Delivering information and brief advice on alcohol (IBA) in social work and social care settings: an exploratory study

Social workers and practitioners working in social care are potentially key players in the prevention of alcohol-related harm and harm reduction for people using services and their carers. This requires attention to workforce development alongside the selection of appropriate tools to support prevention strategies. We report findings from a UK exploratory study into the potential of using Identification and Brief Advice (IBA) as a tool for screening and prevention in social work and social care settings. Thirty-six social workers and social care practitioners attended one of two training workshops on IBA in the South East of England. Pre and post-workshop surveys (n = 35 and n = 20, respectively) and four post-workshop focus groups (n = 36) were conducted with participants to explore the application of IBA taking into account the paradigmatic shift towards prevention and holistic approaches indicated in recent UK legislation and policy. Four themes emerged from the findings: (1) perceptions of the social work/social care role in responding to alcohol problems, (2) ethical concerns, (3) time conflicts and problems of delivering IBA and (4) the role of training. Further studies are needed to evaluate the effectiveness of motivational techniques and tools that social workers can use to promote preventative practise for alcohol-related harm. Different strategies are required to engage and support those working in social care to increase proactive engagement with problematic alcohol use in everyday practise settings

A longitudinal investigation of repressive coping and ageing

This is an Accepted Manuscript of an article published by Taylor & Francis in Aging & Mental Health on October 2016, available online: http://www.tandfonline.com/doi/full/10.1080/13607863.2015.1060941.Two studies investigated the possibility that repressive coping is more prevalent in older adults and that this represents a developmental progression rather than a cohort effect. Study 1 examined repressive coping and mental health cross-sectionally in young and old adults. Study 2 examined whether there was a developmental progression of repressive coping prevalence rates in a longitudinal sample of older adults.Peer reviewedFinal Accepted Versio

Calibrating and adjusting expectations in life: A grounded theory on how elderly persons with somatic health problems maintain control and balance in life and optimize well-being

Aim: This study aims at exploring the main concern for elderly individuals with somatic health problems and what they do to manage this. Method: In total, 14 individuals (mean = 74.2 years; range = 68–86 years) of both gender including hospitalized and outpatient persons participated in the study. Open interviews were conducted and analyzed according to grounded theory, an inductive theory-generating method. Results: The main concern for the elderly individuals with somatic health problems was identified as their striving to maintain control and balance in life. The analysis ended up in a substantive theory explaining how elderly individuals with somatic disease were calibrating and adjusting their expectations in life in order to adapt to their reduced energy level, health problems, and aging. By adjusting the expectations to their actual abilities, the elderly can maintain a sense of that they still have the control over their lives and create stability. The ongoing adjustment process is facilitated by different strategies and result despite lower expectations in subjective well-being. The facilitating strategies are utilizing the network of important others, enjoying cultural heritage, being occupied with interests, having a mission to fulfill, improving the situation by limiting boundaries and, finally, creating meaning in everyday life. Conclusion: The main concern of the elderly with somatic health problems was to maintain control and balance in life. The emerging theory explains how elderly people with somatic health problems calibrate their expectations of life in order to adjust to reduced energy, health problems, and aging. This process is facilitated by different strategies and result despite lower expectation in subjective well-being

Engaging Multistakeholder Perspectives to Identify Patient-Centered Research Priorities Regarding Vaccine Uptake Among Adults With Autoimmune Conditions

Objective: The study objective was to prioritize topics for future patient-centered research to increase uptake of common vaccines, such as for pneumococcal pneumonia, influenza, herpes zoster, human papillomavirus, and severe acute respiratory syndrome coronavirus 2, among adults living with autoimmune conditions. Methods: A steering committee (SC) was formed that included clinicians, patients, patient advocates, and researchers associated with rheumatic diseases (psoriatic arthritis, rheumatoid arthritis, vasculitis), inflammatory bowel disease, and multiple sclerosis. Through a scoping review and discussions, SC members identified research topics regarding vaccine uptake and/or hesitancy for prioritization. A larger multistakeholder alliance that included patients and patient advocates, clinicians, researchers, policy makers, regulators, and vaccine manufacturers conducted a modified Delphi exercise online with three rating rounds and one ranking round. Frequency analysis and comparisons across stakeholder groups were conducted. A weighted ranking score was generated for each item in the ranking round for final prioritization. Results: Through the Delphi process, 33 research topics were identified, of which 13 topics were rated as critical by more than 70% of all stakeholders (n = 31). The two highest ranked critical topics per the full stakeholder group were “How well a vaccine works for adults with autoimmune conditions” and “How beliefs about vaccine safety affect vaccine uptake.”. Conclusion: A multistakeholder group identified key topics as critically important priorities for future research to decrease vaccine hesitancy and improve uptake of vaccines for adults with autoimmune conditions

Geographical segregation and Interleukin-6, a marker of chronic inflammation in older adults

Aim To examine environmental sociodemographic risks of high IL-6, a marker of chronic inflammation in older adults. Methods We spatially linked 1990 USA Census tract demographic and economic measures to a prospective cohort study of representative community residents aged 71 years and older, from over 1700 of whom a cytokine protein and biological marker of chronic inflammation. IL-6, was collected. Using generalized interactive mixed models, we modeled 1989–1990 individual and census level risk factors for the dependent variable high IL-6 between 1992–1993 (high IL-6 = upper quartile: >2.96 pg/ml). Results After individual health risk adjustment, IL-6 remained elevated in communities with greater densities of poor older adults (odd ratio [OR]: 1.25 per 10% increase in exposure. 95% confidence interval [CI]: 1.05, 1.48) and in racially segregated communities (OR: 1.14 per 10% increase in exposure. 95% CI: 1.04, 1.25). Conclusions Socially disadvantaged environments may influence IL-6, a biomarker of age-associated inflammation

Neuroendocrine neoplasms of the appendix: A review of the literature

Appendiceal neuroendocrine neoplasms (ANENs) comprise rare tumors of the appendix, mainly affecting young populations and characterized by a rather favorable prognosis. The aim of this review was to summarize the current knowledge on these neoplasms, focusing on the management and followup of such patients, which still remain under debate. ANENs account for 0.16-2.3% of appendectomies and are usually diagnosed incidentally. The histopathological diagnosis includes the immunohistochemical profile of the tumor in regard to synaptophysin and chromogranin A, as well as the Ki-67 index. The surgical management of ANENs is either simple appendectomy or a more extensive oncological operation including right hemicolectomy. This depends on the stage and the presence of risk factors suggesting a more aggressive disease, such as the exact location, mesoappendiceal or lymphovascular invasion, and the proliferative rate of the tumor. Despite their indolent course, ANENs may relapse. Therefore, lifetime observation is necessary for patients with tumors >2 cm and >1 cm plus additional risk factors; however, more studies should be conducted in order to determine the optimal follow-up strategy. © 2018 International Institute of Anticancer Research. All Right Reserved