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Chemotherapy-induced peripheral neuropathy (CIPN) refers to numbness, tingling, and burning sensation caused by chemotherapy that can cause impairment in Quality of Life (QoL) of the patients. Study assesses severity, risk factors, and quality of life of patients associated with CIPN. A cross sectional descriptive study was conducted at day care ward, tertiary care hospital India. Total of 98 patients receiving paclitaxel for ≥4 months were enrolled by convenient sampling. Data regarding demographics and clinical characteristics, CIPN severity, risk factors, and QoL were collected by structured questionnaires. Study revealed that median score of autonomic symptoms was higher than sensory and motor symptoms. Mean score of FACT/GOG-Ntx sub-domain was 99.05 ± 20.87on a scale of 0 to 152. ECOG Performance status, current exercise behavior, and fruit and vegetable intake was found to be significantly (at p <.05) associated with sensory, motor, and autonomic symptom score. Therefore, CIPN was found to have debilitating effect on QoL. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is one of the most common and serious problems in old age that if not controlled, leads to reduced daily activities. The aim of this study was to determine the effect of acupressure on pain and daily activities in elderly women. Methods: This was a quasi-experimental study with a pre-test and post-test design, which was conducted on 80 elderly women who were referred to the health centers of Qazvin, Iran. The subjects were randomly assigned to the experimental (n=40) and control (n=40) groups. The data were collected by visual analogue scale (VAS) and barthel index (BI). The experimental group received ten sessions of acupressure for three consecutive weeks on the related acupoints (LIV3, UB62, SP9, GB34, UB17, GB30, UB (UB25-UB11), GB20, GB21). Each acupoint was massaged for one minute in a circular motion until the elderly could bear it. The control group received sham acupressure. Post-test was performed one week after the end of ten intervention sessions. The data were analyzed by Chi-square test and independent t-test using SPSS software v. 20. The significance level was set at P<0.05. Results: Before the intervention, there was no statistically significant difference in the level of pain intensity (P=0.352) and daily activities (P=0.420) between the groups. After the intervention, the pain intensity of the subjects in the intervention group decreased (P<0.001) and their daily activities improved compared to the control group (P<0.001). Conclusion: According to the findings, acupressure is an affordable, low-cost, easy, and non-invasive complementary therapy, which is recommended to reduce pain intensity and promote activities of daily living in older women. [ABSTRACT FROM AUTHOR]

In addition to palliative care delivery at home or in hospital, palliative day care centres occupy an in‐between position in palliative care. In palliative day care centres, multidisciplinary teams provide holistic care and support for people with (chronic) life‐limiting conditions, or clients, in a homely surrounding, allowing them to remain living at home while attending a specialist palliative care service. This study aims to evaluate palliative day care centres from a user perspective. We conducted a full‐population cross‐sectional survey of clients (N = 86) and their family caregivers (N = 63) in all five palliative day care centres in Flanders, Belgium from January until December 2019. We used validated instruments supplemented with self‐developed items to measure participants' reasons for use, support provided, unmet support needs and added value to other (palliative) care services across palliative care domains, i.e., physical, psychological, social and spiritual care. Response rate was 77% for clients and 81% for family caregivers. The most often indicated reasons for use were that the client needs social contacts (clients: 73%, caregivers: 65%), to enable the client to live at home as long as possible (resp. 58%, 55%) and to reduce the family caregiver's mental burden (resp. 42%, 65%). Three out of four family caregivers felt better able to combine daily activities with caring for the client (77%) and felt better able to perform their family care‐giving tasks (77%) because the client attends the palliative day care centre. Thirty‐six per cent of clients had received support for social needs exclusively in the palliative day care centre and not from any professionals outside palliative day care. Palliative day care centres seem to be of added value for those care domains to which often less attention is paid in other settings, particularly social and emotional support, both for clients and family caregivers. [ABSTRACT FROM AUTHOR]

The objectives of the study were (a) to compare self‐reported Quality of Life (QoL) in a 24‐month follow‐up of people with dementia attending day care designed for people with dementia (day‐care group, DC) with people with dementia who did not attend day care (control group, CG) and (b) to explore factors associated with QoL. A quasi‐experimental design with a 24‐month follow‐up period was used. The DC group included 181 participants recruited from 53 day‐care services. The CG included 76 participants recruited from 19 municipalities with no available day care designed for people with dementia. The sample covered the four health regions of Norway and inclusion period lasted from December 2013 to July 2015. The Quality of Life in Alzheimer's Disease (QoL‐AD) scale was used as the outcome measure. The differences in QoL between groups and the associations between participant characteristics and QoL, such as depressive symptoms and functional dependency, were examined using a linear mixed model. In the multiple model, the overall trend in QoL did not differ significantly between the DC and CG. However, the DC group exhibited significantly higher self‐reported QoL than the CG at all time points (p < 0.001 at T0, p = 0.018 at T12, and p = 0.006 at T24). Participants with shallow or no awareness who attended day care had significantly higher scores on QoL‐AD than persons with full awareness (p = 0.017). More depressive symptoms (p < 0.001) and higher functional dependency (p < 0.001) were associated with lower self‐reported QoL. The study revealed higher scores of self‐reported QoL among people attending day care compared with those who did not attend, showing that day care might have positive impact on the lives of people with dementia. [ABSTRACT FROM AUTHOR]

Due to the increasing ageing population, how can caregivers effectively provide long-term care services to meet the older adults' needs with finite resources is emerging. In addressing this issue, nursing homes are striving to adopt smart health with the internet of things and artificial intelligence to improve the efficiency and sustainability of healthcare. This study proposed a two-echelon responsive health analytic model (EHAM) to deliver appropriate healthcare services in nursing homes under the internet of medical things environment. A novel care plan revision index is developed using a dual fuzzy logic approach for multidimensional health assessments, followed by care plan modification using case-based reasoning. The findings reveal that EHAM can generate patient-centred long-term care solutions of high quality to maximise the satisfaction of nursing home residents and their families. Ultimately, sustainable healthcare services can be within the communities. [ABSTRACT FROM AUTHOR]

Every country in the world is facing serious demographic aging, since the average life expectancy is consistently increasing. Agencies involved in the implementation of caregiving through long-term care institutions can develop more convenient approaches using information and communication technology to enhance overall efficiency. Communication technology has enabled the strengthening of physiological instruments, improving the efficiency and quality of services, while integrating management systems for optimum efficiency. This work conducted empirical studies, collecting responses to questionnaires from residents and caregivers in five institutions located in the south of Taiwan. The PZB model, proposed by Parasuraman, Zeithaml, and Berry, was used to construct the questionnaire to analyze the service quality following the incorporation of information and communication technology. The results of the empirical study show that 34% and 63% of the relatives of the residents agreed and strongly agreed that the system was practical and convenient, respectively. As for the caregivers, 77% of them agreed or strongly agreed that the system was mobile, practical, and convenient, and they agreed that the system could significantly increase working efficiency, reduce waiting time, and improve administration for chronic diseases among care-home residents. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) is a prodromal phase of dementia and is considered an important period for intervention to prevent conversion to dementia. It has been well established that multicomponent day‐care programs including exercise training, cognitive intervention and music therapy have beneficial effects on cognition, but the effects on cerebral blood flow (CBF) in MCI remain unknown. This study examined whether a multicomponent day‐care program would have beneficial effects on the longitudinal changes of CBF in MCI patients. Methods: Participants were 24 patients with MCI attending a day‐care program; they underwent two 99mTc‐ethyl cysteinate dimer single photon emission computed tomography scans during the study period. We evaluated the association between the changes of regional cerebral blood flow and the attendance rate. Results: There was a significant negative correlation between the reduction of regional CBF in the right parietal region and the attendance rate. We found no significant relation between the baseline CBF images and the attendance rate. Conclusions: Our results suggest that continuous participation in a multicomponent day‐care program might prevent reduction in brain activity in patients with MCI. [ABSTRACT FROM AUTHOR]

Objectives: To describe the perceived and unmet needs for health and social services and their relative importance among families coping with dementia in urban China. Methods: We used data from a cross-sectional survey conducted between 2018 and 2019 in two cities in eastern China. Trained staff conducted structured interviews of family caregivers of people living with dementia at home to obtain individual characteristics as well as types of service needs of families coping with dementia. Service needs and utilization in 24 types of services across five domains (daily living, medical/nursing, rehabilitation, mental health, and other) were examined. Descriptive statistics were used to describe characteristics of the dyads and the ranking of services based on the percentage of respondents with perceived/unmet needs. Results: A total of 170 (87.6%) family caregivers completed the interviews. The mean age of the care recipient was 77.2 years (range: 60–102) and 65.3% were female. The mean age of family caregivers was 58.4 years (range: 28–90), and 57.1% were female. The top five services used by the care recipients were: primary care, medication management, housekeeping, activities of daily living assistance, and adult day service. The five services with the most unmet needs were: legal assistance (42.7%), hospice care (44.7%), respiratory secretion management (expectoration) (57.6%), life enrichment activities (65.4%), and companion care (67.0%). Except for transportation and dressing/grooming, working and nonworking caregivers reported similar relative importance of service needs. Conclusions: The findings suggest that people living with dementia and their family require a wide range of services and supports to live in the community. Future research and policy efforts should target the unmet needs of families to improve dementia care in the community and promote aging-in-place. [ABSTRACT FROM AUTHOR]

Copyright of Alcoholism & Drug Addiction / Alkoholizm i Narkomania is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Day centers provide opportunities for older people to achieve active and healthy aging. Staff play a significant role in day centers, although evidence is lacking concerning their role. To explore the experiences of staff in promoting active and healthy aging at social day centers, interviews with 12 staff working at day centers for older people were carried out. The findings present two categories: the actions of the staff and conditions affecting activities at the day centers. Staff at day centers may play an important role in providing opportunities for older people to maintain health and participation in meaningful activities. [ABSTRACT FROM AUTHOR]

Background: Persons living with dementia (PLWD) in adult day centers (ADCs) represent a complex and vulnerable population whose well-being is at risk based on numerous factors. Greater knowledge of the interaction between dementia, chronic conditions, and social determinants of health would enable ADCs to identify and target the use of their resources to better support clients in need of in-depth intervention. The purpose of this paper is to (a) classify PLWD in ADCs according to their level of medical complexity and (b) identify the demographic, functional, and clinical characteristics of those with the highest degree of medical complexity.Methods: This was a secondary data analysis of 3052 clients with a dementia diagnosis from 53 ADCs across the state of California between 2012 and 2019. The most common diagnosis codes were organized into 28 disease categories to enable a latent class analysis (LCA). Chi-square test, analysis of variance (ANOVA), and Kruskal-Wallis tests were conducted to examine differences among latent classes with respect to clinical and functional characteristics.Results: An optimal 4-class solution was chosen to reflect chronic conditions among PLWD: high medical complexity, moderate medical complexity, low medical complexity, and no medical complexity. Those in the high medical complexity were taking an average of 12.72 (+/- 6.52) medications and attending the ADC an average of 3.98 days (+/- 1.31) per week-values that exceeded any other class. They also experienced hospitalizations more than any other group (19.0%) and met requirements for the nursing facility level of care (77.4%). In addition, the group experienced the greatest frequency of bladder (57.5%) and bowel (15.7%) incontinence.Conclusions: Our results illustrate a high degree of medical complexity among PLWD in ADCs. A majority of PLWD not only have multimorbidity but are socially disadvantaged. Our results demonstrate that a comprehensive multidisciplinary approach that involves community partners such as ADCs is critically needed that addresses functional decline, loneliness, social isolation, and multimorbidity which can negatively impact PLWD. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To examine the expectations of informal caregivers, nurses, and dementia trainers regarding the support of (physical and psychosocial) human needs by humanoid social assistive robots (SARs) in dementia care. A qualitative study was conducted with 11 homogeneous focus groups of informal caregivers, nurses and dementia trainers providing dementia care at home, in adult daycare centers, or in nursing homes. A qualitative content analysis was performed using a concept- and data-driven coding frame. Focus group discussions with 52 individuals were held. Participants reported mostly positive expectations and stated that SARs could offer potential support in all components of human needs, especially in avoiding danger (e.g. recognise danger, organise help), communication/contact with others (e.g. enable telephone calls, provide company), daily activities (e.g. remind of appointments, household obligations), recreational activities (e.g. provide music), eating/drinking (e.g. help cook), and mobility/body posture (e.g. give reminders/instructions for physical exercise). Participants also mentioned some negative expectations in all human needs, predominantly in communication/contact with others (e.g. loss of interpersonal interaction) and avoiding danger (e.g. scepticism regarding emergencies). Participants stated that SARs had great potential to provide assistance in dementia care, especially by reminding, motivating/encouraging and instructing people with dementia. Informal caregivers and nurses also considered them as useful supportive devices for themselves. However, participants also mentioned negative expectations, especially in communication/contact with others and avoiding danger. These findings demonstrate the support caregivers and dementia trainers expect from humanoid SARs and may contribute to their optimisation for dementia care. [ABSTRACT FROM AUTHOR]

Objective: To study the relationship between cesarean Delivery (CD) and overweight in preschool children, considering the presence of birth aspects and demographic characteristics that have been associated with the risk of excess weight. Methods: This retrospective cross-sectional analysis used representative data of children from 2 to 6 years of age at municipal daycare centers in Taubaté, São Paulo, Brazil. The sample included 752 preschoolers. Weight and height were collected in daycare centers, and the nutritional status classification was performed using z scores of Body Mass Index (zBMI). Data analysis was performed in the bivariate and multivariate manner, the latter with the inclusion of another possible risk factor. Adjustments were made for daycare centers time, sex, birth length and weight and maternal schooling. Results: The mean age of preschool children was 4.7 years, and 53.8% were boys. The prevalence of overweight children was 21.7%. The median zBMI of the children born by CD was higher than that of vaginal Delivery (p = 0.0194). The prevalence of overweight showed association with CD (p = 0.0196; PR = 1.397 with 95% CI of 1065–1831). Logistic binary multivariate regression analysis confirmed the association, even in the presence of other possible risk factors (CR: 1.580, 95% CI: 1.072–2.330). Conclusion for Practice: Birth by CD is one of the factors that are associated with the early development of overweight in preschoolers. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity is a predictor of the health outcomes of the older adults, and many approaches have been introduced for its implementation. The present study aimed to investigate the effect of group physical games on life quality (QOL) of older adults at an adult day care center. Methods: This quasi-experimental study was conducted using pre-test and post-test. Using convenience sampling, a total of 50 senior citizens above 60 years of age from two adult daycare centers of Babol and Amol in 2017 was placed in an intervention (25) and a control (25) group, respectively. The intervention group received physical games program twice a week for 6 weeks. The SF12 questionnaire was used to assess the QOL. The statistical analysis of the variables was carried out using t-tests, Wilcoxon, and Mann-Whitney tests at a significant level (P < 0.05) with SPSS software. Results: The QOL scores of the participants in the intervention group, compared to the control group have significantly improved (p < 0.001). The calculated difference for the quality of life of the intervention group was (d = 4.40 ± 2.36) being (d = 1.68 ± 1.74) and (d = 2.72 ± 1.51) in the physical and mental aspects, respectively. Conclusion: Physical exercise program (especially stationary physical game) can improve the quality of life of the older adults both physically and mentally. Therefore, such activities can be used to improve the quality of life of the older adults. [ABSTRACT FROM AUTHOR]

Quality assurance in long-term care settings requires outcome evaluation reflecting client-specific needs of service use. This study aimed to explore the clients’ needs of adult day care (ADC). Data of 360 clients from 11 ADC agencies in Japan were analyzed. Clients’ needs for ADC use were evaluated by their respective ADC staff using 17 items of four domains: “social participation,” “hygiene and health,” “exercise and eating habits,” and “family support.” The prevalence of four domain needs was calculated and the relationship between physical independency and the presence of needs in the four domains was examined by the chi-squared test. A total of 291 (80.8%) clients had one or more needs while 69 (19.2%) clients had none. The social participation need was most prevalent (270, 75.0%) and 249 clients (69.1%) had combination needs, including social participation, along with another domain. “Feeling like revisiting the ADC” was the most common need (60.6%); it was more frequently needed by those with a higher level of independence (p = 0.003). The study findings suggest that an outcome measure relevant to social participation can be considered as the most common benefits of ADC use. However, ADCs with clients who are more dependent should consider hygiene, nursing, and family support needs.

Perhaps old news by the time this commentary is published, but essential to our work with children and families, the U.S. Surgeon General Vivek Murthy has issued a public health advisory about the level of stress that parents in the United States face in trying to raise their children (Murthy, 2024). He cites the APA study statistic that 48% of parents report their day as overwhelming, compared to 26% of other adults (APA, 2023), a study which looked at trauma as a national aftereffect of the pandemic. [ABSTRACT FROM AUTHOR]

Objective: Chemotherapy-induced alopecia (CIA) is one of the most common and distressing side effects of chemotherapy treatment. This study aims to assess the illness perceptions of female patients dealing with CIA, and their associations with demographic and clinical characteristics, coping strategies, and quality of life. The secondary aim was to compare the illness perceptions of patients with CIA with other samples, to help elucidate the specific perceptions of patients with CIA. Method: Forty female patients at risk of severe hair loss due to chemotherapy treatment were included at the oncological daycare unit of a teaching hospital in the Netherlands. Patients were asked to complete the Brief-Illness Perception Questionnaire (B-IPQ) and the Hair Quality of Life (Hair-QoL) questionnaire. Results: Illness perceptions indicated that although patients understood their hair loss, they lacked being able to make sense of managing it, negatively impacting patients' lives. Psychological quality of life was significantly correlated with the B-IPQ domains: consequences, degree of concern, and emotional response. Social quality of life was significantly correlated with psychological quality of life. Patients with CIA felt significantly less able to manage their hair loss, compared to patients with breast cancer and psoriatic arthritis. Conclusion: As patients' beliefs of being able to manage their hair loss are important for adopting and maintaining adequate coping behaviors, additional effort of health care providers in fostering patients' sense of control is indicated, focusing on patients' strengths during and after chemotherapy treatment. In the context of developing interventions for patients with CIA, consequences, concern, and emotional response are the major dimensions that should be taken in account to help patients deal with hair loss. [ABSTRACT FROM AUTHOR]

Pressure ulcers (PUs) have a profound impact on individuals, with studies demonstrating that compared with similarly aged persons, those living with a PU have a significantly lower quality of life. The aim of this study was to explore the impact of the Shanley Pressure Ulcer Prevention Programme (SPUPP) on older persons' knowledge of, and attitudes and behaviours towards, PU prevention. This was a multi‐centre, open‐label, randomised controlled trial. The population of interest was older persons living in the community who attended either a day care centre or a retirement group and were deemed to be at risk of PUs due to reduced mobility. Stratified random sampling was used to randomise based on days of attendance at day care centre/retirement group. Pretest and post‐test were applied to the intervention and control groups. The SPUPP is a multimedia programme delivered using electronic media, hard copy materials, activities, and patient diaries and addresses the key tenets of PU prevention as described by the SKIN bundle. The programme contains five separate sessions delivered over 5 weeks. The impact of the SPUPP was assessed using the patient knowledge of and attitude and behaviour towards PU prevention instrument (KPUP). A total of 64 persons, 32 in each group, took part in the study. Of these, 75% (n = 48) were female, with a mean age of 81.9 years (SD: 5.56 years). Further, 68.8% (n = 44) were either overweight or obese and 40.6% (n = 26) were usually incontinent of urine. There were no differences between the intervention and control groups in mean scores during the pretest stage. However, at post‐test, the mean scores for the intervention group were higher than the control group, 16.87 (SD: 1.88) versus 12.41 (SD: 3.21), respectively. For the post‐test stage, mean differences between the two groups in favour of the intervention group (∆ = 4.46) were statistically significant, as t = 6.76, P =.0001, and equal variances were not assumed. The SPUPP impacted positively on knowledge scores of the participants and positively influenced attitudes and behaviours towards PU prevention. Thus, this research provides information regarding the potential to enhance patient involvement in PU prevention. [ABSTRACT FROM AUTHOR]

Background: Transcranial direct current stimulation (tDCS) has been employed to boost working memory training (WMT) effects. Nevertheless, there is limited evidence on the efficacy of this combination in older adults. The present study is aimed to assess the delayed transfer effects of tDCS coupled with WMT in older adults in a 15-day follow-up. We explored if general cognitive ability, age, and educational level predicted the effects. Methods: In this single-center, double-blind randomized sham-controlled experiment, 54 older adults were randomized into three groups: anodal-tDCS (atDCS)+WMT, sham-tDCS (stDCS)+WMT, and double-sham. Five sessions of tDCS (2 mA) were applied over the left dorsolateral prefrontal cortex (DLPFC). Far transfer was measured by Raven's Advanced Progressive Matrices (RAPM), while the near transfer effects were assessed through Digit Span. A frequentist linear mixed model (LMM) was complemented by a Bayesian approach in data analysis. Results: Working memory training improved dual n -back performance in both groups submitted to this intervention but only the group that received atDCS+WMT displayed a significant improvement from pretest to follow-up in transfer measures of reasoning (RAPM) and short-term memory (forward Digit Span). Near transfer improvements predicted gains in far transfer, demonstrating that the far transfer is due to an improvement in the trained construct of working memory. Age, formal education, and vocabulary score seem to predict the gains in reasoning. However, Bayesian results do not provide substantial evidence to support this claim. Conclusion: This study will help to consolidate the incipient but auspicious field of cognitive training coupled with tDCS in healthy older adults. Our findings demonstrated that atDCS may potentialize WMT by promoting transfer effects in short-term memory and reasoning in older adults, which are observed especially at follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Patient-reported outcomes (PROs) use, via a computer registry, allows patients to report their symptoms enabling the detection of early signs of progression of the disease. For such a record, the patient needs to show certain skills in new technologies use. The present study aimed to analyse the perception and degree of digital literacy of patients undergoing oncological treatment in an Oncology Day Hospital (ODH). Methods: A cross-sectional descriptive study was performed, where the degree of literacy of patients attending antineoplastic treatment at the ODH was examined by means of an anonymous survey. Results: A total of 122 patients have been included in the study. The proportion of subjects who use the electronic mail (TM) and the Internet on a daily basis was 45.1% and 70.5%, respectively, and up to 77.9% from the subjects considered that the use of digital 2.0 strategies could help improve communication between healthcare professional and patient. The TM was determined by the age, educational level and employment status of the individual. Furthermore, the age of the patients conditioned their perception of the usefulness of the web 2.0 tools (T2.0). Conclusion: This study allowed us to establish a target patient profile to conduct the efficient monitoring of cancer progression by PROs. The results have shown that approximately 60% of the patients in our population could be potential candidates to receive PROs-based health care. This approach enables earlier detection of symptoms and signs of progression and consequently, improves health outcomes for cancer patients. [ABSTRACT FROM AUTHOR]

Aim: To clarify the difference in the longitudinal effects of physical exercise on health‐related outcomes according to the baseline frailty status (frail or non‐frail) in community‐dwelling older adults. Methods: Participants included 177 adults aged ≥65 years who carried out multicomponent physical exercises (strength, aerobic, gait and balance) for 40 min, one to three times per week, for 1 year at a day‐care center. Bodyweight, comfortable walking speed, 6‐min walking distance and Mini‐Mental State Examination were measured at baseline and every 3 months. For longitudinal trend, we analyzed the change in scores from baseline for each outcome using the linear mixed effects model. Fixed effects included "group" (frail or non‐frail), "time" (4 time points every 3 months, from 3 to 12 months) and "interaction between group and time." Results: The effect sizes from baseline showed almost all positive values for each outcome. The linear mixed effects model showed significant effects on "interaction between group and time" in changes in bodyweight (P = 0.033), "group" in changes in walking speed (P = 0.013) and "time" in changes in the Mini‐Mental State Examination (P < 0.001). Bodyweight showed a decreasing trend in the non‐frail group after 3 months, unlike in the frail group. For walking speed, moderate effect sizes (d = 0.67–0.74) were sustained over time in the frail group, as did lesser effect sizes (d = 0.26–0.40) in the non‐frail group. Conclusions: Exercise‐based multicomponent interventions were effective for both groups. The longitudinal effects on walking speed and bodyweight were greater in the frail group. Geriatr Gerontol Int 2022; 22: 213–218. [ABSTRACT FROM AUTHOR]

Background: We sought to assess diet quality among people with intellectual disabilities or borderline intellectual functioning, living in residential facilities or receiving day care. Methods: We measured diet quality using the Dutch Healthy Diet Food Frequency Questionnaire (DHD) and compared this between participants with (n = 151) and controls without intellectual disabilities (n = 169). Potential correlates of diet quality were explored. Results: We found lower mean diet quality among people with intellectual disabilities (M = 80.9) compared to controls (M = 111.2; mean adjusted difference −28.4; 95% CI [−32.3, −24.5]; p <.001). Participants with borderline intellectual functioning and mild intellectual disabilities had lower diet quality and higher body mass index than individuals with severe to profound intellectual disabilities. Being female was a predictor of better diet quality. Conclusions: Overall, we found that diet quality was low in the sample of people with intellectual disabilities or borderline intellectual functioning. [ABSTRACT FROM AUTHOR]

This short study looks at the use and benefit of the Vital 5 intervention, using a small cohort of 10 individuals in a London dermatology day centre. The Vital 5 is designed to address the biggest risk factors for ill health facing global populations, namely smoking, alcohol consumption, obesity, blood pressure and mental health. [ABSTRACT FROM AUTHOR]

Objective: To assess the preliminary effects of a buddy-style intervention to improve exercise adherence. Design: A parallel-group, open-label, pilot randomized controlled trial. Setting: Adult day-care centers. Participants: Sixty-five disabled older adults. Interventions: All participants underwent a 12-week home exercise program, and the intervention group received a 5–10 min buddy-style intervention between older adults in the intervention group once weekly at an adult day-care center. Main measures: Based on the exercise log calendar, the number of days of exercise was assessed for each of the three phases: 1–4 weeks, 5–8 weeks, and 9–12 weeks. Short physical performance battery was measured at baseline and after 12 weeks. Results: Of the 590 screened older adults, 65 were recruited and 33 were assigned to the intervention group. One participant in each group withdrew before the program began, and four and five patients in the intervention and control groups, respectively, dropped out by the 12-week assessment. Analysis of covariance of the 28 and 26 patients in the intervention and control groups, respectively, for whom exercise log calendars could be retrieved, showed that the intervention group (24.4/28 days) exercised significantly more days than the control group (20.6/28 days) at 9–12 weeks (P = 0.009). In the between-group effect of the intention-to-treat analysis of short physical performance battery, walking and standing test (P = 0.790, P = 0.829) were not significantly different, and balance test (P = 0.049) was significantly better in the control group. Conclusions: There was a preliminary effect of the buddy-style intervention to improve exercise adherence. [ABSTRACT FROM AUTHOR]

Introduction: Mild cognitive impairment (MCI) is considered an important period for interventions to prevent progression to dementia. Nonpharmacological interventions for MCI include exercise training, cognitive intervention, and music therapy. These play an important role in improving cognitive function, but their effects on brain plasticity in individuals with MCI are largely unknown. We investigated the effects of a multicomponent day-care program provided by the University of Tsukuba Hospital on the longitudinal brain volume changes in MCI patients. Methods: MCI patients who participated in the multicomponent day-care program and underwent whole-brain magnetic resonance imaging (MRI) twice during their participation (n = 14), were included. We divided them into two groups according to their attendance rate and conducted a between-group analysis of longitudinal volume changes in the whole cerebral cortex. Regional brain volumes derived from the patients' MRI were calculated with Freesurfer 6.0.0. Results: The neuroimaging analysis demonstrated that the left rostral anterior cingulate cortex volume was significantly preserved in the high-attendance group compared to that of the low-attendance group. Conclusion: Our results suggest that continuous participation in a multicomponent day-care program could help prevent a volume reduction in memory-related brain areas in patients with MCI. [ABSTRACT FROM AUTHOR]

Accessible Summary: In the UK very few people with learning disability and/or autism and their family‐carers have a paid job although a lot of them may wish to work. National plans from the Government have not helped to change this.This article talks about a consultation we did on adults with learning disabilities and/or autism who attend day centres and their family‐carers. We asked about their current situation, their employment and the barriers to work.We found out that very few people with learning disabilities and/or autism or their family‐carers were employed. We found that there were lots of things stopping people with learning disabilities and/or autism and family‐carers from being able to work.We conclude that disability theories like the "social model of disability" need to go back to looking at inclusion, citizenship and independence, based on the real life experience of people with a learning disability. The government needs to provide strong plans to help people with learning disabilities and/or autism and family‐carers get into work. "Co‐production" networks should be set up between people with learning disabilities and families to support employment. Background: Only 5.9% of working adults with a learning disability are in paid employment and their family‐carers are similarly likely to be unemployed, as they continue to take on an extended caring and advocacy role as the welfare state retreats. Despite social policy efforts to stimulate employment for people with a learning disability, there has been little or no progress. Changes in the language of welfare benefit departments seek to use the words once heralded as success for the Disability rights activists and proponents of the social model: such as Inclusion, independence and citizenship. A new definition of the social model of disability utilising Hannah Arendt needs to redefine the "private" sphere of the lived experience of people with a learning disability to allow for a better understanding of the inter‐dependencies that exist between people with a learning disability, their family carers and a wider support network. Materials and Methods: Empirical data were collected in a mixed methods study while undertaking a consultation on the future of day services for people with a learning disability in a Local Authority in the north of England, UK. Results: The results reveal high levels of inter‐dependence between people with a learning disability and their carers, combined with the continued financial struggle as a lived experience of caring. The study found that barriers in providing care and support restrict the rights of people with a learning disability and their carers to secure employment. Conclusions: There is a need to reconceptualise the social model of disability to more closely resonate with the lived experiences of people with a learning disability and their carers. A newly revised theoretical approach should incorporate the "private" sphere of live acknowledging the inter‐dependent, co‐produced relationships, between people with a learning disability and their carers to support and enable employment for both people with a learning disability and their carers under the Care Act 2014 (Department of Health, 2014). [ABSTRACT FROM AUTHOR]

The Bringing Art to Life (BATL) program was created as an art therapy intervention to increase social engagement, intergenerational engagement, and creative expression among persons living with dementia (PWD) in an adult day service. This is an evaluation of BATL program efficacy. A modified behavioral observation tool was used to quantify meaningful engagements as recorded in ethnographic field notes and test the hypotheses that: 1) engagements increase across art therapy sessions, and 2) engagements were more social than activity or art related. The increase in engagement across session was not significant. However, social engagements (M = 9.61, SD 4.6) were more prevalent than art engagements (M = 5.23, SD = 3.1) in each session (t(99) = 9.52,). A thematic analysis of social interactions recorded in the ethnographic field notes revealed themes related to reminiscence. The quantitative and qualitative data supported the BATL program as effective in engaging participants in social interaction and art activities. Specifically, quantitative data showed participants were engaged in conversations around reminiscence and discussion of creative expression with students. Intergenerational social interaction between PWD and college students is a critical and meaningful part of the BATL program, and the intervention created a safe space with focused activity through engagement with art, and this facilitated PWD in self-expression, including humor, advice, and legacy. [ABSTRACT FROM AUTHOR]

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The demand for lower limb arthroplasty is projected to increase significantly over the next three decades, which poses a major challenge to healthcare services. Novel solutions in arthroplasty services are required to meet the growing volume of patients that require essential orthopaedic surgery. These solutions must be safe, efficient, and reproducible at scale. They must also be robust to the disruption felt with increasing frequency from the need to accommodate the growth of unscheduled inpatient care services. Day case total hip arthroplasty (THA) has become established in North America and is being used with increasing frequency in the UK and Europe. This approach been shown to be safe and effective in a wide variety of settings and is associated with good outcomes and high levels of patient satisfaction. Day case arthroplasty may improve the efficiency and productivity of planned essential surgery by reducing the burden on inpatient services, and consequently the demand for day case THA is likely to increase. It is therefore essential that the principles of day case THA are included in the continued professional development of clinicians in orthopaedic surgery, anaesthetics and perioperative care, and allied health professionals involved in the delivery of arthroplasty services. The first part of this article offers a narrative review of day case THA and considers the relative merits of this approach to lower limb arthroplasty services. The second part describes the experiences of successful units and provides a summary of the principles that are essential to deliver safe and effective care. [ABSTRACT FROM AUTHOR]

Background: Two types of mentalization-based treatment (MBT), day hospital MBT (MBT-DH) and intensive outpatient MBT (MBT-IOP), have been shown to be effective in treating patients with borderline personality disorder (BPD). This study evaluated trajectories of change in a multi-site trial of MBT-DH and MBT-IOP at 36 months after the start of treatment. Methods: All 114 patients (MBT-DH n = 70, MBT-IOP n = 44) from the original multicentre trial were assessed at 24, 30 and 36 months after the start of treatment. The primary outcome was symptom severity measured with the Brief Symptom Inventory. Secondary outcome measures included borderline symptomatology, personality and interpersonal functioning, quality of life and self-harm. Data were analysed using multilevel modelling and the intention-to-treat principle. Results: Patients in both MBT-DH and MBT-IOP maintained the substantial improvements made during the intensive treatment phase and showed further gains during follow-up. Across both conditions, 83% of patients improved in terms of symptom severity, and 97% improved on borderline symptomatology. No significant differences were found between MBT-DH and MBT-IOP at 36 months after the start of treatment. However, trajectories of change were different. Whereas patients in MBT-DH showed greater improvement during the intensive treatment phase, patients in MBT-IOP showed greater continuing improvement during follow-up. Conclusions: Patients in both conditions showed similar large improvements over the course of 36 months, despite large differences in treatment intensity. MBT-DH and MBT-IOP were associated with different trajectories of change. Cost-effectiveness considerations and predictors of differential treatment outcome may further inform optimal treatment selection. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify how the family care of people living with dementia could be supported to make reliance on family care sustainable in the long term despite the impact of stress. A Realist Evaluation (Pawson & Tilley, 1997) was conducted to investigate this aim. An initial review established 'coping' as a primary means of mediating stressors associated with caregiving. However, there was a need to specify which coping approaches/strategies are most effective. In‐depth interviews were conducted with a purposive sample of family carers (n = 18) in a suburb in North East England from 2016 to 2017. Analysis of the data revealed 'social coping' (SC) that included an emotional support component as a critical mediator of family carer stress. Several key hindrances to the utilisation of SC, including underpinning causal factors, are explicated. Ways in which these hindrances might be overcome are discussed and guidelines introduced for how family carers, formal providers and practitioners can facilitate SC as a critical coping strategy in sustaining the family care of people with dementia over the long term. [ABSTRACT FROM AUTHOR]

Objective: To evaluate patients' experiences of shortened hospitalization in relation to bone grafting of unilateral alveolar clefts with mandibular symphyseal bone grafts. Design: Prospective cohort questionnaire study. Setting: Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Denmark. Patients: Thirty-nine (male n = 26, female n = 13) patients with unilateral residual clefts after primary reconstruction, mean age 10.4 years. Interventions: All patients underwent a standardized procedure with closure of the alveolar defect using mandibular symphyseal bone grafts. Patients were discharged within a day after surgery. Within 24 hours after discharge from surgery, patients and their parents filled in a 14-item psychometric questionnaire assessing the quality of their recovery. For all questions, a visual analogue scale (VAS) (0-10) was used. Main Outcome Measure: Patients' experience of shortened hospitalization in relation to secondary bone grafting of alveolar defects. Factors influencing the overall experience were measured using a VAS scale. Results: A significant correlation between "Information from the hospital" and feeling worried and anxious was found (P =.04). Additionally, the ability to sleep correlated with pain (P =.003) and with nausea (P =.001). Conclusions: Although this study included a limited number of patients, the findings suggest that treatment of alveolar residual cleft with bone grafting from the mandibular symphyseal region in a day care surgery setting is characterized by very high patient satisfaction. [ABSTRACT FROM AUTHOR]

Background:The long-term care insurance system for the elderly is being implemented as a social support for the elderly in need of care. As of 2022, as the use of adult day care centre among home benefits is on the rise, it is necessary to devise measures to reduce the caregiving burden and family conflicts targeting the caregivers of the elderly who use adult day care centre. Objectives: The purpose of this study is to examine the dual mediating effect of caregiving mastery and self-esteem on the relationship between caregiving burden and family conflict. Methods:In this study, 304 caregivers of the elderly who received a long-term care grad and were using anadult day care centre were targeted. The data were analysed using SPSS PC+ Win. 24.0 and SPSS PROCESS macro 4.1. Applied statistical techniques were descriptive statistics, reliability analysis, correlation analysis, and double mediating effect analysis. Results:First, the age and length of support for caregivers increased the caregiving burden, but the health and economic status of caregivers lowered the caregiving burden and family conflict, and improved caregiving mastery and self-esteem. Second, the caregiving burden of the family caregiver was 2.51 points (out of 5 points) and family conflict was low at 1.85 points (out of 5 points). The parameter, caregiving mastery, was at 3.40 points (out of 5 points) and self-esteem was at 3.40 points (out of 4 points), which is a fairly high level. Third, the higher the caregiving burden, the higher the family conflict was, but the effect of the caregiving burden on family conflict through caregiving mastery and self-esteem was lowered. Conclusions: In order to reduce the impact of the burden of care on family conflict, it is necessary to improve the ability to solve problems in a positive way, such as mastery of caring and selfesteem. This suggests that adult day care centre need to provide caring education for family caregivers to increase their caring skills and provide counselling to improve their self-esteem. [ABSTRACT FROM AUTHOR]

Introduction: The Cognitive Orientation to daily Occupational Performance (CO-OP) ApproachTM is a leading approach in occupational therapy. Implementing the CO-OP ApproachTM in a group format in day rehabilitation has not yet been explored. Method: In day rehabilitation, a barrier to implementing the CO-OP ApproachTM is the group model. To address these challenges, this feasibility study involved the development, implementation, and evaluation of a CO-OP group for adults. Four patients participated in six group sessions. Pre- and post-measures included the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Subjective data were collected to reflect the participant's experiences during the group. Results: 80% of participants recruited completed the group. All participants demonstrated improvement in goals addressed within the group and goals not addressed within the group on the COPM. AMPS findings were inconclusive. Subjective findings indicated participants appreciated the group learning environment, valued the CO-OP process, were motivated to participate, and would have liked more groups. Conclusion: To our knowledge, this is the first adult CO-OP group in a clinical setting. Results support the feasibility of a CO-OP group in day rehabilitation and the need for further examination of the effectiveness of this intervention. [ABSTRACT FROM AUTHOR]

Oral exercise is a training method for swallowing dysfunction in older adults. The study investigated the effect of oral exercise on tongue pressure in older adults in Taiwanese community day care centers over a 3-month period. Participants over age 50 who were able to communicate and participating for the duration of the 12-week period were recruited from five community day care centers. A 15-min weekly group oral exercise activity was conducted. The tongue pressures were measured and multivariable linear regression models were used to assess the effect of oral exercise intervention on the participants' tongue pressures. A total of 66 older adult participants, among whom the mean age was 78.06 ± 10.74 years. Tongue pressure continued improving during the intervention period, and the mean tongue pressure at the end of the study was 20.63 ± 10.45 kPa, which was significantly higher than the baseline measurement (16.92 ± 10.62 kPa, p < 0.001). Participants exhibited significant improvement in tongue pressure regardless of their age groups. Moreover, participants with one to seven pairs of functional tooth units (FTUs) exhibited significantly more improvement in tongue pressure (16.00 kPa, 95% CI = 2.58–29.43) than those without FTUs (p = 0.021). Oral exercise over a 3-month period significantly improved tongue pressure among the study participants regardless of their gender or age group. Oral exercise should be integrated into comprehensive health promotion programs to assist in the improvement and maintenance of oral function among older adults. [ABSTRACT FROM AUTHOR]

In the military health system, there has been a growing demand for mental health services over the last two decades. Partial hospitalization programs fill a critical niche between outpatient and inpatient services. The present study evaluated immediate and long-term outcomes of a military mental health partial hospitalization program at a large military treatment facility. This study collected retrospective data of active duty patients who completed a 6-day partial hospitalization program within a 2-year period. Results showed that the majority of participants were young, male, and junior enlisted service members endorsing suicidal ideation as well as adjustment/stressor- and depressive-related psychiatric symptoms. Immediately after treatment, participants showed a significant reduction in psychiatric symptoms and dysfunction after treatment. In the long-term, most participants engaged in mental health services post-discharge, though engagement with services decreased over time. In addition, career-impacting medical recommendations were made for over half of participants with almost three-quarters of these recommendations made before or during enrollment in the program. This study expanded the limited evidence base for military mental health partial hospitalization programs. In addition, this study offered data on the frequency of career-impacting medical recommendations made for patients engaged in care at this level of acuity. [ABSTRACT FROM AUTHOR]

Introduction: The use of pain neuroscience education in older adults has seldom been reported. While this age group shows high rates of chronic pain prevalence, its characteristics may also challenge an intervention of this nature. This case series aimed to describe a group intervention of pain neuroscience education and dance in institutionalized older adults with chronic pain. Case Series: Seven older adults institutionalized in a day care center/nursing home with chronic pain entered the study and received a group intervention of six sessions of pain neuroscience education and dance. Participants were assessed at baseline and at the end of the intervention regarding knowledge of pain neurophysiology, pain intensity, depressive symptoms, catastrophizing, fear of movement and lower limb performance. Outcomes: There was a mean (±SD) decrease of −1.0 ± 2.3 for pain intensity and of −6.1 ± 9.7 for pain catastrophizing and a mean increase in the score of the pain neurophysiology questionnaire of 4.0 ± 3.1. Mean change values were smaller than the minimal detectable difference, but a few individual participants changed above the minimal detectable difference (four participants for pain intensity and 2 for pain catastrophizing and knowledge of pain neurophysiology). Conclusion: Results suggest pain neuroscience education is a feasible intervention and when combined with dance may have a positive impact on pain intensity. [ABSTRACT FROM AUTHOR]

Background: Work confers many benefits to persons with psychiatric disabilities. The daycare work programs can be helpful for patients in multiple ways. Many stakeholders plan and implement a daycare work program, including patients, caregivers, trainers, staff members, and professionals. The literature on daycare work programs is limited. The present study aimed to understand the impact and facilitators of a selected daycare work program (Green Skills Program [GSP]) from the lens of stakeholders. Methods: Criterion sampling was used to recruit the stakeholders who have been part of GSP. Twenty-seven stakeholders were interviewed using a researcher-prepared semi-structured interview schedule. Atlas. ti version 9 was used for coding. Thematic analysis was done to identify themes. Results: Stakeholders considered GSP easy, enjoyable, and accommodative to patients with different functioning levels. GSP participation was deemed as gainful engagement and vital to day-structuring. The patients worked in groups, which promoted peer learning and teamwork. Various behavioral, social, and work-related improvements were noted among the patients by the stakeholders. Incentives and social reinforcements were significant motivators. Stakeholders were content with the trainer's way of teaching the patients and felt that she possessed many essential attributes that motivated them and improved their work outcomes. Conclusions: While conceiving daycare work programs, ease of doing activities, accommodation of patients with varying levels of functionality, trainer's aptitude, and use of reinforcements should be considered. [ABSTRACT FROM AUTHOR]

Copyright of GMS Hygiene & Infection Control is the property of German Medical Science Publishing House gGmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: CareMOBI (Mhealth for Organizations to Bolster Interconnectedness) is a mobile application designed to facilitate information exchange between primary care providers (PCPs) and adult day centers (ADCs). A key function of CareMOBI is to synthesize information collected outside of the provider's office (ie,: in the ADC or at home) and distill the most relevant data points into an exportable clinical summary that can help inform clinical decision making by the PCP with information from outside providers who are not formally embedded within health systems. In this study, we used a qualitative approach to understand the acceptability and utility of the clinical summary template within CareMOBI. Methods: Purposive sampling, followed by snowball sampling, was used to recruit PCPs from a variety of primary care practice settings (i.e. home-based, academic). Semi-structured interviews were conducted virtually to elicit feedback on the user-experience after interaction with a prototype template. Interviews were recorded, transcribed, and analyzed using content analysis. Results: Our sample (n = 10) consisted of physicians and nurse practitioners in a variety of settings. Feedback suggested that the summary template facilitates interdisciplinary, bidirectional, succinct, and relevant information exchange across care teams. The summary template effectively integrates observations and assessments from team members, centralizes them, and allows PCPs to hone in on the most salient components to inform clinical decision making for the geriatric patient. The summary gave PCPs "live texture" about what was happening outside the office and represented a significant improvement over other methodologies of information exchange. Prior to implementation into clinical practice, several refinements are necessary based on feedback including integration into the PCP's workflow. Conclusions. The template was viewed by PCPs as a concise and actionable record, in contrast to current communication which is characterized as "bloated"--containing too many pages on nonessential information. The summary could potentially save PCP's time in locating and analyzing historical data to enable rapid patient assessment and prompt more ready and informed action. [ABSTRACT FROM AUTHOR]

Objective: To assess outcomes in adult patients with eating disorders administered enhanced cognitive behavioral therapy (CBT‐E) in a day‐hospital setting. Method: Forty‐three consecutive patients with eating disorders (86% females; mean age 28.8 [SD = 11.8]) were admitted to a 13‐week day‐hospital CBT‐E program. Twenty‐five (58.1%) patients were underweight (i.e., body mass index [BMI] <18.5 kg/m2; BMI 15.4 [SD = 2.2]) and 18 not (mean BMI 23.1 [SD = 6.3]) at baseline. All patients responded poorly to prior outpatient treatment. Body mass index and Eating Disorder Examination Questionnaire (EDE‐Q), Brief Symptom Inventory (BSI), and Clinical Impairment Assessment (CIA) scores were recorded at baseline, end of treatment, and 20‐week follow‐up. Results: In 37 patients (86.0%) who completed the treatment, there were substantial improvements in eating‐disorder features, general psychopathology, clinical impairment, and body weight (only in underweight patients), which were well maintained at follow‐up. Discussion: Day‐hospital CBT‐E is a promising treatment for adults with eating disorders. [ABSTRACT FROM AUTHOR]

Population ageing resulting from declining fertility and extended life expectancy has been occurring rapidly throughout the world. Older adults are faced with multiple physical, psychological and social changes that challenge their sense of self and capacity for healthy ageing. Intergenerational programmes (IGP) in communities have been developed to address a variety of social issues brought about by the population ageing. These programmes focus on promoting intergenerational social contact, supporting educational programmes and facilitating intellectual and/or physical activities in the older adults. This study intended to explore the perception of community‐dwelling older adults towards an IGP in a senior day care centre in Singapore. Purposive sampling was adopted to recruit 15 participants for the study. Individual face‐to‐face interviews were conducted until data saturation was achieved. Interviews were audio‐taped and transcribed verbatim. Thematic analysis was carried out. Four themes and 13 sub‐themes emerged: (1) IGP enhances memory and strength; (2) social interaction between older adults and younger generation; (3) emotional responses to IGP; and (4) attitudes and perception towards the younger generation. The current study illustrated the dynamic social interaction between older adults and the younger generation, as well as the perceived benefits of the IGP. The relationship formed between the two generations entailed companionship, mutual care, trust and affection. Participation in the IGP provided the older adults an opportunity for active engagement in society and development. Continuous effort must be put in to ensure continuity of integration and empowerment of older adults, including the removal of obstacles and barriers that exclude or discriminate against them. The study findings will help facilitate the customisation of IGP to meet the needs of the older adults. With a well‐planned and structured IGP, significant physical, emotional and psychosocial outcomes could benefit the older adults and the younger generation. [ABSTRACT FROM AUTHOR]

The present study aimed to clarify the process of peer support formation and the promotion of recovery in people using psychiatric day care. From January to March 2014, semi-structured interviews were conducted with 18 participants with mental illness living in the community in Japan. The qualitative data were analyzed using a modified grounded theory approach. The results described a two-stage process: (1) awareness of peers with similar disability and distress and (2) formation and utilization of peer support. These results suggest that adjusting the environment and engaging in activities assisting others are useful for facilitating peer support and promoting the recovery of users in psychiatric day care. [ABSTRACT FROM AUTHOR]

Background: Adult day care centers (ADCCs) are a common service provided for frail older adults in the community. We examined the influence of older adults' utilization of ADCC's on their quality of life (QoL), and whether ethno-regional disparities are factors in the gaps found concerning QoL in different regions and between different ethnic groups.Methods: Cross sectional data were collected through structured interviews with 360 older adults attending ADCCs. Participants represented three ethnic groups and three regions in Israel. QoL was assessed by SF-36 questionnaire.Results: The results revealed a positive correlation between weekly hours at the ADCC, satisfaction with attending ADCC, and QoL. Older adults living in the central region had higher QoL than those living in the southern and northern regions. Veteran Israeli Jews reported higher QoL than FSU immigrants Israeli Arabs in all regions. Connection to one's residential area was also correlated with QoL. A significant moderating effect of the interaction (ethnicity*area of residence) on QoL was also revealed.Conclusions: Attending ADCC is a vital community services to promote QoL in later life. Gaps in ADCC utilization between ethnic groups and residential region may cause disparities in QoL, specifically, in minority groups and those living in peripheral regions. Service providers should minimize the disparities by improving accessibility and availability for each person regardless of ethnicity and region of residence. [ABSTRACT FROM AUTHOR]

Natural disasters are often stressful for persons with cognitive impairment (PWCI) and caregivers. We investigated the impact of the Northern California 2017 wildfires on PWCI and caregivers who were participating in a research study of an integrative group movement program at an adult day center affected by the fires. One month and 7 months after the fires, we sent caregivers a survey that included the 10-item Perceived Stress Scale (PSS, range: 0–40) and open-ended questions to assess the psychosocial impact of the fires on PWCI and caregivers. We used paired t-tests to analyze PSS responses and qualitative content analysis for open-ended responses. Thirteen of the 17 caregivers returned at least one survey. Caregivers reported moderate levels of perceived stress at both time points, with no change over time (PSS mean: 20.4 vs. 21.3, p =.31). We identified three psychosocial domains impacted by the fires. First, both PWCI and caregivers experienced emotional distress. Second, PWCI exhibited a range of cognitive responses, including confusion and disorientation, no impact, hyperawareness, and improved cognitive function and adaptability. Third, despite emotional distress, some caregivers reported increased self-efficacy. Our results provide evidence of resilience in some PWCI and caregivers in response to the fires, despite emotional distress. This resilience may have been due to the sense of community that sometimes occurs following natural disasters, or it may have been a result of participating in the study, which was designed to promote social/emotional connectedness and may have provided a source of continuity and support during a time of tragedy. [ABSTRACT FROM AUTHOR]