The social functioning in dementia scale (SF-DEM): exploratory factor analysis and psychometric properties in mild, moderate, and severe dementia

Introduction: The psychometric properties of the social functioning in dementia scale over different dementia severities are unknown. Methods: We interviewed 299 family carers of people with mild, moderate, or severe dementia from two UK research sites; examined acceptability (completion rates); conducted exploratory factor analysis; and tested each factor's internal consistency and construct validity. Results: Of 299, 285 (95.3%) carers completed questionnaires. Factor analysis indicated three distinct factors with acceptable internal consistency: spending time with other people, correlating with overall social function (r = 0.56, P <.001) and activities of daily living (r = −0.48, P <.001); communicating with other people correlating with activities of daily living (r = −0.66, P <.001); and sensitivity to other people correlating with quality of life (r = 0.35, P <.001) and inversely with neuropsychiatric symptoms (r = −0.45, P <.001). The three factors' correlations with other domains were similar across all dementia severities. Discussion: The social functioning in dementia scale carer version measures three social functioning domains and has satisfactory psychometric properties in all severities of dementia

Dramatic Plays as a Tool to Educate Young African-American Females about HIV/AIDS

Rates of HIV/AIDS transmission have increased substantially, particularly among young African American women. According to the Centers for Disease Control and Prevention (CDC), HIV/AIDS is the number one killer for African American women aged 25 to 34. Given that many of these young women are contracting the disease in their late teens and early twenties, there is a need to develop interventions that directly address the needs of this group. The current study sought to assess the effectiveness of theater in increasing knowledge of HIV/AIDS and the likelihood of healthier sexual behavior and choices among 219 young African American women 18 to 39 years of age. Paired sample t-tests revealed that there were significant mean differences in knowledge and intended safe sex behavior after viewing the play. Young women who viewed the play reported increased knowledge of HIV and reported a higher likelihood of engaging in safer sex. Given the high rates of HIV/AIDS among young African American women, more innovative educational and prevention techniques are needed

Measuring the quality of life of family carers of people with dementia: development and validation of C-DEMQOL

Purpose We aimed to address gaps identified in the evidence base and instruments available to measure the quality of life (QOL) of family carers of people with dementia, and develop a new brief, reliable, condition-specific instrument. Methods We generated measurable domains and indicators of carer QOL from systematic literature reviews and qualitative interviews with 32 family carers and 9 support staff, and two focus groups with 6 carers and 5 staff. Statements with five tailored response options, presenting variation on the QOL continuum, were piloted (n = 25), pre-tested (n = 122) and field-tested (n = 300) in individual interviews with family carers from North London and Sussex. The best 30 questions formed the C-DEMQOL questionnaire, which was evaluated for usability, face and construct validity, reliability and convergent/discriminant validity using a range of validation measures. Results C-DEMQOL was received positively by the carers. Factor analysis confirmed that C-DEMQOL sum scores are reliable in measuring overall QOL (ω = 0.97) and its five subdomains: ‘meeting personal needs’ (ω = 0.95); ‘carer wellbeing’ (ω = 0.91); ‘carer-patient relationship’ (ω = 0.82); ‘confidence in the future’ (ω = 0.90) and ‘feeling supported’ (ω = 0.85). The overall QOL and domain scores show the expected pattern of convergent and discriminant relationships with established measures of carer mental health, activities and dementia severity and symptoms. Conclusions The robust psychometric properties support the use of C-DEMQOL in evaluation of overall and domain-specific carer QOL; replications in independent samples and studies of responsiveness would be of value

Public attitudes towards alcohol control policies in Scotland and England: Results from a mixed-methods study

The harmful effects of heavy drinking on health have been widely reported, yet public opinion on governmental responsibility for alcohol control remains divided. This study examines UK public attitudes towards alcohol policies, identifies underlying dimensions that inform these, and relationships with perceived effectiveness. A cross-sectional mixed methods study involving a telephone survey of 3477 adult drinkers aged 16-65 and sixteen focus groups with 89 adult drinkers in Scotland and England was conducted between September 2012 and February 2013. Principal components analysis (PCA) was used to reduce twelve policy statements into underlying dimensions. These dimensions were used in linear regression models examining alcohol policy support by demographics, drinking behaviour and perceptions of UK drinking and government responsibility. Findings were supplemented with a thematic analysis of focus group transcripts. A majority of survey respondents supported all alcohol policies, although the level of support varied by type of policy. Greater enforcement of laws on under-age sales and more police patrolling the streets were strongly supported while support for pricing policies and restricting access to alcohol was more divided. PCA identified four main dimensions underlying support on policies: alcohol availability, provision of health information and treatment services, alcohol pricing, and greater law enforcement. Being female, older, a moderate drinker, and holding a belief that government should do more to reduce alcohol harms were associated with higher support on all policy dimensions. Focus group data revealed findings from the survey may have presented an overly positive level of support on all policies due to differences in perceived policy effectiveness. Perceived effectiveness can help inform underlying patterns of policy support and should be considered in conjunction with standard measures of support in future research on alcohol control policies

Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis

Sleep disturbances are a feature in people living with dementia, including getting up during the night, difficulty falling asleep, and excessive daytime sleepiness and may precipitate a person with dementia moving into residential care. There are varying estimates of the frequency of sleep disturbances, and it is unknown whether they are a problem for the individual. We conducted the first systematic review and meta-analysis on the prevalence and associated factors of sleep disturbances in the care home population with dementia

“Late-onset” ADHD symptoms in young adulthood:is this the same as child-onset ADHD?

Objective: We investigated whether “late-onset” ADHD that emerges in adolescence/adulthood is similar in risk factor profile to: (1) child-onset ADHD, but emerges later because of scaffolding/compensation from childhood resources; and (2) depression, because it typically onsets in adolescence/adulthood and shows symptom and genetic overlaps with ADHD. Methods: We examined associations between late-onset ADHD and ADHD risk factors, cognitive tasks, childhood resources and depression risk factors in a population-based cohort followed-up to age 25 years (N=4224–9764). Results: Parent-rated late-onset ADHD was like child-onset persistent ADHD in associations with ADHD polygenic risk scores and cognitive task performance, although self-rated late-onset ADHD was not. Late-onset ADHD was associated with higher levels of childhood resources than child-onset ADHD and did not show strong evidence of association with depression risk factors. Conclusions: Late-onset ADHD shares characteristics with child-onset ADHD when parent-rated, but differences for self-reports require investigation. Childhood resources may delay the onset of ADHD

An Improved Transit Measurement for a 2.4 R⊕ Planet Orbiting A Bright Mid-M Dwarf K2–28

We present a new Spitzer transit observation of K2–28b, a sub-Neptune (Rp = 2.45 ± 0.28 R⊕) orbiting a relatively bright (V_(mag) = 16.06, K_(mag) = 10.75) metal-rich M4 dwarf (EPIC 206318379). This star is one of only seven with masses less than 0.2 M⊙ known to host transiting planets, and the planet appears to be a slightly smaller analogue of GJ 1214b (2.85 ± 0.20 R⊕). Our new Spitzerobservations were taken two years after the original K2 discovery data and have a significantly higher cadence, allowing us to derive improved estimates for this planet's radius, semimajor axis, and orbital period, which greatly reduce the uncertainty in the prediction of near future transit times for the James Webb Space Telescope (JWST) observations. We also evaluate the system's suitability for atmospheric characterization with JWST and find that it is currently the only small (<3 R⊕) and cool (<600 K) planet aside from GJ 1214b with a potentially detectable secondary eclipse. We also note that this system is a favorable target for near-infrared radial velocity instruments on larger telescopes (e.g., the Habitable Planet Finder on the Hobby–Eberly Telescope), making it one of only a handful of small, cool planets accessible with this technique. Finally, we compare our results with the simulated catalog of the Transiting Exoplanet Survey Satellite (TESS) and find K2–28b to be representative of the kind of mid-M systems that should be detectable in the TESS sample

Spitzer observations confirm and rescue the habitable-zone super-earth K2-18b for future characterization

The recent detections of two transit events attributed to the super-Earth candidate K2-18b have provided the unprecedented prospect of spectroscopically studying a habitable-zone planet outside the solar system. Orbiting a nearby M2.5 dwarf and receiving virtually the same stellar insolation as Earth, K2-18b would be a prime candidate for the first detailed atmospheric characterization of a habitable-zone exoplanet using the Hubble Space Telescope (HST)and James Webb Space Telescope (JWST). Here, we report the detection of a third transit of K2-18b near the predicted transit time using the Spitzer Space Telescope. The Spitzer detection demonstrates the periodic nature of the two transit events discovered by K2, confirming that K2-18 is indeed orbited by a super-Earth in a 33 day orbit, ruling out the alternative scenario of two similarly sized, long-period planets transiting only once within the 75 day Kepler Space Telescope (K2) observation. We also find, however, that the transit event detected by Spitzer occurred 1.85 hr () before the predicted transit time. Our joint analysis of the Spitzer and K2 photometry reveals that this early occurrence of the transit is not caused by transit timing variations, but the result of an inaccurate ephemeris due to a previously undetected data anomaly in the K2 photometry. We refit the ephemeris and find that K2-18b would have been lost for future atmospheric characterizations with HST and JWST if we had not secured its ephemeris shortly after the discovery. We caution that immediate follow-up observations as presented here will also be critical for confirming and securing future planets discovered by the Transiting Exoplanet Survey Satellite (TESS), in particular if only two transit events are covered by the relatively short 27-day TESS campaigns

WHS Guidelines for the Treatment of Pressure Ulcers: 2023 Update

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated that hospital-acquired pressure ulcers cost the health system $26.8 billion annually with over 50% of the cost attributed to treating Stage 3 and 4 pressure injuries. Thus, it is critical to examine the literature and develop guidelines that will improve the outcomes of this complex and costly condition. This guideline update is a compendium of the best available evidence for the treatment of Pressure Ulcers published since the last update in 2015 and includes a new section based on changing demographics entitled ‘Palliative wound care for seriously ill patients with pressure ulcers’. The overall goal of the Wound Healing Society Guideline project is to present clear, concise and commercial free guidelines that clinicians can use to guide care, that researchers can use to develop studies that will improve treatment and that both clinicians and researchers can use to understand the gaps in our knowledge base