Octogenarians unable to return home by postoperative-day 30.

BACKGROUND: For older adults undergoing surgery, returning home is instrumental for functional independence. We quantified octogenarians unable to return home by POD-30, assessed geriatric factors in a predictive model, and identified risk factors to inform decision-making and quality improvement. METHODS: This retrospective cohort study examined patients ≥80 years old from the ACS NSQIP Geriatric Surgery Pilot, using sequential logistic regression modelling. The primary outcome was non-home living location at POD-30. RESULTS: Of 4946 patients, 19.8 â€‹% lived in non-home facilities at POD-30. Increased odds of non-home living location were seen in patients with preoperative fall history (OR 2.92, 95%CI 2.06-4.14) and new postoperative pressure ulcer (OR 2.66, 95%CI 1.50-4.71) Other significant geriatric-specific risk factors included mobility aid use, surrogate-signed consent, and postoperative delirium, with odds ratios ranging from 1.42 (1.19-1.68) to 1.97 (1.53-2.53). CONCLUSIONS: These geriatric-specific risk factors highlight the importance of preoperative vulnerability screening and intervention to inform surgical decision-making.

Parenting styles and personal belief in a just world among Chinese children and adolescents: gender, living location, and age as moderators.

Introduction: The positive development of the personal belief in a just world (PBJW) plays a vital role in academic achievement and mental health among children and adolescents. Therefore, it is necessary to understand the influencing factors of PBJW better. The association between parenting styles and PBJW has been well established, but whether this association varies among different groups remains an open issue. The present study aimed to examine the strength of the associations between parenting styles and PBJW among Chinese children and adolescents and the role of certain moderators (gender, living location, and age) in these associations. Methods: This study employed hierarchical regression and simple slopes analyses to examine data from the National Children's Study of China. The database includes 24,013 Chinese children and adolescents in grades 49 (M = 12.76 years, SD = 1.73), with 53.50% boys. Results: The results indicated that (1) authoritative parenting was positively correlated with PBJW; (2) both authoritarian and permissive parenting styles were negatively correlated with PBJW; (3) the positive relationship between authoritative parenting and PBJW was more prominent in urban regions; the negative relationship between authoritarian and PBJW was stronger in urban regions; and the negative relationship between permissive parenting and PBJW was more pronounced among girls and older children and adolescents. Discussion: These findings highlight important associations between parenting styles and the development of PBJW among Chinese children and adolescents, and suggest strategies for policy-makers, educators, and parents to improve PBJW for different types of Chinese children and adolescents.

Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. 'Other' ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.