171 research outputs found

    Are feelings of collective guilt really an issue in adulthood?

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    Background: People can also feel guilty for transgressions perpetrated by members of the own social group, even without own responsibility. In this brief report, we want to provide empirical information on how frequent such feelings of collective guilt (FCG) in adults may be. Methods: A cross-sectional web-based survey was conducted (2019/05-2020/04), collecting qualitative information on openly asked reasons for feeling guilty in n=604 German adults (mean/SD age=45.3/16.4 years; n=346/57.3% women). Stated reasons were rated as reflecting FCG or not. Agreement between the raters was assessed using Cohen’s kappa. Results: Reasons stated by six (1.0%) of the 604 adults were classified as reflecting FCG (Cohen's kappa=0.664; p<0.001). Reasons stated by two of the adults referred to transgressions committed by Germans during the time of Nazi Germany. Reasons stated by the remaining four adults referred to privileges one may feel guilty also as a member of a certain social group (e.g.; “I live in the West/North and I am White.”). No FCG related to other potentially important sources such as racial or gender inequality/discrimination were expressed. Conclusions: Feelings of collective guilt seem not to play a vital role in the everyday emotional experiences in adulthood

    Outcomes of stable and unstable patterns of subjective cognitive decline: results from the Leipzig Longitudinal Study of the Aged (LEILA75+)

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    Background: Subjective cognitive decline (SCD), i.e., the self-perceived feeling of worsening cognitive function, may be the first notable syndrome of preclinical Alzheimer’s disease and other dementias. However, not all individuals with SCD progress. Stability of SCD, i.e., repeated reports of SCD, could contribute to identify individuals at risk, as stable SCD may more likely reflect the continuous neurodegenerative process of Alzheimer’s and other dementias. Methods: Cox regression analyses were used to assess the association between stability of SCD and progression to MCI and dementia in data derived from the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). Results: Of 453 cognitively unimpaired individuals with a mean age of 80.5 years (SD = 4.2), 139 (30.7 %) reported SCD at baseline. Over the study period (M = 4.8 years, SD = 2.2), 84 (18.5 %) individuals had stable SCD, 195 (43.1 %) unstable SCD and 174 (38.4 %) never reported SCD. Stable SCD was associated with increased risk of progression to MCI and dementia (unadjusted HR = 1.8, 95 % CI = 1.2–2.6; p < .01), whereas unstable SCD yielded a decreased progression risk (unadjusted HR = 0.5, 95 % CI = 0.4–0.7; p < .001) compared to no SCD. When adjusted for baseline cognitive functioning, progression risk in individuals with stable SCD was significantly increased in comparison to individuals with unstable SCD, but not compared to individuals without SCD. Conclusions: Our results, though preliminary, suggest that stable SCD, i.e., repeated reports of SCD, may yield an increased risk of progression to MCI and dementia compared to unstable SCD. Baseline cognitive scores, though within a normal range, seem to be a driver of progression in stable SCD. Future research is warranted to investigate whether stability could hold as a SCD research feature

    Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+)

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    <p>Abstract</p> <p>Background</p> <p>In previous decades a substantial number of community-based studies mostly including dementia cases examined predictors of nursing home admission (NHA) among elderly people. However, no one study has analysed predictors of NHA for individuals without developing dementia before NHA.</p> <p>Methods</p> <p>Data were derived from the Leipzig Longitudinal Study of the Aged, a population-based study of individuals aged 75 years and older. 1,024 dementia-free older adults were interviewed six times on average every 1.4 years. Socio-demographic, clinical, and psychometric variables were obtained. Kaplan-Meier estimates were used to determine mean time to NHA. Cox proportional hazards regression was used to examine predictors of long-term NHA.</p> <p>Results</p> <p>Of the overall sample, 7.8 percent of the non-demented elderly (n = 59) were admitted to nursing home (NH) during the study period. The mean time to NHA in the dementia-free sample was 7.6 years. Characteristics associated with a shorter time to NHA were increased age, living alone, functional and cognitive impairment, major depression, stroke, myocardial infarction, a low number of specialist visits and paid home helper use.</p> <p>Conclusions</p> <p>Severe physical or psychiatric diseases and living alone have a significant effect on NHA for dementia-free individuals. The findings offer potentialities of secondary prevention to avoid or delay NHA for these elderly individuals. Further investigation of predictors of institutionalization is warranted to advance understanding of the process leading to NHA for this important group.</p

    Prevalence of pain and its associated factors among the oldest-olds in different care settings – results of the AgeQualiDe study

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    Background; The prevalence of pain is very common in the oldest age group. Managing pain successfully is a key topic in primary care, especially within the ageing population. Different care settings might have an impact on the prevalence of pain and everyday life. Methods: Participants from the German longitudinal cohort study on Needs, Health Service Use, Costs and Health-related Quality of Life in a large Sample of Oldest-old Primary Care Patients (85+) (AgeQualiDe) were asked to rate their severity of pain as well as the impairment with daily activities. Besides gender, age, education, BMI and use of analgesics we focused on the current housing situation and on cognitive state. Associations of the dependent measures were tested using four ordinal logistic regression models. Model 1 and 4 consisted of the overall sample, model 2 and 3 were divided according to no cognitive impairment (NCI) and mild cognitive impairment (MCI). Results: Results show a decline in pain at very old age but nonetheless a high prevalence among the 85+ year olds. Sixty-three per cent of the participants report mild to severe pain and 69% of the participants mild to extreme impairment due to pain with daily activities. Use of analgesics, depression and living at home with care support are significantly associated with higher and male gender with lower pain ratings. Conclusions: Sufficient pain management among the oldest age group is inevitable. Outpatient care settings are at risk of overlooking pain. Therefore focus should be set on pain management in these settings

    The quality of surgical pathology care for men undergoing radical prostatectomy in the U.S.

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    BACKGROUND. The authors assessed adherence with the College of American Pathologists (CAP) radical prostatectomy (RP) practice protocol in a national sample of men who underwent RP for early-stage prostate cancer. METHODS. Using the National Cancer Data Base, the authors identified a nationally representative sample of 1240 men (unweighted) who underwent RP. For each patient, local cancer registrars performed an explicit medical record review to assess patient-level compliance with surgical pathology report documentation of 7 morphologic criteria (ie, quality indicators). Applying the CAP prognostic factor classification framework, composite measures and all-or-none measures of quality indicator compliance were calculated for the following analytic categories: 1) a strict subset of CAP category I prognostic factors (3 indicators), 2) a broad subset of CAP category I factors (6 indicators), and 3) the full set of 7 indicators. RESULTS. Among a weighted sample of 24,420 patients who underwent RP, compliance with documentation of the CAP category I factors varied from 54% (95% confidence interval [95% CI], 50–58%) for pathologic tumor, lymph node, metastases classification (according to the American Joint Committee on Cancer staging system) to 97% (95% CI, 96–99%) for Gleason score. In composite, RP pathology reports contained 83% (95% CI, 81–84%), 85% (95% CI, 84–87%), and 79% (95% CI, 78–80%) of the recommended data elements measured by the strict CAP category I subset, the broad CAP category I subset, and the full set of 7 indicators, respectively. In contrast to the generally higher composite scores, only 52% (95% CI, 48–56%) and 41% (95% CI, 37–45%) of men who underwent RP had complete documentation in their pathology reports for the strict and broad CAP category I subsets, respectively. CONCLUSIONS. RP surgical pathology reports contained most of the recommended data elements; however, the frequent absence of pathologic stage provides an opportunity for quality improvement. Cancer 2007. © 2007 American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56046/1/22698_ftp.pd
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