Review of \u3cem\u3eSocial Welfare in Japan: Principles and Applications.\u3c/em\u3e Kojun Furukawa. Reviewed by Christina Miyawaki.

Book review of Kojun Furukawa, Social Welfare in Japan: Principles and Applications. Melbourne, Australia: TransPacific Press, 2008. $79.95 hardcover

Moving Beyond Dichotomies: How the Intersection of Race, Class and Place Impacts High School Graduation Rates for African American Students

Over thirty years ago, William Julius Wilson declared that class trumped race as the more significant determinant of social mobility and economic opportunity. Despite the acclaim and scrutiny for Wilson\u27s work, the United States has grown increasingly divided by intersecting factors of race, class and other demographic factors such as place (Massey, 2007). These divisions are especially evident in the public education system. We analyze how race, class and place interact to predict high school graduation rates in a national sample of schools and students. Results confirm that a singular focus on race, class, or locale is insufficient to explain high school graduation rates. However, a more contextualized focus on the interactions between multiple determinants of inequality (e.g. race, class and place) can yield a more nuanced understanding of the indicators driving educational inequalities. Scholars and practitioners need to focus on the manner in which multiple positionalities influence the academic achievement of African American children and young adults

Symptoms of anxiety and depression predicting fall-related outcomes among older Americans: a longitudinal study

BackgroundAnxiety and depressive symptoms are associated with fear of falling and fear of falling-related activity restrictions. However, it remains unknown whether anxiety or depressive symptoms alone could predict fear of falling and activity restrictions in older adults. We sought to determine if anxiety and depressive symptoms alone could be an independent predictor of fear of falling and activity restrictions in community-dwelling older adults.MethodsThis longitudinal analysis used waves 5 (time 1, [T1]) and 6 (time 2, [T2], 1 year from T1) data (N = 6376) from the National Health and Aging Trends Study. The Generalized Anxiety Disorder Scale 2 and Patient Health Questionnaire 2 were used to assess anxiety and depressive symptoms, respectively. Interview questions included demographics, health-related data, and fall worry levels (no fear of falling, fear of falling but no activity restrictions, and activity restrictions). Using multinomial logistic regression models, we examined whether anxiety and depressive symptoms (T1) predicted fear of falling and activity restrictions (T2).ResultsIn wave 5 (T1, mean age: 78 years, 58.1% female), 10 and 13% of participants reported anxiety and depressive symptoms. About 19% of participants experienced fear of falling but not activity restrictions, and 10% of participants developed activity restrictions in wave 6 (T2), respectively. Participants with anxiety symptoms at T1 had a 1.33 times higher risk of fear of falling (95% CI = 1.02–1.72) and 1.41 times higher risk of activity restrictions (95% CI = 1.04–1.90) at T2. However, having depressive symptoms did not show any significance after adjusting for anxiety symptoms.ConclusionsAnxiety symptoms seemed to be an independent risk factor for future fear of falling and activity restrictions, while depressive symptoms were not. To prevent future fear of falling and activity restrictions, we should pay special attention to older individuals with anxiety symptoms.</p

Phosphodiesterase 10A Upregulation Contributes to Pulmonary Vascular Remodeling

Phosphodiesterases (PDEs) modulate the cellular proliferation involved in the pathophysiology of pulmonary hypertension (PH) by hydrolyzing cAMP and cGMP. The present study was designed to determine whether any of the recently identified PDEs (PDE7-PDE11) contribute to progressive pulmonary vascular remodeling in PH. All in vitro experiments were performed with lung tissue or pulmonary arterial smooth muscle cells (PASMCs) obtained from control rats or monocrotaline (MCT)-induced pulmonary hypertensive (MCT-PH) rats, and we examined the effects of the PDE10 inhibitor papaverine (Pap) and specific small interfering RNA (siRNA). In addition, papaverine was administrated to MCT-induced PH rats from day 21 to day 35 by continuous intravenous infusion to examine the in vivo effects of PDE10A inhibition. We found that PDE10A was predominantly present in the lung vasculature, and the mRNA, protein, and activity levels of PDE10A were all significantly increased in MCT PASMCs compared with control PASMCs. Papaverine and PDE10A siRNA induced an accumulation of intracellular cAMP, activated cAMP response element binding protein and attenuated PASMC proliferation. Intravenous infusion of papaverine in MCT-PH rats resulted in a 40%–50% attenuation of the effects on pulmonary hypertensive hemodynamic parameters and pulmonary vascular remodeling. The present study is the first to demonstrate a central role of PDE10A in progressive pulmonary vascular remodeling, and the results suggest a novel therapeutic approach for the treatment of PH

Association of Filial Responsibility, Ethnicity, and Acculturation of Family Caregivers of Older Adults

Thesis (Ph.D.)--University of Washington, 2014With the growing numbers of Asian and Hispanic elder immigrants and their family caregivers, there is a need to understand their caregiving concerns. Researchers have identified that 1st generation immigrant caregivers face care challenges due to cultural differences and extent of acculturation to the host country. However, potential changes in level of filial responsibility and caregiving attitudes among later generations of caregivers have not been examined, which is the focus of this dissertation. Using the 2009 California Health Interview Survey, the first paper describes the characteristics of Asian, Hispanic and non-Hispanic White American family caregivers of older adults in California. Second generation Asians and Hispanics were the youngest while 2nd generation non-Hispanic Whites were the oldest caregivers. Asian and non-Hispanic White caregivers attained a higher education level than Hispanics, but Asian and Hispanic caregivers' educational attainment increased in later generations. The vast majority self-rated their health as good, but the later the generation of Asian and Hispanic caregivers, the poorer their health status. The second paper examines caregiving attitudes and practices among the same racial and ethnic caregiver groups across generations. Based on Gordon's assimilation theory, respite care use, caregiving hours and duration were compared across the three groups. Non-Hispanic White caregivers showed less caregiving involvement in later generations. However, 3rd generation Asian and Hispanic caregivers used respite care the least and spent the most hours and length of care compared to earlier generations, which reveals cultural values of filial responsibility among later generations. The final paper compares filial responsibility among 2nd, 2.5 and 3rd generations of 40 Chinese- and Japanese-American caregivers. The Suinn-Lew Asian Self Identity Acculturation scale and the Filial Values Index measured caregivers' acculturation and filial responsibility levels; these identified later generation caregivers with higher acculturation and filial responsibility scores, indicating a strong sense of filial responsibility among 3rd generation caregivers. Qualitative interviews showed similar patterns of continued caregiving involvement even after the placement of their loved ones in a long-term care facility. Future research includes analyzing more in-depth the reasons and motivations for later generation caregivers' high level of filial caregiving involvement

Health of Vietnamese Older Adults and Caregivers Psychological Status in the United States: Result from the Vietnamese Aging and Care Survey.

Objective: We examined the association between care recipients physical, mental, and cognitive health conditions and caregivers psychological distress in Vietnamese older care recipients and their caregivers.Methods: The Vietnamese Aging and Care Survey was developed for care recipients, and adult-child and spousal caregivers, and inquired about their sociodemographics and health-related variables.Results: Data were collected on 58 caregiver-care recipient dyads. Adult-child and spousal caregivers were on average 43 and 70&nbsp;years-old respectively. The vast majority were female (76%) and born in Vietnam (97%). Adult-child caregivers reported more caregiver burden than spousal caregivers. Care recipients were on average 75&nbsp;years-old. Care recipients of adult-child caregivers reported more depressive symptoms than care recipients of spousal caregivers and were more likely to have mild dementia. Care recipients health had no effect on caregiver depressive symptoms but their educational attainment was associated with caregiver burden and depressive symptoms.Conclusions: This study showed care recipients and caregivers years of education were positively associated with caregivers psychological distress. Vietnamese families lived in ethnic enclaves and shared caregiving responsibilities within the family. However, using available outside resources may alleviate psychological distress of not only caregivers but also families as a whole.Clinical Implications: Healthcare professionals should encourage educated caregivers and educated care recipients to use outside resources to ease caregiving duties

Social support as a moderator of physical disability and mental health in older Vietnamese immigrants in the U.S.: Results from the Vietnamese aging and care survey (VACS)

After the Vietnam War, 1.3 million Vietnamese migrated to the U.S. where they are the fourth largest Asian American subgroup. However, little is known about their health compared to other Asian subgroups. As such, we developed the Vietnamese Aging and Care Survey to understand older Vietnamese immigrants' health in Houston, Texas (N=132). We examined how social support moderated the relationship between their physical disability and mental health (depressive symptoms and loneliness). Most respondents rated their health as fair/poor and more than half lived in extended family households or senior housing in ethnic enclaves. Having more physical disabilities was associated with higher depressive symptoms and loneliness, but higher social support moderated the effect of physical disability on loneliness. Local policymakers and stakeholders might strategize using the existing culturally and linguistically appropriate daycare centers and home and community-based services to mitigate depression and loneliness among older Vietnamese immigrants with physical disabilities

Vietnamese Adult-Child and Spousal Caregivers of Older Adults in Houston, Texas: Results from the Vietnamese Aging and Care Survey (VACS)

Vietnamese are the largest Asian ethnic group in Houston, Texas; however, research on this population is scarce. To address this dearth of knowledge, we developed the Vietnamese Aging and Care Survey. The objective of the study was to explore the sociodemographic and health characteristics of Vietnamese adults aged 65 years and older (n = 132) and their family caregivers (n = 64). Adult-child caregivers (n = 41) were aged between 21 and 65 years old. The majority were married, working, female, and in good to excellent health. Spousal caregivers (n = 23) were between 57 and 82 years old, retired, female, and in fair to good health. Adult children received more caregiving-related help from others compared to spousal caregivers; however, they felt more caregiver burden, had more perceived stress, and were in challenging relationships with care recipients. Differences in life stages of adult-child versus spousal caregivers may contribute to these results. Implications are discussed