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Malnutrition in older adults can decrease quality of life and increase risk of morbidities and mortality. Accurate and timely identification of malnutrition, as well as subsequent implementation of effective interventions, are essential to decrease poor outcomes associated with malnutrition in older adults. The Academy of Nutrition and Dietetics Evidence Analysis Center conducted a systematic review of the literature to develop an evidence-based nutrition practice guideline for the prevention and treatment of malnutrition in older adults. The objective of this guideline was to provide evidence-based recommendations to identify, prevent, or treat protein-energy malnutrition in older adults (mean age ≥65 years) living in long-term care and community settings. This guideline provides 11 nutrition recommendations to inform shared decision making among dietitians, members of the health care team, family members or caregivers, and older adults living in long-term care or the community to prevent or treat malnutrition. Topics include dietitian effectiveness, nutrition assessment tools, oral nutrition supplements, food fortification, and home-delivered and congregate meals. Guideline implementation should include consideration of the importance of comprehensive individualized nutrition care for older adults. Future research is needed to address gaps that were identified related to the validity, reliability, and feasibility of nutrition assessment tools, as well as the effectiveness of dietitian interventions on outcomes of interest in older adults living in long-term care and the community.
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Assistência de Longa Duração , Desnutrição , Avaliação Nutricional , Humanos , Idoso , Desnutrição/prevenção & controle , Desnutrição/terapia , Assistência de Longa Duração/métodos , Idoso de 80 Anos ou mais , Feminino , Terapia Nutricional/métodos , Terapia Nutricional/normas , Avaliação Geriátrica/métodos , Vida Independente , Masculino , Dietética/métodos , Dietética/normas , Estado Nutricional , Medicina Baseada em EvidênciasRESUMO
OBJECTIVE: Individual differences in attachment insecurity can have important implications for experiences of positive emotions. However, existing research on the link between attachment insecurity and positive emotional experiences has typically used a composite measure of positive emotions, overlooking the potential importance of differentiating discrete emotions. METHOD: We conducted a meta-analysis of 10 cross-sectional samples (N = 3215), examining how attachment insecurity is associated with self-reported frequency of experiencing positive emotions, with a distinction made between more social (i.e., love and gratitude) and less social (i.e., peace and awe or curiosity) positive emotions. RESULTS: High (vs. low) levels of both attachment anxiety and avoidance were associated with less frequent experience of positive emotions regardless of their social relevance. When analyzing each emotion separately, we found that attachment anxiety showed negative relations to all emotions except gratitude. Attachment avoidance was negatively associated with all emotions, and the link was even stronger with love (vs. peace, awe, or curiosity). Additional analyses of daily diary data revealed that attachment anxiety and avoidance were also negatively associated with daily experiences of positive emotions, regardless of social relevance. CONCLUSION: Our results underscore the need to further investigate the mechanisms underlying insecure individuals' blunted positive emotional experiences.
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Emoções , Apego ao Objeto , Humanos , Estudos Transversais , Ansiedade/psicologia , AutorrelatoRESUMO
This study examines whether using virtual reality (VR) with older adults with mild cognitive impairment (MCI) or mild to moderate dementia with a family member who lives at a distance can improve the quality of life of the older adult and the family member. Twenty-one older adults in a senior living community and a family member (who participated in the VR with the older adult from a distance) engaged in a baseline telephone call, followed by three weekly VR sessions. The VR was associated with improvements in older adults' affect and stress, relationship with their family member, and overall quality of life, compared to baseline. Family members' negative affect, depressive symptoms, and caregiver burden also decreased and their mental health improved after using the VR, compared to baseline. Using the VR, however, did not change their relationship with the older adult. In addition, older adults and family members who experienced the VR sessions as more socially engaging reported better psychological and relational well-being, with older adults also experiencing greater improvements in overall quality of life. Finally, preliminary results suggest that older adults with dementia and their family members might benefit even more from using the VR than older adults with MCI and their family members.
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Disfunção Cognitiva , Demência , Realidade Virtual , Humanos , Idoso , Qualidade de Vida , Disfunção Cognitiva/psicologia , Família , Demência/psicologiaRESUMO
Sleep has strong influences on affective and social experiences. However, less is known about the reciprocal effects of sleep, affect, and social experiences at a daily level, and little work has considered racial/ethnic minorities at high risk for social disconnection and discrimination. A 7-day daily experience study assessed the bidirectional relationships between daily sleep quality, affect, social experiences, and overall well-being among a sample of Latinx undergraduates (N = 109). Each morning, participants reported on their previous night's sleep. Each evening, they reported their positive and negative affect, experiences of belonging and unfair treatment, and overall well-being that day. Results indicate that, at a daily level, sleep quality predicts next-day affect, belonging, and well-being. Reciprocally, only daily well-being predicts sleep quality. Findings highlight sleep as a potentially powerful antecedent of affective and social experiences likely to be particularly potent for underrepresented minority groups. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-021-00088-0.
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This study examined the effects of a 4-week cognitive training program with neurofeedback (CT-NF) among 86 healthy adults (M = 66.34 years, range 54-84) randomized to either a treatment (app-based ABC games) or control (Tetris) group. Participants completed seven cognitive assessments, pre- and post-intervention, and measured their cortical brain activity using a XB-01 functional near-infrared spectroscopy (fNIRS) brain sensor, while engaging in CT-NF. The treatment (ABC) group showed significant (pre/post-intervention) improvements in memory (MEM), verbal memory (VBM), and composite cognitive function, while the control group did not. However, both groups showed significant improvements in processing speed (PS) and executive function (EF). In line with other studies, we found that strength of cortical brain activity (measured during CT-NF) was associated with both cognitive (pre and post) and game performance. In sum, our findings suggest that CT-NF and specifically ABC exercises, confer improved cognition in the domains of MEM, VBM, PS, and EF.
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Disfunção Cognitiva , Neurorretroalimentação , Idoso , Encéfalo , Cognição , Disfunção Cognitiva/terapia , Função Executiva , Humanos , Neurorretroalimentação/métodosRESUMO
BACKGROUND AND OBJECTIVES: This study tests the feasibility of using virtual reality (VR) with older adults with mild cognitive impairment (MCI) or mild-to-moderate dementia with a family member who lives at a distance. RESEARCH DESIGN AND METHODS: 21 residents in a senior living community and a family member (who participated in the VR with the older adult from a distance) engaged in a baseline telephone call, followed by 3 weekly VR sessions. RESULTS: Residents and family members alike found the VR safe, extremely enjoyable, and easy to use. The VR was also acceptable and highly satisfying for residents with MCI and dementia. Human and automated coding revealed that residents were more conversationally and behaviorally engaged with their family member in the VR sessions compared to the baseline telephone call and in the VR sessions that used reminiscence therapy. The results also illustrate the importance of using multiple methods to assess engagement. Residents with dementia reported greater immersion in the VR than residents with MCI. However, the automated coding indicated that residents with MCI were more kinesically engaged while using the VR than residents with dementia. DISCUSSION AND IMPLICATIONS: Combining networking and livestreaming features in a single VR platform can allow older adults in senior living communities to still travel, relive their past, and engage fully with life with their family members, despite geographical separation and physical and cognitive challenges.
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An ensemble Kalman filter reanalysis has been archived in the Research Data Archive at the National Center for Atmospheric Research. It used a CAM6 configuration of the Community Earth System Model (CESM), several million observations per day, and the Data Assimilation Research Testbed (DART). The data saved from this global, [Formula: see text] resolution, 80 member ensemble span 2011-2019. They include ensembles of: sub-daily, real world, atmospheric forcing for use by all of the nonatmospheric models of CESM; weekly, CAM6, restart file sets; 6 hourly, prior hindcast estimates of the assimilated observations; 6 hourly, land model, plant growth variables, and 6 hourly, ensemble mean, gridded, atmospheric analyses. This data can be used for hindcast studies and data assimilation using component models of CESM; CAM6, CLM5, CICE5, POP2. MOM6, MOSART, and CISM; and non-CESM Earth system models. This large dataset (~ 120 Tb) has a unique combination of a large ensemble, high frequency, and multiyear time span, which provides opportunities for robust statistical analysis and use as a machine learning training dataset.
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In Western culture, romantic love is commonly a basis for marriage. Although it is associated with relationship satisfaction, stability, and individual well-being, many couples experience declines in romantic love. In newlyweds, specifically, changes in love predict marital outcomes. However, the biological mechanisms underlying the critical transition to marriage are unknown. Thus, for the first time, we explored the neural and genetic correlates of romantic love in newlyweds. Nineteen first-time newlyweds were scanned (with functional MRI) while viewing face images of the partner versus a familiar acquaintance, around the time of the wedding (T1) and 1 year after (T2). They also provided saliva samples for genetic analysis (AVPR1a rs3, OXTR rs53576, COMT rs4680, and DRD4-7R), and completed self-report measures of relationship quality including the Eros (romantic love) scale. We hypothesized that romantic love is a developed form of the mammalian drive to find, and keep, preferred mates; and that its maintenance is orchestrated by the brain's reward system. Results showed that, at both time points, romantic love maintenance (Eros difference score: T2-T1) was associated with activation of the dopamine-rich substantia nigra in response to face images of the partner. Interactions with vasopressin, oxytocin, and dopamine genes implicated in pair-bonding (AVPR1a rs3, OXTR rs53576, COMT rs4680, and DRD4-7R) also conferred strong activation in the dopamine-rich ventral tegmental area at both time points. Consistent with work highlighting the role of sexual intimacy in relationships, romantic love maintenance showed correlations in the paracentral lobule (genital region) and cortical areas involved in sensory and cognitive processing (occipital, angular gyrus, insular cortex). These findings suggest that romantic love, and its maintenance, are orchestrated by dopamine-, vasopressin- and oxytocin-rich brain regions, as seen in humans and other monogamous animals. We also provide genetic evidence of polymorphisms associated with oxytocin, vasopressin and dopamine function that affect the propensity to sustain romantic love in early stage marriages. We conclude that romantic love maintenance is part of a broad mammalian strategy for reproduction and long-term attachment that is influenced by basic reward circuitry, complex cognitive processes, and genetic factors.
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In this article, we discuss theory and research on social support and caregiving processes in adult close relationships. We first outline key theoretical principles of attachment theory and of a theoretical perspective on thriving through relationships that builds on attachment theory. We then review empirical research that has tested key theoretical postulates regarding the importance of relational support for both attachment and exploration needs. The empirical review is divided into two components that reflect the two major functions of support/caregiving in close relationships, and that reflect the two different life contexts in which relational support/care is crucial (support in adversity and support for exploration and pursuit of opportunities). We conclude by emphasizing important directions for future research.
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Cuidadores/psicologia , Apoio Social , Adulto , Pesquisa Empírica , Humanos , Relações Interpessoais , Apego ao ObjetoRESUMO
Most health research focuses on the independent associations of positive or negative aspects of close relationships with health outcomes. A small but growing literature has begun to examine interactive effects of positive and negative aspects. These interactive effects frequently predict health independently or above-and-beyond main effects of either the positive or the negative aspects, suggesting unique relationship processes or emergent features of these close relationship patterns. Our goal in this review is to lay out the existing approaches to studying the interactive effects of positive and negative aspects of close relationships, and to review available evidence linking these interactive effects to health outcomes. We conclude by discussing important unresolved issues and highlighting critical directions for future research.
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Close relationships play a vital role in human health, but much remains to be learned about specific mechanisms of action and potential avenues for intervention. This article provides an evaluation of research on close relationships processes relevant to health, drawing on themes from major relationship science theories to present a broad conceptual framework for understanding the interpersonal processes and intrapersonal pathways linking relationships to health and disease outcomes. The analysis reveals that both social connection and social disconnection broadly shape biological responses and behaviors that are consequential for health. Furthermore, emerging work offers insights into the types of social dynamics that are most consequential for health, and the potential pathways through which they operate. Following from this analysis, the authors suggest several research priorities to facilitate the translation of discoveries from relationship science into relationship-based interventions and public health initiatives. These priorities include developing finer grained theoretical models to guide research, the systematic investigation of potential mediating pathways such as dyadic influences on health behavior and physiological coregulation, and taking into account individual differences and contextual factors such as attachment style, gender, socioeconomic status, and culture. In addition, a pressing need exists for laboratory and field research to determine which types of interventions are both practical and effective. (PsycINFO Database Record
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Comportamentos Relacionados com a Saúde , Nível de Saúde , Relações Interpessoais , Empatia , Humanos , Modelos Psicológicos , Teoria Psicológica , Apoio SocialRESUMO
Researchers recently demonstrated that cortisol increases in response to mating-relevant social interactions. An important next step is investigating factors that explain individual differences in cortisol reactivity within these contexts. The current study examined demographic, situational, and individual difference predictors of cortisol reactivity following brief, non-face-to-face interactions with potential dating partners. College students made a video introducing themselves to another participant. During another appointment, they watched a short video of an opposite-sex confederate introducing himself/herself, and believed the other person was watching their video. Participants were told they would get to know the confederate more during a web-chat, which never took place. Participants received either rejection, acceptance, or no feedback from the confederate. Cortisol levels increased over baseline in all feedback conditions. Cortisol increases were particularly strong for participants who perceived the confederate as a more desirable dating partner, participants who were independently rated as a less desirable partner, and men.
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Hidrocortisona/metabolismo , Relações Interpessoais , Distância Psicológica , Rejeição em Psicologia , Saliva/metabolismo , Fatores Sexuais , Parceiros Sexuais , Adolescente , Adulto , Retroalimentação , Feminino , Humanos , Masculino , Parceiros Sexuais/psicologia , Estudantes/psicologia , Adulto JovemRESUMO
Finkel, Rusbult, Kumashiro, and Hannon (2002, Study 1) demonstrated a causal link between subjective commitment to a relationship and how people responded to hypothetical betrayals of that relationship. Participants primed to think about their commitment to their partner (high commitment) reacted to the betrayals with reduced exit and neglect responses relative to those primed to think about their independence from their partner (low commitment). The priming manipulation did not affect constructive voice and loyalty responses. Although other studies have demonstrated a correlation between subjective commitment and responses to betrayal, this study provides the only experimental evidence that inducing changes to subjective commitment can causally affect forgiveness responses. This Registered Replication Report (RRR) meta-analytically combines the results of 16 new direct replications of the original study, all of which followed a standardized, vetted, and preregistered protocol. The results showed little effect of the priming manipulation on the forgiveness outcome measures, but it also did not observe an effect of priming on subjective commitment, so the manipulation did not work as it had in the original study. We discuss possible explanations for the discrepancy between the findings from this RRR and the original study.
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Relações Interpessoais , Perdão , Humanos , Priming de Repetição , Comportamento Sexual , Pensamento , ConfiançaRESUMO
Growing evidence suggests that interpersonal responsiveness-feeling understood, validated, and cared for by other people-plays a key role in shaping the quality of one's social interactions and relationships. But what enables people to be interpersonally responsive to others? In the current study, we argued that responsiveness requires not only accurate understanding but also compassionate motivation. Specifically, we hypothesized that understanding another person's thoughts and feelings (empathic accuracy) would foster responsive behavior only when paired with benevolent motivation (empathic concern). To test this idea, we asked couples (N = 91) to discuss a personal or relationship stressor; we then assessed empathic accuracy, empathic concern, and responsive behavior. As predicted, when listeners' empathic concern was high, empathic accuracy facilitated responsiveness; but when empathic concern was low, empathic accuracy was unhelpful (and possibly harmful) for responsiveness. These findings provide the first evidence that cognitive and affective forms of empathy work together to facilitate responsive behavior.
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Empatia , Características da Família , Relações Interpessoais , Adulto , Emoções , Feminino , Humanos , Masculino , Motivação , Estresse Psicológico/psicologia , Adulto JovemRESUMO
PURPOSE: Non-surgical treatments for cervical intraepithelial neoplasia 2/3 (CIN2/3) are needed as surgical treatments have been shown to double preterm delivery rate. The goal of this study was to demonstrate safety of a human papillomavirus (HPV) therapeutic vaccine called PepCan, which consists of four current good-manufacturing production-grade peptides covering the HPV type 16 E6 protein and Candida skin test reagent as a novel adjuvant. PATIENTS AND METHODS: The study was a single-arm, single-institution, dose-escalation phase I clinical trial, and the patients (n = 24) were women with biopsy-proven CIN2/3. Four injections were administered intradermally every 3 weeks in limbs. Loop electrical excision procedure (LEEP) was performed 12 weeks after the last injection for treatment and histological analysis. Six subjects each were enrolled (50, 100, 250, and 500 µg per peptide). RESULTS: The most common adverse events (AEs) were injection site reactions, and none of the patients experienced dose-limiting toxicities. The best histological response was seen at the 50 µg dose level with a regression rate of 83% (n = 6), and the overall rate was 52% (n = 23). Vaccine-induced immune responses to E6 were detected in 65% of recipients (significantly in 43%). Systemic T-helper type 1 (Th1) cells were significantly increased after four vaccinations (P = 0.02). CONCLUSION: This study demonstrated that PepCan is safe. A significantly increased systemic level of Th1 cells suggests that Candida, which induces interleukin-12 (IL-12) in vitro, may have a Th1 promoting effect. A phase II clinical trial to assess the full effect of this vaccine is warranted.
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The specific pathways through which close relationships promote optimal well-being are not well understood. We describe a model (building on attachment theory's notion of safe haven and secure base support) that explains how close relationships promote thriving. This model defines thriving, identifies distinct contexts through which individuals may thrive (life adversity and life opportunities for growth), describes two distinct social support functions in close relationships that promote thriving (source of strength support and relational catalyst support), and identifies mediators through which relational support leads to long-term thriving.
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Close and caring relationships are undeniably linked to health and well-being at all stages in the life span. Yet the specific pathways through which close relationships promote optimal well-being are not well understood. In this article, we present a model of thriving through relationships to provide a theoretical foundation for identifying the specific interpersonal processes that underlie the effects of close relationships on thriving. This model highlights two life contexts through which people may potentially thrive (coping successfully with life's adversities and actively pursuing life opportunities for growth and development), it proposes two relational support functions that are fundamental to the experience of thriving in each life context, and it identifies mediators through which relational support is likely to have long-term effects on thriving. This perspective highlights the need for researchers to take a new look at social support by conceptualizing it as an interpersonal process with a focus on thriving.