Longitudinal associations between dual sensory impairment and everyday competence among older adults

Given the prevalence of sensory impairment in older adults, the relationship of sensory impairment to everyday competence among older adults is gaining attention. Dual impairment, or concurrent impairments of vision and hearing, affects anywhere from 5% to 21% of older adults. Using Longitudinal Study on Aging data, we examined the longitudinal associations of self-reported dual sensory impairment with everyday competence in self-reported activities of daily living among adults aged 70 and older (N = 5,151). Self-reported dual sensory impairment was associated with higher levels of self-reported functional disability at baseline and at the 2-year follow-up interview, but the effect gradually diminished over time. However, self-reported dual sensory impairment was not associated with greater levels of self-reported disability as compared with self-reported visual impairment alone. Findings highlight the importance of vision and aural rehabilitation programs for older adults to mitigate the loss of competence in later life due to sensory impairment.     

喉气道疾病患儿父母创伤后成长的影响因素

目的探讨喉气道疾病患儿父母创伤后成长的影响因素。方法采用便利抽样法,选择2015年1-11月上海某三级甲等医院耳鼻喉头颈外科收治的96名喉气道疾病患儿父母为研究对象。采用自行编制的一般资料调查表、自我表露、简体中文版事件相关反刍性沉思问卷、简体中文版创伤后成长评定量表、领悟社会支持量表等,调查了喉气道疾病患儿父母的创伤后成长、自我表露、反刍性沉思及社会支持得分情况,并分析其主要影响因素。结果本组患儿父母创伤后成长得分为(43.09±19.399),多元回归分析结果显示,表露经历、目的性反刍性沉思是父母创伤后成长的正向预测因素,可解释其40.1%的总变异(F=32.858,P0.001)。结论本组患儿父母创伤后成长水平相对较低,父母的表露经历及目的性反刍性沉思是其主要影响因素,提示曾经与他人谈论内心感受、且已开始建构创伤事件(孩子患病经历)意义的目的性认知加工的父母,其创伤后成长水平越高。医护人员可为父母提供一个较安全放松的环境,鼓励或引导患儿父母总结应对经验,思考对人生的意义等积极认知加工,进而提升其创伤后成长水平,最终实现良好心理适应。     

Understanding,Experiences, and Reactions to Bullying Experiences in Boys with an Autism Spectrum Disorder

Most previous studies of bullying in young people with an Autism Spectrum Disorder (ASD) have relied on data from adults’ rather than the person with an ASD themselves, thus limiting our understanding of the bullying experience from the child’s perspective. To investigate this issue, 48 high-functioning boys with an ASD, and their mothers, completed an online questionnaire about various aspects of bullying. There were some minor discrepancies between mothers’ and their sons’ reported frequency of bullying. Boys demonstrated an understanding of the behaviour that constitutes bullying that was consistent with the wider literature, enhancing the validity of their responses about their experiences. Sources of bullying included friends, and bullying mostly occurred in the playground. These boys had ineffective coping strategies for bullying, and many reported significant physical and emotional negative reactions. Many boys found that telling adults made their bullying experiences worse, and most kept their bullying experiences to themselves until they reached home, then adopting a range of negative (tantrums) and positive (staying alone to calm down) behaviours. Unfortunately, over half of these boys sought to absent themselves from school as their preferred method for coping with their bullying experiences. These findings have major implications for interventions within schools to reduce bullying and to provide access to learning and social activities.     

Parental Emotion Socialization Strategies and Their Interaction with Child Interpretation Biases Among Children with Anxiety Disorders

Children’s interpretations of events play a significant role in childhood anxiety, and research shows that the parenting environment, in particular, is an important contributor to the manner in which children interpret their experiences. This study examined associations between parental use of punitive and minimization reactions to children’s displays of negative affect, child interpretation biases (self-reports and computerized assessments), and child anxiety symptom severity in a clinical sample of children with anxiety disorders. Forty-four children between 8–12 years of age (M = 9.60, SD = 1.30; 52 % girls; 52 % African American) and their mothers (M = 38.48, SD = 6.86; 57 % married) participated in this study. Child interpretation biases were significantly associated with child-reported anxiety symptoms. Moderation analyses revealed a positive relation between self-reported interpretation biases and anxiety symptoms for children of low-minimization and low-punitive mothers. Likewise, a positive relation between computerized interpretation biases and mother-reported child anxiety symptoms was found for children of low-minimization and low-punitive mothers. However, a negative relationship between computerized interpretation biases and mother-reported child anxiety symptoms was found for children of high-minimization and high-punitive mothers. Findings and implications are discussed in the context of how these parental reactions may be addressed and incorporated in childhood anxiety treatments.     

Severity of pediatric pain in relation to school-related functioning and teacher support: An epidemiological study among school-aged children and adolescents

The current cross-sectional study examined child and adolescent pain severity in relation to various domains of school functioning and, in line with self-determination theory, the potentially protective role of perceived teacher support of child/adolescent autonomy and competence. Data from a large representative sample of Flemish school children and adolescents (N = 10650; 50.8% boys; age range 10–21 years; mean age = 14.33) was collected as part of the World Health Organization (WHO) collaborative Health Behaviour in School-Aged Children (HBSC) survey. Child/adolescent pain severity was graded based on a pediatric pain classification system adapted from that of Von Korff et al. The current study thus provided insight regarding the prevalence of pain among Flemish children/adolescents and, extending the limitations of existing literature, examined the specific role of pain severity across various domains of school functioning. Findings indicated that a sizeable proportion of children reported moderate to severe pain problems (ie, about 14% of children and adolescents were classified in the highest pain grades: ie, grade III or IV). Furthermore, higher pain grades were associated with poorer outcomes across all indices of school functioning (ie, school absenteeism, school-related pressure and satisfaction, and bullying experiences), with the exception of academic performance. However, the association between pain grade and school absenteeism was less pronounced when children perceived their teachers to be highly supportive of competence and autonomy. Furthermore, teacher support of competence appeared to buffer against the harmful effects of severe pain upon instances of bullying experiences at school. Future research directions and implications for school-based interventions are discussed.     

Social Cognitive Theory Determinants of Physical Activity in Adults with Visual Impairments

Individuals with visual impairments tend to spend less time participating in physical activity and more time engaging in sedentary behaviors than their typically developing peers. The purpose of this study was to examine social cognitive theory-based predictors of physical activity and sedentary behavior for adults with visual impairments. Ninety-two participants, recruited from two visual impairment-related organizations in the United States (Women = 50; Men = 42; ages 18–77 [Mage = 46.88, SD = 13.91]), completed three questionnaires. Two-way ANOVAs examined differences across sex and vision; hierarchical multiple regression analyses evaluated factors predicting total metabolic equivalent minutes and sitting time. Hierarchical multiple regression analyses revealed that social support significantly predicted total metabolic equivalent minutes while self-regulation predicted sitting time. Age was not predictive of either dependent variable; vision predicted total metabolic equivalent minutes but not sitting time; sex was a significant factor for sitting not total metabolic equivalent minutes. Visual impairment predicted metabolic equivalent minutes but not sitting time. This study provides the first empirical evidence explaining social cognitive theory constructs as predictors of physical activity and sedentary behavior among adults with visual impairments. These results provide a basis for researchers and practitioners to utilize when conceptualizing, implementing, and evaluating future physical activity interventions focusing on this population.     

Feeling Without Thinking? Anger Provocation Task Predicts Impaired Cognitive Performance in Bipolar Disorder but not Major Depression or Healthy Adults

Elevated anger and impairments in executive functioning are prominent features of bipolar disorder (BD). Given that anger has been found to interfere with some aspects of cognition in healthy individuals, it is possible that heightened anger could compromise cognitive processing even more substantially among individuals with BD. Despite the important clinical and psychosocial implications of such an effect, the precise consequences of anger for cognition in BD are not well understood. To address this, the present study employed a validated anger provocation task and examined its impact on performance of an arithmetic task, assessing both accuracy (number of correct responses) and task engagement (number of responses made) among adults with remitted bipolar I disorder (BD; n = 27), healthy non-psychiatric controls (CTL; n = 29), and a clinical control group of adults with remitted depression (MDD; n = 29). Results revealed that individuals with BD uniquely declined in the number of responses made across the task. In addition, self-reported anger was predictive of reduced task performance among individuals with BD. These results suggest that elevated anger may add to existing executive impairments in BD, compromising these individuals’ ability to remain engaged in cognitively demanding tasks in the context of anger.     

The Parenting Journey of Mothers of Young Adults with Multiple Impairments

Parenting children with cerebral palsy can impact parental health and life satisfaction but few studies have addressed parenting a young adult with multiple impairments. This mixed methods study examined 21 mothers’ well being at 2 time points; when their child with cerebral palsy was 13–22 years old and when their child was 20–30 years old. Scores on three questionnaires indicated that, on average, mothers’ life satisfaction, social support, and perceptions of family functioning did not change significantly between assessment points. Six mothers reported low life satisfaction at both time points. Qualitative analysis of semi-structured interviews at Time 2 revealed that 15 mothers reported physical and/or emotional health challenges as a result of the parenting demands. Their work choices were also affected. For most mothers, their experiences of parenting young adults with extensive impairments had influenced their views of disability, themselves, and life in a positive manner.     

Gaining insight into patients' perspectives on participation in home management activities after traumatic brain injury.

OBJECTIVE: This study investigated performance of home management activities 1 year after traumatic brain injury (TBI), as reported on the Functional Status Examination. METHOD: Home management performance of 164 rehabilitation inpatients (mean age 35.4 years, 77% men, 75% white) with moderate to severe TBI was examined in relation to demographics, injury severity, neuropsychological functioning, and living situation. RESULTS: Fifty-nine percent reported more difficulty or more assistance with home management at 1 year. Nonperformance of individual activities before injury ranged from 16% to 76%. Age (p= .001), living situation after injury (p = .002), and neuropsychological function at 1 year (p = .001) were associated with more limited home management performance after injury as compared to premorbid function. CONCLUSIONS: Home management is challenging 1 year after TBI, especially for older adults and those with greater cognitive impairments. Accurate preinjury information is needed to determine the nature and extent of subsequent losses, guide treatment planning and interventions, and characterize recovery of function.     

Nationwide survey of treatment for pediatric patients with invasive fungal infections in Japan

In Japan, only a few antifungal agents have been approved for children, but in actual clinical practice, various antifungal agents used in adults are administered to pediatric patients with invasive fungal infections (IFIs). However, the pediatric dosages of some antifungal agents are not indicated in the package inserts or mentioned in the Japanese Mycology Study Group 2007 Guidelines for Management of Deep-seated Mycoses. We conducted a nationwide survey to determine how antifungal agents are being used to treat pediatric patients with IFIs in Japan. We sent a questionnaire to 792 medical centers that train pediatricians and received 250 (31.6 %) responses. In the past 5 years, 65 (26.0 %) of 250 facilities reported treating a total of 232 cases of IFIs. The characteristics of pediatric patients with IFIs were almost the same as adult patients except that immunological diseases and neonatal diseases are common as underlying diseases. Antifungal agents used in adults were all used in children. However, the dosages of some antifungal agents deviated from the package insert or guideline recommendations. As for the reasons for selecting a particular antifungal agent, strong antifungal activity (including potency, broad spectrum, and clinical efficacy) was favored over safety. These results can be used to revise guidelines for the management of children with IFIs.     

Treating Social Anxiety Disorder with CBT: Impact on Emotion Regulation and Satisfaction with Life

We examined whether cognitive-behavioral therapy (CBT) would influence the relationship between two distinct forms of emotion regulation (cognitive reappraisal and expressive suppression) and satisfaction with life in patients with social anxiety disorder (SAD). When compared to healthy adults (n = 42) at baseline (Study 1), patients with SAD (n = 128) reported lesser use of cognitive reappraisal, greater use of expressive suppression, and lower levels of satisfaction with life. In a randomized controlled trial of CBT (n = 40) versus a waitlist control group (n = 32) (Study 2), resulted indicated in the CBT group significant group by time interactions for the use of cognitive reappraisal and satisfaction with life, but not for the use of expressive suppression. Regression analyses in Study 2 provide insight into the predictive value of expressive suppression emotion regulation on post-CBT life satisfaction.     

Home-based circuit training program for an adolescent female with severe traumatic brain injury: A case report

Adolescents with traumatic brain injury (TBI) are often discharged from physical therapy (PT) services without transitioning into exertional conditioning programs. Active participation in physical activities with peers at school is essential to achieve a sense of accomplishment and acceptance. Factors such as reduced aerobic fitness and residual gait impairments can lead to limited participation and peer interaction. The purpose of this case report was to describe the impact of home-based circuit training (HBCT) focusing on strength and balance on gait speed (GS), energy expenditure, and functional performance in a 17-year-old female with severe TBI. The participant sustained a TBI from a motor vehicle crash. Although she was ambulatory and independent with the basic activities of daily living following two years of rehabilitation, she presented with activity limitations and participation restrictions at school. The participant performed a 4-week HBCT program developed by a school physical therapist that focused on strength and balance. At the end of 4 weeks, improvements were observed in 6 MWT (change = 79.7 m), GS (change = 0.22 m/s), and the COPM scores (performance score change = 2.8, satisfaction score change = 2.2, MCID = 2). Improvements in functional performance, gait speed, and self-perception of occupational performance were observed following 4-week HBCT. Future clinical trials on short duration, HBCT program for children and young adults with TBI are recommended in order to establish effectiveness of HBCT.     

A Therapy for Tics in Children Managing Underlying Processes: a Pilot Study

Tourette disorder is characterized by tics and is generally associated with many life impairments in childhood. International clinical guidelines recommend treatment with pharmacotherapy and behaviour therapy. The current pilot study reports a single-case design study assessing the effectiveness of an innovative cognitive-behavioural and physiological treatment for decreasing tics in children and adolescents. Fourteen participants aged 8–16 years old were recruited as consecutive referrals from the general population. Eleven cases completed a cognitive-psychophysiological treatment (CoPs) adapted for children and adolescents, and 5 children completed 6- and 12-months follow-up. The CoPs treatment lasted 14–16 sessions and covered 10 major steps principally addressing processes leading up to tics rather than the tics themselves. There was a significant decrease in tic severity as measured by the Tourette Symptom Global Scale overall children. Results showed a decrease of at least one standard deviation at follow-up time measurements and the majority of children showed a further decrease in tic severity at 12-months follow-up. In conclusion, the cognitive psychophysiological treatment reduced severity of tics in children and adolescents as well as in adults (O’Connor, 2015). These findings highlight the necessity for a therapeutic approach which focuses on the central and global processes surrounding tics to help symptom reduction in people with Tourette.     

Falls and functional impairments in cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN): a University of Rochester CCOP study

Purpose

This study was conducted in order to characterize the prevalence of falls and functional impairments (FIs) and their association with chemotherapy-induced peripheral neuropathy (CIPN) in cancer survivors.

Methods

We analyzed baseline assessments from a phase III RCT in cancer survivors with self-reported CIPN scores of >4 out of 10. Patients completed the EORTC QLQ-CIPN-20 for neuropathy and reported falls in the previous 3 months. FIs were defined using the Activities of Daily Living subsection of the Vulnerable Elder’s Scale. Associations of baseline characteristics and CIPN with falls and FIs were examined using logistic regression.

Results

Of 421 patients, 11.9 % experienced recent falls and 26.6 % reported FIs. Motor neuropathy was the only factor associated with falls (OR?=?1.127, p?=?0.01). Factors associated with FIs included non-white race (OR?=?0.335 white relative to non-white, 0.781, p?=?0.01) and greater motor neuropathy scores (OR?=?1.262, p?<?0.0001).

Conclusion

CIPN, primarily motor, is associated with falls and FIs. Future prospective research should investigate the ability of motor neuropathy severity to predict falls.     

Influencing Factors and Consequences of Workplace Bullying among Nurses: A Structural Equation Modeling

Purpose

The purpose of this study was to build and test a model outlining the factors related to workplace bullying among nurses. The hypothesized model included authentic leadership and a relationship-oriented organizational culture as influencing factors, symptom experience and turnover intention as consequences, and positive psychological capital as a mediator of workplace bullying among nurses.

Acute Pain Perception During Different Sampling Methods for Respiratory Culture in Cystic Fibrosis Patients

Context

Reliable identification of lower respiratory tract pathogens is crucial in the management of cystic fibrosis (CF). The multitude of treatments and clinical procedures are a considerable burden and are potentially provoking pain.