Consensus guideline for diagnosis and treatment of childhood idiopathic thrombocytopenic purpura.

A practice guideline aimed at standardizing the treatment for childhood idiopathic thrombocytopenic purpura (ITP) is presented. This consensus guideline is based on a survey carried out via a questionnaire prepared by the ITP Committee of the Japanese Society of Pediatric Hematology and sent to society members. The survey questionnaire included questions on the diagnosis of ITP submitted for the purpose of revising the ITP diagnostic guideline prepared in 1990 by the Research Group for Intractable Hematopoietic Disorders; a revised diagnostic guideline also is presented.

Effect of Early Intervention to Promote Mother - Infant Interaction and Maternal Sensitivity in Japan: A Parenting Support Program based on Infant Mental Health.

This study investigated the effects of the Japanese Early Promotion Program (JEPP), which is based on the Infant Mental Health (IMH) program. The JEPP aims to promote mother-infant interactions by enhancing the mother's ability to respond appropriately her child. Mothers in the JEPP group (n = 15) received support from IMH nurses in a pediatric clinic until their infants reached 12 months of age. The nurses provided positive feedback that emphasized strength of parenting, and assisted the mothers in understanding the construct of their infants. Mother-infant interactions and mother's mental health status were assessed at intake (1-3 months), and at 6, 9, and 12 months of infants' age. The JEPP group data were compared with cross-sectional data of the control group (n = 120). Although JEPP dyads were not found to be significantly different from the control group in general dyadic synchrony, both before and after intervention, JEPP mothers significantly improved their ability to understand their infant's cues and to respond promptly. In the JEPP group, unresponsiveness to infants was reduced in mothers, while infants showed reduced passiveness and enhanced responsiveness to the mother. Furthermore, the intervention reduced the mothers' parenting stress and negative emotions, thereby enhancing their self-esteem.

Measuring Japanese mothers' perception of child abuse: development of a Japanese version of the child abuse blame scale--physical abuse (CABS-PA-J).

BACKGROUND: The Child Abuse Blame Scale - Physical Abuse (CABS-PA) was translated into Japanese and its subscale items modified by the authors according to the Japanese cultural context. The aim of the current study was to investigate the appropriateness, reliability, and clinical applicability of the CABS-PA Japanese version (CABS-PA-J). Modifications were made to enable the determination of child abuse recognition in a Japanese cultural setting and early clinical intervention in child abuse cases. METHODS: The CABS-PA text was translated into Japanese, then back translated. The appropriateness of scale item translations was verified based on e-mail discussions with the original CABS-PA author. Exploratory and confirmatory factor analyses were performed to examine the validity of CABS-PA-J responses and to confirm the validity of factor structure. Criterion-related validity was also confirmed. The Japanese scale was used to examine the characteristic differences between mothers of premature infants (< 1500 g) and those of other infants (>or= 1500 g). RESULTS: Exploratory and confirmatory factor analyses found the factor structure to be similar between the original scale and the translated CABS-PA-J, suggesting adequate factor validity. There was a statistically significant correlation between social support from a spouse or third party and the abuse score on a subscale, partially demonstrating criterion-referenced validity. Similarities and differences were found in the stress reactions of the mothers of premature infants (< 1500 g) and those of other infants (>or= 1500 g). CONCLUSION: CABS-PA-J was shown to be appropriate and reliable. It is an effective tool for determining the recognition of child abuse among Japanese mothers.