Happy Alone? Motivational Profiles of Solitude and Well-Being Among Senior Living Residents.

Research on solitude in older adulthood is scarce, and findings are mixed on whether time alone at this age is risky or beneficial. A mixed-method study was conducted to examine patterns of motivations for solitude among senior living residents (N = 397, Mage = 83) and associations with well-being. Cluster analyses identified four motivational profiles: Low, Positive, Negative, and Dual. Overall, those with Low and Positive motivations for solitude displayed greater levels of well-being on both hedonic (e.g., life satisfaction) and eudaimonic (e.g., personal growth) measures; in particular, the Positive profile showed significantly higher levels of psychological richness. Themes drawn from responses to open-ended survey questions asking about the benefits and challenges of both socializing and being alone are discussed in light of the four motivational profiles, and implications for aging services are discussed.

Preliminary Evaluation of an Osteopathic Manipulative Treatment to Prevent Motion Sickness.

INTRODUCTION: Motion sickness affecting military pilots and aircrew can impact flight safety and, if severe, can lead to disqualification from flight status. However, due to the common adverse effects of motion sickness pharmaceuticals (e.g., drowsiness), medication options are severely limited. The purpose of this study was to explore the potential utility of a nonpharmaceutical method for motion sickness prevention, specifically an osteopathic manipulative technique (OMT).METHODS:A novel OMT protocol for the reduction of motion sickness symptoms and severity was evaluated using a sham-controlled, counterbalanced, between-subjects study design. The independent variable was OMT treatment administered prior to the motion sickness-inducing procedure (rotating chair). The primary dependent measures were total and subscale scores from the Motion Sickness Assessment Questionnaire.RESULTS:The OMT treatment group experienced significantly fewer gastrointestinal (mean scores postprocedure, treatment M = 20.42, sham M = 41.67) and sopite-related (mean scores postprocedure, treatment M = 12.81, sham M = 20.68) symptoms than the sham group while controlling for motion sickness susceptibility. There were no differences between groups with respect to peripheral and central symptoms.DISCUSSION:The results suggest that the treatment may prevent gastrointestinal (nausea) and sopite-related symptoms (sleepiness). These preliminary findings support further exploration of OMT for the prevention of motion sickness. A more precise evaluation of the mechanism of action is needed. Additionally, the duration of the effects needs to be investigated to determine the usefulness of this technique in training and operational settings.Thomas VA, Kelley AM, Lee A, Fotopoulos T, Boggs J, Campbell J. Preliminary evaluation of an osteopathic manipulative treatment to prevent motion sickness. Aerosp Med Hum Perform. 2023; 94(12):934-938.

Glioblastoma Multiforme Survivor With Radiation-Induced Consequences: A Case Report.

Glioblastoma multiforme is an aggressive malignant tumor of the brain with a poor prognosis and no known cure. Current treatment options for this aggressive malignancy include surgical resection, adjuvant radiation therapy, and systemic pharmacological therapy. This case report presents one patient's experience with resolved glioblastoma multiforme treated by surgical resection and radiation therapy and discusses her later development and treatment of a radiation-induced meningioma. Despite developing radiation-induced morbidities, the patient experienced an extended life because of the aggressive treatment. It is thought that the young age of this patient at the time of diagnosis may have contributed to her prolonged survival time. When balancing aggressive treatment plans to increase survival time in glioblastoma multiforme patients, risks and potential consequences of treatment, such as post-surgical changes, vascular dementia, strokes, and meningiomas, should be weighed and discussed with the patient. Furthermore, striving for a high quality of life should be kept at the forefront of every treatment plan in all patients with glioblastoma multiforme.

Practicing engaged research through pandemic times: do not feed the animals?

From 'Feed the Birds' to 'Do Not Feed the Animals' takes an engaged approach in which science communication is both process and outcome of the research. The project started in the UK in March 2020, coinciding with government-imposed lockdowns in response to the COVID-19 pandemic; since the project's engagement had been designed around in-person interactions, a rapid and creative rethink was needed. This paper outlines the redesign of the project and describes a hybrid model of on-line and in-person engagement, integrating new skills and technologies which the pandemic catalysed, with well-established in-person practice in science communication. Our research develops good practice for online, participatory science communication, and supports the advancement of engaged research more widely.

A Multi-Sectoral Approach Improves Early Child Development in a Disadvantaged Community in Peru: Role of Community Gardens, Nutrition Workshops and Enhanced Caregiver-Child Interaction: Project "Wawa Illari".

Background: Multi-dimensional monitoring evaluation and learning strategies are needed to address the complex set of factors that affect early child development in marginalized populations, but few studies have explored their effectiveness. Objective: To compare improvement of health and development of children 0-3 years between intervention communities (IC) and control communities (CC) from peripheral settlements of Lima. Sequential interventions included: (1) home and community gardens, (2) conscious nutrition, and (3) parenting workshops following the International Child Development Program (ICDP). Methods: Interventions were delivered by community health promoters (CHPs) using a "step-by-step" learning system. Both IC and CC were monitored before the interventions began, at 8 and 12 months (n = 113 IC and 127 CC children). Data were collected on household characteristics, diet, food security, health indicators (history of diarrhea and respiratory infections, hemoglobin, intestinal parasites, anthropometry), caregiver-child interactions and stress, and achievement of Pan-American Health Organization age-specific developmental milestones. Stepwise multiple logistic regressions were used to determine if the interventions affected food insecurity, as well as motor, social/cognitive and language delays. Results: At baseline, 2.6% were categorized as "suspected developmental delay" and 14.2% were on "alert for development delay." Food insecurity, diarrhea and respiratory infections were lowered following the interventions. Through the "step-by-step" approach, caregivers in IC gained skills in gardening, conscious nutrition and parenting that reduced the risk of food insecurity [Adjusted Risk Ratio = 0.20 (95% CI: 0.08-0.51)] and language delay [0.39 (0.19-0.82)] but not motor or social/cognitive delay. Use of a multiple micronutrient supplement decreased the risk of motor delay [0.12 (0.03-0.56)], but more pets were associated with higher risk of motor [3.24 (1.47-7.14)] and social/cognitive delay [2.72 (1.33-5.55)], and of food insecurity [1.73 (1.13-2.66)]. Conclusion: The combined interventions delivered by CHPs helped to mitigate the impact of adversity on food insecurity and language delay. Additional improvements may have been detected if the interventions had continued for a longer time. Our results indicate that control of infections and pets may be needed to achieve measurable results for motor and social/cognitive development. Continuous monitoring facilitated adjusting implementation strategies and achieving positive developmental outcomes.

Motivation matters: Development and validation of the Motivation for Solitude Scale - Short Form (MSS-SF).

INTRODUCTION: Motivation is an overlooked but crucial factor in determining whether solitude is psychologically beneficial or risky. This paper describes the development and validation of the Motivation for Solitude Scale - Short-Form (MSS-SF), a measure grounded in Self-Determination Theory that differentiates between intrinsic versus extrinsic motivations for solitude. METHODS: Emerging adult (N = 803) and adolescent (N = 176) participants were recruited in four successive samples from the United States for the purposes of scale development and validation. Participants completed an on-line survey that included the MSS-SF and various well-being and personality measures. RESULTS & CONCLUSIONS: Confirmatory Factor Analyses resulted in a two-factor solution, selfdetermined solitude (SDS) and not self-determined solitude (NSDS), and showed the MSS-SF to be reliable with adolescents and emerging adults, with satisfactory convergent and discriminant validity. Engaging in solitude for extrinsic, not self-determined reasons was associated with loneliness, social anxiety, and depressive symptomatology; in contrast, solitude chosen for intrinsic, self-determined reasons was positively correlated with well-being, for emerging adults in particular. The MSS-SF goes beyond preference for solitude to distinguish two distinctly different motivations for solitude, and in so doing, allows researchers to better understand the affordances and risks of being alone for adolescents and emerging adults.

Digital Photograph Security: What Plastic Surgeons Need to Know.

BACKGROUND: Sharing and storing digital patient photographs occur daily in plastic surgery. Two major risks associated with the practice, data theft and Health Insurance Portability and Accountability Act (HIPAA) violations, have been dramatically amplified by high-speed data connections and digital camera ubiquity. The authors review what plastic surgeons need to know to mitigate those risks and provide recommendations for implementing an ideal, HIPAA-compliant solution for plastic surgeons' digital photography needs: smartphones and cloud storage. METHODS: Through informal discussions with plastic surgeons, the authors identified the most common photograph sharing and storage methods. For each method, a literature search was performed to identify the risks of data theft and HIPAA violations. HIPAA violation risks were confirmed by the second author (P.B.R.), a compliance liaison and privacy officer. A comprehensive review of HIPAA-compliant cloud storage services was performed. When possible, informal interviews with cloud storage services representatives were conducted. RESULTS: The most common sharing and storage methods are not HIPAA compliant, and several are prone to data theft. The authors' review of cloud storage services identified six HIPAA-compliant vendors that have strong to excellent security protocols and policies. These options are reasonably priced. CONCLUSIONS: Digital photography and technological advances offer major benefits to plastic surgeons but are not without risks. A proper understanding of data security and HIPAA regulations needs to be applied to these technologies to safely capture their benefits. Cloud storage services offer efficient photograph sharing and storage with layers of security to ensure HIPAA compliance and mitigate data theft risk.

Sex-specific neuroanatomical correlates of fear expression in prefrontal-amygdala circuits.

BACKGROUND: The neural projections from the infralimbic region of the prefrontal cortex to the amygdala are important for the maintenance of conditioned fear extinction. Neurons in this pathway exhibit a unique pattern of structural plasticity that is sex-dependent, but the relationship between the morphologic characteristics of these neurons and successful extinction in male and female subjects is unknown. METHODS: Using classic cued fear conditioning and an extinction paradigm in large cohorts of male and female rats, we identified subpopulations of both sexes that exhibited high (HF) or low (LF) levels of freezing on an extinction retrieval test, representing failed or successful extinction maintenance, respectively. We combined retrograde tracing with fluorescent intracellular microinjections to perform three-dimensional reconstructions of infralimbic neurons that project to the basolateral amygdala in these groups. RESULTS: The HF and LF male rats exhibited neuroanatomical distinctions that were not observed in HF or LF female rats. A retrospective analysis of behavior during fear conditioning and extinction revealed that despite no overall sex differences in freezing behavior, HF and LF phenotypes emerged in male rats during extinction and in female rats during fear conditioning, which does not involve infralimbic-basolateral amygdala neurons. CONCLUSIONS: Our results suggest that the neural processes underlying successful or failed extinction maintenance may be sex-specific. These findings are relevant not only to future basic research on sex differences in fear conditioning and extinction but also to exposure-based clinical therapies, which are similar in premise to fear extinction and which are primarily used to treat disorders that are more common in women than in men.

Expanding the chronic care framework to improve diabetes management: the REACH case study.

BACKGROUND: Reducing the burden of chronic conditions among minorities requires novel approaches to prevent and manage disease. OBJECTIVES: This paper describes the expansion of the Chronic Care Model (CCM) to include a community focus for improving diabetes self-management and reducing health disparities. METHODS: The literature review assesses the concept of "community" in improving outcomes as viewed by proponents of the CCM for chronic disease. The CCM was then modified and informed by experiences of a major community-based participatory action initiative to improve diabetes outcomes, the Racial and Ethnic Approaches to Community Health (REACH) Charleston and Georgetown Diabetes Coalition. RESULTS: Based on our experiences with community-based and health systems diabetes interventions, we present examples of improvements within both health delivery practice sites and other community systems that are essential for improving diabetes outcomes and reducing disparities. Building on the Centers for Disease Control and Prevention's (CDC) principles of community involvement, our coalition activities provide examples of working with community partners to frame this enhanced ecologically grounded Community CCM (CCCM). CONCLUSION: The resulting CCCM integrates expanded conceptual frameworks, evidence-based practice, community-based evidence and participatory actions, and highlights the possibilities and challenges for improving chronic disease outcomes and reducing disparities via community programs that foster individual, systems, community, and policy change.

Scheduled hysterectomy for second-trimester abortion in a patient with placenta accreta.

BACKGROUND: As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion. CASE: A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy termination at 15 weeks of gestation. Scheduled hysterectomy was performed to avoid hemorrhage and subsequent complications. The patient did well postoperatively; her course was complicated only by a wound infection treated as an outpatient. Pathology was consistent with placenta increta. CONCLUSION: Placenta accreta has increased 13-fold in the past 30 years. In select patients with evidence of abnormal placentation, scheduled hysterectomy for termination of pregnancy is an option that may be considered.

Three Hundred Sixty Degree Feedback: program implementation in a local health department.

Three Hundred Sixty Degree Feedback systems, while popular in business, have been less commonly implemented in local public health agencies. At the same time, they are effective methods of improving employee morale, work performance, organizational culture, and attainment of desired organizational outcomes. These systems can be purchased "off-the-shelf," or custom applications can be developed for a better fit with unique organizational needs. We describe the City of Milwaukee Health Department's successful experience customizing and implementing a 360-degree feedback system in the context of its ongoing total quality improvement efforts.

Reducing disparities for African Americans with diabetes: progress made by the REACH 2010 Charleston and Georgetown Diabetes Coalition.

Racial and Ethnic Approaches to Community Health (REACH 2010) is a U.S. Centers for Disease Control and Prevention demonstration program that responds to the U.S. Department of Health and Human Services' goal to eliminate racial and ethnic disparities in health status by the year 2010. As part of REACH 2010, community projects were funded to develop, implement, and evaluate community action plans to improve health care and outcomes for racial and ethnic populations. This article describes the program and details the progress of the REACH 2010: Charleston and Georgetown Diabetes Coalition in reducing disparities in care. Approaches employed by the Coalition included community development, empowerment, and education related to diabetes; health systems change associated with access, care, and education; and coalition advocacy. Racial disparities were identified for 12,000 African Americans with diabetes in this urban/rural South Carolina community. After 24 months, significant differences that initially ranged from 11% to 28% in African Americans (when compared with whites/others) were not observed on 270 chart audits for A1C, lipid and kidney testing, eye examinations, and blood pressure control. Future efforts will focus on maintaining progress, eliminating other disparities, and identifying the contributions of each intervention in eliminating racial disparities.

The Wisconsin Arthritis Program--a new partnership to reduce the leading cause of disability.

There are known and effective strategies to prevent arthritis, reduce symptoms, decrease disability, and improve quality of life. For example: Weight management and physical activity may lower risk. Early diagnosis and appropriate self-management may decrease pain. Arthritis Self-help Course, an evidence-based education program, may reduce pain and enhance self-management. The new Wisconsin Arthritis Program will engage citizens, health professionals, and organizations together as partners to reach more people in order to utilize effective strategies to prevent arthritis, reduce symptoms, decrease disability, and improve quality of life.

The state of arthritis in Wisconsin.

Arthritis is the leading cause of disability and functional limitation in Wisconsin and trails only heart disease as the leading cause of work disability. In 2001, the estimated prevalence of arthritis/chronic joint symptoms (CJS) among US adults was 33%, representing approximately 69.9 million adults. Wisconsin has established a statewide program to address this chronic condition. Prior to its inception, no state-based arthritis surveillance was available. The Wisconsin Behavioral Risk Factor Surveillance System (BRFSS) first included questions on chronic joint symptoms and doctor-diagnosed arthritis in 2000. That data provides a baseline to describe the burden of arthritis in Wisconsin. This report summarizes the prevalence of arthritis and its distribution among Wisconsin adults. Proven public health interventions should be applied and new interventions developed to improve function, decrease pain, and delay disability among persons with arthritis, particularly those at highest risk for functional impairment and disability.

Obesity and physical inactivity among Wisconsin adults with arthritis.

INTRODUCTION: Arthritis is the leading cause of disability in Wisconsin, and affects approximately 34% of Wisconsin adults. Obesity is an established risk factor for arthritis; however, the relationship between arthritis and obesity has not been well characterized at the population level in Wisconsin. OBJECTIVES: Describe the relationship between arthritis, obesity, physical inactivity, and efforts to lose weight among Wisconsin adults. METHODS: Wisconsin Behavioral Risk Factor Surveillance System 2000-2001. Arthritis was defined by either doctor diagnosis or self-reported chronic joint symptoms. RESULTS: Overall, 36% of respondents had arthritis. Among adults with arthritis, 28% were obese (BMI>30) compared to 16% without arthritis. The prevalence of leisure time physical inactivity was substantially higher among those with arthritis compared to those without arthritis (27.8% vs. 19.2%). Although prevalence of obesity was higher among those with arthritis, only 46% of adults with arthritis made an effort to lose weight. CONCLUSIONS: A high proportion of adults with arthritis are obese and are physically inactive, even though studies have shown that weight loss and regular physical activity relieve arthritis symptoms. Efforts should be made to promote weight loss and physical activities among adults with arthritis.