Locomotion development and infants' object interaction in a day-care environment.

This longitudinal study examined the relationship between the development of locomotion and infants' interaction with others involving objects. Observations took place in a multi-person situation-a day-care class-for one-year-old infants for 1 year. The study participants were 13 infants and 7 caregivers (all Japanese). Frequencies of infants' manual contact with objects and moving before contact with them did not differ according to locomotion developmental level. However, infants who began walking engaged in more social interactions than those who were cruising or crawling. Throughout all locomotor developmental periods, social interactions increased in frequency when more caregivers were present. As infants began to walk, they moved more prior to social interactions, had more frequent bidirectional and triadic social interactions, and moved and interacted more often with others during a single object episode. These results suggest that crawlers' engagement with objects is relatively object-oriented, while for walkers, locomotion seems to be driven by social stimuli. Infants who have begun to walk moved among caregivers and peers in a multi-person environment and developed more elaborated social interactions through objects.

Development of Implicit Links Between Effort, Pain, and Recovery.

This article describes three studies that examined Japanese children's and adults' intuitive perceptions regarding the links between pain, effort, and healing. A total of 79 six-year-olds, 81 nine-year-olds, 74 twelve-year-olds, and 66 adults were presented with scenarios involving modern and traditional medical interventions and were examined with regard to how the level of pain and effort presented in the scenarios influenced their views of healing. It was consequently found that the 6-year-olds tended to judge painful interventions as aversive, while adults considered them to be effective. Furthermore, overall, effortful interventions were believed to be more efficacious than painful ones. The children and adults appeared to assume that people who have tried hard and expended considerable effort deserve to be healed quickly. These results are in accord with the coexistence model, which posits that an individual can have coexisting scientific and folk beliefs across his/her life course.

Associations between Difficulty in Accessing Maternal and Child Health Services and Stress Responses among Mothers Raising Young Children during the COVID-19 Pandemic in Japan.

In Japan, maternal and child health (MCH) services were canceled or limited during the COVID-19 pandemic, potentially damaging the mental health of mothers raising young children. This study aimed to examine associations between difficulty in accessing MCH services and various stress responses among such mothers in Japan. An Internet-based questionnaire survey was conducted in November 2022 targeting mothers raising young children who had registered with a Japanese online research company (n = 1032). The questionnaires included items from the Public Health Research Foundation Stress Checklist (Short Form) (PHRF-SCL(SF)), sociodemographic variables, and questions about difficulty accessing MCH services due to COVID-19. Chi-squared tests and multivariate logistic regression analysis were performed. In total, 45.7% of mothers experienced difficulty in accessing MCH services due to COVID-19. Mean PHRF-SCL(SF) scores were 4.9 for anxiety, 7.3 for tiredness, 2.8 for autonomic symptoms, and 5.2 for depression. These scores indicated worse stress responses than the general population and mothers raising young children before the COVID-19 pandemic. Mothers who experienced difficulty in accessing MCH services due to COVID-19 were 1.47-1.53 times more likely to be associated with high stress responses (PHRF-SCL(SF) scores). Given the difficulty mothers faced accessing MCH services due to COVID-19 and the negative impact this had, careful follow-up and support are necessary for mothers affected by the COVID-19 pandemic.

Imitation among infants in a day-care center and the development of locomotion.

To examine the relationship between imitation and locomotor development among peers during infancy, we observed free play in a class of infants in a day-care center over a one-year period. The analysis included 16 infants (mean age was 8.3 months (SD=2.3) at the beginning of the observation) and 5 caregivers. The longitudinal data were divided into the crawling, cruising, and walking periods, and the imitation of object manipulation that took place among the infants during each period was analyzed. With the development of locomotion, peer-to-peer imitation became frequent. Infants who had acquired the ability to walk demonstrated imitation more frequently in triadic interactions than in dyadic interactions. Imitation took place between infants, but it was often mediated by caregivers rather than directly between infants. The results suggest that the acquisition of locomotor skills is a link in a developmental cascade from motor development to infant peer interaction. However, it is reasonable to interpret the results as indicating that the development of locomotion does not directly affect infant interactions in isolation, but rather that walking increases both the sharing and manipulation of objects with caregivers and proximity to peers, and their combined effects form a cascade.

Role of Maternal and Child Health Handbook on Improving Maternal, Newborn, and Child Health Outcomes: A Systematic Review and Meta-Analysis.

The objective of this review is to assess and synthesize the role of the maternal and child health (MCH) handbook on improving healthcare service utilization, behavior change, and health outcomes for women and children. A systematic search of all relevant existing reports was conducted on 14 January 2021, using the following online bibliographic databases: PubMed, EMBASE, MEDLINE, The Cochrane Library, Academic Search Premier, Emcare, APA PsycINFO, and Web of Science. Two reviewers independently performed study selection, data extraction, and quality assessment. We included 7 trials from 1430 articles, and a total of 2643 women. As overall risk of bias assessment, most domains of the Cochrane risk-of-bias assessment tool showed a high or unclear risk of bias. The risk of ≥6 antenatal care (ANC) visits was 19% higher (RR 1.19, 95% CI 1.09 to 1.30, I2 = 47%, 2 studies, 955 women, moderate certainty of evidence) and skilled birth attendants during delivery was 13% higher (RR 1.13, 95% CI 1.04 to 1.24, I2 = 0%, 2 studies, 1094 women, low certainty of the evidence) in the intervention group than in the control group. The MCH handbook can increase maternal health service utilization and early breastfeeding practice. It also leads to a sense of autonomy during ANC, better communication with healthcare providers, and support from family members.

Impact of village health volunteer support on postnatal depressive symptoms in the remote rural areas of Lao People's Democratic Republic: a cross-sectional study.

BACKGROUND: Village health volunteers (VHVs) are responsible for providing primary care in the communities of Laos. Unlike other districts, in Xepon more than 90% of VHVs are male and therefore experience difficulties interacting with pregnant women. To improve outreach to pregnant women, especially among ethnic minorities, a new project was implemented by local municipalities in 2017: newly selected female VHVs were paired to work with existing male VHVs. The objective of this study was to compare the postnatal depressive symptoms of ethnic minority mothers supported by pair-VHVs and single-VHVs in remote rural areas of Lao People's Democratic Republic (PDR). METHODS: A cross-sectional study was conducted in March 2019. Mothers who had delivered a baby within 1 year preceding the study were recruited from 36 villages. Of the 305 mothers, 227 responded. The questionnaires included (1) demographic characteristics such as age, economic status, and birth experience; (2) self-decision to go to a health center/hospital to receive antenatal care; (3) type of VHVs (pair or single), support, and information from VHVs during pregnancy, support from husband and relationship with husband; (4) the Edinburgh Postnatal Depression Scale (EPDS). A Mann-Whitney U test, chi-square test, and multiple linear regression analysis were performed. Ethical approval was obtained from the University of the Ryukyus and National Ethics Committee for Health Research of Lao PDR. RESULTS: The average total EPDS score was 5.5 among mothers supported by pair-VHV and 7.0 among mothers supported by single-VHV. Results of the multiple linear regression analysis showed that the EPDS score was significantly lower among mothers supported by pair-VHV (ß=-1.18, p <0.05) even after adjusting for economic and biological factors. CONCLUSIONS: Mothers supported by pair-VHV had a significantly lower EPDS score than those supported by single-VHVs in this study area, suggesting that the support of male and female VHV pairs contributed to improving mental health status among ethnic minority mothers in remote rural areas of Lao PDR. Expanding the program to train female VHVs working with male VHVs is necessary for improving maternal and child health in a rural district of Lao PDR.

Factors influencing the choice of facility-based delivery in the ethnic minority villages of Lao PDR: a qualitative case study.

BACKGROUND: Facility-based delivery has been promoted to improve maternal and child health care in Lao PDR and a free delivery policy was introduced at designated health care facilities (HCF) in 2013. However, according to birth records of HCFs in the impoverished and remote district, only a few women utilized the HCFs despite good physical accessibility. The aim of this study was to analyze the factors influencing the choice of facility-based delivery in the impoverished and remote district after a free delivery policy was introduced. METHODS: Qualitative case study was employed. Focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted from August to October 2015. Five hamlets (or small village) located along the main road where only a few women delivered at HCFs were selected for the study based on birth records. The participants of the FGDs and IDIs were the village heads, village health volunteers, women who delivered at home or at a health facility within the past 2 years, their husbands, and mothers or mothers-in-law. Thematic analysis was used to analyze the data. RESULTS: A total of 12 FGDs and 27 IDIs were conducted, and the number of participants was 105. The factors influencing the choice of facility-based delivery were classified into nine categories and 19 subcategories. The categories were labeled, "perception of childbirth," "traditional health concept: sabaai (a condition of health, ease, and comfort)," "perception of health care facilities and staff," "previous pregnancy and childbirth experience," "mode of available transportation," "financial burden of childbirth at health care facility," "family and community context," "institutional context," and "government policy on delivery." CONCLUSION: Our study demonstrated that five major factors negatively influenced the choice of facility-based delivery: (1) perception of childbirth, (2) preference for sabaai, (3) financial burden, (4) family decision-making, and (5) institutional context. To promote facility-based delivery in the impoverished and remote district, three strategies are recommended: (1) promoting community-based health education involving women and strengthening community-based mutual support, (2) clarifying items essential for delivery at HCFs, and (3) making HCFs more comfortable in terms of "sabaai."

The development of Japanese mother-infant feeding interactions during the weaning period.

During the weaning period, infants are not skilled at self-feeding and caregivers play a prominent role in feeding. Solid feeding is therefore an inherently collaborative and interactive process between infants and caregivers. The present study examined how caregivers and infants coordinate their solid feeding interactions, based on naturalistic longitudinal observations of three Japanese mother-infant dyads. The main results were as follows. Four or five months after weaning (about 10-11 months of age), children's mouth movements and mothers' arm movements became more synchronized, and the success or failure of coordinated feeding became independent on children's gaze behavior. During this same period, both mothers' and children's body movements accelerated. Specifically, children's food-intake motions and mothers' food-carrying movements became faster together, although before 10-11 months fluctuations of these motions were not as correlated. Finally, at 9-11 months of age rhythmic body movements became frequent. From the first day of weaning, all three mothers swayed their bodies rhythmically while feeding, and about 2-3 months later their children also began to sway as they ate, at first infectiously but later spontaneously. These observations indicate how specific behavioral development contributes to mother-infant coordination in feeding.

Japanese mother-infant collaborative adjustment in solid feeding.

During the weaning period, infants are not skilled at self-feeding and caregivers play a prominent role in feeding. Therefore, solid feeding is an inherently collaborative and interactive process between caregivers and infants. The present study examined how caregivers and infants coordinate to construct solid feeding interactions, as an analysis of naturalistic longitudinal observations of three Japanese mother-infant dyads. The main results were as follows. After 2 or 3 months post-weaning, mothers' arm movements became non-fluid while feeding children. This non-fluidity was associated with rapid changes in the movement patterns of the mother's arms and the child's mouth. Compared to the development of children's mouth movements, mothers' arm movements developed quickly. This imbalance in the pace of change may have been one cause of non-fluency. While feeding, even though mothers did not eat the children's food, they frequently moved their mouths as if they were eating. The frequency of this maternal behavior differed according to their feeding styles, and mothers' movement patterns corresponded well with their babies' mouth movements. These findings clarify the importance of mothers' eating-like mouth movements for the weaning process.