Developing a death literacy index.

Performing end-of-life care can be a catalyst for developing a capacity called death literacy. This study aimed to develop a comprehensive and useable measure of death literacy that has the potential to assess interventions with individuals, communities, and societies. Using a mixed methods approach, a Death Literacy Index was developed from personal narratives and input from practitioners and experts. Refined on a sample of 1330 Australians using exploratory and confirmatory factor analysis and structural equation modeling, a 29-item Death Literacy Index was found to be reliable and demonstrated construct validity. Further studies are needed to test predictive validity.

Binge drinking upregulates accumbens mGluR5-Homer2-PI3K signaling: functional implications for alcoholism.

The glutamate receptor-associated protein Homer2 regulates alcohol-induced neuroplasticity within the nucleus accumbens (NAC), but the precise intracellular signaling cascades involved are not known. This study examined the role for NAC metabotropic glutamate receptor (mGluR)-Homer2-phosphatidylinositol 3-kinase (PI3K) signaling in regulating excessive alcohol consumption within the context of the scheduled high alcohol consumption (SHAC) model of binge alcohol drinking. Repeated bouts of binge drinking ( approximately 1.5 g/kg per 30 min) elevated NAC Homer2a/b expression and increased PI3K activity in this region. Virus-mediated knockdown of NAC Homer2b expression attenuated alcohol intake, as did an intra-NAC infusion of the mGluR5 antagonist MPEP [2-methyl-6-(phenylethynyl)pyridine hydrochloride] (0.1-1 microg/side) and the PI3K antagonist wortmannin (50 ng/side), supporting necessary roles for mGluR5/Homer2/PI3K in binge alcohol drinking. Moreover, when compared with wild-type littermates, transgenic mice with an F1128R point mutation in mGluR5 that markedly reduces Homer binding exhibited a 50% reduction in binge alcohol drinking, which was related to reduced NAC basal PI3K activity. Consistent with the hypothesis that mGluR5-Homer-PI3K signaling may be a mechanism governing excessive alcohol intake, the "anti-binge" effects of MPEP and wortmannin were not additive, nor were they observed in the mGluR5(F1128R) transgenic mice. Finally, mice genetically selected for a high versus low SHAC phenotype differed in NAC mGluR, Homer2, and PI3K activity, consistent with the hypothesis that augmented NAC mGluR5-Homer2-PI3K signaling predisposes a high binge alcohol-drinking phenotype. Together, these data point to an important role for NAC mGluR5-Homer2-PI3K signaling in regulating binge-like alcohol consumption that has relevance for our understanding of the neurobiology of alcoholism and its pharmacotherapy.

Baby boomers' attitudes to maintaining sexual and intimate relationships in long-term care.

OBJECTIVES: Australian aged care policy is wholly focused on individual "consumers" and consequently neglects the needs of dyadic partners. This paper highlights partnered baby boomers' attitudes to maintaining sexual and intimate relationships in residential care. METHODS: In 2016, cross-sectional data were collected using an online survey of partnered baby boomers recruited using social media. Qualitative data were analysed using word frequency, keywords-in-context and thematic analysis. Descriptive statistics were generated from quantitative data. RESULTS: There were 168 participants (85% female), aged 51-71 years. Many reported that remaining together and continuing physical and sexual contact were important in aged care contexts-necessitating private couple's suites, shared beds, access to condoms, lubricants and sexual health professionals. CONCLUSIONS: Considerable cultural change will be required to raise residential aged care to the standard expected by some partnered baby boomers. Shifting to a more couple-centred approach may benefit partnered residents' health and well-being.

Happily partnered older adults' relationship-enhancing behaviours.

OBJECTIVE: Relationship-enhancing behaviours that contribute to older adults' well-being are scarcely considered in "active ageing" discourses despite relationship quality having been repeatedly linked to health outcomes. This paper explores such behaviours in older adults. METHODS: Cross-sectional data were collected in 2016 from 168 partnered baby boomers (born 1946 to 1965) using an online survey. The 36 qualitative and quantitative questions were analysed using mixed methods. RESULTS: Participants were predominantly women (85%), with a mean age of 62 years (SD = 5.2). Relationship-enhancing behaviours included verbal and non-verbal cues, physical affection and pleasurable sexual activities. A couple's shared bed was an important relationship setting. CONCLUSION: For happily partnered older adults, relationship quality improves personal well-being. As a social determinant of healthy ageing, health policies and programs are needed to support older adults' relationship quality. To this end, the development of targeted relationship interventions for delivery in health settings is warranted.