Mild Behavioral Impairment and Cerebrovascular Profiles Are Associated with Early Cognitive Impairment in a Community-Based Southeast Asian Cohort.

Background: Mild behavioral impairment (MBI) is one of the earliest observable changes when a person experiences cognitive decline and could be an early manifestation of underlying Alzheimer's disease neuropathology. Limited attention has been given to investigating the clinical applicability of behavioral biomarkers for detection of prodromal dementia. Objective: This study compared the prevalence of self-reported MBI and vascular risk factors in Southeast Asian adults to identify early indicators of cognitive impairment and dementia. Methods: This cohort study utilized baseline data from the Biomarkers and Cognition Study, Singapore (BIOCIS). 607 participants were recruited and classified into three groups: cognitively normal (CN), subjective cognitive decline (SCD), and mild cognitive impairment (MCI). Group comparisons of cognitive-behavioral, neuroimaging, and blood biomarkers data were applied using univariate analyses. Multivariate logistic regression analyses were conducted to investigate the association between cerebrovascular disease, vascular profiles, and cognitive impairment. Results: SCD had significantly higher depression scores and poorer quality of life (QOL) compared to CN. MCI had significantly higher depression scores; total MBI symptoms, MBI-interest, MBI-mood, and MBI-beliefs; poorer sleep quality; and poorer QOL compared to CN. Higher Staals scores, glucose levels, and systolic blood pressure were significantly associated with MCI classification. Fasting glucose levels were significantly correlated with depression, anxiety, MBI-social, and poorer sleep quality. Conclusions: The results reflect current research that behavioral changes are among the first symptoms noticeable to the person themselves as they begin to experience cognitive decline. Self-reported questionnaires may aid in early diagnoses of prodromal dementia. Behavioral changes and diabetes could be potential targets for preventative healthcare for dementia.

Proactive career management for female health professionals: a scoping review protocol.

INTRODUCTION: Many women in frontline healthcare positions face work demands that are incompatible with their needs and aspirations, resulting in poorer work satisfaction and engagement, and greater probability of leaving their jobs. Proactive career management is associated with elevated well-being and career success but may not be accessible to female health professionals who encounter social, cultural and structural barriers. The complex and diverse nature of proactive career management and absence of a comprehensive review on the topic necessitates a synthesis of extant literature. This study aims to identify (i) proactive career management behaviours and activities among female health professionals and (ii) outcomes of proactive career management initiatives. This study will contribute to a larger study on encouraging proactive career management behaviours among Singapore female health professionals. METHODS AND ANALYSES: Scoping review is used as our method of evidence synthesis to provide a comprehensive overview of all available constructs and markers of interest. This study started in January 2022. Original research, reviews, short reports, letters, methodologies and case studies relevant to our objectives will be examined with guidance from Arksey and O'Malley's framework. The literature contained in scientific databases and grey literature sources will be thoroughly searched. Two independent reviewers will screen citations for eligibility and extract data from the included articles. Extracted data will be narratively synthesised by two independent reviewers using Braun and Clarke's six steps of thematic analysis. We will observe the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews standards in reporting the results. An advisory panel will provide insights on the applicability of the results to negate confirmation bias. ETHICS AND DISSEMINATION: Ethics clearance is not required. Dissemination plans include peer-reviewed journal publication and conference presentations. REGISTRATION DETAILS: This review was registered on open science framework (Registration DOI: https://doi.org/10.17605/OSF.IO/2SY8V).

The Good Enough Parenting early intervention schema therapy based program: Participant experience.

BACKGROUND AND OBJECTIVES: Schema therapy (ST) has become a mainstream therapy for the treatment of psychopathology and has been validated through a series of large scale, international randomized control trials. Among other things, schema therapy emphasizes the meeting of core emotional needs in children by primary caregivers as these unmet needs continue to adversely affect their lives into adulthood. An early intervention parenting program has been developed to help parents meet these core emotional needs in order to prevent the development of psychopathology in the first place. The program, Good Enough Parenting, is equally focused on reducing problems and strengthening parenting practices, regardless of where the child is on the "disordered to well-being continuum". This study aims to explore "patient experience" by users of this program. Best clinical research guidelines advocate that participants should be used as collaborators rather than pure recipients; this process should predate large scale trials. DESIGN: An exploratory qualitative study with 55 parent-participants of Good Enough Parenting was conducted. METHODS: One-to-one interviews were conducted with participants, using critical incident technique and guided by semi-structured interview schedule, to explore their experiences with the program. Transcripts were then analyzed using thematic analysis. RESULTS: Coding showed a high degree of inter-rater reliability (kappa value of 0.78). The themes that emerged were Cultivating Awareness of Parents' Own Schemas, Cultivating Intentionality, Working through Developmental Issues, Responses to Challenges at Home, Performing Multiple Roles, and the Learning Process. Participants overwhelmingly reported satisfaction within these key themes. CONCLUSIONS: The results support the development of the program and the choice of "participant reported outcome measures" for use in subsequent randomized controlled trials.

Formal Long-Term Care: Informal Caregivers' Subjective Well-Being and Service Utilization.

This thesis aimed to elucidate the role of informal caregiver subjective well-being in explaining formal long-term care service (LTCS) use. A systematic review and meta-analysis of literature found that elevated caregiver burden, caregiver depression, and poorer caregiver health status are associated with increased formal LTCS use. Quantitative analyses of longitudinal data collected from stroke survivors and their caregivers revealed that increased caregiving burden and caregiver depression are prospective and concurrent predictors of stroke rehabilitation use at 12-month post-stroke, and that non-distressed caregivers at 3-month post-stroke and 12-month post-stroke are likely to have cared for stroke rehabilitation users at 12-month post-stroke.