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Associations of Mental and Behavioral Problems among Children Exposed to Intimate Partner Violence Previously and Visits with Their Fathers Who Perpetrated the Violence  [PDF]
Sachiko Kita, Megumi Haruna, Miku Yamaji, Masayo Matsuzaki, Kiyoko Kamibeppu
Open Journal of Nursing (OJN) , 2017, DOI: 10.4236/ojn.2017.73029
Abstract: Background: Intimate partner violence has long-term and negative effects on the health of mothers and children worldwide. This study aimed to identify the mental and behavioral effects of past exposure to intimate partner violence among children and examine their associations with the children’s visits with their fathers who perpetrated the intimate partner violence. Methods: A cross-sectional study of women who had been abused by their intimate partners and had one or more children aged 4 - 18 years old was conducted from March 2015 to December 2016. Questionnaires were used to collect (1) demographic data about the mothers and children, (2) information about the children’s visits with the mother’s former partner (i.e., father), and (3) psychological data using the Hospital Anxiety and Depression Scale and the Child Behavior Checklist/4 - 18. Results: The average scores and rates of internalizing, externalizing, and total problems among the children who had been exposed to intimate partner violence were: 10.8 (SD = 10.4), 26 (51.0%); 9.0 (SD = 9.0), 14 (27.5%); and 26.3 (SD = 21.5), 15 (29.4%), respectively. Children’s visits with fathers who were IPV perpetrators were significantly associated with the internalizing (AOR = 12.6, β = 0.56; p < 0.05) and total problems scores (AOR = 17.9, β = 0.48; p < 0.05). Conclusion: Attention should focus on traumatized children exposed to intimate partner violence, and thorough and cautious assessments and decisions regarding visits with their fathers who are IPV perpetrators are essential to safeguard and improve their mental and behavioral health.
Pelvic floor function and advanced maternal age at first vaginal delivery  [PDF]
Mikako Yoshida, Ryoko Murayama, Maki Nakata, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Hiromi Sanada
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.34A005

Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery at a younger age. Methods: Seventeen women (age: 35.5 ± 3.5, BMI: 21.1 ± 3.2) were studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire-Short Form. Pelvic floor function was assessed by the anteroposterior diameter of the levator hiatus using transperineal ultrasound. Women who delivered for the first time at 35 years and/or older were defined as being of advanced maternal age. Results: Nine of 17 women (52.9%) were of advanced maternal age and 5 experienced postpartum stress urinary incontinence. Four of these 5 women (80.0%) were of advanced maternal age. The anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 3 and 6 months postpartum (p < 0.01). Among the continent women, the anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 6 months postpartum (p = 0.004). However, among the advanced maternal age women, all parameters of the anteroposterior diameter of the levator hiatus were not significantly different between the women with and without stress urinary continence. Conclusion: Recovery of pelvic floor function following delivery may be delayed in women of advanced maternal age at first delivery because of the damage to the pelvic floor during pregnancy and vaginal delivery, resulting in increase in the incidence of stress urinary incontinence.

The effects of an exercise program on health-related quality of life in postpartum mothers: A randomized controlled trial  [PDF]
Megumi Haruna, Etsuko Watanabe, Masayo Matsuzaki, Erika Ota, Mie Shiraishi, Ryoko Murayama, Mikako Yoshida, SeonAe Yeo
Health (Health) , 2013, DOI: 10.4236/health.2013.53058

Background and Objective: There is controversy on the psychological effects of postpartum exercise. The study aimed to evaluate the effectiveness of a postpartum exercise program on health-related quality of life and psychological well-being. Methods: We conducted a randomized controlled trial in Tokyo, Japan. The intervention groups participated in ball-exercise classes (weekly exercise of 90 minutes for four weeks) at three months postpartum. The exercise class included the following: 1) greeting and warm-up; 2) aerobic exercise involving bouncing on an exercise ball 55 or 65 cm in diameter; 3) rest and self-introduction; 4) stretching and cooling down. The primary outcome measure was health-related Quality of Life (QOL) assessed using the MOS Short-Form 36-Item Health Survey (SF-36v2). The secondary outcome measures were Rosenberg Self-Esteem Scale (RSES) and Edinburgh Postnatal Depression Scale (EPDS) scores. The intervention group was compared to the control group at four months postpartum. Results: Of the 120 women screened, 110 women met the study criteria. Nine could not be included and the remaining 101 were allocated randomly into intervention and control groups (50 and 51 participants respectively). Analysis of covariance adjusting for baseline values indicated that the SF36 subscales of physical functioning (p = 0.018) and vitality (p = 0.016) significantly improved in the intervention group compared to the control group, although there were no significant differences between the groups in the SF36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. The RSES increased in the intervention group (p = 0.020) compared to the control group. No significant group differences were observed in EPDS scores. Conclusions: The postpartum exercise class program provided to healthy postpartum women appears to have contributed to promoting health-related QOL and self-esteem.

Does Antenatal Fear of Childbirth Predict Postnatal Fear of Childbirth? A Study of Japanese Women  [PDF]
Mizuki Takegata, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Tadaharu Okano, Elisabeth Severinsson
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.52017
Abstract: The study aimed to determine whether antenatal fear of childbirth (expectation) could predict postnatal fear of childbirth (experience) by taking account of other antenatal psychological variables (anxiety and depression) as well as birth outcomes in Japanese women. A longitudinal observational study was conducted at a clinic in Tokyo, Japan, in 2011. Self-report questionnaires were distributed to 240 Japanese women at 37 gestational weeks (Time 1) and on the second day after delivery (Time 2). Regression analyses by means of structural equation modelling were conducted in both the primiparous and the multiparous group. The models exhibited good fit (chisquare value/degree of freedom = 1.10 - 1.62, comparative fit index = 0.92 - 0.99 and root mean square error of approximation = 0.03 - 0.07). Antenatal fear of childbirth was the most predictive variable of postnatal fear of childbirth in both the primiparous (β = 0.58, p = 0.002) and the multiparous group (β = 0.62, p < 0.001). In conclusion, antenatal fear of childbirth was a significant predictor of postnatal fear of childbirth when other antenatal psychological variables and birth outcomes were taken into account. Pregnant women who are strongly afraid of childbirth need special attention before and after delivery.
Psychometric Evaluation of the Japanese Wijma Delivery Expectancy/Experience Questionnaire Version B  [PDF]
Mizuki Takegata, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Tadaharu Okano, Elisabeth Severinsson
Open Journal of Nursing (OJN) , 2017, DOI: 10.4236/ojn.2017.71002
Abstract: The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is a widely accepted approach to measuring fear of childbirth and is available in two versions: antenatal (version A) and postnatal (version B). The aim of this study was to develop the Japanese W-DEQ version B and confirm its validity and reliability among Japanese women. A self-administered questionnaire incorporating the translated Japanese W-DEQ (JW-DEQ) version B and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) was distributed to Japanese mothers at two days postpartum. Of the 246 women recruited, 231 who completed the questionnaire at two days postpartum were analyzed. An exploratory factor analysis of the JW-DEQ version B revealed four factors: fear, lack of positive anticipation, isolation and riskiness. The JW-DEQ version B exhibited a positive correlation with the HADS anxiety subscale (r = 0.34, p < 0.001). The Cronbach’s α value derived from the total 33 items was 0.95. This study provides evidence of the factorial, concurrent validity and the internal consistency of the JW-DEQ version B. However, a further study involving participants from different demographic groups will be required.
Sex Work, Motivations for Entry, and the Combined Impact of Both on Mental Health: A Case Report of Japanese Female Patients within Therapeutic Relationships  [PDF]
Masayo Uji
Open Journal of Psychiatry (OJPsych) , 2015, DOI: 10.4236/ojpsych.2015.52026
Abstract: The purpose of this study was to explore the motivations for entry into the sex industry. The narratives of four Japanese female psychiatric patients with a past experience of sex work were used for analysis. I identified not only practical factors such as financial difficulties or lack of job skills, but also various psycho-social factors, namely: weak emotional ties with their mothers since infancy, their mothers’ tendency to prioritize sons over daughters, unremitting needs for maternal care, fear of rejection and object-seeking behavior, desire to control others, envy and aggressive self-destructive behavior, difficulties in establishing female peer relationships during adolescence, proneness to dependency on male objects through sexual relationships, past histories of crime and delinquency, weak internal motivation, frequent acting out, and addictive behaviors. In this article I discussed whether their mental maladjustment was purely the product of their past experiences as sex workers, or whether in fact both the maladjustment and the motivations for entry were derived from personality characteristics developed since infancy. Although not applicable to every Japanese sex worker, this article presents a preliminary hypothesis regarding the contribution of the above multi-dimensional factors to the motivations for entry, and the following mental maladjustment.
Case Reports of Two Japanese Female Patients’ Reintegration into Society: Discussing the Interactions between a Patient’s Personality and Group Mentality  [PDF]
Masayo Uji
Psychology (PSYCH) , 2015, DOI: 10.4236/psych.2015.615198
Abstract: Based on the experiences of psychiatric patients who were in the process of rehabilitation after a significant period of rest and recuperation, the author aimed at analyzing the phenomena that facilitate as well as hinder patient maladjustment, in order to identify ways for clinical psychiatry to support patients’ rehabilitation processes. Two female patients with pathological personality traits who were in the process of rehabilitation were chosen. One attended a community center that offers employment for people with mental disorders, followed by a vocational rehabilitation center for the unemployed; the other returned to an ordinary job for which she was qualified. The author first investigated the interactions between their personalities and the group mentalities in their workplaces, and then analyzed these interactions using psychodynamic theories. The dynamic interactions between these patients’ personality pathologies and the group mentalities of the workplaces they chose for their rehabilitation seemed to play a crucial role in determining whether they experienced maladjustment or not. Various phenomena experienced by an individual in a community setting should not be ascribed solely to either the person’s personality or the community group mentality, but rather to the interaction between the two. Community centers for people with mental disorders must provide support that facilitates the accomplishment of the original purposes of the group, but also helps each group member improve their self-esteem. At the end of this article, the author argues that the narcissistic need for approval cannot be dismissed simply as pathological, but should be seen as a ubiquitous phenomenon in the contemporary Japanese ethos.
Validity and reproducibility of folate and vitamin B12 intakes estimated from a self-administered diet history questionnaire in Japanese pregnant women
Mie Shiraishi, Megumi Haruna, Masayo Matsuzaki, Ryoko Murayama, Satoshi Sasaki, Sachiyo Murashima
Nutrition Journal , 2012, DOI: 10.1186/1475-2891-11-15
Abstract: A sample of 167 healthy subjects with singleton pregnancies in the second trimester was recruited at a private obstetric hospital in metropolitan Tokyo from June to October 2008 (n = 76), and at a university hospital in Tokyo from June 2010 to June 2011 (n = 91). The dietary intakes of folate and vitamin B12 were assessed using the DHQ. The serum concentrations of folate and vitamin B12 were measured as reference values in the validation study. To assess the reproducibility of the results, 58 pregnant women completed the DHQ twice within 4-5 week interval.Significantly positive correlations were found between energy-adjusted intakes and serum concentrations of folate and vitamin B12 (r = 0.286, p < 0.001 and r = 0.222, p = 0.004, respectively). After excluding the participants with nausea (n = 121), the correlation coefficient for vitamin B12 increased to 0.313 (p = 0.001). When participants were classified into quintiles based on intakes and serum concentrations of folate and vitamin B12 , approximately 60% were classified in the same or adjacent quintile. The intraclass correlation coefficients of the two-time DHQ were 0.725 for folate and 0.512 for vitamin B12 .The present study indicated that the DHQ had acceptable validity and reproducibility for assessing folate and vitamin B12 intakes in Japanese pregnant women.Low birth weight is a major cause of perinatal morbidity and low birth weight babies are susceptible to cardiovascular disease in later life [1]. The incidence of low birth weight increased in Japan from 6.3% in 1990 to 9.6% in 2007 [2]. One possible reason for the low birth weight is low intake of micronutrients during pregnancy [3,4]. For instance, folate and vitamin B12 deficiency can lead to retardation of fetal development through hyperhomocysteinemia, which negatively affects DNA methylation and cell proliferation [5-8]. Assessment of an individual's nutritional status including folate and vitamin B12 is therefore important to prevent the harmful
Breast Surgery with Application of Doughnut Mastopexy Lumpectomy Technique  [PDF]
Kyoichi Matsuzaki
Modern Plastic Surgery (MPS) , 2012, DOI: 10.4236/mps.2012.24022
Abstract: Purpose: Doughnut mastopexy lumpectomy (DML) is a breast resection technique in which a tissue segment is removed and the breast reshaped through a doughnut-shaped de-epithelialized periareolar area. In this study, we attempted to determine whether the DML technique could be useful for other types of breast surgery, in addition to breast cancer lumpectomy. Methods: This study examined a total of 4 patients who underwent the DML technique and were followed up for at least 1 year postoperatively. One patient underwent phyllodes tumor resection, 1 patient underwent removal of a siliconoma, and 2 patients underwent breast reduction mammaplasty. Results: This method enabled en-bloc removal of a large tissue mass or large foreign body that could not be removed through a short periareolar incision. The surgical method of this study enabled the extent of de-epithelialization to be changed according to the size and location of the mass to be excised; good cosmetic results were also obtained. In addition, the surgical method enabled the facile excision of tumors and foreign materials. Conclusions: The DML technique is a useful surgical method that is applicable to other breast surgeries, in addition to breast cancer surgery.
Usefulness of Free Nipple-Areola Complex Graft for Nipple Malposition after Nipple Sparing Mastectomy  [PDF]
Kyoichi Matsuzaki
Modern Plastic Surgery (MPS) , 2012, DOI: 10.4236/mps.2012.24021
Abstract: Purpose: This article identifies the advantage and disadvantage of a free nipple areola complex graft (FNACG) for nipple malposition which resulted from tissue-expander insertion and subsequently replaced with an implant after nipple sparing mastectomy (NSM). Methods: The subjects were three such patients treated using FNACG and who were followed up for at least one year postoperatively. The surgical outcome was assessed for symmetry of nipple-areola position, graft take, depigmentation, and shrinkage. Results: In all patients, the graft was accurately transferred to a position to achieve symmetry with the unaffected breast, and there was complete graft take in the areola by simple surgical design and techniques. No depigmentation of the areola was observed. The size of the areola was almost unchanged after grafting in two patients, but areolar shrinkage occurred in one other patient. There was complete graft take in the nipple in one patient and no depigmentation of the nipple was observed. Necrosis occurred at the tip of the nipple in two other patients. These patients had depigmentation, and the height of nipples decreased in proportion to the level of necrosis. Conclusion: FNACG can be a useful method if its advantages and disadvantages are well considered.
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