Social support mediates social frailty with anxiety and depression.

BACKGROUND: Anxiety and depression are prevalent comorbidities in patients with chronic obstructive pulmonary disease (COPD). However, existing research has yielded conflicting findings regarding the effects of social frailty on anxiety and depression. The primary aim of this study is to validate the relationship between social frailty and social support with anxiety and depression in patients with acute exacerbations of COPD (AECOPD) and to investigate whether social support could explain the variations in prior study outcomes for patients with AECOPD. METHODS: Of the 315 patients hospitalized with AECOPD at the respiratory intensive care unit of a large tertiary care institution in Sichuan Province of China, between August 2022 and June 2023 who were surveyed, 306 were included in the analysis after excluding missing data. We conducted a logistic regression analysis to examine the associations of social frailty and social support with anxiety and depression and performed mediation analyses to examine whether social support mediates the relationship of social frailty with anxiety and depression. RESULTS: The logistic regression analysis revealed that social frailty did not associate anxiety or depression in patients with AECOPD. The mediation analysis supported this idea and indicated that while social frailty does not directly influence anxiety or depression, it can through social support. CONCLUSIONS: The findings suggest that while social frailty may not directly impact anxiety or depression in patients with AECOPD, social support plays a crucial mediating role. Enhancing social support can indirectly alleviate anxiety and depression among these patients. Enhancing social support networks should thus be prioritized by healthcare providers and family members to improve mental health outcomes in this patient population.

Identification and prediction of frailty among community-dwelling older Japanese adults based on Bayesian network analysis: a cross-sectional and longitudinal study.

BACKGROUND: Frailty is a multifactorial syndrome; through this study, we aimed to investigate the physiological, psychological, and social factors associated with frailty and frailty worsening in community-dwelling older adults. METHODS: We conducted a cross-sectional and longitudinal study using data from the "Community Empowerment and Well-Being and Healthy Long-term Care: Evidence from a Cohort Study (CEC)," which focuses on community dwellers aged 65 and above in Japan. The sample of the cross-sectional study was drawn from a CEC study conducted in 2014 with a total of 673 participants. After excluding those who were frail during the baseline assessment (2014) and at the 3-year follow-up (2017), the study included 373 participants. Frailty assessment was extracted from the Kihon Checklist, while social relationships were assessed using the Social Interaction Index (ISI). Variable selection was performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression and their predictive abilities were tested. Factors associated with frailty status and worsening were identified through the Maximum-min Hillclimb algorithm applied to Bayesian networks (BNs). RESULTS: At baseline, 14.1% (95 out of 673) participants were frail, and 24.1% (90 out of 373) participants experienced frailty worsening at the 3-years follow up. LASSO regression identified key variables for frailty. For frailty identification (cross-sectional), the LASSO model's AUC was 0.943 (95%CI 0.913-0.974), indicating good discrimination, with Hosmer-Lemeshow (H-L) test p = 0.395. For frailty worsening (longitudinal), the LASSO model's AUC was 0.722 (95%CI 0.656-0.788), indicating moderate discrimination, with H-L test p = 0.26. The BNs found that age, multimorbidity, function status, and social relationships were parent nodes directly related to frailty. It revealed an 85% probability of frailty in individuals aged 75 or older with physical dysfunction, polypharmacy, and low ISI scores; however, if their social relationships and polypharmacy status improve, the probability reduces to 50.0%. In the longitudinal-level frailty worsening model, a 75% probability of frailty worsening in individuals aged 75 or older with declined physical function and ISI scores was noted; however, if physical function and ISI improve, the probability decreases to 25.0%. CONCLUSION: Frailty and its progression are prevalent among community-dwelling older adults and are influenced by various factors, including age, physical function, and social relationships. BNs facilitate the identification of interrelationships among these variables, quantify the influence of key factors. However, further research is required to validate the proposed model.

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.

Active use of local exercise facilities can improve physical performance of community-dwelling older adults.

[Purpose] In this study, we investigated the effects of local exercise facility use on physical function of Japanese community-dwelling older adults. [Participants and Methods] We analyzed data obtained from a cohort project initiated in 1991. The study included approximately 4,800 individuals from suburban areas of central Japan; we investigated 322 older individuals residing in Municipality A, who underwent physical fitness assessments in 2018 and 2019. We recorded participants' exercise facility use frequency and physical performance, based on handgrip strength, open-eye single-leg standing, timed up-and-go, and walking speed tests. [Results] Baseline values in the open-eye single-leg standing test were significantly higher in the no-use than in the low- and high-use groups. Follow-up assessments revealed that grip strength was significantly higher in the high-use than in the no- and low-use groups. [Conclusion] Active use of exercise facilities was positively correlated with maintenance and improvement in physical fitness among participants, which highlights the benefits of easily accessible exercise facilities in maintaining long-term physical function. Future studies should focus on functions that extend beyond physical fitness to develop effective support programs that address the evolving health needs of the aging population.

Patterns of social relationships among community-dwelling older adults in Japan: latent class analysis.

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

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.

Changes in social interaction over 20 years and the effects of community resources use among community-dwelling elderly persons.

Objectives　Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods　The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results　Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion　The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social interaction, including social curiosity and independence, has increased over 20 years. The effect of preventive intervention in local elderly management centers, health care centers, and health promotion facilities may be one of the causes for this increase.

Buffering effect of parental engagement on the relationship between corporal punishment and children's emotional/behavioral problems.

BACKGROUND: Previous research has established links between corporal punishment and children's developmental problems, but few studies have investigated the moderating effect of positive parenting between corporal punishment and children's developmental difficulties in detail. This study investigated the buffering effect of parental engagement on the association between corporal punishment and children's emotional/behavioral problems. METHODS: The main caregivers completed the Evaluation of Environmental Stimulation Scale (EES), which is an evaluation of daily parenting behaviors, and the Strengths and Difficulties Questionnaire (SDQ), which evaluates children's developmental problems. RESULTS: Corporal punishment was associated with worse emotional and behavioral problems in children, whereas parental engagement in games or sports was associated with fewer emotional symptoms. Similarly, parental engagement in homework or housework significantly moderated the association between corporal punishment and children's behavioral problems. CONCLUSIONS: Parental engagement positively moderated the association between parental corporal punishment and children's developmental difficulties. This association varied with child gender.

[The influence of caregivers' anxiety and the home environment on child abuse. A study of children attending child-care centers].

OBJECTIVES: The prevalence of child abuse is increasing in Japan. Therefore, we need appropriate and practical approaches for implementing feasible prevention, early detection, and support services for abused children. The purpose of this study was to examine child-rearing anxieties and the home environment as factors affecting caregivers of suspected abused children who attend child-care centers . METHODS: First, we applied the millennium edition of the Japan Child and Family Research Institute (JCFRI) Child Rearing Support Questionnaire, and the Index of Child Care Environment (ICCE), for 1,801 caregivers whose children were enrolled in child-care centers based in City A. The millennium edition of the JCFRI Child Rearing Support Questionnaire measures difficulties in childcare for caregivers in terms of feelings, anxiety, and tendencies toward depression. The ICCE measures the quality and frequency of involvement of caregivers with their children and the child-care environment. Next, we interviewed the directors and child-care professionals in the centers to collect information on child abuse. The children were divided into two groups: abused and non-abused. The "abused group" consisted of the children whom the directors and professionals of the child-care centers suspected of being "possibly abused" and so had been placed under the protection of the center; furthermore, the center exchanged information with the City A Municipality "City A municipal government" about these children. We conducted Fisher's exact test to examine the relationship between the "abused group" and the "non-abused group," in relation to child-rearing anxiety and the children's home environments. Questionnaire scores from the two groups were assessed. We calculated odds ratios to examine the significant factors related to child abuse. Our dependent variable was child abuse, our main independent variables were items related to child-care difficulties and the child-care environment, and the moderating variables were age and gender. We used multiple logistic regression to assess the actual child abuse predictors. RESULTS: The odds ratios obtained by comparing the "abused group" with the "non-abused group" showed that the caregivers of children in the "abused group" had a 5.5-fold greater odds of saying, "I am riddled with uneasiness and awful feelings," and a 4.6-fold greater odds of saying, "I do not have anyone to look after my child except a child-care center." The moderating variables (age and gender) were not significant. CONCLUSION: Child-care professionals have a policy for ensuring there is concrete and usable support for caregivers, depending on the relationship between the abused child and the difficulties present in the child's environment. We suggest that awareness of these relationships can be promoted as an aid for early child abuse detection, support, and prevention.

Longitudinal effects of parental adverse childhood experiences on offspring problematic media use: The serial mediating role of psychological distress and harsh discipline.

BACKGROUND: Adverse childhood experiences (ACEs) may lead to increased problematic media use (PMU). However, whether parental adverse childhood experiences predict offspring PMU, and the mediating roles of psychological distress and harsh discipline, two common mechanisms underlying the intergenerational transmission of parental ACEs, in this relationship have not been examined in Chinese samples. OBJECTIVE: This study examined the serial mediating effects of psychological distress and harsh discipline on the association between parental ACEs and children's PMU. PARTICIPANTS AND SETTING: Participants were 617 three-year-old children and their parents (mean age of 33.24 years, SD = 4.01) from Wuhu, China. METHODS: Parents completed online questionnaires measuring ACEs, psychological distress, and demographic information in September 2022 (Time 1). Parents completed online questionnaires measuring harsh discipline and offspring PMU in September 2023 (Time 2). Macro Process 6 was used to test two serial mediating effects of psychological distress and corporal punishment, as well as psychological distress and psychological aggression. A total of 5000 bootstrap samples were used to estimate the 95 % confidence intervals. A significant effect was indicated by a 95 % confidence interval that did not include zero. RESULTS: The findings suggest that parental ACEs directly and positively predict offspring PMU. Psychological distress and harsh discipline mediate the association between maternal ACEs and offspring PMU parallelly and sequentially. CONCLUSIONS: Our findings highlight the importance of addressing psychological distress and harsh discipline when designing interventions targeting Chinese parents exposed to ACEs and their children.

Do multigenerational homes moderate the intergenerational transmission of maternal adverse childhood experiences?

ABSTRACTBackground: Maternal adverse childhood experiences (ACEs) may lead to increased behavioural problems in children. However, the mediating roles of psychological distress and corporal punishment, two common mechanisms underlying the intergenerational transmission of maternal ACEs, in these relations have not been examined in Chinese samples. Multigenerational homes (MGH) are the dominate living arrangement in China; however, limited research focuses on the effects of MGHs on the intergenerational transmission of maternal ACEs.Objective: This study explored the parallel mediating effects of corporal punishment and psychological distress on the association between maternal ACEs and children's behaviour and whether MGHs can strengthen or weaken the relationship between maternal ACEs and corporal punishment or psychological distress.Participants and setting: Participants were 643 three-year-old children and their mothers (mean age of 32.85 years, SD = 3.79) from Wuhu, China.Methods: Mothers completed online questionnaires measuring ACEs, psychological distress, corporal punishment, their family structure, and children's behavioural problems. This study used a moderated mediation model.Results: The findings suggest that psychological distress and corporal punishment mediate the association between maternal ACEs and children's behavioural problems. The mediating role of corporal punishment was found depend on whether mothers and their children reside in MGHs. MGHs were not found to have a moderating role in the indirect relationship between maternal ACEs and children's behaviour problems via psychological distress.Conclusion: Our findings highlight the importance of addressing psychological distress and corporal punishment when designing interventions targeted Chinese mothers exposed to ACEs and their children, especially those living in MGHs.

Psychological distress and corporal punishment have parallel mediating roles in the associations between maternal adverse childhood experiences and offspring behavioural problems.Mothers with more adverse childhood experiences and in multigenerational homes were more likely to use corporal punishment.Multigenerational homes did not moderate the indirect relationship via psychological distress.

Association of Frailty with Patient-Report Outcomes and Major Clinical Determinants in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Purpose: This study aimed to explore the correlation of frailty status with disease characteristics and patient-reported outcomes (PROs) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and determine the sensitivity and specificity of modified COPD PRO scale (mCOPD-PRO) for detecting frailty. Patients and Methods: This cross-sectional study surveyed 315 inpatients with AECOPD from a tertiary hospital in China from August 2022 to June 2023. Patient frailty and PROs were assessed using the validated FRAIL scale and mCOPD-PRO, respectively. Spearman's ρ was used to assess the relevance of lung disease indicators commonly used in clinical practice, and ordinal logistic regression analyses were used to identify the variables associated with frailty status. The validity of mCOPD-PRO in discriminating frail or non-frail individuals was determined using the receiver operating characteristic curve. Results: The participants (N=302, mean age 72.4±9.1 years) were predominantly males (73.2%). Among them, 43 (14.3%) patients were not frail, whereas 123 (40.7%) and 136 (45.0%) patients were pre-frail and frail, respectively. The FRAIL scale was moderately correlated with the mCOPD-PRO scores (Spearman's rank correlation coefficient [Rs]=0.52, P<0.01) for all dimensions (Rs=0.43-0.49, P<0.01). Patients residing in rural areas (odds ratio [OR], 1.67; 95% confidence interval [95% CI], 1.01-2.76) and with higher mCOPD-PRO scores (OR, 4.78; 95% CI, 2.75-8.32) were more likely to be frail. Physically active patients (OR, 0.42; 95% CI, 0.21-0.84) were less likely to be frail. In addition, mCOPD-PRO had good discriminate validity for detecting frailty (area under the curve=0.78), with a sensitivity and specificity of 84.6% and 60.8%, respectively. The optimal probability threshold for mCOPD-PRO was ≥1.52 points. Conclusion: In patients with AECOPD, frailty is closely related to PROs and disease characteristics. Additionally, the mCOPD-PRO score can distinguish well between frail and non-frail patients. Our findings provide support for interventions targeting frail populations with AECOPD.

Patients with chronic obstructive pulmonary disease often have concomitant frailty that may lead to disease deterioration such as acute exacerbations, hospital readmissions, disability, and premature death. Patient-reported outcomes are often used in clinical practice to measure patients' disease characteristics and overall status. Whether patients' frailty state is associated with patient-reported outcomes and if so, which factors are associated with frailty remain unclear. This study, conducted in China, examined their relationship as well as identified factors associated with frailty states. 302 hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease completed a questionnaire answering questions about disease severity, frailty state, anxiety, and depression. The findings suggest that people who live in rural areas, self-reported more severe overall conditions, and are physically inactive are more likely to be frail. Patient-reported outcomes can distinguish between frail and non-frail patients. Therefore, patient-reported outcomes can be used to assess the extent of frailty; early screening of AECOPD combined frailty population and implementation of interventions can help mitigate the adverse effects of frailty.

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.

Factors associated with health service utilization in Ulaanbaatar, Mongolia: a population-based survey.

BACKGROUND: Understanding patterns of health service utilization can improve health care and increase use of health services. We examined patterns of health service utilization among residents of Ulaanbaatar, Mongolia. METHODS: A total of 500 adults were surveyed using paper-based questionnaires. The χ(2) test and multiple logistic regression were used to identify associations between factors. RESULTS: 44.1% of respondents had visited a physician during the previous 12 months. After controlling for determinants, the significant predictors of utilization of health service were attention to health examinations (OR = 3.6, CI: 1.93-6.76), being married (OR = 2.7, CI: 1.50-4.72), being satisfied with the overall cleanliness of the hospital (OR = 2.4, CI: 1.12-5.19), being a nonsmoker (OR = 2.2, CI: 1.21-3.98), having periodic physical examinations (OR = 2.2, CI: 1.25-3.71), not being a hospital patient during the previous 3 years (OR = 2.1, CI: 1.22-3.73), having proper documentation (OR = 1.9, CI: 1.10-3.43), having medical insurance (OR = 1.9, CI: 1.96-3.28), not wanting to receive information on food and nutrition (OR = 0.6, CI: 0.36-0.96), having more than 5 household members (OR = 0.5, CI: 0.50-0.85), low income (OR = 0.5, CI: 0.30-0.85), lack of concern for food and nutrition (OR = 0.5, CI: 0.28-0.84), self-medication during the past 12 months (OR = 0.4, CI: 0.24-0.69), and desire for treatment abroad (OR = 0.4, CI: 0.20-0.60). CONCLUSIONS: A number of health-related behaviors and sociodemographic factors were important predictors of health service utilization.

Intergenerational associations of adverse and positive maternal childhood experiences with young children's psychosocial well-being.

Background: Maternal adverse childhood experiences (ACEs) are believed to have negative consequences on offspring health. However, positive childhood experiences (PCEs) may be concurrent with ACEs, and little is known about how ACEs and PCEs transmit intergenerationally in the context of each other.Objective: To explore the independent effect of maternal ACEs and PCEs on offspring psychosocial well-being and how ACEs and PCEs are intergenerationally transmitted in their context.Method: Data were 2587 mother-child dyads in Anhui provinces of China. Mothers retrospectively reported their ACEs and PCEs, as well as provided demographic characteristics and their children's psychosocial well-being. Logistic regression models were performed to explore the associations of maternal ACEs and PCEs with offspring psychosocial well-being.Results: Separate unadjusted logistic regression models showed that children with mothers reported high ACEs scores were more likely to have psychosocial challenges (total difficulties and prosocial problems), while children whose mothers reported high PCEs scores were less likely to have psychosocial challenges. When we added maternal ACEs and PCEs to a same model, we found that PCEs slightly neutralised the negative effects of ACEs on offspring's total difficulties and prosocial problems. When stratified by sample, mothers with high PCE scores and higher maternal ACEs were related with a higher risk of offspring total difficulties; mothers with low levels of ACEs and high PCEs tend to report a lower risk of offspring total difficulties.Conclusions: Results suggest that PCEs are positively and intergenerationally transmitted. Results suggest that PCEs are positively and intergenerationally transmitted. More programme should be provided to increase maternal PCEs. When preventing the intergenerational transmission of ACEs, specific interventions should be provided to mothers with different levels of PCEs.

Positive childhood experiences positively transmit intergenerationally.Stronger relationship between maternal ACEs and risk of offspring total difficulties was observed among mothers with above-average positive childhood experiences scores.A stronger relationship between maternal PCEs and fewer offspring total difficulties was observed among mothers with low adverse maternal childhood experiences scores.

Adverse Childhood Experiences, Resilience, and Emotional Problems in Young Chinese Children.

Resilience plays an important role in the relationship between adverse childhood experiences (ACEs) and children's health. Young children are often neglected in ACEs research and suffer from the negative consequences of ACEs. However, few studies have focused on the relationship between ACEs and emotional problems in young Chinese children and the moderating and mediating effect of resilience on this relationship. This study included young children at the beginning of their kindergarten year (n = 874, 42.80 ± 4.09 months) from Wuhu City, China, to examine the mediation and moderation effects of resilience on early-life ACEs and emotional problems. Our results show a positive direct effect of ACEs on emotional problems. Furthermore, a positive indirect effect of ACEs and emotional problems on resilience was found. A moderating effect of resilience was not observed in this study. Our findings (a) highlight the significance of paying more attention to early ACEs and revealing a better understanding of the effect of resilience on ACEs at an early age and (b) indicate that age-specific interventions should be provided to enhance young children's resilience when exposed to adversity.

Maternal adverse childhood experiences and behavioral problems in Chinese preschool children: The moderated mediating role of emotional dysregulation and self-compassion.

BACKGROUND: The negative effects of maternal adverse childhood experiences (ACEs) may have a direct intergenerational effect on a child's behavior. This topic has been widely examined, but few studies have explored the underlying mechanism and protective factors influencing maternal ACEs and offspring's behavioral problems in the Chinese context. OBJECTIVE: This study aims to investigate the mediating effect of emotional dysregulation on the relationship between maternal ACEs and offspring behavior and examine whether self-compassion can moderate this association. PARTICIPANTS AND SETTING: The participants were 2282 preschoolers (52 % male) with a mean age of M = 62.63 months (SD = 9.28) and their mothers. They were from northern, central, and southern Anhui Province China, and data were collected in relation to the family's socioeconomic status by population density of children in the region. METHODS: Data were collected from the mothers with respect to maternal ACEs, emotional dysregulation, and self-compassion. Mothers provided information regarding children's behavior and demographic characteristics. A moderated mediation model was analyzed through SPSS. RESULTS: First, the presence of maternal ACEs was positively associated with offspring behavioral problems. Second, maternal emotional dysregulation mediated the relationship between ACEs and offspring behavioral problems. Third, mothers' self-compassion moderated the indirect relationship between ACEs and offspring behavioral problems via emotional dysregulation. CONCLUSIONS: Our findings highlight the critical role of emotional dysregulation and self-compassion in the relationship between maternal ACEs and offspring behavioral problems. Interventions should target maternal emotional dysregulation and self-compassion to minimize the risk of intergeneration transmission of negative effects.

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.

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.