An examination of Anglo and Latino parenting practices: Relation to behavior problems in children with or without developmental delay

The transactional model of development has received empirical support in research on at-risk children. However, little is known about the role of ethnicity or child delay status (i.e., developmental delay [DD] or typical cognitive development [TD]) in the process of parents adapting to their child's behavior problems and special needs. We examined whether Latina (N = 44) and Anglo (N = 147) mothers of 3-year-old children with or without DD differed in their use of two parenting practices, maternal scaffolding and sensitivity. We also examined how the status and ethnic groups differed in child behavior problems at ages 3 and 5 and whether parenting predicted change in behavior problems over time in the ethnic and status groups. Analyses generally supported previous research on status group differences in behavior problems (DD higher) and parenting practices (TD higher). Parenting practices predicted a decrease in externalizing problems from child age 3 to 5 years among Latino families only. Child developmental status was not associated with change in behavior problems. Cultural perspectives on the transactional model of development and implications for intervention are discussed.     

Executive function and attention in young adults with and without Developmental Coordination Disorder – A comparative study

The current research aimed at examining the executive function (EF) of young adults with Developmental Coordination Disorder (DCD) in comparison to young adults without DCD. The study used a randomized cohort (N = 429) of young adults with DCD (n = 135), borderline DCD (n = 149) and control (n = 145), from a previous study. This initial cohort was asked to participate in the current study three to four years later. Twenty-five individuals with DCD (mean age = 24 years, 1 month [SD = 0.88]; 18 males), 30 with borderline DCD (mean age = 24 years, 2 month [SD = 0.98]; 18 males) and 41 without DCD (mean age = 25 years, 2 months [SD = 1.91]; 20 males) participated in this study. Participants completed the BRIEF-A questionnaire, assessing EF abilities and the WURS questionnaire, assessing attention abilities. The DCD and borderline DCD groups had significantly lower EF profiles in comparison with the control group but no significant differences were found between the DCD and borderline DCD groups. While a high percentage of attention problems were found in both DCD groups, the executive functioning profiles remained consistent even when using the attention component as a covariate. The study results suggest that young adults with DCD have EF problems which remain consistent with or without attention difficulties.     

Systematic review of factors associated with depression and anxiety disorders among older adults with Parkinson's disease

Depression and anxiety disorders have a substantial impact on the quality of life, the functioning and mortality of older adults with Parkinson's disease (PD). The purpose of this systematic review was to examine the factors associated with the prevalence of depression and anxiety disorders among individuals with PD aged 60 years and older. Following a literature search in PubMed, PsycINFO, CINAHL, and EMBASE, 5 articles met the inclusion criteria (adults aged 60 years and older, individuals with PD, and with depression and anxiety disorders, and English-language peer reviewed articles) and were included in this review. These studies were conducted in the U.S (n = 3), in Italy (n = 1) and the U.K (n = 1). Findings indicated that autonomic symptoms, motor fluctuations, severity and frequency of symptoms, staging of the disease, and PD onset and duration were associated with the prevalence of depression and anxiety disorders among older adults suffering from PD. Despite the limited number of studies included in the review, depression and anxiety disorders are often unrecognized and untreated and the comorbidity greatly exacerbates PD symptoms. The identification of factors associated with the development of depression and anxiety disorders could help in designing preventive interventions that would decrease the risk and burden of depression and anxiety disorders among older adults with PD.     

Using Quality Indicator Codes to Identify Patients’ Fall Risk in Inpatient Rehabilitation Facilities

ObjectiveTo discover if quality indicator (QI) codes are associated with patient falls in inpatient rehabilitation facilities (IRFs).DesignThis retrospective cohort study explored differences between patients who fell and those who did not fall. We analyzed potential associations between QI codes and falls using univariable and multivariable logistic regression models.SettingWe collected data from electronic medical records at 4 IRFs.ParticipantsIn 2020, our 4 data collection sites admitted and discharged a total of 1742 patients older than 14 years . We only excluded patients (N=43) from statistical analysis if they were discharged before admission data had been assigned.InterventionsNot applicable.Main Outcome MeasuresUsing a data extraction report, we collected age, sex, race and ethnicity, diagnosis, falls, and QI codes for communication, self-care, and mobility performance. Staff documented communication codes on a 1-4 scale and self-care and mobility codes on a 1-6 scale, with higher codes representing greater independence.ResultsNinety-seven patients (5.71%) fell in the 4 IRFs over a 12-month period. The group who fell had lower QI codes for communication, self-care, and mobility. When adjusting for bed mobility, transfer, and stair-climbing ability, low performance with understanding, walking 10 feet, and toileting were significantly associated with falls. Patients with admission QI codes below 4 for understanding had 78% higher odds of falling. If they were assigned admission QI codes below 3 for walking 10 feet or toileting, they had 2 times greater odds of falling. We did not find a significant association between falls and patients’ diagnosis, age, sex, or race and ethnicity in our sample.ConclusionsCommunication, self-care, and mobility QI codes appear to be significantly associated with falls. Future research should explore how to use these required codes to better identify patients likely to fall in IRFs.     

Cognitive impairment no dementia and associations with health literacy,self-management skills,and functional health status

ObjectivesTo determine the prevalence of cognitive impairment no dementia (CIND) among a diverse, community-based population, and establish associations between CIND and health literacy, chronic disease self-management and functional health status.Methods863 primary care adults without dementia aged 55–74. Adjusted logistic and linear regressions were used to assess associations between CIND (None, Mild, Moderate/Severe) and outcomes.Results36 % participants exhibited CIND. It was strongly associated with limited health literacy (Newest Vital Signs: Mild [OR 3.25; 95 % CI 1.93, 5.49], Moderate/Severe [OR 6.45; 95 % CI 3.16, 13.2]; Test of Functional Health Literacy in Adults: Mild [OR 3.46; 95 % CI 2.08, 5.75], Moderate/Severe [OR 8.82; 95 % CI 4.87, 16.0]; all p’s < 0.001) and poor chronic disease self-management (Mild [B = −11.2; 95 % CI −13.5, -8.90], Moderate/Severe CI [B = −21.0; 95 % CI −23.6, −18.4]; both p’s < 0.001). Associations between CIND and functional health status were non-significant.ConclusionsCIND was prevalent in this cohort, and strongly associated with requisite skills for managing everyday health needs.Practice ImplicationsAttention to subtle declines in chronic disease self-care may assist with CIND identification and care management within this population. When CIND is observed, clinicians should also expect and address difficulties with self-management.     

Adapting a peer-led self-management program for breast cancer survivors in Switzerland using a co-creative approach

ObjectiveThe peer-led Cancer Thriving and Surviving Program (CTS) has demonstrated improved health outcomes for cancer survivors. We describe a co-creative process for adapting the CTS for breast cancer survivors in Switzerland and integrating the program into the clinical pathway of Swiss breast centers.MethodsA co-creative approach was employed. Breast cancer survivors and health care professionals (total n = 81) participated in three workshops, an online rating, and a consensus conference. An iterative cycle (evidence, ideas, refining, rating, and synthesis) guided the adaptation process.ResultsSurvivors involvement in the adaptation process allowed to tailor the self-management program to the psychosocial needs identified as the highest priority. New contents “Being a woman”, “Breast cancer and my (working) life” and “My exercise” were added to the CTS. Program duration was expanded from 6 to 7 weeks. Transition to follow-up care was considered as the optimal time point for program integration into the clinical pathway.ConclusionThe co-creative process may serve as a model in adapting supportive interventions for cancer. A subsequent pilot testing examined the feasibility and preliminary efficacy.Practice implicationsCombining expertise of health care professionals and patients to co-create a peer-led breast cancer self-management program may enhance acceptability and adoption.