Psychosocial Changes Research Articles

Взаємозв'язок між психічним здоров'ям та особистісним розвитком у студентської молоді

B a c k g r o u n d . The article presents the results of research on the concept of mental health and personal development. The purpose of the study: to study the relationship between mental health and personal development of student youth. M e t h o d s . To solve the tasks, the work used methods of theoretical and empirical research: a) theoretical methods – analysis, classification, types, and generalization – made it possible to scientifically and theoretically substantiate the data we received; b) empirical methods – diagnostic methods (J. Rotter's "Locus of Subjective Control" methodology and the Questionnaire "Self-Assessment of Anxiety, Frustration, Aggressiveness, and Rigidity"), comparative analysis of research results, and mathematical data processing methods. R e s u l t s . During this study, it was found that the mental health and personal development of students are closely interconnected and significantly affect their academic performance, career prospects and general well-being. The results of the study indicate that a low level of anxiety, frustration, aggressiveness, and rigidity contributes to an active life position, striving for achievements, initiative, and responsibility. C o n c l u s i o n s . Specific features of mental health and personal development of students are determined. The student period is a dynamic and transitional stage of a person's life, characterized by significant psychosocial changes. It is accompanied by intensive training, the search for one's own identity and place in life, as well as adaptation to new social conditions. Mental health plays a critical role in the personal development of student youth, affecting academic success, social interactions, emotional well-being, and self-actualization.

Diet and the gut microbiota-immune axis in the context of perinatal mental health: Protocol for a prospective cohort study.

Physiological and psychosocial changes experienced by women during the perinatal period may put them at risk for postpartum mental health disturbances. Accumulating evidence suggests that dietary patterns may influence mental health through the modulation of the gut microbiota and its effects on host immune activity. Thus, targeting the gut microbiota via dietary intake could serve as both a preventative and therapeutic strategy in improving perinatal mental health. Here, we present a protocol for a prospective cohort study that primarily aims to determine if diet quality during pregnancy is protective against postpartum depression severity. Secondary objectives will examine if microbiota- and blood-based inflammatory markers may be associated with the relationship between prenatal diet quality and postpartum depression severity, as well as with associations between additional dietary and mental health outcomes. Dietary patterns and mental health symptoms will be documented in 100 pregnant women at 4 time points during pregnancy and postpartum. Participants will also provide stool and blood samples at the same time points to determine microbiota composition and predicted function and inflammatory factors, respectively. Stool microbiota will be analyzed using 16S ribosomal RNA gene sequencing and bioinformatics tools (QIIME 2/PICRUSt2). Inflammatory factors will be determined using high-sensitivity antibody-based immunoassays. Statistical analyses will include linear mixed models and hierarchical linear mixed effect models. The study was approved by the Research Ethics Boards of the Royal Ottawa Health Care Group (#2022002) and of the University of Ottawa (#H-06-22-8013). Informed consent will be obtained from all participants before their enrollment. Findings from this study will help develop evidence-based dietary recommendations and potential interventions for women susceptible to or suffering from postpartum mental health issues that are accessible, noninvasive, and have potential to play a role in prevention and treatment.

Sexual pleasure and HIV-related worry in female sex workers on oral pre-exposure prophylaxis in south-western Uganda.

Female sex workers (FSWs) contribute disproportionately to HIV transmission in Uganda, and pre-exposure prophylaxis (PrEP) is effective in preventing HIV among cisgender women. Psychological factors are important for PrEP uptake, but few studies have examined psychosocial changes due to PrEP use in Uganda. In 2021, we recruited 524 FSWs in three Trans-African Highway towns and four fishing communities in south-western Uganda. We conducted structured interviews among women who were attending routine PrEP follow-up visits in six health units. Bivariable and multivariable modified regression using a robust covariance matrix estimator were used to identify factors associated with experiencing increased sexual pleasure and less worry about HIV because of PrEP. Overall, 80.9% participants reported that sex was more pleasurable because of taking PrEP. There were statistical trends for sex being more pleasurable when taking PrEP or when having condomless sex with casual paying partners (aPR=1.19, 95% CI=1.07-1.32, P=0.001). Almost three-quarters of the participants (76.3%) were less worried about getting HIV because of PrEP. Condomless sex with casual paying partners (aPR=1.17, 95% CI=1.05-1.31, P=0.032, P=0.003) and being On PrEP for the past 1-2years (aPR=1.18, 95% CI=1.00-1.38, P=0.032) was significantly associated with HIV-related worry (aPR=1.17, 95% CI=1.05-1.31, P=0.032, P=0.003)Conclusions:We found a positive impact of PrEP in Ugandan FSWs on two key psychosocial dimensions: (1) more pleasurable sex; and (2) less worry about acquiring HIV. Interventions aiming to increase PrEP uptake may find it useful to focus on psychosocial dimensions.

Factors Influencing Stroke Internal Stigma Among Stroke Survivors.

Poststroke internal stigmatization in patients is often overlooked, yet it makes significant contribution to their recovery and quality of life. After stroke, the survivors often have negative perception toward themselves triggered by the internal stigma. Consequently, it affects the rehabilitation outcomes and increases the risk of long-term complications. Therefore, deeper analysis related to the factors influencing the internal stigma was crucial in order to develop an appropriate and innovative strategy to overcome this issue and optimize the recovery in stroke survivors. This study aimed to identify predominant factors influencing the internal stigma in stroke survivors in Indonesia. This study used descriptive analytical design and applied stratified nonprobability consecutive sampling involving 439 poststroke respondents from nine hospitals in Bali throughout 2023. This study used various instruments, namely stroke stigma scale (SSS), perceived family support, stroke self-efficacy scale (SSEQ), stroke awareness questionnaire, self-acceptance scale, knowledge of stroke and the respondents' demographic data. The analysis was conducted using Pearson product-moment correlation and multiple regression. The results from multiple regression analysis showed that self-acceptance (β = .374, p = .000), self-awareness (β = .132, p = .000), self-efficacy (β = .154, p = .000), family support (β = .090, p = .015), age (β = .083, p = .000), and stroke symptoms (β = -.347, p = .000) could explain the internal stigma for 62.8% (F = 124.266, p = .000). Self-acceptance became the most predominant factor towards internal stigma in the stroke survivors because it showed the ability in accepting changes after stroke, which eventually helped them to overcome the challenge and free themselves from internal stigma that interrupted the process of recovery and adaptation to poststroke physical and psychosocial changes.

Social support via Internet communication technology for diabetes self-management: a scoping review.

The global prevalence of diabetes has been increasing over the past 30 years, leading to a rise in complications; diabetes is the leading cause of amputations, blindness, and kidney failure in developed countries. Diabetes self-management is challenging due to the complex lifestyle changes required. Social support from family and friends plays a crucial role in overcoming barriers to healthy behavior choices. Integrating Internet and communication technologies with social support interventions has the potential to improve diabetes self-management. A scoping review was conducted by searching PubMed, Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Association for Computing Machinery (ACM) Digital Library databases for studies combining diabetes, Internet and communication technologies, and social support interventions. Inclusion criteria focused on adult patients with diabetes and primarily Internet and communication technologies-based strategies to initiate and enhance social support. Data abstraction included study population, design, outcomes, social support domains emphasized, support relationship intervention strategy, and Internet and communication technologies modality. The review identified 39 articles and 33 unique studies representing 27 unique interventions utilizing peer web forums, interactive voice recordings, messaging-based interventions (including Short Message Service and instant messaging), and email as Internet and communication technologies modalities. Various outcomes were reported, including improvements in perception of social support, psychosocial well-being, behavior changes, and clinical outcomes. Existing support relationships may be more effective in promoting behavior change and clinical outcomes compared to developing new relationships. Studies that explicitly measured patients' perception of support consistently showed improvements in psycho-social, behavioral, and clinical outcomes. This scoping review highlights the pivotal role of social support in diabetes self-management. By integrating Internet and communication technologies into interventions, diverse modalities such as web forums and text messaging have shown promise in enhancing patients' perception of support and improving psychosocial well-being, behavior changes, and clinical outcomes. The emphasis on leveraging existing support relationships, rather than establishing new ones, underscores the effectiveness of personalized, patient-centered approaches. These findings provide essential insights for healthcare strategies, emphasizing the need to harness technology and existing social networks to empower individuals in managing diabetes effectively.

Social Support Relations With Level Of Depression In The Elderly At Graha Marie Joseph Pontianak

Background:Elderly is someone who has reached the age of 60 years and over. As a person gets older, the elderly will experience a change either physical, psychosocial or social changes. One of the most prominent changes is the physical alteration, which is characterized by changes in biological functions that cannot be prevented from being present. Purpose: The purpose of this study was to determine the relationship between social support and the incidence of depression in the elderly at Graha Marie Joseph Pontianak. Methodology: The research method used Cross Sectional, sampling techniques using purposive sampling techniques with a sample of 24 respondents, Data analysis used is univariate analysis, bivariate using product moment tests, if the data is normally distributed and Spearman Rank if the data is not distributed normally. Results: It was found that the level of depression in the elderly at Graha Marie Joseph Pontianak was included in the category of mild depression, social support p = 0.048. Conclusion: There is a relationship between social support and the level of depression in the elderly.

Exploring the Lived Experience of Aging among Chronically Homeless Older Adults

Introduction/background summary: Twenty-four percent of Canada’s homeless shelter users are over the age of 50 years, a number that is predicted to rise [1]. Homeless older adults experience chronic health issues. They encounter barriers to accessing and utilizing healthcare and social services, such as stigma and misalignment between their needs and available services.
 Why did you do it? Designing healthcare and social services to address the needs of older adults aging with homelessness first requires evidence of their experiences. This study explores the conceptualization of older chronically homeless adults’ lived experiences related to aging.
 Who is it for? The research is for healthcare and social service providers and policymakers, populations that are homeless, researchers, and advocates interested in issues of homelessness.
 Who did you involve and engage with?Collaboration will occur with staff members and research participants in the study setting. Staff offer insights into participants’ recruitment, engagement and retention. Participants provide feedback on the interview questions, their transcribed interview notes, and written descriptions of their stories. Knowledge translation products and actionable items to improve service delivery will be co-created with the study settings.
 What did you do? The phenomenological research explores the aging experiences of older adults living with chronic homelessness. Participants will be recruited from four social service organizations and screened using the eligibility screening survey. Twenty eligible participants will be selected from the screening for data collection. The interview questions will be piloted with participants. Qualitative data collection occurs through face-to-face interviews and unstructured observations of participants in the study settings. Quantitative descriptive data will be gathered using the demographic survey and the SF-12 Short Form Health Assessment Survey. The NVivo software will be utilized to analyze the qualitative data. Quantitative data analysis will be completed with the SPSS statistical software.
 What results did you get? What impact did you have? Expected results include evidence of participants’ early physiological and psychosocial changes related to aging, healthcare and social service unmet needs and service utilization, and strategies utilized to manage developmental tasks related to aging. This study contributes new knowledge on the aging experiences of older adults living with chronic homelessness. It helps to inform healthcare and social service policy and emerging practices, including person-centred care and integrated healthcare.
 What is the learning for the international audience?The results will be transferable or interesting to international audiences that are involved in areas of research, policy, practice and advocacy related to homelessness.
 What are the next steps? The next steps involve knowledge translation at conferences, symposiums, presentations and publications. Researchers will collaborate with the study settings to translate the research findings into actionable policy, service design, and delivery mechanisms.
 References
 1.Gaetz S., Dej E., Richter T., & Redman M. (2016). The State of Homelessness in Canada 2016. Toronto: Canadian Observatory on Homelessness Press.
 

Penerapan Metode Therapeutic Community di LRPPN Bhayangkara Indonesia Kota Medan

The increase of drug abuse in Indonesia over the years has been costly, both to individuals and to society. One effort that can be made to free drug users from addiction is rehabilitation. The purpose of this devotion is to know the social work methods that are used at Lembaga Rehabilitasi Pencegahan Penyalahgunaan Narkotika Bhayangkara Indonesia Kota Medan. The method of this devotion is a descriptive qualitative with data collection techniques through observation and in-depth interviews with social worker and addiction counselor that are working at Lembaga Rehabilitasi Pencegahan Penyalahgunaan Narkotika Bhayangkara Indonesia Kota Medan. The results of the study indicate that a standard of social work adopted at Lembaga Rehabilitasi Pencegahan Penyalahgunaan Narkotika Bhayangkara Indonesia Kota Medan is a nine-month therapeutic community method focused on psychosocial changes. Therapeutic community is a joint treatment performed between former drug users by living in one environment and thus helping one another to achieve healing.

HEALTH AND FUNCTION FROM MID LIFE TO LATE ADULTHOOD: FINDINGS FROM THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION (SWAN)

Abstract Midlife (age 40-64) is characterized by physiologic, psychosocial and situational change, and a time when women experience the seminal endocrinological event of menopause. From a lifecourse perspective, understanding the relationship between midlife and older adult health is critical, particularly for identifying modifiable factors in midlife that impact later life health and functioning. Previous research has demonstrated that midlife health and functioning is dynamic and thus potentially amenable to intervention, though there remain crucial gaps in our understanding of this period. The Study of Women’s Health Across the Nation (SWAN) is an observational multi-racial/ethnic (White, Black, Chinese, Japanese, Hispanic) longitudinal study of 3,302 women recruited in 1996 from 7 sites in the United States (Boston, MA; Newark, NJ; Pittsburgh, PA; Detroit-area, MI; Chicago, IL; Oakland, CA; Los Angeles, CA). Over the past 27 years, women have participated in up to 17 near-annual study visits, spanning from midlife (age 42-52 years at baseline) to later life (age 69-79 years). This symposium features new science from SWAN including: an examination of rate of change in depressive symptoms across the menopausal transition (Avis); the impact of impaired glucose levels in midlife on muscle quality and power (Leis); the importance of sleep regularity for cognitive function (Derby); and the association of urinary incontinence with disability (Dugan). The symposium provides information regarding data and biospecimen access for investigators interested in using SWAN resources (Brooks). The Discussant will consider the implications of studying midlife health and function in relation to health and well-being in late adulthood.

Frailty in the Elderly and its Impact on Quality of Life

Introduction:The elderly undergo bio psychosocial and functional changes that reduce their ability to adapt to the environment. In addition, pathological processes occur that make the elderly more susceptible to frailty. Methodology:The methodology used for this analysis was based on a literature review, in which the sources were obtained from the SciELO, Google Scholar, and PubMed data platforms. Discussion: Ageing raises concerns about the impact on the quality of life of these individuals (Lenardt et al., 2016). According to Who (1995), quality of life is an individual's perception of their position in life according to the context in which they live and their relationship with expectations, goals, and concerns. In this sense, it can be seen that quality of life suffers from internal and external influences (Jesus et al., 2018).

Pengembangan Keberbakatan dan Minat Siswa dalam Konteks Pendidikan

Pengembangan Keberbakatan dan Minat Siswa dalam Konteks Pendidikan

Abstract B019: “It's probably just hemorrhoids”: A qualitative exploration of psychosocial and lifestyle changes and challenges accompanying an early-onset colorectal cancer diagnosis

Abstract Background: Colorectal cancer (CRC) among adults aged < 50 years (early-onset CRC [EOCRC]) is projected to be the leading cause of cancer-related death by 2030. Unanswered questions remain regarding the effects of EOCRC on quality-of-life and psychosocial outcomes affected by an EOCRC. This qualitative study explored the lived experiences and perceptions of a sample of adult EOCRC survivors in the United States through one-on-one interviews. Methods: An early-onset CRC advocate survivor team (AST) member led 27 structured interviews virtually with adults diagnosed with early-onset CRC (mean age at diagnosis = 33.93±5.90). The interview guide consisted of 10 questions, which was co-developed by the lead author, third author, and two AST members. Data was analyzed using a 9-step inductive approach, where a hybrid coding approach was employed that involved both a priori codes as well as any concepts, actions, relationships, and meanings that differed from the pre-set codes. Results: Study participants were from across the country, with over half living in the Southern (44.4%) or Midwestern (22.2%) regions. Most participants were women (66.6%) and self-identified as Non-Hispanic White (85.2%). The age of study participants at the time of interview ranged from 28 to 53 years (mean age = 40.19 ± 5.99) and their age at diagnosis ranged from 26 to 44 years (mean age at diagnosis = 33.93 ± 5.90). Six overarching themes were identified from the interviews with two to three subthemes: 1) Signs and Symptoms (Self-Misdiagnosis, Provider Misdiagnosis), 2) Risk Factors (Family History, Lifestyle, Blame/Defensiveness), 3) System-Level Factors (Provider Recommendations, Navigating Care/Pace of Treatment, Perceptions of Medical Workers), 4) Quality of Life (Fertility and/or Sexual Health, Mental Health/Therapy, Self-Advocacy), 5) Social Support (Support Groups and Family, Friends, and Others), and 6) Reflection (Prevention, Personal, Advocacy). Conclusions: The overall lived-experiences gathered from interviewees highlights specific needs of early-onset CRC identify patients that can be used to inform educational material and comprehensive care. Although the causes of the increase in young-onset CRC remain unknown, psychosocial as well as lifestyle changes and challenges should be considered during treatment and future intervention as well as throughout survivorship in this younger population of CRC patients. Impact: The lived experiences and perceptions of EOCRC survivors highlight specific needs of this population that can inform both educational materials and comprehensive care. Citation Format: Charles R. Rogers, Kevin M. Korous, Mary A. De Vera, Aasma Shaukat, Ellen Brooks, Candace Henley, Wenora Johnson, Tiana N. Rogers. “It's probably just hemorrhoids”: A qualitative exploration of psychosocial and lifestyle changes and challenges accompanying an early-onset colorectal cancer diagnosis [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B019.

The Protective Role of L-carnitine on Psychosocial Stress-induced Changes in Gene Expression and Protein Levels of Matrix Metalloproteinases, Serum Corticosterone in a Rat Model.

Psychosocial stress (STS) is a common stress in modern societies. Chronic STS is associated with the impairment of a broad range of cognitive functions in humans and with prolonged abnormalities in memory. Matrix metalloproteinases (MMPs), a protein family of zinccontaining endopeptidases, are essential in neuro-inflammation and involved in neurodegenerative diseases. L-Car possessed neuroprotective, antioxidant, and anti-inflammatory properties and was shown to modulate MMPs. The current study aimed to examine the protective effect of L-Carnitine (L-CAR) on STSinduced changes in serum corticosterone levels, MMP-2, -9, and -12 protein and mRNA expression in the hippocampus as a possible mechanism for L-CAR protective effect on STS-induced memory impairment. The chronic STS and L-CAR (300 mg/kg/day, i.p) were simultaneously administered for 6 weeks to adult male Wistar rats. Serum corticosterone and protein levels of MMP-2, -9 and -12 were evaluated using ELISA. Real-Time PCR techniques were used to determine the mRNA levels of MMP-2, -9 and -12 in the hippocampus. The findings showed that serum corticosterone levels and MMP-2 and -9 protein levels were significantly increased (p<0.05) in the STS group compared to the control. Similarly, RT-PCR findings showed that the mRNA of those proteinases significantly increased (p<0.05) following the intruder method. On the other hand, the administration of L-CAR restored the alterations in corticosterone levels and MMPs gene and protein expression induced by chronic STS. STS induced elevations in corticosterone and MMP-2 and -9 levels in the hippocampus. L-CAR, on the other hand, exhibited protective effects against the STS-induced changes in MMP-2 and -9.

Conflicts in Adolescence and Their Association with Closeness: Results of a Multi-Perspective Study from Germany

Adolescence is marked by rapid biological and psychosocial changes that profoundly impact parent–child communication in order to reorganize responsibilities and move toward a more egalitarian relationship. Therefore, our primary objective in the present study was to explore the influence of changing conflict frequency and intensity on the perceived level of closeness between parents and adolescents, considering the perspectives of both parties involved. Using 10-wave longitudinal data with measures of parents (n = 17,005) and their children (n = 15,841) aged seven to 16 from the German Panel “Analysis of Intimate Relationships and Family Dynamics” (pairfam), the present study used fixed-effects models to address the research goal. The findings indicate that, for parents and adolescents, an increase in both conflict frequency and intensity corresponds to a more pronounced decline in closeness. Higher levels of initial closeness when the participants entered the survey resulted in milder decreases in closeness when conflict intensity was higher, a pattern observed for both parents and adolescents. Regarding conflict frequency, no impact of initial closeness was discerned among parents, while an opposing effect was found among adolescents. These findings shed light on changes in parent–child communication during the transition from early to middle adolescence, underscoring the need for further exploration of the closeness–conflict association.

The impact of lockdowns or severe social restrictions during COVID-19 pandemic on glycaemic control of adults suffering with type 2 diabetes mellitus: a review

Glycemic control in diabetes has shown to improve insulin sensitivity and reduce both microvascular and microvascular complications in diabetes mellitus. In 2020, with the globe facing COVID-19 pandemic. The governments and authorities resorted to lockdowns to reduce the spread of infection. We aimed to find the impact of lockdowns during COVID-19 pandemic on glycaemic control of adults suffering with type 2 diabetes mellitus. (T2DM). We systematically searched 5 medical databases MEDLINE via PubMed, Embase, CINAHL, web of science and Cochrane library up to 16th November 2021 using key terms. Total of 24899 articles were identified by the search, of which 17571 articles were excluded for duplication, 7303 were excluded after screening for title and abstract, and further 16 articles excluded after full text review. We analyzed the final 9 observational studies fulfilling the criteria. The 2177 participants from final 9 observational studies, 5 studies showed worsening glycemic control during lockdown period, 2 reported improvement and 2 showed no significant change. We noticed that weight was correlating with glycated hemoglobin change. Studies with lockdown period &gt;10weeks reported greater HbA1c deterioration and the farther HbA1c check done from start of lockdown, higher HbA1c values noticed. Glycemic control overall in type 2 diabetes has worsened due to lockdown measures which may be due to reduced physical activity, change in diet or psychosocial changes. There has also been increase in BMI (Body Mass Index) correlating with raise in HbA1c. More in-depth review is required into long term impact of lockdowns on diabetes.

Deteksi Dini Anemia dengan Pemeriksaan Haemoglobin (Hb) Pada Remaja Putri di Pondok Pesantren Maqna ul Ulum Jember

Adolescence is a transition period from childhood to adulthood, marked by physical, psychological and psychosocial changes (Dieny, 2014). According to Basic Health Research (Riskesdas) in 2018, the prevalence of anemia in adolescent girls was 32%. Fulfilling nutritional needs during adolescence would maximize the reproductive organs function which will lead to a better conception result.&#x0D; This community service was carried out in December 2022 at the Maqnaul Ulum Islamic Boarding School, Jember. This community service was carried out because of the anemia cases in teenagers is quite high. The method used in community service is examining Hb (Haemoglobin) levels in every young woman in Islamic boarding schools.&#x0D; The examination results of the hemoglobin levels female students showed that 10 female students had anemia, 31 female students did not have anemia. Through this Hb examination, it is expected that teenagers can prevent anemia and avoid other health problems that occur in teenagers

Glucose and Psychosocial Outcomes 12 Months Following Transition from Multiple Daily Injections to Advanced Hybrid Closed Loop in Youth with Type 1 Diabetes and Suboptimal Glycemia.

Objective: To investigate 12-month glycemic and psychosocial changes following transition from multiple daily injections (MDI) to advanced hybrid closed-loop (AHCL) therapy in youth (aged 13-25 years) with type 1 diabetes and suboptimal glycemia (glycated hemoglobin [HbA1c] ≥8.5% [69 mmol/mol]). Research Design and Methods: Prospective, single arm, dual-center study in 20 participants. Extension phase outcomes reported after 12 months, including HbA1c, time in glycemic ranges, AHCL system performance, and psychosocial questionnaires assessing quality of life, diabetes treatment, and sleep. Results: After 12 months, 19 out of 20 participants continued to use AHCL. Average time-in-range 70-180 mg/dL (3.9-10.0 mmol/L) improved from 27.6% ± 13.2% to 62.5% ± 11.4%. This translated to an average 2.5 percentage-point (27.1 mmol/mol) improvement in HbA1c from 10.5% ± 2.1% (91.2 mmol/mol) at baseline to 8.0% ± 0.9% (64.1 mmol/mol) at 12 months. Psychosocial questionnaires and very high HbA1c at study entry indicated significant diabetes-associated burden for both individuals and parents. After 12 months, improvements were observed in general and diabetes-specific health-related quality of life, as well as in diabetes treatment satisfaction. Safety data were reassuring with a diabetic ketoacidosis rate of 0.15 per participant-year after 12 months of AHCL (compared to 0.25 per participant-year in the 12 months before the study). Conclusions: After 12 months of AHCL usage, this study highlights the potential for substantial and sustained glycemic and psychosocial improvements among individuals experiencing considerable diabetes burden and suboptimal glycemia, following their switch from MDI to AHCL.

Communication Openings: A Novel Approach for Serious Illness Communication in Homecare.

Serious illness communication in homecare about hospice and/or palliative care transitions is lacking due to clinical culture. The purpose of the current study was to understand communication openings using COMFORT™, a palliative care communication model used to train nurses. Qualitative, focus group interviews with 31 homecare nurses were conducted. Data were transcribed verbatim and thematically analyzed using NVivo software, followed by hand-sorting. Four themes for communication openings for initiating discussions about potential hospice and/or palliative care transitions were identified: Organizational Openings (homecare appropriateness, eligibility requirements, and staffing); Patient Openings (patient physical decline, psychosocial changes, safety concerns, and denying/stopping care); Caregiver Openings (caregiver physical changes and patient readiness); and Nurse Openings (need for hospice, checking for prognosis understanding, increasing interprofessional care needs, and providing end-of-life care). This study extends the concept of communication openings in the COMFORT model. Further development of communication openings as part of COMFORT communication is needed in educational and intervention research. [Journal of Gerontological Nursing, 49(11), 33-41.].

4 Interactions of Inflammation and Psychosocial Stress on White Matter Integrity Over Time in Older Black Adults

Objective:Higher levels of inflammation are associated with risk factors for Alzheimer’s disease and related dementias (ADRD) in older Black adults including psychosocial stressors (e.g., discrimination and early life adversity) and white matter alterations. Yet, limited work has investigated these risk factors together in a longitudinal neuroimaging study, despite the well-known ADRD disparity in older Black adults. Using data from the Minority Aging Research Study and African American Clinical Core of the Rush Alzheimer’s Disease Center, we examined interactions of psychosocial stressors and change in inflammation on changes in white matter integrity as measured via diffusion tensor imaging (DTI).Participants and Methods:Older Black adults (n=102) without known dementia at baseline (age=75.8±6.1 years; 87.3% female; education=15.4±2.7 years) completed blood draws at two time points (follow-up=2.4±0.7 years), neuroimaging at two or more time points (follow-up=3.7±1.8 years), and psychosocial questionnaires at one time point coinciding with the first blood draw/neuroimaging. Blood serum was assayed using highly-sensitive multiplexed sandwich ELISA for interleukin-6, c-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-a) and a change score was calculated for each inflammatory marker (T2 - T1). The Williams Everyday Discrimination Scale quantified experiences of discrimination in all participants and a 16-item questionnaire of emotional and physical trauma from age 0-18 assessed early life adversity in a participant subset (n=63). DTI-derived tract-based spatial statistics (TBSS) slope change measures for trace of the diffusion tensor, fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) were calculated, with the first two scans matched in time to blood assays. Linear regression models investigated interactions of each inflammatory marker change score (separately) and either discrimination or early life adversity (separately) on trace, FA, AD, and RD slopes as individual outcomes adjusting for age, sex, education, white matter hyperintensities (total volume and voxelwise), cardiovascular risk factors, statin and analgesic medications, thyroid conditions, and depression. Statistical significance was determined at p&lt;0.05 using family wise error correction and threshold free cluster enhancement.Results:Discrimination moderated the relationship between TNF-a and AD whereby those with increasing TNF-a and higher levels of discrimination had increasing levels of AD over time in white matter tracts connecting the left and right cerebellum, the left pallidum and medulla, and the left superior frontal gyrus and left thalamus. Both discrimination and early life adversity moderated associations between CRP and AD, where increases in CRP and higher psychosocial stressors (of either type) resulted in decreasing AD over time in tracts involving cingulate, frontal, and parietal regions. Discrimination and early life adversity also moderated associations between CRP and RD, where increasing CRP combined with greater psychosocial stressors resulted in decreasing RD in right hemisphere association and projection tracts connecting frontal, parietal, central, and subcortical regions.Conclusions:TNF-a and CRP interacted with measures of psychosocial stress to associate with DTI-derived TBSS slope change measures of AD and RD in differential, and at times, paradoxical ways. Findings suggest that both risk and resilience as related to brain connectivity may be co-occurring in the presence of psychosocial stressors for older Black adults.

Meningkatkan Derajat Kesehatan Melalui Pendekatan Biopsikospiritual Pada Kelompok Lansia

Introduction: as we get older, the aging process continues and causes various kinds of changes. The body will experience changes in structure and physiology. There are 4 changes due to the aging process, namely physical and functional changes, mental changes, psychosocial changes and spiritual changes. To survive the decline in body function, the elderly must be able to continue to adapt to the situation. Objective: To improve the level of health through a biopsychospiritual approach in the elderly group with a total of 146 activity participants in the active elderly category. Method: Implementation of community service is carried out through stages: Preparation, Socialization, Implementation of Activities (Explanation of material, Simulation and Evaluation) and Closing. Results: Based on the data above, it can be seen that the problems experienced by the activity participants were high blood pressure, dizziness, pain in the joints, pain in the stomach and solar plexus area, mild anxiety and sleep disturbances and a feeling of hopelessness due to the pain they complained about. Furthermore, the evaluation results at the end of the activity showed an increase in understanding of the material presented by the presenters. With an average increase of 50%. This community service activity is documented in the pictures below. Conclusion: Based on the results of the evaluation of Community Service activities, the picture of understanding about efforts to improve health status through a biopsychospiritual approach in the elderly group through education and simulation has increased quite significantly.