Assessment of Sensory Processing Issues in Children with Neurodevelopmental Disorders and Experiences of Maltreatment.

This study aims to identify the sensory characteristics of children with both developmental disabilities such as ASD and ADHD and a history of child maltreatment (DM group), children with developmental disabilities (DD group), and typically developed children (TD group). The sensory characteristics of 24 children were assessed through virtual reality and self-administered questionnaires. The results elucidated that the duration of gazing at the "teacher" (60-75 s) was significantly different with the DM group's gaze being shorter than the DD group's gaze (p = 0.042). The duration of the "others" gaze (45-60 s) was also significantly different with the DM group's gaze being longer than the DD and TD groups' gaze (p = 0.018; p = 0.030). Additionally, the scores for tactile sensitivity, taste/smell sensitivity, under-responsive/seeks sensation, and the total short-term sensory profile were significantly different between the DM-DD and DD-TD groups. The scores of the heart rate perception test and Multidimensional Assessment of Interoceptive Awareness were significantly lower in the DM and DD groups. In conclusion, children who have experienced trauma and developmental disabilities may have different sensory characteristics than children with only developmental disabilities or none, implying the need for further research and tailored care.

Gender Differences in the Association between Psychological Distress and Sociability among Older Adult Survivors: Cross-Sectional Survey Four Years after the 2016 Kumamoto Earthquake in Japan.

Mental health deterioration after a disaster is a concern. Individuals' sociability is expected to relate to the risk of this deterioration; however, research focusing on older adults is lacking. We aimed to investigate the relationship between psychological distress and sociability in older adults who survived the 2016 Kumamoto earthquake. We conducted a self-reported questionnaire survey in 2020. Data on 3,588 people aged 65 years and over (2,024 women and 1,564 men, mean age 74.6 ± 7.2, mean ± standard deviation) were analyzed. The overall prevalence of psychological distress (the Kessler psychological distress scale: K6 ≧ 10) was 10.5%; by gender, it was 11.2% in women and 9.5% in men. Logistic regression analysis revealed that, in the total sample, age, gender, public housing, reduction in income resulting from the coronavirus disease 2019 pandemic, self-rated unhealthy conditions, subjective social isolation, and a lack of awareness of community events were positively associated with psychological distress. For women, a lack of community participation was positively related to psychological distress. For men, not knowing the change in school district after relocation was negatively associated with psychological distress, probably due to men's scarce community participation and reliance on friendships, compared to women's stronger dependence on community. Moreover, having a family member or friend to consult with was associated with a lower risk of psychological distress, regardless of gender. Gender differences were related to different conditions of social participation and types of social relationships. Enhancing community participation and family relationships among women and social contact with friends among men is essential.

Meaning of community activity participation for older adults in couple households.

Objective: Currently, 65.3% of older adults in Japan live in couple households. If one partner dies, the other may be unable to reconstruct their lifestyles, have health problems, or become isolated. Participation in community activities helps them maintain physical, mental, and social health. This study aimed to clarify the meaning of participation in community activities among older adults in couple households. Methods: Semi-structured individual interviews were used to collect data. In February 2019, six adults aged 65 and above who had lived with their spouses for at least one year and continuously participated in community activities were interviewed in Miyazaki City, Japan. Data were analyzed using the KJ method (a qualitative method that organizes ideas in a bottom-up fashion developed by Kawakita Jiro), supervised by a professional instructor. Results: The results revealed seven symbols using this method: 1) building a cooperative relationship with a spouse: respect the willingness to work hard for members; 2) consideration for relationships with other organizations: pay attention to every detail; 3) proactive attitude: don't leave everything to others, 4) attitude of questioning one's way of being: myself in connection to others, 5) connection among participants: increased awareness directed toward others, 6) spiritual fulfillment: time, place, and opportunity for outings, 7) physical and mental self-control for continued community activities: growing awareness of health care. Conclusions: For older adults in couple households, it is found that participation in community activities helps them receive support from their spouses and gain a proactive attitude, and the connection between participants contributes to physical and mental control and also improves their health.

Factors Related to Physical Activity among Older Adults Who Relocated to a New Community after the Kumamoto Earthquake: A Study from the Viewpoint of Social Capital.

Previous studies have shown an association between social capital and physical activity in older adults. Older adults who relocated after the Kumamoto earthquake may become physically inactive, and the extent of this inactivity may be buffered by social capital. Accordingly, this study applied the social capital perspective to examine factors that affect the physical activity of older adults who relocated to a new community after the Kumamoto earthquake. We conducted a self-administered mail questionnaire survey with 1494 (613 male, 881 female, mean age 75.12 ± 7.41 years) evacuees from temporary housing in Kumamoto City, aged 65 years and above, who relocated to a new community after the earthquake. We performed a binomial logistic regression to examine the factors affecting participants' physical activity. The results showed that physical inactivity (decreased opportunities for physical activity, decreased walking speed, and no exercise habits) was significantly associated with non-participation in community activities, lack of information about community activities, and being aged 75 years and over. Lack of social support from friends was significantly associated with lack of exercise habits. These findings encourage participation in community activities, alongside giving and receiving social support in health activities that target older adults who relocated to new communities after the earthquake.

Noncompliance with Hypertension Treatment and Related Factors among Kumamoto Earthquake Victims Who Experienced the COVID-19 Pandemic during Postearthquake Recovery Period.

Survivors of the Kumamoto earthquake of 2016 experienced the coronavirus disease (COVID-19) outbreak while carrying additional burdens that might bring inadequate coping. This cross-sectional survey aimed to identify untreated and interrupted consultations among those with hypertension and related factors and to identify the disaster's long-term effects. Of the 19,212 earthquake survivors who had moved to permanent housing, 7367 (4196 women and 3171 men, mean age 61.8 ± 17.3 years) completed a self-administered questionnaire. The prevalence of hypertension was 41.4%. The results of the logistic regression analysis with the significant independent variables in the bivariate analysis were: reduced income due to COVID-19 (AOR = 3.23, 95%CI = 2.27-4.58) and poor self-rated health (AOR = 2.49, 95%CI = 1.72-3.61) were associated with a risk of untreated or discontinued treatment. Moreover, living in rental, public or restoration public housing was also significantly associated with a higher risk of hypertension noncompliance (AOR = 1.92, 95%CI = 1.20-3.07; AOR = 2.47, 95%CI = 1.38-4.42; AOR = 4.12, 95%CI = 1.14-14.90). These results suggest that changes due to COVID-19, the extent of self-rated health and the type of permanent housing influence the hypertension consulting behaviour of earthquake survivors during recovery. It is crucial to implement long-term public support for the mental health, income and housing concerns of the survivors.

Depression, Insomnia, and Probable Post-Traumatic Stress Disorder among Survivors of the 2016 Kumamoto Earthquake and Related Factors during the Recovery Period Amidst the COVID-19 Pandemic.

The aftereffects of the severe 2016 Kumamoto earthquake were complicated by the COVID-19 pandemic. This study aimed to identify mental health problems and related factors among survivors five years after the earthquake and clarify its long-term effects. A cross-sectional survey was conducted in 2020 among 19,212 survivors affected by the earthquake who moved from temporary to permanent housing. We analysed 8966 respondents (5135 women, 3831 men; mean age 62.25 ± 17.29 years). Logistic regression analysis was conducted to examine associations between mental health problems and socioeconomic factors. Prevalence rates of psychological distress, insomnia, and probable post-traumatic stress disorder were 11.9%, 35.2%, and 4.1%, respectively. Female gender (OR = 1.33, 95% CI = 1.13-1.57; OR = 1.21, 95% CI = 1.08-1.34; OR = 1.81, 95% CI = 1.41-2.32), public housing (OR = 2.14, 95% CI = 1.63-2.83; OR = 1.54, 95% CI = 1.26-1.88; OR = 2.41, 95% CI = 1.62-3.58), loneliness (OR = 9.08, 95% CI = 7.71-10.70; OR = 5.55, 95% CI = 4.90-6.30; OR = 3.52, 95% CI = 2.77-4.49), COVID-19-induced activity reduction (OR = 1.41, 95% CI = 1.19-1.66; OR = 1.86, 95% CI = 1.68-2.07; OR = 1.80, 95% CI = 1.40-2.31), and COVID-19-induced income reduction (OR = 1.33, 95% CI = 1.12-1.57; OR = 1.43, 95% CI = 1.28-1.59; OR = 1.92, 95% CI = 1.51-2.43) were significantly associated with mental health problems. These results suggest that gender, current housing, loneliness, and COVID-19 affected the survivors' mental health during recovery.

A Preliminary Study of Assessing Gaze, Interoception and School Performance among Children with Neurodevelopmental Disorders: The Feasibility of VR Classroom.

Children with developmental disabilities (DDs) have sensory modulation disorders that interrelate school performance. Virtual reality (VR) has demonstrated the potential to become a neuropsychological assessment modality. This study was conducted to explore the feasibility of the VR classroom for assessing their characteristics of gaze, school performance, and interoception. School-aged children were assigned to the DD group or control group. A VR classroom was designed to evaluate their gaze patterns to distracting events. Interoception was assessed using the Heart Rate Perception test and the Multidimensional Assessment of Interoceptive Awareness (MAIA). The DD group had a significantly longer gaze duration on the virtual teacher during 30-45 s of the VR classroom event (p < 0.05). The mean score of the quiz and the Heart Rate Perception test showed a significant tendency to be lower than the children of the control group. The DD group scored significantly lower in six of eight subscales of the MAIA. These results showed the potential of VR classroom to evaluate the difference of sensory modulation between school-aged children with DDs and typically developed children. Future research is necessary to investigate the validity of the VR environment used in this study.

Pediatric dentists' perspectives of children with special health care needs in Japan: developmental disabilities, phobia, maltreatment, and multidisciplinary collaboration.

BACKGROUND: The number of children diagnosed with developmental disabilities (DDs) or other chronic difficulties has risen. However, each professional's awareness of children with developmental, emotional and behavioural difficulties may differ, allowing their special needs to be overlooked at child health checkups until secondary difficulties appear. Therefore, it is necessary to explore the multi-professional views of children with such chronic difficulties. This study investigates pediatric dentists' perception of children with potential chronic difficulties. METHODS: Interviews were conducted with 21 pediatric dentists, and the transcripts were analyzed using grounded theory to develop categories for the theoretical assessment. RESULTS: Four themes emerged regarding the children with potential chronic difficulties: children exhibiting possible DDs with awkward social communication and interaction; severe rampant caries possibly derived from maltreatment; dental phobia possibly derived from mental health problems; a complicated home environment where their mothers exhibit poor oral health literacy. CONCLUSIONS: This study's findings imply that participants' concept of children of concern included the risks of poor oral health and mental health problems that other healthcare professionals might overlook. It is recommended that multidisciplinary professionals engaging in child health checkups be aware of children's oral and mental health status as well as potential DDs and child maltreatment.

A hybrid concept analysis of children of concern: Japanese healthcare professionals' views of children at a high risk of developmental disability.

BACKGROUND: The new Diagnostic and Statistical Manual of Mental Disorders (fifth edition, DSM-5) redefined the boundaries of autism as a spectrum. It has been reported that the number of schoolchildren with undiagnosed developmental disorders (DDs) has risen in Japan. Such children referred to as kininaru-kodomo (KK, "children of concern") by healthcare professionals fall into a gray area. Therefore, KK are often overlooked at infant medical checkups. This leaves KK without necessary medical care and special needs education. It is urgent to explore the KK concept to enable professionals to properly assess and provide for the healthcare needs of these children at a high risk of DD, ideally with early intervention. METHODS: A hybrid model of concept analysis was conducted. Working definitions were obtained from a systematic literature review in the theoretical phase. Subsequent in-depth personal interviews initiated in the fieldwork phase corroborated and refined the concept. These qualitative data were integrated in the final analytical phase to yield the practice-based real definition of KK in clinical settings. RESULTS: Three themes emerged regarding KK children: children who require special care, children whose special healthcare needs are owing to both individual and environmental factors, and children waiting for the development of a new support system for them or their parents. CONCLUSIONS: This study implies that KK are children who require special support because of individual and environmental factors. The concept of KK is considered useful for keeping children with undiagnosed DDs and/or other healthcare needs connected with support networks. It is strongly recommended that a screening tool be developed that reflects the concept of children at a high risk of DD so that children in this gray area may receive necessary support even before diagnosis.

The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study.

BACKGROUND: Professionals in Japan tend to regard the individual contexts of persons with spinal cord injury (SCI) as the cause of their passive participation in self-care activities or self-management. However, the meaning of self-care involves variables that interrelate with sociocultural factors. Thus, it is necessary to uncover its meaning in the perceptions of persons with cervical spinal cord injury (CSCI) in order not only to implement better rehabilitation but also to understand the sociocultural constraints that determine the injured person's attitudes to self-care and long-term health outcomes. METHODS: Semi-structured interviews with 29 CSCI participants from fourteen municipalities of Osaka, Hyogo, and Ehime prefectures were conducted. Participants contributed diverse perspectives on rehabilitation, lay-professional and family relationships, health promotion, and body conceptions. Interviews were recorded, transcribed and analyzed using the grounded theory approach to inter-relate categories and to develop theoretical constructions. RESULTS: Four main themes emerged from the data: rehabilitation for independence in ADLs; detachment from the body and self; embodiment; and self-management. From the participants' point of view, rehabilitation programs in Japan aim at improving body functions for ADL performance, but provide little health education. These rehabilitation values might hinder some participants from developing self-esteem for their bodies. Moreover, socially-shaped family caregivers' active engagement in the participants' self-care allowed many participants to entirely rely on them for care. Through embodiment, participants found that self-care was not merely a means of independence in ADLs but also of self-management to enhance health and well-being, requiring collaborative relationships with caregivers. CONCLUSION: Personal factors such as low motivation for self-care might be in part a reflection of social expectations of dependence for persons with CSCI. However, the shift in the meaning of self-care from ADLs to self-management implies more active participation in health care needs, shaped through social exchanges. Not only personal factors but also sociocultural factors influence the injured person's valuation of self-care. There is a need for further research to better understand sociocultural influences on illness behaviors among persons with CSCI, so that clinical and community practice can develop accordingly.

Illness experience of adults with cervical spinal cord injury in Japan: a qualitative investigation.

BACKGROUND: There is growing recognition that healthcare policy should be guided by the illness experience from a layperson's or insider's perspective. One such area for exploration would include patient-centered research on traumatic Spinal Cord Injury (SCI), a condition associated with permanent physical disability requiring long-term and often complex health care. The chronicity of SCI can, in turn, affect individuals' sense of self. Although previous research in Western countries suggests that people with SCI find a way to cope with their disability through social participation and family bonds, the process of adjustment among people with cervical SCI (CSCI) living in Japan may be different because of the restrained conditions of their social participation and the excessive burden on family caregivers. The purpose of this study was to examine the impact of injury and the process of accommodation in people with CSCI in Japan. METHODS: Semi-structured home interviews were conducted with 29 participants who were recruited from a home-visit nursing care provider and three self-help groups. Interviews were recorded, transcribed and analyzed based on the grounded theory approach. RESULTS: Five core categories emerged from the interview data: being at a loss, discrediting self by self and others, taking time in performance, restoring competency, and transcending limitations of disability. Overall, the process by which participants adjusted to and found positive meaning in their lives involved a continuous search for comfortable relationships between self, disability and society. CONCLUSIONS: The results of this study suggest that persons with CSCI do not merely have disrupted lives, but find positive meaning through meaningful interactions. Family members added to the discredit of self by making the injured person entirely dependent on them. Gaining independence from family members was the key to restoring competency in people with CSCI. At the same time, social participation was pursued for transcending the limitations of disability. The results also imply that social issues affect how people interpret their disability. These findings suggest that public health policy makers should recognize the need to enhance independence in people with disability as well as change the social assumptions about their care.