Objectives Mothers who experience difficulty in childrearing are becoming increasingly more prevalent in Japan. This study described and classified mothers' childrearing difficulty in terms of their children's behavioral characteristics and related factors.
Methods Self-administered questionnaires were distributed to 818 mothers at their children's 3-year-old health checkup in eight suburban cities in Japan. The questionnaire consisted of items assessing the mother's experience of difficulty in childrearing for the child undergoing the checkup. The subjects were classified into four groups according to their children's behavioral characteristics: “low needs,” “internalizing behavior,” “externalizing behavior,” and “comorbid internalizing-externalizing behavior.” Multiple regression analysis was performed to examine the relationships between mothers' difficulty in childrearing and related factors.
Results A total of 775 respondents were divided as follows: 332 mothers had children with low needs, 104 had those with internalizing behavior, 230 had those with externalizing behavior, and 109 had those with comorbid internalizing-externalizing behavior. Mothers in the low needs group showed less childrearing difficulty than did mothers in the other groups. Childrearing difficulty increased by group in the following order: internalizing, externalizing, and comorbid internalizing-externalizing. In all four groups, mothers with low self-efficacy and less appraisal support from their family encountered greater childrearing difficulty. In the low needs group, experiencing childrearing difficulty with another child was related experiencing childrearing difficulty with the child undergoing the checkup. In the internalizing behavior group, mothers who had experienced greater difficulty in childrearing were more likely to be housewives and of younger age, and were more likely to have had boys as the child undergoing the checkup. In the externalizing behavior group, mothers with more difficulty in childrearing were more likely to be younger and less healthy, have less appraisal support from their friends, and live in apartments. In the comorbid internalizing-externalizing group, if the mothers were housewives, they were more likely to have difficulty in caring for their other children, receive less appraisal support from their friends, and experience more difficulty in childrearing.
Conclusion The results showed that mothers' difficulty in childrearing and the factors related to this difficulty differed according to their children's behavioral characteristics. Public health nurses could provide more effective care and support to mothers by considering children's behavioral characteristics.

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Objectives To investigate the effect of determining birthdays by social factors on the distribution of daily live births.
Methods We obtained data on live births tabulated by date and birthplace (hospitals, clinics, and maternity homes) between 1981 and 2010 in Japan from the National Vital Statistics System. This study analyzed the variations in live births for each day of the week, as well as for several specific days observed to have a systematic variation in the number of live births. We determined the ratio of the mean daily live births on those specific days to the overall daily average each month (the birth number ratio). The standardized deviation (the ratio of the deviation to the standard deviation for the day of week) regarding the birth number ratio of each specific day was also determined.
Results The birth number ratio in hospitals and clinics was highest on Tuesdays and lowest on Sundays. Hospitals showed a large difference in the birth number ratio between weekdays and weekends, although the difference in the birth number ratio between weekdays and Saturdays was smaller in clinics than in hospitals. The birth number ratio during the first three days of the New Year was lower than that on Sundays. Until approximately 1995, the standardized deviation on February 29th and April 1st (the end of the Japanese school year) showed abnormally low values, while those on March 1st and April 2nd showed significantly high values. Following that time period, the significant variations on February 29th (only on Sundays), April 1st (only on Sundays), March 1st, and April 2nd almost completely disappeared. Maternity homes showed equivalent results until the 1980s or the middle of the 1990s.
Conclusion The variations in the days of the week were inconsistent with nationwide policies for consultation in each setting. These results indicate that some birth dates were set for institutional reasons or maternal preferences (i.e., the day after the leap day or the next school year) by using or avoiding obstetric intervention. The abnormal variation on leap days and on April 1st might be related to fictitious reporting. More recent variations in the birth number ratio on specific days suggest that some individuals may avoid obstetric intervention. The results of this study indicate that determining birthdays by social factors may have been practiced in maternity homes until approximately 1990.

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Objectives Interviews were conducted with elderly people who had participated in the Care-Prevention Leadership Training Course (CPLTC), and had then established voluntary groups that practice care-prevention activities. This study examined the process and factors associated with the establishment of voluntary groups among subjects.
Methods The subjects were ten 62- to 76-year-old community-dwelling elderly in Tokyo who had taken the CPLTC. Data were obtained from 40- to 90-minute semi-structured interviews concerning the process of voluntary-group establishment. The data were then qualitatively analyzed using a modified grounded theory approach. Some of the concepts associated with the voluntary-group establishment were extracted, and organized into categories. These relationships were comparatively reviewed, and a figure for the results was constructed.
Results Subjects went through the following processes and feelings while establishing voluntary groups: “feelings that encourage participation in the local community,” “opportunity for participation in the local community,” “recognition of issues in the local community,” “recognition of the importance of care prevention,” “enhanced motivation for voluntary-group activities,” and “recognition of requirements to establish a voluntary-group through its preparation.” In addition, related factors were as follows; “past experience,” “experience in the local community,” “experience in CPLTC,” “support in the local community,” “support in CPLTC,” “support in establishment of voluntary groups,” and “feelings that promote or inhibit activities for the voluntary-group establishment.” These processes were considered to be core concepts: “feelings and experiences that lead to participation in the local community,” “deep understanding through experiences in the community and CPLTC,” and “enhancement of motivation and skills for the activities through voluntary-group preparation.”
Conclusion The results showed that the community-dwelling elderly experienced gradual changes in their feelings, awareness, and related factors concerning their establishment of voluntary groups. The data showed that three points of view were important in those changes: “participation in the local community,” “recognition of issues in the local community,” and “enhanced motivation and skills for community activities.” With transition-related factors taken into account, it is possible to effectively support elderly who are establishing voluntary groups by promoting involvement in the local community, holding courses, and providing preparatory support for group establishment.

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[in Japanese]

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