Longitudinal assessment of the relationship between frailty and social relationships among Japanese older adults: a random intercept cross-lagged panel model.

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 (ß = -0.514, p < 0.001). At the interpersonal level, frailty was cross-sectionally associated with social relationships separately at T1(ß = -0.389, p < 0.01), T2 (ß = -0.343, p < 0.001) and T3 (ß = -0.273, p < 0.05). Moreover, social relationships were associated with subsequent increases in symptoms of frailty in all measurement waves (ß = -0.332, p < 0.001; ß = -0.169, p < 0.01) and vice versa (ß = -0.149, p < 0.05; ß = -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.

Social Frailty and Functional Status in Japanese Older Adults: The Mediating Role of Subjective Cognitive Function.

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 (ß = -0.53, P < .001), and the rate of change in social frailty was negatively associated with that in functional status (ß = -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 (ß = -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 (ß = -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.

Estimating rainfall interception loss of three dominant shrub species in an oasis-desert ecotone using in situ measurements and the revised Gash analytical model.

Canopy interception loss affects the local water budget by removing a non-negligible proportion of rainfall from the terrestrial surface. Thus, quantifying interception loss is essential for thoroughly understanding the role of vegetation in the local hydrological cycle, especially in dryland ecosystems. However, sparse shrubs in dryland ecosystems have not been sufficiently studied, owing to time- and labor-intensive field experiments and challenging model parameterization. In this work, 4-year growing season field experiments on rainfall partitioning were conducted for three dominant shrub species (Haloxylon ammodendron, Nitraria sphaerocarpa, and Calligonum mongolicum) in an oasis-desert ecotone in northwestern China. The revised Gash analytical model was well parameterized, which reliably simulated the cumulative interception loss for sparse shrubs, and the validated model performed better for H. ammodendron, followed by C. mongolicum and N. sphaerocarpa, with relative errors of 8.4%, 15.4%, and 23.9%, respectively. The mean individual interception loss percentage for H. ammodendron (28.4%) was significantly higher than that for C. mongolicum (11.0%) and N. sphaerocarpa (10.9%) (p < 0.05), which could be ascribed to the higher canopy storage capacity and wet-canopy evaporation rate of H. ammodendron. For all shrub species, the majority proportion of interception loss occurred during canopy saturation and drying-out periods, accounting for approximately 79-85% of the cumulative interception loss. Overall, the mean local interception loss of three dominant shrub species in the ecotone removed nearly 17% of the corresponding cumulative rainfall during the growing season. These results not only provide methodological references for estimating the interception loss of sparse vegetation in dryland ecosystems, but also provide scientific insights for water resource management and ecosystem restoration in water-limited regions similar to the experimental site.

Latent Subtype of Cognitive Frailty among Multimorbidity Older Adults and Their Association with 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.

Social Relationships and Onset of Functional Limitation among Older Adults with Chronic Conditions: Does gender matter?

Objectives: 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 ≥65 years old. 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. Results: A total of 422 participants (190 males and 232 females) were included in the final analysis. High social relationships demonstrated significant adverse effects (odds ratio [OR] = 0.77, 95% confidence interval [CI]: 0.64-0.93) on the decline of IADL in the overall sample, particularly for females (OR = 0.71, 95% CI: 0.55-0.93) but not as much for males (P = 0.131). Conclusion: This finding suggests that functional limitation was influenced by social relationships among disabled older adults and the influence of social relationships on functional limitation differed based on gender.

Patterns of Movement Performance among Japanese Children and Effects of Parenting Practices: Latent class analysis.

Objectives: This study aimed to examine the long-term effects of parenting practice during preschool years on children's movement performance in primary school. Methods: This three-year longitudinal study included 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 patterns, labelled as 'least difficulties' (n = 131, 58.2%), 'low back pain' (n = 68, 30.2%) and 'most difficulties' (n = 26, 11.6%). After controlling for age, gender, having siblings or not, family structure, standardised body mass index, sleep condition and dietary habits, the researchers 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% confidence interval [CI]: 0.105-0.783). In addition, if parents take children to meet peers of a similar age frequently, children would have a 0.339 times lower probability of being in 'most difficulties' class (95% CI: 0.139-0.825). Conclusion: 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.

Experimental partitioning of rainfall into throughfall, stemflow and interception loss by Haloxylon ammodendron, a dominant sand-stabilizing shrub in northwestern China.

Rainfall partitioning by the vegetation canopy represents a significant component of the local hydrological cycle by reshaping the amount and spatial distribution of rainfall. Measuring the components of rainfall partitioning, however, has been a challenging task due to laborious- and time-consuming field experiments. In this study, to probe the influences of long-term afforestation on dynamic patterns of rainfall partitioning, the dominant sand-stabilizing shrub Haloxylon ammodendron at three different ages was selected for field measurements during the 2020-2021 growing season. The throughfall percentage for young H. ammodendron (YH, 75.9 %) was significantly higher than that for middle-aged H. ammodendron (MAH, 63.4 %) and mature H. ammodendron (MH, 62.4 %) (p < 0.05 for all cases). However, the interception loss percentage of YH (22.3 %) was significantly lower than that for MAH (35.0 %) and MH (36.5 %) (p < 0.05 for all cases). No significant difference was found for stemflow percentage among YH (1.8 %), MAH (1.5 %) and MH (1.1 %). Smaller rainfall events contributed to a higher interception loss percentage and a lower net rainfall percentage for all ages. Both throughfall and stemflow percentage first showed increasing trends and then tended to be stable with increasing rainfall amount and duration, whereas interception loss percentage showed the opposite patterns. Rainfall partitioning was significantly correlated with the plant area index, stem basal area and canopy height (p < 0.05 for all cases), which may account for significant differences in rainfall partitioning patterns, as all shrubs experienced the same weather conditions. The average funneling ratio was 56.6, 26.7 and 17.9 for YH, MAH and MH, respectively. These results suggested that H. ammodendron afforestation can have a significant impact on rainfall partitioning by reducing net rainfall reaching the soil and may have some implications for local water budget and ecosystem management in oasis-desert ecotones.

Changes in Social Relationships and Physical Functions in Community-Dwelling Older Adults.

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.

Measurement invariance and country difference in children's social skills development: Evidence from Japanese and Chinese samples.

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.

Subtyping of Internalizing and Externalizing Behaviors in Japanese Community-Based Children: A Latent Class Analysis and Association with Family Activities.

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.

Role of Multifaceted Social Relationships on the Association of Loneliness with Depression Symptoms: A Moderated Mediation Analysis.

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.

Development of Social Skills in Kindergarten: A Latent Class Growth Modeling Approach.

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.

Multimorbidity and functional limitation: the role of social relationships.

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.

A qualitative study on the psychological experience of caregivers of COVID-19 patients.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is spreading rapidly, bringing pressure and challenges to nursing staff. OBJECTIVE: To explore the psychology of nurses caring for COVID-19 patients. METHODS: Using a phenomenological approach, we enrolled 20 nurses who provided care for COVID-19 patients in the First Affiliated Hospital of Henan University of Science and Technology from January 20, to February 10, 2020. The interviews were conducted face-to-face or by telephone and were analysed by Colaizzi's 7-step method. RESULTS: The psychological experience of nurses caring for COVID-19 patients can be summarized into 4 themes. First, negative emotions present in early stage consisting of fatigue, discomfort, and helplessness was caused by high-intensity work, fear and anxiety, and concern for patients and family members. Second, self-coping styles included psychological and life adjustment, altruistic acts, team support, and rational cognition. Third, we found growth under pressure, which included increased affection and gratefulness, development of professional responsibility, and self-reflection. Finally, we showed that positive emotions occurred simultaneously with negative emotions. CONCLUSIONS: During an epidemic outbreak, positive and negative emotions of the front-line nurses interweaved and coexisted. In the early stage, negative emotions were dominant and positive emotions appeared gradually. Self-coping styles and psychological growth played an important role in maintaining mental health of nurses.

Concentrated Growth Factors Can Inhibit Photoaging Damage Induced by Ultraviolet A (UVA) on the Human Dermal Fibroblasts In Vitro.

BACKGROUND Photoaging is the main cause of extrinsic skin aging. Daily exposure to ultraviolet A (UVA) accelerates the process of photoaging. The present study aimed to understand the role of concentrated growth factors (CGF) on UVA irradiated human skin cells. MATERIAL AND METHODS We isolated and subcultured normal human dermal fibroblasts (NHDFs) from 6 different human dorsal skins and established photoaging models of NHDFs irradiated by UVA to detect the influence of CGF on fibroblasts in vitro. Three groups were examined: normal, cellular photoaging model (total dosages of 18J·cm--⁻²-), and cellular photoaging model plus CGF. In our study, we used the MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay method to measure the cell viability. We also used reactive oxygen species (ROS) assay and superoxide dismutase (SOD) assay to measure respectively the amount of oxygen free radicals and antioxidative enzymes. We compared the migration rates among the photoaging model groups, the control groups, and the CGF-treated culture medium groups that were irradiated. RESULTS Our study results indicated that 5% CGF can reduce UVA-induced human skin fibroblasts damage significantly, improve the viability of NHDFs significantly, and largely decrease the UVA irradiation effect (P<0.05). The migration rates of the normal group and the UVA-irradiated NHDFs in the 5% CGF group had significantly increased migration rates (P<0.05), compared to the control medium group. The migration rates of the UVA-irradiated NHDFs in 5% CGF exceed those of the normal group. These results showed that 5% CGF could greatly promote cellular proliferation, migration, and SOD at the same time that the amounts of ROS were markedly decreased. CONCLUSIONS These experimental findings offer some important insights into CGF's capacity for scavenging ROS, improving SOD, and increasing migration rates in NHDFs irradiated by UVA.

[A qualitative research on the psychological experience of hospitalized patients with acute myocardial infarction].

OBJECTIVE: To observe the psychological experience of patients with acute myocardial infarction (AMI) during hospitalization. METHODS: From November 2012 to February 2013, semi-structured interviews were conducted in 10 patients with AMI in the Cardiovascular Department of First Affiliated Hospital of Henan University of Science and Technology. Grounded theory approach was performed to analyze the collected data. RESULTS: The 6 themes and 3 secondary themes during their hospitalization were: helplessness and dependence when AMI was diagnosed fear of immediate death induced by AMI, confusion on various problems such as operation time, excretory after PCI and limited knowledge details, the feel of safety after PCI, the fear of AMI, and the worry about overtreatment. CONCLUSIONS: Hospitalized AMI patients have complicated psychological responses. Medical staff should provide targeted strategies and timely communication with AMI patients to reduce their psychological burden.