Strategies To Support Older Adults’ Mental Health During the Transition Into Residential Aged Care: A Qualitative Study of Multiple Stakeholder Perspectives

BackgroundThe move from home into residential care is one of the most stressful life experiences for older adults. ‘Relocation stress’ is a significant risk factor for anxiety and/or depression in aged care residents. Whether long-term or recently diagnosed, these mood disorders are associated with a decline in overall well-being, daily functioning and independence. The mental health needs of older adults are often poorly recognised and supported, including during the transition into residential care. Despite growing interest in how to facilitate this major life transition, few studies have taken the perspective of multiple stakeholders. The aim of this study was to explore resident, relative and staff experiences of the transition into residential aged care, and to identify strategies to support the mental health of older adults at this time. MethodsSemi-structured interviews were conducted with 35 aged care residents, relatives and staff, between January and April 2021. Participants were selected using purposive and convenience sampling. Interviews were audio recorded and transcribed verbatim. Data were analysed inductively and grouped into themes. ResultsResults were distilled into three main categories related to the overall transition experience, residents’ mental health needs and strategies to support residents’ mental health. A novel contribution of this study relates to the need to address a broad misunderstanding of the role of pastoral care and subsequent under-utilisation of a potentially valuable resource. ConclusionsBy describing transition experiences and the resources to support residents’ mental health, findings of this study provide practical, ‘real world’ suggestions for reducing relocation stress. New resources developed from the findings include guides, checklists and short question-and-answer films, in which current residents and staff describe strategies to support mental health and overall quality of life. Similar resources could be used to support transitions in other care settings.

Do partnership dissolutions and living alone affect systemic chronic inflammation? A cohort study of Danish adults

BackgroundPartnership breakups and living alone are associated with several adverse health outcomes. The aim of this study, carried out in Denmark, is to investigate whether accumulated numbers of divorces/partnership breakups or years lived alone across 26 years of adult life are associated with levels of inflammation, and if vulnerability with regards to gender or educational level can be identified.Methods4835 participants from the Copenhagen Aging and Midlife Biobank (CAMB) aged 48–62 years were included. Data on accumulated numbers of partnership breakups and years living alone were retrieved from a national standardised annual register. Inflammatory markers interleukin 6 (IL-6) and high sensitivity C-reactive protein (hsCRP) were measured in blood samples. Multivariate linear regression analyses were adjusted for age, educational level, early major life events, body mass index, chronic diseases, medicinal intake affecting inflammation, acute inflammation and personality scores.ResultsFor men, an association was found between an increasing number of partnership breakups or number of years living alone and higher levels of inflammatory markers. No such association was found for women, and no evidence of partnership breakups and educational level having a joint effect was found for either gender.ConclusionThe findings suggest a strong association between years lived alone or accumulated number of partnership breakups and low-grade inflammation for middle-aged men, but not for women. Among those of either sex with a lower level of education, no specific vulnerability to accumulated years lived alone or number of breakups was identified.

Emotional anticipation of future vocational transitions: A person-centered approach

Most future educational and career transitions represent major life events that individuals anticipate to a considerable extent, possibly with multiple emotions at the same time. However, few studies have examined the emotions that individuals experience when they anticipate a future educational or career transition, imagine how it will occur, the consequences it will have for them, and visualize their coping efforts. The aims of the present dissertation are fourfold. First, we explore individuals’ combinations of multiple future-oriented emotions at the prospect of three major educational and career transitions: (a) the transition from high school to higher education, (b) the transition from higher education to the job market, and (c) the transition from unemployment to employment. Due to the rather exploratory nature of our first research question, our second objective pertains to the replication of these combinations and the investigation of similarities between several groups of individuals based on (a) gender, (b) institutional context, and (c) the temporal distance before the transition. Third, we examine several antecedents of individuals’ combinations of future-oriented emotions. These antecedents ranged from career-related constructs such as career decidedness and career adaptability to affective mechanisms such as cognitive appraisals, trait affect, and emotion regulation. Finally, we examine the behavioral effects of future-oriented emotions in terms of anticipated vocational planning and effort. Overall, the present dissertation brings several implications in highlighting the combinations of future-oriented emotions that individuals experience when anticipating important vocational transitions, a research strand that is scarce both in vocational and emotion research. From a practical point of view, the evidence of several combinations—and the differences and similarities among several groups or contexts—carries practical implications for designing and implementing career-related interventions. Finally, examining antecedents and outcomes of future-oriented emotions combinations underlines the importance of taking emotional anticipation processes into account when individuals prepare for and cope with major educational and career transitions.

Peritoneal Dialysis with Rigid Catheters in Children with Acute Kidney Injury: A Single-Centre Experience

Peritoneal dialysis (PD) is a simple and preferred modality of dialysis for children with acute kidney injury (AKI) in resource poor countries. The aim of the study is to evaluate the utility and safety of acute PD using rigid catheter in critically ill children admitted to pediatric intensive care unit (PICU) with emphasis on short-term patient and renal outcome and complications. In this retrospective study, outcome and complications of PD using rigid catheter were evaluated in 113 critically ill children admitted in PICU of a tertiary care hospital from 2014 to 2019. The most common causes for AKI were sepsis (39.8%), dengue infection (16.8%), and hemolytic uremic syndrome (13.2%). In 113 patients, 122 PD catheters were inserted, and the median duration of PD was 60 (IQR: 36–89) hours. At the initiation of PD, 64 (56.6%) patients were critically ill requiring mechanical ventilation and inotropes, 26 (23%) had disseminated intravascular coagulation, and 42 (37%) had multiorgan dysfunction syndrome. PD was effective and there was a significant improvement in urea and creatinine, and one-third patients (n = 38; 33.6%) had complete renal recovery at the end of PD. Total complications were seen in 67% children but majority of them were metabolic (39.8%). Total catheter related complications were seen in 21.2% and peritonitis was seen in 4.4%. Catheter removal due to complications was required in 8.8% children. Overall, among children on PD, 53.7% survived. Acute PD with rigid catheters can be performed bedside in absence of soft catheters and significant clearance can be obtained without major life-threatening complications.

Impact of Primary Hemostasis Disorders on Late Major Bleeding Events among Anticoagulated Atrial Fibrillation Patients Treated by TAVR

Background: Bleeding events are among the striking complications following transcatheter aortic valve replacement (TAVR), and bleeding prediction models are crucially warranted. Several studies have highlighted that primary hemostasis disorders secondary to persistent loss of high-molecular-weight (HMW) multimers of the von Willebrand factor (vWF) and assessed by adenosine diphosphate closure time (CT-ADP) may be a strong predictor of late major/life-threatening bleeding complications (MLBCs). Pre-existing atrial fibrillation (AF) is a frequent comorbidity in TAVR patients and potentially associated with increased bleeding events after the procedure. Objectives: This study evaluated the impact of ongoing primary hemostasis disorders, as assessed by post-procedural CT-ADP > 180 s, on clinical events after TAVR among anticoagulated AF patients. Methods: An ongoing primary hemostasis disorder was defined by post-procedure CT-ADP > 180 s. Bleeding complications were assessed according to the Valve Academic Research Consortium-2 (VARC-2) criteria. The primary endpoint was the occurrence of late MLBCs at one-year follow-up. The secondary endpoint was a composite of mortality, stroke, myocardial infarction, and rehospitalization for heart failure. Results: In total, 384 TAVR patients were included in the analysis. Of these patients, 57 patients (14.8%) had a prolongated CT-ADP > 180 s. Increased MLBCs were observed in patients with CT-ADP > 180 s (35.1% versus 1.2%; p < 0.0001). Conversely, the occurrence of the composite endpoint did not differ between the groups. Multivariate analysis identified CT-ADP > 180 s (HR 28.93; 95% CI 9.74–85.95; p < 0.0001), bleeding history, paradoxical aortic stenosis (AS), and major vascular complications following TAVR as independent predictors of late MLBCs. Conclusion: Among patients with anticoagulated AF, a post-procedural CT-ADP > 180 s was identified as a strong independent predictor of late MLBCs. These findings suggest that persistent primary hemostasis disorders contribute to a higher risk of late bleeding events and should be considered for a tailored, risk-adjusted antithrombotic therapy after TAVR.

Assessment of the Depression Level among Medical Students at University of Baghdad, College of Medicine

Background: Depression, a state of low mood and aversion to activity, can affect people's thoughts, behavior, tendencies, feelings, and sense of well-being. It can either be short-term or long-term, depending on the severity of the person's condition. Risk factors include personal or family history of depression, major life changes, trauma, stress, certain physical illnesses, and medications. Objective: This study investigates the prevalence of depression among medical students at the University of Baghdad, college of medicine in Iraq, and the association between some variables and depression. Subjects and Methods: A cross-sectional study design with a convenience sampling method was conducted. A sample of 323 medical students attending the University of Baghdad, college of medicine, were included in this study between July 2019 and September 2019, regardless of their age or gender. The study included five grades according to the year 2019-2020. An online survey was conducted using Google Forms which included two sections. Section 1 included questions about participants' demographics. The second section included the PHQ-9 (Patient Health Questionnaire-9) score. Results: A total of 323 students of different demographics participated in this study. The number of males was 108 (33.4%), and the number of females was 215 (66.6%). The frequency of participants who got mild depression was the highest, i.e., 127 (39.3%), whereas 85 (26.3%) were non-depressed. Therefore, this study sample had a high prevalence of depression. On the other hand, the frequency of mild-moderate depression was 57.9%. Conclusion: The prevalence of depression among medical students at the University of Baghdad was high. Gender, having friends, having a medical condition or disease, having family issues, whether it's easy to communicate with others, encountering an event that affected them, and having a family member who suffers from a psychological condition are associated with depression among students. In contrast, age, marital status, college year, seeking help in the past, and having a part-time job have no association with depression

Emotional anticipation of future vocational transitions: A person-centered approach

Most future educational and career transitions represent major life events that individuals anticipate to a considerable extent, possibly with multiple emotions at the same time. However, few studies have examined the emotions that individuals experience when they anticipate a future educational or career transition, imagine how it will occur, the consequences it will have for them, and visualize their coping efforts. The aims of the present dissertation are fourfold. First, we explore individuals’ combinations of multiple future-oriented emotions at the prospect of three major educational and career transitions: (a) the transition from high school to higher education, (b) the transition from higher education to the job market, and (c) the transition from unemployment to employment. Due to the rather exploratory nature of our first research question, our second objective pertains to the replication of these combinations and the investigation of similarities between several groups of individuals based on (a) gender, (b) institutional context, and (c) the temporal distance before the transition. Third, we examine several antecedents of individuals’ combinations of future-oriented emotions. These antecedents ranged from career-related constructs such as career decidedness and career adaptability to affective mechanisms such as cognitive appraisals, trait affect, and emotion regulation. Finally, we examine the behavioral effects of future-oriented emotions in terms of anticipated vocational planning and effort. Overall, the present dissertation brings several implications in highlighting the combinations of future-oriented emotions that individuals experience when anticipating important vocational transitions, a research strand that is scarce both in vocational and emotion research. From a practical point of view, the evidence of several combinations—and the differences and similarities among several groups or contexts—carries practical implications for designing and implementing career-related interventions. Finally, examining antecedents and outcomes of future-oriented emotions combinations underlines the importance of taking emotional anticipation processes into account when individuals prepare for and cope with major educational and career transitions.

Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury

Purpose: Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study. Method: This clinical focus article was written by the Academy of Neurologic Communication Disorders and Sciences TBI Research Group along with a VR expert. Authors engaged in deliberative, agenda-based discussions beginning with a literature review based on previous systematic studies. Discussions explored relevant VR and SLP practices. Results: This clinical focus article presents key VR models in parallel with SLP assessment and treatment to illustrate best practice patterns in an RTW field with a dearth of SLP-specific literature. We summarize general VR approaches and four evidence-supported VR models for adults with TBI. We highlight how a model of interprofessional assessment can assist with planning and communication of important work-related concerns. We illustrate how the chronological model of work return can assist with developing goals and planning treatment. Conclusions: SLPs play an important role in identifying, managing, and collaborating with an RTW team following TBI. A working knowledge of VR models can assist with improving the dialogue between SLPs and VR professionals and can inform practice when working with persons with TBI who have work return as a goal.

Transitions Into and Out of Voluntary Work Over the Life Course: What is the Effect of Major Life Events?

The aim of the current study is to investigate which major life events are associated with transitions into and out of volunteering over the life course and, especially, why these associations exist. Social Production Function theory is used to derive hypotheses, which are tested using longitudinal data (adult subsample) from Lifelines. Associations between major life events and (a) volunteer take-up, nonvolunteer sample ( N = 59,773) and (b) volunteer cessation, volunteer sample ( N = 32,143) are studied by applying Linear Probability Modeling. Results show clear associations between specific major life events and starting and quitting volunteering. The influence on the latter is stronger than on the former. Most findings are in line with our theory-based expectations indicating that (a) voluntary work contributes especially to the fulfillment of the needs for status, stimulation, and behavioral confirmation and (2) life events causing losses (gains) in these needs are associated with a higher likelihood to take-up (quit) volunteering.

Depression, anxiety, and happiness in dog owners and potential dog owners during the COVID-19 pandemic in the United States

Major life events, such as the COVID-19 pandemic, affect psychological and physiological health. Social support, or the lack thereof, can modulate these effects. The context of the COVID-19 pandemic offered a unique opportunity to better understand how dogs may provide social support for their owners and buffer heightened symptoms of stress, anxiety and depression and contribute to happiness during a major global crisis. Participants (768 pet dog owners and 767 potential pet dog owners) answered an online survey, including validated depression, anxiety, happiness psychometric scales, attitude to and commitment towards pet, and perceived social support. Potential pet dog owners were defined as individuals who did not own a dog at the time of the survey but would be very or extremely interested in owning one in the future. Dog owners reported having significantly more social support available to them compared to potential dog owners, and their depression scores were also lower, compared to potential dog owners. There were no differences in anxiety and happiness scores between the two groups. Dog owners had a significantly more positive attitude towards and commitment to pets. Taken together, our results suggest that dog ownership may have provided people with a stronger sense of social support, which in turn may have helped buffer some of the negative psychological impacts caused by the COVID-19 pandemic.