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Background A sinus of Valsalva aneurysm involving a single cusp is a rare condition, and coronary computed tomography angiography with fractional flow reserve-computed tomography helps evaluate not only the anatomical aspects of the aneurysm and coronary artery but also the physiological details of coronary artery disease. Case summary A 71-year-old woman presented with exertional chest pain and dyspnoea. Enhanced computed tomography revealed an aneurysmal change in the right sinus of Valsalva, and coronary computed tomography angiography revealed diffuse narrowing of the proximal segment of right coronary artery due to mechanical stretching by the large Valsalva aneurysm. Fractional flow reserve-computed tomography revealed a significantly low fractional flow reserve (0.50 in the distal right coronary artery). A modified Bentall procedure was performed with a 21 mm bioprosthetic valve and a 24 mm Valsalva graft conduit for the aortic root aneurysm; mitral valve annuloplasty was performed for mitral valve regurgitation. Post-operative coronary computed tomography angiography revealed no significant stenosis in the proximal segment of the right coronary artery. Furthermore, fractional flow reserve-computed tomography revealed a normalized fractional flow reserve in the distal right coronary artery. The patient experienced relief from chest pain and was discharged 19 days after the surgery. Discussion A right coronary sinus of Valsalva aneurysm, which caused right coronary artery ischaemia, was successfully treated using a modified Bentall procedure. Coronary computed tomography angiography and fractional flow reserve-computed tomography revealed anatomical and functional improvements in the right coronary artery ischaemia post-operatively. [ABSTRACT FROM AUTHOR]

Background: This study tested a hypothesised model of the effects of adverse life events on the mental health of middle‐aged and older adults living alone, as mediated by thought suppression and help‐seeking behaviours, considering gender differences. Methods: A questionnaire survey was conducted on a sample of 1202 (622 men; 580 women) individuals from 247445 residents aged 50–79 in District A of Tokyo. The questionnaire items covered parameters on adverse life events, help‐seeking behaviour, thought suppression, and mental health status. Results: Multiple group structural equation‐modelling analysis revealed that the seriousness of adverse life events, help‐seeking behaviours, and mental health scores were higher in women than in men. No significant gender differences were observed in thought suppression. The findings support all three proposed hypotheses: severe adverse life events will: (a) give rise to help‐seeking behaviours, which will have a positive effect on mental health; (b) intensify thought suppression, which will harm mental health; and (c) inhibit help‐seeking behaviour, especially in single middle‐aged and older adult men. Conclusion: There is a need to develop interventional programs based on the theory of replacement thinking to encourage help‐seeking behaviours in middle‐aged and older adults. [ABSTRACT FROM AUTHOR]

Antenatal maternal mental health status not only predicts postpartum mental status, but also influences family health. In Asia, however, little scientific research has been conducted on antenatal parenting intervention to date, nor has there been much emphasis on fathers in considerations of parenting support. Building upon our past research achievements that showed a strong need for parenting support focusing on the mental health aspect in Japan and Vietnam, we report on the process of adapting an Australian antenatal group-based psychosocial intervention involving fathers into Japanese and Vietnamese public service settings. The intervention was feasible at given sites and well accepted among volunteer couples. The presented processes to ease adaptation may be useful to other health professionals in Asian regions undertaking similar initiatives. (Contains 3 tables.)

The article explores the social relationships and well-being of families with middle-aged hikikomori, individuals experiencing prolonged isolation. It identifies the prevalence of hikikomori in older adults, their demographic characteristics, and the impact on family dynamics. It underscore the challenges faced by these families, emphasizing the importance of addressing isolation among middle-aged hikikomori for community well-being.