Emiko TANAKA

Copyright © 2016, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. Background Since limited, specific assessments of social environments have previously been used, with the effect of a change in social interaction proving rare in previous studies, this study sought to clarify the specific association between changes in social interaction and symptoms of dementia. Methods The participants were elderly people, aged > 60 years, from a suburban community. All the participants formed part of the investigation from 2008 to 2011. The Index of Social Interaction was used to measure social interaction among elderly people. Data of dementia were obtained from Health and Welfare Center of local government. The chi-square test and a logistical regression analysis were used to examine the relationship between changes in social interaction and dementia. Results There were 321 participants without missing data. The results showed that "reading newspapers" was a positive change in social interaction in relation to the risk of dementia (odds ratio = 3.45, confidence interval: 1.04-11.45). Conclusion This study focused on changes in social interaction and found that a positive change could help prevent dementia. Specifically, this study indicated that elderly people's engagement with the social environment and in intellectual activities would prevent dementia.

© 2017 by Nova Science Publishers, Inc. Based on 17 years of cohort research examining childcare quality improvement, a “cloud computing-based support system for comprehensive childcare” and the Scale for Assessing Social Skill Development in Children were developed and implemented. The system contains five support tools consisting of a web application and mechanism for implementing quality childcare according to the Plan-Do-Check-Act cycle. The system’s effectiveness in aiding social skill development in children with autism was determined via a series of follow-up studies. For example, we were able to assess the system’s ability to target the following problem areas: “autonomy” (e.g., a child smiles or laughs during a teaching demonstration and a child attempts to elicit a caregiver’s response), “responsiveness” (e.g., a child vocalizes or babbles within five seconds of a caregiver’s verbalization and a child vocalizes or babbles within five seconds of a caregiver’s gesture, touch, or facial expression change), “empathy” (e.g., a child gives, shows, or points toward task material to share emotions with a caregiver and a child looks at a caregiver’s face for social referencing), and “emotional selfregulation” (e.g., a child stops displaying distress when a caregiver does not respond). In this chapter, we argue that continuous system use and development will provide greater evidence of its efficacy, assist in expertise acquisition, and contribute to the healthy development of children and their caregivers.

Objective: The present study aimed to examine whether or not the physical fitness self-evaluation scale (PSE) can be used to predict long-term fall-related risks in the elderly, as well as the reliability and validity of the scale. Methods: In 1996 and 2011, cohort surveys were conducted involving (1,095) elderly people aged 60 years or older living in Village T, adjacent to a large city in the Chubu region of Japan. Data on 288 people who participated in both the 1996 and 2011 surveys were analyzed. Survey items included PSE, fall-related items, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), Index of Social Interaction (ISI), and exercise habits. The internal consistency of the scale was also examined by calculating Cronbach's coefficient alpha to assess its reliability. Partial rank correlation analysis was then conducted to examine the criterion-related validity. Results: The reliability of the scale was high: Cronbach's coefficient alpha was 0.90. For males, partial correlation functions with the PSE at baselines were 0.227 for the fall rate (p<.05), 0.375 for the TMIG-IC (p<.01), 0.329 for the ISI (p<.01), and 0.339 for the exercise habits (p<.01). Secondly, for females, significant but weak partial correlations were noted between the PSE in 1996 and fall-related items of the 2011 scale. Regarding the measurement of physical fitness in 2011, there were significant partial correlations between the present scale and PSE for maximum stride (males: 0.314, p<.05) and 5-m walking (females: -0.304, p<.01). Conclusion: The PSE did not show adequate effectiveness from the viewpoint of the validity of the scale to predict fall-related risks. However, the survey results suggest that PSE may serve as a useful scale to evaluate long-term support and intervention programs for fall prevention and their directions.

© 2015 Japan Pediatric Society. Background: Previous research has established links between corporal punishment and children's developmental problems, but few studies have investigated the moderating effect of positive parenting between corporal punishment and children's developmental difficulties in detail. This study investigated the buffering effect of parental engagement on the association between corporal punishment and children's emotional/behavioral problems. Methods: The main caregivers completed the Evaluation of Environmental Stimulation Scale (EES), which is an evaluation of daily parenting behaviors, and the Strengths and Difficulties Questionnaire (SDQ), which evaluates children's developmental problems. Results: Corporal punishment was associated with worse emotional and behavioral problems in children, whereas parental engagement in games or sports was associated with fewer emotional symptoms. Similarly, parental engagement in homework or housework significantly moderated the association between corporal punishment and children's behavioral problems. Conclusions: Parental engagement positively moderated the association between parental corporal punishment and children's developmental difficulties. This association varied with child gender.

目的 本研究は,成人の典型的なかかわり場面における行動観察評価と臨床評定の関連から,行動観察による社会能力評価「かかわり指標(成人用)IRSA:Interaction Rating Scale Advanced実践版」の臨床的妥当性を検討することを目的とする。方法 18歳以上の男女43名を対象に,日常的なかかわり場面を再現した2名1組の課題を実施した。研究者によるIRSA実践版を用いた行動観察評価と,臨床専門職による臨床評定を得点化し,関連を検討した。行動観察評価および臨床評定による「協調」「自己制御」「自己表現」の各領域得点と総合得点について,Spearmanの相関係数を算出した。結果 行動観察評価と臨床評定の間には「協調」(r=0.62)「自己制御」(r=0.61)「自己表現」(r=0.59)「総合」(r=0.72)すべての項目に有意(p<0.001)な正の関連がみられた。考察 行動観察評価得点と臨床評定得点に相関がみられ,IRSA実践版の臨床的妥当性が示された。社会能力の特徴を簡便に測定できる「IRSA実践版」を実践の場で活用することにより,社会能力の向上,発揮に困難のある成人に対する支援への一助につながる可能性がある。(著者抄録)

OBJECTIVES: The prevalence of child abuse is increasing in Japan. Therefore, we need appropriate and practical approaches for implementing feasible prevention, early detection, and support services for abused children. The purpose of this study was to examine child-rearing anxieties and the home environment as factors affecting caregivers of suspected abused children who attend child-care centers .METHODS: First, we applied the millennium edition of the Japan Child and Family Research Institute (JCFRI) Child Rearing Support Questionnaire, and the Index of Child Care Environment (ICCE), for 1,801 caregivers whose children were enrolled in child-care centers based in City A. The millennium edition of the JCFRI Child Rearing Support Questionnaire measures difficulties in childcare for caregivers in terms of feelings, anxiety, and tendencies toward depression. The ICCE measures the quality and frequency of involvement of caregivers with their children and the child-care environment. Next, we interviewed the directors and child-care professionals in the centers to collect information on child abuse. The children were divided into two groups: abused and non-abused. The "abused group" consisted of the children whom the directors and professionals of the child-care centers suspected of being "possibly abused" and so had been placed under the protection of the center; furthermore, the center exchanged information with the City A Municipality "City A municipal government" about these children. We conducted Fisher's exact test to examine the relationship between the "abused group" and the "non-abused group," in relation to child-rearing anxiety and the children's home environments. Questionnaire scores from the two groups were assessed. We calculated odds ratios to examine the significant factors related to child abuse. Our dependent variable was child abuse, our main independent variables were items related to child-care difficulties and the child-care environment, and the moderating variables were age and gender. We used multiple logistic regression to assess the actual child abuse predictors.RESULTS: The odds ratios obtained by comparing the "abused group" with the "non-abused group" showed that the caregivers of children in the "abused group" had a 5.5-fold greater odds of saying, "I am riddled with uneasiness and awful feelings," and a 4.6-fold greater odds of saying, "I do not have anyone to look after my child except a child-care center." The moderating variables (age and gender) were not significant.CONCLUSION: Child-care professionals have a policy for ensuring there is concrete and usable support for caregivers, depending on the relationship between the abused child and the difficulties present in the child's environment. We suggest that awareness of these relationships can be promoted as an aid for early child abuse detection, support, and prevention.

Objective: This study attempted to clarify the types of developmental problems that predict low social competence among children. Method: Subjects were 3-5-year-old children recruited from all authorized child-night-care centers and attached child-day-care facilities across Japan. Caregivers filled out questionnaires regarding the child's sex and number of siblings, and childcare professionals completed the Checklist of Children with Difficulties and Social Skill Scale (SSS). The Checklist of Children with Difficulties contains 33 subscales, and the SSS consists of 3 factors: "cooperation," "self-control," and "assertion." The sample included 519 children (245 girls) evaluated by both the Checklist of Children with Difficulties at 3 years old and the SSS after 2 years. We examined the relationships between developmental problems and difficult behaviors and social competence by using multiple logistic regression analysis, controlling for sex and number of siblings. Results: Significant relationships were found between low social competence and the following subscales: "Hypersensitivity for the sound" (odds ratio = 38.86; 95% confidence interval = 4.21-358.85), "Hypersensitivity for the light" (odds ratio =14.21; 95% confidence interval =2.69-75.10), "Unnatural relationship" (odds ratio = 14.10; 95% confidence interval = 3.99-49.78), "Indifference" (OR = 4.06; CI = 1.64-10.03), "Stickler for anything" (OR= 5.53; CI = 2.33-13.12), " The rage is so strong" (OR= 2.44; CI = 1.10-5.40), "Hyperkinesis" (OR= 3.46; CI = 1.75-6.86), "Rowdy" (OR= 2.47; CI = 1.02-5.98), "Defiant attitude" (OR= 6.00; CI = 2.13-16.95), "The problem of language" (OR= 6.34; CI = 2.97-13.53), "Break a rule" (OR= 9.10; CI = 3.73-22.22), and "Delay in acquiring age-appropriate habits" (OR= 4.93; CI 2.11-11.51). Conclusion: In light of the current findings, it is necessary to provide special attention and support to individual children at a very early age.

Objective: This study attempts to clarify ways by which childcare professionals can promote social competence in children. Method: Focus group interviews were conducted with nineteen child care professionals (three groups) working in a nursery center that had conducted competence-development programs for not only typically developing children but also children with developmental disabilities. Results: Care professionals were found to play seven roles: objective clarification, helping enjoy, interpersonal relationships, expanding social network, changing the rhythm, promoting flexibility and adjustment when participating in group activities, keeping the future in perspective, and evaluating the effects of measures to promote social competence. Through analysis of interview data, we extracted fifteen categories: clarification of childcare policy, inculcating self-efficacy in the children, improving communication skills, readiness to face challenges, relationship with children, recognizing each child's individuality, cooperation between staff members, cooperation with parents, new community, organizing events, changing the status quo, a curriculum that matched children's development, expansion of activity, sending out signals, and understanding parents' perspectives. Conclusion: The findings, which reflect the actual voices of childcare professionals, are expected to aid in the realization of community empowerment.

目的 40年にわたり統合保育を実施している保育専門職に対しグループインタビューを行い,質の高い統合保育とインクルーシブ教育の推進要因を明らかにすることを目的とした。方法 障害児を積極的に受け入れている認可保育園の専門職に対してフォーカス・グループインタビューを実施した。対象は8名(男性4名,女性4名),社会福祉法人理事長,保育園の園長,主任クラスの保育専門職者,障害者の共同生活介護事業管理者であった。内容は,統合保育の原点と展開についてであった。グループインタビューから得られた結果をカテゴリー化し,質の高い統合保育を展開するための要因を抽出し分析した。結果 質の高い統合保育の推進要因を「個の領域」「相互の領域」「地域システムの領域」の3領域に分類した。具体的な要因としては「共感性の獲得」「表現力の獲得」「自己効力感の獲得」「仲間同士のかかわり」「保育士のかかわり」「地域社会とのかかわり」「社会ニーズへの先見性」の6点であった。結論 質の高い統合保育とは,仲間同士や保育士とのかかわりを通し子どもの社会性の育みを促進する保育である。インクルーシブ教育の推進には社会ニーズへの先見性,養育者にとどまらず地域住民を巻き込み地域の活性化に貢献するコミュニティ・エンパワメントの必要性が示唆された。(著者抄録)

Objective: Social development is one of the important outcomes examined in child care research. Factors related to parenting and the overall child-rearing environment, which includes the mother's mental health, are hypothesized to contribute to children's social development, above all, in early childhood. The purpose of this study was to determine whether parenting satisfaction and stress at 9 month affect the social competence of 30-month-olds. Methods: The study participants were 311 dyads of 9-month-old children and their mothers. Each mother completed questionnaires to provide child-rearing-related information, including information on parenting satisfaction and stress, when their child was 9 months old. Caregiver-child interaction was observed when the child was 30 months old, and the features of the interaction were studied using the Interaction Rating Scale (IRS), a measure of social competence. Results: Regression analysis showed that the children's total scores on the IRS were significantly related to their mothers' satisfaction and parenting stress when the children were 9 months old. At the same time, the caregivers' total scores were also related to their children's total scores on the IRS. Multiple regression analysis was performed, after controlling for genders of children, to analyze the association between the children's social competence and the mothers' satisfaction (β=0.12, p=0.03) and caregiver-child interaction (β=0.41, p<0.01). Conclusions: The results suggest that mothers' satisfaction in child rearing is an important factor affecting the social development of children at 30 months of age.

Natural products, such as wooden ones, are attracting increasing interest worldwide because of the growing desire for an ecologically friendly and sustainable society. In particular, the healing effects and safety benefits of wood products have been explored, but few studies have evaluated their effects on the behavior and well-being of older adults in assisted living facilities. Thus, the present study was conducted to explore how wood products affected quality of life in elderly people. Participants were 44 elderly people and 30 health social care professionals in a single assisted living facility. Independent evaluators observed and rated the elderly people's behavior, using the Alzheimer's Disease Related Quality of Life and the Interaction Rating Scale Advanced over one month of using wood products daily. Furthermore, at baseline and one month later, participants completed a "tree drawing task" intended to assess their internal environment. Then, their health status and activities of daily living through regular observation were evaluated by professionals, who also completed a questionnaire evaluating subjective comfort, both before and after using wood products. Our results indicated that regular use of wood products significantly increased social interaction and harmonious relations, activity levels, and mental energy in elderly people. Furthermore, care professionals reported increased positive subjective comfort after using these products. Thus, using wood products on a daily basis appeared to improve the quality life of frail elderly, by stimulating emotional relationships through improved cognitive function. © SGEM2013 All Rights Reserved by the International Multidisciplinary Scientific GeoConference SGEM.

Background: Understanding patterns of health service utilization can improve health care and increase use of health services. We examined patterns of health service utilization among residents of Ulaanbaatar, Mongolia. Methods: A total of 500 adults were surveyed using paper-based questionnaires. The Χ2 test and multiple logistic regression were used to identify associations between factors. Results: 44.1% of respondents had visited a physician during the previous 12 months. After controlling for determinants, the significant predictors of utilization of health service were attention to health examinations (OR = 3.6, CI: 1.93-6.76), being married (OR = 2.7, CI: 1.50-4.72), being satisfied with the overall cleanliness of the hospital (OR = 2.4, CI: 1.12-5.19), being a nonsmoker (OR = 2.2, CI: 1.21-3.98), having periodic physical examinations (OR = 2.2, CI: 1.25-3.71), not being a hospital patient during the previous 3 years (OR = 2.1, CI: 1.22-3.73), having proper documentation (OR = 1.9, CI: 1.10-3.43), having medical insurance (OR = 1.9, CI: 1.96-3.28), not wanting to receive information on food and nutrition (OR = 0.6, CI: 0.36-0.96), having more than 5 household members (OR = 0.5, CI: 0.50-0.85), low income (OR = 0.5, CI: 0.30-0.85), lack of concern for food and nutrition (OR = 0.5, CI: 0.28-0.84), self-medication during the past 12 months (OR = 0.4, CI: 0.24-0.69), and desire for treatment abroad (OR = 0.4, CI: 0.20-0.60). Conclusions: A number of health-related behaviors and sociodemographic factors were important predictors of health service utilization. © 2013 Amarsanaa Gan-Yadam et al.

The purpose of this exploratory study was to examine the effects of (a) parent-child interaction and (b) home environment on the early development of empathy in toddlers. A total of 176 Japanese families (both young children and their parents) were enrolled in this study. Laboratory assessment of children's empathy development and caregiver's rearing competence was made during a controlled observation of parent-child interaction. The results of this study suggest that of all the factors examined, the degree of parent-child interaction, the stability of long-term parenting practices, parental attitude, and mother's mental health status were correlated with development of empathy in children. These findings provide new indicators for the development of individualized intervention methods for use in clinical practice. © 2012 Wiley Periodicals, Inc.

© 2012 Nova Science Publishers, Inc. The purpose of this paper is to describe the gender differences of social competence development using the Interaction Rating Scale (IRS) from eighteen months to seven year old. The participants in our study, which was conducted as part of a Japan Science and Technology Agency (JST) cohort study project, were 370 dyads of children with their caregivers who were followed up and surveyed at eighteen and thirty months and 82 dyads at seven years old. The participants completed the five minute interaction session and were observed using the IRS. The results indicated the gender differences of IRS scores. Girls achieved a higher score at all ages. Girls were more likely to demonstrate empathy at eighteen months, emotional regulation at eighteen months and thirty months, motor regulation at thirty months and seven years old, compared to boys. Along with the patterns of difference between boys and girls, the IRS is effective in describing features of social competence development.

Objectives This six-year follow-up study was designed to analyze the relationship between social interaction and dementia. Method All participants (aged 65 years and above) lived in farming communities near major urban centers in Japan (n=558). The contents of the questionnaire covered social interaction (using an index of social interaction constituting 18 items), health status, physical function, family structure, life events, age, and gender. Results After the baseline survey, 108 subjects were analyzed within the six-year period: (1) baseline age and physical function were related to dementia; (2) greater social interaction was positively related to reduced dementia; (3) the multiple logistic regression analysis adjusted for baseline age, gender, and physical function indicated that low frequency of newspaper reading was related to increased dementia. Discussion These findings highlight the importance of social interaction in dementia.

目的 本研究は,住民と保健福祉専門職に対するフォーカス・グループインタビューを実施し,高齢者支援に向けたコミュニティ・エンパワメント展開のための当事者のニーズを抽出することを目的とした。方法 大都市近郊農村自治体住民と保健福祉専門職4グループに対するフォーカス・グループインタビューを実施した。対象の内訳は男性22名,女性20名,合計42名で,年齢は30〜70歳代であった。各グループのインタビューから得られた結果をシステム理論に基づきカテゴリー化し,コミュニティ・エンパワメントに関するニーズを抽出した。結果 『個・相互・地域システム』のシステム構造に基づいて高齢者支援に向けたコミュニティ・エンパワメント展開のための当事者のニーズを抽出した結果,次のニーズが明らかになった。まず『個』の領域においては,「生きがい,楽しみ」「健康な生活への主体的な取り組み」「保健福祉サービスの活用」が,次に『相互』の領域においては,「交流の必要性」「相互支援体制の整備」が,また『地域システム』の領域においては,「地域の魅力化」「安心・安全な地域システムづくり」「地域で支え合う人材育成」「健康に関する支援の充実」のニーズである。結論 健康は,単にヘルスサービス供給にとどまらず,保健活動に関する意思決定における住民参加の原則に基づいて増進される。今回得られた住民の「なまの声」をもとに,当事者のニーズを活かした保健福祉活動の今後の発展が求められる。(著者抄録)

Background: Over the fast decides, after transition from a socialist system to a market economy, Mongolia has been quite impressive in social and economic development. But these improvements have not been meaningful impacts on health services, poverty reduction and environmental and sustainable development. During this transition period many families were plunged into poverty, social services were reduced and women were losing their equal opportunities. In order to solve the problems faced to community, it needs to promote empowerment and advancement for both men and women. Although basic human indicators are almost equal for Mongolian men and women, there are very few studies have examined in community empowerment and gender differences in Mongolia. Addressing and reducing the gender and socioeconomic disparities in the health of population is very important and the aim of this study was to investigate gender differences in health seeking pathways among the communities in Ulaanbaatar city, Mongolia. Methods: Five hundred randomly selected adult respondents were surveyed through paper based questionnaires. Each respondent represents one household and the survey was carried out urban and peri-urban areas in Ulaanbaatar city, Mongolia. Results: However, the health statuses of women were found to be lower than men, males are less likely to seek health care than females. The results show that women were more likely to have periodical exams than men. Also the most respondents did not participate in health enhancing activities. Conclusions: Even, there was some significant gender differences in health seeking behaviour, there were no gender barriers in health seeking behaviour in Mongolian society. In other hand the process of empowering community need to be more developed and surveyed at all level in Mongolia and there is much need to continue this kind of studies.

Objective: This study aimed to examine the association between elders' social interaction and their subsequent functional capacity. Method: A longitudinal study based on interview and investigation were carried out with the sample of elderly people who living in the rural community of Japan. Total 267 elderly people aged 60 and over were enrolled in this study in 2005 and 2008. The data of social interaction and activity of daily living (ADL) including basic ADL (BADL) and instrumental ADL (IADL) were analyzed by logistic regression analysis to examine the associations between elders' social interaction and their functional status 3 years later. Results: Subjects were consisted of 117 men (mean age±standard deviation, 68±7.0 years) and 150 women (69±7.6 years). During the 3-year follow up, after controlling for elders' age and gender, the significant factors of social activities related to their future BADL included: having a hobby (odds ratio=-1.57, p<0.05); having a self-identity as a useful social role (odds ratio: -1.78, p<0.05). For future IADL it included: Participation in community activities (odds ratio: -1.57.95%, p<0.05); Feeling importance in normal life (odds ratio: -1.65, <0.05) and using handy equipments (odds: -1.47, p<0.05). Conclusion: The findings in the present study clarified the links between elders' social interactions and their functional capacity three years later in the sample of rural community. It indicated that more social interaction which engages their physical and intellectual function can probably retard elders' function capacity decline.

Background: Early mother-child interaction is an important environmental factor for children, but there are only few observational studies looking into this in Japan. There is a need for research based on an observational and longitudinal study. Methods: This project, conducted in Japan, sought to examine the relations between children's social competence and early mother-child interaction and adaptation of 174 toddlers and mothers. The Interaction Rating Scale (IRS) was used to assess children's social competence and caregiver's parenting features when children are 18, 30 and 42 months old. Results: The results showed that early mother-child interaction was related to the children's autonomy, responsiveness, empathy, motor regulation, and emotional regulation assessed by the IRS. Conclusion: These findings show that early mother-child interaction is related to children's social competence at 42 months of age.

Background: Sleeping is important to children's development. There are some findings that sleep improvement of children with autism resulted in the improvement in social relatedness. Therefore sleeping patterns may be important to develop social skills. The aim of this study is to find the interaction between sleeping patterns, especially waking up patterns and social skill in healthy children. Methods: All authorized child-night-care centers and attached child-day-care facilities across Japan participated in the study when the children were two to four year-olds. Parents filled in questionnaires regarding sleeping time, and service providers evaluated the development of each child in the facility every year. Results: The trajectory of children's social skill in cooperation, self- regulation, and assertion were adopted. There was an association between cooperation and waking-up patterns, even after adjusting in gender. Conclusions: These findings show that waking-up patterns play the important roles for children's social skill. Further research is needed in order to clarify the correlation between sleeping patterns and social skill.

Background: With an increasing number of working mother in Japan, resulted to the concomitant increase in the using of non-parental childcare facilities to help look after the child. This increase in non-parental care has led to a dramatic change in the traditional child-rearing environment. Besides, young children's vocabulary and communication competences were demonstrated to be tightly correlated with early parenting practice. Methods: A total of 398 children and their working mothers were recruited from Japanese government-licensed childcare facilities. Children's developments were assessed by childcare professionals and parenting behaviors were collected by questionnaire which was filled by mothers. Results: The results show that mother singing songs with child (OR=3.079, P=0.0024) and playing with child (OR=9.393, P=0.0137) are beneficial to children's vocabulary development one year later. Conversely, punishment (OR=4.702, P=0.0088) child would exacerbate child vocabulary developmental delay. Mother playing with child (OR=6.119, P=0.043) also contribute to child's competence of communication, meanwhile, mother has confidence about childrearing (OR=3.553, P=0.0233) promote to children's communication development as well. Daily mother-child interaction in early childhood is crucial predictor for young children's language development later. Conclusion: Working mothers should increase the daily parent-child interaction activities with young children consciously in their free time, so as to promote children's competence development in vocabulary and communication

We aimed to clarify the effects of mothers' praise-when their children were 18 months-on the trajectory of their children's social competence from 18 months to 30 months. The participants were 194 mother-child dyads whose interaction was observed when the children were 18 months and 30 months. The features of mother-child interaction were examined using the Interaction Rating Scale (IRS) as an aspect of social competence. Logistic regression analysis was performed with the trajectory of social competence from 18 months to 30 months as the dependent variable and the actual behaviors of caregivers' praise as independent variables while controlling for the children's gender and the mothers' age and educational background. It was found that the mothers' actual praise-related behavior influenced the trajectory of their children's social competence from 18 months to 30 months.

Background: Dementia is one of the most common diseases in the elderly. Japan has the highest life expectancy in the world, which means that serious health problems such as dementia are prevalent among a large segment of the Japanese population. The purpose of this study was to explore the relationship between lifestyle habits and dementia among community dwelling older adults by conducting a cohort study. Methods: This was a prospective cohort study conducted over 6 years. The study was carried out in a farming community near a major urban center in Japan. Results: The participants consisted of 525 elderly adults aged 65 years or older. Multiple logistic regression analysis after adjustment for sex and age indicated that the diagnosis of dementia was 4.0 times higher among participants who did not take breakfast (p<0.01, CI=1.3-11.8), 2.7 times higher among participants who did snack (p<0.05, CI=1.1-6.5), 2.5 times higher among participants who did not care for salt consumption (p<0.05, CI=1.1-5.8), and 2.7 times higher among participants who did not care for nutrient balance (p<0.05, CI=1.2-6.2). Conclusion: According to our results, several lifestyle habits were associated with dementia. Appropriate interventions are required for high-risk individuals, including those with mild cognitive impairment. Evaluation and counseling by the physician is likely to strongly influence patient and caregiver awareness of dementia and hopefully slow disease progression. We suggest that public nurses may have the capacity to assess community dwelling elderly individuals in this manner in the Japanese health system.

Objectives. This study was designed to clarify the relation between continuity of social interaction and eight-year-mortality in a group of elderly people. Methods. The participants were all 65 years or older living in farming communities near major urban centers in Japan (n=554). The contents of the questionnaire covered social interaction (using an "Index of Social Interaction" consisting of 18 items), health status, activities of daily living (ADL), age and gender. Results. A total of 84 subjects died within the eight year period after the baseline survey: 1) baseline age and ADL were related to the eight-year mortality; 2) continuity of social interaction was positively related to reduced mortality; 3) multiple logistic regression analysis adjusted for baseline age, gender, physical function, health status, and ADL indicated that continuity of social interaction was related to reduced mortality. Discussion. These findings highlight the importance of continuing social interaction in successful aging.

A cohort study focusing on dental health, dental behavior and mortality was carried out among the elderly residents of a village near the city Nagoya. The aim of the study was to assess the possible role of dental health and dental behavior as a predictor of mortality. A survey, conducted during the period from 2002 to 2008, targeted 1012 people over the age of 60. Upon completion of the survey, multiple logistic regression was used to analyze factors affecting the survival rate. The results revealed a significant correlation between 6-year mortality levels and oral health behavior as indicated by a yes answer to the following questions; "Do you know the 8020 Movement?"; "Do you go to the dentist as soon as possible, if you need to?"; "Do you brush your teeth two times or more during a day?"; "Do you go to the dentist for a routine dental health check-up?". Within the positive responder group logistic regression analyses further revealed that the mortality rate was significantly dependent upon age and gender when using the yearly number of routine dental health check-ups as the independent variable. Our results support the hypothesis that a routine dental health check up strongly correlates with an increased survival rate and a longer lifespan.

This study demonstrated the criterion-related validity of Social Skill Scale (SSS) with Interaction Rating Scale (IRS) by children with behavioral or environmental difficulties. SSS constructs 3 factors, "cooperation", "self-control" and "assertion", IRS does 5 subscales for child items, "Autonomy", "Responsiveness to caregiver", "Empathy", "Motor self regulation" and "Emotional self regulation", converged with 3 factors equal to SSS. Participants were 2-6 year old 121 children evaluated by both SSS and the child items of IRS. As expected, "cooperation" significantly correlated with "Responsiveness to caregiver" "Empathy", "self-control" with "Motor self regulation" "Emotional self regulation", and "assertion" with "Autonomy". The results showed that these 2 scales have broad utility by choosing different situation for child support.

目的 本研究は,虐待に関連する養育者側および子ども側要因を経年的な分析により明らかにし,虐待の早期発見・早期支援に向けた支援への一助とすることを目的とした。方法 全国の認可夜間および併設昼間保育園(18園)に在籍する2〜6歳の子どもと保護者2,050名が対象であり,担当保育専門職より「気になる子ども」と評価された40名の園児のうち,2006年度における虐待の聞き取り調査で「虐待」の「確定」「疑い」と評価された6名を対象とし,基準年(2005年)と1年後(2006年)のデータ双方から育児環境と発達状況を分析した。担当保育専門職には「子どもの気になる行動」「園児用発達チェックリスト」の記入とともに,「虐待やネグレクトの有無」について聞き取り調査を行った。結果 虐待の聞き取り内容では,「疑い」5名,「確定」1名であった。子どもの発達は1年後に「リスクあり」が増加しており,子どもの発達リスクと虐待との関係が示された。その中で1名は1年後に発達が好転しており,背景に保護者の昼間勤務への転職による生活の改善があった。乳幼児の発達に「規則正しい生活リズム」と「情緒的安定」が重要であることが示された。育児環境では「父・母の協力が乏しい」「子どもを持つ友人との交流が乏しい」が基準年および1年後ともに高い割合であり,保護者は配偶者や友人のサポートが得られず孤立した中で子育てをしていた。子どもの失敗への対応に「たたく」と答えた2名は,「精神的に不安定な母親」と「しつけに厳しい父親」であった。また「先週子どもをたたいた回数」は「1〜2回以上」が半数以上おり,虐待のグレーゾーンを示していた。「たたいた」と基準年および1年後に回答した保護者のうち3名は同じ人で,子どもの失敗に対し「たたく」と答えた2名と「母子家庭で高校生の姉が面倒を見ているケース」であった。保護者特性では,「育児の自信がない」と半数が基準年および1年後に回答しており,保護者の背景要因に即した適切な支援が求められている。「保育園に行くのを楽しみにしている」は基準年および1年後ともに全数であり,保育園は家庭でのかかわりを日常的に補完する役割を担っていた。結論 児童虐待の早期発見・早期支援のために,保育園等乳幼児期の子どもの支援機関で活用可能な根拠のある支援技術の普及と地域や家庭における子育て支援システムの構築が期待される。(著者抄録)

本研究の目的は、育児環境の実態から、夜間に及ぶ長時間保育を行っている保育所が担う支援的役割について考察することである。保育所設置基準を満たして認可され、厚生労働省の延長保育促進事業の基準に基づく19時以降に及ぶ保育を実施している全国の保育所(41所)に在籍する子どもの養育者2,232名を対象として自記式質問票調査を行った。保育所は子どものすこやかな発達を促すかかわりを子どもの発達状態に合わせて日常的に提供し、子どものすこやかな発達を支える役割を担っていた。夜間に及ぶ長時間保育に携わる保育士は、養育者のサポートを通じ、子どもに関する深刻な問題の予防に寄与してきた可能性が示唆された。(著者抄録)

目的:本研究は、子どもの社会能力を構造的に評価する「かかわり指標」を用いて、18ヵ月児の応答性に焦点をあて、社会能力に関連する養育環境の特徴を明らかにすることを目的とした。方法:対象は、18ヵ月児とその養育者172名である。養育者に対する記名自記式質問紙および「かかわり指標」による子どもの「応答性」に対する観察評価を実施した。質問紙内容は、子どもの性別、きょうだいの有無、家族構成、経済状況、両親の年齢、教育レベル、職業、育児環境(4領域13項目)である。結果:応答性得点と育児環境について、対象属性を調整して関連を検討した。その結果、子どもの応答性と、「子どもに本を読み聞かせる機会」および「配偶者の育児協会の機会」との有意な関連がみられた。結論:家庭における適切な子どもへのかかわりや配偶者の育児協力が、18ヵ月児の社会能力に影響する一要因である可能性が示唆された。(著者抄録)

Objective The purpose of this study is to evaluate the reliability and validity of the Interaction Rating Scale (IRS) for assessing a child's social competence. We examined the internal consistency of IRS and criterion-related validity of IRS and NCAST Parent-Child Interaction Program Teaching Scale (NCATS). Methods The samples of this study ware 211 dyads of children and their caregivers who participated in the Japan Science and Technology Agency project. To evaluate the criterion-related validity of IRS, an image of the setting of the child-caregiver interaction was coded by both IRS and NCATS. The correlation between each subscale of IRS and the demographic information was calculated using Pearson's correlation coefficient. Considering the internal consistency of IRS, Cronbach's alpha was used. Pearson's correlation coefficient was calculated to assess the criterion-related validity between the subscales of IRS and NCATS. Results Cronbach's alpha of IRS was 0.91, and in the domains of the child and caregiver, Cronbach's alpha values were 0.88 and 0.85, respectively. Pearson's correlation coefficient between IRS total score and NCATS total score was 0.89, the child's total score was 0.70, and the caregiver's total score was 0.98 (p<0.001). Discussion The high internal consistency of IRS and significant correlations of results of IRS with those of NCATS confirmed the reliability and criterion-related validity of IRS.

Background We examined the longitudinal relationship between children's social competence at eighteen months of age and the caregiver's attitude of the importance of "praise", with particular emphasis on the change in their attitude when their children were four and nine months old. Methods A total of 176 children with their parents from two Japanese cities were recruited for this study. The children's social competence and the parent's competence for rearing children were assessed when the toddlers were eighteen months old, using the IRS (Interaction Rating Scale) that was developed by the authors. Results The parent's continuous attitude towards the importance of "praise" when children at both four and nine months old improved the children's level of social competence at eighteen months old, after controlling for such factors as children's gender, family type, sibling, mother's and father's age, mother's and father's career, mother's and father's educational level, and family income. Conclusion It is interesting that even infants of four to nine months old were affected by the parent's continuous attitude towards the importance of "praise" and this attitude affects the development of the child's social competence later.

Background: The purpose of this paper is to describe the gender differences of the Interaction Rating Scale (IRS) as an evidence-based practical index of children's social skills and parenting. Methods: The participants in our study, which was conducted as part of a Japan Science and Technology Agency (JST) cohort study project, were 370 dyads of children with their caregivers were followed up and surveyed at aged 18, 30, and 42 month. The participants completed the five minute interaction session and were observed using the IRS. Results: The results indicated the gender differences of IRS scores. Girls got rather high score at all ages. IRS can measure children's social skill development and parenting with high validity. Along with the qualitative differences of interaction between boys and girls, the IRS is effective in describing features of social skill development and parenting. Conclusion: The IRS provides further evidence of the fact that in order to study children's social skill development, it is important to evaluate various features of the caregiver-child interaction as a predictor of social skills. © 2010 Elsevier Ltd. All rights reserved.

Background: With increasing numbers of women joining the evening/nighttime and extended-hour workforce, there is a need for quality childcare during these hours. Methods: This project, conducted in Japan, sought to compare the effects of expanded child-care on the development and adaptation of 185 young children after five years in care. Parents completed a survey on the childrearing environment at home, their feelings of self-confidence, and the presence of support for childcare. Childcare professionals evaluated the development of children. Results: The results of multiple regression analysis indicate that factors in the home environment, not length of center-based care, explained developmental risks five years later. Conclusion: High quality center-based childcare provides good condition of children's development after five years. For further evidence to study children's development, it is important to follow up to evaluate various features of longer duration. © 2010 Elsevier Ltd. All rights reserved.

Background: The purpose of this paper is to describe the features of the Interaction Rating Scale (IRS) as an evidence-based practical index of children's social skills and parenting. Methods: The participants in our study, which was conducted as part of a Japan Science and Technology Agency (JST) project, were 370 dyads of children (aged 18, 30, and 42 month) and 81 dyads of 7-year-old children with their caregivers. The participants completed the five minute interaction session and were observed using the IRS. Results: The results indicated that the IRS can measure children's social skill development and parenting with high validity. Along with the discriminate validity for pervasive development disorder (PDD), attention-deficit/hyperactivity disorder (ADHD), abuse and maltreatment, a high correlation with the SDQ (Strength and Difficulties Questionnaire), and high reliability, the IRS is effective in describing features of social skill development. Conclusions: The IRS provides further evidence of the fact that in order to study children's social skill development, it is important to evaluate various features of the caregiver-child interaction as a predictor of social skills. © 2010 by the Japan Epidemiological Association.

Background: Praise from caregivers has been shown as an important influence on the development of social competence in early adolescence. However, the effects of praise in younger children have not been investigated. We examined how the trajectory of children's social competence from 18 months to 30 months of age was related to their caregiver's attitude towards the importance of praise at times when their child was 4 months and 9 months old. Methods: We studied 155 mother-child dyads, whose interactions during play were observed both when the child was 18 months and 30 months old, which was conducted as part of a Japan Science and Technology Agency (JST) project. The child's social competence was assessed using the Interaction Rating Scale (IRS). Demographic data was obtained when the child was 4 months old, and the caregiver's attitude towards the importance of praise when the child was both 4 months and 9 months old. A logistic regression analysis controlling for the effects of demographic variables was performed. Results: We found that children who had received continuous praise from their mother when they were 4-9 months of age had a decreased risk of low social competence at 18-30 months of age. Conclusions: A mother's attitude towards the importance of praise at early stages of her child's development has an important influence on the later trajectory of social competence. © 2010 by the Japan Epidemiological Association.

Background: Many studies have suggested that the daily emotional interactions between a child and his/her caregiver play a significant role in his/her development. The purpose of this study was to determine whether the trajectory patterns of parenting patterns of caregivers raising toddlers affect the social competence of the toddlers. Methods: The study participants were 246 dyads of 18-month-old children (baseline) and their caregivers, which was conducted as part of a Japan Science and Technology Agency (JST) project. We used the Interaction Rating Scale (IRS) to evaluate the children's social competence. We assessed the child rearing environments by analyzing the caregivers' responses to the Index of Child Care Environment (ICCE). Results: Multiple logistic regression analysis showed that the children's total score on the IRS was significantly related to how frequently they sang songs together with their caregivers. Their score was also significantly related to how closely their caregiver worked with his/her partner in raising the child. These relationships did not change according to demographic information. Conclusions: The results confirm previous findings on the relationship between parenting patterns and children's social competence. In particular, the study shows that varied and continual parenting significantly affects a child's social competence. © 2010 by the Japan Epidemiological Association.

Background: The purpose of this study was to examine the relations between children's social competence and initial index of theory of mind at 30 months of age. Methods: The participants of the study were 322 toddlers and parents/caregivers who were registered with the Japan Science and Technology Agency (JST) project. They completed a five-minute interaction session, which was coded using the Interaction Rating Scale (IRS) as an evidence-based practical index of children's social competence. In addition, the children were asked to complete a diverse-desire task as a ToM (theory of mind) index. Results: The results showed that the ToM index was related to the total score and subscales of the IRS, such as Empathy and Emotional regulation. Conclusions: These findings show that the IRS score was related to ToM task performance at 30 months of age. © 2010 by the Japan Epidemiological Association.

Background: It is known that sleep problems impact children's health, learning, and school performance. The purpose of this paper is to examine the association between sleeping habits and social competence development. Methods: Three hundred and nine caregiver-child dyads participated in this study, which was conducted as part of a Japan Science and Technology Agency (JST) project. The caregivers answered some questionnaires about sleeping habits when the child was 9 months and 18 months old. Caregiver-child interaction was observed when the child was 30 months old, and the features of the interaction were examined using the Interaction Rating Scale (IRS) as a measure of social competence. Results: The caregivers' attitude toward sleeping in the 9-month period was found to be significantly correlated with the children's social competence at 30 months. Moreover the caregivers' attitude toward sleeping in the 9-month period significantly correlated with the children's sleeping habits at 9 and 18 months. Conclusions: These findings show that the caregivers' attitude toward sleeping is an important factor influencing the development of children's social competence. © 2010 by the Japan Epidemiological Association.

Background: The present study examines gender differences in the correlations between intelligence and developmental problems as well as social competence in first graders. Methods: Ninety parent-child dyads participated in this study. The children comprised 7-year-olds recruited from the first grade of an elementary school. All the children were administered the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), Parent-child Interaction Rating Scale (IRS), and the parent report version of Strength and Difficulties Questionnaire (SDQ). Results: The findings clarified that the processing speed of boys significantly correlated with their peer relationship. On the other hand, the emotional symptoms exhibited by girls had a more common association with their intellectual abilities. The correlations between parenting and intellectual abilities differed in boys and girls. Conclusions: Children's gender should be taken into account when assessing the diversity in their intellectual abilities and developmental problems. Moreover, parenting also influences the development of children in various ways. © 2010 by the Japan Epidemiological Association.

Background: This study investigated developmental change and stability in infant responses to the still-face (SF) situation, as well as predictive validity at age 18 months, focusing on autonomy and responsiveness. Methods: A total of 231 children (117 boys and 114 girls) and their Japanese mothers were observed in a face-toface SF situation at two infant ages (4 and 9 months), as well as a caregiver-child teaching interaction at age 18 months. Each infant's facial expression, gaze direction, and vocalization were coded according to the SF paradigm, including the Natural Interaction (NI) and SF phases. Each child's Autonomy and Responsiveness to the Caregiver at age 18 months were both evaluated by means of the Interaction Rating Scale. Results: The results indicated that negative facial expression and vocalization in the SF phases at age 9 months predicted the Autonomy rating at age 18 months, while positive facial expression and gaze toward the caregiver in the NI at age 9 months predicted the Responsiveness to Caregiver rating at age 18 months. Conclusions: The results are discussed in the context of developmental continuity and change in the children's social cognition and voluntary movements. © 2010 by the Japan Epidemiological Association.

目的 本研究は,発達障害のなかでも特に社会性の障害をその特徴とする広汎性発達障害(PDD)に焦点を当て,就学前児用社会スキル尺度(第1因子:協調,第2因子:自己制御,第3因子:自己表現)の下位尺度得点との関連およびその予測妥当性を検討することで,社会スキル発達リスク該当児の早期発見,早期支援への一助とすることを目的とした。方法 対象は,2000年から2006年にかけて,全国夜間保育園連盟に加入している21都道府県98ヶ所の認可保育園に在籍している2歳から6歳までの園児である。方法は,各保育園の担当保育士が,年1回,就学前児用社会スキル尺度を用いて各園児の社会スキルを評価した。また,発達障害に関しては,2006年および2007年に各園で「気になる子ども」としてあげられた園児の中から,医療機関の診断,所見で発達障害(PDD,ADHD(注意欠陥多動性障害),MR(精神遅滞))の確定もしくは疑いの診断をうけている園児のデータを訪問調査の協力を得た各保育園から収集した。分析は,発達障害の確定もしくは疑い該当児を除く園児を「非該当」,PDD該当児を「PDD該当」と2群に分類し,年齢ごとに就学前児用社会スキル尺度の各下位尺度得点に関して2群間の平均値の差の検定を実施した。つづいて,PDD(該当,非該当)を目的変数,就学前児用社会スキル尺度の各下位尺度得点を説明変数としたロジスティック回帰分析を年齢ごとに実施した。結果 各下位尺度得点に関して,「PDD該当」児と「非該当」児それぞれの平均値は,年齢経過にしたがって平均値の推移に大きな差がみられた。「非該当」児では,年齢の経過とともに各下位尺度得点の平均値が上昇していく傾向があるが,「PDD該当」児では推移の変化に乏しい。特に4歳以降では「非該当」児と「PDD該当」児のすべての下位尺度得点平均値が有意な差を示しており,「PDD該当」児の社会スキルは「非該当」児に比較して低いことが示された。一方,ロジスティック回帰分析結果では,2歳,3歳において第3因子(協調)でのみ,また4歳,5歳,6歳ではすべての因子で有意な関連がみられた。結論 就学前児用社会スキル尺度は,4歳以降では「PDD該当」リスクが社会スキル尺度の全因子で,また医療機関の診断が確定しにくい2歳,3歳では,第3因子(自己表現)の下位尺度得点で,「PDD該当」への移行を把握可能であることが示唆された。本尺度が,子育て支援専門職にとってPDD児の早期発見,早期支援のための評価手法の一助となることが期待される。(著者抄録)