Association of Spousal Social Support in Child-Rearing and Marital Satisfaction with Subjective Well-Being among Fathers and Mothers.

This study explored the association of spousal support and marital satisfaction with the subjective well-being of fathers and mothers using a mediation analysis. Data were gathered from 360 fathers and 338 mothers (aged 25-50 years). Subjective well-being was measured as an outcome using the Japanese version of the World Health Organization-Five Well-Being Index. Marital satisfaction was measured as a mediating variable using the Japanese version of the Marital Relationship Satisfaction Scale. Spousal social support (including instrumental, emotional, and appraisal support) was measured as an independent variable using four-point scales. Control variables were the father's and mother's ages, number of children, age of the youngest child, children going to nursery school or kindergarten, use of childcare services, self-evaluated low economic status, and weekday working hours. Among fathers, instrumental and emotional support had significant direct and indirect effects, with the latter mediated by the impact of marital satisfaction on subjective well-being; appraisal support had only significant indirect effects. Among mothers, instrumental support had significant direct and indirect effects; emotional and appraisal support had only significant indirect effects. Our findings indicate that social support from spouses has protective direct and indirect effects on subjective well-being among parents and suggest the need for mutual support between spouses to facilitate effective co-parenting.

Mixed-methods research of motivational processes in workers' adoption of healthy behavior.

BACKGROUND: In occupational health, the maintenance and promotion of workers' health, especially lifestyle motivation-based interventions, have gained considerable attention and are actively implemented. Motivational theories include self-determination theory, and some studies focus on healthy lifestyles. However, the effectiveness of health promotion interventions varies depending on the health awareness and motivation of the participants. Therefore, this study aimed to clarify the processes by which workers are motivated to improve their health and to identify the need for and type of support according to their motivation. METHODS: Using a mixed-research design, an initial questionnaire survey of 94 employees (mean age = 40.97 ± 9.65) at a multicenter company in Japan, followed by semi-structured interviews with 16 employees (mean age = 40.13 ± 9.45) from the high- and low-motivation groups, were conducted. Multiple regression analysis followed by modified grounded theory-based analysis of the results of the first stage was used and the quantitative and qualitative results were integrated. RESULTS: In the first stage, autonomous motivation scores were predicted by the behavioral change stage and relatedness satisfaction/frustration. The second stage revealed that "the process of reflecting and managing one's own health while receiving support and feedback for maintaining and improving health" was the motivational process of workers. Result integration revealed that motivation increased through repeatedly escaping and adjusting to real problems and situational coping until the behavioral change. Despite interruptions during behavioral change, receiving feedback from others could increase motivation and continued behavioral change. CONCLUSION: Regardless of their level of motivation for health behaviors, workers indicated that support from others was essential. The nature of this support was found to range from providing information to offering feedback. Interventions individualized by the identified process could enable customized motivation-driven health guidance.

A Thickening Agent Using Dioscorea japonica Powder Exhibits Suitable Properties for People with Dysphagia.

In an aging society, the novel concept of added food functionality in a dysphagia diet is necessary for preventing diseases and maintain nutrition intake. The present study evaluated the utilization of Dioscorea japonica as a thickened liquid for people with dysphagia due to its unique physical properties and beneficial effects on chronic inflammation. The viscosity of the prepared thickened liquid using freeze-dried Dioscorea japonica powder was compared with those of xanthan gum and commercially available thickened liquids in selected conditions resembling to cooking. Dioscorea japonica powder showed high versatility, because the viscosity of its thickened liquid could be easily adjusted by modifying its blending amount and temperature. The thickened liquid of Dioscorea japonica had the most stable viscosity among the thickened liquids when NaCl was added and exhibited excellent resistance to α-amylase, similar to that of the other thickened liquids. The viscosity of the thickened liquid of Dioscorea japonica was relatively stable on changing the pH, but it was slightly unstable when the temperature changed. Overall, the thickened liquid of Dioscorea japonica powder has excellent viscosity stability, comparable to or better than commercially available thickened liquids, and is expected to be used as a new thickened liquid with added food functionality.

Eight-Year Trends in the Effect of the Great East Japan Earthquake on Obstetrics Outcomes: A Study from the Fukushima Health Management Survey.

Information regarding the longitudinal effects of natural/environmental disasters on obstetrics outcomes is limited. This study aimed to analyze the longitudinal changes in obstetrics outcomes over 8 years after the Great East Japan Earthquake and the Fukushima power plant accident. We used data from the first 8 years of the Pregnancy and Birth Survey by the Fukushima prefectural government, launched in 2011. We compared data on obstetrics outcomes by year and divided Fukushima Prefecture into six districts based on administrative districts. Longitudinal changes in the occurrence of preterm birth before 37 gestational weeks, low birth weight, and anomalies in newborns were accessed using the Mantel-Haenszel test for trends in all six districts. Overall, 57,537 participants were included. In 8 years, maternal age, conception rate after sterility treatment, and cesarean section delivery incidence increased. Although significant differences were observed in preterm birth and low birth weight occurrence among districts, there was no significant trend in the occurrence of preterm birth, low birth weight, and anomalies in newborns in all six districts of Fukushima Prefecture. The Great East Japan Earthquake and Fukushima power plant accident were associated with increased cesarean section delivery incidence but had no significant adverse effects on obstetrics outcomes.

[Association between gender role attitudes and social support from mothers and paternal involvement in childcare].

Objective　Paternal involvement in child-rearing is an action goal of Healthy Parents and Children 21 (Tier 2), and should be actively promoted. Clarifying the related factors may contribute to countermeasures for promoting paternal involvement in child-rearing. This study aimed to examine the association between fathers' gender role attitudes and social support from their spouses (i.e., the mothers of the children) and their involvement in child-rearing.Methods　We obtained the data of fathers involved in childcare (aged 25-50 years; all full-time workers) through an internet research company. The paternal involvement in childcare scale (11 items, 4-point scale, e.g., "taking care of children," "cooking") was used as the dependent variable. The independent variables were gender role attitude ("Husbands should work outside the home and wives should take care of the home," 4-point scale) and social support from the mothers of the children (including appraisal, emotional, and instrumental support). The control variables were father's age, mother's employment status, number of children, the age of the youngest child, children going to nursery school or kindergarten, use of childcare services, self-evaluation of low economic status, work hours on weekdays, and marital relationship satisfaction.Results　The data of 360 men were analyzed (mean age 36.8 years, standard deviation 5.6). The results of the multivariable regression analyses with interaction terms are as follows: gender role attitude was significantly associated with childcare (ß=-0.103) and housework (ß=-0.125); appraisal support was significantly associated with childcare (ß=0.142) and housework (ß=0.199); and the interaction between gender role attitude and instrumental support was significant (ß=0.176), indicating that, in individuals with a high gender role attitude score, a higher level of instrumental support was related to a higher childcare score (ß=0.242).Conclusions　Fathers with egalitarian gender role attitudes and those who receive appraisal support from the other parent are more likely to participate in childcare. In addition, fathers with traditional gender role attitudes who receive instrumental support from the other parent may tend to participate in childcare.

Effects of External Radiation Exposure on Perinatal Outcomes in Pregnant Women After the Fukushima Daiichi Nuclear Power Plant Accident: the Fukushima Health Management Survey.

BACKGROUND: This study aimed to investigate the effects of maternal exposure to external radiation on perinatal outcomes among women who experienced the Fukushima Daiichi Nuclear Disaster (FDND) using the Fukushima Health Management Survey (FHMS). METHODS: Data from the Pregnancy and Birth Survey and Basic Survey in the FHMS were combined to analyze external maternal radiation exposure following the FDND, and the relationship between radiation dose and perinatal outcomes was analyzed using binomial logistic regression analysis. Missing dose data were supplemented using multiple imputation. RESULTS: A total of 6,875 individuals responded to the survey. Congenital anomalies occurred in 2.9% of patients, low birth weight (LBW) in 7.6%, small for gestation age (SGA; <10th percentile) in 8.9%, and preterm birth in 4.1%. The median maternal external radiation dose was 0.5 mSv (maximum, 5.2 mSv). Doses were classified as follows: <1 mSv (reference), 1 to <2 mSv, and ≥2 mSv. For congenital anomalies, the crude odds ratio for 1 to <2 mSv was 0.81 (95% confidence interval [CI], 0.56-1.17) (no participants with congenital anomaly were exposed to ≥2 mSv). At 1 to <2 mSv and ≥2 mSv, the respective adjusted odds ratios were 0.91 (95% CI, 0.71-1.18) and 1.21 (95% CI, 0.53-2.79) for LBW, 1.14 (95% CI, 0.92-1.42) and 0.84 (95% CI, 0.30-2.37) for SGA, and 0.91 (95% CI, 0.65-1.29) and 1.05 (95% CI, 0.22-4.87) for preterm birth. CONCLUSION: External radiation dose due to the FDND was not associated with congenital anomalies, LBW, SGA, or preterm birth.

The Effects of the Great East Japan Earthquake on Perinatal Outcomes: Results of the Pregnancy and Birth Survey in the Fukushima Health Management Survey.

There are limited studies on the long-term effects of natural/environmental disasters, especially nuclear disasters, on obstetric outcomes. This study aimed to review the results of perinatal outcomes immediately after the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi Nuclear Power Plant accident, as well as their long-term trends over 8 years, in the Fukushima Health Management Survey. The annual population-based Pregnancy and Birth Survey is conducted as part of the Fukushima Health Management Survey. The Fukushima Prefecture government launched it to assess the health conditions of pregnant women and their neonates after the GEJE. The self-reported questionnaire was sent to 115,976 pregnant women by mail from January 2012, with 58,344 women responding to the questionnaire (50.3% response rate). Pregnancy complications, such as gestational hypertension, respiratory diseases, and mental disorders, increased in some women who were pregnant at the time of the earthquake and immediately after the earthquake. However, the direct effects on newborns, such as preterm birth, low birth weight, and congenital anomalies, were not immediately clear after the earthquake. Although there were significant differences in the occurrence of preterm birth and low birth weight among the districts, there was no change in the occurrences of preterm birth, low birth weight, or anomalies in newborns in Fukushima Prefecture from the fiscal year 2011 to the fiscal year 2018. Therefore, the long-term effects of the post-disaster radiation accident on perinatal outcomes are considered to be very small.

Postpartum Mental Health of Mothers in Fukushima: Insights From the Fukushima Health Management Survey's 8-year Trends.

With the aim of monitoring the mental and physical health of mothers and children following the Fukushima nuclear accident and providing them with necessary care, we have been conducting an annual survey of expectant and nursing mothers since 2011. The Pregnancy and Birth Survey is a mail-in survey of about 15,000 individuals, with a response rate of approximately 50.0% each year. In addition, because respondents to a survey conducted in the immediate aftermath of the disaster showed a particularly high rate of depression, follow-up surveys have been conducted at 4 years after childbirth. Reviewing the results of surveys from FY 2011 through FY 2018, we found that the prevalence of depressive symptoms among mothers was highest in the survey after childbirth and decreased over time. Data of follow-up surveys showed that the prevalence of depression was lower than immediately after childbirth and then decreased over time. The proportion of mothers with radiation anxiety was higher among respondents in the FY 2011 follow-up than in the FY 2014 follow-up, indicating the prolonged impact of the nuclear accident, especially among those who gave birth immediately after the disaster. Characteristics of mothers who received telephone parenting counseling included first delivery, caesarean section, living in evacuation zones, not being able to receive medical examinations as scheduled, and having radiation anxiety. Continuous care should be provided to mothers who gave birth immediately after the nuclear accident, including routine perinatal care and parenting support, provision of information on radiation, and long-term monitoring of their wellbeing.

Reliability and validity of the Japanese treatment self-regulation questionnaire for Japanese workers.

BACKGROUND: Motivational interventions are used as preventive measures in occupational health. However, existing studies primarily focus on motivation methods and not the stage of motivation-the process from extrinsic to intrinsic motivation. The treatment self-regulation questionnaire (TSRQ) can predict workers' health at each motivational stage. Accordingly, this study examined the reliability and validity of the Japanese version of the TSRQ (Diet and Exercise) in occupational health settings. METHODS: Responses of 912 workers were analyzed. In this study, the Cronbach's alphas were 0.85 for Diet and 0.84 for Exercise after excluding items with low Item-Total correlations. Regarding convergent validity, there was a weak correlation between behavior modification stages and the TSRQ. Regarding structural validity, confirmatory factor analysis was performed assuming a four-factor structure. RESULTS: The goodness-of-fit indices were: Comparative Fit Index (CFI) = 0.94, Tucker Lewis Index (TLI) = 0.92, and Root Mean Square Error of Approximation (RMSEA) = 0.07 for Diet and CFI = 0.92, TLI = 0.91, and RMSEA = 0.08 for Exercise. CONCLUSION: The Japanese version of the TSRQ has a certain degree of reliability and validity. It can measure motivation for Diet and health-related behaviors in occupational health settings. The findings of this study may serve as a basis for promoting primary and secondary prevention.

Factors Associated With Smoking Relapse Among Women in Japan From Pregnancy to Early Parenthood.

OBJECTIVE: To identify factors, including mental health, associated with smoking relapse among women in Japan from pregnancy to early parenthood. DESIGN: Secondary analysis of data from an ongoing cross-sectional study conducted between 2013 and 2016. SETTING: We mailed questionnaires to all women who received a maternal and child health handbook from a municipality in Fukushima Prefecture or who underwent a maternal health checkup and gave birth in Fukushima Prefecture. PARTICIPANTS: Of the 28,562 women who responded to the questionnaire, 6,747 who previously smoked and quit around the time they registered their pregnancies were included in the analysis. METHODS: Participants were divided into groups according to smoking relapse status: a nonrelapse group, which included those who maintained smoking cessation, and a relapse group, which included those who quit smoking but later relapsed. We further classified the latter group into those who quit smoking before or after pregnancy registration. We used a logistic regression model with forced entry to calculate adjusted odds ratios. RESULTS: Of the 6,747 participants who previously smoked, 881 (13.1%) relapsed. Regardless of the timing of smoking cessation, younger age and living in a specific region of Fukushima Prefecture were associated with smoking relapse. Relapse was associated with symptoms of depression in participants who quit smoking before registration and with multiparity in participants who quit smoking after registration of their pregnancies. CONCLUSIONS: Support for women at risk of smoking relapse after pregnancy requires consideration of regional characteristics and incorporation of family and mental health support with a focus on younger women.

Implementation and Evaluation of Life-planning Lecture to Enhance Perspective-Taking among High School Students: A School-based Nonrandomized Waitlist Intervention Study in Japan.

INTRODUCTION: The Australian "empathy session," which is a parenting program aimed at alleviating postpartum depression by increasing empathy among expecting couples, was adapted to a life-planning education program for Japanese high school students. In this present study, we aimed to assess changes in high school students' empathy levels. METHODS: A nonrandomized, controlled, waitlist intervention was performed in 210 first-year students. They were divided into intervention and waitlist control groups. The life-planning lecture consisted of two parts: (1) reproductive health and (2) empathy and communication skills. The main outcome indicator was the Perspective-Taking subscale of an empathy index. Logistic regression was used to examine the association between the intervention and change in the Perspective-Taking scale score controlling for background factors. RESULTS: As per our findings, a significant difference was noted in the scale scores of Perspective-Taking before and after the program within the intervention group (3.76 ± 0.61 before the lecture and 3.86 ± 0.64 after the lecture; P = 0.01). In the between-group analysis, the likelihood of an increase in the scale score of Perspective-Taking was significantly higher in the intervention group (OR = 2.29, 95 % confidence interval = 1.23-4.26). CONCLUSIONS: Japanese high school students' Perspective-Taking improved through learning reproductive life-planning and communication skills.

[Development of the Japanese version of the cognitive failure scale (the Short Inventory of Minor Lapses) for Japanese women involved in child care].

Objectives Child care involves mentally and physically intensive work. Women involved in child care are prone to various cognitive failures (e.g., forgetting to carry something or missing an appointment) because of being overburdened with child care activities and chores, constantly limited attention for coping with the frequent demands of children, and cognitive deterioration in the perinatal period. We conducted a survey of women caring for children aged 3 months to 6 years old, aiming to 1) develop a Japanese version of the cognitive failure scale (named the Short Inventory of Minor Lapses [SIML]), and 2) examine the psychometric properties of the scale (including factor structure, validity, reliability, and score distribution), and comparing the scale score according to job status, the youngest child's age, and the number of children.Methods We used data obtained through an internet research company from 310 women (aged 25-45 years; 155 full-time workers and 155 housewives), caring for children aged 3 months to 6 years old. We used the 15-item SIML with a five-point Likert-type scale. We also collected information about employment status, maternal age, the youngest child's age, the number of children, income, the status of using child-care services, sleep duration, fatigue, and neuroticism.Results The scale consisted of one factor. Cognitive failure was found to have the following correlations with memory complaints (polyserial correlation=0.66), sleep duration (r=-0.17), fatigue (r=0.32), and neuroticism (r=0.22). Cronbach's alpha for the scale was 0.94. A three-way analysis of variance (including main effects of working status, the youngest child's age, and the number of children) in cognitive failure revealed significant main effects of the youngest child's age (aged 0-3 years: mean (standard deviation [SD])=34.9 (11.5) point, > aged 4-6 years: mean (SD)=32.6 (10.5) point, partial η2=0.013), and the number of children (only one: mean (SD)=32.4 (11.3) points < two or more: mean (SD)=34.9 (10.9) points, and partial η2=0.014). A three-way analysis of covariance in cognitive failure adjusted for mother's age demonstrated a significant main effect of the youngest child's age (partial η2=0.014).Conclusion Our findings confirmed the psychometric properties of the Japanese version of SIML among women involved in child care (including factor structure, validity, reliability, and score distribution).

Characteristics and changes in the mental health indicators of expecting parents in a couple-based parenting support program in Japan.

Postpartum depression is a serious problem not only for mothers, but also for their children and families. Evidence is scarce on the effectiveness of couple-targeted antenatal interventions aimed at preventing postpartum depression in Asia. Therefore, we implemented an antenatal parenting support program from Australia ("empathy program") at three sites in Japan, and assessed the characteristics of participating couples and changes in their mental health indicators before and after the program (during pregnancy and 6 weeks postpartum, respectively). In this program, participant couples discussed concerns during pregnancy and a "difficult day" scenario with other same-gender participants and then with their own partners. In total, 100 couples attended the program. Among 60 participating mothers, 20% screened positive for maternal depression symptoms (defined as an Edinburgh Postnatal Depression Scale greater than 9). Changes in paternal empathy and maternal antenatal Edinburgh Postnatal Depression Scale score were significantly associated with maternal postpartum Edinburgh Postnatal Depression Scale score in multivariable analyses. Our results indicate that a key in preventing postpartum depression is paternal involvement and long-term support from antenatal phase.

Development and Implementation of an Internet Survey to Assess Community Health in the Face of a Health Crisis: Data from the Pregnancy and Birth Survey of the Fukushima Health Management Survey, 2016.

The Pregnancy and Birth Survey of the Fukushima Health Management Survey is a questionnaire survey that has been conducted annually since 2011 in Fukushima Prefecture. Since 2016, the survey has been available online as well as in paper form. This study aimed to determine whether making the survey available online improved response rates and to identify the characteristics of paper and online survey respondents and their results. Using LimeSurvey, we constructed an online survey environment that enabled responses via computer or mobile device. Respondents could choose whether to respond on paper or online. The response rate for the 2016 survey was 51.8%, an increase of 3.5% over the previous year. Of these responses, 15.8% were made online. Online respondents were mostly primiparous. Further, while there was no difference in the percentage of respondents who provided free responses, the amount written was higher in paper surveys than in online surveys. The combination of paper and online surveys increased convenience for respondents and contributed to improved response rates. In addition, paper surveys were superior in terms of allowing respondents to express their feelings and opinions.

Pregnancy and Birth Survey of the Fukushima Health Management Survey.

The Pregnancy and Birth Survey was started by Fukushima Medical University as part of the Fukushima Health Management Survey in 2011 in order to assess the physical and mental health of mothers and provide parenting support (telephone counseling) for those in need. The present study reviewed the major findings from 4 annual surveys conducted from 2011 to 2014. Overall proportions of preterm deliveries, low birth weight infants, and congenital anomalies in the first year were almost the same as those in national surveillance data. The prevalence of depressive symptoms among the mothers held steady at about 25% over the 4 years. Regarding the content of parenting counseling, the proportion of mothers who voiced concerns about radiation decreased each year. This survey should be continued to provide support to mothers in Fukushima.

Fukushima Mothers' Concerns and Associated Factors After the Fukushima Nuclear Power Plant Disaster.

This study aimed to clarify the frequency of and temporal changes in the content of mothers' free written opinions obtained in the Fukushima Health Management Survey Pregnancy and Birth Survey from 2011 to 2013. A self-administered questionnaire was mailed to women who delivered babies in Fukushima Prefecture. The questionnaire asked about maternal and child health. Expression of mothers' concerns about radiation decreased over time. Common to the top 5 codes across the 3 years were "radiation effect on fetus and infant" and "information provision including survey results." Participants who wrote free opinions were significantly more likely to be aged ≥30 years and to have depressive symptoms. Our descriptive analysis of the qualitative data showed a clear shift in mothers' concerns from radiation-related issues to their own physical and mental health. Mothers who expressed concerns were more likely to report negative physical and mental health.

Factors Associated with Infant Feeding Methods after the Nuclear Power Plant Accident in Fukushima: Data from the Pregnancy and Birth Survey for the Fiscal Year 2011 Fukushima Health Management Survey.

Objectives The objective of this study was to assess the frequency of and factors associated with infant feeding methods after the Fukushima nuclear power plant accident using data from the Fukushima Health Management Survey. Methods We conducted an anonymous self-administered questionnaire survey of 16,001 women who gave birth around the time of the Great East Japan Earthquake and registered their pregnancies at Fukushima Prefecture municipal offices between August 1, 2010 and July 31, 2011. The responses of 8366 women were analyzed. Chi square tests and multiple logistic regression analysis were used to compare various factors between women who had formula-fed their children because of concern regarding radioactive contamination or other reasons and those who had breastfed exclusively. Results The percentage of women who had breastfed exclusively was 30.9 %. The percentage of women who had both breastfed and formula-fed or formula-fed exclusively was 69.1 %, of which 20.3 % formula-fed because of concern regarding radioactive contamination of breast milk. The use of formula feeding because of concern about radioactive contamination was significantly higher in women who had resided within the evacuation area and those whose regular antenatal care had been interrupted. The use of formula feeding for other reasons was significantly higher in women who had resided within the evacuation area and lower for those who had willingly switched to another medical institution. Conclusions for Practice Our results suggest the importance of providing breastfeeding support to women who are forced to evacuate or whose antenatal care is interrupted after a disaster.

Enhancement of antigen presenting ability in the leukemic plasmacytoid dendritic cell line (PMDC05) by lentiviral vector-mediated transduction of CD80 gene.

PMDC05, a leukemic plasmacytoid dendritic cell (pDC) line which was established in our laboratory, showed a capacity of generating antigen-specific cytotoxic T lymphocytes (CTLs). In order to enhance an antigen presenting ability of PMDC05, PMDC05 was transduced with CD80 gene by lentiviral vector, which was named as PMDC11. PMDC11 displayed a strong antigen presenting ability even without any stimulation, and by culturing with stimulators such as calcium ionophore PMDC11 gained a more potent antigen presenting ability. Our data suggested PMDC11 could be applied as antigen presenting cells more efficiently in adoptive cellular immunotherapy for tumors and severe infections in comparison with PMDC05.