田中 笑子

OBJECTIVE: This study aimed to explore the direct and indirect effects of social frailty on functional state trajectories mediated by subjective cognitive function in older adults. DESIGN: Longitudinal study. SETTING AND PARTICIPANTS: Overall, 514 adults aged ≥65 years living in a suburban area of central Japan were included in this study. METHODS: Five-item social frailty index (going out, visiting, feeling helpful, living alone, and talking to others), subjective cognitive function from the Kihon Checklist, and instrumental activities of daily living disability. Latent growth curve models were applied to examine the longitudinal relations among the variables. RESULTS: During the 6-year follow-up in latent growth curve models, the initial level of social frailty in older adults was negatively associated with that of functional status (β = -0.53, P < .001), and the rate of change in social frailty was negatively associated with that in functional status (β = -0.78, P < .001). In the mediation model, the indirect effect from the social frailty level to functional status level through subjective cognitive function level was significant (β = -0.14, 95% CI -0.29, -0.09); the rates of change in subjective cognitive function mediated the relationship between those in social frailty and functional status (β = -0.35, 95% CI -0.46, -0.25). CONCLUSIONS AND IMPLICATIONS: This study found that there is an association between social frailty and functional status in Japanese older adults. Subjective cognitive function mediated this relationship. Hence, additional research is required to investigate additional potential factors linking social frailty and functional status in order to gain a better understanding of the underlying mechanisms.

OBJECTIVES: This study aimed to explore the bidirectional association between frailty and social relationships in older adults while distinguishing between interpersonal and intrapersonal effects. METHODS: A prospective cohort study of community-dwelling older adults was conducted in Japan in three waves spanning six years with follow-ups in every three years. Random intercept cross-lagged panel model was used to explore temporal associations between frailty and social relationships. RESULTS: Data for 520 participants (mean age 73.02 [SD 6.38] years, 56.7% women) were analyzed. Across individuals, frailty was associated with social relationships (β = -0.514, p < 0.001). At the interpersonal level, frailty was cross-sectionally associated with social relationships separately at T1(β = -0.389, p < 0.01), T2 (β = -0.343, p < 0.001) and T3 (β = -0.273, p < 0.05). Moreover, social relationships were associated with subsequent increases in symptoms of frailty in all measurement waves (β = -0.332, p < 0.001; β = -0.169, p < 0.01) and vice versa (β = -0.149, p < 0.05; β = -0.292, p < 0.001). CONCLUSIONS: The results suggest that frailty was associated with lower levels of social relationships. Frailty improvement programs can be combined with interventions to enhance social relationships, which will be beneficial in preventing frailty. The results emphasize the importance of combining clinical treatments of frailty with interventions to improve social relationships.

This study aimed to explore all the relevant subtypes of cognitive frailty among Japanese community-dwelling older adults with multimorbidity. Moreover, it examined the associations between these potential subtypes of cognitive frailty and social relationships. This study targeted relevant cross-sectional data regarding community-based older adults with multimorbidity. It employed a person-centered method to perform a latent class analysis and explore the subtypes of cognitive frailty among older adults. Moreover, a multinominal logistic regression analysis was employed to examine the association between potential subtypes of cognitive frailty and social relationships. Data for 396 participants (mean age, 75.8 [SD, 7.3] years; 51.3% females) were analyzed. Three cognitive frailty subtypes were subsequently revealed: the robust group (42.0%), the group with partial cognitive frailty (38.6%), and the group with cognitive frailty (19.4%). People with high levels of social relationships were more likely to be in the robust and the partial cognitive frailty groups. This study identified different subtypes of cognitive frailty among multimorbid older adults and highlighted the significance of social relationships. These findings could serve as a reference for conceptualizing cognitive frailty through the person-centered method. Promoting a high level of social relationships could be useful to prevent the cognitive frailty among older adults with multimorbidity.

Self-control and cooperation are interrelated among preschoolers, and research on the effect of age at entry into childcare on both variables remains controversial. Using a random intercept cross-lagged panel model, this study examined the bidirectional relationships between self-control and cooperation and the effect of age at entry into childcare using three waves of data (2018, 2019, and 2020) from 316 Japanese preschoolers (age three in 2018; 58.9% boys). The positive association between the two constructs occurred at the between- and within-person levels. No significant differences were found in the age of entry into childcare. The findings reveal a developmental link between self-control and cooperation, the implications of which are further discussed.

Objective: This study aimed to examine the longitudinal association between social relationships and physical functioning among community-dwelling older adults with chronic conditions. Methods: Self-reported questionnaires were distributed and collected between 2014 and 2017 from participants aged 65 years and older. The Index of Social Interaction was used to evaluate social relationships, and the instrumental activities of daily living (IADL) subscale of the Tokyo Metropolitan Institute of Gerontology Index of Competence was used to examine functional status. Data from 422 participants (190 men and 232 women) were included in the final analysis. Results: High social relationships demonstrated significant adverse effects (OR = 0.77, 95% CI = 0.64 – 0.93) on the decline of IADL in the overall sample, particularly for women (OR = 0.71, 95% CI = 0.55 – 0.93) but not for men ( p = 0.131). Conclusion: The finding suggests that functional limitation was influenced by social relationships among the disabled older adults, and the influence of social relationships on functional limitation differed based on gender. Keywords: Interpersonal Relations; Functional Status; Gender; Aged; Chronic Disease; Longitudinal Studies; Health Behaviour.

Objectives: The study aimed to examine the long-term effects of parenting practice during preschool years on children’s movement performance in primary school. Methods: This study involved a three-year longitudinal study including 225 children aged 3–6 years old. Parents reported baseline parenting practice and evaluated children’s movement performance three years later. Latent class analysis was used to explore latent classes of movement performance. A post hoc test was used to identify the characteristics of different patterns. Finally, adjusted multinomial logistic regression models were used to test the influence of parenting practice on identified patterns of movement performance. Results: Children in this study were grouped into three movement performance pattens, labelled as ‘least difficulties’ (58.2%, n = 131), ‘low back pain’ (30.2%, n = 68), and ‘most difficulties’ (11.6%, n = 26). After controlling for age, gender, having siblings or not, family structure, BMI SDS, sleep condition and dietary habits, we found that if parents played games with children frequently, the children would have a 0.287 times lower probability of being in the ‘low back pain’ class, 95%CI [0.105, 0.783], and if parents take children to meet peers of a similar age frequently, the children would have a 0.339 times lower probability of being in ‘most difficulties’ class, 95%CI [0.139, 0.825]. Conclusions: Primary healthcare providers should pay careful attention to children with movement difficulties. The study provides longitudinal evidence to support the applicability of positive parenting practice in early childhood to prevent children’s movement difficulties. Keywords: Movement performance; Parenting practice; Latent class analysis; Child; Longitudinal study; Japan.

Strong relationship exists between loneliness and depression in older adults. However, the effect of multifaceted social relationships on the relationship between loneliness and depression has not been explored. The purpose of the current study was to find out how multifaceted social relationships affect the aforementioned processes. We investigated and evaluated the loneliness status, depression symptoms, social relationships, and demographic information of 1116 older adults aged ≥65 years living in rural Japan. The final 555 participants were included in the analysis. Statistical evidence showed a direct effect between loneliness and depression symptoms. Additionally, the mediation model found that social curiosity and participation acted as mediators between loneliness and depression symptoms. Further, independence and participation, independence, and feeling safe played a conditional moderating role in the model of loneliness–social curiosity–depression symptoms and loneliness–participation–depression symptoms, respectively. Interaction can be an individual moderator in the link between loneliness and depression symptoms without any mediator. The moderated mediation model suggests that social curiosity and participation could mediate the association between loneliness and depression symptoms. In this process, independence, participation, and feeling safe may act as moderators.

ABSTRACT Background Social relationships are associated with physical function. However, little scholarly attention has been focused on the effect of changing social factors on physical function. Purpose This study was designed to examine the effects on physical function of changes in social relationships in adults aged 65 years and older. Methods This study is part of a longitudinal, prospective cohort study that was conducted on community-dwelling older adults in a suburban area of central Japan. Baseline self-report data were collected in 2011, and a follow-up survey was conducted in 2017. Social relationships were assessed using the Index of Social Interaction, and physical function was evaluated using a subscale of the Kihon Checklist. Chi-square tests, Mann–Whitney U tests, and multiple logistic regression analysis were used to analyze data from 442 older adults who were functionally independent at baseline. Results After controlling for covariates in 2011, negative changes in social relationships (odds ratio [OR] = 3.20, 95% CI [1.18, 8.69]) were found to be associated with physical function decline. Moreover, 1-point increases in the different social-relationship values between baseline and follow-up were associated with protective effects against functional decline (OR = 0.71, 95% CI [0.63, 0.80]). Furthermore, median trends between baseline and follow-up revealed associations between decreasing (OR = 4.18, 95% CI [1.53, 11.39]) and continuously low (OR = 2.98, 95% CI [1.42, 6.28]) social relationships and physical function decline. Conclusions/Implications for Practice The findings support a strong association between negative changes in social relationships and physical function decline and highlight the importance of promoting social relationships to delay physical function decline in older adults.

This study investigated the household secondary attack rate (HSAR) of patients with coronavirus disease (COVID-19) during the omicron variant-dominant period. The HSAR of COVID-19 cases during the omicron variant-dominant period (4-20 January 2022) was calculated and compared with the delta variant-dominant period (20 August to 7 November 2021) in Itako, Japan. In Itako, all 47 and 119 samples tested during the omicron and delta variant-dominant periods were negative and positive, respectively, for the L452R mutation. We used a generalized estimating equation regression model. The HSAR was 31.8% (95% confidence interval (CI) 27.7-36.2) for 456 household contacts during the omicron variant-dominant period; it was higher than that during the delta variant-dominant period (25.2%) (adjusted risk ratio [aRR] 1.61, CI 1.13-2.28). During the omicron variant-dominant period, HSAR was lower for the household contacts of completely vaccinated index patients (27.3%) than for contacts of other index patients (41.2%) (vaccine effectiveness for infectee 0.43, 95% CI 0.16-0.62) and was significantly higher for female contacts than for male contacts (36.2% vs. 26.1%; aRR 1.29, 95% CI 1.01-1.65). The HSAR was significantly higher during the omicron variant-dominant period than the delta variant-dominant period. The vaccination of index patients might protect household contacts.

We conducted a study to investigate the proportion of patients with asymptomatic coronavirus disease 2019 (COVID-19) infected with the Delta variant compared with those infected with the wild-type strain at the time of confirmation. A total of 504 patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by viral transmission through household contact in Ibaraki, Japan were included. The proportion of asymptomatic COVID-19 patients at the time of confirmation was compared between patients infected with L452R mutation strain from June to September 2021 and those infected with the wild-type strain from November 2020 to January 2021, and was found to be 14.2% and 28.8%, respectively (relative risk, 0.49; 95% confidence interval, 0.35-0.70). The proportion of asymptomatic COVID-19 patients by viral transmission through household contact was lower among the Delta variant than those among the wild-type strain at the time of confirmation. It might contribute to attenuation of transmission.

The diversity of child social skills development is not well detected among Asian countries. Culturally validated assessments are needed for practitioners to evaluate child social skills. This study tested the measurement invariance of the Social Skill Scale (SSS) across Japanese and Chinese samples and explored country differences in child social skills development. The SSS utilizes a widely used factor structure (assertion, self-control, and cooperation subdomains) and has established Japanese and Chinese versions. We conducted investigations with an identical process and materials with different language versions, collecting data from 931 Japanese kindergarten children (Mage = 4.35, SDage = 1.07; 53.6% boys) and from 1130 Chinese kindergarten children (Mage = 4.47, SDage = 1.00; 52.3% boys). We used multiple confirmatory factor analysis to test measurement invariance of the SSS and established the validity, reliability, and scalar measurement invariance for the first-order factor structure of the SSS across the two country samples. We also examined country differences on the associations between demographics, parenting practice, and child social skills development. We found that, compared to the Chinese sample, cooperation skills significantly increased more with age among the Japanese sample. However, spanking was negatively related to self-control skills development in both countries. Our findings contribute to the demonstration of the diversity of child social skills development and have important implications for assessing and developing child social skills using culture-specific strategies.

Objectives: Eating behaviour in early childhood serves as a foundation for future health outcomes. Diet patterns can have long-term beneficial or adverse effects on social behaviour development. Therefore, the objective of this study was to evaluate food consumption frequency in 1- to 6-year-olds as an eating behaviour-related predictor of behaviour problems six years later. Methods: This longitudinal study involved 124 mother-child dyads from a project named ‘Community Empowerment and Care for Wellbeing and Health Longevity’ initiated in 1991 and conducting surveys every three years. We studied children aged 1–6 years in July 2011, with a follow-up assessment in August 2017. The primary exposure examined was the frequency of food items intake. The primary outcome was behaviour problems as assessed by the Strengths and Difficulties Questionnaire (SDQ). Results: The adjusted results suggested that a higher intake of leafy green and light-coloured vegetables were significantly associated with decreased odds of conduct problems and prosocial behaviour problems in Japanese children. However, no associations were observed among fruits, milk, small fish, eggs, soybeans, seaweed, and any SDQ subscales. Conclusion: This study shows that eating leafy green and light-coloured vegetables may have a protective effect on a child’s conduct and prosocial behaviour problems. Due consideration should be given to children’s eating habits in the early stages of their lives, to ensure better mental health.&#x0D; Keywords: Child; Diet; Impulsive Behaviour; Longitudinal Studies; Mental Health; Nutrients; Sugars; Vegetables.

This study aimed to elucidate the household secondary attack rate (HSAR) of the Delta variant in comparison to the Alpha variant, and evaluate the risk factors among unvaccinated household contacts of patients with coronavirus disease 2019 (COVID-19). We studied household contacts of index cases of COVID-19 infected with Delta (L452R mutation), Alpha (N501Y mutation), and wild strain from December 2020 through November 2021 in Itako, Japan. The HSARs of the entire household contact, and the contact of index case with Delta variant were calculated and compared across the risk factors. We used a generalized estimating equation regression model for the multivariate analysis. We enrolled 1257 unvaccinated contacts from 580 households. The HSAR was higher in household contacts of index patients with Delta (48.5%) than with Alpha variant (21.7%) (aOR = 3.34, p = 0.000). In Delta variants, the HSAR was higher in household contacts with spousal relationships to index patients (63.4%) than contacts with other relationships (45.5%) (aOR 1.94, p = 0.026), and was lower in household contacts of index patients aged ≤19 (33.1%) than for contacts of index cases aged 20-59 years (52.6%) (aOR = 0.50, p = 0.027). The result of our study can be used to devise informed strategy to prevent transmission within households.

Externalizing and internalizing behavioral problems occurs at a high rate among children. However, this has rarely been examined among Japanese children using a person-oriented method. Hence, this study aims to explore its subtypes and clarify their association with family-based group activities. We conducted a cross-sectional survey in a typical community-based suburban area for all families with primary school children in Japan. We investigated children’s internalizing and externalizing behaviors based on the Japanese version of the Strengths and Difficulties Questionnaire (SDQ), and different types of activities that family members frequently engaged in. Data from 206 families were collected and used for the analysis. The subtypes were explored using latent class analysis (LCA). The relationship between family activities and latent class membership was analyzed using a logistic regression model. Moreover, three latent class models and their probabilities were identified, namely, risk group (31.3%), moderate group (44.9%), and normal group (23.8%). Frequent family activities including play sports, traveling or hiking, watching TV and communicating, cooking or making a dessert, and doing housework, which were significantly related to the normal group. These results would add evidence to potential types of children’s behavioral problems and preventive childcare practices needed in the primary gate of families.

Self-care ability and social skills are potential areas of difficulty for preschool children. However, values about young children's self-care ability are different worldwide. This longitudinal study examined the influence of early self-care ability on social skills at the end of the preschool years. Participants were 509 children recruited from kindergartens and child care centers across Japan, whose self-care ability and social skills were assessed at baseline year and three years later (Age of children in 2015 at baseline: M = 35 months, SD = 6.1 months). The study found that gender was significantly associated with social skills, while preschool facility entrance age was only associated with assertion skills. After controlling gender and entrance age, early self-care ability was still positively related to later assertion and cooperation (Assertion: OR = 2.55, 95% CI = 1.00-6.51; Cooperation: OR = 3.15, 95% CI = 1.23-8.07). Implications of the findings are discussed in the context of cultural diversity, highlighting the importance of cultivating children's age-appropriate self-care ability based on daily observations and evaluations.

<title>Abstract</title><sec> <title>Background</title> Social relationships may be the key to successful aging among older adults. However, little is known about the variability of social relationships among community-dwelling older people. This study aimed to describe the patterns of social relationships and examine the differences in sociodemographic characteristics and mental and physical health status among these patterns. </sec><sec> <title>Methods</title> We obtained the data from a questionnaire survey in 2017 for older adults aged 65 and above who lived in a suburban area in Japan. The Index of Social Interaction (ISI) was used to evaluate social relationships. The final sample comprised 964 people who were independently mobile and answered at least one item of the ISI. To clarify the patterns of social relationships, latent class analysis was performed with five subscales of ISI treated as indicator variables. Multinomial logistic regression was conducted to examine the factors associated with the patterns of social relationships. </sec><sec> <title>Results</title> The patterns of social relationships were classified into three classes: “Active” (73.6%), “Socially isolated” (14.7%), and “Less motivated” (11.7%). Persons who had depressive symptoms were more likely to be allocated to the “Socially isolated” (Odds Ratio [OR] 1.80, 95% Confidence Interval [CI] 1.13–2.86) or the “Less motivated” groups (OR 1.69, 95% CI 1.00–2.85) compared to the “Active” group. In addition, men (OR 1.72, 95% CI 1.07–2.76) and those living alone (OR 3.07, 95% CI 1.43–6.61) were more likely to be allocated to the “Socially isolated” group. Moreover, those who were dependent, according to the instrumental activities and daily living functions, were more likely to be assigned to the “Socially isolated” (OR 2.19, 95% CI 1.21–3.97) or “Less motivated” (OR 6.29, 95% CI 3.47–11.39) groups. </sec><sec> <title>Conclusion</title> This study revealed the patterns of social relationships in older adults and suggested that there may be variations of social relationships among community dwellers. The results also indicated the necessity of assessing individual patterns of social relationships and devising strategies for each pattern in public health practice. </sec>

The COVID-19 pandemic has impacted the daily life and social relationships of pre-school children globally. While many studies have examined the impact of the pandemic on children, few have compared the home environment and children’s social skills before and after the pandemic. To address this research gap, we used data from the Japan Child Care Cohort study, which included questions on home environment answered by parents (1748 in 2019 and 1349 in 2020) of children aged 0–6 years using self-reported questionnaires and data on the social skills of children aged 1–6 years (1917 in 2019 and 1989 in 2020) that were evaluated by childcare professionals in childcare centres. Using the Chi-square test, home environments and social skills were compared. We found that frequencies of family meals, no punishment, and a positive attitude toward children’s mistakes were higher in 2020. In contrast, frequencies of shopping together, visiting children’s friends and relatives, and having social support from others were lower in 2020. Additionally, children’s social skills in 2019 were better than in 2020. Childcare institutions can consider these differences and create a support plan to ensure quality child-rearing practices and healthy child development.

Social skills acquired during early childhood are often the foundation for success later in life. Using a nationwide survey dataset in Japan, this study aims to explore the multiple growth trajectories of social skills among children in kindergarten by using a latent class growth modeling approach. It also examines whether, and to what extent, the home-rearing environment at early age predict trajectories of social skills development. Children in this study were assessed on social skills at three waves, four home-rearing environment dimensions (human stimulation, social stimulation, avoidance of punishment, and social support for parenting) and demographic background were measured at wave 1. The results indicated that three distinct growth trajectories of social skills existed during kindergarten: high increase levels, moderate increase levels, and decreased levels. The avoidance of punishment and children's gender significantly predicted the growth trajectories of social skills. Thus, the results suggest that more attention should be paid to the home-rearing environment and boys.

© 2020 Elsevier B.V. Objectives: To examine the relationship between multimorbidity and functional limitation, and how social relationships alter that association. Methods: This cross-sectional study used data collected by self-reported questionnaires from adults aged 65 years and older living in a rural area in Japan in 2017. This analysis included complete data from 570 residents. Multimorbidity status was defined as having two chronic diseases exist simultaneously in one individual, and the function status was measured by their long-term care needs. Social relationships were assessed by the Index of Social Interaction and divided into high and low levels. Multiple logistic regression analysis was used to examine the association between social relationships and functional limitation and to assess the role of social relationships in this association. Results: The logistic regression model indicated that the risk of functional limitation was higher in multimorbidity participants than free-of-multimorbidity participants (OR = 2.55, 95% CI = 1.56–4.16). Compared with participants with no multimorbidity and a high level of social relationships, low level of social relationships increased the risk of functional limitation among participants both with and without multimorbidity, with the OR = 7.71, 95% CI = 3.03–19.69 and OR = 3.28, 95% CI = 1.30–8.27, respectively. However, no significant result was found in participants with multimorbidity and a high level of social relationships (P = 0.365). Conclusions: Multimorbidity was associated with functional limitations. However, this association could be increased by a low level of social relationships and decreased by a high level of social relationships.

© 2019 The Royal Society for Public Health 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.

目的:近年、働く世代における高ストレスやメンタルヘルスの不調和が課題となっている。本研究の目的は地域住民を対象とした調査データにより、成人期の社会とのかかわりと精神的健康の関連について、年齢階層別の検討により明らかにすることである。方法:飛島村に在住する20歳から59歳の全住民を対象に、2014年および2017年に自記式質問紙調査を実施し、両年に回答のあったもののうち主要な変数に欠損のなかった948名を分析対象とし、社会とのかかわり状況と3年後の精神的健康との関連を分析した。まず、年齢、性別を説明変数、精神的健康を目的変数とした単変量ロジスティック回帰分析を実施した。次に、10歳ごとの年代で層化し、社会とのかかわりを説明変数、精神的健康を目的変数とした単変量ロジスティック回帰分析を行った。最後に、年齢と性別を調整変数として加えた多重ロジスティック回帰分析を行った。結果:多重ロジスティック回帰分析の結果、成人期全体では社会のかかわりのうち、生活の主体性領域および他者とのかかわり領域と精神的健康に有意な関連を認めた。年齢階層別の検討では、30歳代は生活の主体性領域、生活の安心感領域と、40歳代は生活の主体性領域、他者とのかかわり領域と精神的健康に有意な関連がみられた。生活主体性が高く、他者とのかかわりが多いほど3年後のストレスなどの軽減につながる可能性が示唆された。結論:成人期での社会とのかかわりは、精神的健康の維持に寄与する重要な要因の一つである可能性が示唆された。30歳、40歳代では物事に積極的に取り組むことに加え、30歳代では、生活に安心感が持てること、40歳代では身近な相談相手などの他者とのかかわり重要性が示された。全世代、特に30歳、40歳代を対象とした地域での支援の重要性を示唆するものと考える。(著者抄録)

© 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background & aim: Hypertension as a risk factor for cardiovascular disease has growing prevalence. An increase in body weight is typically followed by an increase in blood pressure. This study aimed to investigate the association of general and central obesity with hypertension in Indonesian women using WHO and Indonesian classification systems. Methods: Cross-sectional study of Indonesian women aged 18 years or and more (313,714 participants), using national level Indonesia National Basic Health Research (2013). Results: The prevalence of hypertension in Indonesian women in this study was 32.8%. Based on logistic regression analysis, hypertension was significantly associated with residential area, educational attainment, self-reported smoking status, cardiovascular disease, chronic kidney disease, diabetes mellitus, body mass index and waist circumference. Furthermore, the odds of having hypertension for general and central obesity according to WHO classification were adjusted odds ration (aOR) 2.61, 95% CI 2.52–2.70 and aOR 1.50, 95% CI 1.46–1.53. By Indonesian classification were aOR 2.21, 95% CI 2.16–2.26 and aOR 1.48, 95% CI 1.45–1.51. Conclusion: By using International WHO and standard Indonesia classification systems, general and central obesity were associated with hypertension in Indonesia women. Thus, not only general obesity but also central obesity should be used to assess obesity in Indonesian women.

© 2018 Although early institutionalization has been shown to have broad, detrimental effects on child developmental outcomes, there have been few attempts to systematic measure which aspects of the institution and caregiving environment associate with negative psychological outcomes. The current study uses a culturally and contextually modified early adolescent version of the Home Observation for Measurement of the Environment Inventory (EA-HOME-JP) in Japanese child welfare institutions (CWIs) to provide preliminary data on relevant variables in the caregiving environment that associate with domains of perceived self-competency. Forty-six children and young people (Agemean = 13 years 9 months) and their 35 primary caregivers from 11 CWIs were interviewed using EA-HOME-JP. Children and young people also self-reported on their perceived cognitive, physical, social competencies, and sense of self-worth. Participants within the same residential environments exhibited marked variation across each EA-HOME-JP subscale suggesting that the same rearing environment can be experienced differently by different individuals. Interestingly, EA-HOME-JP scores did not vary with care type (large-ward, middle-ward, and family-like), Instead, CWIs grouped within the same care type showed significant variation to one another on EA-HOME-JP subscales. Importantly, EA-HOME-JP scores, rather than care type, associated with aspects of competency (cognitive competency and sense of self-worth). As these findings are based on a small number of participants, they will require further replication in larger samples ascertained from other regions in Japan. Ultimately, these data may contribute to considerations over optimal packages of residential rearing in Japan.

© 2018 The Author(s). Background: Many reports argue that sleep is important for children's health, learning, and academic performance. The purpose of this longitudinal study was to examine the association between sleep and the development of social competence in infants. Methods: This study was conducted as part of a Japan Science and Technology Agency (JST) project. Caregivers responded to the Japan Children's Study Sleep Questionnaire when children were 18 months old. The interactions of caregivers and children were observed when children were 18, 30, and 42 months old, and rated with the Interaction Rating Scale, which is a measure of social competence. Results: Nocturnal sleep duration of more than 10 h and an earlier bed time than 22:00 were significantly correlated with two trajectory groups (low point and high point transition groups) of children's social competence at 18, 30, and 42 months. Further, total sleep duration of more than 12.25 h and an earlier bed time than 22:00 were significantly correlated with the trajectory of children's social competence at 18, 30, and 42 months. Conclusions: Sleep duration and sleep onset time are important factors in children's development of social competence. Trial registration The ethics committee of the JST approved this study on March 19, 2001. The registration number is 356-1.

© 2016 Japan Geriatrics Society Aim: Previous studies have shown that social relationships positively contribute to the functioning of older adults. However, the particular aspects of social relationships that are most predictive remain unknown. Consequently, the current study aimed to clarify what elements of social relationships impacted the maintenance of functioning among older adults. Methods: The present study used baseline data collected in 2011, and follow-up surveys were carried out 3 years later. Participants included individuals aged 65 years or older who lived in a suburban community in Japan. A total of 434 participants met inclusion criteria for the study and were included in analysis. The Index of Social Interaction measure consists of five subscales (independence, social curiosity, interaction, participation and feeling of safety), and was used to assess the multiple elements of social relationships. Results: After controlling for age, sex, disease status and mobility in 2011, the results showed that the social curiosity subscale was significantly associated with functional status after 3 years (OR 1.29, 95% CI 1.02–1.63). Other Index of Social Interaction subscales were non-significant. Conclusions: The current study suggests that interaction with environment and multifaceted social relationships have the strongest impact on functional ability for older adults in Japan. Geriatr Gerontol Int 2017; 17: 1522–1526.

<p>目的：養育者の生活リズムの乱れが子どもの睡眠を不規則にし、子どもの成長発達に影響するとした報告が多数ある。一方、子どもの睡眠不規則と、養育者のストレスの関連が指摘されている。そこで本研究では、就学前児の睡眠リズムと就労する養育者のストレスとの関連を明らかにすることを目的とした。</p><p>方法：全国の認可保育所21箇所を利用する養育者に、2014年4月～2015年3月に質問紙調査を実施した。5〜6歳児をもつ養育者593人のうち404人から回答を得た。就労する養育者のストレスを目的変数、子どもの睡眠リズム、仕事負担感、育児の自信喪失感、子どもの性別、家族構成を説明変数としてカイ二乗検定を行った。家族構成は2つのモデルで検討した。さらに多重ロジスティック回帰分析により、各項目のオッズ比を算出した。</p><p>結果：調査項目に欠損のない就労する母親350人を分析対象とした。多重ロジスティック回帰分析の結果、モデル1では、就労する養育者のストレス高群は低群と比較して、育児の自信喪失感3.10倍、仕事負担感2.34倍、子どもの睡眠リズム1.97倍と、有意に高かった。モデル2では、育児の自信喪失感3.12倍、家族構成2.39倍、仕事負担感2.33倍子どもの睡眠リズム1.93倍と、有意に高かった。</p><p>結論：子どもの睡眠リズムと就労する養育者のストレスの関連を明らかにした。子どもの睡眠習慣の確立は、子どもの健やかな成長発達のみならず、養育者のストレスマネジメントの観点からも重要である可能性が示唆された。</p>

<p>目的 孤立化，無縁化と高齢者の社会との関わりの問題が社会問題とされる現在，実際の社会との関わりの変化を比較した研究や社会との関わりへの影響要因に関する研究は乏しい。本研究は地域在住高齢者の20年間の社会関連性の変化および，コミュニティリソースに焦点を当てて，その影響要因を明らかにすることを目的とする。</p><p>方法 対象は大都市近郊に存する農村である飛鳥村に居住する65歳以上高齢者である。分析は，1994年から2014年に行われた計8回の悉皆調査の質問紙調査においてそれぞれの調査年度ごとに社会関連性指標の領域点および総合得点を算出し，1994年時と2014年時の得点をWilcoxonの順位和検定を用いて比較した。また，社会関連性の変化の要因を明らかにするため，2014年の社会関連性を目的変数とした多重ロジスティック回帰分析を行い，2011年時のコミュニティリソースの利用経験（地域包括支援センターや保健センター，健康増進施設，図書館）の利用との3年後の関連を検討した。多重ロジスティック回帰モデルには調整因子として年齢・性別・疾患・移動能力を投入した。</p><p>結果 1994年と2014年の社会関連性指標得点を比較するとすべての年代で総合得点が有意に上昇し，男女別にみると女性の総合得点が漸増していた。領域別では，生活の主体性領域で，女性の65歳以上および75-84歳の得点が有意に上昇していた。社会への関心領域は男女ともに得点が有意に漸増しており，20年間で高齢者の社会への関心が高まっていた。社会関連性の要因分析では，健康増進施設の利用および地域包括センター，保健センターの利用が3年後の社会関連性総合得点と関連していた。</p><p>結論 本研究では，社会関連性指標に着目し，同一コミュニティの高齢者の20年間の社会との関わりの推移を総合的，領域的に明らかにした。地縁の希薄化など高齢者の社会との関わりの低下が注目されている昨今だが，本研究の結果より，高齢者の社会への関心や生活の主体化などの社会との関わりが20年で高くなっていることが示唆された。これらは地域包括支援センターや保健センターでの予防的介入や健康増進施設での介入など介護予防事業の効果が一因として考えられる。</p>

© 2016 Reduction of children's behavioral problems has the potential to ameliorate parental stress, mental health problems, and family dysfunction. The current study was designed as a 3-year longitudinal study with secondary data. A total of 99 caregivers with preschool aged children were required to complete two self-reported questionnaires: the Index of Child Care Environment and Strengths and Difficulties Questionnaire. It demonstrated that a positive home-rearing environment had a positive influence on children's behavioral problem 3 years’ later. Our study suggests that we may reduce behavioral problems in children's later development by providing a positive home rearing environment.

目的 本研究の目的は,住民の「なまの声」からコミュニティ・エンパワメント展開のための当事者ニーズを抽出し,健康に対する考え方や工夫を把握することである。また,2008年と2011年の変化を抽出し,今後の健康長寿に向けた方策策定への一助とすることである。方法 大都市近郊農村自治体住民と保健福祉専門職10グループ73名(男性34名,女性39名)にフォーカス・グループ・インタビューを2011年に実施した。各グループのインタビューから得られた結果をシステム理論に基づきカテゴリー化し,コミュニティ・エンパワメントに関するニーズを抽出した。その結果を2008年に行ったフォーカス・グループ・インタビューと比較し,3年間の変化をまとめた。結果 重要カテゴリーとしては大きな変化がみられなかった。しかし,内容に少しずつ変化がみられた。"個"の領域では,『予防の意識づけ』や『心の余裕』さらには『自分で決定』することの重要性が新たに述べられた。また,保健福祉サービスの活用の難しさも述べられた。"相互"の領域では,継続させることの重要性と『情報との交流』の大切さが述べられた。また,『家族の協力と理解』の困難さも語られた。"地域システム"の領域では,交通が不便であるためのポジティブな側面が語られた。また,在宅でより生活しやすくするために医療と福祉の連携を強化する必要性と防災や心のケアの重要性が述べられた。『健康に関する支援の充実』では幼児期からの健康教育とともに,介護している家族への支援の充実を望む声が多く聞かれた。結論 「地域の絆」「地域の安全」「心の病」に関する関心が高まっていたのは,東日本大震災という未曽有の災害前後の比較であったためと考える。また,個人のペースの重要性が述べられていたのは,時代の変化によるものと考えられた。(著者抄録)