English-speaking Adults Research Articles

Navigating the Path to Inclusion: Understanding Barriers and Facilitators to Clinical Trial Participation Among Chinese Older Adults in the United States with Multimorbidity.

Older adults with multimorbidity are underrepresented in clinical trials, with enrollment of Asians particularly low. Understand perspectives of US Chinese older adults regarding clinical trial participation. Focus group interviews analyzed using thematic analysis. Community/senior centers, academic health systems in Northern and Southern California, and a nationwide registry of Asian Americans/Pacific Islanders. Mandarin- and English-speaking Chinese adults aged ≥ 65years with multimorbidity. Themes related to barriers and facilitators of enrollment in clinical trials of medications. We conducted 12 focus groups: 7 with non-US-born and 5 with US-born Chinese older adults (n = 83 total). Mean age was 74years (SD = 5.9), 43 (51.8%) were female, and 47 (56.6%) Mandarin-speaking. US-born participants had greater educational attainment than non-US-born participants. Participants took a mean of 6.1 prescriptions (SD = 1.5). Barriers to participation in clinical trials of medications included lack of awareness of/exposure for patients and community-based Chinese physicians, preference for natural/traditional medicine, risk aversion and safety concerns, desire for privacy, and inconvenience. Trusted influences included physicians, hospitals/health systems, Asian/Chinese community centers, and family (for non-US-born participants). Suggestions to enhance participation included using language and culturally concordant materials/personnel, educating community-based Chinese physicians about clinical trials, involving patient-trusted physicians in recruitment, promoting trials on conditions common in Chinese people or for an existing condition, and financial incentives. US-born participants expressed greater understanding and willingness to join trials. All groups attributed low clinical trial enrollment to non-US-born Chinese adults. Chinese older adults perceived obstacles to clinical trial participation that could be mitigated by involving trusted physicians in recruitment, using language and culturally concordant materials/staff, and educating patients and community-based physicians. Recognition of differences in attitudes among US- and non-US-born Chinese people may be important to tailoring recruitment strategies.

Whether and how to store firearms in the home: Qualitative insights from care partner experiences in the Safety in Dementia Trial.

Most people with dementia (PWD) in the United States live in community settings supported by family and/or unpaid care partners. Firearms access is one of many decisions care partners navigate alongside PWD in efforts to prevent injuries and deaths. Conversations about firearms access are socially challenging, although specific challenges to be overcome have not been described. As part of the larger Safety in Dementia Trial, we interviewed care partners about their views and experiences regarding firearms access in the home where the PWD resides. Interviewees were English-speaking adults (≥18 years) in the United States who are unpaid care partners of community-dwelling PWD. Responses to interview discussions related to (1) a desire for safety, and (2) fear of firearm violence was analyzed using a focusing process to categorize views into essential themes. Fifty care partners, who were primarily female (58%), White (66%), adult children (56%), and living in the same household (64%), participated in interviews between February 2023-February 2024. Dominant themes emerging from the focusing technique included (1) firearms as a necessary component of home safety; (2) fear of accidental/impulsive firearm violence; (3) observed risk and "near misses"; and (4) differing views on home firearms as a source of conflict. Thematic descriptions did not differ according to care partner's relationship to the PWD (adult child, spouse, other). Considering whether and how to alter access to firearms where PWD reside can be difficult for care partners to navigate. Care partners expressed a desire to limit firearms access, but worried both about creating conflict with the PWD and the self-defense implications of making firearms inaccessible. Findings were similar across subsets of care partners indicating that standardized tools and messaging to care partners may be effective in promoting safety in homes with PWD.

Foreign language talker identification does not generalize to new talkers.

Listeners identify talkers less accurately in a foreign language than in their native language, but it remains unclear whether this language-familiarity effect arises because listeners (1) simply lack experience identifying foreign-language talkers or (2) gain access to additional talker-specific information during concurrent linguistic processing of talkers' speech. Here, we tested whether sustained practice identifying talkers of an unfamiliar, foreign language could lead to generalizable improvement in learning to identify new talkers speaking that language, even if listeners remained unable to understand the talkers' speech. English-speaking adults with no prior experience with Mandarin practiced learning to identify Mandarin-speaking talkers over four consecutive days and were tested on their ability to generalize their Mandarin talker-identification abilities to new Mandarin-speaking talkers on the fourth day. In a "same-voices" training condition, listeners learned to identify the same talkers for the first 3days and new talkers on the fourth day; in a "different-voices" condition, listeners learned to identify a different set of voices on each day including the fourth day. Listeners in the same-voices condition showed daily improvement in talker identification across the first 3days but returned to baseline when trying to learn new talkers on the fourth day, whereas listeners in the different-voices condition showed no improvement across the 4days. After 4days, neither group demonstrated generalized improvement in learning new Mandarin-speaking talkers versus their baseline performance. These results suggest that, in the absence of specific linguistic knowledge, listeners are unable to develop generalizable foreign-language talker-identification abilities.

Neuroimaging Findings for the Overnight Consolidation of Learned Non-native Speech Sounds

Abstract Research over the past two decades has documented the importance of sleep to language learning. Sleep has been suggested to play a role in establishing new speech representations as well; however, the neural mechanisms corresponding to sleep-mediated effects on speech perception behavior are unknown. In this study, we trained monolingual English-speaking adults to perceive differences between the Hindi dental vs. retroflex speech contrast in the evening. We examined the blood oxygen level dependent signal using functional magnetic resonance imaging during perceptual tasks on both the trained talker and on an untrained talker shortly after training, and again the next morning. We also employed diffusion tensor imaging to determine if individual differences in white matter structure could predict variability in overnight consolidation. We found greater activity in cortical regions associated with language processing (e.g., left insula) on the second day. Fractional anisotropy values in the anterior thalamic radiation and the uncinate fasciculus was associated with the magnitude of overnight change in perceptual behavior on the generalization (untrained) talker, after controlling for differences in sleep duration and initial learning. Our findings suggest that speech-perceptual information is subject to an overnight transfer of information to the cortex. Moreover, neural structure appears to be linked to individual differences in efficiency of overnight consolidation.

Recovery of Comfort and Capability After Upper Extremity Fracture Is Predominantly Associated With Mindset: A Longitudinal Cohort From the United Kingdom

OBJECTIVES: To determine the relative influence of mindset and fracture severity on 9-month recovery trajectories of pain and capability after upper extremity fractures. METHODS: Design: Secondary use of longitudinal data. Setting: Single Level-1 trauma center in Oxford, United Kingdom. Patient selection: English-speaking adults with isolated proximal humerus, elbow, or distal radius fracture managed operatively or nonoperatively were included, and those with multiple fractures or cognitive deficit were excluded. Outcome measures and comparisons: Incapability (Quick-DASH) and pain intensity (11-point rating scale) were measured at baseline, 2–4 weeks, and 6–9 months after injury. Cluster analysis was used to identify statistical groupings of mindset (PROMIS Depression and Anxiety, Pain Catastrophizing Scale, and Tampa Scale for Kinesiophobia) and fracture severity (low/moderate/high based on OTA/AO classification). The recovery trajectories of incapability and pain intensity for each mindset grouping were assessed, accounting for various fracture-related aspects. RESULTS: Among 703 included patients (age 59 ± 21 years, 66% women, 16% high-energy injury), 4 statistical groupings with escalating levels of distress and unhelpful thoughts were identified (fracture severity was omitted considering it had no differentiating effect). Groups with less healthy mindset had a worse baseline incapability (group 2: β = 4.1, 3: β = 7.5, and 4: β = 17) and pain intensity (group 3: β = 0.70 and 4: β = 1.4) (P < 0.01). Higher fracture severity (β = 4.5), high-energy injury (β = 4.0), and nerve palsy (β = 8.1) were associated with worse baseline incapability (P < 0.01), and high-energy injury (β = 0.62) and nerve palsy (β = 0.76) with worse baseline pain intensity (P < 0.01). Groups 3 and 4 had a prolonged rate of recovery of incapability (β = 1.3, β = 7.0) and pain intensity (β = 0.19, β = 1.1) (P < 0.02). CONCLUSIONS: Patients with higher levels of unhelpful thinking and feelings of distress regarding symptoms experienced worse recovery of pain and incapability, with a higher effect size than fracture location, fracture severity, high-energy injury, and nerve palsy. These findings underline the importance of anticipating and addressing mental health concerns during recovery from injury. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

The Impact of Loneliness and Social Anxiety on Casual Social Contacts.

Introduction In the wake of the COVID-19 pandemic, loneliness and social isolation have become major public health crises. Loneliness has reached epidemic levels and negatively impacts both health and quality of life. "Casual contacts" is a developing line of research that may hold promise in stemming the current crisis. Casual contacts referto interactions and relationships with people who are neither family nor friends.Our objectives are to (a) document the impact of casual contacts on community-based adults (Studies 1 and 2) and (b) study the impact of loneliness (Studies 1 and 2) and social anxiety (Study 2) on responses to casual contact. Based on prior studies, we expect to find that casual contacts have a generally positive impact on mood.However, the association of both loneliness and social anxiety with hypervigilance to social threat leads to the broad hypothesis that individuals with each of these conditions would be more likely to respond negatively to casual contacts than would others without those conditions. Method This correlational research recruited convenience samples of English-speaking adults living in the United States, using the online platform Survey Monkey. There were no selection criteria beyond (a) language and location and (b) the sample beinggenerally balanced for age and gender. Partial correlation and analysis of covariance were used to examine theassociation of loneliness and social anxiety with feeling worse after casual contacts, while controlling for age, gender, household size, household income, and size of town.Because the current study examines a novel area, individual differences that affect how people experience casual contacts, we ran two studies enabling us to examine whether the results replicated. In total, we surveyed 546 community-dwelling adults about their casual contacts, 174 in Study 1 and 372 in Study 2. Data cleaning was used to minimize/eliminate meaningless and random answers resulting in a final total study sample of 393 participants: 123 in Study 1 and 270 in Study 2. Results The results indicate that casual contacts are common, with fewer than 4% having neither verbal nor electronic contact with an acquaintance weekly, and typically have a positive impact (Study 1 and Study 2). Nevertheless, a significant minority of casual contacts result in negative experiences, which is more probable among respondents who were lonely (Study 1 and Study 2) and/or had higher levels of social anxiety (Study 2). Exploratory analyses showed that both loneliness and social anxiety are linked to feeling worsefor longer periods of time after casual contacts and that positive feelings tend to dissipate more rapidly for those with higher loneliness scores (Study 2). Conclusions These results indicate that clinicians developing interventions that involve casual contacts must consider how to do so safely and effectively for those with a higher degree of loneliness and/or social anxiety.

High variability phonetic training facilitates categorical perception of Mandarin lexical tones in L2 older adults: A link to auditory processing

The current study investigated the facilitatory effects of High Variability Phonetic Training (HVPT) in second language (L2) categorical perception (CP) of Mandarin lexical tones. It also explored whether and how individual differences in auditory processing predicted gains from such training. The participants were 32 native English-speaking adults aged over 60 years who were learning Mandarin Chinese as their L2. They were randomly divided into the HVPT group (HG) ( n = 16) and the control group (CG) ( n = 16). Their L2 CP performance was assessed through an identification task and discrimination task before training, immediately after training, and two months later. Auditory processing tests were also conducted to measure the participants’ ability to encode spectral and temporal details of sounds. Linear mixed-effects (LME) models showed that, compared to the CG, the HG exhibited a more pronounced improvement in tonal categorization. Furthermore, regression analysis confirmed that individual differences in perceptual acuity significantly predicted gains from training in L2 CP of Mandarin lexical tones.

A cross-cultural study of different facets of dissociation: Validity and relationship with childhood trauma

BackgroundDissociative symptoms are often conceptualized as a response to childhood trauma. However, most previous studies did not consider dissociation as a multidimensional phenomenon and only focused on English-speaking samples. ObjectivesTo establish the cross-cultural validity of dissociation and examine the relationship of childhood trauma with different specific dissociative symptoms across two different samples. Participants and settingData from two surveys were analyzed (N = 781 Chinese-speaking adults and N = 468 English-speaking adults). MethodsParticipants completed the Childhood Trauma Subsection of the Brief Betrayal Trauma Survey and the Multiscale Dissociation Inventory (MDI) in their respective languages. We first established the measurement invariance of the MDI across the samples. Then, we examined the correlations between childhood trauma and different dimensions of dissociation. ResultsThe six-factor structure of MDI achieved configural, metric and scalar invariance across the samples. In both samples, childhood trauma was significantly correlated with all facets of dissociation (rs = 0.227 to 0.450, p < .001), after controlling for age and gender. While depersonalization (r = 0.450) had the strongest correlation with childhood trauma in the Chinese-speaking sample, memory disturbance (r = 0.333) had the strongest correlation with childhood trauma in the English-speaking sample. ConclusionsDissociation is a valid, multidimensional construct associated with childhood trauma across cultures. Yet, social and cultural factors might influence this relationship. Further studies on the complex relationship between childhood trauma and different specific dissociative symptoms, as well as possible moderators, are needed.

Smoking cessation program preferences of individuals with chronic obstructive pulmonary disease: a qualitative study.

To explore the views of tobacco-smoking chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO) patients on telehealth-based cessation programs and the role of e-cigarettes as an aid to quit smoking. Tobacco smoking accelerates the progression of COPD. Traditional smoking cessation programs often do not entirely address the unique needs of COPD patients, leading to suboptimal effectiveness for this population. This research is aimed at describing the attitudes and preferences of COPD and ACO patients toward innovative, telehealth-based smoking cessation strategies and the potential application of e-cigarettes as a quitting aid. A qualitative exploratory approach was adopted in this study, employing both focus groups and individual interviews with English-speaking adults with diagnosed COPD or ACO. Participants included both current smokers (≥ 5 cigarettes/day) and recent ex-smokers (who quit < 12 months ago). Data were systematically coded with iterative reliability checks and subjected to thematic analysis to extract key themes. A total of 24 individuals participated in this study. The emergent themes were the perceived structure and elements of a successful smoking cessation program, the possible integration of telehealth with digital technologies, and the strategic use of e-cigarettes for smoking reduction or cessation. The participants stressed the importance of both social and professional support in facilitating smoking cessation, expressing a high value for insights provided by ex-smokers serving as mentors. A preference was observed for group settings; however, the need for individualized plans was also highlighted, considering the diverse motivations individuals had to quit smoking. The participants perceived online program delivery as potentially beneficial as it could provide immediate access to support during cravings or withdrawals and was accessible to remote users. Opinions on e-cigarettes were mixed; some participants saw them as a less harmful alternative to conventional smoking, while others were skeptical of their efficacy and safety and called for further research.

Understanding the influences on hospital discharge decision-making from patient, carer and staff perspectives

BackgroundGaps in discharge planning are experienced by 41% of hospital patients in Australia. There is an established body of knowledge regarding the features of the discharge process that need to be improved to avoid subsequent hospital readmission and enhance the discharge experience. However, many of these studies have focused solely on factors related to unplanned hospital readmissions and there has been limited success in operationalising improvements to the discharge process. The aim of this study was to explore and describe the factors that influence the decision to discharge adult medical patients from hospital, from patient, carer and staff perspectives.MethodsA qualitative descriptive study was conducted in one acute medical ward in Melbourne, Australia. The study data were collected by observations of clinical practice and semi-structured interviews with patients, carers and staff. Participants were: i) English-speaking adults identified for discharge home, ii) patient carers, and iii) staff involved in the discharge process. Observation data were analysed using content analysis and interviews data were analysed using thematic analysis.ResultsTwenty-one discharges were observed, and 65 participants were interviewed: 21 patients, two carers, and 42 staff. Most patients (76%) were identified as being ready for discharge during morning medical rounds, and 90% of discharge decisions were made collaboratively by the medical team and the patient. Carers were observed to be notified in 15 discharges by the patient (n = 8), doctors (n = 4), or nursing staff (n = 3). Five themes were constructed from thematic analysis of interviews: Readiness for Home, Fragmented Collaboration, Health Literacy, Unrealistic Expectations, and Care beyond Discharge. A collaborative team and supportive carers were considered to enhance risk assessment and discharge planning, however fragmented communication between clinicians, and between clinicians and patients/carers was a barrier to discharge decision-making.ConclusionsOur study highlights the need for a more coordinated approach to discharge decision-making that optimises communication with patients and carers and multidisciplinary workflows and reduces fragmentation. The importance of patient-centred care and a personalised approach to care are well established. However, there is a need to design systems to customise the entirety of the patient journey, including the approach to discharge decision making.

A - 79 Comparison of Neuropsychological Test Performance between Monolingual Older Adults with Varying Cognitive Profiles

Abstract Objective With the rapid aging and cultural differences of the Latinx population, psychologists have expressed concerns regarding neuropsychological evaluations used for Alzheimer’s disease (ad), including the appropriateness of normative data and misinterpretation of test scores. This study explores various facets of neuropsychological performance between Spanish and English-speaking older adults with ad or normal cognition (NC). Method Participants (N = 17,716) from a de-identified database from the National Alzheimer’s’ Coordinating Center were administered Boston Naming Test-30 items (BNT-30), Animal &amp; Vegetable Verbal Fluency, Digit Symbol, Mini-Mental Status Examination (MMSE), Logical Memory I &amp; II (LM-I &amp; II), and Trail Making Test A &amp; B (TMT-A &amp; B). Correlations, multiple linear hierarchical regressions, and two-factor Analyses of Variance (ANOVAs) were used. Results Significant associations between interest areas (e.g., sex, ethnicity, race, age, education level, and/or age of cognitive onset) and test performances were found in each diagnosis group. Primary language, education level, and diagnosis were found to be significant predictors of LM-I (f2 = 0.19), LM-II (f2 = 0.22), and TMT-B (f2 = 0.15) performance. Significant interactions of primary language and diagnosis group were found among test performances for the MMSE, LM-II, Animals Verbal Fluency, TMT-A, and TMT-B (p &amp;lt; 0.05). Conclusions Further research is warranted to understand the complexity of using neuropsychological assessments to detect ad-related deficits among Spanish-speaking Latinx individuals. Evidence-based neuropsychological practice guidelines must acknowledge the importance of education level and primary language on test performance.

Individual differences in the consistency of neural and behavioural responses to speech sounds

There are documented individual differences among adults in the consistency of speech sound processing, both at neural and behavioural levels. Some adults show more consistent neural responses to speech sounds than others, as measured by an event-related potential called the frequency-following response (FFR); similarly, some adults show more consistent behavioural responses to native speech sounds than others, as measured by two-alternative forced choice (2AFC) and visual analog scaling (VAS) tasks. Adults also differ in how successfully they can perceive non-native speech sounds. Interestingly, it remains unclear whether these differences are related within individuals. In the current study, native English-speaking adults completed native phonetic perception tasks (2AFC and VAS), a non-native (German) phonetic perception task, and an FFR recording session. From these tasks, we derived measures of the consistency of participants’ neural and behavioural responses to native speech as well as their non-native perception ability. We then examined the relationships among individual differences in these measures. Analysis of the behavioural measures revealed that more consistent responses to native sounds predicted more successful perception of unfamiliar German sounds. Analysis of neural and behavioural data did not reveal clear relationships between FFR consistency and our phonetic perception measures. This multimodal work furthers our understanding of individual differences in speech processing among adults, and may eventually lead to individualized approaches for enhancing non-native language acquisition in adulthood.

Community-engaged randomised controlled trial to disseminate COVID-19 vaccine-related information and increase uptake among Black individuals in two US cities with rheumatic conditions.

Inequities in COVID-19 infection and vaccine uptake among historically marginalised racial and ethnic groups in the USA persist. Individuals with rheumatic conditions, especially those who are immunocompromised, are especially vulnerable to severe infection, with significant racialised inequities in infection outcomes and in vaccine uptake. Structural racism, historical injustices and misinformation engender racial and ethnic inequities in vaccine uptake. The Popular Opinion Lleader (POL) model, a community-based intervention that trains trusted community leaders to disseminate health information to their social network members (eg, friends, family and neighbours), has been shown to reduce stigma and improve care-seeking behaviours. This is a community-based cluster randomised controlled trial led by a team of community and academic partners to compare the efficacy of training POLs with rheumatic or musculoskeletal conditions using a curriculum embedded with a racial justice vs a biomedical framework to increase COVID-19 vaccine uptake and reduce vaccine hesitancy. This trial began recruitment in February 2024 in Boston, Massachusetts and Chicago, Illinois, USA. Eligible POLs are English-speaking adults who identify as Black and/or of African descent, have a diagnosis of a rheumatic or musculoskeletal condition and have received >=1 COVID-19 vaccine after 31 August 2022. POLs will be randomised to a 6-module virtual educational training; the COVID-19 and vaccine-related content will be the same for both groups however the framing for arm 1 will be with a racial justice lens and for arm 2, a biomedical preventative care-focused lens. Following the training, POLs will disseminate the information they learned to 12-16 social network members who have not received the most recent COVID-19 vaccine, over 4 weeks. The trial's primary outcome is social network member COVID-19 vaccine uptake, which will be compared between intervention arms. This trial has ethical approval in the USA. This has been approved by the Mass General Brigham Institutional Review Board (IRB, 2023P000686), the Northwestern University IRB (STU00219053), the Boston University/Boston Medical Center IRB (H-43857) and the Boston Children's Hospital IRB (P00045404). Results will be published in a publicly accessible peer-reviewed journal. NCT05822219.

A Qualitative Exploration of the Impact, Management, and Existing Psychological Support Available for Adults Living with Skin Conditions.

Skin conditions carry a significant physical, psychological, and social burden. People with skin conditions often engage in health-threatening behaviours that can worsen symptoms and increase cardiovascular disease risk. However, access to dedicated psychological and behaviour-change support is limited. The impact, management, and existing psychological support available to adults living with skin conditions was qualitatively explored to inform the development of a psychologically supportive digital intervention. Qualitative research involving a hybrid inductive- deductive approach was performed. Data collection and analysis were theoretically informed by the Common-Sense Model of Self-Regulation. Eight synchronous online group interviews with 43 English-speaking adults (≥ 18 years) with a range of skin conditions were conducted. Data were analysed using Reflexive Thematic Analysis. Three superordinate themes are outlined: (i) visibility underpinning life course impairment, (ii) seeking control amid uncertainty, and (iii) existing support for people with skin conditions. Skin conditions carry a substantial psychological burden, yet dermatology service provision is sub-optimal and patients often resort to seeking support from unreliable sources. Psychological support can have benefits, but barriers exist. This study reinforces the need for high-quality psychological support, and that patients wanted digital means to support effective self- management.

Is the feeling of 'weakness' associated with unhelpful thoughts or distress regarding symptoms?

This cross-sectional study looked for factors associated with feelings of weakness, level of capability and pain intensity in people seeking musculoskeletal speciality care for non-traumatic upper extremity conditions. A survey was conducted in 139 English-speaking adults, with 135 participants completing it. We found that greater intensity of feelings of weakness correlated with higher distress regarding symptoms and with older age. Lower level of capability was associated with greater intensity of feelings of weakness, greater distress regarding symptoms and older age. Higher pain intensity was associated with greater distress regarding symptoms and greater intensity of feelings of weakness. These findings suggest that the symptom of weakness may be a cue to explore potential distress about symptoms in addition to examining for actual weakness. This understanding could be a guide to a more compassionate approach to alleviate distress rather than focusing on neuromuscular pathophysiology alone, with the potential to reduce unnecessary tests and treatments.Level of evidence: IV.

Neural Decoding of Spontaneous Overt and Intended Speech.

The aim of this study was to decode intended and overt speech from neuromagnetic signals while the participants performed spontaneous overt speech tasks without cues or prompts (stimuli). Magnetoencephalography (MEG), a noninvasive neuroimaging technique, was used to collect neural signals from seven healthy adult English speakers performing spontaneous, overt speech tasks. The participants randomly spoke the words yes or no at a self-paced rate without cues. Two machine learning models, namely, linear discriminant analysis (LDA) and one-dimensional convolutional neural network (1D CNN), were employed to classify the two words from the recorded MEG signals. LDA and 1D CNN achieved average decoding accuracies of 79.02% and 90.40%, respectively, in decoding overt speech, significantly surpassing the chance level (50%). The accuracy for decoding intended speech was 67.19% using 1D CNN. This study showcases the possibility of decoding spontaneous overt and intended speech directly from neural signals in the absence of perceptual interference. We believe that these findings make a steady step toward the future spontaneous speech-based brain-computer interface.

Using Near-Infrared Spectroscopy and Education to Support Older Adults with Diabetic Foot Ulcers to Age-in-Place: A Case Series.

The objective of this article is to demonstrate the added value of foot care provided by an RN with foot care training to older adults in their home by focusing on four older adults with diabetic foot ulcers. The RN used a mobile multispectral near-infrared spectroscopy device to enhance the assessment of the diabetic foot ulcers. The Mobile Seniors Wellness Network methodically engaged with English-speaking adults 55 years and older living within a 90-minute radius of the city's community health center. Older adults were referred to the research project through various sources. The participation group included 366 participants with varying holistic healthcare concerns and financial stressors that impacted their ability to age well in place. Over the course of visits by the RN and registered social worker, positive outcomes were facilitated through the collaboration of the participant and the multidisciplinary team, thus enhancing the individual's confidence to remain at home longer. In a time of ongoing provincial health crisis, it may be cost-effective to provide in-home support to those who want to age well in their communities by deploying a Mobile Seniors Wellness Network system throughout the province and enhancing the RN's assessment of feet with a portable and innovative technology tool.

Continuum: A Postdischarge Supportive Care Intervention for Hospitalized Patients With Advanced Cancer

ContextPatients with advanced cancer are at increased risk for multiple hospitalizations and often have considerable needs postdischarge. Interventions to address patients’ needs after transitioning home are lacking. ObjectivesWe sought to demonstrate the feasibility and acceptability of a postdischarge intervention for this population. MethodsWe conducted a single-arm pilot trial (n = 54) of a postdischarge intervention, consisting of a video visit with an oncology nurse practitioner (NP) within three days of discharge to address symptoms, medications, hospitalization-related issues, and care coordination. We enrolled English-speaking adults with advanced breast, gastrointestinal, genitourinary, or thoracic cancers experiencing an unplanned hospitalization and preparing for discharge home. The intervention was deemed feasible if ≥70% of approached patients enrolled and ≥70% of enrolled patients completed the intervention within three days of discharge. Two weeks after discharge, patients rated the ease and usefulness of the video technology on a 0–10 scale (higher scores indicate greater ease of use). NPs completed postintervention surveys to assess protocol adherence. ResultsWe enrolled 54 of 75 approached patients (77.3%). Of enrolled patients (median age = 65.0 years), 83.3% participated in the intervention within three days of discharge. The median ease of participating in the intervention was 9.0 (IQR: 6.0–10.0) and the median usefulness of the intervention was 7.0 (IQR: 4.5–8.0). The majority of visits focused on symptom management (85.7%), followed by posthospital medical issues (69.0%). ConclusionAn oncology NP-delivered intervention immediately after hospital discharge is a feasible and acceptable approach to providing postdischarge care for hospitalized patients with advanced cancer.

Perception of second language phonetic contrasts by monolinguals and bidialectals: A comparison of competencies.

This study aims to examine the perception of English vowels by Greek monolingual and bidialectal speakers of English as a second language (L2) and assess the predictions of the Universal Perceptual Model (UPM). Adult Cypriot Greek (CG) bidialectal speakers and Standard Modern Greek (SMG) monolingual speakers participated in classification and discrimination tests. The two groups were matched for various linguistic, sociolinguistic, and cognitive factors. Another group of adult English speakers served as controls. Data analysis has been conducted with the use of Bayesian regression models. The results of the discrimination test were predicted by acoustic similarity only to some extent, whereas perceptual similarity predicted most contrasts, confirming the hypotheses of UPM. A crucial finding was that bidialectals outperformed monolinguals in the discrimination of L2 contrasts. The advantage observed in bidialectals could be attributed to the greater flexibility of their speech categories, stemming from exposure to more diverse linguistic input.

Anxiety sensitivity in relation to smoking dependence motives among Latinx persons who smoke.

Hispanic/Latinx (hereafter Latinx) persons are an established tobacco disparities population in the United States (US). Past work has suggested that individual differences in anxiety sensitivity, or the fear of arousal-based sensations, is one important cognitive construct for smoking maintenance and relapse among Latinx persons who smoke. However, previous research has not examined if anxiety sensitivity is associated with motivational facets of smoking dependence among this tobacco disparities population. In the current study, anxiety sensitivity was explored in terms of smoking motives for primary, secondary, and overall cigarette dependence. Participants included 336 English-speaking Latinx adults in the US who smoked cigarettes daily (Mage = 35.53, SD = 8.65, 37.3% Female). Results indicated that anxiety sensitivity was statistically significantly and positively related to higher primary and secondary dependence motives and marginally statistically significant to cigarette dependence; findings were evident after adjusting for numerous theoretically relevant variables (e.g., depression). Overall, the current study is the first to document linkages between anxiety sensitivity and numerous motivational bases of tobacco dependence among Latinx persons who smoke from the US.