Incidence and Predictors of Incontinence-Associated Skin Damage in Nursing Home Residents With New-Onset Incontinence.

PURPOSE: The purpose of this study was to determine the incidence and predictors of incontinence-associated dermatitis (IAD) in nursing home residents. METHODS: Records of a cohort of 10,713 elderly (≥65 years) newly incontinent nursing home residents in 448 nursing homes in 28 states free of IAD were followed up for IAD development. Potential multilevel predictors of IAD were identified in 4 national datasets containing information about the characteristics of individual nursing home residents, nursing home care environment, and communities in which the nursing homes were located. A unique set of health practitioner orders provided information about IAD and the predictors of IAD prevention and pressure injuries in the extended perineal area. Analysis was based on hierarchical logistical regression. RESULTS: The incidence of IAD was 5.5%. Significant predictors of IAD were not receiving preventive interventions for IAD, presence of a perineal pressure injury, having greater functional limitations in activities of daily living, more perfusion problems, and lesser cognitive deficits. CONCLUSION: Findings highlight the importance of prevention of IAD and treatment/prevention of pressure injuries. A WOC nurse offers expertise in these interventions and can educate staff about IAD predictors, which can improve resident outcomes. Other recommendations include implementing plans of care to improve functional status, treat perfusion problems, and provide assistance with incontinence and skin care to residents with milder as well as greater cognitive deficits.

Adolescents' conscious processes of developing regulation: learning to appraise challenges.

To understand regulation and agency, it important to consider the nature of the regulatory challenges that adolescents must deal with. These include emotional, motivation, interpersonal, and other obstacles and problems. In this chapter, the author discusses the challenges reported by youth working on arts, technology, and social justice projects in organized programs and how they learn to address them. Adolescents' new higher-order cognitive capacities allow them to better understand the irregularities and complexity of real-world challenges. They also use these capacities to consciously develop skills to navigate these challenges.

Differing profiles of developmental experiences across types of organized youth activities.

This study inventoried the types of developmental and negative experiences that youth encounter in different categories of extracurricular and community-based organized activities. A representative sample of 2,280 11th graders from 19 diverse high schools responded to a computer-administered protocol. Youth in faith-based activities reported higher rates of experiences related to identity, emotional regulation, and interpersonal development in comparison with other activities. Sports and arts programs stood out as providing more experiences related to development of initiative, although sports were also related to high stress. Service activities were associated with experiences related to development of teamwork, positive relationships, and social capital. Youth reported all of these positive developmental experiences to occur significantly more often in youth programs than during school classes.