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Objective: People living with dementia are at risk of mouth and dental problems. Many receive help with this aspect of personal care from family carers or homecare workers. We explored the views of homecare providers and carers on how this aspect of personal care is addressed and implemented. Materials and methods: In this qualitative study we conducted semi‐structured interviews with carers (all family members), homecare workers and managers providing support to people living with dementia in their own homes. Interview questions focused on daily care practices, exploring barriers and facilitators to oral care. Interviews were recorded online or over the telephone, transcribed, and thematically analysed. Results: Carers (n = 8), homecare workers (n = 9) and homecare managers (n = 15) were recruited from across England in 2021–2022. Across interviews, two main themes were identified: (i) Missed opportunities to address oral care, which is not always seen as a priority despite the importance and potential risk of neglect. (ii) Challenges in delivering oral care, including factors related to the person living with dementia (such as cognitive and physical decline) and factors related to the care infrastructure and policies such as training, perception of roles, allocated time, and consistency of care. Discussion: More emphasis could be given to the training and skills of homecare providers to identify and prevent dental problems and to assist carers. Several strategies and tools (oral care checklists, greater detail around oral care in care assessments and care plans) could be used to enhance this aspect of personal care for people living with dementia. Key points: Mouth and teeth care is important for people living with dementia in their own homes because they are at higher risk of dental problems than the general population. However, this aspect of personal care can be overlooked and information may not be shared or recorded.Mouth and teeth care and the risks of poor oral hygiene in dementia could be more consistently addressed and more integrated in assessment and care planning.There are barriers to addressing oral care. The practitioners could utilise available resources or checklists as reminders to have these assessments in place.Oral health care guidelines and skills training in homecare may be timely. [ABSTRACT FROM AUTHOR]

The pathophysiology of stroke is well characterized, and 9 out of 10 strokes are due to modifiable factors. However, preventive strategies thus far have been relatively ineffective in curbing the global stroke burden, which is projected to increase given the aging of the world's population and epidemiological transition in many low- to middle-income countries. In this review we will summarize our current understanding of behavioral, environmental, and metabolic stroke risk factors not covered elsewhere in this issue. Specifically, we will review the evidence for environmental and household air pollution, smoking, and alcohol use. We will subsequently provide a conceptual framework for stroke prevention strategies, categorizing them as those aimed at changing health care systems and/or provider behavior and those targeting behaviors of patients and/or their caregivers, families, and support networks. The field of stroke prevention is relatively nascent, and little is known about how to optimize health care systems so that providers prescribe evidence-based care for stroke prevention, patients have access to care to receive such services, adherence and control of risk factors are optimized, and patients are empowered to manage their own risk factors andmake lifestyle changes, including eating healthy diets (high in fruits, vegetables, and whole grains and low in sodium and sugar-sweetened beverages), engaging in regular physical activity, not smoking, and limiting alcohol consumption. In the next several years, we will likely develop a better understanding of which strategies are effective for modifying vascular risk factors, and how to design and implement successful interventions. Key questions to be answered include optimal theoretical frameworks, delivery models, team composition, timing, dose, intensity, and frequency, taking into account cultural, sociodemographic, and regional differences in patient populations. [ABSTRACT FROM AUTHOR]

This study examines data from a survey conducted at a U.S. public research university, focusing on students' behaviors and attitudes toward the library, both physical and online. The analysis categorizes student users and nonusers based on demographics such as full-time enrollment, first-generation status, college, and grade point average (GPA). Results indicate that first-generation students were most likely to never use the online library. Low GPA respondents visited the physical library most frequently, whereas high GPA students were more inclined to use e-resources. The discussion section includes suggestions for improving services and resources to support student success. [ABSTRACT FROM AUTHOR]

The article discusses a study which compares the ability of a repetitive task-specific practice regimen to the subjects with chronic, balanced upper extremity impairment. Volunteers were recruited from local stroke support groups and outpatient rehabilitation clinics. It focused on Stroke Impact Scale activities of daily living (ADL) domains. It concluded that therapist managed repetitive task-specific practice assimilating robotics is adequate.

OBJECTIVES To assess the validity of our observational experience that a short course of oral prednisolone therapy might be of value in the management of symptoms of chronic pelvic pain syndrome (CPPS) in men. PATIENTS AND METHODS Twenty-one men with CPPS (inflammatory or non-inflammatory) for ≥6 months, and who had failed to improve with standard antibiotic therapy, were randomized to receive either a 1-month reducing course of oral prednisolone (nine) or an equivalent placebo regimen (12 men). The outcome measures used were the McGill Pain Questionnaire, the Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire-30 (GHQ-30) and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), which were completed at baseline and 3 months. RESULTS Outcomes were analysed for the 18 patients (six treated, 12 placebo) who completed the 3 months of follow-up. At both baseline and 3 months, respectively, there was no statistically significant difference between the groups in the NIH-CPSI total score ( P = 0.48 and 0.62; Mann–Whitney U-test), or in the HADS (anxiety, P = 0.85 and 0.67; depression P = 0.96 and 0.74), and there was no significant improvement or deterioration over time. Although not statistically significant, there was a trend to improvement in the depression score for the active group ( P = 0.13). However, the clinical significance is doubtful, as both baseline and follow-up depression scores were within the normal range. No patient had clinically negative changes in depression. A 3-month follow-up analysis was not possible for the McGill Pain Questionnaire or GHQ-30 as not all patients completed the questionnaire. CONCLUSIONS Whilst the study showed no clinical benefit of using corticosteroids in the management of CPPS, the few patients recruited limited the validity of firm conclusions from the data. There was a trend towards an improvement of depression levels amongst subjects. The study highlights the difficulties of recruitment and illustrates the complex psychological profiles of patients with CPPS. [ABSTRACT FROM AUTHOR]

In the present study, the authors investigated age differences in children's understanding (a) that a person's behavior may contribute to the formation of a shared opinion within the peer group and (b) that origins of a reputation can be direct or indirect. The authors read stories in which a target character engaged in either prosocial or antisocial interactions with peers to children in kindergarten, 2nd, and 4th grade. They then asked the children to judge how various peers viewed the target character. Children's explanations indicated that children in all of those age groups understood that firsthand experience influenced peers' opinions, and by 2nd grade, children understood that indirect experience or gossip also might have contributed to an individual's reputation. [ABSTRACT FROM AUTHOR]

Investigates children's understanding of inference as a source of knowledge. Children's observations about a puppet which made a statement about the color of hidden toys; Distinction made by 8-year and 9-year old children between inference and looking from guessing; Increase in the tendency of children to explain the puppet's knowledge with age.

Purpose: Medically underserved adults with spinal cord injury (SCI) remain at high risk of incurring medically serious pressure injuries even after receiving education in prevention techniques. The purpose of this research is to identify circumstances leading to medically serious pressure injury development in medically underserved adults with SCI during a lifestyle-based pressure injury prevention program, and provide recommendations for future rehabilitation approaches and intervention design. Methods: This study entailed a qualitative secondary case analysis of treatment notes from a randomized controlled trial. Participants were 25 community-dwelling, medically underserved adults with SCI who developed medically serious pressure injuries during the course of the intervention of the RCT. Results and conclusions: Among the 25 participants, 40 unique medically serious pressure injuries were detected. The six themes related to medically serious pressure injury development were: (1) lack of rudimentary knowledge pertaining to wound care; (2) equipment and supply issues; (3) comorbidities; (4) non-adherence to prescribed bed rest; (5) inactivity; and (6) circumstances beyond the intervention's reach. Together, these factors may have undermined the effectiveness of the intervention program. Modifications, such as assessing health literacy levels of patients prior to providing care, providing tailored wound care education, and focusing on equipment needs, have potential for altering future rehabilitation programs and improving health outcomes. To provide patients with spinal cord injury with the necessary information to prevent medically serious pressure injury development, health care providers need to understand their patient's unique personal contexts, including socio-economic status, language skills, and mental/cognitive functioning. When providing wound care information to patients with spinal cord injury who have developed a medically serious pressure injury, practitioners should take into account the level of health literacy of their patient in order to provide education that is appropriate and understandable. Practitioners should be aware of how to help their patient advocate for outside services and care that address their equipment needs, such as finding funding or grants to pay for expensive medical equipment. [ABSTRACT FROM AUTHOR]

ABSTRACT. The authors investigated children's understanding of how mistaken beliefs can arise through misinterpretation of ambiguous information. Children (N = 91), aged 4 to 5 years, were given pre-and posttests on their ability to infer a puppet's interpretation of a restricted-view drawing after the puppet had been led to an erroneous expectation about the drawing's identity. Before the posttest, the children received either self-explanation training or other-explanation training in which they explained the source of their own or a puppet's misinterpretations of drawings; a control group received no training. The children who received training improved from pre-to posttest, and those who had practiced explaining misinterpretations by referring to previously viewed pictures or to features of a target picture showed the greatest improvement. These results indicate that learning to explain misinterpretations can help children recognize situations in which misinterpretations are likely to occur. [ABSTRACT FROM AUTHOR]