Disrupted family reunification: Mental health, race, and state-level factors.

The children's mental health landscape is rapidly changing, and youth with mental health conditions (MHCs) are overrepresented in the child welfare system. Mental health is the largest unmet health need in child welfare, so MHCs may affect the likelihood of system reentry. Concerns regarding mental health contribute to calls for expanded supports, yet systems contact can also generate risk of continued child welfare involvement via surveillance. Still, we know little about how expanded supports at the state-level shape child welfare outcomes. Using the Adoption and Foster Care Analysis Reporting System (AFCARS), we examine the association between MHCs and system reentry within 36 months among youth who reunified with their families in 2016 (N = 41,860). We further examine whether this association varies across states and White, Black, and Latinx racial and ethnic groups via two- and three-way interactions. Results from multilevel models show that, net of individual and state-level factors, MHCs are associated with higher odds of reentry. This relationship is stronger for youth in states that expanded Medicaid by 2016 and with higher Medicaid/CHIP child participation rates. The results also show evidence of the moderating role of state-level factors, specifically student-to-school counselor ratio, diverging across racial and ethnic groups. Our results suggest a need for systems of care to better support youth mental health and counteract potential surveillance.

Social Isolation and Worsening Health Behaviors Among Older Adults During the COVID-19 Pandemic.

OBJECTIVES: We examine the relationship between social isolation, poor health behaviors, and the perceived worsening of older adults' health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors. METHODS: Drawing on data from the National Social Life Health and Aging Project Round 3 (2015) and its coronavirus immune disease 2019 (COVID-19) substudy (2020; N = 2,549), we use generalized linear models to explore how indicators of social isolation during the COVID-19 pandemic-infrequent in-person contact with friends and family in 2020 and decreased in-person contact with friends and family since COVID-19 started-are associated with (1) poor health behaviors (low physical activity, drinks per week, smoking, and poor sleep) in 2020 and (2) perceived worsening of health behaviors (reports of decreased physical activity, increased drinking and smoking, and feeling less rested) since the pandemic started. RESULTS: Infrequent in-person contact was not associated with poor health behaviors. Decreases in in-person contact, on the other hand, were associated with worsening health behaviors. Older adults who reported decreases in in-person contact were more likely to perceive a decrease in physical activity, an increase in drinking, and feeling less rested. Emotional well-being, particularly loneliness compared to anxiety or depressive feelings, partially mediated the relationship between perceived worsening of health behaviors and a decrease in in-person contact with friends, and to a lesser extent, with family. DISCUSSION: Our study suggests that in-person contact may play a distinct role in shaping older adults' well-being during the pandemic.

Political Trust, Mental Health, and the Coronavirus Pandemic: A Cross-National Study.

Objectives: We investigate whether older adults who place greater trust in their political leadership fare better in terms of mental wellbeing during the COVID-19 pandemic. We also test if and how the trust-wellbeing relationship varies across individual- and country-level moderators. Methods: Based on cross-national data consisting of over 13,000 older adults in 66 countries, we estimate a series of multilevel models. Results: Within countries, political trust is significantly negatively associated with depressive symptoms. And this association is stronger for those who are subjectively less healthy. Between countries, the trust-depression link at the individual level is stronger in more "fragile" states. These findings are robust to a host of confounders including the experienced level of anxiety stemming from COVID-19. Discussion: During the novel coronavirus pandemic, political trust provides a significant mental health buffer for older adults. This protective role varies partly as a function of individual and contextual vulnerability.

Examining the Complex (Curvilinear and Contingent) Associations between Social Distancing Compliance and Subjective Health during a Global Health Crisis.

OBJECTIVES: This study investigated a potential curvilinear link between social distancing behavior and subjective health in later life. It also evaluated whether food insecurity and community social capital moderated the focal relationship. METHODS: Data were drawn from three waves of the COVID Impact Survey (N = 19,234). Mixed-effects models were fitted. RESULTS: Social distancing has a non-monotonic (U-shaped) relationship with subjective health, i.e., individuals with low and high levels of social distancing show relatively better health. Moreover, the negative linear relationship between social distancing and health is weaker among people suffering from food insecurity as well as those living in communities with lower stocks of social capital. DISCUSSION: This study sheds new light on the health implications of social distancing during the pandemic. Our findings dovetail with the steeling hypothesis, i.e., that social distancing is less harmful for U.S. older adults exposed to prior stressful or vulnerable conditions.

Detecting Risk of Neglect in NSHAP Round 3 Using New Follow-Up Questions to Activities of Daily Living Measures.

OBJECTIVES: Elder neglect is a type of elder abuse wherein an older adult's basic needs remain unmet through negligence. The risk of neglect and its harmful consequences coincides with the need for care that arises with difficulties completing activities of daily living (ADLs) and instrumental activities of daily living (IADLs). In this paper, we describe how new questions included in Round 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP-R3) can help detect the risk of elder neglect. METHODS: Based on the 2,340 respondents who indicated problems with at least one ADL or IADL, we categorized respondents as at a higher risk of neglect if they were either: (a) not getting wanted help (WANTHELP) or (b) getting help from an undependable caregiver (UNRELIABLE). We tested the external validity of these indicators by examining their association with NSHAP-R3 measures of physical and mental health, personal hygiene, home tidiness, social support, and elder mistreatment, using t tests and chi-square tests. RESULTS: Those labeled higher neglect risk based on the WANTHELP variable showed significantly worse self-rated physical health, personal hygiene, room tidiness, mental health, partner support, family support, and elder mistreatment. The same correlates were significantly associated with higher neglect risk based on the UNRELIABLE variable, except for self-rated physical health, personal hygiene, and room tidiness. DISCUSSION: Findings suggest that these new measures can be useful for identifying NSHAP respondents who are at risk of types of neglect that can be associated with having I/ADL limitations.

Childhood Background Measures and Their Associations With Later-Life Physical, Mental, and Social Health in the National Social Life, Health, and Aging Project.

OBJECTIVE: We describe each childhood background measure available in the National Social Life, Health, and Aging Project (NSHAP), report preliminary population estimates for each measure by age and gender, and validate the childhood measures by showing that the associations between the NSHAP childhood measures and later-life health outcomes are consistent with previous studies on this topic. METHOD: Childhood background measures included family life happiness, family structure, parental educational attainment, perceived financial situation, experience of violence, witness of violence, childhood health, and place of birth. We measured self-rated health, depressive symptoms, and social support to assess later-life physical, mental, and social health. Logistic and linear regression models were used for the binary and continuous outcome variables, respectively. RESULTS: Older age groups were more likely than those in younger age groups to report a poor financial situation in childhood, lower parental education, and intact family structure and were less likely to have experienced or witnessed a violent event as a child. Growing up in a happy and well-educated family was associated with better physical, mental, and social health in older ages. DISCUSSION: NSHAP childhood data included a variety of measures assessing the family social environment during childhood, providing a valuable resource for the study of early-life determinants of health and well-being over the life course.

Social Network Types and Depressive Symptoms among Older Korean Men and Women.

This study explores the social network types of older Korean men and women, and the relationship of those networks to depressive symptoms. A population of 4608 older adults who participated in the Living Profiles of Older People Survey (LPOPS) were included in the study. Seven criterion variables-marital status, living arrangements, frequency of contact with children, close friends, and close relatives, participation in social activities, and total network size-were included in a K-means cluster analysis. Multivariable logistic regression analysis of the impact of social network type on depressive symptoms was conducted. We identified two "diverse type" social networks (diverse-married and diverse-unmarried) in women, and one diverse type and one "social-activity-focused type" network in men. Family focused type and two "restricted type" social networks (restricted-couple-focused, and restricted-unmarried) were identified in both men and women. The restricted-unmarried and restricted-couple-focused networks were associated with more depressive symptoms in both men and women. However, the family focused type was associated with more depressive symptoms only in women. The results indicated that social network types, and their impact on depressive symptoms, differ by gender. There is a need for further research on gender differences in the social network types of older adults across diverse cultures.

Downregulated miR-18b-5p triggers apoptosis by inhibition of calcium signaling and neuronal cell differentiation in transgenic SOD1 (G93A) mice and SOD1 (G17S and G86S) ALS patients.

BACKGROUND: MicroRNAs (miRNAs) are endogenous non-coding RNAs that regulate gene expression at the post-transcriptional level and are key modulators in neurodegenerative diseases. Overexpressed miRNAs play an important role in ALS; however, the pathogenic mechanisms of deregulated miRNAs are still unclear. METHODS: We aimed to assess the dysfunction of RNAs or miRNAs in fALS (SOD1 mutations). We compared the RNA-seq of subcellular fractions in NSC-34 WT (hSOD1) and MT (hSOD1 (G93A)) cells to find altered RNAs or miRNAs. We identified that Hif1α and Mef2c were upregulated, and Mctp1 and Rarb were downregulated in the cytoplasm of NSC-34 MT cells. RESULTS: SOD1 mutations decreased the level of miR-18b-5p. Induced Hif1α which is the target for miR-18b increased Mef2c expression as a transcription factor. Mef2c upregulated miR-206 as a transcription factor. Inhibition of Mctp1 and Rarb which are targets of miR-206 induces intracellular Ca2+ levels and reduces cell differentiation, respectively. We confirmed that miR-18b-5p pathway was also observed in G93A Tg, fALS (G86S) patient, and iPSC-derived motor neurons from fALS (G17S) patient. CONCLUSIONS: Our data indicate that SOD1 mutation decreases miR-18b-5p, which sequentially regulates Hif1α, Mef2c, miR-206, Mctp1 and Rarb in fALS-linked SOD1 mutation. These results provide new insights into the downregulation of miR-18b-5p dependent pathogenic mechanisms of ALS.

Social Networking Site Usage and Its Impact on Depressive Symptoms among Older Men and Women in South Korea.

Background: We examined the rate of social networking site (SNS) usage and the relationship between SNS usage and depressive symptoms among older men and women in South Korea. Methods: The data were obtained from the Living Profiles of Older People Survey (LPOPS), which comprises a nationally representative sample of non-institutionalized Korean older adults living in the community. A total of 10,073 older persons (4286 men and 5787 women) were included in the analysis. Results: A total of 26.0% of the total study population reported to use social network sites. Of the men and women, 32.6 and 21.1%, respectively, used SNS. A higher educational level and higher equivalent household income, lower number of chronic illnesses, no limitation in daily activities, living with others, and having good relationships with friends and neighbors were associated with higher SNS usage among older men and women. SNS usage was significantly associated with reduced depression scores in older men, but not in women. Conclusions: The difference in SNS usage between older men and women might be partially explained by differential exposure to digital technologies and disadvantages in education and economic opportunities. Education programs for digitalization and opportunities to engage with technology need to be provided.

A review of the present state and future policy alternatives for home visit nursing services in Korea.

OBJECTIVES: The aim of this study was to describe the current state of home visit nursing services in the Korean context and to suggest future policy directions. DESIGN: First, the three home visit nursing services that have developed in Korea are compared using the analytic framework provided by Gilbert and Terrell in 2012. The framework is based on four dimensions of social welfare: users, services, source of funds, and service delivery process. Second, we perform a strength, weakness, opportunity, and threat analysis to suggest comprehensive and constructive home visit nursing service policies for the future. RESULTS: Specifically, we advocate the creation of an organization that steers the central government to operate an integrated management organization to distribute services and reduce redundancy for preventing the waste of both medical and state financial resources. This study also recommends the development of educational programs to improve the quality of services and service evaluation criteria for the objective assessment of those services. CONCLUSIONS: These policy guidelines may prove useful both for Korea and for other countries that intend to prepare or revise their home visit nursing service systems.

The effects of community-based visiting care on the quality of life.

This study explored factors contributing to the quality of life of community-based home visiting care service users in Korea through a two-level multilevel model. The community health care center's organizational factors including the total number of visiting nurses and visiting nurses' rehire rate were treated as covariates. For participant's individual factors (Level 1), only subjective health status and the presence of cerebral vascular disease significantly explained the quality of life. Visiting nurses' demographic factors (Level 2) were not statistically significant. However, the total number of visiting nurses and visiting nurses' rehire rate were significant. Therefore, to increase an elderly adult's quality of life through community-based home visiting care services, a community health care center's organizational factors should be considered in addition to patient characteristics. This result may prove useful not only for Korea but also for other countries that intend to reform their community-based home visiting care services.

[Fall risk in low-income elderly people in one urban area].

PURPOSE: The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. METHODS: The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. RESULTS: Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbidity of diabetes with visual deficits, and with depression. CONCLUSION: Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.