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BACKGROUND: We examined the effects of home-delivered cognitive-behavior therapy (CBT) on depressive symptoms among rural, diverse, and vulnerable older adults. Furthermore, we differentiated depression into its two salient aspects: psychological and somatic. METHOD: Data came from a randomized controlled experiment of CBT on 134 individuals residing in rural Alabama. RESULTS: Cognitive-behavior therapy resulted in significantly lower depressive symptom severity scores. When depressive symptoms were categorized as psychological or somatic, CBT was found to significantly improve the former but not the latter. Notably, there was a trend toward somatic symptom improvement. CONCLUSION: Cognitive-behavior therapy can be an effective treatment for depression in a hard-to-reach group of older adults. Home delivery affords advantages but is also an expensive delivery modality. Diverse older adults responded to the CBT intervention.
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Terapia Cognitivo-Conductual , Trastorno Depresivo/terapia , Servicios de Atención de Salud a Domicilio , Servicios de Salud Rural/organización & administración , Poblaciones Vulnerables , Anciano , Anciano de 80 o más Años , Alabama , Terapia Cognitivo-Conductual/economía , Terapia Cognitivo-Conductual/organización & administración , Trastorno Depresivo/economía , Trastorno Depresivo/psicología , Femenino , Costos de la Atención en Salud , Servicios de Salud para Ancianos/economía , Servicios de Salud para Ancianos/organización & administración , Servicios de Atención de Salud a Domicilio/economía , Servicios de Atención de Salud a Domicilio/normas , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Escalas de Valoración Psiquiátrica , Servicios de Salud Rural/economía , Población RuralRESUMEN
Volunteers offer means through which social workers may extend their ability to support individuals with serious illnesses near the end of life. This study explored the experience of volunteers on teams organized initially as a grassroots movement in response to stigmatized and often socially isolated people with HIV/AIDS dying in the community. Volunteer care teams later expanded to individuals with other serious illnesses. This model spread as a means of meeting the growing need for practical support for seriously ill homebound individuals. Yet, little has been reported in the scientific literature about the interworkings of these teams and their optimal level of functioning. Qualitative inquiry, in the form of semi-structured interviews, explored perspectives of 10 volunteers with experience in volunteer team caring and identified the social processes that shaped their work. The volunteers discussed balance between positive life meaning gained from volunteer work, lessons learned, and negative aspects of a volunteer team approach to caring for the seriously ill in the community. Further investigation is warranted to validate the volunteer care team approach as a cost-effective tool to help seriously ill individuals and caregivers.
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Grupo de Atención al Paciente/organización & administración , Servicio Social/organización & administración , Cuidado Terminal/organización & administración , Cuidado Terminal/psicología , Voluntarios/psicología , Adulto , Alabama , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Habitat loss is the principal threat to species. How much habitat remains-and how quickly it is shrinking-are implicitly included in the way the International Union for Conservation of Nature determines a species' risk of extinction. Many endangered species have habitats that are also fragmented to different extents. Thus, ideally, fragmentation should be quantified in a standard way in risk assessments. Although mapping fragmentation from satellite imagery is easy, efficient techniques for relating maps of remaining habitat to extinction risk are few. Purely spatial metrics from landscape ecology are hard to interpret and do not address extinction directly. Spatially explicit metapopulation models link fragmentation to extinction risk, but standard models work only at small scales. Counterintuitively, these models predict that a species in a large, contiguous habitat will fare worse than one in 2 tiny patches. This occurs because although the species in the large, contiguous habitat has a low probability of extinction, recolonization cannot occur if there are no other patches to provide colonists for a rescue effect. For 4 ecologically comparable bird species of the North Central American highland forests, we devised metapopulation models with area-weighted self-colonization terms; this reflected repopulation of a patch from a remnant of individuals that survived an adverse event. Use of this term gives extra weight to a patch in its own rescue effect. Species assigned least risk status were comparable in long-term extinction risk with those ranked as threatened. This finding suggests that fragmentation has had a substantial negative effect on them that is not accounted for in their Red List category.
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Extinción Biológica , Modelos Teóricos , Animales , Aves/fisiología , Conservación de los Recursos Naturales , Ecosistema , Especies en Peligro de Extinción , Dinámica Poblacional , RiesgoRESUMEN
OBJECTIVE: We examined positive and negative religious coping as moderators of the relation between physical limitations, depression, and desire for hastened death among male inmates incarcerated primarily for murder. METHODS: Inmates over the age of 45 years who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7 years; SD = 10.68). Multiple regression analyses included age, race/ethnicity, parole belief, physical health, positive or negative religious coping, and all two-way interactions represented by the product of health and a religious coping variable. RESULTS: Older inmates and those who reported greater levels of positive religious coping endorsed fewer symptoms of depression, whereas those who reported greater levels of negative religious coping endorsed more symptoms of depression. Inmates who reported higher levels of depression endorsed a greater desire for hastened death. The effect of physical functioning on desire for hastened death is moderated by negative religious coping such that those who endorsed higher levels of negative religious coping reported a greater desire for hastened death. CONCLUSIONS: Examinations of religious/spiritual practices and mindfulness-based interventions in prison research have assumed a positive stance with regard to the potential impact of religious/spiritual coping on physical and mental health. The current findings provide cautionary information that may further assist in selection of inmates for participation in such interventions.
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Trastorno Depresivo/psicología , Estado de Salud , Prisioneros/psicología , Religión , Espiritualidad , Adaptación Psicológica , Anciano , Actitud Frente a la Muerte , Humanos , Masculino , Persona de Mediana Edad , Análisis de RegresiónRESUMEN
Meaning-based coping, particularly religious coping, might lead to positive emotions in stressful situations. Religious coping is common among older adults. We explored the experience of religious coping, organizational religious affiliation, and one's relationship with God among older adults with advanced chronic illness and their caregivers. Research questions included: How is religious coping experienced in this context? How is a relationship with God experienced in coping? How is meaning experienced in this context? Brief qualitative interviews uncovered descriptions of experiences using the qualitative descriptive method. Three themes were identified: God is a provider, one's religion and relationship with God when coping are essential, and the God-person relationship is intimate. Care recipients coped through their personal relationship with God, whereas caregivers coped through religious beliefs and support. Meaning was defined as purpose, responsibility, and duty.
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Adaptación Psicológica , Cuidadores/psicología , Enfermedad Crónica/psicología , Religión y Psicología , Estrés Psicológico , Anciano , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación CualitativaRESUMEN
Climate change shifts ecosystems, altering their compositions and instigating transitions, making climate change the predominant driver of ecosystem instability. Land management agencies experience these climatic effects on ecosystems they administer yet lack applied information to inform mitigation. We address this gap, explaining ecosystem shifts by building relationships between the historical locations of 22 ecosystems (c. 2000) and abiotic data (1970-2000; bioclimate, terrain) within the southwestern United States using 'ensemble' machine learning models. These relationships identify the conditions required for establishing and maintaining southwestern ecosystems (i.e., ecosystem suitability). We projected these historical relationships to mid (2041-2060) and end-of-century (2081-2100) periods using CMIP6 generation BCC-CSM2-MR and GFDL-ESM4 climate models with SSP3-7.0 and SSP5-8.5 emission scenarios. This procedure reveals how ecosystems shift, as suitability typically increases in area (~ 50% (~ 40% SD)), elevation (12-15%) and northing (4-6%) by mid-century. We illustrate where and when ecosystems shift, by mapping suitability predictions temporally and within 52,565 properties (e.g., Federal, State, Tribal). All properties had ≥ 50% changes in suitability for ≥ 1 ecosystem within them, irrespective of size (≥ 16.7 km2). We integrated 9 climate models to quantify predictive uncertainty and exemplify its relevance. Agencies must manage ecosystem shifts transcending jurisdictions. Effective mitigation requires collective action heretofore rarely instituted. Our procedure supplies the climatic context to inform their decisions.
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Stable or growing populations may go extinct when their sizes cannot withstand large swings in temporal variation and stochastic forces. Hence, the minimum abundance threshold defining when populations can persist without human intervention forms a key conservation parameter. We identify this threshold for many populations of Caprinae, typically threatened species lacking demographic data. Doing so helps triage conservation and management actions for threatened or harvested populations. Methodologically, we used population projection matrices and simulations, with starting abundance, recruitment, and adult female survival predicting future abundance, growth rate (λ), and population trend. We incorporated mean demographic rates representative of Caprinae populations and corresponding variances from desert bighorn sheep (Ovis canadensis nelsoni), as a proxy for Caprinae sharing similar life histories. We found a population's minimum abundance resulting in ≤ 0.01 chance of quasi-extinction (QE; population ≤ 5 adult females) in 10 years and ≤ 0.10 QE in 30 years as 50 adult females, or 70 were translocation (removals) pursued. Discovering the threshold required 3 demographic parameters. We show, however, that monitoring populations' relationships to this threshold requires only abundance and recruitment data. This applied approach avoids the logistical and cost hurdles in measuring female survival, making assays of population persistence more practical.
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Especies en Peligro de Extinción , Rumiantes/crecimiento & desarrollo , Animales , Femenino , Humanos , Dinámica Poblacional , Rumiantes/fisiología , Borrego Cimarrón/crecimiento & desarrollo , Borrego Cimarrón/fisiologíaRESUMEN
Managing water (e.g., catchments) to increase the abundance and distribution of game is popular in arid regions, especially throughout the southwest United States, where biologists often manage water year-round for desert bighorn sheep (Ovis canadensis nelsoni). Bighorn may visit water when predators (e.g., mountain lions [Puma concolor], coyotes [Canis latrans]) do not, suggesting that differences in species ecology or their surface water requirements influence visit timing. Alternatively, visits by desert bighorn sheep and predators may align. The former outcome identifies opportunities to improve water management by providing water when desert bighorn sheep visit most, which hypothetically may reduce predator presence, range expansion and predation, thereby supporting objectives to increase sheep abundances. Since advancing water management hinges on understanding the patterns of species visits, we identified when these three species and mule deer (Odocoileus hemionus) visited managed waters in three North American deserts (Chihuahuan, Sonoran, Mojave). We unraveled the ecological basis describing why visits occurred by associating species visits with four weather variables using multi-site, multi-species models within a Bayesian hierarchical framework (3.4 million images; 105 locations; 7/2009-12/2016). Desert bighorn sheep concentrated visits to water within 4-5 contiguous months. Mountain lions visited water essentially year-round within all deserts. Higher maximum temperature influenced visits to water, especially for desert bighorn sheep. Less long-term precipitation (prior 6-week total) raised visits for all species, and influenced mountain lion visits 3-20 times more than mule deer and 3-37 times more than sheep visits. Visits to water by prey were inconsistent predictors of visits to water by mountain lions. Our results suggest improvements to water management by aligning water provision with the patterns and ecological explanations of desert bighorn sheep visits. We exemplify a scientific approach to water management for enhancing stewardship of desert mammals, be it the southwest United States or arid regions elsewhere.
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Animales Salvajes/fisiología , Conducta Predatoria/fisiología , Borrego Cimarrón/fisiología , Animales , Teorema de Bayes , Clima Desértico , Sudoeste de Estados Unidos , Abastecimiento de AguaRESUMEN
With most of the world's Caprinae taxa threatened with extinction, the IUCN appeals to the development of simple and affordable sampling methods that will produce credible abundance and distribution data for helping conserve these species inhabiting remote areas. Traditional sampling approaches, like aerial sampling or mark-capture-recapture, can generate bias by failing to meet sampling assumptions, or by incurring too much cost and logistical burden for most projects to address them. Therefore, we met the IUCN's challenge by testing a sampling technique that leverages imagery from camera traps with conventional distance sampling, validating its operability in mountainous topography by comparing results to known abundances. Our project occurred within a captive facility housing a wild population of desert bighorn sheep (Ovis canadensis) in the Chihuahuan desert of New Mexico, which is censused yearly. True abundance was always within our 90% confidence bounds, and the mean abundance estimates were within 4.9 individuals (average) of the census values. By demonstrating the veracity of this straightforward and inexpensive sampling method, we provide confidence in its operability, urging its use to fill conservation voids for Caprinae and other data-deficient species inhabiting rugged or heavily vegetated terrain.
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Seguimiento de Parámetros Ecológicos/métodos , Ecosistema , Densidad de Población , Borrego Cimarrón , Animales , Artiodáctilos , Conservación de los Recursos Naturales , New Mexico , Robótica , Tamaño de la MuestraRESUMEN
Identifying climatic drivers of an animal population's vital rates and locating where they operate steers conservation efforts to optimize species recovery. The population growth of endangered whooping cranes (Grus americana) hinges on juvenile recruitment. Therefore, we identify climatic drivers (solar activity [sunspots] and weather) of whooping crane recruitment throughout the species' life cycle (breeding, migration, wintering). Our method uses a repeated cross-validated absolute shrinkage and selection operator approach to identify drivers of recruitment. We model effects of climate change on those drivers to predict whooping crane population growth given alternative scenarios of climate change and solar activity. Years with fewer sunspots indicated greater recruitment. Increased precipitation during autumn migration signified less recruitment. On the breeding grounds, fewer days below freezing during winter and more precipitation during breeding suggested less recruitment. We predicted whooping crane recruitment and population growth may fall below long-term averages during all solar cycles when atmospheric CO2 concentration increases, as expected, to 500 ppm by 2050. Species recovery during a typical solar cycle with 500 ppm may require eight times longer than conditions without climate change and the chance of population decline increases to 31%. Although this whooping crane population is growing and may appear secure, long-term threats imposed by climate change and increased solar activity may jeopardize its persistence. Weather on the breeding grounds likely affects recruitment through hydrological processes and predation risk, whereas precipitation during autumn migration may influence juvenile mortality. Mitigating threats or abating climate change should occur within ≈30 years or this wild population of whooping cranes may begin declining.
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Setting conservation goals and management objectives relies on understanding animal habitat preferences. Models that predict preferences combine location data from tracked animals with environmental information, usually at a spatial resolution determined by the available data. This resolution may be biologically irrelevant for the species in question. Individuals likely integrate environmental characteristics over varying distances when evaluating their surroundings; we call this the scale of selection. Even a single characteristic might be viewed differently at different scales; for example, a preference for sheltering under trees does not necessarily imply a fondness for continuous forest. Multi-scale preference is likely to be particularly evident for animals that occupy coarsely heterogeneous landscapes like savannahs. We designed a method to identify scales at which species respond to resources and used these scales to build preference models. We represented different scales of selection by locally averaging, or smoothing, the environmental data using kernels of increasing radii. First, we examined each environmental variable separately across a spectrum of selection scales and found peaks of fit. These 'candidate' scales then determined the environmental data layers entering a multivariable conditional logistic model. We used model selection via AIC to determine the important predictors out of this set. We demonstrate this method using savannah elephants (Loxodonta africana) inhabiting two parks in southern Africa. The multi-scale models were more parsimonious than models using environmental data at only the source resolution. Maps describing habitat preferences also improved when multiple scales were included, as elephants were more often in places predicted to have high neighborhood quality. We conclude that elephants select habitat based on environmental qualities at multiple scales. For them, and likely many other species, biologists should include multiple scales in models of habitat selection. Species environmental preferences and their geospatial projections will be more accurately represented, improving management decisions and conservation planning.
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CONTEXT: Palliative care patients and their family caregivers may have a foreshortened perspective of the time left to live, or the expectation of the patient's death in the near future. Patients and caregivers may report distress in physical, psychological, or existential/spiritual realms. OBJECTIVES: To conduct a randomized controlled trial examining the effectiveness of retired senior volunteers (RSVs) in delivering a reminiscence and creative activity intervention aimed at alleviating palliative care patient and caregiver distress. METHODS: Of the 45 dyads that completed baseline assessments, 28 completed postintervention and 24 completed follow-up assessments. The intervention group received three home visits by RSVs; control group families received three supportive telephone calls by the research staff. Measures included symptom assessment and associated burden, depression, religiousness/spirituality, and meaning in life. RESULTS: Patients in the intervention group reported a significantly greater reduction in frequency of emotional symptoms (P=0.02) and emotional symptom bother (P=0.04) than the control group, as well as improved spiritual functioning. Family caregivers in the intervention group were more likely than control caregivers to endorse items on the Meaning of Life Scale (P=0.02). Only improvement in intervention patients' emotional symptom bother maintained at follow-up after discontinuing RSV contact (P=0.024). CONCLUSION: Delivery of the intervention by RSVs had a positive impact on palliative care patients' emotional symptoms and burden and caregivers' meaning in life. Meaningful prolonged engagement with palliative care patients and caregivers, possibly through alternative modes of treatment delivery such as continued RSV contact, may be necessary for maintenance of therapeutic effects.
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Cuidadores/psicología , Enfermedades Profesionales/prevención & control , Cuidados Paliativos/psicología , Psicoterapia de Grupo/métodos , Apoyo Social , Estrés Psicológico/prevención & control , Voluntarios , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/psicología , Estrés Psicológico/psicología , Resultado del TratamientoRESUMEN
Habitat loss and attendant fragmentation threaten the existence of many species. Conserving these species requires a straightforward and objective method that quantifies how these factors affect their survival. Therefore, we compared a variety of metrics that assess habitat fragmentation in bird ranges, using the geographical ranges of 127 forest endemic passerine birds inhabiting the Atlantic Forest of Brazil. A common, non-biological metric - cumulative area of size-ranked fragments within a species range - was misleading, as the least threatened species had the most habitat fragmentation. Instead, we recommend a modified version of metapopulation capacity. The metric links detailed spatial information on fragment sizes and spatial configuration to the birds' abilities to occupy and disperse across large areas (100,000+ km(2)). In the Atlantic Forest, metapopulation capacities were largely bimodal, in that most species' ranges had either low capacity (high risk of extinction) or high capacity (very small risk of extinction). This pattern persisted within taxonomically and ecologically homogenous groups, indicating that it is driven by fragmentation patterns and not differences in species ecology. Worryingly, we found IUCN considers some 28 of 58 species in the low metapopulation capacity cluster to not be threatened. We propose that assessing the effect of fragmentation will separate species more clearly into distinct risk categories than does a simple assessment of remaining habitat.
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Aves/crecimiento & desarrollo , Ecosistema , Especies en Peligro de Extinción/estadística & datos numéricos , Árboles/crecimiento & desarrollo , Algoritmos , Animales , Aves/clasificación , Brasil , Conservación de los Recursos Naturales/métodos , Conservación de los Recursos Naturales/estadística & datos numéricos , Geografía , Modelos Biológicos , Passeriformes/clasificación , Passeriformes/crecimiento & desarrollo , Densidad de Población , Dinámica PoblacionalRESUMEN
PURPOSE: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated primarily for murder. DESIGN AND METHODS: Inmates over the age of 45 who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7; SD = 10.68). RESULTS: We found a 3-way interaction indicating that the effect of parole expectation on desire for life-sustaining treatment varied by race/ethnicity and treatment. Minority inmates desired cardiopulmonary resuscitation or feeding tubes only if they believed that they would be paroled. The model predicting desire for palliative care was not significant. Future days of desired life were related to prospective health condition, fear of death, negative affect, and trust in prison health care. Caucasian inmates expressed a desire for more days of life out of prison, whereas minority inmates did not differ in days of desired life either in or out of prison. Minorities wanted more days of life than Caucasians but only if they believed that they would be paroled. IMPLICATIONS: End-of-life care for the burgeoning inmate population is costly, and active life-sustaining treatments may not be desired under certain conditions. Specifically, expectation of parole but not current functional ability interacts with future illness condition in explaining inmates' desire for active treatment or days of desired life in the future.
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Envejecimiento , Atención a la Salud , Cuidados Paliativos/psicología , Prisioneros/psicología , Órdenes de Resucitación/psicología , Enfermo Terminal/psicología , Actitud Frente a la Muerte/etnología , Atención a la Salud/economía , Atención a la Salud/ética , Atención a la Salud/normas , Humanos , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Relaciones Médico-Paciente , Prisiones/ética , Órdenes de Resucitación/ética , Encuestas y Cuestionarios , Enfermo Terminal/estadística & datos numéricos , Estados Unidos/epidemiologíaRESUMEN
PURPOSE: Exemplary care (EC) is a new construct encompassing care behaviors that warrants further study within stress process models of dementia caregiving. Previous research has examined EC within the context of cognitively intact older adult care recipients (CRs) and their caregivers (CGs). This study sought to expand our knowledge of quality of care by investigating EC within a diverse sample of dementia CGs. DESIGN AND METHODS: We examined the relation between CG subjective appraisal (daily care bother, burden, and behavioral bother), EC, and CG emotional outcomes (depression and positive aspects of caregiving [PAC]). Specifically, EC was examined as a possible mediator of the effects of CG subjective appraisals on emotional outcomes. Using a bootstrapping method and an SPSS macro developed by Preacher and Hayes (2008 Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models), we tested the indirect effect of EC on the relation between CG subjective appraisals and CG emotional outcomes. RESULTS: Overall, EC partially mediates the relation between the subjective appraisal variables (daily care bother, burden, and behavioral bother) and PAC. Results for depression were similar except that EC did not mediate the relation between burden and depression. This pattern of results varied by race/ethnicity. IMPLICATIONS: Overall, CGs' perception of providing EC to individuals with dementia partially explains the relation between subjective appraisal and symptoms of depression and PAC. Results of this study suggest that interventions may benefit from training CGs to engage in EC to improve their emotional outcomes and quality of care.