Relationship between personal recovery, autobiographical memory, and clinical recovery in people with mental illness in the acute phase.

Aim: Narratives are important in psychiatric rehabilitation. People with a psychiatric diagnosis find it difficult to recall specific autobiographical memories of events that lasted less than a day. Although personal narratives play a central role in personal recovery, the factors influencing personal and clinical recovery, such as psychiatric symptoms and cognitive function, have not been fully explored. Therefore, this study examined the associations between personal recovery and autobiographical memory, age, psychiatric symptoms, and neurocognitive function. Method: The Self-Identified Stage of Recovery, Parts A and B (SISR-A, SISR-B), Autobiographical Memory Test (AMT), Japanese version of the Brief Assessment Scale of Schizophrenia Cognitive Function, and Brief Psychiatric Symptom Rating Scale were administered to 40 individuals with psychiatric disorders who were undergoing psychiatric rehabilitation. Results: A significant positive correlation was found between the total number of specific memories in the AMT and total SISR-B scores. A binary logistic regression analysis revealed that the total number of specific memories, especially high responsiveness to negative cue words, significantly predicted greater personal recovery. Age, psychiatric symptoms, and neurocognitive function did not significantly predict higher personal recovery. Conclusion: In psychiatric rehabilitation, negative episodes should be treated with caution; however, they may also facilitate personal recovery.

Sensory processing, autonomic nervous function, and social participation in people with mental illnesses.

Introduction: This study investigated the relationship between sensory processing, respiratory sinus arrhythmia, and social participation in people with psychiatric disorders. Method: This study recruited 30 participants, primarily women, from a psychiatric university hospital with a mental health diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (mean age: 37.7 ± 16.0 years). Sensory processing, autonomic nervous function, and social participation were measured using the Adolescent/Adult Sensory Profile®, respiratory sinus arrhythmia, and World Health Organization Disability Assessment Schedule, respectively. Through mediation analysis, a model wherein sensory processing mediated the relationship between respiratory sinus arrhythmia and social participation was developed. Results: Social participation was moderately to highly correlated with Adolescent/Adult Sensory Profile® quadrants (excluding sensory seeking) and respiratory sinus arrhythmia. Furthermore, the mediation analysis revealed that sensory avoiding mediated the relationship between respiratory sinus arrhythmia and social participation, consequently counteracting the direct relationship. Conclusion: A mediation model was constructed, which indicated that individuals with psychiatric disorders and low parasympathetic nervous system activity expressed higher sensory processing quadrant of sensory avoiding. Ultimately, this was associated with reduced social participation.

A Simulation Model of Escapable and Non-Escapable Areas from Which Pregnant Women Can Reach Tsunami Evacuation Buildings: The Case in 110 Elementary School Districts in Nagoya City, Aichi, Japan.

OBJECTIVE: The objective of this study was to establish a method for evaluating the possibility of pregnant women evacuating to tsunami evacuation buildings in coastal areas affected by tsunami. METHODS: We used data published by the Japanese government and a general-purpose geographic information system to develop a simulation method for evaluating the possibility of evacuation. The data included the number of pregnant women in each elementary school district, tsunami inundation forecast maps, location information of tsunami evacuation buildings, and the number of ordinary buildings. We used our method to conduct a tsunami evacuation possibility simulation for pregnant women in each elementary school district in 7 wards of Nagoya, Japan. RESULTS: Dense population areas at low elevations are high-risk areas from which many pregnant women may not be able to evacuate. Districts with evenly distributed tsunami evacuation buildings tend to have a lower risk. CONCLUSIONS: The proposed simulation method was able to determine the risk in elementary school districts in densely populated low-lying areas. However, it is suggested that the risk tends to be estimated higher in school districts where there are differences in elevation and the building distribution is not uniform.

Road Centerline Data Accumulation for Rescue Workers Whose Expertise Is Not GIS.

OBJECTIVES: The objective of this study is to provide road centerline data for professionals of disaster medicine areas who are often beginners in GIS use. METHODS: Newly developed vector tile format data were converted into shapefile format data, then were organized as second level medical districts to which medical professionals are accustomed. RESULTS: Road centerline data in Japan is being prepared to release from Association for Promotion of Infrastructure Geospatial Information Distribution free of charge. CONCLUSION: Professionals of disaster medicine areas increased their accessibility of GIS. Logistic planning for evacuation activities and dispatching of rescue teams were improved.

Predicted Number of Pregnant Women in Aichi Prefecture, Japan: Estimation by Machine Learning Database Construction for Disaster Preparation.

Aichi prefecture, Japan is predicted to be hit by Mega-earthquake. Aichi Prefectural Association of Midwives has been making efforts to improve disaster preparedness for pregnant women. This project aims to acquire area data of pregnant women for simulated studies of rescue activities. Number of women in census survey areas in Nagoya City was acquired from nationwide data of pregnant women by machine learning (Cascade-Correlation Learning Architecture). Quite high correlation coefficients between actual data and estimation data were observed. Rescue simulations have been carried out based on the data acquired by this study.

Estimation of Pregnant Women Possibly Left Behind in Tsunami Predicted Areas of Nagoya City: A Simulation for Rescue Planning.

OBJECTIVE: In case of an outbreak of Nankai Trough Mega-earthquake, it is predicted that a tsunami would invade Nagoya City within 100 minutes, hitting about one third of the City of Nagoya. If the administrative plan of the city and midwives' expertise are coordinated, pregnant women's chances of survival will increase. The authors carried out this simulation study in an attempt to improve consistency of the two efforts. METHOD: We estimated the number of pregnant women using a machine learning model. The evacuation distance of pregnant women was estimated on the basis of the data of road center line. RESULTS: Through this simulation study, it became clear that preparation for approximately 2600 pregnant women escaping from tsunami predicted area and for about 1200 pregnant women possibly left in the area is needed. CONCLUSIONS: Our study suggests that triage point planning is needed in areas where pregnant women are evacuated. The triage makes it possible to transport women to appropriate hospitals.

Prevalence and associated factors of suicidality in Japanese adolescents: results from a population-based questionnaire survey.

BACKGROUND: Suicide is the leading cause of death among Japanese adolescents. However, knowledge gaps regarding contemporary demographics and factors associated with suicidality among Japanese adolescents are a major concern. This study examined the prevalence of suicidality among Japanese adolescents and investigated associated factors. METHODS: A population-based questionnaire survey investigating general health was administered to 22,419 adolescents aged 13-18 years. The 29-item questionnaire covered emotional status, family function, cyberbullying, suicidality, and stressors (e.g., relationships with parents/friends, school performance, and sexual identity). We conducted multiple logistic regression analysis to identify factors associated with suicidality in this population. RESULTS: The prevalence of suicidal ideation was 21.6% in males and 28.5% in females, and that of attempted suicide was 3.5% in males and 6.6% and in females. Bullying and stress related to family relationships had the strongest associations with suicidality. Exposure to cyberbullying had the highest odds ratio for both junior high (3.1, 95% confidence interval [CI] 2.1-4.4) and high school students (3.6, 95% CI 2.5-5.3). Other factors significantly associated with suicidality were sex, emotional status, and stress about relationships with friends, sexual identity, school records, and academic course. Adolescents accessed a variety of resources to cope with stressors, with the Internet being the most common resource consulted. CONCLUSIONS: Suicidality is commonly experienced among Japanese adolescents. Although there are many associated risk factors, cyberbullying is of particular concern. Recognition of factors associated with adolescent suicidality will inform further research and suicide prevention efforts for healthcare providers and families.

[Parenting anxiety and childhood development of twins as compared to singletons].

OBJECTIVE: Parenting anxiety has been highlighted recently because it tends to be a problem of mother-child relationships and a factor in child maltreatment. Compared to mothers of singletons, it is reported that mothers of twins experience a greater physical and mental burden of parenting. This study aims to investigate whether mothers of twins have more parenting anxiety than those of singletons and whether parenting anxiety affects child's mental development in both twin and singleton groups. METHODS: 218 mothers of 0 to 2-year-old twins were recruited at seventeen organizations for twin rearing in Kinki area, western Japan, from March to May 2005. Questionnaires were mailed or handed out to the mothers. In all, 124 mothers of twins (56.9%) returned the questionnaires. 5 data sets were excluded because of twins' cerebral paralysis or other reasons and 119 data sets (96.0%) were analyzed. A total of 348 mothers of singletons were collected at four preschools and two public health centers in the same area from March 2005 to March 2006. Questionnaires were mailed or handed out and were returned by 101 mothers (28.1%). 4 data sets were excluded because of the presence of twins or over age children and 97 data sets (96.0%) were analyzed. The core questionnaires included the JCFRI Child Rearing Support Questionnaire for measurement of parenting anxiety and the Tsumori-Inage Infant Developmental Scale. RESULTS: 1. Compared to their counterparts with singletons, mothers of twins showed significantly higher scores for parenting anxiety, including general confusion of parenting and negative feelings toward their children. 2. On multiple logistic regression analysis, high parenting anxiety in mothers of 2-year-old twins, especially negative feelings were related to delay in the children's mental development. However, there was no significant relationship with twins aged 0 or 1 year and with singletons of 0 to 2 years of age. CONCLUSIONS: The results suggest that negative feelings toward children influence mother-child interactions and complicate relationships. Parenting anxiety is a severe problem in mothers of twins not only because it causes mental problems in mothers but also because it has an impact on child mental development.

Behavioral outcome including attention deficit hyperactivity disorder/hyperactivity disorder and minor neurological signs in perinatal high-risk newborns at 4-6 years of age with relation to risk factors.

BACKGROUND: Diagnostic problems with the criteria of attention deficit hyperactivity disorder (ADHD) in the Diagnostic Statistical Manual, 4th edn, have been identified. The aim of this study was to clarify whether the minor neurological signs test (MNT) the authors had previously reported was a predictor for the criteria of ADHD or hyperactivity disorder (HD) in perinatal risk children at 4-6 years of age and what kind of risk factors related to MNT. METHODS: A total of 136 children discharged from neonatal intensive care units were examined at the age of 4-6 years by a developmental neuropediatrician using both MNT and diagnostic criteria of DSM-IV ADHD/ICD-10 (International Classification of Diseases, 10th edn) HD. SPSS base and professional were used for statistical analysis. RESULTS: On comparison of diagnostic criteria between ADHD (11.0%) and HD (27.5%), the incidence in the same subjects showed significant difference. MNT scores showed significant correlation with criteria of ADHD (P < 0.01) and HD (P < 0.05). Diagnostic validity of MNT for predicting ADHD was demonstrated with 78% sensitivity and 79% specificity. High positive rates on MNT did not show a significant difference between the very low birthweight (VLBW) and non-low birthweight (NLBW) groups. Behavioral outcome with relation to risk factors were analyzed using multiple regression analysis. Apgar 5 in the NLBW group and toxemia of pregnancy and small for gestational age (SGA) in VLBW group were highly correlated with behavioral outcome. CONCLUSIONS: Minor neurological signs test score was a significant predictor for criteria of ADHD and HD. High incidences of positive MNT were suspected in not only VLBW children but also NLBW children and Apgar 5 in NLBW children and toxemia of pregnancy and SGA in VLBW children influenced behavioral outcome.