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For patients hospitalized with COVID-19, delirium is a serious and under-recognized complication, and people experiencing homelessness (PEH) may be at greater risk. This retrospective cohort study compared delirium-associated risk factors and clinical outcomes between PEH and non-PEH. This study used patient records from 154 hospitals discharged from 2020–2021 from the Texas Inpatient Public Use Data file. Study subjects (n = 878) were patients, aged 18–69 years, who were hospitalized with COVID-19 and were identified as homeless. The baseline group included (n = 176,518) patients with COVID-19 aged 18–69 years who were not homeless. Logistic regression models were used to identify risk factors for delirium. Relevant risk factors included chronic comorbidities, substance use disorders, and traumatic brain injury (TBI). Seven of the delirium-associated risk factors were more prevalent among PEH compared to baseline. PEH had higher rates of TBI, alcohol, cannabis, and opioid use disorders. PEH had significantly higher rates of delirium (10.6% vs. 8.1%; P<0.01). However, PEH had fewer respiratory complications, including pneumonia (48.5% vs. 81.9%; P<0.001) and respiratory failure (28.7% vs. 61.9%; P<0.001), and lower in-hospital mortality (3.3% vs. 9.5%; P<0.001). The anti-viral Remdesivir had a protective effect against delirium (AOR = 0.63; CI: 0.60, 0.66). Mean hospital length of stay (LOS) was more than twice as long for delirious patients compared with non-delirious patients (18.4 days vs. 7.7 days; P<0.001). Delirium greatly increased the risk of in-hospital mortality (AOR = 3.8; CI: 3.6, 4.0). For PEH (n = 29) who died from COVID-19, delirium was present in more than half (52%) of cases. Hospitals should screen PEH for delirium and adopt nursing protocols to prevent delirium and reduce its severity. [ABSTRACT FROM AUTHOR]

Mental health issues are prominent among gender minorities; however, research examining these issues among college campuses is limited, and has often overlooked individuals who identify outside of transgender or cisgender identities. Our findings indicated that transgender participants reported the highest rates and frequencies of non-suicidal self injury, suicidal thoughts, and suicide attempt compared to cisgender peers; followed closely by gender-expansive participants. Gender minority participants reported higher rates of family distress and social anxiety. [ABSTRACT FROM AUTHOR]

Our study sought to provide a more nuanced understanding of the significant issues experienced by young adult survivors of child-maltreatment (CM) prior to seeking counseling services. More specifically, we examined differences between survivors of CM and participants with no CM histories related to non-suicidal self-injury (NSSI), suicidal ideation, and suicide attempt, and scores on the Counseling Center Assessment of Psychological Symptoms (CCAPS). In our sample of N = 2604 post-secondary students seeking counseling services, CM histories were significantly associated with higher frequencies of NSSI, suicidal ideation, and suicide attempt. Further, results indicated that survivors of CM reported significantly higher mean scores on all CCAPS subscales and were more likely to report scores that were considered "elevated" when compared to peers with no reported CM history. Implications for college counseling centers and college mental health providers are discussed. [ABSTRACT FROM AUTHOR]

Author(s): Samantha D. Outcalt[sup.1] [sup.2] [sup.3] [sup.9] , Kurt Kroenke[sup.1] [sup.3] [sup.4] , Erin E. Krebs[sup.5] [sup.6] , Neale R. Chumbler[sup.7] , Jingwei Wu[sup.8] , Zhangsheng Yu[sup.8] , Matthew J. [...], Both posttraumatic stress disorder (PTSD) and depression are highly comorbid with chronic pain and have deleterious effects on pain and treatment outcomes, but the nature of the relationships among chronic pain, PTSD, and depression has not been fully elucidated. This study examined 250 Veterans Affairs primary care patients with moderate to severe chronic musculoskeletal pain who participated in a randomized controlled pain treatment trial. Baseline data were analyzed to examine the independent associations of PTSD and major depression with multiple domains of pain, psychological status, quality of life, and disability. PTSD was strongly associated with these variables and in multivariate models, PTSD and major depression each had strong independent associations with these domains. PTSD demonstrated similar relationships as major depression with psychological, quality of life, and disability outcomes and significant but somewhat smaller associations with pain. Because PTSD and major depression have independent negative associations with pain, psychological status, quality of life, and disability, it is important for clinicians to recognize and treat both mental disorders in patients with chronic pain.

Provides information about correlates of disruptive behaviors among nursing home residents with dementia. Observation of a wide range of behaviors (N=45) across 11 months were analyzed. Findings suggest that cognitive status, but not health variables, predicts disruptive behavior among nursing home residents with dementia. (Author/MKA)

Background: Stroke is a life-disrupting, costly event for many stroke patients and their families. An estimated 4.8 million stroke survivors are living in the community with some level of disability, [...]

This article investigates the independent additive and the interactive effects of being an informal caregiver of an elderly parent and three role commitments (being married, having a child or grandchild coreside, and being employed) on depressive symptomatology. For the respondents with a living mother, being a caregiver to their mother was not associated with the level of depressive symptoms. For the respondents with a living father, being a caregiver to their father was associated with higher levels of depressive symptoms. Respondents who were caregivers to their father reported lower depressive symptom scores due to being married and due to being employed. Being married and being employed may provide an alternative source of integration and thus buffer the detrimental effects that caregiving for a father has on depressive symptomatology. The findings are discussed in the context of role strain and role enhancement perspectives. Keywords: caregiving; depression; role commitments

The COVID-19 pandemic has disrupted non-essential in-person research activities that require contact with human subjects. While guidelines are being developed for ramping up human subjects research, one component of research that can be performed remotely is participant screening for lower limb function and gait impairments. In this commentary, we summarize evidence-supported clinical assessments that have potential to be conducted remotely in a safe manner, to make an initial determination of the functional mobility status of persons with neurological disorders. We present assessments that do not require complex or costly equipment, specialized software, or trained personnel to administer. We provide recommendations to implement remote functional assessments for participant recruitment and continuation of lower limb neurorehabilitation research as a rapid response to the COVID-19 pandemic and for utilization beyond the current pandemic. We also highlight critical research gaps related to feasibility and measurement characteristics of remote lower limb assessments, providing opportunities for future research to advance tele-assessment and tele-rehabilitation. [ABSTRACT FROM AUTHOR]