Improving Screening for Depression and Fall Risk in Community Dwelling Older Adults

Purpose. Falls and depressive symptoms are common in the older adult population and are associated with significant morbidity and mortality. The relationship between depression and falls is bidirectional. Given that community health nurses are critical health care personnel in assessing risk for depression and falls in the older adult population, the purpose of this project was to implement screening measures for depression and falls in an older adult population. Methods:Nurses from a community health outreach team implemented depression and fall risk screening assessment with an older adult population 65 years and older in their homes. The Geriatric Depression Scale, Short Form (GDS-15) was used to assess depression and a risk assessment for falls was developed for the purposes of this project by content experts and piloted. Data was collected over a 4-month period, with results provided to the individuals’ primary care providers (PCPs) for referral as indicated. Community health nurses provided screening results to primary care providers (PCPs). Referrals were initiated at the discretion of the PCP. Results: During the 4-month screening period, thirty depression and fall risk assessments were completed. Seven (23%)of the thirty individuals screened positive for depression and falls; 7 positive screenings for falls; 9 individuals (30%) scored suggestive of depression (GDS-15\u3e5) and 2 individuals (7%) scored indicative of depression (GDS-15 \u3e=10). The screening resulted in 10 referrals to counseling, 7 referrals to physical therapy and 2 referrals to psychiatric nurse practitioners. Conclusion: Implementation for depression and fall risk screening is feasible by community health nurses. Challenges in understanding whether the referrals were accomplished remain

Fatigue in Rheumatoid Arthritis Benchmark Study

Fatigue is perceived as one of the dominant symptoms of Rheumatoid Arthritis (RA) along with the pain that affects activities of daily life. RA-related fatigue was also described as unpredictable in its severity, duration, frequency, and intensity (Primdahl et al., 2019). The fatigue can mean feeling overwhelmed with feeling tired, unmotivated, increased pain, lack of concentration, or not getting enough sleep to combat the feeling of being tired (Choy & Dures, 2019). According to Widemark (2014), it is estimated that 40% to nearly 90% of RA patients experience chronic fatigue. The fatigue can happen at any time with RA. It is reported during remission and during flare-ups of joint pain and swelling. The physiological and psychological impact that fatigue has on a patients’ daily life should equally be addressed. There are medications to slow joint deformity and reduce pain, but there is no medication or defined regimen for the management of RA-related fatigue

A simple model of ac hopping surface conductivity in ionic liquids

The boundary conditions proposed to discuss the charge exchange taking place in an ionic liquid in contact with non-blocking electrodes are reconsidered in a dynamic situation. Assuming that the variation of the bulk ionic current density depends linearly on the surface value of the ionic current density, the frequency dependence of the phenomenological parameter is determined. The analysis has been performed in the framework where the relaxation times are smaller than a maximum relaxation time τM, and that the response function is independent on the value of the relaxation time. Using simple physical considerations, an expression for the surface conductivity describing the ionic charge exchange at the electrode is obtained. According to our calculations, its frequency dependence is similar to that predicted for the electric conductivity in disordered materials when the mechanism is of the hopping type. From measurements of impedance spectroscopy, by the best fit of the experimental data, the temperature dependence of the hopping time, of the dc surface conductivity, and of the diffusion coefficient are derived. They are in good agreement with the theoretical predictions obtained with the random distribution of surface energy barrier. Keywords: Ionic liquids, Non-blocking electrodes, Electrical impedance spectroscopy, AC hopping surface conductivit

Health Benefits Are Associated With Employment Status For People With Intellectual Disabilities

Recent studies demonstrate that people with developmental disabilities are at increased risk for preventable illnesses. In our study, we examined several variables suspected to be major contributing factors, with emphasis on job security and employment. The development of sheltered workshops was initially an attempt to promote employment opportunities for people with intellectual and developmental disabilities (IDD), though at subminimum wages. We explored whether these workshops allow for adequate community and healthcare engagement that is necessary for overall health and wellbeing. We designed a study that allowed us to statistically compare health-related data among states that eliminated sheltered workshops with those continuing this practice. These results were compared with internally available data (N=79) at Champlain Community Services (CCS), a specialized employment organization in Vermont serving people with IDD. We quantified health outcomes based on Medicaid standards which include annual wellness visits with a PCP, annual dental visits, and ensuring individuals are up to date on vaccinations. Additionally, we quantified other predictors for general wellbeing including current smoking status and body mass index (BMI). The results of our study indicated that people with IDD from states that have eliminated sheltered workshops tend to have better health outcomes with notable exemplary outcomes in consumers involved with CCS. We anticipate the results of this study will assist organizations, such as CCS, by articulating the impact of sheltered workshops on people living with IDD and receiving subminimum wage.https://scholarworks.uvm.edu/comphp_gallery/1309/thumbnail.jp

Mental and substance use disorders from early adolescence to young adulthood among indigenous young people: final diagnostic results from an 8-year panel study

Objective—Our objective was to investigate change in prevalence rates for mental and substance abuse disorders between early adolescence and young adulthood in a cohort of indigenous adolescents who participated in an 8-year panel study. Method—The data are from a lagged, sequential study of 671 indigenous adolescents (Wave 1) from a single culture in the Northern Midwest USA and Canada. At Wave 1 (mean age 11.3 years, Wave 4 (mean age 14.3 years), Wave 6 (mean age 16.2 years), and at Wave 8 (mean age 18.3 years) the tribally enrolled adolescents completed a computer-assisted personal interview that included DISC-R assessment for 11 diagnoses. Our yearly retention rates by diagnostic wave were: Wave 2, 94.7 %; Wave 4, 87.7 %; Wave 6, 88.0 %; Wave 8, 78.5 %. Results—The findings show a dramatic increase in lifetime prevalence rates for substance use disorders. By young adulthood, over half had met criteria of substance abuse or dependence disorder. Also at young adulthood, 58.2 % had met lifetime criteria of a single substance use or mental disorder and 37.2 % for two or more substance use or mental disorders. The results are compared to other indigenous diagnostic studies and to the general population. Conclusions—A mental health crisis exists within the indigenous populations that participated in this study. Innovations within current mental health service systems are needed to address the unmet demand of adolescents and families

Electron Neutrino and Antineutrino Appearance in the Full MINOS Data Sample

We report on v(e) and (v) over bar (e) appearance in v(mu) and (v) over bar (mu) beams using the full MINOS data sample. The comparison of these v(e) and (v) over bar (e) appearance data at a 735 km baseline with theta(13) measurements by reactor experiments probes delta, the theta(23) octant degeneracy, and the mass hierarchy. This analysis is the first use of this technique and includes the first accelerator long-baseline search for (v) over bar (mu) -\u3e (v) over bar (e). Our data disfavor 31% (5%) of the three-parameter space defined by delta, the octant of the theta(23), and the mass hierarchy at the 68% (90%) C.L. We measure a value of 2sin(2)(2 theta(13))sin(2)(theta(23)) that is consistent with reactor experiments. DOI: 10.1103/PhysRevLett.110.17180