Social relationships and functional status among Japanese elderly adults living in a suburban area

OBJECTIVES

Social relationships may help in maintaining functional status among older adults. This study examined the types of social relationships that were related to functional status among Japanese community-dwelling older adults.

STUDY DESIGN

This is a prospective cohort study.

METHODS

We used baseline data from 2008 and conducted follow-up surveys six years later. Participants included individuals older than 65 years who lived in a suburban community in Japan. The Index of Social Interaction measure was used to assess multiple elements of social relationships. Two functional status outcomes were set: (1) functional decline and (2) functional decline and mortality. A multiple logistic regression model was used to examine the association between social relationships and functional decline six years later.

RESULTS

After controlling for age, sex, family structure and disease status in 2008, poor social curiosity (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.02-1.69) and interaction (OR = 2.57, 95% CI: 1.20-5.51) were found to be associated with functional decline. Furthermore, social curiosity (OR = 1.39, 95% CI: 1.14-1.69) and interaction (OR = 2.84, 95% CI: 1.44-5.59) were also associated with the composite outcome.

CONCLUSIONS

Social curiosity and interacting with others were significantly associated with functional status. Promotion of social interaction may be essential for preventing future need for care.

Oxytocin efficacy is modulated by dosage and oxytocin receptor genotype in young adults with high-functioning autism: a 24-week randomized clinical trial

Recent studies have suggested that long-term oxytocin administration can alleviate the symptoms of autism spectrum disorder (ASD); however, factors influencing its efficacy are still unclear. We conducted a single-center phase 2, pilot, randomized, double-blind, placebo-controlled, parallel-group, clinical trial in young adults with high-functioning ASD, to determine whether oxytocin dosage and genetic background of the oxytocin receptor affects oxytocin efficacy. This trial consisted of double-blind (12 weeks), open-label (12 weeks) and follow-up phases (8 weeks). To examine dose dependency, 60 participants were randomly assigned to high-dose (32 IU per day) or low-dose intranasal oxytocin (16 IU per day), or placebo groups during the double-blind phase. Next, we measured single-nucleotide polymorphisms (SNPs) in the oxytocin receptor gene (OXTR). In the intention-to-treat population, no outcomes were improved after oxytocin administration. However, in male participants, Clinical Global Impression-Improvement (CGI-I) scores in the high-dose group, but not the low-dose group, were significantly higher than in the placebo group. Furthermore, we examined whether oxytocin efficacy, reflected in the CGI-I scores, is influenced by estimated daily dosage and OXTR polymorphisms in male participants. We found that >21 IU per day oxytocin was more effective than ⩽21 IU per day, and that a SNP in OXTR (rs6791619) predicted CGI-I scores for ⩽21 IU per day oxytocin treatment. No severe adverse events occurred. These results suggest that efficacy of long-term oxytocin administration in young men with high-functioning ASD depends on the oxytocin dosage and genetic background of the oxytocin receptor, which contributes to the effectiveness of oxytocin treatment of ASD.

A pilot study of social competence assessment using interaction rating scale advanced

Purpose. The purpose of this paper is to clarify the validity of the Interaction Rating Scale Advanced (IRSA) as an evidence-based practical index of social skills. Methods. The participants in our study were 17 high school students. The participants completed the five-minute interaction session and were observed using the IRSA. Their teacher evaluated their social competence based on regular observation in school. Results. The results indicated the high correlation between IRSA scores and teacher's practical evaluation. IRSA can measure social competence with high validity. Conclusion. The IRSA provides further evidence of the fact that in order to study social competence development, it is important to evaluate various features of the interaction like IRSA subscales.

Implications for the development of children in over 11 hours of centre-based care

BACKGROUND

With increasing numbers of women joining the evening/night-time and extended-hour workforce, there is a need for quality childcare during these hours. This project, conducted in Japan, sought to compare the effects of expanded childcare on the development and adaptation of 648 young children after 2 years in care.

METHOD

All parents in 41 governmentally licensed child care facilities in Japan completed a survey on the child-rearing environment at home, their feelings of self-efficacy, and the presence of support for childcare to provide a baseline of information. Two years later, 648 of these parents were surveyed again. Childcare professionals evaluated the development of children at both times.

RESULTS AND DISCUSSION

The results of multiple regression analysis indicate that factors in the home environment, not length of centre-based care, explained developmental risks 2 years later.

Maternal child-rearing behaviors and correlates in rural minority areas of Yunnan, China

An epidemiological survey of maternal child-rearing behaviors was conducted in the rural minority areas of Yunnan, China. An interview of 2019 rural mothers of Hani, Yi, Hui, Miao, and Han and 544 urban mothers with children younger than 7 years of age showed that 51.7% of these rural mothers placed their infants in swaddling clothes. In the rural sample, exclusive breastfeeding occurred at frequency rates of 76.7% and 34.2% during 3 and 6 months postpartum, respectively. Maternal training and playing behaviors were reported less frequently, whereas physical punishment for children's misbehavior was more commonly found in the child-rearing behavior of rural mothers. Maternal child-rearing behaviors differed significantly among ethnic groups as well as between urban and rural areas. Maternal child-rearing behaviors were significantly associated with maternal education level, family type, family income, maternal age at delivery, and number of children in the family. Children's gender had no significant association with maternal child-rearing behaviors.

[Social interaction and mortality in a five year longitudinal study of the elderly]

This study clarified the relationship between social interaction and mortality using a five year longitudinal study. The subjects were all 60 years or above who lived in a farming community near major urban centers in Japan (n = 1,069). A total of 153 subjects died within the five year period after the baseline survey. A questionnaire was utilized, the contents of which were about social interaction (using the "Index of Social Interaction" which consisted from 5 subscales: Independence, Social curiosity, Interaction, Feeling of Safety, and Participation in the society), health status, life style, and subjects' feeling about themselves. The results were as follows: 1) low score on "Index of Social Interaction" was significantly related to five-year mortality, 2) the mean score of "index of Social Interaction" of deceased was significantly lower then survived subjects aged 75 and over, 3) logistic regression analysis adjusted for age, sex, length of education, and health status revealed that odds of mortality were significantly high with lower score in the Index of Social Interaction.

Prevalence and correlates of malnutrition among children in rural minority areas of China

BACKGROUND

Child growth retardation and malnutrition remain a matter of uttermost public concern in economically disadvantaged areas of China. The present study aimed to estimate the prevalence of protein-energy malnutrition with various anthropometric indices and examine its correlates in a large sample of poor rural minority children.

METHODS

A total of 2019 children under 7 years of age belonging to the Hani, Yi, Hui, Miao ethnic minority groups and the Han major group were drawn from four poor rural minority counties in the Yunnan Province of China. Well-trained investigators completed child physical measurements and maternal interviews. Protein-energy malnutrition was defined as being underweight (weight for age), wasting (weight for height) and stunting (height for age) on the basis of reference data from the National Center of Health Statistics (NCHS)/World Health Organization (WHO).

RESULTS

The respective prevalence of moderate and severe protein-energy malnutrition was 15.8 and 3.1% for underweight children, 31.8 and 19.2% for stunting and 0.9 and 0.5% for wasting. Stunting was most common in children aged 2 years. Boys were more likely to suffer from malnutrition. Logistic regression analyses showed that lower family income, lower parental height, belonging to the Miao, Yi and Hani ethnic groups compared with Han and poorer maternal child-rearing behavior significantly increased the risk for stunting of children.

CONCLUSIONS

Protein-energy malnutrition is relatively high in the rural minority children of China. Chronic socioeconomic underdevelopment and genetic effects, rather than a severe or immediate lack of food, may lead to protein-energy malnutrition.

[Visiting nurses' self evaluation of their professional skills and knowledge related to care management]

Evaluation methods for assessing professional skills and knowledge has become very important in this age of cooperation and coordination of health-social professionals. We have developed conceptual framework as well as practical methods to assess professional skills and knowledge for health-social professions' interrelationship. The purpose of this study is to clarify the visiting nurses' self evaluation of their professional skills and knowledge related to care management. Subjects (238 visiting nurses) and controls (894 other kinds of health-social professionals) were asked to answer a questionnaire on "Evaluation of professional skills and knowledge", which had 3 mainstreams--basic skills and knowledge, management skills and knowledge, and general evaluation. Each subscale included essential items for professional skills and knowledge, covering all health-social professions. Results of investigation showed that more than 98.2% of visiting nurses agreed to the framework of this evaluation and items. Differences in evaluation according to kinds of profession were few. The structure of items related to professional knowledge and skills were clearly shown by cluster analysis, and coefficient alphas were more than 0.95 for each subscale. In conclusion, this evaluation would be practical for visiting nurses. "Evaluation of professional skills and knowledge" will be useful for visiting nurses to facilitate their coordination with other kinds of professionals on the job and they will also be able to utilize it in educational situations.

[Evaluation of environmental stimulation for 18 months and the related factors]

With the disinteglation of social ties in the community, the role of environmental stimulation as an important function in children's health has been recognized and social services to evaluate the environmental stimulation are important. The Evaluation of Environmental Stimulation (EES) is a questionnaire which directly evaluates the interaction between the child and caregiver, and its effectiveness as a support system. The purpose of this study is to clarify characteristics of the EES by using statistical analysis. The subjects were 388 children of about 18 months who came for the compulsory health examinations. Caregivers were asked to answer the questionnaire. The results are as follows; 1) Children at risk for physical, mental and social development scored low for the 'social stimulation' subscale and in total score. 2) Children at the risk of medical and social diagnosis got fewer points in 'independence' subscale, 'physical stimulation' subscale, and total score than children without risk. 3) By ANOVA statistics, risk for development and risk for medical and social diagnosis had interactions according to child's sex. These results show that EES is effective in finding the risk of environment for children and for development of prevention measures, and appears to be useful as a screening system for health social services.

[Evaluation of environmental stimulation and its relation to physical deterioration in the elderly after 3 years--a health-social longitudinal study]

A comprehensive longitudinal study was started in 1991 and has been continuing every year to develop an evaluation of environmental stimulation (EES). The subjects were all the 60 years or above who lived in a farming community near major urban centers in Japan (n = 693). The contents of the interview were about the interaction between the individual and the environment, health status and life style, their feeling about themselves, and social activities. The results were as follows; 1) Environmental stimulation was divided into 5 subscales by factor analysis. i.e.: a) Interactive stimulation through family members and other people, b) Material stimulation, c) Social interactive stimulation, d) Availability of physical environment, e) Promoting self reliance and interaction. The cumulative prevalence rate for these factors was 54.2% and Cronbach alpha was 0.78, 2) Lack of environmental stimulation was significantly correlated to physical deterioration over the 3 years duration of the study. Further research is needed on this cohort to develop a more effective scale of environmental stimulation which can predict precisely the physical deterioration related to socio-psychological factors.