Changes in Challenging Behaviors Accompanying Transition to a New Facility in Individuals with Intellectual Disabilities.

Challenging behavior (CB), the most common example being extreme self-injurious or aggressive/destructive behavior, is often observed as a major behavior issue in individuals with severe intellectual disabilities. This study investigated how CB changed among residents of a facility for people with disabilities before and after it was restructured from a traditional format single room shared by two to three individuals with approximately 20 residents lived together to a format featuring private areas with two rooms per resident and a unitcare system. Twenty-one residents of Care Home A, which was rebuilt in the new care format, were selected. Care staff completed a questionnaire one month before, one month after, and six months after residents moved to the new facility. Scores were compared among each time point. The results revealed significant reductions in residents' aggressive, stereotyped, and targeted behaviors, such as hitting their own head and fecal smearing. The major features of the restructured facility were a living space consisting of two private rooms per resident and a shift to unit care for the entire ward. These new features enabled residents to reduce destructive stimuli and made it easier to understand what to do in each private room.

Anthracyclines and the risk of arrhythmias: A systematic review and meta-analysis.

BACKGROUND: There have been controversial findings from recent studies regarding anthracyclines use and the subsequent risk of arrhythmias. This study aimed to evaluate the existing evidence of the risk of arrhythmias in patients treated with anthracyclines. METHODS: PubMed, Scopus, and Web of Science databases were searched up to April 2022 using keywords such as "anthracycline" and "arrhythmia." Dichotomous data were presented as relative risk (RR) and confidence interval (CI), while continuous data were presented as mean difference (MD) and CI. Revman software version 5.4 was used for the analysis. RESULTS: Thirteen studies were included with a total of 26891 subjects. Pooled analysis showed that anthracyclines therapy was significantly associated with a higher risk of arrhythmia (RR: 1.58; 95% CI: 1.41-1.76; P < .00001), ST segment and T wave abnormalities (RR: 1.73, 95% CI: 1.18-2.55, P = .005), conduction abnormalities and AV block (RR = 1.86, 95% CI = 1.06-3.25, P = .03), and tachycardia (RR: 1.736, 95% CI: 1.11-2.69, P = .02). Further analyses of the associations between anthracyclines and atrial flutter (RR = 1.30, 95% CI = 0.29-5.89, P = .74), atrial ectopic beats (RR: 1.27, 95% CI: 0.78-2.05, P = .34), and ventricular ectopic beats (RR: 0.93, 95% CI: 0.53-1.65, P = .81) showed no statistically significant results. Higher doses of anthracycline were associated with a higher risk of arrhythmias (RR: 1.49; 95% CI: 1.08-2.05; P = .02) compared to the lower doses (RR: 1.36; 95% CI: 1.00-1.85; P = .05). Newer generations of Anthracycline maintained the arrhythmogenic properties of previous generations, such as Doxorubicin. CONCLUSION: Anthracyclines therapy was significantly associated with an increased risk of arrhythmias. Accordingly, Patients treated with anthracyclines should be screened for ECG abnormalities and these drugs should be avoided in patients susceptible to arrhythmia. The potential benefit of the administration of prophylactic anti-fibrotic and anti-arrhythmic drugs should also be explored.

Factors influencing postpartum depression among Japanese parents: A prospective longitudinal study.

AIM: Postpartum depression (PPD) may have negative effects on the parents and lead to impaired cognitive, socioemotional, and behavioral development in their children. The purpose of this study was to examine factors associated with PPD in parents during the first year after delivery. METHODS: This study used a self-administered questionnaire. Questionnaires were mailed at 5 days, 3 months, 6 months, and 1 year after delivery, respectively. The particpants were 107 pairs of mothers and fathers. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Data on sense of coherence (SOC), Quality Marriage Index, Social Support Scale, Mother-to-Infant Bonding Scale, and sociodemographic variables were collected. Multiple regression analysis was performed to examine the strength of the association between several variables and the EPDS at each survey period for fathers and mothers, respectively. RESULTS: The prevalence of PPD in the first-year postpartum ranged from 12.1%-23.4% to 7.5%-8.4% for fathers and mothers, respectively. SOC had the strongest impact on EPDS scores for both fathers and mothers at all four survey periods. CONCLUSIONS: Our findings suggest that stress coping skills are an important factor affecting PPD throughout the first-year postpartum for both fathers and mothers.

Burnout among kindergarten teachers and associated factors.

Burnout among kindergarten teachers is a subject of great concern. Although burnout is reported to be significantly associated with turnover intention and work engagement, few studies have examined factors associated with burnout among these teachers. Therefore, in the present study, we performed a cross-sectional survey of burnout and associated factors among kindergarten teachers. We distributed 3363 questionnaires to all 205 authorized kindergartens and childcare institutions in Nagasaki Prefecture and received 1086 responses (response rate: 32.3%). The participants were limited to full-time female class teachers. After excluding survey forms with incomplete content, we ultimately examined valid responses from 442 participants. The survey examined burnout (Maslach Burnout Inventory, MBI), teacher stress (Nursery Teacher's Stress Scale, NTSS), coping behaviors (Brief Scales for Coping Profile, BSCP), and social support (Social Support Scale, SSS). A multiple regression analysis revealed that all 3 MBI subscales were positively associated with "understanding of how to handle children" on the NTSS and negatively associated with "superiors" on the SSS. "Emotional exhaustion" was significantly associated with "interpersonal relations at work" and "lack of time" on the NTSS, and "avoidance and suppression" on the BSCP. "Depersonalization" was significantly associated with age, "disconnect in working conditions" on the NTSS, and "proactive problem solving" and "venting emotions to others" on the BSCP. "Diminished professional accomplishment" was significantly associated with age, "lack of time" on the NTSS, and "proactive problem solving" and "change in perspective" on the BSCP. These results suggest that support from superiors that enables teachers to better understand children and handle them appropriately is necessary to prevent burnout.

The Relationship between Motor Coordination Ability, Cognitive Ability, and Academic Achievement in Japanese Children with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder.

Motor coordination abilities are related to cognitive abilities and academic achievement in children with neurodevelopmental disorders. However, the similarities and differences of these relationships in children with autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (AD/HD) have not been explored. The purpose of this study was to investigate the relationship between motor coordination abilities, cognitive abilities, and academic achievement in Japanese children with ASD and AD/HD. Participants included 20 children with ASD, 20 children with AD/HD, and 20 typically developing children, matched for age and gender. Their motor coordination abilities were assessed with the Movement Assessment Battery for Children-2 (MABC-2). Furthermore, cognitive ability and academic achievement were assessed with the Kauffman Assessment Battery for Children-II (K-ABCII). Results demonstrated that the MABC-2 Total score significantly correlated with the K-ABCII Simultaneous processing, Planning, Total cognitive ability, Writing and Arithmetic scores in children with ASD. However, in children with AD/HD, there was no significant correlation between MABC-2 and K-ABCII subscale scores. The results of this study indicated that the relationship between motor coordination ability, cognitive ability, and academic achievement differs between ASD and AD/HD. This difference might indicate the non-similarity of neurological characteristics and encourage consideration for an approach that accommodates the features of neurodevelopmental disorders in children.

Relationship between Sensitivity Tendency and Psychological Stress Reactivity in Healthy Students.

This study examined the relationship between sensory processing sensitivity and psychological stress reactivity in 69 healthy Japanese university students. The Japanese version of the Highly Sensitive Person Scale and the Japanese version of the Adolescent/Adult Sensory Profile were used for subjective assessment. The Galvanic skin response was measured as an objective measure of stress responses while the participants were completing the Stroop task. The Wilcoxon signed-rank test, the Spearman rank correlation coefficient, and the Mann−Whitney U test were conducted for data analysis. The results demonstrated that there was no significant correlation between the Japanese version of the Highly Sensitive Person Scale and Galvanic skin response. However, there was a marginal trend toward significance between low registration in the Japanese version of the Adolescent/Adult Sensory Profile and Galvanic skin response (rs = 0.231, p < 0.10; rs = 0.219, p < 0.10), suggesting that self-rated sensitivity was not necessarily associated with objective measures. These results indicate that sensory processing sensitivity analyses require the consideration of the traits and characteristics of the participants and multifaceted evaluations using a sensitivity assessment scale other than the Japanese version of the Highly Sensitive Person Scale.

Visual attention affects late somatosensory processing in autism spectrum disorder.

PURPOSE: Somatosensory processing problems are often reported in individuals with autism spectrum disorder (ASD), along with an abnormal multimodal integration of visual, tactile or proprioceptive information. However, the effects of visual stimulation and attention on somatosensory processing in ASD remain unknown. This study explores the effects of visual attention on somatosensory processing in ASD. MATERIALS AND METHODS: The neural activity in somatosensory areas and associated regions was investigated by measuring somatosensory evoked potentials (SEPs) elicited by median nerve stimulation, in three different conditions (closed eyes, open eyes and focused attention to a visual task). Nine individuals with ASD and nine typically developing (TD) individuals participated in the study. RESULTS: There were significant interactions between groups (ASD, TD) and conditions (closed eye, open eye, visual task requiring focused attention) for P100-N140 SEP amplitudes evaluated by 2-way analysis of variance. Post hoc analyses revealed that the P100-N140 amplitude with closed eyes recorded larger SEPs in the ASD group than in the TD group at C3' of the international 10-20 system. In the ASD group, the P100-N140 amplitude elicited smaller responses during visual tasks than with closed or open eyes. There were no significant differences in N20-P25 SEP components. CONCLUSIONS: These findings suggest that visual attention affects the later stages of somatosensory processing in individuals with ASD.

Factors associated with kindergarten teachers' willingness to continue working.

ABSTRACT: The turnover rate among kindergarten teachers in advanced countries is extremely high. As such, there is an urgent need to determine the reasons for this turnover and to identify ways to prevent it. The current study investigates the individual and environmental factors that impact kindergarten teachers' willingness to continue working.A total of 600 kindergarten teachers in Japan participated in this study. Participants responded to questionnaires regarding their willingness to continue working, mental health, work engagement, and the availability of social support. Multiple logistic regression analysis was used to analyze participants' data, with willingness to continue working for 5 or more years as the dependent variable. Additionally, Spearman rank correlation was used to examine the correlations between factors associated with willingness to continue working.Factors such as older age, living with a spouse, caring for younger children (up to 2 years old) at work, good mental health, and higher work engagement were significantly associated with teachers' higher willingness to continue working. Factors such as marriage, health and family problems, overtime work, issues with workplace childcare, and education policy, working time/day problems, human relations, and difficulties taking care of children were correlated with teachers' lack of willingness to continue working.The findings of this cross-sectional study suggest that welfare benefits and individual support systems could be key elements to encourage kindergarten teachers to continue working and could lead to their improved job satisfaction and mental health. Balanced work conditions and workers' high agreement with their workplace's overall childcare or educational policies may lead to lower turnover. Some programs - such as relationship counselling - could have a positive impact on teachers' mental health and job satisfaction.

The mental health status of children who have been evacuated or migrated from rural areas in Fukushima prefecture after the Fukushima daiichi nuclear power station accident:results from the Fukushima health management survey.

INTRODUCTION: We evaluated the mental health status of children residing in Kawauchi village (Kawauchi), Fukushima Prefecture, after the 2011 accident at the Fukushima Daiichi Nuclear Power Station, based on the children's experience of the nuclear disaster. METHODS: We conducted this cross-sectional study within the framework of the Fukushima Health Management Survey (FHMS);FHMS data on age, sex, exercise habits, sleeping times, experience of the nuclear disaster, and the "Strengths and Difficulties Questionnaire (SDQ)" scores for 156 children from Kawauchi in 2012 were collected. Groups with and without experience of the nuclear disaster - "nuclear disaster (+)" and "nuclear disaster (-)" - were also compared. RESULTS: Our effective response was 93 (59.6%);the mean SDQ score was 11.4±6.8 among elementary school-aged participants and 12.4±6.8 among junior high school-aged ones. We statistically compared the Total Difficulties Scores (TDS) and sub-item scores of the SDQ between "elementary school" and "junior high school" or "nuclear disaster" (+) and (-). There was no significant difference between these items. CONCLUSIONS: We found indications of poor mental health among elementary and junior high school-aged children in the disaster area immediately following the accident, but no differences based on their experience of the nuclear disaster. These results indicate the possibility of triggering stress, separate to that from experiences related to the nuclear disaster, in children who lived in affected rural areas and were evacuated just after the nuclear disaster.

Neonatal behavior and social behavior and sensory issues in 18-month toddlers.

BACKGROUND: There has long existed a need for early detection and early intervention for children with autism spectrum disorder. Accordingly, the aim of this study was to demonstrate, in a prospective manner, the relationship between behavioral features during the neonatal period and social behavior and sensory issues at 18 months. METHODS: Participants were 105 full-term infants considered "healthy" by an obstetrician. The behavioral features of the infants were evaluated using the Neonatal Behavioral Assessment Scale (NBAS) between 2 and 7 days after birth. Follow-up assessments were conducted 18 months later using a Japanese version of the Modified Checklist for Autism in Toddlers (M-CHAT-JV) and the Infant / Toddler Sensory Profile (ITSP). RESULTS: Sixteen (15.2%) of the 105 infants were M-CHAT-JV-positive. There were significant differences between the M-CHAT-JV-positive and M-CHAT-JV-negative groups in two of the NBAS clusters: orientation and motor. We observed a significant negative correlation between the NBAS orientation cluster and the ITSP "low registration" and "auditory processing" sections, as well as between the NBAS motor cluster and the ITSP "sensation avoiding" and "tactile processing" sections. Logistic regression analysis showed that the NBAS orientation cluster and ITSP low registration were significantly associated with the M-CHAT-JV at 18 months. CONCLUSIONS: The results suggest a relationship between the NBAS orientation cluster in full-term neonates and their social behavior and sensory features at 18 months.

Relationship between parenting stress and children's behavioral characteristics in Japan.

BACKGROUND: The evaluation of a child tends to differ between the mother and father regardless of whether the child has a disability or not, although parents have key information about the behavioral characteristics of the child. The number of reports in Japan, however, is limited. We, therefore, investigated the relationship between the parenting stress experienced by parents of non-clinical preschool children and the children's behavioral characteristics. METHOD: The subjects were 83 pairs of mothers and fathers with non-clinical children in kindergarten and nursery school (average age, 59.1 ± 13.0 months; 36 boys, 47 girls). The study was conducted using the Parenting Stress Index-Short Form (PSI-SF) and the Strengths and Difficulties Questionnaire (SDQ). RESULTS: There was no difference in the PSI-SF scores between mothers and fathers, but hyperactivity/inattention, peer relationship problems, and the total score of the SDQ were significantly higher in fathers. On multiple regression analysis, parenting stress experienced by fathers was significantly related to hyperactivity/inattention, while parenting stress experienced by mothers was significantly related to peer relationship problems and emotional symptoms. CONCLUSION: Children's behavioral characteristics related to parenting stress differ between mothers and fathers.

Factors associated with preschool workers' willingness to continue working.

In industrialized countries, the turnover rate of preschool workers is extremely high and now represents a social problem. Consequently, it has become important to promote stable early care and educational environments for this population. Several factors related to working environments are known to affect turnover intention; however, the specific factors related to turnover intention among preschool workers have not yet been identified. Considering this, the objective of the present study was to determine factors associated with preschool workers' willingness to continue working.The participants of this study were 1137 preschool workers based in Nagasaki Prefecture, Japan. Multivariate logistic regression analysis was used to analyze the participants' data, with willingness to continue working for 5 years or more set as the dependent variable.Analysis of the results for all subjects clearly showed that male sex, older age, good mental health, high number of social supports, and good work engagement have a positive effect on willingness to continue working. Further, stratifying the participants in terms of age revealed that for preschool workers under 39 years, male sex, good mental health, high number of social supports, and good work engagement act positively in regard to willingness to continue working. Meanwhile, for those over 40 years, it was found that permanent employment and good work engagement act positively in this regard. Thus, work engagement was the only common factor between preschool workers under 39 and over 40.The findings of this cross-sectional study demonstrate that the factors associated with willingness to continue working among preschool workers differ between younger and older professionals. These findings underline the importance of considering age categories when attempting to maximize such professionals' willingness to continue working.

Relationship between Motor Coordination, Cognitive Abilities, and Academic Achievement in Japanese Children with Neurodevelopmental Disorders.

BACKGROUND/OBJECTIVE: Motor coordination impairment is common in children with neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (AD/HD). The purpose of this study was to investigate the relationship between motor coordination, cognitive ability, and academic achievement in Japanese children with neurodevelopmental disorders. METHODS: Thirty-four school-age (6-12 years old) children with neurodevelopmental disorders and 34 age-matched typically developing (TD) children were recruited in this study. Correlations between the scores of the Movement Assessment Battery for Children-2 (M-ABC2) and the Kaufman Assessment Battery for Children - Second Edition (K-ABCII) that assesses cognitive abilities, and academic achievement were analyzed. RESULTS: The children with neurodevelopmental disorders obtained a lower total score and all component scores on M-ABC2 compared to the TD children. In children with neurodevelopmental disorders, M-ABC2 Manual Dexterity score was significantly correlated with K-ABCII Simultaneous Processing (r = .345, p = .046), Knowledge (r = .422, p = .013), Reading (r = .342, p = .048), Writing (r = .414, p = .017), and Arithmetic (r = .443, p = .009) scores. In addition, M-ABC2 Balance score was significantly correlated with K-ABCII Learning (r = .341, p = .048), Writing (r = .493, p = .004), and Arithmetic (r = .386, p = .024) scores. CONCLUSION: These findings stress that it is essential to accurately identify motor coordination impairments and the interventions that would consider motor coordination problems related to cognitive abilities and academic achievement in Japanese children with neurodevelopmental disorders.

Effectiveness of Earmuffs and Noise-cancelling Headphones for Coping with Hyper-reactivity to Auditory Stimuli in Children with Autism Spectrum Disorder: A Preliminary Study.

OBJECTIVE/BACKGROUND: The purpose of this pilot study was to examine the effectiveness of standard earmuffs and noise-cancelling (NC) headphones in controlling behavioural problems related to hyper-reactivity to auditory stimuli in children with autism spectrum disorder (ASD). METHODS: Twenty-one children with ASD aged 4-16 years (16 boys and 5 girls), after a 2-week nonwearing baseline period, were asked to use standard earmuffs and NC headphones for 2 weeks, in a random order. Parents or teachers rated participants' behaviours that were related to their reaction to auditory stimuli. RESULTS: Four participants refused to wear either the earmuffs or the NC headphones. It was found that the T-score on the Goal Attainment Scaling was significantly higher during the earmuff period than that in the baseline period (Z = 2.726, p = .006). The behaviours of 5 children with ASD improved during the NC headphone period as compared with those in the baseline period; there were no differences in the T-scores on the Goal Attainment Scaling between the NC headphone period and the baseline period (Z = 1.689, p = .091) and between the earmuff and NC headphone periods (Z = -0.451, p = .678). CONCLUSION: This study demonstrated the effectiveness of standard earmuffs and NC headphones in helping children with ASD to cope with problem behaviours related to hyperreactivity to auditory stimuli, therefore, children with ASD could use earmuffs to help to deal with unpleasant sensory auditory stimuli.

Relationship between Sympathetic Skin Responses and Auditory Hypersensitivity to Different Auditory Stimuli.

[Purpose] Auditory hypersensitivity has been widely reported in patients with autism spectrum disorders. However, the neurological background of auditory hypersensitivity is currently not clear. The present study examined the relationship between sympathetic nervous system responses and auditory hypersensitivity induced by different types of auditory stimuli. [Methods] We exposed 20 healthy young adults to six different types of auditory stimuli. The amounts of palmar sweating resulting from the auditory stimuli were compared between groups with (hypersensitive) and without (non-hypersensitive) auditory hypersensitivity. [Results] Although no group × type of stimulus × first stimulus interaction was observed for the extent of reaction, significant type of stimulus × first stimulus interaction was noted for the extent of reaction. For an 80 dB-6,000 Hz stimulus, the trends for palmar sweating differed between the groups. For the first stimulus, the variance became larger in the hypersensitive group than in the non-hypersensitive group. [Conclusion] Subjects who regularly felt excessive reactions to auditory stimuli tended to have excessive sympathetic responses to repeated loud noises compared with subjects who did not feel excessive reactions. People with auditory hypersensitivity may be classified into several subtypes depending on their reaction patterns to auditory stimuli.

Characterization of prostaglandin E1 transport in rat renal brush-border membrane.

Transport of prostaglandin E(1) (PGE(1)) was investigated in rat renal brush-border membrane vesicles. The uptake of [(3)H]PGE(1) was sensitive to osmosis and temperature. This uptake was saturable and mediated by high-affinity (K(m)=2.1 microM)/low-capacity (V(max)=17.4 pmol/mg protein/30 sec) and low-affinity (K(m)=526.5 microM)/high-capacity (V(max)=1,032.5 pmol/mg protein/30 sec) transport systems. [(3)H]PGE(1) uptake was Na(+)-independent and inhibited by various eicosanoids including PGE(2) and PGF(2alpha). Bromcresol green and sulfobromophthalein, potent inhibitors of prostaglandin transporter (PGT), significantly decreased [(3)H]PGE(1) uptake. Uptake was also inhibited by indomethacin and probenecid, which reportedly have little effect on PGT. Benzylpenicillin and taurocholate decreased the uptake of [(3)H]PGE(1). Like p-[(14)C]aminohippurate (PAH) uptake by vesicles, the uptake of [(3)H]PGE(1) was stimulated by an inside-positive membrane potential, created by applying an inward K(+) gradient and valinomycin. However, the uptake of [(3)H]PGE(1) was not inhibited by PAH, suggesting that PAH and PGE(1) are transported by separate transport systems. [(3)H]PGE(1) uptake was not stimulated by outwardly directed gradients of Cl(-) nor unlabeled PGE(1), indicating that an anion exchanger may not be involved in PGE(1) transport. These findings suggest that the transport of PGE(1) in rat renal brush-border membrane is mediated by specific transport system(s), at least in part, by a potential-sensitive transport system.