Children's injuries in legislated types child-care institutions.

Background: Severe injuries in child-care institutions are an important social issue. However, no reports on this matter have been made in Japan. This study examined trends in severe injuries at child-care institutions, including the impact of the coronavirus disease 2019 (COVID-19) pandemic.

Association of perinatal factors with neurodevelopmental referrals in a population-based cohort study in Japan.

Although the causes of neurodevelopmental disorders remain unknown, several environmental risk factors have attracted considerable attention. We conducted a retrospective, longitudinal, population-based cohort study using data from infant health examinations of children born to mothers with pregnancies between April 1, 2014 and March 31, 2016 in Kobe City to identify the perinatal factors associated with neurodevelopmental referrals in 3-year-old children. There were 15,223 and 1283 children in the normal and referral groups, respectively.

[Association of prenatal maternal, prenatal secondhand, and postnatal secondhand smoking exposures with the incidence of asthma/atopic dermatitis in children: An epidemiological study using checkup data of mothers and children in Kobe city].

Objectives　Despite suggested associations among smoking exposures and the prevalence of allergic diseases in children, studies examining the effect of prenatal maternal smoking and secondhand smoking on the occurrence of these diseases in children are limited. Our study aimed to investigate the association between prenatal maternal smoking as well as secondhand smoking and the incidence of asthma or atopic dermatitis in children.Methods　We included checkup data of a total of 53,505 children living in Kobe, Japan, without missing values for exposure or outcome, between April 1, 2004, and March 31, 2013.

Seizure prevalence in children aged up to 3 years: a longitudinal population-based cohort study in Japan.

Objective: To investigate the prevalence of seizures/febrile seizures in children up to 3 years of age and examine the effects of gestational age at birth on the risk for febrile seizures.

Design: Retrospective longitudinal population-based cohort study.

Setting: Kobe City public health center, Kobe, Japan, from 2010 to 2018.

Association between maternal hypertensive disorders of pregnancy and child neurodevelopment at 3 years of age: a retrospective cohort study.

Hypertensive disorders of pregnancy (HDP) affect up to 10% of women during pregnancy and influence child neurodevelopment, including mental and motor function. We assessed whether HDP, including gestational hypertension, preeclampsia, superimposed preeclampsia, and eclampsia, correlate with motor and mental developmental abnormalities in 3-year-old children, using data obtained between April 2004 and March 2013 through a mandatory population-based health checkup of mothers and children in Kobe city, Japan. The primary outcome was motor and mental developmental abnormalities at 3 years of age; parental-reported questionnaires and physician's medical examinations were evaluated.

Low plasma D-dimer predicts absence of intracranial injury and skull fracture.

Background: Intracranial injury (ICI) is a leading cause of morbidity in children; however, the use of computed tomography (CT) to evaluate ICI has significant risks in children. A recent study suggests D-dimer is associated with ICI. We surveyed the performance of plasma D-dimer in ruling out ICI or skull fracture (SF) in children with head trauma.

Indication for voiding cystourethrography during first urinary tract infection.

Background: There is confusion surrounding the precise indications for voiding cystourethrography (VCUG) during the assessment of vesicoureteral reflex (VUR) after a first febrile urinary tract infection (UTI). The aim of this study was to determine the combination of clinical, laboratory and ultrasonography factors correlating with grades IV-V VUR in young children with a first febrile UTI.

Methods: Children 0-24 months of age who were brought to the emergency department at National Center for Child Health and Development with the diagnosis of first time febrile UTI between March 2004 and May 2011, were enrolled.

Pediatric resident perceptions of shift work in ward rotations.

Although the long working hours of physicians are considered to be a social issue, no effective policies such as duty hour regulations have so far been proposed in Japan. We implemented an overnight call shift (OCS) system for ward rotations to improve the working environment for residents in a pediatric residency program. We later conducted a cross-sectional questionnaire asking the residents to compare this system with the traditional overnight call system.

High Rate of Febrile Seizures in Japanese Children With Occult Bacteremia.

Objectives: Fever of 39°C or higher and a white blood cell (WBC) count of 15,000/μL or greater are known predictors of occult bacteremia (OB). However, because of a decreasing prevalence of OB, WBC counts have become poor predictors of OB in populations of routinely immunized children. Thus, we aim to evaluate the clinical characteristics of OB in Japanese children and identify potential risk factors for OB.

Mentoring the next generation of physician-scientists in Japan: a cross-sectional survey of mentees in six academic medical centers.

Background: Physician-scientists play key roles in biomedical research across the globe, yet prior studies have found that it is increasingly difficult to recruit and retain physician-scientists in research careers. Access to quality research mentorship may help to ameliorate this problem in the U.S.

Trends and variations in infant mortality among 47 prefectures in Japan.

Objectives: To determine IMR trends and regional variations among 47 prefectures in Japan and to identify associated population-based factors.

Methods: We conducted an ecological study of infant mortality rate (IMR) by analyzing publicly available data from the Ministry of Health, Labour and Welfare of Japan. Outcome measure for trend is the IMR for each of 47 prefectures from 1999 to 2007; for variation, IMRs for 2006 and 2007 in each prefecture were averaged.

Regional variations in prevalence of postpartum depressive symptoms: population-based survey.

The purpose of the present study was to verify that there are regional variations in the detection rate of postpartum depressive symptoms in mothers. A population-based survey of all women who gave birth in Fushimi Ward, Kyoto City during the period 1 December 2008-31 October 2010 was carried out. The Edinburgh Postnatal Depression Scale (EPDS) was completed by 2567 mothers of infants to measure postpartum depressive symptoms.

Maternal childrearing anxiety reflects childrearing burden and quality of life.

Background: The government of Japan has recently initiated public programs to allay maternal childrearing anxiety. The aim of the present study was to determine the prevalence of childrearing anxiety and describe its relationships with perceived childrearing burden and maternal quality of life (QOL).

Methods: A secondary analysis was done of survey data from 1229 mothers enrolled in the Seiiku Birth Cohort Study at the National Center for Child Health and Development between November 2003 and December 2006.

A novel Internet-based blended learning programme providing core competency in clinical research.

Rationale, Aims And Objectives: We developed a novel Internet-based blended learning programme that allows busy health care professionals to attain core competency in clinical research. This study details the educational strategies and learning outcomes of the programme.

Method: This study was conducted at Kyoto University and seven satellite campuses from September 2009 to March 2010.

A decision analysis of the effectiveness of the pediatric telephone triage program in Japan.

Pediatric telephone triage programs have been initiated to reduce overcrowding of pediatric medical facilities, yet it is unclear what impact these programs have on reducing after hours room visits. This study used a decision analysis model and data from reference literature to investigate the effectiveness of this program and determine the factors that influence the results. The decision analysis model focused on a hypothetical group of children who were not undergoing ongoing treatment but developed symptoms or sustained injuries thought to require a nighttime visit to a medical facility.

Can pediatricians accurately identify maternal depression at well-child visits?

Background: The feasibility of a two-item screening tool for maternal depression in a pediatric setting was recently reported. We assessed whether the accuracy of pediatrician recognition of maternal depression during the one-month well-child visit could be improved by an educational intervention using the two-item screening tool.

Methods: We conducted an educational intervention for pediatric residents in a suburban hospital in Tokyo, Japan, with outcome measurement before and after.

Screening for maternal depression in primary care pediatrics.

Purpose Of Review: An estimated 10-20% of mothers suffer from postpartum depression. Given its profound impact on both mother and infant and the availability of effective interventions, pediatricians can improve identification and referral of mothers with postpartum depression by screening regularly during well child visits. The purpose of this paper is to review and assess recently developed screening tools.

Test performance of two-question screening for postpartum depressive symptoms.

Background: The Edinburgh Postnatal Depression Scale (EPDS) is commonly used to screen for postpartum depression, but it is difficult to consistently administer it to all mothers during busy well-child visits owing to the fact that it is time-consuming. The purpose of the present paper was to evaluate the performance of a concise, two-question screening tool in the detection of mothers with postpartum depressive symptoms who had a high EPDS score.

Methods: The study involved 103 mothers attending a single hospital for 1 month well-child visits.