Exposure to violence in relation to personality traits, coping abilities, and burnout among caregivers in nursing homes: a case-control study

Background: Although violence toward caregivers occurs often and caregivers’ ability to interact and deal with difficult situations is relevant in preventing such violence, few studies have been conducted that focus on caregivers’ characteristics. Aim: This study explores the relationship between perceived exposure to violence and demographical factors, parental rearing, personality traits including coping abilities, defence styles, and burnout among caregivers working in nursing homes. Method: A total of 196 caregivers working in nursing homes were included. They were asked to complete questionnaires concerning demographical factors and exposure to violence. One group of female caregivers reporting no exposure to violence (n = 20) was matched with one group of exposed to violence (n = 20). Both groups were asked to complete questionnaires concerning parental rearing, personality traits, coping abilities, and burnout. Result: Around 68.4% of the caregivers had been exposed to violence during the previous year and 22.4% several times a week. Caregivers 50 years of age or younger and employed in geriatric care for more than 3 years were more frequently exposed to violence. Inter‐group differences were found regarding ‘maternal rejection’ and ‘burnout’. No statistical differences could be found concerning defence styles, coping ability, temperament, or character aspects. Conclusion: Violence toward caregivers occurs frequently and appears to be influenced by several factors. ‘Maternal rejection’ and ‘burnout’ among caregivers exposed to violence might influence the communication between caregivers and residents, rendering more violence. However, personality traits among caregivers do not seem to be associated with exposure to violence.     

A fish consumption study of anglers in an at-risk community: a community-based participatory approach to risk reduction

ABSTRACT Objective: To determine the effectiveness of a community-partnered risk communication intervention tailored for subsistence anglers in a public housing community.
Design and sample: A one group, pretest, posttest design was used to test the effectiveness of the intervention in a sample ( n =23, age range 18–75 years, 100% African American) of subsistence anglers residing in a public housing community in close proximity to a Superfund clean-up site. Face-to-face surveys were conducted at baseline and 3 months post the intervention to assess changes in knowledge and behaviors.
Intervention: A socioculturally appropriate risk communication intervention was developed, implemented, and evaluated in the targeted community. The risk communication included an interactive power point presentation, visual demonstration by a role model, and distribution of low literacy written materials, followed by a booster mailing of materials 1 month past the initial intervention. Evaluation measures included survey instruments on knowledge and self-reported fishing behaviors.
Results: Participants showed improved knowledge and behavior change related to trimming fish, consumption by pregnant women and children, and consumption of large fish.
Conclusions: The sociocultured tailored risk communication intervention demonstrated promising outcomes in this community and should be evaluated in a larger population of subsistence anglers.     

Differences in perceived communication barriers among nurses and elderly patients in China

Abstract   In China, limited information exists about nurses' and elderly patients' perceptions of barriers to the communication process. Therefore, the purposes of this study were to identify the major communication barriers (nurse-related, patient-related, and environment-related) perceived both by nurses and elderly patients and to determine the perceived differences in the level of importance of the communication barriers between nurses and elderly patients. The sample consisted of 84 nurses and 75 elderly patients who completed a demographic questionnaire and a communication barriers questionnaire. The findings suggested that the nurses and elderly patients often selected similar barriers related to the communication process. The nurses tended to assign higher values to the communication barriers that were found to be significantly different from those of the elderly patients. The study findings provide information about which type of barriers nurses need to address so as to facilitate effective communication with elderly patients.     

A comparison of five fMRI protocols for mapping speech comprehension systems

Aims: Many fMRI protocols for localizing speech comprehension have been described, but there has been little quantitative comparison of these methods. We compared five such protocols in terms of areas activated, extent of activation, and lateralization. Methods: fMRI BOLD signals were measured in 26 healthy adults during passive listening and active tasks using words and tones. Contrasts were designed to identify speech perception and semantic processing systems. Activation extent and lateralization were quantified by counting activated voxels in each hemisphere for each participant. Results: Passive listening to words produced bilateral superior temporal activation. After controlling for prelinguistic auditory processing, only a small area in the left superior temporal sulcus responded selectively to speech. Active tasks engaged an extensive, bilateral attention, and executive processing network. Optimal results (consistent activation and strongly lateralized pattern) were obtained by contrasting an active semantic decision task with a tone decision task. There was striking similarity between the network of brain regions activated by the semantic task and the network of brain regions that showed task‐induced deactivation, suggesting that semantic processing occurs during the resting state. Conclusions: fMRI protocols for mapping speech comprehension systems differ dramatically in pattern, extent, and lateralization of activation. Brain regions involved in semantic processing were identified only when an active, nonlinguistic task was used as a baseline, supporting the notion that semantic processing occurs whenever attentional resources are not controlled. Identification of these lexical‐semantic regions is particularly important for predicting language outcome in patients undergoing temporal lobe surgery.     

Cortical auditory dysfunction in benign rolandic epilepsy

Purpose: To evaluate cortical auditory function, including speech recognition, in children with benign rolandic epilepsy (BRE).
Methods: Fourteen children, seven patients with BRE and seven matched controls, underwent audiometric and behavioral testing, simultaneous EEG recordings, and auditory-evoked potential recordings with speech and tones. Speech recognition was tested under multiple listening conditions.
Results: All participants demonstrated normal speech recognition abilities in quiet, as well as normal peripheral and subcortical auditory function. BRE patients performed significantly worse than controls when speech recognition was tested under adverse listening conditions, including background noise. Five BRE patients who were impaired on two or more tests had centrotemporal spiking on awake EEG. There were no significant group differences in the latency or amplitude of early N100 cortical responses to speech or tones. Conversely, the mismatch negativity, a preattentive index of cortical processing that is elicited passively, was absent or prolonged for speech, but not tones, in BRE patients as compared to controls.
Discussion: Children with BRE demonstrated specific speech recognition impairments. Our evoked potential findings indicate that these behavioral impairments reflect dysfunction of nonprimary auditory cortex and cannot be attributed solely to attention difficulties. A possible association between auditory impairments and centrotemporal spiking (>1/min) on awake EEG was identified. The pattern of speech recognition impairments observed is a known risk factor for academic difficulties in school-age children. Our results underscore the importance of comprehensive auditory testing, using behavioral and electrophysiological measures, in children with BRE.     

Psychiatric disorders in advanced cancer

BACKGROUND: Emotional distress and psychiatric disorders are common among patients with advanced cancer. Oncologists play an important role in screening for these conditions, providing first-line treatment and referring patients for further evaluation and treatment when indicated. METHODS: The literature on psycho-oncology was reviewed, focusing on the epidemiology, assessment, and treatment of psychiatric disorders (adjustment disorders, major depression, anxiety and post-traumatic stress, personality disorders, substance abuse, and major mental disorders such as schizophrenia and bipolar disorder) in patients with advanced cancer. Communication skills and the role of the oncologist in dealing with end-of-life issues were also reviewed. Relevant data were summarized from the most recent systematic reviews, epidemiological studies, and intervention trials. Clinical recommendations are provided. RESULTS: About 50% of patients with advanced cancer meet criteria for a psychiatric disorder, the most common being adjustment disorders (11%-35%) and major depression (5%-26%). Both psychosocial and pharmacological treatments are effective for anxiety and depression, although existing studies have methodological limitations. Collaboration with mental health specialists is recommended for patients with personality disorders, major mental illness, and substance abuse problems. Effective communication involves active listening, exploring emotion and meaning, addressing prognosis, and discussing end-of-life issues when relevant. CONCLUSIONS: Treating psychiatric conditions improves quality of life in patients with advanced cancer. Oncologists play a key role in screening for psychiatric disorders, initiating first-line treatments for depression and anxiety, and communicating with patients and caregivers about prognosis and end-of-life issues.     

Oral care behavior after purging in a sample of women with bulimia nervosa

BackgroundBulimia nervosa (BN) is a mental health disorder associated with serious dental problems. The authors surveyed patients with a diagnosis of BN about their oral health behaviors after purging and their perspectives on barriers to patient-initiated discussion of eating disorders (EDs) with oral health professionals (OHPs).MethodsA convenience sample of women with BN who were receiving treatment at major ED treatment centers (those centers that are members of the Academy of Eating Disorders, Deerfield, Ill.) completed a 45-item, self-reported online survey that the authors use to assess oral care behaviors after purging, dental problems and barriers to communication with their dentists. Inclusion criteria were being 18 years or older, female and a U.S. resident, as well as having a clinical diagnosis of BN. A sample of 292 women began the survey, and 201 (68.8 percent) completed the survey.ResultsThe survey results indicated that 32.5 percent of participants reported brushing their teeth immediately after purging, which is contraindicated. Although 92.4 percent of participants acknowledged having dental problems, only 29.2 percent of these participants discussed their BN with a dentist.ConclusionsThe survey results show that although participants with BN had a high level of concern about their oral health and a high incidence of oral health problems, less than one-third considered their OHPs to be the most helpful source of oral health information.Practical ImplicationsOHPs must be educated about how to approach patients when an ED is suspected, develop practice protocols for discussing secondary prevention with patients and develop practice policies about disclosing ED (for example, purging) to a parent or guardian.     

An Evaluation of Operant Behavioural Economics in Functional Communication Training for Severe Problem Behaviour

ABSTRACT

Objective: This single-case experiment examined the use of behavioural economic concepts in a function-based treatment for problem behaviour.

Methods: Behavioural economic analyses were used to evaluate the strength of functions of problem behaviour and this information was used to inform elements of function-based treatment for one child with a neurodevelopmental disorder.

Results: Findings from this experiment indicated that the incorporation of behavioural economic measures resulted in positive treatment effects that were maintained throughout all phases of the evaluation, including those implemented by caregivers.

Conclusions: These results suggest that behavioural economic concepts and procedures can be successful adjuncts to evidence-based assessments and treatments for problem behaviour.