Adult Life Research Articles

Redefining university success from the voices of autistic graduates and their support networks

ABSTRACT This article explores the concept of university success and the contextual factors that promote it from the perspectives of autistic Spanish graduates and their support networks (families, friends, peers, faculty, disability services and other professionals). A narrative methodology was used with semi-structured interviews, personal written narratives from graduates, and co-designed interviews with autistic graduates to gather insights from their key supporters. Data analysis was inductive with a system of categories and codes. The results highlight a multidimensional view of success beyond attaining the academic degree, encompassing well-being, a sense of belonging, shaping support networks and the development of adult life skills. It also highlights the crucial role of human support in the university setting, especially in creating inclusive environments that promote the growth and agency of autistic students. This study contributes to a more inclusive understanding of university success and provides recommendations for strengthening inclusion in higher education.

Cross-Cultural Adaptation and Content Validation of the Yonsei Lifestyle Profile for Older Adults in the United States.

As the global population ages, there is a growing need for tools to assess lifestyle factors that impact the health and quality of life of older adults. The Yonsei Lifestyle Profile (YLP), originally developed in SouthKorea, is a comprehensive tool for evaluating key lifestyle domains. However, cultural and linguistic differences between countries necessitate the adaptation of such tools for use in diverse populations. This study addresses the gap by developing an English version of the YLP (YLP-E) for older adults in the United States. As the global population continues to age, maintaining and improving the health and quality of life of older adults has become increasingly important. This study aimed to develop a YLP-E, a cross-cultural adaptation of the Korean version of the YLP, that can be used for older American adults. The Delphi method was used to consult expert panels regarding the cultural and linguistic appropriateness of the translation. The translation process involved a two-way translation-back-translation procedure and iterative revisions based on expert feedback. The final YLP-E tool, which incorporated feedback on linguistic and cultural adequacy, consisted of 3 lifestyle domains (physical activity, activity participation and nutrition) with 62 items. The second round improved the content validity, with the linguistic content validity ratio (CVR) and cultural CVR reaching 0.86 and 0.94, respectively. The YLP-E is a valuable tool for comprehensively assessing and monitoring the lifestyle of older American adults and holds promise for further refinement and validation across diverse demographic settings. Future research needs to focus on utilizing the YLP-E to develop personalized interventions aimed at improving the health and quality of life of older adults and evaluating the tool's efficacy in promoting healthy aging.

Detection and treatment of developmental dysplasia of the hip in infants: updates and recommendations.

Developmental dysplasia of the hip (DDH) is common and is a source of potentially avoidable morbidity through childhood and adult life. Despite progress over the past century, there is a wide variation in policy, practice and outcomes between countries. This review considers information from a geographically wide range of locations to evaluate the impact of these variations and understand how these variations arise. The aim is to help clinicians and policymakers adopt the best practices for their population. There is a lack of randomized controlled trials to guide decisions on screening. Given the large numbers to treat and preexisting practices, it is unlikely that such trials of sufficient statistical power will be performed. However, many whole population studies are becoming available from different countries that allow an assessment and comparison of the impact of their strategies. Standardizing metrics in studies and defining late diagnosis would improve comparisons across studies. The general trend appears to favour universal screening to reduce the risk of late diagnosis, the need for surgery and the subsequent poorer outcomes. Notably, resource-constrained countries like Mongolia have successfully implemented universal screening, showing that effective strategies can be adopted regardless of resources.

Overweight and obese body condition in ~4.9 million dogs and ~1.3 million cats seen at primary practices across the USA: prevalences by life stage from early growth to senior

Adult dogs and cats in overweight or obese condition are common, but prevalence data for different life stages, especially growth, are limited, and may help inform when preventative measures may be most effective. In this retrospective observational study, prevalences of overweight and obese condition were determined from the electronic medical records of dogs and cats of all life stages visiting [veterinary clinic name redacted as per journal protocol] Pet Hospital in the USA between 2020 and 2023. Animals were identified either by body condition score (BCS; overweight 6–7; obese 8–9) or from a clinical diagnosis of overweight condition or obesity when recorded. Life stages (early growth, late growth, young adult, adult, mature, and senior) were defined by age range, adjusted for species and breed size in dogs. Individuals could only be included once within each life stage, with the maximum BCS used. Prevalence was determined for the 4-year period and for each calendar year. The evolution of BCS was also assessed for animals with multiple records. In total, 4,933,916 unique dogs and 1,341,118 unique cats were included. In dogs, prevalences of overweight or obese condition were: 0.9% and <0.0% (early growth), 9.5% and 0.3% (late growth), 24.4% and 1.9% (young adult); 44.5% and 8.4% (adult), 50.1% and 12.6% (mature); 46.4% and 11.3% (senior). In cats, prevalences of overweight or obese condition were: 0.8% and <0.0% (early growth); 10.7% and 0.4% (late growth); 36.2% and 3.6% (young adult); 47.2% and 13.9% (adult); 44.8% and 21.7% (mature); and 32.0% and 12.6% (senior). From 2020 to 2021 and 2021 to 2022 prevalences of overweight and obese condition in dogs and overweight condition in cats increased in most life stages. The prevalence of overweight condition in dogs and obese condition in cats and dogs significantly decreased between 2022 and 2023 for some life stages. The odds ratio of an overweight or obese condition in adulthood was 1.85 (95% confidence interval [CI]: 1.81, 1.86); P ≤ 0.001) for dogs and 1.52 (95% CI: 1.48, 1.56; P ≤ 0.001) for cats where an overweight or obese condition was recorded during growth. In conclusion, both overweight and obese condition are prevalent throughout adult life, peaking during the mature life stage in dogs and cats, with overweight or obese condition during growth persisting into adulthood in most affected animals. Veterinarian-led prevention strategies are recommended from growth onwards, including the use of growth standard charts.

Functional Implications of Age-Related Atrophy of the Corpus Callosum.

The corpus callosum plays a critical role in inter-hemispheric communication by coordinating the transfer of sensory, motor, cognitive, and emotional information between the two hemispheres. However, as part of the normal aging process, the corpus callosum undergoes significant structural changes, including reductions in both its size and microstructural integrity. These age-related alterations can profoundly impact the brain's ability to coordinate functions across hemispheres, leading to a decline in various aspects of sensory processing, motor coordination, cognitive functioning, and emotional regulation. This review aims to synthesize current research on age-related changes in the corpus callosum, examining the regional differences in atrophy, its underlying causes, and its functional implications. By exploring these aspects, we seek to emphasize the clinical significance of corpus callosum degeneration and its impact on the quality of life in older adults, as well as the potential for early detection and targeted interventions to preserve brain health during aging. Finally, the review calls for further research into the mechanisms underlying corpus callosum atrophy and its broader implications for aging.

Systematic Review: Integrated Models of Care for Managing Irritable Bowel Syndrome.

Multidisciplinary integrated models of care show promise for improving symptoms and quality of life (QoL) in adults with irritable bowel syndrome (IBS). To describe and evaluate the characteristics of integrated models of care for IBS and identify how digital health is being used in these models of care. Four databases were searched to March 2024 for studies that included adults with IBS who participated in multidisciplinary integrated models of care that delivered non-pharmacological therapies. The template for intervention description and replication (TIDieR) checklist was used to appraise study quality and extract model of care characteristics, which were mapped against the Project INTEGRATE framework to establish topics. Sixteen studies (6 randomized controlled trials, 2 quasi-experimental, 8 cohort studies) reported 14 integrated models of care including 2165 patients of which 918 were IBS patients. Integrated models of care led to improved IBS symptoms (n = 11/13 models of care) and QoL (n = 6/9 models of care). Studies showed moderate compliance with the TIDieR checklist. Five topics were established: clinicians involved, therapies provided, location and mode of delivery, coordinating clinical partnerships, and sharing visions and values of integrated care. Most commonly, a gastroenterologist coordinated care with a psychologist, dietitian, and/or nurse in tertiary care. Psychological, dietary, and physical therapies were provided by n = 11, n = 8, and n = 3 integrated models of care, respectively. Six models of care provided joint consultations or group sessions. Four models of care used digital health such as telephone coaching or online modules. Integrated models of care for IBS exhibited diverse characteristics including the clinicians involved, the therapies provided and the mode of delivery of each therapy. There is a need to evaluate the use of digital health and the delivery of integrated models of care in primary care settings.

Effectiveness of Ai Chi as Aquatic Intervention for Balance Impairments in Community-dwelling Older Adults in India: A Randomised Controlled Study

Introduction: Balance impairment is a significant concern for older adults in India and worldwide, as it increases the risk of falls and affects quality of life. Aquatic therapy, particularly Ai Chi, which is not a widely popular intervention in India, offers a low-impact approach to improving balance. Aim: To investigate the effectiveness of Ai Chi in improving balance among community-dwelling older adults compared to conventional aquatic therapy. Materials and Methods: This randomised controlled trial investigated the effectiveness of Ai Chi compared to Conventional aquatic therapy (Control group) in improving balance among community-dwelling older adults. Thirty participants aged 60 and above with balance impairments were randomly assigned to either the Ai Chi or control group. Both groups received 40- minute aquatic therapy sessions three times a week for eight weeks. Balance was assessed using the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), and Dynamic Gait Index (DGI) before (P1), after four weeks (P2), and after eight weeks of intervention (P3). An Independent t-test was used for between-group analyses, and a Dependent t-test was used for within-group analysis. A Bonferroni test was applied to analyse differences between groups. Results: The participants had a mean age of 72 years, ranging from 65 to 80 years. The mean baseline scores for the BBS, TUGT, and DGI were 39.06, 13.33, and 14.13, respectively. After four weeks of intervention, the mean scores improved to 42.03, 11.73, and 15.69 for the BBS, TUGT, and DGI, respectively. Following the eighth week of intervention, the mean scores further improved to 46.23, 10.66, and 16.23 for the BBS, TUGT, and DGI, respectively. There were significant differences between the pretest and posttest 1 (MD=3.80, p-value=0.005), post-test 1 and post-test 2 (MD=4.8, p-value &lt;0.001), and between the pretest and posttest 2 (MD=8.608, p-value &lt;0.001). These analyses indicated that measures of static and dynamic balance improved consistently in both the groups. A post-hoc analysis of BBS scores showed both short-term and long-term improvements in the Ai Chi group compared to the control group. Conclusion: The study concluded that Ai Chi is an effective and enjoyable intervention for enhancing balance and potentially reducing the risk of falls and improving overall quality of life in older adults.

Association of a Liver Allocation Policy Change With Domestic Travel for Liver Transplantation.

In 2020, liver allocation policy in the United States was changed to allow for broader organ sharing, which was hypothesized to reduce patient incentives to travel for transplant. Our objective was to describe patterns of travel for domestic liver transplant pre- and post-acuity circle (AC) implementation. Incident adult liver transplant listings between August 16, 2016, and February 3, 2020 (pre-AC) or June 13, 2020, and December 3, 2023 (post-AC) were obtained from the Scientific Registry of Transplant Recipients. We used previously defined geographic catchment areas to classify patients as (1) no travel, (2) travel to a neighboring region, and (3) travel beyond a neighboring region. We used multinomial logistic regression to identify characteristics associated with travel and cause-specific hazards modeling to estimate the association between travel and time to deceased donor transplant, stratified by model for end-stage liver disease (MELD) score and AC era. Among 83 033 liver candidates, 76% were listed in their home region. Black race, lower educational attainment, increased neighborhood social deprivation, and Medicaid were significantly associated with decreased odds of traveling beyond a neighboring region. After AC, traveling beyond a neighboring region was associated with an increased hazard of transplant for patients with a MELD score <15 (cause-specific hazard ratio [csHR]: 1.25; 95% confidence interval [CI], 1.11-1.40), MELD score 15-24 (csHR: 1.19; 95% CI, 1.07-1.31), and MELD score 25-34 (csHR: 1.15; 95% CI, 1.01-1.32). Travel frequency, geographic patterns of travel, and characteristics associated with travel were largely unchanged after AC. Changes to allocation policy alone may not equalize patient means or desire to travel for transplant care.

Self-care and quality of life in older adults: a literature review

Self-care and quality of life in older adults: a literature review

Brazilian Amazon Coast is an essential habitat for threatened and evolutionarily distinct sharks and rays

Despite the high proportion of endangered species of elasmobranchs occurring in coastal areas subjected to intense fishing pressure, most of the existing habitat use information applies to pelagic species. Recent research efforts have substantially increased the information available on the habitat use of overlooked and often data deficient species. Here, we use vertebrae microchemistry data to study the habitat use patterns of four species of threatened sharks and two species of stingrays occurring in the Brazilian Amazon Coast (BAC). We obtained vertebrae samples from specimens sold in fish markets along the entire BAC area and analyze element:Ca ratios for four elements: Mg, Mn, Sr, and Ba. Our results demonstrate that most species likely complete their entire life cycle in the same region, with little to no use of freshwater habitats, and sympatric occurrence of neonates, juveniles, and adult life stages. The wingfin stingray, the only benthic-restricted species analyzed, differed substantially from all other species, with strong reliance on estuarine areas. The scalloped hammerhead has the largest variability in chemical trace elements, suggesting the use of habitats with wide variations. American cownose ray, daggernose, shovelbill, and smalleye hammerhead sharks showed strong reliance on the same type of habitat throughout their ontogenetic development. Our findings underscore the importance of the BAC as an Essential Fish Habitat for these species, a critical area for improved fisheries management given the widespread population declines and historical overfishing, and the danger of proposed oil exploration in the area can pose to its elasmobranch populations.

Adolescent work values and adult attainment in key social domains two decades later: evidence from a population-based longitudinal study of Norwegian men and women

ABSTRACT Adolescence is a crucial period for the formation of work values, which are strongly linked to young people’s educational and occupational choices. However, longitudinal studies that systematically explore interlinkages between adolescent work values and attainment in other relevant domains of adult life are scarce. This study addresses this gap by using longitudinal survey data from the Young in Norway panel (N = 1,527) linked to administrative registers. We investigated the prospective associations between four dimensions of adolescents’ work values and attainment at age 34 in social domains that traditionally mark a successful transition to adulthood. Findings revealed that adolescents driven by intrinsic work values left parental homes earlier but obtained lower wages. Those with altruistic values were more likely to marry and become parents. Extrinsically oriented adolescents achieved higher earnings. Adolescents with challenge aversion values faced poorer educational and labour market outcomes. Interaction analyses revealed that intrinsic values had stronger negative associations with earnings among men than women. Overall, this study indicates that work values formed during high school years are intricately related to later outcomes in key social domains of adult life. The findings highlight the importance of timely career guidance to help adolescents develop strong positive work values.

Pathophysiology and diagnostic criteria of PCOS.

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic syndrome mainly characterized by ovarian dysfunction, which is only one manifestation of a more complex syndrome with a significant systemic impact. We review scientific literature on the pathophysiology and diagnosis of PCOS evaluating the most relevant data from original articles, reviews and meta-analyses published until June 2024. From a pathophysiological point of view, the concurrence of both metabolic aspects, such as insulin resistance and obesity, and hormonal alterations, such as hyperandrogenemia, might produce the most relevant clinical signs and/symptoms of this syndrome, for instance menstrual irregularities, hair loss, acne and hirsutism. In the latest years, many pieces of evidence highlighted the importance of family history and genetics in the development of the syndrome during adolescence and adult life. According to the available data, hypovitaminosis D could play a detrimental role in the pathogenesis and clinical manifestations of PCOS. PCOS is a challenging endocrine and metabolic dysfunction, due to its different expression among women and to the difficulty in obtaining an accurate diagnosis. The most appropriate approach to women affected by PCOS should involve a multi-step strategy, taking into account the characteristics of each patient, in order to identify the best non-pharmacologic and pharmacologic approach to manage both short- and medium-, and long-term sequelae.

Diabetes duration over the adult life course and associations with cardiac structure in later life

Abstract Background Type 2 diabetes mellitus (T2DM) is associated with adverse left ventricular (LV) remodelling including an increase in LV mass. With falling global age of onset of T2DM, knowing the impact of T2DM duration over the adult life course on future cardiac structure is increasingly important. Purpose We studied the association of T2DM duration over the adult life course with cardiac structure in a British birth cohort. Methods Participants in the MRC National Survey of Health and Development, (the 1946 British birth cohort) underwent comprehensive investigations including echocardiography at 60-64y. The diagnosis of T2DM and age of onset was established from self-report, doctor diagnosis and/or glycated haemoglobin. The relationship between T2DM duration (3-year intervals) and LV structure (LV mass indexed to height1.7 (LVMi), LV end-diastolic volume indexed to height1.7 (LVEDVi) and LV remodelling index (LVRI)) measured at 60-64y was investigated using multivariable linear regression models. Results Age at echocardiography was 63.2±1.10 years and 701 (47.4%) were men (Table-1). Longer T2DM duration was associated with higher LVMi (1.09 (95% CI [0.364, 1.81], g/m1.7 per 3-year; p=0.003) and was independent of confounders (model-2) (Table-2). The was no relationships with LVEDVi and LVRI. The association of T2DM with LVMi was also independent of glycaemia estimated by HbA1c at 60-64y (model-3) (Table-2). Conclusions Longer duration of T2DM is associated with elevated LVMi in later life independent of current glycaemia. Preventing or delaying the onset of T2DM may have beneficial effects on the subsequent risk of cardiovascular disease.

Baricitinib Provides Significant Improvements in Quality of Life and Functioning in Adults with Moderate-to-Severe Atopic Dermatitis with Baseline Body Surface Area ≤ 40% and Severe Itch.

Patients with moderate-to-severe atopic dermatitis (AD), a body surface area (BSA) of ≤ 40%, and an itch numerical rating scale (NRS) score of ≥ 7 ("BARI itch dominant") have been characterized as an important group to consider for the oral janus kinase (JAK) 1/2 inhibitor baricitinib (BARI). Herein we aim to evaluate quality of life (QoL) and functioning outcomes in adult patients with BSA ≤ 40% and itch NRS ≥ 7 at baseline (BL) who received BARI 4mg in the topical corticosteroid (TCS) combination trial BREEZE-AD7. BREEZE-AD7 was a randomized, double-blind, placebo-controlled, parallel-group outpatient study involving adult patients with moderate-to-severe AD who received once-daily placebo or 2-mg or 4-mg BARI in combination with TCS for 16weeks. Patients eligible for enrollment had to have BSA ≥ 10%. This post-hoc analysis focused on placebo and BARI 4mg for patients with BSA ≤ 40% and itch NRS ≥ 7. QoL impairment was measured using a Dermatology Life Quality Index (DLQI) of ≤ 5, and functioning outcomes were assessed using the Work Productivity and Activity Impairment (WPAI) questionnaire. Data were reported descriptively. Last observation carried forward (LOCF) data were reported, excluding data collected after the first rescue therapy date or permanent study drug discontinuation. Non-responder imputation was used to account for missing data. At BL, patients with BSA ≤ 40% and itch NRS ≥ 7 had high QoL impairment. The mean DLQI score at BL for patients who received BARI 4mg and placebo indicates a very large effect of AD on patients' QoL. Patients who received BARI and placebo experienced a significant itch burden and reported a similar itch NRS. At week 16, 61.5% of patients treated with BARI 4mg indicated that it had no to only a small effect on their QoL (DLQI ≤ 5), versus 24.1% for patients receiving placebo (p < 0.01). A decrease in WPAI work impairment score of - 41.6 for BARI patients and - 7.0 for placebo patients was observed at week 16 (p < 0.01). Patients receiving BARI also observed a noticeable improvement in WPAI daily activity impairment of - 30.4 from baseline at week 16 compared to patients on placebo, who achieved - 12.2 (p < 0.01). Despite having high QoL impairment at baseline, patients with itch-dominant AD treated with BARI 4mg showed marked benefits in QoL, daily life activity, and work function compared to placebo after 16 weeks of treatment. Limitations include the small sample size analyzed.

Bridging Gaps: Enhancing Sleep and Health Disparities in Latino Families with Young Adults with Autism Using a Culturally Adapted Intervention.

The present study examined the effects of a culturally adapted intervention, ¡Iniciando! la Adultez, on sleep and health-related quality of life (HRQoL) in Latino young adults with autism spectrum disorder (ASD) and their Spanish-speaking parents. The intervention targeted the transition to adulthood, a period associated with increased challenges in sleep and HRQoL, particularly for underserved Latino populations. Participants included 26 young adults and 38 parents who completed assessments at baseline and post-treatment. The results indicated significant improvements in several HRQoL domains for both groups, with young adults reporting enhanced emotional well-being, social functioning, and general health. Parents experienced notable improvements in subjective sleep quality, sleep latency, and global sleep quality, alongside enhanced emotional well-being and general health. Correlational analyses revealed significant associations between baseline sleep quality and post-treatment HRQoL, acculturative stress, and mental health outcomes, suggesting the interconnectedness of these factors. Parents generally reported poorer sleep and HRQoL than young adults at both time points, highlighting the ongoing challenges they face. Despite some improvements, overall sleep quality remained suboptimal, emphasizing the need for further refinement of interventions. This study underscores the importance of culturally tailored approaches in addressing the unique needs of Latino families affected by ASD and highlights the potential benefits of such interventions in improving sleep and HRQoL. Future research should explore the long-term sustainability of these improvements and address the remaining gaps in sleep quality. The findings contribute to a growing body of evidence supporting the need for culturally sensitive interventions in promoting well-being in marginalized communities.

Effect of Bacillus subtilis ATCC 122264 on intestinal gas symptoms and quality of life in adults with functional bloating

Effect of Bacillus subtilis ATCC 122264 on intestinal gas symptoms and quality of life in adults with functional bloating

Impact of diffuse idiopathic skeletal hyperostosis on quality of life and locomotive syndrome in community-dwelling older adults: the Yakumo study

Diffuse idiopathic skeletal hyperostosis (DISH) is a common disease in older adults that causes extensive spinal ankylosis. However, its impact on quality of life (QOL) and locomotive syndrome (LS) remains unknown. Thus, we aimed to evaluate the DISH effect on QOL and LS in community-dwelling middle-aged and older adults. Data of community volunteers who attended a health checkup in 2018–2019 were assessed. A total of 455 subjects were included. Whole spine lateral radiographs were obtained to detect DISH according to the Resnik criteria. QOL was evaluated using SF-36 and EQ5D HUSV. LS was evaluated using the stand-up and two-step tests and GLFS-25. Multivariate regression analysis was performed, adjusting for sex, age, body mass index, and knee osteoarthritis. Additionally, a sex-stratified analysis was performed. DISH was detected in 83 (18.2%) participants. Multivariate analysis demonstrated that DISH was significantly associated with low EQ5D HSUV. Multivariate analysis in men demonstrated that DISH was associated with low PCS, low EQ5D HSUV, high LS stage. Multivariate analysis in women demonstrated that DISH was not associated with any QOL or LS. DISH may be associated with a poor QOL. Additionally, DISH is more common and produces a greater clinical impact in men than in women.

Lifecourse research in cancer: context, challenges, and opportunities when exploring exposures in early life and cancer risk in adulthood

As the global population ages, and rates of modifiable risk factors for cancer change, cancer incidence and mortality continue to increase. While we understand many modifiable risk factors related to diet, nutrition, bodyweight, and physical activity in adulthood that influence cancer risk, how exposure during childhood, adolescence, and young adulthood impacts cancer risk is less clear. This is partly because the timeline from initial mutation to cancer development and diagnosis can span several decades. This long latency period creates methodological, ethical, and financial issues; as well as resource and feasibility challenges in the design, implementation, and data analysis of lifecourse studies. As such, the large majority of lifecourse studies are observational, often using recall data which has inherent bias issues. Concurrently, a new research era has begun, with mature birth cohort studies that are phenotyped/genotyped and can support studies on adult cancer risk. Several studies and consortia contain information spanning the lifecourse. These resources can support association, mechanistic and epigenetic investigations into the influences of multi-disciplinary (e.g. genetic, behavioural, environmental) factors, across the lifecourse and critical time periods. Ultimately, we will be able to produce high-quality evidence and identify how/when early life risk factors impact cancer development and survival.

Relationship between social support, functional outcomes and health-related quality of life in working-aged adults at three months after ischemic stroke: results from the FRAILTY study

BackgroundThe relationship between social support and functional outcomes and health-related quality of life (HRQoL) after ischemic stroke (IS) remains unclear, especially in working-aged patients.AimTo assess the relationship between perceived social support, functional outcomes, post-stroke psychosocial symptoms, and HRQoL in working-aged adults three months after IS.MethodsA prospective and correlational design was used. Patients of working age (18–65 years) admitted for first-ever IS were enrolled in the prospective FRAILTY (Factors Affecting the Quality of Life After Ischemic Stroke in Young Adults) study (NCT04839887). HRQoL (using the Stroke Impact Scale, Quality of Life in Neurological Disorders), social support (using the Multidimensional Scale of Perceived Social Support), functional outcomes (using a modified Rankin Scale—mRS), and post-stroke psychosocial symptoms were assessed three months after IS. Descriptive statistics, Wilcoxon signed-rank test, Spearman’s correlations and multiple linear regression were used for analysis.ResultsA total of 121 (54.5% males, mean age 51.7 ± 8.4 years) IS patients were analyzed. Of those, 87.7% had excellent clinical outcomes (mRS 0–1) after three months. Patients reported significant improvement in all domains of self-reported HRQoL except memory and communication after three months. The overall perceived social support was not associated with HRQoL domains. Post-stroke depression was negatively associated with all domains of HRQoL. Living arrangements (living alone) and post-stroke depression were negatively associated with perceived social support after IS.ConclusionsMore insight into the relationship between variables of HRQoL in working-aged adults might increase their social participation, strengthen supportive relationships, and promote their recovery and rehabilitation process. Focusing on the management of emotional problems and supporting functional outcomes may be modifiable factors that may represent targets for strategies to improve the HRQoL. Further research is needed to clarify the relationship between pre-stroke perceived social support and its types and post-stroke psychosocial symptoms in the long term.

Characteristics associated with career self-reliance behaviors of nurses working in nursing homes in Japan: A cross-sectional study.

With an aging global population, establishing integrated systems for long-term care is challenging in several countries. Adequate and quality service for older adults in nursing homes can improve their quality of life. The career self-reliance of nurses working in nursing homes may affect the quality of life of older adults; this suggests a need for educational support for career self-reliance behavior. Our study aimed to identify characteristics associated with the career self-reliance behaviors of nurses working in nursing homes. Data were collected from nurses working in 789 nursing homes in Japan using questionnaires in 2018. The questionnaire consisted of the Scale of Career Self-Reliance Attitude, Career Self-Reliance Behavior to measure the degree of nurses' career self-reliance, questions about personal attributes, work environment, and work commitment; and the Clinical Nursing Competence Self-Assessment Scale. A multiple regression analysis was conducted using career self-reliance as the dependent variable and characteristics as the independent variables. Consequently, a total of 336 questionnaires were collected, of which 289 without missing data were analyzed. Of the 289 participants, 79 (27.3%) had certifications or licenses other than those for nursing or had completed graduate school. As a result of multiple regression analysis, a higher frequency of nursing practice (β = 0.38, p <0.001) was associated with career self-reliance attitudes. Having certifications or licenses other than those for nursing or completing graduate school (β = 0.11, p = 0.03), job satisfaction as a nurse (β = 0.12, p = 0.03), higher frequency of nursing practice (β = 0.28, p <0.001), and a higher degree of career self-reliance attitude (β = 0.45, p <0.001) were associated with career self-reliance behavior. Relationships with supervisors or colleagues were not associated with career self-reliance. It is important for nurses working in nursing homes to enrich their nursing practice, continue learning, and be satisfied with their jobs to improve their career self-reliance. Nurses and administrators working in nursing homes should make efforts to obtain these characteristics for nurses' career self-reliance behaviors. Particularly, maintaining nursing practice frequency is essential for improving the quality of life of older adults through nurses' career self-reliance.