Attributional retraining: Promoting psychological wellbeing in older adults with compromised health.

Older adults make up the largest portion of the population of physically inactive individuals. Health challenges, and psychological barriers (e.g., maladaptive causal attributions), contribute to reduced activity engagement and low perceived control. This pilot study tested an attributional retraining (AR) intervention designed to increase control-related outcomes in a physical activity context for older adults with compromised health. Using a randomized treatment design, we examined treatment effects on a sample of older adults attending a day hospital (N = 37, M age = 80). We employed ANCOVAs, controlling for age, sex, and morbidity, to assess differences in post-treatment outcomes between AR and No-AR conditions. AR recipients (vs. No-AR) reported lower post-treatment helplessness and more perceived control over their health. Our study offers evidence for AR to increase control-related outcomes and lays the groundwork for further research into supporting older adult populations with compromised health.

Risk for post-thrombotic syndrome after lower-limb deep vein thrombosis: location of the thrombus or residual thrombi? / Risk razvitiia posttromboflebiticheskogo sindroma posle tromboza glubokikh ven nizhnikh konechnostei: lokalizatsiia tromba ili rezidual'nyi tromboz?

BACKGROUND: Many works aimed to determine factors that influence the onset of postthrombotic syndrome after an acute episode of deep venous thrombosis. We aimed to compare the prognostic value of the most proximal extent of thrombus (proximal and distal DVT) versus the residual thrombosis as identified by venous ultrasonography performed during follow-up. METHOD: We conducted a retrospective study of prospectively collected 1183 consecutive cohort patients in the RIETE registry after a first episode of deep venous thrombosis and assessed for postthrombotic syndrome after 12 months. RESULTS: Multivariate analysis revealed that: residual thrombosis (OR 1.40; 95% CI 0,88-2,21), the presence of cancer (OR 1.38; 95% CI: 0,64-2,97), immobility (OR 1.31; 95% CI 0,70-2,43) and estrogen-containing drugs use (OR 2.08, 95% CI 0,63-6,83), all had a predictive value for the occurrence of PTS. CONCLUSION: Our study results revealed that ultrasound finding of residual thrombosis is more predictive than proximal location of thrombus for postthrombotic syndrome after episode of deep venous thrombosis. Real life data from a large group of patients from the RIETE registry substantiates that.

Utilization of a time-limited holiday hotline by older adults.

Lonely older adults are frequently hesitant to reach out for help because they fear forced institutionalization or other loss of control over their lives. The utilization of a time-limited holiday hotline for outreach to lonely older persons is examined. There were 306 calls from aged persons. Grief and bereavement were the primary themes of these calls. Trained professionals and supervised students staffed the telephone bank and provided such services as responsive listening and community referrals.

Health care barriers and interventions for battered women.

Family violence is a major public health problem. Battered women present with multiple physical injuries in hospital emergency rooms, clinics, and personal physicians' offices. Yet, they are often not identified as battered and fail to receive appropriate treatment for the nonphysical effects of these events. Instead, only discrete physical injuries are identified. The authors explore the literature to identify barriers in recognizing and treating battered women. These barriers are viewed as a microcosm of the larger public health problem in which battered women fear identifying themselves and often are not recognized by public health professionals. Some barriers pertain to the victims themselves; others can be attributed to the attitudes of medical care providers in emergency rooms, clinics, and private physicians' offices. The many faceted needs of victims require a variety of interventions including medical models, criminal justice intervention systems, and social models for change. Some intervention strategies that are currently being employed in various programs in the United States are described.

The time-limited hot line.

Although long-term hot lines that focus on crisis intervention will undoubtedly dominate as an organizational model, time-limited approaches will be used with increasing frequency. The primary impetus behind their proliferation is the increasing visibility of the electronic media, particularly television, in investigating and reporting pressing health, mental health, and human services problems. As the mass media increasingly produces special reports, documentaries, and docudramas directed toward social problems and issues, local health and human services agencies will become increasingly motivated to provide a forum for public response. The time-limited issue- or problem-oriented hot line is the ideal vehicle for public response as well as for extending the human services network. This type of hot line also offers social workers a unique opportunity to share important mental health information through the media.

Computed tomographic evaluation of therapeutically induced changes in primary and secondary brain tumors.

A prospective study was initiated to evaluate computed tomography as a method for monitoring therapeutically induced changes in brain tumors. Early postoperative scans may be misleading in the evaluation of residual tumor because of trauma to the blood-brain barrier during operation. The size of the dominant mass (17/25), enhancement (11/25), edema (11/25), and ventricular distortion (14/25) were decreased in many patients after radiation therapy. Occasional tumors increased in size during radiation therapy (3/25). Enlargement of the lateral ventricles developed in 9 of 25 patients. Computed tomography offers definite advantages over nuclide brain scans, angiography and other diagnostic studies for evaluating therapeutically induced changes in brain tumors.