Neighborhood Environments and Healthy Life Expectancy in Older Adults: A 6-year Longitudinal Cohort Study Based on Data from the Japan Gerontological Evaluation Study.

Introduction: A well-established association exists between health and neighborhood land use patterns, including parks, roads, and other physical environments, also called the built environment. Previous studies have demonstrated that the built environment influences health, particularly among older populations, because the scope of activities in such populations is limited. Herein, we investigated the association between specific neighborhood environments and the healthy life expectancy of older individuals. Methods: Data at two time points (2013 and 2019) from the Japan Gerontological Evaluation Study were used in this study. The study comprised a sample of 8,956 residents aged ≥65 years who were not certified for long-term care. Information on the presence or absence of eight types of neighborhood environments was collected using a questionnaire. A multistate life table analysis was conducted to determine the association between perceived neighborhood environments and healthy life expectancy. Results: Significant differences were observed in the "parks and sidewalks suitable for exercise and walking" category. The group that perceived "parks and sidewalks suitable for exercise and walking" had an approximately 1.2-year longer healthy life expectancy than the group that did not perceive such parks and sidewalks. In addition, individuals who lived within walking distance of a park were more physically active than those who did not. Conclusions: Safe, walkable neighborhoods with excellent parks may encourage physical activity among older adults and extend their healthy lifespan. Future research is warranted to identify the underlying mechanisms.

Estimating Health Expectancy in Japanese Communities Using Mortality Rate and Disability Prevalence.

Introduction: Although mortality and disability are known to be associated with health expectancy (LE), few studies have assessed the extent to which a reduction in their prevalence can extend a person's LE. Moreover, differences in this relationship based on gender have not been established. Thus, in this study, we constructed a regression model using the rate of mortality and prevalence of disability to predict LE in older adults (≥65 years) and assess the relationships between LE, mortality rate, and disability prevalence based on gender. Methods: Data were collected from Japan's population registry and long-term insurance records (N = 344). Multiple linear regression was used to analyze the relationship between LE, mortality rate, and disability prevalence, stratified by gender. Results: Age-adjusted mortality rate and disability prevalence significantly predicted LE and were significantly correlated with the measured LE index for both genders. For every 1% annual decrease in age-adjusted mortality, LE increased by 1.54 years for men and 2.15 years for women. Similarly, a 1% annual decrease in age-adjusted disability prevalence increased LE by 0.22 years for men and 0.32 years for women. The regression model coefficients indicated that the strength of the association between LE, mortality rate, and disability prevalence differed between genders. Our model accurately predicted LE (men: adjusted R2 = 0.968, women: adjusted R2 = 0.994). Conclusions: Health promotion policies that are geared toward increasing health expectancy can be evaluated using mortality rate and disability prevalence as prognostic indicators. The strength of the association between LE, mortality, and disability differed between genders, suggesting the need for gender-specific policy planning to increase LE for both genders.

Evaluating the Effectiveness of Educational Interventions in Family Planning for Men in Developing Countries: A Systematic Review.

Introduction: Unintended pregnancy is associated with national socioeconomic development and gender inequality. In addition to contraception, educational interventions that promote family planning and address gender dynamics are considered important in preventing unintended pregnancy. While the importance of encouraging men's participation in family planning has been advocated, most studies have focused on the application of interventions to women or populations in high-income countries only. Therefore, we conducted a systematic review to evaluate the effects of educational interventions on men in low- and middle-income countries in terms of knowledge, attitudes, practices, and gender dynamics. Methods: Three electronic databases (CINAHL, Ovid MEDLINE, and Web of Science) were searched for studies published from January 1980 to October 2022. Keywords such as "men/husband," "family planning," "contraception," and "education" were combined to identify studies. Two independent reviewers conducted screening and data extraction, and the risk of bias was assessed using the Risk of Bias 2 tool. The quality of evidence was evaluated according to the GRADE Handbook. Results: The database search identified 16,086 articles, of which 4 cluster randomized controlled trials (RCTs) and 1 RCT were ultimately included. Each of them was conducted in four different countries: Malawi, Guatemala, Tanzania, and India. Changes in knowledge, attitude, family planning, and gender dynamics were the outcomes used to assess the effectiveness of interventions. The five selected articles exhibited an effect on ≥1 indicator for each outcome. However, the quality of evidence was determined to be low or very low owing to the risk of bias, heterogeneity, and imprecision. Conclusions: Determining the effectiveness of educational interventions in family planning for men in low- and middle-income countries requires additional high-quality intervention studies. As family planning is influenced by various background factors, it is important to develop appropriate interventions for each context and define relevant indicators that can be compared across contexts.

Evaluating the effectiveness of a social and emotional learning program among preschool children in Japan: an experimental cohort study.

BACKGROUND: Research on school maladjustment has increasingly focused on social skills, such as the ability to control emotions, collaborate with others, and achieve goals. Social and emotional learning (SEL) is one approach to nurturing social skills. However, few preventive interventions to promote SEL have been conducted among young children, particularly in Asian countries, including Japan. Therefore, this study examined the effectiveness of an SEL program-Fun FRIENDS-among children in Japan. METHODS: In mid-2022, the Fun FRIENDS program was administered to 115 children aged 4-5 years, who were enrolled in two kindergartens. The program was administered to the entire class as part of their kindergarten activities. The control group included 93 children in three kindergartens. This study included 94 participants (81.7%) in the intervention group and 66 (71.0%) in the control group, whose parents agreed with the assessment of their skills. Fun FRIENDS is a support program based on a cognitive-behavioral approach. The program aims to teach children how to cope with anxiety and stress and develop resilience and confidence to face difficulties. The program includes 10 sessions, each lasting approximately 1 h and conducted once per week. To examine the program's effectiveness, teachers evaluated these children's social skills before and after program implementation using the Social Skill Scale. RESULTS: Results showed significant post-intervention improvements in self-control and cooperation scores among children in the intervention group, compared with pre-intervention. Further, post-intervention self-control and cooperation scores were significantly higher among children in the intervention group than the control group. CONCLUSIONS: SEL implemented on a class-wide basis could be effective in early childhood. An early approach targeting preschool-aged children is necessary to prevent school maladjustment. A universal approach implemented on a whole-class basis could contribute to improving children's social skills.

Parental support for physical activity and children's physical activities: a cross-sectional study.

BACKGROUND: Physical activity (PA) in school-aged children is imperative for physical and mental development. However, there has been reduced PA among children in recent years owing to environmental changes, resulting in declining physical strength and athletic ability. Although parents' and children's PA has been found to be correlated, the specific parental caregiving attitudes associated with children's actual levels of PA during school-age years remain unknown. Therefore, this study aimed to examine the relationship between parental support for PA and children's levels of PA. METHODS: In 2017, a self-reported questionnaire survey was administered to 1,515 third-grade students (8-9 years old) and their caregivers in Nagoya, Aichi, a major metropolitan area in Japan. The main items surveyed included the attitudes of children and parents towards PA and the children's actual PA level. Multiple regression analysis was conducted with parental involvement related to PA as the explanatory variable and children's PA as the objective variable. RESULTS: In total, 717 children with valid responses were included in the analysis. The mean age of the children was 9.08 ± 0.33 years; 366 (51.0%) were boys, and 351 (49.0%) were girls. For moderate-to-vigorous and vigorous PA, PA levels tended to be significantly higher in children whose parents provided logistic support such as enrolling their children in a sports club. However, for moderate PA and walking, PA levels tended to be significantly higher in children whose parents used community resources. Modeling and limiting sedentary activities were not associated with children's PA. CONCLUSIONS: The results of this study suggest that direct parental assistance for PA such as logistic support encourages children to engage in moderate-to-vigorous PA; in addition, parental use of community resources may encourage children to engage in moderate and light PA such as walking. Conversely, indirect and negative involvement such as modeling and limiting sedentary activities were not associated with children's PA. Therefore, logistic support may need to be strengthened to encourage moderate-to-vigorous and vigorous PA, which is important for children's health.

Geriatric symptoms associated with healthy life expectancy in older people in Japan.

BACKGROUND: We investigated the relationship between characteristic geriatric symptoms and healthy life expectancy in older adults in Japan. Additionally, we determined relationship predictors that would help formulate effective approaches toward promoting healthy life expectancy. METHODS: The Kihon Checklist was used to identify older people at high risk of requiring nursing care in the near future. We evaluated the association of geriatric symptoms with healthy life expectancy while considering risk factors (frailty, poor motor function, poor nutrition, poor oral function, confinement, poor cognitive function, and depression). Data from the 2013 and 2019 Japan Gerontological Evaluation Studies were used. Healthy life expectancy was assessed using the multistate life table method. RESULTS: Overall, 8,956 individuals were included. For both men and women, healthy life expectancy was shorter in the symptomatic group than in the asymptomatic group for several domains of the Kihon Checklist. For men, the difference between individuals with risk factors and those with no risk factors was the maximum for confinement (3.83 years) and the minimum for cognitive function (1.51 years). For women, the difference between individuals with risk factors and those with no risk factors was the maximum for frailty (4.21 years) and the minimum for cognitive function (1.67 years). Healthy life expectancy tended to be shorter when the number of risk factors was higher. Specifically, the difference between individuals with ≥3 risk factors and those with no risk factors was 4.46 years for men and 5.68 years for women. CONCLUSIONS: Healthy life expectancy was negatively associated with characteristic geriatric symptoms, with strong associations with frailty, physical functional decline, and depression. Therefore, comprehensive assessment and prevention of geriatric symptoms may increase healthy life expectancy.

Association between the Standardized Mortality Ratio and Healthy Life Expectancy in Japan.

Introduction: Healthy life expectancy (HLE) remains the principal target of various health plans. We aimed to identify the areas of priority and determinants of mortality to extend HLE across local governments in Japan. Methods: HLE according to secondary medical areas was calculated using the Sullivan method. People requiring long-term care of level 2 or higher were considered unhealthy. Standardized mortality ratios (SMRs) for major causes of death were calculated using vital statistics data. The association between HLE and SMR was analyzed using simple and multiple regression analyses. Results: The average (standard deviation) HLE values were 79.24 (0.85) and 83.76 (0.62) years for men and women, respectively. A comparison of HLE revealed regional health gaps of 4.46 (76.90-81.36) and 3.46 (81.99-85.45) years for men and women, respectively. The coefficients of determination for the SMR of malignant neoplasms with HLE were the highest and were 0.402 and 0.219 among men and women, respectively, followed by those of cerebrovascular diseases, suicide, and heart diseases among men and those of heart disease, pneumonia, and liver disease among women. When all major preventable causes of death were analyzed simultaneously in a regression model, the coefficients of determination were 0.738 and 0.425 among men and women, respectively. Conclusions: Our findings suggest that local governments should prioritize preventing cancer deaths via cancer screening and smoking cessation measures in health plans, with a special focus on men.

Changes in the Number of Public Health Nurses Employed in Local Governments in Japan During the Covid-19 Pandemic: A Cross-Sectional Study.

Introduction: Prefectural public health centers in Japan conducted epidemiological surveys of all COVID-19 patients, which subsequently increased their workload as the infection rate increased. The survey was conducted by public health nurses (PHNs); therefore, an increase in their workload was expected. However, changes in the number of PHNs have not yet been examined. This study focused on recruiting PHNs to local governments in Japan during the COVID-19 pandemic. Methods: This cross-sectional study of 150 local government public health centers was conducted from November to December 2021. The survey items included the number of full-time and part-time PHNs, number of PHNs who resigned or retired from the job, and number of PHNs recruitment examinations conducted between 2017 and 2021. For all variables, the mean, standard deviation, and minimum and maximum values for each municipality and year were calculated, and a one-way analysis of variance was performed. Conclusion: The response rate of the questionnaires was 54.0% (81/150). The change in the employment status of PHNs from 2019 to 2020 was not statistically significant in 2020, which was the COVID-19 outbreak year. However, the number of full-time PHNs increased by 2.6, while part-time PHNs almost doubled from 5.2 ± 8.3 to 10.8 ± 9.6 (p = .61) for prefectures, from 13.6 ± 13.1 to 21.5 ± 34.8 (p = .23) for cities, and from 16.8 ± 26.8 to 52.3 ± 132.5 (p = .70) for wards. The survey revealed that since the COVID-19 pandemic, the ratio of part-time to full-time PHNs significantly increased. Current status reports of public health centers will encourage political decisions and research on the factors necessary to balance the supply and demand of full-time PHNs.

Association between sleep habits and behavioral problems in early adolescence: a descriptive study.

BACKGROUND: Sleep habits are related to children's behavior, emotions, and cognitive functioning. A strong relationship exists between sleep habits and behavioral problems. However, precisely which sleep habits are associated with behavioral problems remains unclear. Therefore, the purpose of this study is to clarify the relationship between sleep habits and behavioral problems in early adolescence. METHODS: This study used data from a larger longitudinal research, specifically, data from the year 2021. First-year junior high school students (12-14 years) in Japan were surveyed; their parents (N = 1288) completed a parent-report questionnaire. The main survey items were subject attributes, the Pittsburgh Sleep Quality Index (PSQI), and the Strength and Difficulties Questionnaire (SDQ). RESULTS: Of the 652 valid responses received, 604 individuals who met the eligibility criteria (no developmental disability in the child and completion of all survey items) were included in the analysis. To examine the relationship between sleep habits and behavioral problems, logistic regression analysis using the inverse weighted method with propensity score was conducted with sleep habits (sleep quality, time to fall asleep, sleep duration, sleep efficiency, sleep difficulty, use of sleeping pills, difficulty waking during the day, and sleep disturbances) as explanatory variables and behavioral problems (overall difficulty in SDQ) as objective variables. The propensity score was calculated by employing the logistic regression using the inverse weighted method based on propensity scores. Propensity scores were calculated based on gender, family structure, household income, and parental educational background. The results showed that behavioral problems tended to be significantly higher in the group at risk for sleep quality, sleep difficulties, daytime arousal difficulties, and sleep disturbances than in the group with no risk. CONCLUSION: The results suggest that deterioration in sleep quality, sleep difficulties, daytime arousal difficulties, and sleep disturbances may increase the risk of behavioral problems in adolescents.

Socioeconomic Status and the Sense of Coherence among Japanese People Living with HIV.

People living with HIV (PLWH) are forced to live with multiple and severe stressors. Focusing on sense of coherence (SOC), which is a concept of salutogenic and stress coping capacity, is useful in PLWH support. This study aimed to examine the association between SOC and socioeconomic status (SES) for Japanese PLWH. Methods: This study used data from the HIV Futures Japan national survey, which is an online survey with a cross-sectional design. This survey of PLWH in Japan was conducted from July 2013 to February 2014 and December 2016 to July 2017, resulting in 1422 valid responses. The mean age (SD) was 38.6 years (8.3). The 13-item SOC scale score was divided into two groups, based on Japanese standard score in a previous study, and logistic regression analysis was performed. Results: Education levels were indirectly associated with SOC through occupation. Compared to freelance-profession/self-employed, "unemployed job seekers" (OR [95%CI] = 2.16 [1.16, 4.04]) and "homemaker/recuperating/student" (2.09 [1.09, 4.02]) were directly related to poor SOC, regardless of income. Also, there is a clear SOC disparity in income (compared to ">8 million yen/year", "<1 million yen/year" was 2.94 [1.46, 5.92], and "1−2.99 million yen/year" was 2.49 [1.33, 4.68]). Conclusion: It became clear that there is a relationship between SOC and SES. The results of this research provide important evidence for health promotion measures for PLWH.

Experience of annual events in the family and social adjustment of school-age children.

BACKGROUND: Parent-child relationships, the rearing attitudes of parents toward their children as well as the interactive relationships, such as play and cultural activities that parents and children enjoy together, serve as important factors in predicting a child's growth and development. These experiences of annual events celebrated with the family may be related to the school-age child's development. However, this relationship has not been investigated sufficiently. Therefore, this study aimed to identify the relationship between the experience of annual events observed in the family and a child's social adjustment. METHODS: In 2019, a self-administered questionnaire survey targeting fifth graders (ages 10-11) in Japan was conducted with children's parents. Major survey items included participants' characteristics (child's sex, family composition, siblings, household income, and parents' educational backgrounds), annual events observed in the family (Setsubun or the day before the start of spring, Mother's Day, Father's Day, the Tanabata or Weaver Festival, Respect for the Aged Day, Winter solstice, etc.), and the child's social adjustment (Strengths and Difficulties Questionnaire). A total of 653 children who met the criteria of not having any developmental disorders were included as participants for the analysis. RESULTS: The participants had celebrated an average of 15.47 (± 5.52) annual events with their families that year. The number of annual events celebrated was significantly related to family composition and the parents' educational backgrounds. We found that children who came from families with numerous experiences of annual events were more likely to have higher prosocial behavior and were less likely to have externalizing or internalizing problems. The same pattern was found even after adjusting for the family's socioeconomic background and other factors; that is, children who came from families having diverse experiences of annual events were more likely to show prosocial tendencies. CONCLUSIONS: Our findings suggest that the experience of annual events observed with family potentially enhances a child's prosocial behavior. Thus, celebrating and preserving cultural and personal events in the amily context may be an important developmental experience in terms of children's social adjustment.

Predicting the Number of Suicides in Japan Using Internet Search Queries: Vector Autoregression Time Series Model.

BACKGROUND: The number of suicides in Japan increased during the COVID-19 pandemic. Predicting the number of suicides is important to take timely preventive measures. OBJECTIVE: This study aims to clarify whether the number of suicides can be predicted by suicide-related search queries used before searching for the keyword "suicide." METHODS: This study uses the infoveillance approach for suicide in Japan by search trends in search engines. The monthly number of suicides by gender, collected and published by the National Police Agency, was used as an outcome variable. The number of searches by gender with queries associated with "suicide" on "Yahoo! JAPAN Search" from January 2016 to December 2020 was used as a predictive variable. The following five phrases highly relevant to suicide were used as search terms before searching for the keyword "suicide" and extracted and used for analyses: "abuse"; "work, don't want to go"; "company, want to quit"; "divorce"; and "no money." The augmented Dickey-Fuller and Johansen tests were performed for the original series and to verify the existence of unit roots and cointegration for each variable, respectively. The vector autoregression model was applied to predict the number of suicides. The Breusch-Godfrey Lagrangian multiplier (BG-LM) test, autoregressive conditional heteroskedasticity Lagrangian multiplier (ARCH-LM) test, and Jarque-Bera (JB) test were used to confirm model convergence. In addition, a Granger causality test was performed for each predictive variable. RESULTS: In the original series, unit roots were found in the trend model, whereas in the first-order difference series, both men (minimum tau 3: -9.24; max tau 3: -5.38) and women (minimum tau 3: -9.24; max tau 3: -5.38) had no unit roots for all variables. In the Johansen test, a cointegration relationship was observed among several variables. The queries used in the converged models were "divorce" for men (BG-LM test: P=.55; ARCH-LM test: P=.63; JB test: P=.66) and "no money" for women (BG-LM test: P=.17; ARCH-LM test: P=.15; JB test: P=.10). In the Granger causality test for each variable, "divorce" was significant for both men (F104=3.29; P=.04) and women (F104=3.23; P=.04). CONCLUSIONS: The number of suicides can be predicted by search queries related to the keyword "suicide." Previous studies have reported that financial poverty and divorce are associated with suicide. The results of this study, in which search queries on "no money" and "divorce" predicted suicide, support the findings of previous studies. Further research on the economic poverty of women and those with complex problems is necessary.

Maternal Work-Life Balance and Children's Social Adjustment: The Mediating Role of Perceived Stress and Parenting Practices.

The participation of women with young children in the Japanese labor force has increased dramatically in recent years, bringing growing potential for conflict between work and family roles amid inadequate social systems, such as childcare support. Thus, work-life balance (WLB) of mothers may influence their children's mental health and lifestyle. This study aims to clarify the relationship between parents' WLB and children's mental health, as well as the underlying factors of parental stress and nurturing attitude. The study is based on a questionnaire survey administered in 2019 to fifth-grade elementary school students and their caregivers in Aichi Prefecture, Japan. The regression results indicated that the higher the work-family negative spillover, the higher the child's externalizing and internalizing problems, and the higher the positive spillover, the lower the problems and the higher the prosocial behaviors. Path analysis indicates that maternal WLB is negatively and positively related to children's behavior through maternal stress and parenting practices. The study suggests that maternal WLB is related to children's emotional and behavioral problems. WLB may impact children's emotional and behavioral problems through parents' mental health and involvement with their children, particularly because of work arrangements changing with the COVID-19 pandemic.

Erratum: Hosokawa, R., et al. Associations between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan. Int. J. Environ. Res. Public Health 2020, 17, 6301.

Due to an error during production, the legend of Figure 2 in the published paper [...].

Associations Between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan.

Japan has the highest life expectancy in the world. However, this does not guarantee an improved quality of life. There is a gap between life expectancy and healthy life expectancy. This study aimed to reveal the features of healthy life expectancy across all secondary medical areas (n = 344) in Japan and examine the relationship among healthcare resources, life expectancy, and healthy life expectancy at birth. Data were collected from Japan's population registry and long-term insurance records. Differences in healthy life expectancy by gender were calculated using the Sullivan method. Maps of healthy life expectancy were drawn up. Descriptive statistics and correlation analysis were used for analysis. The findings revealed significant regional disparities. The number of doctors and therapists, support clinics for home healthcare facilities and home-visit treatments, and dentistry expenditure per capita were positively correlated with life expectancy and healthy life expectancy (correlation coefficients > 0.2). They also revealed gender differences. Despite controlling for population density, inequalities in healthy life expectancy were observed, highlighting the need to promote social policies to reduce regional disparities. Japanese policymakers should consider optimal levels of health resources to improve life expectancy and healthy life expectancy. The geographical distribution of healthcare resources should also be reconstituted.

The Relationship between Neighborhood Environment and Child Mental Health in Japanese Elementary School Students.

Limited research has examined the relationship between neighborhood environment and mental health outcomes in elementary school students (middle childhood). In countries with high relative poverty, little is known about how neighborhood conditions are related to children's health after controlling for family socioeconomic status; thus, it is necessary to distinguish the particular neighborhood characteristics relevant to behavioral risk in children, independent of socioeconomic position. Using a self-report survey completed by parents, we assessed neighborhood environment characteristics, children's behavioral outcomes, and family socioeconomic status in fourth grade students from Nagoya, in Aichi prefecture, Japan (n = 695). A multiple linear regression was conducted to evaluate to what extent neighborhood characteristics predict child behaviors, after adjusting for socioeconomic variables. Greater aesthetic quality, walkability, accessibility of healthy foods, safety, and social cohesion were inversely linked to children's behavioral problems and positively linked to social competence, suggesting that quality of living environment may affect behavioral outcomes in children, even after controlling for socioeconomic factors. Developing a quality environment that matches these characteristics may minimize the negative impact of a family's socioeconomic distress and is likely to aid socioeconomically disadvantaged parents and their children. Thus, policies and programs that enhance the neighborhood environment for socioeconomically disadvantaged families should be promoted.

Exposure to marital conflict: Gender differences in internalizing and externalizing problems among children.

PURPOSE: Marital conflict is integral to children's psychosocial well-being. Extant research has shown that the effects of marital conflict on children are likely to vary by gender, indicating that gender plays a significant and complex role in the relationship between marital conflict and child adjustment. Focusing on gender, this study investigates the link between specific marital conflict tactics and children's mental health symptoms in families in which the parents live together. METHODS: This study gathered data from 799 children and their parents in Japan by means of a questionnaire focusing on marital conflict and child behavioral problems. Marital conflict (verbal aggression, physical aggression, stonewalling, avoidance-capitulation, child involvement, and cooperation) was assessed using a Conflict and Problem-Solving Scale. Children's behavioral problems (externalizing and internalizing symptoms) were assessed using the Strengths and Difficulties Questionnaire. RESULTS: The findings highlight the significant impact of specific interparental conflict on children's behavioral problems, demonstrating that there are differences according to the child's gender. More specifically, multivariate analyses targeting boys revealed that cooperation was significantly inversely associated with externalizing problems and internalizing problems, while avoidance-capitulation and verbal aggression were significantly positively associated with externalizing problems. In contrast, multivariate analyses targeting girls revealed that cooperation was significantly inversely associated with externalizing problems and internalizing problems, while avoidance-capitulation and stonewalling were significantly positively associated with internalizing problems. CONCLUSION: This study reveals that interparental conflict is associated with children's behavioral problems. Constructive marital conflict was significantly inversely associated with externalizing and internalizing problems in both boys and girls. Meanwhile, destructive marital conflict (i.e., avoidance-capitulation and verbal aggression) was significantly positively associated with externalizing problems in boys and significantly positively associated with internalizing problems in girls. These findings contribute to the substantial literature demonstrating the relationship between family processes and the development of disruptive behavior disorders in children.

Factors determining parenting stress in mothers of children with atopic dermatitis.

BACKGROUND: Atopic dermatitis (AD) influences a child's emotional and social well-being, as well as his or her physical health. The influence of AD on the daily lives of parents and caregivers has also been documented. This study examined how parenting stress is affected by demographic background, characteristics of children's AD, and their family systems. METHODS: The participants were mothers of children, aged 2-6 years old, who had been diagnosed with AD. The predictive power of a model of parenting stress was examined using multiple regression analysis (stepwise), with parenting stress (PSI-SF) as the dependent variable, and children's demographics, including characteristics of AD; parents' demographics; QoL of families of children with AD (JCMV-CADIS); and family functioning (FAI) as independent variables. We handled missing values using a multiple imputation method. RESULTS: The pooled coefficients obtained from the multiple regression analysis after multiple imputation indicated that "family cohesion," "family system flexibility," "emotions related to social factors" and "occupation of mother" determined parenting stress. Lower family cohesion and family system flexibility predicted higher parenting stress. The high impact of "emotions related to social factors" on families' QoL predicted higher parenting stress. Full-time work by mothers predicted lower parenting stress. CONCLUSIONS: The current results reveal that "family cohesion," "family system flexibility," "emotions related to social factors" and "full-time work by mothers" predicted parenting stress of mothers who had children with AD.

The Effectiveness of Japan's Community Centers in Facilitating Social Participation and Maintaining the Functional Capacity of Older People.

This study examines the effectiveness of a community center in Japan at promoting social participation and sustaining its regular users' functional capacity. The surveys were distributed to 108 physically and cognitively independent local older people; 72 responses were received. There were 16 regular users and 56 nonregular users. An inverse probability of treatment-weighted Poisson regression analysis was performed, and prevalence rate ratios were computed for social participation and functional capacity according to respondents' use of the center. Results showed that using the center regularly facilitated social participation, contributing to the maintenance of living functions. Regular users' social participation was promoted through opportunities in sports and volunteer organizations. Their living functions were maintained through instrumental self-maintenance and intellectual activity. Community centers evidently enable beneficial gatherings of older people, encourage social participation, and help to maintain higher level activities of daily living. Thus, they might offer effective preventative care for older people.

Role of Parenting Style in Children's Behavioral Problems through the Transition from Preschool to Elementary School According to Gender in Japan.

While ineffective discipline can be attributed to authoritarian and permissive parenting styles, little research has examined the role of gender in the association between parenting style and early childhood behavioral problems. Thus, this study aimed to clarify the effects of authoritarian and permissive parenting on children's externalizing and internalizing behaviors during the preschool-to-elementary-school transition according to gender in Japan. A sample of 1668 Japanese children (853 boys and 815 girls) were followed longitudinally over one-year intervals, and assessed based on parenting styles (the Parenting Scale), children's behavioral problems (the Strengths and Difficulties Questionnaire), and family characteristics. Multivariate analyses revealed that, when analyzed by gender, authoritarian discipline influenced externalizing problems in boys (ß = 0.048, p = 0.047) and girls (ß = 0.067, p = 0.023), while permissive discipline influenced externalizing problems in boys only (ß = 0.049, p = 0.038). The results document the relationship between family processes and the development of disruptive behavior disorders in children. Support for parents employing such child-rearing styles in early childhood may be effective in reducing school maladjustment.