The Moderation Role of Neuroticism for Anxiety among Burdened Dementia Caregivers: A Study on Care Giver-Recipient Dyads.

Caregiving burden proves to be a risk factor of anxiety disorders and anxiety affection. The current study investigates how an endogenous personality dimension - neuroticism - moderates the association between caregiving burden and anxiety affection. Between 2015 and 2017, the study deployed a cross-sectional survey of 674 (response rate = 89%) older adults who were hospitalized for dementia at two hospitals. From all primary caregivers of these patients, 661 agreed to participate in the survey which yielded 661 matched dyads as the final sample. Caregiving burden, neuroticism, and anxiety affection were each measured by established assessment instruments. We employed multivariate OLS regression to test the moderator and regressor effects. We found that care burden is a significant risk factor of higher levels of anxiety affection (ß = .17, p < .001), and accounts for 4.6% of the variance in anxiety. Neurotic personality is also significantly associated with a greater level of anxiety (ß = .26, p < .001). Neurotic personality moderates the association between anxiety and care burden (ß = .24, p < .001). Our findings suggest that social and healthcare workers should assess caregiver personality and burden as well as provide support, resources, and coping strategies to those with neurotic personality traits or high care burden in an effort to reduce anxiety among caregivers.

Human-mediated disturbance in multitrophic interactions results in outbreak levels of North America's most venomous caterpillar.

Anthropogenic environmental change is predicted to disrupt multitrophic interactions, which may have drastic consequences for population-level processes. Here, we investigate how a large-scale human-mediated disturbance affects the abundance of North America's most venomous caterpillar species, Megalopyge opercularis. Specifically, we used a natural experiment where netting was deployed to cover the entire canopies of a subset of mature southern live oak trees (Quercus virginiana) to exclude urban pest birds (grackles and pigeons), throughout an 8.1 km2 area encompassing a medical centre in Houston, Texas. We used this experimental exclusion to test the following hypothesis: release from avian predators increases caterpillar abundance to outbreak levels, which increases the risk to human health. Results from a multi-year survey show that caterpillar abundance increased, on average, more than 7300% on netted versus non-netted trees. Thus, increases in caterpillar abundance due to anthropogenic enemy release increase human exposure to this venomous pest, and should be considered a health threat in the area. This study emphasizes the unforeseen consequences of ecological disturbance for species interactions and highlights the importance of considering ecology in urban planning.

Alcopops, taxation and harm: a segmented time series analysis of emergency department presentations.

BACKGROUND: In Australia, a Goods and Services Tax (GST) introduced in 2000 led to a decline in the price of ready-to-drink (RTD) beverages relative to other alcohol products. The 2008 RTD ("alcopops") tax increased RTD prices. The objective of this study was to estimate the change in incidence of Emergency Department (ED) presentations for acute alcohol problems associated with each tax. METHODS: Segmented regression analyses were performed on age and sex-specific time series of monthly presentation rates for acute alcohol problems to 39 hospital emergency departments across New South Wales, Australia over 15 years, 1997 to 2011. Indicator variables represented the introduction of each tax. Retail liquor turnover controlled for large-scale economic factors such as the global financial crisis that may have influenced demand. Under-age (15-17 years) and legal age (18 years and over) drinkers were included. RESULTS: The GST was associated with a statistically significant increase in ED presentations for acute alcohol problems among 18-24 year old females (0 · 14/100,000/month, 95% CI 0 · 05-0 · 22). The subsequent alcopops tax was associated with a statistically significant decrease in males 15-50 years, and females 15-65 years, particularly in 18-24 year old females (-0 · 37/100,000/month, 95% CI -0 · 45 to -0 · 29). An increase in retail turnover of liquor was positively and statistically significantly associated with ED presentations for acute alcohol problems across all age and sex strata. CONCLUSIONS: Reduced tax on RTDs was associated with increasing ED presentations for acute alcohol problems among young women. The alcopops tax was associated with declining presentations in young to middle-aged persons of both sexes, including under-age drinkers.

Length of hospital stay and discharge disposition in older trauma patients.

As the number of older adults increases and life expectancies are increasing, more incidences of traumatic injury are expected in this population. In this study, the relationships between demographic variables, pain, days from admission to therapy evaluation, length of stay and discharge disposition were examined in 132 older adults who had experienced a traumatic event. Results showed that significant relationships existed between pain, age, comorbidities, injury severity and days from admission to therapy evaluation and length of stay; those with less pain, greater age and had more days between admission and when the first therapy evaluation occurred had longer lengths of stay. In addition, demographic variables, overall length of stay and pain intensity during therapy were associated with discharge location; for longer lengths of stay and higher pain, older trauma patients were less likely to be discharged to home.

Building a research-focused academic practice partnership: A stepwise approach.

The 20th century began a period of reform in nursing education and practice, with more nurses receiving advanced degrees and serving in key leadership roles throughout healthcare organizations. During this period, the transformation of the healthcare delivery system encouraged innovation and collaboration between academic nursing programs and other healthcare entities to develop partnerships based on a shared vision and goals. As a result, nurses are negotiating academic-practice partnership agreements and leading interprofessional teams to meet the needs of collaborating organizations. This article describes a stepwise approach to building a research-focused academic practice partnership, from a needs assessment to an evaluation of the partnership.

Strategies for transitioning from a clinical position to a faculty role.

The nation faces a continued shortage of nurses that is projected to worsen in the next decade. The nursing shortage is fueled by a lack of faculty to educate nurses for entry into practice and advanced nursing practice positions. Many faculty enter academia after achieving expertise in a specialty area of clinical practice. These expert clinicians transition to novice faculty, a move that can be challenging and overwhelming. New faculty require guidance in understanding the various academic regulatory organizations; university structure, policies, and regulations; faculty responsibilities related to the university missions of teaching, service, practice, and scholarship; and face challenges with the need for new skills such as classroom management, curriculum development, and an understanding of the different culture and language of academia. The authors provide evidence from the literature and strategies and tips based on their experience for an expert clinician's successful transition from a clinical role to an academic position.

Childhood Disadvantage and Adult Functional Status: Do Early-Life Exposures Jeopardize Healthy Aging?

OBJECTIVES: To examine whether childhood disadvantage is associated with later-life functional status and identify mediating factors. METHODS: Unique and additive effects of five childhood domains on functional status were assessed at baseline (2006) and over time (2006-2016) in a sample of 13,894 adults from the Health and Retirement Study (>50 years). Adult health behaviors and socioeconomic status (SES) were tested as mediators. RESULTS: Respondents exposed to multiple childhood disadvantages (OR = .694) as well as low childhood SES (OR = .615), chronic diseases (OR = .694), impairments (OR = .599), and risky adolescent behaviors (OR = .608) were less likely to be free of functional disability by baseline. Over time, these unique and additive effects of childhood disadvantage increased the hazard odds of eventually developing functional disability (e.g., additive effect: hOR = 1.261). Adult health behaviors and SES mediated some of these effects. DISCUSSION: Given the enduring effects of childhood disadvantage, policies to promote healthy aging should reduce exposure to childhood disadvantage.

Longitudinal links between behavioral activation coping strategies and depressive symptoms of U.S. adults living alone during the COVID-19 pandemic.

The COVID-19 pandemic and related physical distancing measures have posed a significant threat to the mental health of adults, particularly those living alone. Accordingly, the World Health Organization implemented the #HealthyAtHome program, encouraging people to keep in regular contact with loved ones, stay physically active, and keep a regular routine. The current study aims to examine a micro-longitudinal link between behavioral activation coping strategies (exercise, meditation, relaxation, and social connection) and depressive symptoms among adults who lived alone during the COVID-19 pandemic. We used 21 biweekly waves of longitudinal data from the Understanding America Study (UAS) collected between April 2020 and February 2021 (N = 1,280). The multilevel models with correlated random effects were estimated to examine lagged effects of coping strategies (t-1) on depressive symptoms (t). The results showed that exercise was predictive of lower depressive symptoms even after controlling for time-invariant and time-varying covariates. The results showed that modifiable lifestyle factors, such as taking time to exercise, may be beneficial for the mental health of Americans living in single-person households.

Do Early-Life Social, Behavioral, and Health Exposures Increase Later-Life Arthritis Incidence?

OBJECTIVES: This study investigates direct and indirect influences of childhood social, behavioral, and health exposures on later-life osteoarthritis and rheumatoid arthritis development. METHODS: Drawing from cumulative inequality theory and six waves of the Health and Retirement Study (2004-2014), we estimate structural equation modeling-based discrete-time survival analysis of the association between six childhood exposure domains and both osteoarthritis and rheumatoid arthritis incidence for men (n = 2720) and women (n = 2974). Using the delta method to test for mediation, we examine indirect effects via selected health-related risks and resources. RESULTS: Risky adolescent behavior is associated with rheumatoid arthritis incidence for women (h.O.R. = 1.883, 95% C.I. [1.016, 3.490]), whereas several types of childhood exposures are associated with later-life osteoarthritis development for both men and women. Experiencing two or more childhood socioeconomic disadvantages is indirectly associated with osteoarthritis (men: coef. = 0.024, 95% C.I. [0.003, 0.045]; women: coef. = 0.111, 95% C.I. [0.071, 0.150]) and rheumatoid arthritis (men: coef. = 0.037, 95% C.I. [0.000, 0.074]; women: coef. = 0.097, 95% C.I. [0.035, 0.159]) development through adult body mass index. DISCUSSION: Findings highlight the importance of childhood contexts in understanding the development of later-life osteoarthritis and rheumatoid arthritis.

Scientists without borders: lessons from Ukraine.

Conflicts and natural disasters affect entire populations of the countries involved and, in addition to the thousands of lives destroyed, have a substantial negative impact on the scientific advances these countries provide. The unprovoked invasion of Ukraine by Russia, the devastating earthquake in Turkey and Syria, and the ongoing conflicts in the Middle East are just a few examples. Millions of people have been killed or displaced, their futures uncertain. These events have resulted in extensive infrastructure collapse, with loss of electricity, transportation, and access to services. Schools, universities, and research centers have been destroyed along with decades' worth of data, samples, and findings. Scholars in disaster areas face short- and long-term problems in terms of what they can accomplish now for obtaining grants and for employment in the long run. In our interconnected world, conflicts and disasters are no longer a local problem but have wide-ranging impacts on the entire world, both now and in the future. Here, we focus on the current and ongoing impact of war on the scientific community within Ukraine and from this draw lessons that can be applied to all affected countries where scientists at risk are facing hardship. We present and classify examples of effective and feasible mechanisms used to support researchers in countries facing hardship and discuss how these can be implemented with help from the international scientific community and what more is desperately needed. Reaching out, providing accessible training opportunities, and developing collaborations should increase inclusion and connectivity, support scientific advancements within affected communities, and expedite postwar and disaster recovery.

Early Origins of Body Mass in Later Life: Examining Childhood Risks and Adult Pathways.

Prior research reveals that negative early-life experiences play a major role in the development of obesity in later life, but few studies identify mechanisms that alter the lifetime risk of obesity. This study examines the influence of negative childhood experiences on body mass index (BMI) and obesity (BMI ≥30) during older adulthood and the psychosocial and behavioral pathways involved. Using a nationally representative sample, we examine the influence of cumulative misfortune as well as five separate domains of misfortune on BMI and obesity. Results show that four of the five domains are associated with BMI and obesity either directly, indirectly, or both. The influence of cumulative misfortune on the outcomes is mediated by three adult factors: socioeconomic status, depressive symptoms, and physical activity. The mediators identified here provide targets for intervention among older adults to help offset the health risks of excess BMI attributable of early-life exposure to misfortune.

Research in nursing education and the institutional review board/ethics committee.

BACKGROUND: Institutional review board (IRB) or research ethics committee approval is intended to protect the rights of human subjects. Assurance that ethical standards are met is essential for educational research and quality improvement (QI) projects involving human subjects. PURPOSE: The purposes were to describe the requirements of nursing journals for educational studies and QI projects related to education to be reviewed by an IRB or a research ethics committee and to identify the types of statements of approval or exemption to be included in manuscripts. METHOD: The investigators employed an electronic survey sent to members of the International Academy of Nursing Editors list serve. Responses representing 64 nursing journals were received. RESULTS: The majority of journals that publish academic educational studies (n = 32, 86.5%) always required IRB or other ethics committee review, and 17 (45.9%) required the same for QI projects related to education. An IRB or research ethics committee review was always required by journals for educational studies (n = 24, 88.9%) and for QI projects (n = 14, 51.9%) involving the professional development of nurses. CONCLUSIONS: Educational studies that involve human subjects should be reviewed by an IRB or other type of research ethics committee before implementing the study. Any determination of exemption should be made by the IRB or research ethics committee, not by the investigator.

Collaboration between civilian and military healthcare professionals: a better way for planning, preparing, and responding to all hazard domestic events.

Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial. This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.

Strategies to Turn a Graduate School Paper Into a Publishable Journal Manuscript.

Graduate students complete papers for course requirements, doctor of nursing practice and master's projects, and doctoral dissertations. The valuable information contained in these school papers may be appropriate for publication in professional journals. Graduate students must learn the key differences between school paper and journal article styles. Using this critical information, students can revise their school papers in journal style and achieve a successful publication that contributes to the literature and, ultimately, to the care of patients and their families.

Early Social Origins of Biological Risks for Men and Women in Later Life.

We investigate whether childhood exposures influence adult chronic inflammation and mortality risk via adult health characteristics and socioeconomic status (SES) and whether gender moderates these relationships. Analyzing a longitudinal national sample of 9,310 men and women over age 50, we found that childhood SES, parental behaviors, and adolescent behaviors were associated with adult chronic inflammation via health characteristics and SES in adulthood. The process of disadvantage initiated by low childhood SES (i.e., adult health risk factors, socioeconomic disadvantage, and chronic inflammation) subsequently raised mortality risk. In addition, gender moderated the mediating influence of childhood SES via unhealthy behaviors and parental behaviors via adult SES. Demonstrating how social forces shape biological health through multiple mechanisms informs health policies by identifying multiple points of intervention in an effort to reduce the lasting consequences of childhood disadvantage.

Childhood Misfortune and Handgrip Strength Among Black, White, and Hispanic Americans.

OBJECTIVE: Although early-life insults may affect health, few studies use objective physical measures of adult health. This study investigated whether experiencing misfortune during childhood is associated with handgrip strength (HGS) in later life. METHOD: Data on childhood misfortune and adult characteristics from the Health and Retirement Study were used to predict baseline and longitudinal change in HGS among White, Black, and Hispanic American men and women. RESULTS: Regression analyses revealed that multiple indicators of childhood misfortune were related to HGS at baseline, but the relationships were distinct for men and women. Over the study, having one childhood impairment predicted steeper declines in HGS for men, but childhood misfortune was unrelated to HGS change among women. Hispanic Americans had lower baseline HGS than their non-Hispanic counterparts and manifested steeper declines in HGS. DISCUSSION: The relationship between childhood exposures and adult HGS varied by the type of misfortune, but there was no evidence that the relationship varied by race/ethnicity. The significant and enduring Hispanic disadvantage in HGS warrants greater attention in gerontology.

Pearls of wisdom for chief academic nursing leaders.

There is a significant shortage of executive leadership in nursing academia with large numbers of deans have retired and many more are expected in the upcoming years (AACN, 2015). This has resulted in a steady upward trend of nursing schools reporting a change in deans over the past 5 years; many of the changes in academic nursing leadership involve deans who are new to the role. The role expectations of chief academic nursing leaders are very complex and for which few new leaders are completely prepared. This article describes the role and competencies of the chief academic nursing leader and presents "pearls" for success for new leaders assuming this role.

Does Early-Life Misfortune Increase the Likelihood of Psychotropic Medication Use in Later Life?

Life-course research has linked childhood experiences to adult mental illness, but most studies focus on anxiety or depressive symptoms, which may be transient. Therefore, this study investigates whether childhood misfortune is associated with taking psychotropic medication, a measure reflecting an underlying chronic mental disorder. Data are from three waves of a national survey of 2,999 U.S. men and women aged 25-74 years. Four domains of childhood misfortune (childhood socioeconomic status, family structure, child maltreatment, and poor health) are considered-specified as separate domains and a single additive measure-as key predictors of psychotropic medication use. Findings reveal an association between additive childhood misfortune and adult psychotropic medication use, net of adult risk factors. Psychotropic medication use is also more likely during the 20-year study for adults who experienced maltreatment and poor health during childhood. These results reveal the importance of early intervention to reduce consumption of psychotropic medications and associated costs.

What Do We Mean by Accumulation? Advancing Conceptual Precision for a Core Idea in Gerontology.

In recent decades, the concept of accumulation has gained prominence in research on aging, health, and social stratification. Accumulation is now studied in multiple disciplines, revealing that cumulative processes are crucial to understanding patterns of differentiation over the life course. Although this research has demonstrated the empirical value of studying accumulation, the concept has taken on different and sometimes inconsistent meanings. To address these inconsistencies, we propose an interdisciplinary conceptual framework of accumulation that focuses on objects, timing, thresholds, de-accumulation, and the levels and consequences of accumulation. Providing a coherent framework of accumulation will aid conceptual precision, guide future research, and inform public policies related to aging and the life course.

Early Origins of Adult Cancer Risk Among Men and Women: Influence of Childhood Misfortune?

OBJECTIVE: To examine the effect of five childhood misfortune domains-parental behavior, socioeconomic status, infectious diseases, chronic diseases, and impairments-on all-site and selected site-specific cancer prevalence and all-site cancer incidence. METHOD: Panel data from the Health and Retirement Study (2004-2012) were used to investigate cancer risk among adults above the age of 50. RESULTS: Risky parental behavior and impairment in childhood were associated with higher odds of all-site cancer prevalence, and childhood chronic disease was associated with prostate cancer, even after adjusting for adult health and socioeconomic factors. Moreover, having one infectious disease in childhood lowered the odds of colon cancer. Cancer trends varied by race and ethnicity, most notably, higher prostate cancer prevalence among Black men and lower all-site cancer among Hispanic adults. DISCUSSION: These findings underscore the importance of examining multiple domains of misfortune because the type and amount of misfortune influence cancer risk in different ways.