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Elder mistreatment is common, serious, and under-recognized, with Emergency Department and hospital clinical encounters offering a potential but currently unrealized opportunity to identify and help older adults experiencing mistreatment. Interdisciplinary emergency department and hospital-based response teams represent a promising care model to address this. This manuscript describes two such teams and introduces a special issue dedicated to this work.
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The bioblitz phenomenon has recently branched into cities, presenting exciting opportunities for local governments to channel participants' efforts toward local issues. The City Nature Challenge (CNC) is one such initiative that has been quickly taken up by hundreds of municipalities worldwide. Despite high levels of participation, we still lack a framework for evaluating how the CNC contributes to local biodiversity knowledge and to inform local government practices. In the present article, we develop such a tool and present a case study that illustrates its applicability. We demonstrate that the collected records contributed to a better understanding of contemporary, local biodiversity patterns and provide a more realistic representation of understudied groups such as insects and fungi. Importantly, we show that the CNC presented local governments with a cost-effective tool to make informed, evidence-based management and policy decisions, improve education and engagement programs, foster cross-council collaborations, and support a stronger sense of environmental stewardship within the local community.
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Elder mistreatment, including elder abuse and neglect, is a difficult diagnosis to make and manage for most providers. To address this, two elder abuse consultation teams were developed for patients in the hospital and emergency department settings. As these teams have developed, the providers involved have obtained specialized training and experience that we believe contributes to a new field of elder abuse geriatrics, a corollary to the well-established field of child abuse pediatrics. Providers working in this field require specialized training and have a specialized scope of practice that includes forensic evaluation, evaluation of cognition and capacity, care coordination and advocacy for victims of abuse, and collaboration with protective services and law enforcement. Here we describe the training, scope of practice, ethical role, and best practices for elder mistreatment medical consultation. We hope this will serve as a starting point for this new and important medical specialty.
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AIMS: Intimate partner violence (IPV) is a global public health concern with negative effects on individuals and families. The present study investigated the prevalence, risk factors and gender disparities associated with IPV during the Shanghai 2022 Covid-19 lockdown - a public health emergency which may have exacerbated IPV. METHODS: We estimated the total IPV prevalence and prevalence of physical, sexual and verbal IPV by using an adapted version of the Extended-Hurt, Insult, Threaten, Scream scale. This cross-sectional study was carried out using a population quota-based sampling of Shanghai residents across 16 districts during the 2022 Shanghai lockdown (N = 2026; 1058 men and 968 women). RESULTS: We found a distinct gendered dynamic, where women reported a significantly higher prevalence of experienced IPV (27.1%, 95% confidence interval [CI]: 23.1-31.4) compared to men (19.8%, 95% CI: 16.1-24.0). Notably, the prevalence estimate mirrored the national lifetime IPV prevalence for women but was over twice as high for men. In multivariable logistic regression analyses, economic stress (income loss: adjusted OR [aOR] = 2.42, 95% CI: 1.28-4.56; job loss: aOR = 1.73, 95% CI: 1.02-2.92; financial worry much more than usual: aOR = 1.89, 95% CI: 1.00-3.57) and household burden (one child at home: aOR = 1.81, 95% CI: 1.12-2.92; not enough food: aOR = 1.67, 95% CI: 1.04-2.70) were associated with increased odds of overall IPV victimization among women but not men. With regard to more serious forms of IPV, job loss (aOR = 2.27, 95% CI: 1.09-4.69) and household burden (two or more children at home: aOR = 2.95, 95% CI: 1.33-7.69) were associated with increased odds of physical IPV against men. For women, a lack of household supplies was associated with increased odds of physical IPV (water: aOR = 3.33, 95% CI: 1.79-6.25; daily supplies: aOR = 2.27, 95% CI: 1.18-4.35). Lack of daily supplies (aOR = 2.17, 95% CI: 1.03-4.55) and job loss (aOR = 2.66, 95% CI: 1.16-6.12) were also associated with increased odds of sexual IPV. CONCLUSIONS: Although a larger proportion of women reported IPV, men experienced greater IPV during the lockdown than previously estimated before the pandemic. Economic stressors, including job loss, and household burden were critical risk factors for serious forms of IPV. Improving gender equality that my account for disparities in IPV in China is critically needed. Policies that mitigate the impact of economic losses during crises can potentially reduce IPV.
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Violencia de Pareja , Masculino , Niño , Humanos , Femenino , Prevalencia , Estudios Transversales , China/epidemiología , Factores de RiesgoRESUMEN
Interdisciplinary Emergency Department/hospital-based teams represent a promising care model to improve identification of and intervention for elder mistreatment. Two institutions, Weill Cornell Medicine/NewYork-Presbyterian Hospital and the University of Colorado Anschutz Medical Campus have launched such programs and are exploring multiple strategies for effective dissemination. These strategies include: (1) program evaluation research, (2) framing as a new model of geriatric care, (3) understanding the existing incentives of health systems, EDs, and hospitals to align with them, (4) connecting to ongoing ED/hospital initiatives, (5) identifying and collaborating with communities with strong elder mistreatment response that want to integrate the ED/hospital, (6) developing and making easily accessible high-quality, comprehensive protocols and training materials, (7) offering technical assistance and support, (8) communications outreach to raise awareness, and (9) using an existing framework to inform implementation in new hospitals and health systems.
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The importance of psychological detachment during nonwork time has been emphasized, and its effect on depressive symptoms has been identified. However, the mechanism underlying this association remains to be elucidated. This study was conducted to identify the indirect role of emotional exhaustion in the association between psychological detachment and depressive symptoms and the moderating role of self-compassion in the relationship between emotional exhaustion and depressive symptoms on the basis of the recovery-engagement-exhaustion model and emotion regulation theory. Through an online survey, relevant data were collected from 727 university teachers (mean age, 37.65 ± 7.77 years; 38.5% men). Indirect and moderation effect were analyzed through structural equation modeling (Mplus). Psychological detachment was found to be associated with depressive symptoms through emotional exhaustion. Self-compassion moderated the association between emotional exhaustion and depressive symptoms. The association between emotional exhaustion and depressive symptoms was weaker among university teachers with high levels of self-compassion than among those with low levels of self-compassion. This study improves our understanding of the association between psychological detachment and depressive symptoms by identifying the emotional pathway and protective function of self-compassion. Interventions for improving mental health in work context should be designed considering psychological detachment and self-compassion to deal with work-induced emotional strain.
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Depresión , Autocompasión , Masculino , Humanos , Adulto , Persona de Mediana Edad , Femenino , Depresión/psicología , Empatía , Emociones , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Although many programmes have been developed to address elder mistreatment, high-quality, rigorous evaluations to assess their impact are lacking. This is partly due to challenges in conducting programme evaluation for such a complex phenomenon. We describe here the development of a protocol to mitigate these challenges and rigorously evaluate a first-of-its-kind emergency department/hospital-based elder mistreatment intervention, the Vulnerable Elder Protection Team (VEPT). METHODS AND ANALYSIS: We used a multistep process to develop an evaluation protocol for VEPT: (1) creation of a logic model to describe programme activities and relevant short-term and long-term outcomes, (2) operationalisation of these outcome measures, (3) development of a combined outcome and (4) design of a protocol using telephone follow-up at multiple time points to obtain information about older adults served by VEPT. This protocol, which is informing an ongoing evaluation of VEPT, may help researchers and health system leaders design evaluations for similar elder mistreatment programmes. ETHICS AND DISSEMINATION: This project has been reviewed and approved by the Weill Cornell Medicine Institutional Review Board, protocol #20-02021422. We aim to disseminate our results in peer-reviewed journals at national and international conferences and among interested patient groups and the public.
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Abuso de Ancianos , Servicios Médicos de Urgencia , Humanos , Anciano , Abuso de Ancianos/diagnóstico , Abuso de Ancianos/prevención & control , Hospitales , Estudios LongitudinalesRESUMEN
The emergency department and hospital provide a unique and important opportunity to identify elder mistreatment and offer intervention. To help manage these complex cases, multi-disciplinary response teams have been launched. In developing these teams, it quickly became clear that social workers play a critical role in responding to elder mistreatment. Their unique skillset allows them to establish close connections with community resources, collaborate with various hospital stakeholders, support patients/families/caregivers through challenging situations, navigate the legal and protective systems, and balance patient safety and quality of life in disposition decision-making. The role of the social worker on these multi-faceted teams includes conducting a comprehensive biopsychosocial assessment, helping to develop a safe discharge plan, and making appropriate referrals, among other responsibilities. Any institution considering developing a multi-disciplinary program should recognize the critical importance of social work.
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OBJECTIVES: Elevations in pain catastrophizing (PC) are associated with more severe pain, emotional distress, and impairment within samples with chronic pain. However, brain structure correlates underlying individual differences in PC are not well understood and predict more severe pain and impairment within samples with chronic pain. This study assessed links between regional gray matter volume (GMV) and individual differences in PC within a large mixed chronic pain sample. MATERIALS AND METHODS: Chinese adult community dwellers with chronic pain of at least 3 months duration (101 women and 59 men) completed self-report measures of background characteristics, pain severity, depression, and a widely validated PC questionnaire as well as a structural magnetic resonance imagining scan featuring voxel-based morphology to assess regional GMV correlates of PC. RESULTS: After controlling for demographic correlates of PC, pain severity, and depression, higher PC scores had a significant, unique association with lower GMV levels in the inferior temporal area of the right fusiform gyrus, a region previously implicated in emotion regulation. DISCUSSION: GMV deficits, particularly in right temporal-occipital emotion regulation regions, correspond to high levels of PC among individuals with chronic pain.
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Dolor Crónico , Sustancia Gris , Masculino , Adulto , Humanos , Femenino , Dolor Crónico/psicología , Individualidad , Vida Independiente , Encéfalo/patología , Imagen por Resonancia Magnética , CatastrofizaciónRESUMEN
This study examined whether creativity at work and outside of work had the same (or different) Big Five personality antecedents. Results revealed that although self-reported personal creativity outside of the workplace was related to the Openness to Experience trait only, supervisor-rated work creativity was associated with Openness, Extraversion, and Conscientiousness, and that after controlling for the effects of Extraversion and Conscientiousness, Openness did not contribute incremental validity in predicting work creativity, whereas when the impact of Openness was controlled for, Extraversion and Conscientiousness incrementally contributed to the prediction. Therefore, the study supported that while creativity was consistently driven by Openness across settings, the predictive effects of other traits (i.e., Extraversion and Conscientiousness) on creativity varied in work and non-work environments. Study limitations and implications for research and practices are discussed.
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Introduction: There is a gap between aspiring to co-produce and co-create value in integrated healthcare and realising that in practice, particularly with complex needs and multiple stakeholders. Key principles from literature on value-based healthcare offer a conceptual framework for building suitable care platforms to support practice. This paper outlines the Complex Care and Recovery Management Framework (CCaRM) as an example of co-platforming value-based healthcare within case level practice. Description: The CCaRM was co-produced with clinicians and service users in a learning disability service. Highlighted are 6 value-making themes for building collaborative value over time, alongside case management. "Experience-in-use" was that it made sense to participants, and activated service-users and clinicians. Further empirical evaluation is needed. Discussion: There was encouragement that the CCaRM approach was implementable. Alongside further evaluative work, key issues would be: collaborating with local participants; supporting training; reconciling case-level perspectives with wider systems. Progressing integrated value-based healthcare involves: refreshing focus on the case-based view; ways of operationalising complexity; value-based case management; customisation of care styles and "democratic outcomes" within co-platforming systems. Conclusion: In principle, the CCaRM contributes to operationalising collaborative value-based healthcare for complex cases. It surfaces further research themes to refocus value and integrated care thinking. Further empirical work is needed.
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What are creative employees like, aside from being high on Openness to Experience? Based on a sample of 170 full-time working professionals in the consulting industry, the present study investigated the Big Five personality predictors of both supervisory perceptions and performance ratings of creative individuals at work. Results suggested that those with higher Openness and Extraversion but lower Agreeableness, were more likely to be perceived as creative people by their supervisors. In terms of their actual creative performance on the job, employees with higher Openness, Extraversion, and Conscientiousness, received better supervisory ratings. In highlighting the impact of other Big Five traits in addition to Openness, we interpreted the findings in terms of motives to get ahead or get along and further discussed the implications of the study results for personality and creativity research in the workplace.
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Creatividad , Personalidad , Humanos , Motivación , Extraversión Psicológica , Condiciones de TrabajoRESUMEN
The Body Acceptance by Others Scale-2 (BAOS-2) was developed to assess overall perceived body acceptance by others. In two studies, we evaluated its structure, reliability and validity among young adults in China. In Study 1, 435 women and 322 men completed newly translated simplified Chinese versions of the BAOS-2 and Functionality Appreciation Scale (FAS), conceptually related body image questionnaires and demographic items. Exploratory factor analyses supported a 13-item unidimensional BAOS-2 structure across men and women. Internal consistency, test-retest reliability, convergent validity and discriminant validity were also supported. Study 2 (307 men, 396 women) replicated the original gender-invariant BAOS-2 structure in confirmatory factor analysis and bolstered evidence for convergent, discriminant and incremental validity. Predictive validity, examined via longitudinal analyses, indicated baseline BAOS-2 scores and/or concomitant changes in BAOS-2 scores over time were related to improvements on other positive and negative body image measures at a six-month follow-up. Supplementary analyses replicated the original unidimensional FAS factor structure and provided considerable support for its psychometrics across samples. In sum, this research supported psychometric properties of the BAOS-2 among young adults in China and underscored its potential utility in predicting changes in other body image experiences over time.
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Imagen Corporal , Masculino , Adulto Joven , Femenino , Humanos , Imagen Corporal/psicología , Reproducibilidad de los Resultados , Estudios Prospectivos , Análisis Factorial , Psicometría/métodos , Encuestas y Cuestionarios , ChinaRESUMEN
Objectives This pilot study aimed to explore the perceived benefits of a new children's sensory garden in a healthcare centre in south-eastern Melbourne that provides specialised care, support and guidance to parents. Methods A mixed-method research design was employed in this study comprising a combination of quantitative (surveys) and qualitative (interviews) data collection methods. A total of 19 staff and 36 parents completed surveys relating to their experiences in the new garden. Results The staff members and parents surveyed were found to use the new children's garden on a regular basis and suggested that the new garden provided them with an opportunity to escape and feel calmer and had positively impacted on their interactions with their child. Interviews were also undertaken with four staff members who indicated that they believe the new garden is affording them perceived personal wellbeing benefits and that the activities in the new garden led to better perceived outcomes for families. Conclusion The perceived benefits reported provide support for the development of sensory gardens at other similar healthcare facilities.
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Familia , Jardinería , Niño , Atención a la Salud , Humanos , Padres , Proyectos PilotoRESUMEN
Cross-cultural studies suggest that people typically prefer to eat familiar foods from their own culture rather than foreign foods from other cultures. On this basis, it is plausible that neural responsiveness elicited by palatable food images from one's own culture differ from those elicited by food depictions from other cultures. Toward clarifying this issue, we examined neural activation and self-report responses to indigenous (Chinese) versus Western food images among young Chinese adults. Participants (33 women, 33 men) viewed Chinese food, Western food and furniture control images during a functional magnetic resonance imaging (fMRI) scan and then rated the images on "liking," "wanting," and "difficult resisting." Analyses indicated there were no significant differences in self-report ratings of Chinese versus Western food images. However, Chinese food images elicited stronger activation in regions linked to cravings, taste perception, attention, reward, and visual processing (i.e., cerebellum crus, superior temporal gyrus, supramarginal gyrus, middle temporal gyrus, inferior parietal lobule, posterior insula, middle occipital gyrus; inferior occipital gyrus). Conversely, Western food images elicited stronger activation in areas involved in visual object recognition and visual processing (inferior temporal gyrus, middle occipital gyrus, calcarine). These findings underscored culture as a potentially important influence on neural responses to visual food cues and raised concerns about the ecological validity of using "standard" Western food images in neuroimaging studies of non-Western samples. Results also provide foundations for designing culturally informed research and intervention approaches in non-Westerns contexts guided by the use of external food cues that are most salient to the cultural group under study.
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OBJECTIVES: To determine the prevalence and predictors of willingness to consider becoming a paid home care worker. DESIGN: Cross-sectional telephone-based survey study. SETTING AND PARTICIPANTS: 800 adult residents of New York State participating in the 2020 Empire State Poll, an annual survey conducted in English and Spanish using random-digit dialing. METHODS: Willingness to consider working as a paid home care worker was analyzed as the main outcome. Survey questions also involved demographics and unpaid caregiving experience. We used multinomial logistic regression to examine associations between participant characteristics and willingness to be a paid caregiver. RESULTS: Participants had a mean age of 47.7 years (95% CI 45.4-50.0). Demographic information included 51.1% female gender, 65.4% White race, 13.4% Black race, 6.4% Asian or Pacific Islander, 14.8% another race, 19.1% Hispanic/Latino ethnicity, and 43.0% household income below $50,000 per year. A weighted 25.4% of participants would consider becoming a paid home care worker. In an adjusted model, willingness to be a paid home care worker was associated with younger age [odds ratio (OR) 0.98, 95% CI 0.96-1.00, P = .032], female gender (OR 2.46, 95% CI 1.35-4.46, P = .003), Black or other race (OR 2.40, 95% CI 1.11-5.17, P = .026, and OR 3.13, 95% CI 1.30-7.54, P = .011, respectively), Hispanic ethnicity (OR 2.26, 95% CI 1.06-4.81, P = .035), household income below $50,000 per year (OR 2.00, 95% CI 1.03-3.88, P = .040), and having provided unpaid family caregiving (OR 2.08, 95% CI 1.15-3.76, P = .016). CONCLUSIONS AND IMPLICATIONS: A quarter of New Yorkers would consider working as a paid home care worker. Willingness to consider this occupation was associated with the demographic characteristics disproportionately represented in the current home care workforce. Improved working conditions and compensation could help attract and retain home care workers, thereby addressing the rising need for home care in the United States.
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Servicios de Atención de Salud a Domicilio , Adulto , Cuidadores , Estudios Transversales , Femenino , Hispánicos o Latinos , Humanos , Masculino , Persona de Mediana Edad , New York , Estados UnidosRESUMEN
BACKGROUND: An emergency department (ED) visit provides a unique opportunity to identify elder abuse and initiate intervention, but emergency providers rarely do. To address this, we developed the Vulnerable Elder Protection Team (VEPT), an ED-based interdisciplinary consultation service. We describe our initial experience in the first two years after the program launch. METHODS: We launched VEPT in a large, urban, academic ED/hospital. From 4/3/17 to 4/2/19, we tracked VEPT activations, including patient characteristics, assessment, and interventions. We compared VEPT activations to frequency of elder abuse identification in the ED before VEPT launch. We examined outcomes for patients evaluated by VEPT, including change in living situation at discharge. We assessed ED providers' experiences with VEPT via written surveys and focus groups. RESULTS: During the program's initial two years, VEPT was activated and provided consultation/care to 200 ED patients. Cases included physical abuse (59%), neglect (56%), financial exploitation (32%), verbal/emotional/psychological abuse (25%), and sexual abuse (2%). Sixty-two percent of patients assessed were determined by VEPT to have high or moderate suspicion for elder abuse. Seventy-five percent of these patients had a change in living/housing situation or were discharged with new or additional home services, with 14% discharged to an elder abuse shelter, 39% to a different living/housing situation, and 22% with new or additional home services. ED providers reported that VEPT made them more likely to consider/assess for elder abuse and recognized the value of the expertise and guidance VEPT provided. Ninety-four percent reported believing that there is merit in establishing a VEPT Program in other EDs. CONCLUSION: VEPT was frequently activated and many patients were discharged with changes in living situation and/or additional home services, which may improve safety. Future research is needed to examine longer-term outcomes.
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Abuso de Ancianos , Servicios Médicos de Urgencia , Humanos , Anciano , Abuso de Ancianos/diagnóstico , Abuso de Ancianos/prevención & control , Grupos Focales , Derivación y Consulta , Servicio de Urgencia en HospitalRESUMEN
US Environmental Protection Agency (USEPA) Procedures for the Derivation of Equilibrium Partitioning Sediment Benchmarks (ESBs) for the Protection of Benthic Organisms: Metal Mixtures are based on the principle that metals toxicity to benthic organisms is determined by bioavailable metals concentrations in porewater. One ESB is based on the difference between simultaneously extracted metal (SEM) and acid volatile sulfide (AVS) concentrations in sediment (excess SEM). The excess SEM ESBs include a lower uncertainty bound, below which most samples (95%) are expected to be "nontoxic" (defined as a bioassay mortality rate ≤24%), and an upper uncertainty bound, above which most samples (95%) are expected to be "toxic" (defined as a mortality rate >24%). Samples that fall between the upper and lower bounds are classified as "uncertain." Excess SEM ESBs can, in principle, be improved by normalizing for organic carbon (OC). OC is a binding phase that reduces metals bioavailability. OC normalization should improve the accuracy of bioavailable metal concentration estimates, thus tightening uncertainty bounds. We evaluated field-collected sediments from 13 studies with excess SEM, OC, and bioassay data (n = 740). Use of the OC-normalized excess SEM benchmarks did not improve prediction accuracy. The ESB model predicts OC-normalized excess SEM exceeding the upper benchmark even when toxicity is not observed, because error in the OC normalization model increases at low OC concentrations. To minimize the likelihood of incorrectly identifying nontoxic samples as toxic, we recommend that OC normalization of excess SEM should not be considered for sediments with an OC concentration <1% and is questionable for sediments with an OC concentration of 1%-4%. Additional focused studies are needed to confirm or refine the minimum sediment OC concentrations that are applicable for reducing uncertainty in toxicity predictions due to excess SEM. Integr Environ Assess Manag 2022;18:174-186. © 2021 SETAC.
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Metales Pesados , Contaminantes Químicos del Agua , Benchmarking , Monitoreo del Ambiente , Sedimentos Geológicos , Metales Pesados/análisis , Estados Unidos , United States Environmental Protection Agency , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidadRESUMEN
The United Nations Sustainable Development Goals, New Urban Agenda and Paris Agreement on Climate Change are blueprints for health promotion action that mandate human health is linked inextricably to the health of the environment. In the Anthropocene, new indicators are required to promote community engagement with, and measurement of, healthy and sustainable wellbeing for people and planet. This study explored the need for a metric such as the Happy Planet Index that explicitly links human health to health of the environment for a local level scale in Australia. The project arose from an international coalition of health promoters advocating for 'planetary health' approaches. Qualitative description methods guided the study design involving key informant interviews (n = 17) and four focus groups (n = 27 participants) with health and/or sustainability academics, practitioners and policy-makers. Document analysis of health and environment indices and policy mandates augmented the analysis. Qualitative content analysis techniques were used to analyse the findings. There was strong interest for a local level composite indicator, such as a rescaled Happy Planet Index (life expectancy × life satisfaction × equity adjustment/ecological footprint) for use at a local level. The value of a composite index was: its ability to promote community engagement with planetary health thinking; an advocacy tool for joint health and sustainability policy; to justify programs on health and environmental co-benefits; and to provide a mechanism for correlative comparisons between local governments and national comparisons. However, disciplinary silos currently limit partnerships for health promotion and planetary health and a local composite index could help bridge these divides.
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Planetas , Desarrollo Sostenible , Humanos , Victoria , Cambio Climático , Naciones UnidasRESUMEN
The present paper reports on the preliminary validation of a Chinese version of Steel's Irrational Procrastination Scale (IPS). To this end, the nine items of the IPS were translated into Chinese and data were collected from a sample of 2,361 mainland Chinese college students. Confirmatory factor analysis (CFA) was used to examine the dimensional structure of the IPS, and multigroup CFA (MG CFA) was carried out to evaluate the measurement invariance across gender. Results revealed that the Chinese IPS had adequate internal consistency reliability, adhered to the one-factor structure, and exhibited strong or scalar invariance across the two gender subgroups, thereby providing support for the internal construct validity of the scale. Additionally, the IPS scores were found to be strongly and negatively related to the Conscientiousness personality trait while showing weak correlations with the other traits, which provided some support for the convergent and divergent validity of the Chinese IPS. Study limitations and future research directions (e.g., expanding the empirical evidence for the scale's criterion-related validity) are discussed.