Navigating later life transitions: An evaluation of emotional and psychological interventions

Transitions in later life, for instance retiring from paid work, changing career, ending or starting a relationship, can have a major impact on people’s lives and their wellbeing. Recognising a gap in preventative support for transitions such as these, the Calouste Gulbenkian Foundation (CGF; UK Branch) has funded a number of projects that provide group-based psychological and emotional support as part of its Transitions in Later Life (TiLL) programme. CGF and the Centre for Ageing Better partnered on the evaluation of two of these courses — Working Longer and Living Life to the Full, a two-day course run by Cheshire and Wirral Partnership NHS Foundation Trust (CWP) and Changing Gears, a three-day course run by Age & Opportunity in Dublin, Ireland. The aim of the evaluation was to find out what impact the courses had on individual attributes that would help people be better prepared for later life transitions; what changes people make as a result of the courses; and what practice, resources or processes in the organisations are important in ensuring their implementation and efficacy

State Takeover, School Restructuring, Private Management, and Student Achievement in Philadelphia

Following a state takeover of the Philadelphia public schools in 2002, 45 schools were turned over to private managers, making Philadelphia the site of the nation's largest experiment in the private management of public schools. This collaborative study by RAND Corporation and Research for Action examines achievement effects in the privately managed schools, as well as in schools with district-led interventions, and examines these effects in the context of districtwide trends in achievement

Genes of the serotonergic and dopaminergic pathways and their interaction affect the expression of Behavioural and Psychological Symptoms in Dementia (BPSD).

Although there is evidence for the involvement of genes of serotonergic and dopaminergic systems in the manifestation of the Behavioural and Psychological Symptoms in Dementia (BPSD), genetic association studies are contradictory. We used 1008 probable AD patients from the UK and applied a Multiple Indicators Multiple Causes (MIMIC) approach to investigate the effect of 11 polymorphisms in the serotonergic and dopaminergic systems, on four behavioural sub-phenotypes, namely "psychosis"," moods", "agitation" and "behavioural dyscontrol", as well as on 12 NPI items. Significant findings included the association of DRD1 A48G with "psychosis" (p=0.037), the association of DAT1 VNTR with "agitation" (p=0.006) and the association of DRD4 with "moods" sub-phenotype (p=0.008). In addition, associations were identified between DRD1 A48G and DAT1 VNTR with aberrant motor behaviour (AMB) symptoms (p=0.001 and p=0.015 respectively), between DRD4 and sleep disturbances (p=0.018) and between 5HTTLPR and apathy (p=0.033). Finally, significant interactions were observed between COMT Val158Met and 5HTTLPR with "psychosis" (p=0.026), between HTTLPR and STin2 with "psychosis" (p=0.005), between DAT1 3'UTR VNTR and COMT Val158Met with "agitation" (p=0.0001) and between DAT1 3'UTR VNTR and 5HTTLPR with the "moods" factor (p=0.0027). The complexity of the interrelations between genetic variation, behavioural symptoms and clinical variables was efficiently captured by this MIMIC model

Outdoor Adventure Therapy to Increase Physical Activity in Young Adult Cancer Survivors

Physical activity (PA) has numerous benefits for cancer survivors, but limited research exists on PA interventions in young adult cancer survivors. Outdoor adventure therapy is a potential method of increasing PA in this demographic. The primary purpose of this non-randomized parallel group study was to determine whether the outdoor adventure camp experience (vs. wait list control) would increase participants’ PA levels immediately following the 7-day camp, as well as three months later. Secondary aims examined correlates of greater PA, including pre-post camp changes in sedentary behavior, exercise self-efficacy, environmental change self-efficacy, perceived barriers to exercise, physical activity enjoyment, and physical activity variety. Sixty-six control and 50 intervention participants were given validated quantitative questionnaires at baseline, 1 week (end of camp) and at the 3-month follow-up. Repeated measures multivariate analysis of variance (RMANOVA) was used to compare group changes over time. Using intent to treat analysis, adjusting for age, gender, age at diagnosis, and baseline minutes of PA per week, there was a significant difference (p=.0001) in minutes of PA per week between groups at both 1 week and 3 months. Bonferroni adjusted post-hoc analysis indicated that, relative to baseline, the intervention group had significantly (p=.0001) greater increases in PA at both 1 week (577 minutes vs. 9 minute increases) and 3 month follow-ups (133 minute increases vs. 75 minute decreases; p=.001) respectively. Significant intervention-related improvements were also observed in TV viewing hours/week (p=.001), hours sitting/week (p=.001), “Excuses” score of the Perceived Barriers to PA questionnaire (p=.04), Enjoyment of Structured Activities (p=.04), and PA Variety (p=.0001) at 1 week but not at the 3 month follow-up. No significant effects were observed for changes in exercise self-efficacy, environmental change self-efficacy, or the other subscales scores. In conclusion, outdoor adventure therapy has the potential to increase PA levels in cancer survivors both immediately following camp, as well as long-term. However, effects tend to wane after camp termination. Future research should explore the relationship between correlates of PA and PA levels in outdoor adventure therapy camp participants and methods to promote sustained PA after camp termination

Clinical lactation practice: 20 years of evidence

Lactation consultants depend on a vast multidisciplinary knowledge base to support their practices. To coincide with the 20-year anniversary of the International Lactation Consultant Association, the authors sought to highlight the knowledge base to demonstrate how practice has been affected. Using standard databases, they extracted English-language scientific literature related to breastfeeding and maternal and infant health outcomes; factors associated with breastfeeding initiation, exclusivity, and duration; lactation physiology; common breastfeeding challenges; breastfeeding practices within vulnerable populations; health professional support of breastfeeding; and breastfeeding practices in developing countries of Africa. Summaries of research are provided to demonstrate scientific method and knowledge evolution. As the knowledge of the biological, behavioral, and environmental factors that affect breastfeeding continues to grow, researchers and lactation consultants will identify additional research areas. Thus, the cycle of describing and explaining phenomena, testing interventions to improve practice, and ultimately improving breastfeeding outcomes worldwide will continue

Ready student one: Simulation-based education, virtual reality, and the perception of stress

Aim: To investigate differences in the physiological perception of physiotherapy student stress undergoing two types of simulated environments.Design: Quasi-experimentalMethods: Students enrolled in a Doctor of Physiotherapy program were subjected to two stressors: a neurological patient simulation (SIM) and a free-roaming virtual reality (VR) immersive gaming scenario. Physiological parameters including respiratory rate, heart rate, skin temperature, salivary cortisol, and α- amylase were collected prior to, immediately post, and 15, 30, and 60 minutes after each scenario. NASA- task load index (TXL) assessed participants’ perceptions of stress prior to, and at the end of, each scenario. Repeated measures linear mixed model analysed the impact of sampling time, stressor, and their interaction on the physiological parameters and NASA-TXL.Results: The VR experience elicited a marked increase in cortisol concentration (1.7nmol/L SE 0.8, p=0.045) from baseline, but not α-amylase, levels immediately after the task. The SIM experience did not influence the concentration of salivary stress markers, although α-amylase concentrations were higher in samples obtained pre-SIM compared to pre-VR samples. NASA-TXL results indicated that students perceived themselves as performing worst and being more stressed, frustrated, and insecure prior to, and after, the SIM compared to the VR task.Conclusion: The SIM scenario had a greater anticipatory perceived stress while the VR immersive gaming experience highlighted greater post-event physiological response to stress