower than in younger and middle-aged individuals, no significant difference was observed. 2) When moving indoors, all of the elderly, middle-aged and young individuals showed a recognition rate of 70%-80%. The recognition rate was high regarding obstacles such as floors, televisions and chests of drawers but low for obstacles in the bathroom and steps on the path. The rate of recognizing steps of doorsills forming the division between a Japanese-style room and corridor as well as obstacles in a Japanese-style room was low, and the rate in the elderly was low, being 40% or less. Conclusion: The rate of recognizing steps of doorsills as well as obstacles in a Japanese-style room was lower in the elderly in comparison with middle-aged or young individuals.

Association between mobile technology use and child adjustment in early elementary school age

The time that children spend using digital devices is increasing rapidly with the development of new portable and instantly accessible technology, such as smartphones and digital tablets. Although prior studies have examined the effects of traditional media on children’s development, there is limited evidence on the impact of mobile device use. The current study aimed to clarify the link between mobile device use and child adjustment. The sample included 1,642 children aged 6 in first grade at elementary schools in Japan. Parents completed a self-report questionnaire regarding their children’s use of mobile devices and emotional/behavioral adjustment. We performed inverse probability of treatment weighted (IPTW) logistic regression to compute odds ratios (OR) for emotional/behavioral problems according to mobile device use. The values for IPTW analysis were computed based on variables assessing sociodemographics and child characteristics. Among the participants, 230 (14.0%) were regular users (60 minutes or more on a typical day) and 1,412 (86.0%) non-regular users (under 60 minutes on a typical day). Relative to non-regular use, regular use of mobile devices was significantly linked to conduct problems (IPTW-OR: 1.77, 95% CI: [1.03–3.04], p < .05) and hyperactivity/inattention (IPTW-OR: 1.82, 95% CI: [1.15–2.87], p < .01). Based on these results, routine and frequent use of mobile devices appear to be associated with behavioral problems in childhood.

Effect of socioeconomic status on behavioral problems from preschool to early elementary school – A Japanese longitudinal study

Purpose Social inequalities are widely accepted to have a deleterious effect on children’s mental health, and those with lower socioeconomic status generally experience more mental health issues. In this study, we examine the impact of socioeconomic situations of children’s families during their early childhood on the children’s social adaptation in Japanese elementary school. Methods The current investigation consisted of two sets of data relating to two separate years (with a one-year interval). The participants included preschoolers aged five years at Time 1 (the first year) and first graders aged six years at Time 2 (the second year); 1,712 met the inclusion criteria for both years. Parents of the participants completed a self-reported questionnaire regarding their SES (i.e., family economy and mother’s education) and their children’s mental health. Mental health was assessed using the Child Behavior Checklist/4–18, Parent Report. Results For each SES indicator, we found an inverse relationship across all the symptom dimensions. Specifically, bivariate analyses revealed that lower family income, maternal education level, and paternal education level predict all three domains of behavioral problems (i.e., internalized problems, externalized problems, and total behavioral problems). Further, multivariate analyses revealed that lower family income consistently predicts all domains of behavioral problems, lower maternal education level predicted externalized problems and total behavioral problems, and paternal education level did not predict any clinically significant behavioral problems. Conclusion In this sample, we found that, for children, family income and parental education when entering preschool were significant predictors of mental health problems after elementary school enrollment; in particular, low income and low maternal educational achievement predicted a high probability of the development of a psychiatric disorder. A greater understanding of the mechanisms of these associations could contribute to improvements in interventions aimed at preventing child maladjustment.

A cohort study on elderly individuals newly certified as requiring long-term care: comparison of rates of care-needs certifications between basic checklist respondents/specific health examinees and non-respondents/non-examinees of 37,000 elderlies in a city

Objective: The rates of care-needs certification were mainly compared between two cohorts: 7,820 specific health checkup examinees/basic checklist respondents and 29,234 non-examinees/non-respondents. Subjects and Methods: Among approximately 37,000 elderly citizens of X City, the number of individuals newly certified as requiring long-term care were observed from the date of the first specific health checkup in 2008 to March 31, 2013. The aggregated totals of these individuals and associated factors were evaluated. Results: 1. Support Required 1, Support Required 2, and Long-term Care Required (level 1) certified individuals accounted for approximately 80% of newly certified individuals aged 65–74 years. Newly certified individuals aged 75 years and over had similar results with 37.2% of them being certified Support Required 1, 19.4% certified Support Required 2, and 22.9% certified Long-term Care Required (level 1). 2. The primary factors for care-needs certification in individuals aged 65–74 years were arthritic disorder in 27.6%, falls and bone fractures in 11.3%, and malignant neoplasm and cerebrovascular disease, among others. This was similar for individuals aged 75 years or over. 3. Of the 7,820 specific health checkup examinees/basic checklist respondents, 1,280 were newly certified as requiring long-term care (16.4%) compared to 7,878 (26.9%) of the 29,234 non-examinees/non-respondents. Therefore, the latter cohort had a significantly higher rate of individuals who were newly certified as requiring long-term care. Conclusion: Both specific health checkups and basic checklists are effective health policies to protect frailty in community elderlies.

A retrospective cohort study on the risk assessment of newly certificated long-term care need of elderly individuals in a community: Basic checklist and specific health checkup

Objective: This study aimed to examine the factors influencing the requirement of a certificate of long-term care using a basic checklist and items listed in the Special Health Checkup. Method: This study included 7,820 individuals living in Uji city, who were selected from among 8,000 elderly individuals who, in 2008, underwent a specific health checkup (hereafter referred to as the ‘specific health checkup for the old-old elderly individuals’) for those aged 75 years and above. They answered questions from basic checklists at the time, and 180 individuals were excluded as they had already qualified for requiring the certificate of long-term care at the time of the checkup. The follow-up period extended from the day of the specific health checkup for the old-old elderly individuals to March 31, 2013. The data were analyzed using the certificate of needing long-term care as the response variable. The explanatory variables were the basic attributes, items listed in the specific health checkup for the old-old elderly individuals, interview sheets, and basic checklists. Cox proportional hazards regression analysis was conducted. Results: In total, 1,280 elderly individuals qualified for requiring the certificate of needing long-term care. The risk factors for the young-old elderly individuals aged 65 to 74 years were as follows: hepatic dysfunction (hazard ratio {HR}=1.69), the presence of subjective symptoms (HR=1.41), an above-normal abdominal circumference (HR=1.36), old age (HR=1.13), a reduced frequency of going out since the previous year (HR=1.87), the use of support for standing up after being seated on a chair (HR=1.86), no deposit or withdrawals made (HR=1.84), the anxiety of falling down (HR=1.50), an inability to climb stairs without holding a railing or wall (HR=1.49), as well as an increased difficulty in eating tough food items compared with 6 months prior (HR=1.44). The risk factors for the old-old elderly individuals were as follows: a positive reaction on proteinuria (HR=1.27), anemia (HR=1.18), old age (HR=1.10), inability to travel on a bus or train by themselves (HR=1.53), the inability to climb stairs without holding a railing or wall (HR=1.48), weight loss (HR=1.36), a reduced sense of appreciation of the activities they had previously participated in, over a span of 2 weeks (HR=1.30), the use of support for standing up after being seated on a chair (HR=1.23), and the anxiety of falling down (HR=1.20). Conclusion: The items listed in the specific medical checkup as well as the basic checklists were found to be risk factors for both the young-old elderly individuals and the old-old elderly individuals, indicating the need to utilize these lists for the prevention of nursing even in the late stages of life. Moreover, these results suggest the importance of screening elderly individuals suffering from hyperkinesis using the basic checklist and conducting preventive interventions in order to maintain and improve their physical functions.

Progress in Systematization of Discharge Planning in Medical Institution in Japan.

無作為に抽出した全国の医療機関に退院計画システム化の進捗状況について調査を行った。その結果退院調整専門職がいる医療機関は約20%であった。今後医療機関が退院計画の実施によってケアの質を高めるためには, 退院計画のシステム化, 退院調整専門職や退院計画部門の設置, 患者や家族の参加による退院計画の立案と修正, 社会資源に関する十分な情報の開示, 効率的なスクリーニングとモニターリングおよびフォローアップシステムの整備, 外来機能の見直しや訪問看護部門の設置と充実, 関連諸機関との連携強化等が課題であることが明らかになった。