Differences in time-based task characteristics help to explain the age-prospective memory paradox.

Prior prospective memory (PM) research shows paradoxical findings-young adults outperform older adults in laboratory settings, but the reverse is found in naturalistic settings. Moreover, young-old outperform old-old adults in laboratory settings, but show no age differences in naturalistic settings. Here we highlight how time-based task characteristics have differed systematically between studies conducted in laboratory (time-interval cues) and naturalistic settings (time-of-day cues) and argue that this apparent paradox is a function of comparing disparate task types. In three experiments, we tested this hypothesis using analogous paradigms across settings, with event-based, time-of-day, and time-interval cued PM tasks. Experiment 1 compared young (n = 40) and older (n = 53) adults on a laboratory paradigm that measured PM tasks embedded in a virtual, daily life narrative; and on a conceptually parallel paradigm using a customized smartphone application (MEMO) in actual daily life. Results revealed that on the MEMO, older adults outperformed young adults on the time-of-day tasks but did not differ on the time-interval or event-based task. In contrast, older adults performed worse than young adults in the laboratory. Experiment 2 compared PM performance in young-old (n = 64) and old-old (n = 40) adults using the same paradigms. Young-old outperformed old-old adults in the laboratory; however, group differences were not evident in daily life. Experiment 3 compared young (n = 42) and older (n = 41) adults, and largely replicated the findings of Experiment 1 using a more demanding version of MEMO. These findings provide novel and important insights into the limiting conditions of the age-PM paradox and the need for a finer theoretical delineation of time-based tasks.

Development and testing of a model for risk and protective factors for eating disorders and higher weight among emerging adults: A study protocol.

Research has demonstrated that eating disorders (ED) and higher weight have lifetime co-occurrence suggesting that they may be best considered within a common etiological model. Although we know that body dissatisfaction is likely to be a risk factor for both outcomes, other proposed risk and protective factors for each condition have not been adequately explored. The current paper tests a conceptual model that is based on a review of the existing literature from both areas of scholarship. It considers biological, sociocultural, psychological, and behavioral factors that may contribute to both outcomes. The model will be tested in a longitudinal design with an initial sample of 600 emerging adults (aged 18-30) per country in nine different countries (total sample = 5400 participants). Questionnaires will be completed online on two occasions, 12 months apart. The first full phase of the study commenced in July 2018, the same time Body Image was approached to publish this protocol paper (the final revised paper was submitted in September 2019), and data collection will be finalized in December 2019. Multi-group path analysis will identify the biopsychosocial predictors - both cross-sectionally and longitudinally - of both ED and higher weight, and how these vary across countries and gender.

Psychometric evaluation supported construct validity, temporal stability, and responsiveness of the Osteoarthritis Questionnaire.

OBJECTIVES: The Osteoarthritis Questionnaire (OA-Quest) is a new measure of individual burden of osteoarthritis, composing seven brief (4-11 items; total 42 items), independent scales. This study describes the psychometric evaluation of the OA-Quest. Specifically, temporal stability, convergent and discriminant validity, and responsiveness of the OA-Quest to joint replacement surgery were examined. STUDY DESIGN AND SETTING: Participants were drawn from rheumatology (n = 62), orthopedic (n = 90), and community (n = 175) settings. Temporal stability of the OA-Quest was evaluated over a 2-week period and was assessed with intraclass correlation coefficients. Responsiveness was assessed with standardized effect sizes and paired samples t-tests. Convergent and discriminant validity was assessed with a multitrait multimethod confirmatory factor analysis (MTMM CFA). RESULTS: The OA-Quest scales had high temporal stability, with intraclass correlation coefficients between 0.75 (lost productivity) and 0.94 (physical limitations) and showed improvements of expected magnitude and direction 3 months after joint replacement surgery, supporting their responsiveness. MTMM CFA supported the convergent and discriminant validity of the OA-Quest, demonstrated by adequate model fit (χ2 = 483.54, df = 184, P < 0.001, comparative fit index = 0.95, Tucker-Lewis index = 0.93, root mean square error of approximation = 0.07, standardized root mean square residual = 0.06) and factor loadings of the expected magnitude and direction. CONCLUSION: The OA-Quest has strong evidence of temporal stability, construct validity, and is responsive to change following joint replacement surgery.

The Cost of Osteoporosis, Osteopenia, and Associated Fractures in Australia in 2017.

Osteoporosis and osteopenia are increasingly prevalent conditions among older adults. Not only do the fractures associated with poor bone health have significant health consequences for the individual, but also their economic impact is placing increasing financial burden on governments and society. This study aimed to determine the direct economic cost of osteoporosis, osteopenia, and fractures among Australians aged 50 years and older in 2017. This study uses previous Australian data on the incidence and prevalence of osteoporosis and osteopenia together with recent Australian data on health service utilization after fracture to provide an estimate of the economic burden of osteoporosis. A bottom-up costing approach was used to determine the average direct health care and non-health care total costs of a fracture, as well as the average community health service costs of managing individuals with osteoporosis or osteopenia. The total direct cost of osteoporosis in Australia in 2017 was estimated to be $3.44 billion (AUD 2017, USD 2.77 billion). Treatment of fractures accounted for 68% of total direct costs, and non-fracture management of osteoporosis accounted for 32%. Hip fractures accounted for the highest proportion (43%) of the total direct cost of fractures, although fractures at "other" sites accounted for 38.5%. Fractures among individuals aged 70 years and older accounted for 74% of the direct costs (55% and 19% in women and men, respectively). Fracture costs in those with osteopenia accounted for 50% of direct fracture treatment costs. This up-to-date cost analysis estimated that costs in 2017 were three times higher than in 2007. These estimates will aid clinicians, policy makers, researchers, and health care organizations to acknowledge the economic importance of reducing osteoporosis-related fractures and associated costs. This provides a strong public health case to promote bone health that will assist in reducing future fracture-related costs. © 2018 American Society for Bone and Mineral Research.

Depression and Anxiety Among Partner and Offspring Carers of People With Dementia: A Systematic Review.

BACKGROUND AND OBJECTIVES: Family carers of people with dementia (PWD) experience high rates of depression and anxiety. However, the factors that are associated with these mental health concerns among family carers are not well understood. The purpose of this review was to identify factors that are associated with depression and anxiety in family carers of PWD. RESEARCH DESIGN AND METHODS: A systematic review was conducted of studies that examined depressive or anxiety symptoms among family caregivers of community-dwelling older adults with dementia. Twenty-six studies met inclusion criteria and were included in the review. RESULTS: Depressive and anxiety symptoms were related to demographic factors, dementia characteristics, carer psychological and social factors, and dyadic relationship factors. Some prominent factors were consistently associated with depressive symptoms across studies. Female carers and adult-child carers, rather than spousal carers, were more likely to experience depressive symptoms. Carers' coping strategies and activity restriction were also found to be strongly related to depressive symptoms. Severity of dementia-related problematic behaviors was related to carers' depression and anxiety symptoms. In addition, relationship type and quality were important factors associated with depressive symptoms. DISCUSSION AND IMPLICATIONS: Several important risk factors for carer depression were highlighted in this review. However, a lack of measurement precision and a reliance on cross-sectional studies limits our understanding of exactly how depression and anxiety progress during the caregiving experience. The implications for prevention and intervention programs for depression and anxiety are discussed, as well as suggestions for future research to improve the quality of research in this area.

Is it all bleak? A systematic review of factors contributing to relationship change in dementia.

ABSTRACTBackground:The care of community-dwelling people with dementia often occurs in the context of pre-existing family relationships. The presence of dementia can result in changes to the quality of those relationships. The purpose of this systematic review is to identify factors that enhance or challenge the quality of spousal or offspring relationships in the context of dementia. METHODS: Both qualitative and quantitative studies were included in a systematic review of the literature. Thematic analysis of results was conducted that examined factors related to the relationship quality of community dwelling people with dementia and their spousal or offspring carer. Meta-analysis was not possible due to the heterogeneity of the included studies. RESULTS: Four themes were extracted from seven qualitative studies: connection to the carer role; identity of the people with dementia; current efforts to maintain relationship connection; and the dyads response to dementia. Each of these four themes incorporated positive and negative facets that impacted on relationship quality. An analysis of nine quantitative and one mixed methods studies identified four domains: influence of dementia characteristics; connection within the dyad; relationship response to stress and carer burden; and carer demographic factors. CONCLUSIONS: The findings of this review highlight relationship factors that are important for supporting relationship quality for the people with dementia and the carer individually, as well as for the dyad together. These findings extend an existing framework of relationship quality in dementia. Implications for interventions to enhance relationship quality in the dementia context are discussed.

I just can't please them all and stay sane: Adult child caregivers' experiences of family dynamics in care-giving for a parent with dementia in Australia.

Family caregivers of people with dementia who live within the community often experience stress and poor quality of life due to their care-giving role. While there are many factors that affect this, one influential factor is the family context. This study focussed on adult child caregivers. It examined the specific ways that family dynamics contribute to adult child caregivers' distress in the context of caring for a parent with dementia. Semi-structured interviews were conducted with 17 participants who were adult child primary caregivers for a parent with dementia who was living within the community. Interviews were audiotaped and transcribed verbatim. Transcripts were analysed using thematic analysis. Four themes were identified that represented areas of particular concern and distress for the caregivers: family expectations and caregivers' lack of choice in adopting the care-giving role; denial and differential understandings of dementia among family members; differential beliefs and approaches to care-giving among family members; and communication breakdown between family members. The findings demonstrate several avenues for further research including the development of interventions to support adult child caregivers and address problematic family dynamics within the context of caring for a parent with dementia.

"I just don't focus on my needs." The unmet health needs of partner and offspring caregivers of people with dementia: A qualitative study.

BACKGROUND: Family caregivers of people with dementia have significant unmet health needs. There is a lack of research that differentiates between the needs that are specifically relevant to partner and offspring caregivers. OBJECTIVE: The aim of this study was to examine the health needs of partner and offspring caregivers of older people with dementia, including the barriers they experience in meeting their needs. METHOD: Semi-structured interviews were conducted with 24 family caregivers of community-dwelling people with dementia. Of these, 12 were partner caregivers (4 men, 8 women) and 12 were offspring caregivers (2 men, 10 women). The interviews were transcribed and analysed using thematic analysis. RESULTS: Five themes were identified within the data. The first theme represents caregivers' overall assessment and perception of their health needs. The remaining four themes represent the most important aspects of caregivers' health needs; mental health, emotional support and social relationships, healthy diet and exercise, and personal time. While these themes were similar for offspring and partner caregivers, the specific needs and barriers within these areas were different. A prominent barrier for partner caregivers was that they had difficulty in acknowledging their needs. Despite this, partner caregivers demonstrated unmet emotional support needs, as they no longer had emotional support from their partner with dementia. They also had an unmet need for time away from the care-giving role, yet they were reluctant to leave the person with dementia. Offspring caregivers' unmet health needs were easily identified and were focused on their unmet mental health needs and feeling socially isolated. These unmet mental health and social support needs were related to their unmet health needs in other areas such as exercise, diet and having time to themselves. CONCLUSION: Caregivers have significant unmet needs and these are often complex, multidimensional, and they often differ between partner and offspring caregivers. Gaining a more detailed understanding of the needs and barriers that are particularly relevant to either partner or offspring caregivers will assist in the development of interventions that are tailored to the unique needs of caregivers.

Gender, marital status and longevity.

Most studies report a positive relationship between marital status and health, with findings consistent across cultures and countries. Gender effects are significant, with men demonstrating greater health benefit than women. The vast majority of the research has examined heterosexual marriages, yet there has been rapid evolution in society of cohabitation patterns, who can marry, and roles in marriage. In this review, we summarise research findings and discuss important future challenges. Broader work looking at the impact of social connectedness, loneliness and support on survival should be supported. Human relationships are crucial to our health and wellbeing - caring and support promote significantly better health outcomes.

"There isn't an easy way of finding the help that's available." Barriers and facilitators of service use among dementia family caregivers: a qualitative study.

BACKGROUND: Family caregivers of people with dementia have significant unmet needs in regard to their caregiving role. Despite this, they are reluctant to utilize services to reduce their burden. The aim of this study was to examine the barriers and facilitators of service use among family caregivers of people with dementia. METHOD: Semi-structured interviews were conducted with 24 family caregivers of community-dwelling people with dementia. Of these, 12 were partner caregivers (4 men, 8 women) and 12 were offspring caregivers (2 men, 10 women). The interviews were transcribed and analyzed using thematic analysis. RESULTS: Six main barriers and three facilitators were identified. These barriers and facilitators were relevant across many types of services and supports. The barriers were: the inability to find information about relevant services or support, the poor quality or mistrust of the services, the inflexibility of services, caregivers' beliefs about their obligations to the caregiving role and resistance by the care recipient. Key facilitators were: having good communication with the care recipient, having an "expert" point of contact, and having beliefs about the caregiving role that enabled the use of services. CONCLUSION: Given the significant changes in the aged care service-system, it is important to discuss the barriers faced by family caregivers of people with dementia. This will inform the development of targeted strategies to address the lack of service use among these family caregivers.

Healthy me: A gender-specific program to address body image concerns and risk factors among preadolescents.

This study evaluated a gender-specific, school-based program to promote positive body image and address risk factors for body dissatisfaction. In total, 652 children aged 8-10 years participated (335 intervention, 317 wait-list control). Children participated in four 60min sessions and a recap session at three months post-intervention. The broad content areas were body image, peer relationships, media awareness, healthy diet, and exercise. The activities and examples for each session were gender specific. The recap session was an overview of the four sessions. Assessment measures were completed at pre-intervention, post-intervention, and after the recap. Boys and girls in the intervention demonstrated higher muscle esteem and vegetable intake at post-intervention, compared to children in the control condition. Boys and girls demonstrated higher body esteem, muscle esteem and fruit and vegetable intake at the recap. Boys in the intervention demonstrated less investment in masculine gender norms at post-intervention and at recap.

Children's body image and social comparisons with peers and the media.

Social comparisons are related to the development of body dissatisfaction among adolescents and adults, yet this relationship remains relatively unexamined among children. This study examines children's peer and media-related social comparisons, and how this impacts on their body image. Children aged 8-10 years completed interviews (17 girls and 19 boys in individual interviews, and 16 girls and 16 boys in focus groups). Analyses revealed that appearance-related comparisons were more common among girls, whereas sports/ability-related comparisons were more common for boys. In addition, boys viewed media comparisons as inspiring, whereas girls reported negative emotions. Implications for future research and prevention programmes are discussed.

A systematic review of body dissatisfaction and sociocultural messages related to the body among preschool children.

This systematic review examines body dissatisfaction and the influence of sociocultural messages related to body image among preschool children. The review was conducted according to the PRISMA guidelines and 16 studies were included in the final analysis. Findings suggest that children under the age of 6 years old experience body dissatisfaction, however, the proportion of children who are dissatisfied varied from around 20% to 70%, depending on the method of assessment. The literature was divided on whether preschool aged girls experience more body dissatisfaction than boys. Parental influence appears to be an important factor in the development of preschool children's body dissatisfaction and attitudes. However, more research is needed to understand the influences of children's peers and the media. The need for more sensitive measures of body dissatisfaction and prevention programs for preschool children is discussed.

Hearing Their Voice: A Systematic Review of Dementia Family Caregivers' Needs.

PURPOSE: The number of Australians living with dementia is expected to increase from currently 332,000 to 900,000 by 2050. Around 200,000 unpaid caregivers are caring for community-dwelling people living with dementia, and therefore, supporting the caregivers' needs is of paramount importance. The aim of this systematic review was to understand the perceived needs of immediate family caregivers of community-dwelling older adults with dementia. DESIGN AND METHODS: We examined qualitative studies that reported on the self-perceived needs of partner and/or offspring caregivers who were caring for community-dwelling older adults with dementia. RESULTS: Two themes were developed from 12 studies: caregiver needs related to the management of older people with dementia and caregivers' personal needs. The first theme further included four subthemes: information and knowledge needs; activities of daily living, instrumental activities of daily living and Behavioural and Psychological Symptoms of Dementia support needs; formal care support needs; and informal care support needs. The second theme consisted of two subthemes: the need to address caregivers' physical and psychological health and the need to manage caregivers' own lives. IMPLICATIONS: The findings have important implications for the development of interventions that comprehensively address caregivers' individual needs. Caregivers' unmet needs highlight key areas for improvement in policy and service provision. The findings demonstrate the need for more rigorous qualitative studies exploring the perceived needs of partner and offspring caregivers respectively. Furthermore, examining the underlying relationships between different caregiver needs is warranted.

A qualitative study of preadolescent boys' and girls' body image: gendered ideals and sociocultural influences.

This qualitative study examined preadolescent boys' and girls' body ideals, and peer and media factors that shape these ideals. Sixty-eight children aged 8-10 participated in semi-structured interviews: 19 boys and 17 girls in individual interviews and 16 boys and 16 girls in eight group interviews. Techniques from grounded theory were used to analyze the data. Findings demonstrated that fitness was an important element of boys' and girls' body ideals. For boys the emphasis was on sport, and this was promoted by their peer interactions and the sportsmen they admired. For girls the focus was on looking good, and this was reinforced by their peer conversations, and the actresses and singers they admired. Focus groups further highlighted how peers both reinforced media messages, yet also helped children critique media messages. Implications are discussed for prevention programs that need to be specifically tailored for boys and girls.