[Effects of Wearing Face Masks to Prevent Infectious Diseases On Children's and Adolescents' Well-Being and Behavior: An Interview Study]. / Auswirkungen des Tragens von Gesichtsmasken zur Prävention von Infektionskrankheiten auf das Befinden und Verhalten von Kindern und Jugendlichen: Eine Interviewstudie.

AIM: To investigate the effects of wearing masks in terms of well-being, behavior and psychosocial development on children and adolescents during the COVID-19 pandemic. METHODS: Expert interviews were conducted with educators (n=2), teachers from primary and secondary education (n=9), adolescent student representatives (n=5) as well as paediatricians from primary care (n=3) and the public health service (n=1), transcribed and subjected to thematic analysis using MAXQDA 2020. RESULTS: The most frequently reported short- and medium-term direct effects of mask-wearing were primarily in terms of limited communication due to a reduction in hearing and facial expressions. These restrictions in communication had consequences for social interaction and teaching quality. It is assumed that there will be effects on language development and social-emotional development in the future. A reported increase in psychosomatic complaints as well as anxiety, depression and eating disorders was attributed more to the conglomerate of distancing interventions than to just wearing of masks. Vulnerable groups were children with developmental difficulties, those with German as a foreign language, younger children, and shy and quiet children and adolescents. CONCLUSION: While the consequences of mask-wearing for children and adolescents can be described quite well for different aspects of communication and interaction, effects on aspects of psychosocial development cannot be clearly identified yet. Recommendations are made primarily for dealing with the limitations in the school setting.

Reevaluation of a clinical resource for assessment of delirium, dementia, and depression.

There is a perennial need to extend geriatrics knowledge and expertise to primary care providers to meet the unique needs of older patients. Reaching the target population of providers in an effective manner presents challenges for educators and evaluation of education programs. Gaps in a previous dissemination of an Assessment Guide for delirium, dementia, and depression were addressed through a multimodal strategy to reach a greater proportion of the intended audience, primary care clinicians, and to further evaluate the clinical impact of this learning resource. Sixty-five health care providers completed a forced choice online questionnaire. The majority of respondents were primary care providers (62.5%) who used the Assessment Guide in clinical activities such as patient assessment and patient education. Semistructured interviews with selected key informants (N = 16) provided examples of clinical impact such as improved diagnosis and changes in medication.

Clinical trial of a home safety toolkit for Alzheimer's disease.

This randomized clinical trial tested a new self-directed educational intervention to improve caregiver competence to create a safer home environment for persons with dementia living in the community. The sample included 108 patient/caregiver dyads: the intervention group (n = 60) received the Home Safety Toolkit (HST), including a new booklet based on health literacy principles, and sample safety items to enhance self-efficacy to make home safety modifications. The control group (n = 48) received customary care. Participants completed measures at baseline and at twelve-week follow-up. Multivariate Analysis of Covariance (MANCOVA) was used to test for significant group differences. All caregiver outcome variables improved in the intervention group more than in the control. Home safety was significant at P ≤ 0.001, caregiver strain at P ≤ 0.001, and caregiver self-efficacy at P = 0.002. Similarly, the care receiver outcome of risky behaviors and accidents was lower in the intervention group (P ≤ 0.001). The self-directed use of this Home Safety Toolkit activated the primary family caregiver to make the home safer for the person with dementia of Alzheimer's type (DAT) or related disorder. Improving the competence of informal caregivers is especially important for patients with DAT in light of all stakeholders reliance on their unpaid care.

Health care workforce development in rural america: when geriatrics expertise is 100 miles away.

The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics and gerontology and in quality improvement (QI) and support to implement a local QI project; in addition, elective options include webinars, audio conferences, clinical practica, and mentoring. The program is effective in improving core competencies in geriatrics and in improving clinical care for older Veterans who receive health care in rural clinics.

Education partnerships between GRECCs and other VA organizations, Non-VA governmental agencies, academic medical centers, and centers of excellence.

Gerontology and geriatrics are interdisciplinary professions. The quality of the care and services provided by the members of these professions depends upon the strength and integrity of the partnerships between the professionals working together. This article summarizes the partnerships created by the Department of Veterans Affairs Geriatric Research, Education, and Clinical Centers. This myriad of partners has formed the basis of successful programming to improve clinical care, to expand research projects, and most specifically, to produce educational opportunities in geriatrics and gerontology that have the potential to improve the quality of life for older Veterans.

Dissemination strategies: the evolution of learning resources on the evaluation of delirium, dementia, and depression.

Clinicians experience great pressures to provide timely, effective, and evidence-based medical care. Educators can aid these clinicians through the development of new tools that can facilitate timely completion of clinical tasks. These tools should summarize evidence-based information in a convenient format that allows easy use. This article describes one process in which a group of Geriatric Research, Education, and Clinical Center educators identified an area where important new information accrued, their development of a new clinical and teaching tool for imparting the new information, the initial dissemination of the tool to a preliminary target audience, and the initial evaluation of the new tool to determine how to improve its distribution and use beyond the original target audience.

Clinical research participation among aging adults enrolled in an Alzheimer's Disease Center research registry.

In light of our limited understanding of what motivates older adults to participate in clinical studies of Alzheimer's disease (AD), the current study examines incentives and barriers to participating in AD clinical research among older adults. 235 participants enrolled in the Boston University Alzheimer's Disease Center research registry (75 ± 8 years, range 58-99 years, 60% female), a longitudinal registry from which individuals are recruited into other clinical studies, completed a survey assessing registry participation satisfaction, religiousness, trust in healthcare institutions, and medical research attitudes. Most participants reported initially enrolling in the registry for societal benefit. Insufficient time was a commonly endorsed barrier to enrolling in other Center-approved studies, particularly among younger participants. Driving and a lack of transportation to the medical facility were also barriers, particularly for older participants. Transportation was the most popular incentive, followed by home-based visits (particularly for older participants and participants with less formal education) and compensation (particularly among respondents from racial/ethnic minority groups). Participation interest in other studies was associated with favorable medical research attitudes (r = 0.34, p = 0.00003) but not religiousness (r = -0.09, p = 0.21), or trust in healthcare institutions (r = 0.09, p = 0.17). Among older adults, societal benefit is a motivating factor for registry enrollment; however, participation in additional studies is hindered by insufficient time among younger participants and transportation barriers among older participants. Providing transportation, home-based visits, and modest compensation may improve participation rates. Furthermore, favorable attitudes toward medical research are strongly associated with interest in enrolling in additional studies and may serve as a beneficial outreach triage technique.

Perceptions, knowledge, incentives, and barriers of brain donation among African American elders enrolled in an Alzheimer's research program.

PURPOSE: To learn about African American older adults' knowledge and perceptions of brain donation, factors that relate to participating or not participating in a brain donation research program, and methods to increase African American brain donation commitment rates in the context of an Alzheimer's disease (AD) research program. DESIGN AND METHODS: African American older adults (n = 15) from the Boston University Alzheimer's Disease Core Center participant research registry enrolled in 1 of 2 focus groups of 90 min about brain donation. Seven participants were selected for a third follow-up focus group. RESULTS: Focus group transcripts were analyzed using consensual qualitative research methods, and 8 overarching themes emerged: (a) perceptions of and misconceptions about brain donation procedures, (b) racial minorities in medical research, (c) racial disparities and discrimination in medical settings, (d) influence of religion and spirituality, (e) family perceptions of and involvement in donation, (f) family history of disease and desire to find a cure, (g) prior exposure to medical and research settings, and (h) culturally sensitive approaches to brain donation. IMPLICATIONS: Culturally relevant educational protocols need to be created for use with African American older adults. These protocols should include information about brain donation procedures, rates of AD among Black elders, and potential benefits of donation to Black communities; inclusion of religious figures, family, and peers in donation education and decisions; and methods to address mistrust, including cultural competence trainings for staff.

Caregiver competence to prevent home injury to the care recipient with dementia.

Home safety is a major concern for persons with a progressive dementia, such as Alzheimer's disease, because much direct care is provided in the home setting. This study used the Home Safety/Injury Model as a frame work to describe the domain of caregiver competence, one of the model's key constructs. Interview data from the perspectives of 17 informants yielded a total of 68 clinical situations that allowed exploration of the scope and dimensions of caregiver competence to prevent accidents in the home. The factors most influential for effective caregiver prevention of home injury were family support, an acceptance and ability to make role changes, teaching and role modeling from professionals, and long-standing values and family traditions. No single factor was sufficient to achieve effective caregiving for making the home safer, but the strength of one or two factors could compensate for the absence of others.

Genetic susceptibility for Alzheimer's disease: why did adult offspring seek testing?

This study explored why adult offspring of individuals with Alzheimer's disease (AD) sought genetic susceptibility testing for AD. Participants (N = 60) were a subset of subjects from the first randomized controlled clinical trial to offer such testing. Qualitative analysis revealed two central constructs: altruism and learning. Planning for the future, hoping to prevent AD, and need to know were concepts that explained the value of learning. These results add important contextual information into why people might seek information on their genetic risk for a severe neurodegenerative disease for which there are, as yet, no preventative treatments. As genetic susceptibility testing for numerous other diseases enters clinical medicine, these findings can enhance the knowledge and sensitivity of researchers and clinicians when they are asked by participants or patients whether they should be tested.

Promoting safer home environments for persons with Alzheimer's disease. The Home Safety/Injury Model.

This article describes a Home Safety/Injury Model derived from Social Cognitive Theory. The model's three components are safety platform, the person with dementia, and risky behaviors. The person with dementia is in the center, located on the safety platform composed of the physical environment and caregiver competence. The interaction between the underlying dementia and indicators of frailty can lead to the person with dementia performing risky behaviors that can overcome the safety platform's resources and lead to an accident or injury, and result in negative consequences. Through education and research, the model guides proactive actions to prevent risky behaviors of individuals with dementia by promoting safer home environments and increased caregiver competence.

Critical care nursing expertise during air transport.

The purpose of this study was to describe the practical knowledge possessed by registered nurses that are part of the Air Force's Critical Care Air Transport Team (CCATT) and distinguish salient features of CCATT knowledge to critical care nursing in the hospital. This research study used descriptive, exploratory methods. Twelve CCATT nurses, identified as experts, were included in the study. Data were collected using written narratives by each participant; group interviews in which nurses discussed the written narratives; and individual interviews. Data were analyzed using interpretive phenomenology. Four major themes developed from the data. The knowledge embedded in CCATT nursing included: preflight preparation, in-flight assessment and environment, characteristics of CCATT nurse, and hospital vs. in-flight nursing practice. CCATT nurses improvise and provide nursing care based on past experiences using a broad critical care knowledge base. This has led to the development of a unique body of knowledge for nursing care. The areas of assessment and preparation described by the CCATT nurses can serve as a template for the Air Force's CCATT training program and CCATT orientation checklists. This study also identified several topics for future research.

Postoperative recovery at home after ambulatory gynecologic laparoscopic surgery.

The purposes of this descriptive, correlational study were to measure pain, fatigue, and functional limitations affecting the "at home" recovery process for ambulatory gynecologic laparoscopic surgery and to explore the relationships between these variables and the return to normal activities. Subjects (N = 91) recorded daily ratings of pain, fatigue, and function on a Home Recovery Log for 6 days postoperatively. The findings indicate that 95% of subjects resumed basic self-care activities such as dressing, bathing, and eating by postoperative day (POD) 3; however, less than 40% of subjects were able to perform other role functions such as shopping, laundry, and work outside of the home. A logistic regression model indicated that pain ratings and functional status on POD 2 were the best predictors of subjects who would need more than 5 days to resume their usual activities and routines. The findings have implications for preoperative teaching and telephone follow-up for ambulatory surgery patients. Preoperative teaching should prepare women for the additional days needed for recovery of instrumental activities of daily living to enable them to make alternate plans as necessary. Furthermore, because pain on POD 2 was the single most significant predictor of delayed recovery, moving the follow-up phone call from the morning to the late afternoon of POD 1 may help the nurse to identify patients who will need extra assistance with pain management.