Neighborhood social capital and infant physical abuse: a population-based study in Japan

Purpose We sought to investigate the relationship between neighborhood social capital and infant physical abuse using a population-based sample of women with 4-month-old infants in Japan. Methods: A questionnaire was administered to women who participated in a 4-month health checkup program (n = 1277; valid response rate, 80 %). We inquired about their perceptions of the level of trust in their neighborhood (an indicator of “social capital”) as well as the availability of support from their personal social networks. Infant physical abuse during the past month was assessed by self-reports of spanking, shaking or smothering. Results: The prevalence of infant physical abuse at 4 months of age was 9.0 % (95 % confidence interval [CI], 7.6–10.7 %). Women living in trusting neighborhoods were less likely to report infant physical abuse compared to those living in areas with low neighborhood trust (odds ratio [OR] 0.25, 95 % CI 0.06–0.97). In addition, women with supportive social networks were less likely to report infant physical abuse (OR 0.59, 95 % CI 0.36–0.99). Conclusions: In addition to one’s personal social network, social trust in the neighborhood was independently associated with lowered risk of infant physical abuse. To prevent infant abuse, interventions should consider strengthening community social bonds in addition to strengthening the social network of isolated mothers

Factors Related to Positive Feelings of Caregivers Who Provide Home-Based Long-Term Care for Their Family Members in Japan

Background. The objective is to elucidate the factors related to the positive feelings of family caregivers who are engaged in home-based elderly care. Methods. The study utilized the data of a cross-sectional citywide survey in Japan. The survey was conducted with 1,821 subjects and the final analysis was performed on 435 subjects. Questions for recipients such as those on their care levels, causes of care, whereas the primary caregivers were asked about whether they had positive feelings toward caregiving, and whether their opinion was reflected in care policies. Results. The factors s that showed a positive association with positive feelings were “the caregiver’s opinion is reflected in care policies” (OR: 5.05, 95% CI: 2.60–9.87) and “the caregiver is in good health condition” (OR: 2.02, 95% CI: 1.02–3.93). The factors that showed a negative association were “the caregiver is a daughter-in-law of the care recipient” (OR: 0.42, 95% CI: 0.21–0.82) and “the care recipient is an elderly person with cognitive impairment” (OR: 0.36, 95% CI: 0.18–0.70). Conclusions. The study suggests the necessity of providing support for caregivers in terms of empowerment and health management. Furthermore, they suggest that special attention should be paid to caregivers at risk of being unable to sustain positive feelings toward caregiving

Family caregiving problems of suspected elderly neglect: A review of forensic autopsy cases in Japan

Background. Elder abuse is a severe violation of human rights, and the most recent domestic violence issue to gain the attention of public and medical communities especially highly aged country like Japan. Methods. To clarify family caregiving problems related to elder neglect in Japan, we reviewed 178 autopsies conducted between 2000 and 2003 at one centre. Results. Of the 178 cases (134 males and 44 females), 53 involved people were 65 years old and over (30%). A careful investigation of these 53 autopsy reports (39 males and 14 females) allowed us to exclude obvious causes of death, such as traffic and other accidents, drowning, poisoning, alcoholism, and clear disease pathology. We were left with nine cases of suspected neglect (three males and six females). The mean age of victims was 82.1 years (range, 68–91). According to the autopsy reports, two were severely starved, two were putrefied or mummified, three had pressure sores, two had dementia and three would have had difficulty in performing the activities of daily living. Each victim had lived with one family member; their sons in five cases, and a grandson, brother, wife or husband in each case. The caregivers’ ages ranged from 27 to 76 years, and five were unemployed; in three cases, the family incomes were very low. Of the caregivers, two were depressed, one was an alcoholic and one had dementia. Conclusions. This investigation indicated that elderly parents living with their sons are a high-risk group for neglect. A family support system is needed to target male caregivers who are likely isolated from social services. Autopsy cases provide valuable information for public health to prevent similar cases in future. Keywords: Elder abuse, Elder neglect, Male caregivers, Family caregiving, Autopsy records

Predictors of volunteerism: A study of older adults in Japan

Volunteerism has risen steadily as a viable activity at old age in Japan for it gives older adults ways to contribute to society as well as enhancing their quality of life. It has also been addressed by the national government and adopted by many local municipalities under the long-term care insurance program as a health promotion and preventive care activity. However, studies examining why older adults volunteer and why some don’t are limited. Using a modified version of Baltes and colleagues’ model of competence, this study examines the predictors of volunteerism among older adults in Japan. Data from a city located northeast of Tokyo was used (n=703). Results indicated that basic competence does not predict volunteerism, but rather competence gained from experiences. To increase the number of older volunteers, the study suggests that civic engagement must start at an earlier age coupled with financial stability. Keywords: volunteerism, older adults, Japan, competence, long-term care insuranc

Comprehensive Assessment of Risk Factors of Cause-Specific Infant Deaths in Japan

Background: Public attention is given to infants with socially high risks of child abuse and neglect, while clinical attention is provided to infants with a biologically high risk of diseases. However, few studies have systematically evaluated how biological or social factors cross over and affect cause-specific infant mortality.Methods: We linked birth data with death data from the Japanese national vital statistics database for all infants born from 2003–2010. Using multivariate logistic regression, we examined the association between biological and social factors and infant mortality due to medical causes (internal causes), abuse (intentional external causes), and accidents (unintentional external causes).Results: Of 8,941,501 births, 23,400 (0.26%) infants died by 1 year of age, with 21,884 (93.5%) due to internal causes, 175 (0.75%) due to intentional external causes, and 1,194 (5.1%) due to unintentional external causes. Infants with high social risk (teenage mothers, non-Japanese mothers, single mothers, unemployed household, four or more children in the household, or birth outside of health care facility) had higher risk of death by intentional, unintentional, and internal causes. Infant born with small for gestational age and preterm had higher risks of deaths by internal and unintentional causes, but not by intentional causes.Conclusions: Both biological as well as social factors were associated with infant deaths due to internal and external causes. Interdisciplinary support from both public health and clinical-care professionals is needed for infants with high social or biological risk to prevent disease and injury

Hospital-based care utilization of children with medical complexity in Japan

BackgroundFew studies have investigated the hospital‐based care utilization of children with medical complexity (CMC) in Japan. This study examined the frequency and differences in hospital‐based care utilization for CMC according to the level of medical complexity (moderate and severe).MethodsMedical records of three pediatric tertiary hospitals in one prefecture were examined in 2014. We examined the number of outpatient visits and of admissions to the hospital for CMC in the 5 years after the introduction of home medical care.ResultsOf 92 CMC, 55 had medical complexity that was moderate (CMC‐moderate) and 37 had medical complexity that was severe (CMC‐severe). The number of CMC who had medical care introduced at home had increased year by year, especially that of CMC <2 years old; the number of older CMC (i.e. 7–17 years old) had also increased in 2010–2014. The median total outpatient visits was 20 (IQR, 13–29 visits) for CMC‐moderate and 20 (IQR, 17–26 visits) for CMC‐severe in the first year. CMC‐severe had significantly longer length of admissions in the 5 years than CMC‐moderate. The number of total visits and admissions during the subsequent 4 years (from the second to the fifth year) was slightly decreased compared with the first year, but this was not significantly different.ConclusionsCMC had high utilization of hospital‐based care, and consistently utilized hospital‐based care in the 5 years after the introduction of home medical care. Further study is needed to examine both hospital‐based and home/community‐based services use

Association between Hope for the Future and Academic Performance in Adolescents: Results from the K-CHILD Study

In Japan, having hope for the future is emphasized in school. This study aimed to examine the association between hope for the future and academic performance among Japanese adolescents. Data were taken from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study conducted in 2016. Participants included 3477 adolescents in the eighth grade (i.e., 13&ndash;14 years old) in Kochi Prefecture. Information on hope for the future, self-rated academic performance, and time used for studying or playing was provided by the adolescents via a questionnaire. The question on resilience was answered by their caregivers. Propensity-score matching was applied for the allocation of hope for the future. Overall, 2283 adolescents (65.6%) had some form of hope for the future. Adolescents having hope for the future showed a higher self-rated academic performance (&beta; = 0.21, 95% confidence interval (Confidence Interval (CI) = 0.10 to 0.32)), spent more time studying except in class (Odds Ratio (OR) = 1.89, 95% CI = 1.37 to 2.61), read more books (OR = 1.45, 95% CI = 1.19 to 1.75), and had a higher score of resilience (&beta; = 1.48, 95% CI = 0.98 to 1.98), while the time to watch TV or DVDs was not different (p = 0.61). Our results highlight the importance of encouraging adolescents to have hope for the future to promote academic performance

Association between Children&rsquo;s Engagement in Community Cultural Activities and Their Mental Health during the COVID-19 Pandemic: Results from A-CHILD Study

Social learning experiences developed through engagement in community cultural activities can affect a child&rsquo;s development. Few studies have examined how children&rsquo;s engagement in community activities is related to their mental health. This study aimed to examine associations between children&rsquo;s participation in community cultural activities and their mental health. We targeted all sixth-grade children in all 69 primary schools in Adachi City, Tokyo, using the Adachi Child Health Impact of Living Difficulty (A-CHILD) study (n = 4391). Parents answered the validated Japanese version of the Strength and Difficulties Questionnaire (SDQ) to assess child mental health, the child&rsquo;s engagement in community cultural activities. The community activity in which children most frequently participated was local festivals. Participating in local festivals was significantly associated with lower behavioral difficulties (&beta; = &minus;0.49, SE = 0.17, p = 0.005) and higher prosocial behaviors (&beta; = 0.25, SE = 0.07, p &lt; 0.001) after adjusting for demographic variables, family social capital, and parent-child interactions. These results highlight the importance of children&rsquo;s engagement in community cultural activities for their mental health during the COVID-19 pandemic

Stressors and coping strategies among single mothers during the COVID-19 pandemic.

ObjectivesIncreased levels of stress have been reported among parents due to the factors associated with the COVID-19 pandemic. Although social support is known as a protective factor for the stressors, restrictions due to the pandemic could influence the provision and forms of social support. To date, few qualitative studies have examined the stressors and coping strategies in detail. In particular, the role of social support for single mothers during the pandemic remains largely unclear. The purpose of this study is to explore the stressors and coping strategies of single parents during the COVID-19 pandemic, with a focus on social support as a coping strategy.MethodsIn-depth interviews with 20 single mothers were conducted in Japan between October and November 2021. Data were deductively coded using thematic coding based on codes related to stressors and coping strategies, focusing on social support as a coping strategy.ResultsMost interviewees recognized additional stressors after the COVID-19 outbreak. Five stressors were mentioned by the participants: (1) fear of infection, (2) financial concerns, (3) stress caused by interactions with their children, (4) restrictions on childcare facilities, and (5) stress related to staying at home. The major coping strategies were (1) informal social support from family, friends, and coworkers, (2) formal social support from municipalities or nonprofit organizations, and (3) self-coping strategies.ConclusionSingle mothers in Japan recognized additional stressors after the COVID-19 outbreak. Our results support the importance of both formal and informal social support for single mothers, either in-person or online, to cope with stress during the pandemic