Determinants of Self-Rated Health Disparities among Independent Community-Dwelling Older Adults: An Age-Stratified Analysis.

In response to the distinctive healthcare requirements of independent, healthy, community-dwelling older adults in Japan and other developed countries with aging populations, the current study examined the differences in factors associated with self-rated health (SRH) between the following two age groups: young-old (65-74) and old-old (75 and above). Age-stratified analysis was used to provide a comprehensive understanding of the unique health challenges faced by these demographic segments and to inform the development of targeted interventions and health policies to improve their well-being. The results of a cross-sectional study of 846 older adults in Yokohama, Japan, who completed self-administered questionnaires, revealed that high SRH was consistently linked with the low prevalence of concurrent medical issues in both age groups (<75 and ≥75) (ß: -0.323, p < 0.001 in the <75 group; ß: -0.232, p < 0.001 in the ≥75 group) and increased subjective well-being (ß: 0.357, p < 0.001 in the <75 group; ß: 0.244, p < 0.001 in the ≥75 group). Within the ≥75 age group, higher SRH was associated with more favorable economic status (ß: 0.164, p < 0.001) and increased engagement in social activities (ß: 0.117, p = 0.008), even after adjusting for age, sex, and economic status. These findings may inform the development of targeted interventions and policies to enhance the well-being of this growing population in Japan and other developed countries.

Subjective Well-Being and Related Factors among Independent, Healthy, Community-Dwelling Older Adults in Japan.

(1) Background: Subjective well-being (SWB) is internationally recognized as an important health-related factor for most age groups and is particularly influential for life quality and expectancy in independent, healthy, community-dwelling older adults. However, the physical function and community participation correlates of SWB in independent living older adults in super-aging societies and other influencing factors remain underexplored. (2) Methods: A total of 926 independent, healthy, community-dwelling older adults aged 65 years and above registered in Yokohama, Japan, were included. Respondents' mean age was 78.1 years (standard deviation = 6.7), and 74.0% were women. The dependent variable was SWB. The independent variables were respondents' demographic characteristics, physical factors (visual, hearing, and cognitive functions, and mobility), and community and social factors (participation in community groups, social networks, and community commitment. (3) Results: The mean (standard deviation) WHO-5 score was 16.3 (5.1). Significant factors associated with WHO-5 score were visual function (odds ratio [OR]: 0.708; 95% confidence interval [CI]: 0.352-0.690), hearing function (OR: 0.615; CI: 0.431-0.878), community groups (OR: 1.310; CI: 1.003-1.059), community commitments (OR: 1.180; CI: 1.132-1.231), and social networks (OR: 1.525; CI: 1.142-2.037) adjusted for the effects of demographic factors. (4) Conclusions: These findings are important because factors associated with SWB are likely to contribute to individual well-being and longevity and to developing a healthy super-aged society.

Effectiveness of the Online Daily Diary (ONDIARY) program on family caregivers of advanced cancer patients: A home-based palliative care trial.

OBJECTIVES: There are many effective palliative care programs for patients with advanced cancer. However, little is known about effective programs for family caregivers of patients with advanced cancer, especially in home-based palliative care settings. This study aimed to determine the effect of the Online Daily Diary (ONDIARY) program on the quality of life (QOL) of family caregivers of patients with advanced cancer in home-based palliative care settings. METHODS: This study used a quasi-experimental design with a control group. The sample comprised 60 family caregivers (intervention group n = 30, control group n = 30) of patients with advanced cancer receiving home-based palliative care. The intervention group was assigned to the ONDIARY program in addition to usual care, and the control group was assigned to usual care. Group allocation was not randomized. The ONDIARY program is a 7-day online diary intervention program that aims to enhance emotional competence. Outcome measures were feasibility assessment, and primary and secondary outcome assessment. Primary and secondary outcome measures were the Caregiver Quality of Life Index-Cancer (CQOLC) and the six-item Kessler Psychological Distress Scale (K6). Repeated measures analysis of variance was performed on each measure, with group and group × time interactions. RESULTS: There was a significant group × time interaction in CQOLC scores (F = 9.324, P = 0.003). The CQOLC scores of family caregivers in the intervention group were maintained after the intervention, whereas those in the control group declined. There was no significant difference in K6 scores between the two groups. CONCLUSION: The results suggest that the ONDIARY program in addition to usual care has potential to be effective in preventing decline and maintaining QOL of family caregivers of patients with advanced cancer in home-based palliative care settings.

Global 137Cs fallout inventories of forest soil across Japan and their consequences half a century later.

Japanese forests were exposed to multiple sources of radioactive contamination. To acquire scientific guidance on forest management planning, it is crucial to understand the long-term radiocesium (137Cs) distribution (and redistribution) over time. To obtain robust evidence of the residual global fallout of 137Cs (137Cs-GFO) after a few decades, we determined 137Cs-GFO inventory in forest soil at 1171 soil pits of 316 plots evenly spaced across Japan from 2006 to 2011, shortly before the Fukushima Dai-ichi Nuclear Power Plant accident. The activity concentration measurements were performed using a NaI well-type scintillation counter. The average (±SD) 137Cs-GFO in forest soil (0-30 cm from the surface) of the National Forest Soil Carbon Inventory (NFSCI) sampling plots uniformly extracted from the entire country was estimated to be 2.27 ± 1.73 kBq m-2 (n = 316) as of Oct. 1, 2008. A high nationwide spatial variation was found in 137Cs-GFO, where relatively high 137Cs-GFO was found along the Sea of Japan compared with the total annual precipitation. We also obtained a reconstructed decay-corrected cumulative 137Cs-GFO dataset from the fallout observatories as the initial 137Cs-GFO. The cumulative 137Cs-GFO of fallout observatories averaged 2.47 ± 0.95 kBq m-2 (n = 39) as of Oct. 1, 2008 and displayed spatial variation similar to that in forest soil. To identify whether 137Cs-GFO remains in forest soil across Japan, we examined a general linear mixed-effect model comparing 137Cs-GFO between forest soil and the observatory under normalized annual precipitation and region. The model did not indicate a significant difference, but relatively lesser 137Cs-GFO was found in forest soil, where the least-squares mean of 137Cs-GFO in forest soils was 79.1% of that of the observatory. The variation in 137Cs-GFO in forest soils within NFSCI sampling plots was 1.4 times greater than that among plots. The high spatial variation in 137Cs-GFO within a 0.1-ha plot strongly suggested the redistribution of 137Cs-GFO within the forest catchment. The vertical distribution pattern of 137Cs-GFO across three depth layers indicated that the 137Cs-GFO redistributions were likely attributed to the movements of sediments and mass. Moreover, when extracting soil pits assumed to have the least soil disturbance from the vertical distribution pattern, no significant difference in 137Cs-GFO was observed between forest soil and observatory data. These findings provide important insights into the stability of 137Cs-GFO in the forest ecosystem. Considering the potential hotspot where 137Cs-GFO can accumulate deeper in the soil (>30 cm in depth), most 137Cs-GFO has remained in the forest for decades. Our study offers microscale heterogeneous 137Cs-GFO distribution in forests for ensuring long-term forest management planning necessary for both the long-term migration and local accumulation of 137Cs in forests.

Elevated Creatine Kinase and Lactic Acid Dehydrogenase and Decreased Osteocalcin and Uncarboxylated Osteocalcin are Associated with Bone Stress Injuries in Young Female Athletes.

Stress fractures are a limitation for athletes not only in sports performance but in activities of daily living. Thus, preventing them is crucial. In female athletes, a triad of symptoms including low energy availability, functional hypothalamic amenorrhea and osteoporosis are considered risk factors for stress injuries, but biomarkers predictive of these outcomes are not available. Here, we evaluated 56 female university athletes and found that 13 had a history of stress bone injuries. Logistic regression analysis demonstrated that dysmenorrhea including amenorrhea, but not reduced food intake or body weight loss, was significantly associated with stress injuries. When we subdivided subjects into stress fracture and non-fracture groups, we found that serum levels of creatine kinase (CK) and lactic acid dehydrogenase (LDH) were significantly higher in the fracture group, while osteocalcin and uncarboxylated osteocalcin (ucOC), which are bone forming parameters, significantly decreased. Low vitamin D levels are associated with stress fractures, but serum vitamin D levels were higher in fracture compared to non-fracture subjects. We followed up 32 subjects for one year, and three exhibited new stress injuries during that period. A history of stress fracture history is significantly associated with experiencing a new stress fracture. We also found that subjects with new fracture performed significantly greater exercise activity than did non-fracture subjects. Taken together, our data indicate that increased serum CK and LDH and decreased serum osteocalcin and ucOC are biomarkers of stress injuries, and evaluating these markers along with dysmenorrhea, stress fracture history or high sports activity could predict future stress fractures in female athletes.

[Development of a Japanese Version of the Short-Form FAMCARE Scale for family caregivers of terminal cancer patients at home in Japan].

AIM: To develop a Japanese version of the short-form FAMCARE Scale (Ornstein, 2015) for family caregivers of terminal cancer patients at home. METHODS: The survey was conducted with 316 family caregivers of terminal cancer patients at home selected as eligible participants in 11 major regions in Japan (the Tokyo metropolitan area, and the prefectures of Tochigi, Ibaraki, Saitama, Chiba, Kanagawa, Nara, Hyogo, Kagawa, Ehime, and Saga). Construct validity was confirmed using a confirmatory factor analysis, and the Caregiver Quality of Life Index-Cancer (CQOLC) scale was administered to assess criterion-related validity. RESULTS: A total of 120 family caregivers provided valid responses. The mean±standard deviation of the age of the family caregivers was 64.6±12.0 years, and 91 (75.8%) were female. A factor analysis of the results showed that the Japanese version of the 10-item and 5-item short-form FAMCARE Scale was a unidimensional construct, and a confirmatory factor analysis demonstrated a goodness of fit index of 0.910 and 0.972, an adjusted goodness of fit index of 0.835 and 0.916, a comparative fit index of 0.968 and 0.992, and a root mean square error of approximation of 0.095 and 0.081, respectively. The Cronbach's α coefficients of the 10- and 5-item scales were 0.95 and 0.93, respectively. The scale scores were significantly correlated with the family caregiver's quality of life (CQOLC) (10-item r=0.304, P<0.01; 5-item r=0.311, P<0.01). CONCLUSION: The Japanese version of the 10-item and 5-item short-form FAMCARE Scale was found to have sufficient reliability and validity for assessing family satisfaction with terminal cancer patient at home in Japan.

Quality of life among the family caregivers of patients with terminal cancer at home in Japan.

AIM: To identify the associated factors of quality of life (QOL) among the family caregivers of patients with terminal cancer at home. METHODS: The design was an epidemiological study with self-administered questionnaires by mail. Date collection was carried out in the Tokyo Metropolitan, Tochigi, Ibaraki, Saitama, Chiba, Kanagawa, Nara, Hyogo, Kagawa, Ehime, and Saga prefectures in Japan. The participants who met the criteria for the present study were 262 family caregivers. Their QOL was assessed by the Japanese version of the Caregiver Quality of Life Index-Cancer. The potential factors that are associated with family caregivers' QOL included three factors: patient factors, including demographic characteristics and disease-related factors, family caregiver factors, including demographic characteristics, health conditions, and self-efficacy of family caregiving, and environmental factors, including instrumental, emotional, informational support, and satisfaction with the home care service. A multiple regression analysis was conducted in order to identify the associated factors with family caregivers' QOL. RESULTS: A total of 74 family caregivers participated in this study (response rate: 33.2%). The mean age of the family caregivers was 63.6 years and 79.7% was female. The multiple regression analysis indicated that depression, self-efficacy of family caregiving, the subcaregiver, and satisfaction with the home care service were associated with family caregivers' QOL. CONCLUSION: It is recommended that health practitioners should develop interventions for family caregivers in order to enhance the competence of the individual and home care system in order to achieve the sustainability of high-quality home care for patients with terminal cancer and the family caregivers' QOL.

Development of a community's self-efficacy scale for preventing social isolation among community-dwelling older people (Mimamori Scale).

BACKGROUND: Among older people in developed countries, social isolation leading to solitary death has become a public health issue of vital importance. Such isolation could be prevented by monitoring at-risk individuals at the neighborhood level and by implementing supportive networks at the community level. However, a means of measuring community confidence in these measures has not been established. This study is aimed at developing the Community's Self-Efficacy Scale (CSES; Mimamori scale in Japanese) for community members preventing social isolation among older people. METHODS: The CSES is a self-administered questionnaire developed on the basis of Bandura's self-efficacy theory. The survey was given to a general population (GEN) sample (n = 6,000) and community volunteer (CVOL) sample (n = 1,297). Construct validity was determined using confirmatory factor analysis. Internal consistency was calculated using Cronbach's alpha. The Generative Concern Scale (GCS-R) and Brief Sense of Community Scale (BSCS) were also administered to assess criterion-related validity of the CSES. RESULTS: In total, 3,484 and 859 valid responses were received in the GEN and CVOL groups, respectively. The confirmatory factor analysis identified eight items from two domains-community network and neighborhood watch-with goodness of fit index = 0.984, adjusted goodness of fit index = 0.970, comparative fit index = 0.988, and root mean square error of approximation = 0.047. Cronbach's alpha for the entire CSES was 0.87 and for the subscales was 0.80 and higher. The score of the entire CSES was positively correlated with the GCS-R in both the GEN (r = 0.80, p < 0.001) and CVOL (r = 0.86, p < 0.001) samples. CONCLUSIONS: The CSES demonstrated adequate reliability and validity for assessing a community's self-efficacy to aid in its preventing social isolation among older people. The scale is potentially useful for promoting health policies, practices, and interventions within communities. This may help prevent social isolation among older people and contribute to overall well-being in aging societies in Japan and abroad.

[Effects of an implicit internal working model on attachment in information processing assessed using Go/No-Go Association Task].

The purposes of the present study were (a) to use both a relational-anxiety Go/No-Go Association Task (GNAT) and an avoidance-of-intimacy GNAT in order to assess an implicit Internal Working Model (IWM) of attachment; (b) to verify the effects of both measured implicit relational anxiety and implicit avoidance of intimacy on information processing. The implicit IWM measured by GNAT differed from the explicit IWM measured by questionnaires in terms of the effects on information processing. In particular, in subliminal priming tasks involving with others, implicit avoidance of intimacy predicted accelerated response times with negative stimulus words about attachment. Moreover, after subliminally priming stimulus words about self, implicit relational anxiety predicted delayed response times with negative stimulus words about attachment.

Lineage diversification and hybridization in the Cayratia japonica-Cayratia tenuifolia species complex.

The Cayratia japonica-Cayratia tenuifolia species complex (Vitaceae) is distributed from temperate to tropical East Asia, Southeast Asia, India, and Australia. The spatiotemporal diversification history of this complex was assessed through phylogenetic and biogeographic analyses. Maximum parsimony, neighbor-joining, and maximum likelihood methods were used to analyze sequences of one nuclear (AS1) and two plastid regions (trnL-F and trnC-petN). Bayesian dating analysis was conducted to estimate the divergence times of clades. The likelihood method LAGRANGE was used to infer ancestral areas. The Asian C. japonica and C. tenuifolia should be treated as an unresolved complex, and Australian C. japonica is distinct from the Asian C. japonica-C. tenuifolia species complex and should be treated as separate taxa. The Asian C. japonica-C. tenuifolia species complex was estimated to have diverged from its closest relatives during the Late Eocene (35.1 million years ago [Ma], 95% highest posterior densities [HPD]=23.3-47.3Ma) and most likely first diverged in mid-continental Asia. This complex was first divided into a northern clade and a southern clade during the middle Oligocene (27.3Ma; 95% HPD=17.4-38.1Ma), which is consistent with a large southeastward extrusion of the Indochina region relative to South China along the Red River. Each of the northern and southern clades then further diverged into multiple subclades through a series of dispersal and divergence events following significant geological and climatic changes in East and Southeast Asia during the Miocene. Multiple inter-lineage hybridizations among four lineages were inferred to have occurred following this diversification process, which caused some Asian lineages to be morphologically cryptic.

Trans fatty acid intake and serum cholesterol levels in young Japanese women.

There are very limited data concerning the influence of low-level trans fatty acid (TFA) intake on blood lipid levels. In this study, correlation of total and diene TFA intake with serum cholesterol levels was studied in young Japanese women. The mean intakes of total and diene TFAs were 0.36% and 0.05% of energy, respectively. There was a significant correlation between total fat intake and TFA intake. TFA intake was significantly correlated with erythrocyte TFA content. Total TFA intake was not correlated with total, LDL- or HDL-cholesterol levels. No correlatuon was found between diene TFA intake and cholesterol level. Total and diene TFA intake were not correlated with hemoglobin A1c or C-reactive protein levels. These results suggest that the average TFA intake of young Japanese women does not adversely affect serum cholesterol levels.

Crystallization and preliminary X-ray analysis of human S100A13.

S100A13 is a member of the S100 family of EF-hand-containing calcium-binding proteins and plays an important role in the secretion of fibroblast growth factor-1 and interleukin 1alpha, two pro-angiogenic factors released by the endoplasmic reticulum/Golgi-independent non-classical secretory pathway. Human S100A13 was heterologously expressed in Escherichia coli, purified and crystallized by the hanging-drop vapour-diffusion method using PEG 3350 as the precipitant. The crystals diffracted X-rays from a synchrotron-radiation source to 1.8 A resolution and the space group was assigned as primitive orthorhombic P2(1)2(1)2(1).