The preschool years are a critical time for the development of emotion regulation, which is vital for children’s intellectual and social growth. Children with behavior problems are at particular risk of developing poor regulatory skills. Understanding factors underlying emotion dysregulation in children with behavior problems is therefore important for fostering children’s emotional development. Although theory and research suggest executive function may be important in this regard, its role among children at-risk for emotion dysregulation remains unclear. The goal of the current study was to examine whether executive function predicted trajectories of emotion dysregulation from age 3 to age 5 among children with behavior problems. This study focused on 199 3-year-old children with behavior problems who took part in a larger longitudinal study. Results revealed that response inhibition and working memory were not predictive of later emotion dysregulation. However, children who exhibited worse delay of gratification at ages 3 and 4 had greater symptoms of externalizing emotion dysregulation at age 5. In addition, children who made more omission errors on a test of attentional control at ages 3 and 4 exhibited greater externalizing emotion dysregulation at age 5. Gender differences emerged on two measures of delay of gratification and one measure of attentional control. Results suggest that specific facets of executive function may play an important role in difficulties with emotion dysregulation across the preschool years and that this pattern may differ across boys and girls.

Introduktion: Benskörhet är vanligt förekommande och är ett tillstånd där skelettets funktion försämras. Minskad bentäthet påverkas av faktorer såsom kost, fysisk aktivitet, ålder och hormoner. Av alla som får en höftledsfraktur över 75 års ålder avlider 30% av patienterna inom ett år. Benskörhet bidrar till minskad styrka, muskelmassa och större risk för fler framtida frakturer. Syfte: Syftet med studien är att sammanställa och jämföra studier kring fysisk träning hos äldre (60+) och träningens effektivitet vid osteoporos eller osteopeni. Metod: Metoden genomfördes enligt avancerad sökning i Pubmed, CINAHL och Scopus där endast RCT studier inkluderades. Kvalitetsgranskningen skedde enligt PEDro-skalan. Resultat: Artikelsökningen gav 288 träffar, efter artikelsökningen återstod 12 st artiklar. Resultatet av BMD analyserades  i femur, ländrygg, underarm, underben och total body. Styrketräning, multikomponent träning och vibrationsträning har visat ökning av BMD i femur och ländrygg. Submaximal träning kombinerat med läkemedel ger effekt på BMD. Vibrationsträning ser en ökning av BMD i distala radius och tibia. Konklusion: Högintensiv träning, multikomponent träning och vibratorisk träning gav effekt på BMD. Vandring och aerobisk träning gav inte lika stor effekt på BMD. Däremot sågs att varierad träning minskar fallrisk och att komponenter såsom styrka, balans, aerobisk kapacitet och koordination är viktiga för ökad och bibehållen fysisk funktion samt för att förhindra fallrisk hos äldre. Fysioterapeuter och sjukvårdens samarbete är viktigt för att minska risken för frakturer hos äldre.

Yes / This study investigates how men’s body image develops over time. 14 men aged between 45 and 67 years completed in-depth interviews where they discussed their body image since childhood, prompted in some cases by photographs of themselves at different ages that they brought to the interviews. Transcripts were analysed using inductive thematic analysis. From the participants’ accounts it was evident that body concerns did not steadily improve or worsen, but waxed and waned over time. Results are discussed in relation to understanding changing body concerns in men’s lives, and the implications of these for future research and practice.

No / To identify factors available to general practitioners (GPs) that are predictive of mortality within a general practice-based population of heart failure patients, and to report the sensitivity and specificity of prognostic information from GPs. Methods: Five hundred and forty-two heart failure patients aged >60 years were recruited from 16 UK GP surgeries. Patients completed quality-of-life and services use questionnaires every 3 months for 24 months or until death. Factors with independent significant association with survival were identified using Cox proportional hazards regression analysis. Results: Women had a 58% lower risk of death. Patients self-reporting New York Heart Association Classification III or IV had an 81% higher risk of death. Patients aged 85+ years had over a five-fold risk of death as compared with those aged <65 years. Patients with a co-morbidity of cancer had a 78% higher risk of death. Of the 14 patients who died in a 12-month period, the GPs identified 11 (sensitivity 79%). They identified 133 of the 217 who did not die (specificity 61%). Discussion: Predictors readily available to GPs, such as patient characteristics, are easy to adapt to use in general practice, where most heart failure patients are diagnosed and treated. Identifying factors likely to influence death is useful in primary care, as this can initiate discussion about end-of-life care. / Department of Health.

Yes / Many intervention studies lack an investigation and description of the factors that are relevant to its success or failure, despite its relevance to inform future interventions. This study aimed to explore the facilitators and barriers to the implementation of a psycho‐educational intervention for care assistants caring for people with dementia in aged‐care facilities. A process evaluation was carried out alongside a pretest/post‐test controlled study conducted in aged‐care facilities. Seven focus‐group interviews involving 21 care assistants (female; mean age 43.37 ± 10.0) and individual semi‐structured interviews with two managers (female; mean age 45.5 ± 10.26) were conducted 2 weeks and 6 months after the intervention, in two aged‐care facilities. Interviews were recorded, transcribed and submitted to content analysis by two independent researchers. Results were organised into implementer, participant and organisation level hindered and facilitator factors. Findings enable the interpretation of the experimental results and underscore the importance of collecting the perception of different grades of staff to obtain information relevant to plan effective interventions. / Foundation for Science and Technology (FCT). Grant Number: SFRH/BD/72460/2010 and RIPD/CIF/109464/2009

Yes / This study assessed the effects of a psycho-educational intervention on direct care workers' person-centredness during morning care to residents with dementia. A controlled pretest–posttest study was conducted in four aged-care facilities with 56 direct care workers (female, mean age 44.72 ± 9.02). Two experimental facilities received a psycho-educational intervention comprising person-centred care competences and stress management skills; control facilities received an education-only intervention, without stress support. In total, 112 video-recorded morning care sessions were coded using the Global Behaviour Scale. Both groups reported significantly higher scores on eight of 11 items of the Global Behaviour Scale and on the Global Behaviour Scale total score at posttest (F=10.59; p=0.02). Global Behaviour Scale total score improvements were higher for the experimental group, with values close to significance (F=3.90; p=0.054). The findings suggest that a psycho-educational intervention may increase care workers' person-centredness. Further research is needed to explore the long-term sustainability and extent of its benefits on workers and residents. / Foundation for Science and Technology

No / Epidemiological evidence suggests that nonsteroidal, anti-inflammatory drugs (NSAIDs) may retard the progression of Alzheimer's disease (AD). In the present study, we have chronically treated adult (4¿5 months old) and aged (20+ months) rats with water adulterated with aspirin, and examined spatial learning in a swim maze. Adult rats (n=40) and aged rats (n=20) were divided into separate groups assigned to receive either normal drinking water or water with 2 mg/ml of aspirin dissolved in it. For 6 weeks, we monitored daily water and/or drug intake before testing all rats in a standard swim maze over an 8-day period. On average, each rat drank approximately 25 ml of water/day with no apparent control versus aspirin group differences. There was no effect of aspirin in young adult rats except during a visible platform trial where aspirin-treated rats performed better than controls. In contrast, aspirin markedly improved performance in the aged rats during hidden and visible platform trials. Such group differences abated by the eighth test day when all rats performed equally well. The improvements in performance were not correlated with changes in swim speeds indicating that the enhancement was not due to facilitated motor output. These data reveal that a modest, 6-week treatment regimen with aspirin in aged rats is sufficient to induce improvements in both speed of learning and strength of the learned response. We have yet to address the key question as to underlying physiological mechanism(s) that might underpin this augmented cognitive performance. Moreover, it would be useful to ascertain whether or not chronic NSAID treatment might reduce the extent of learning impairments in aged, cognitively impaired animals.

Yes / Background: In older people living with frailty, polypharmacy can lead to preventable harm like adverse drug reactions and hospitalisation. Deprescribing is a strategy to reduce problematic polypharmacy. All stakeholders should be actively involved in developing a person-centred deprescribing process that involves shared decision-making. Objective: To co-design an intervention, supported by a logic model, to increase the engagement of older people living with frailty in the process of deprescribing. Design: Experience-based co-design is an approach to service improvement, which uses service users and providers to identify problems and design solutions. This was used to create a person-centred intervention with the potential to improve the quality and outcomes of the deprescribing process. A ‘trigger film’ showing older people talking about their healthcare experiences was created and facilitated discussions about current problems in the deprescribing process. Problems were then prioritised and appropriate solutions were developed. Review located the solutions in the context of current processes and procedures. An ideal care pathway and a complex intervention to deliver better care were developed. Setting and participants: Older people living with frailty, their informal carers and professionals living and/or working in West Yorkshire, England, UK. Deprescribing was considered in the context of primary care. Results: The current deprescribing process differed from an ideal pathway. A complex intervention containing seven elements was required to move towards the ideal pathway. Three of these elements were prototyped and four still need development. The complex intervention responded to priorities about (a) clarity for older people about what was happening at all stages in the deprescribing process and (b) the quality of one-to-one consultations. Conclusions: Priorities for improving the current deprescribing process were successfully identified. Solutions were developed and structured as a complex intervention. Further work is underway to (a) complete the prototyping of the intervention and (b) conduct feasibility testing. / National Institute for Health and Care Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC)

Care in the community increasingly means care by the community, i.e. the family. The present focus on informal carers by policy makers reflects their importance to the success of community care legislation (NHS and Community Care Act, 1990; Carers (Recognition and Services) Act, 1995). Much of the published information on the impact of caring has neglected the circumstances of carers from minority ethnic groups. Hence, this research explores the caring situations and experiences of informal carers of older people from Gujarati, Punjabi and white indigenous communities. Semi-structured interview schedules were used to elicit both quantitative and qualitative information from each of the three groups. Overall, the data confirmed some universal features of caring in that it is the family, and in particular women, who care for older people. However, the motivation for caring dffered between the three cultural groups. Findings also showed that many of the socio-demo graphic characteristics in the Gujarati and Punjabi groups were similar in that they tended to be co-resident, were younger and cared for a younger age group than white indigenous carers. However, a closer look at the data on the psychosocial aspects of caring revealed some distinct differences between the two South Asian groups. Gujarati and white indigenous carers reported higher levels of morale, significantly lower levels of stress and significantly higher perceived coping abilities than the Punjabi group of carers. This latter group reported using a proportionately lower number of active coping strategies and more avoidance coping techniques than Gujarati and white indigenous carers. Punjabi carers were also significantly less satisfied with any help received from formal and informal sources than the other two groups. In light of these findings, which emphasize some distinct dfferences in caring circumstances, a number of recommendations are made for both policy makers and future research

Sammanfattning Titel: Patienters erfarenheter av kontakten med äldresköterskan i primärvården. Bakgrund: Andelen äldre människor i Sverige ökar eftersom vi lever längre. Med stigande ålder ökar mottagligheten för sjukdom. Både sjukdom och åldersförändringar kan ge funktionsnedsättningar men trots detta bor många äldre med hälso- och sjukvårdsbehov hemma utan inskrivning i den kommunala hemsjukvården. Syfte: Att belysa patienters erfarenheter av kontakten med äldresköterska inom primärvården. Metod: Studien utgår från en kvalitativ design med induktiv ansats. Fem patienter deltog enskilt i en semistrukturerad intervju. Dataanalysen genomfördes med kvalitativ manifest innehållsanalys. Resultat: De intervjuade upplevde att samtalet är den viktigaste erfarenheten av kontakten med äldresköterskan. Patienterna upplever att kontakten ger dem stöd och minskad oro i vardagen. Deras trygghet ökar genom den kontinuitet och tillgänglighet som äldresköterskan erbjuder. Slutsats: Det arbete som äldresköterskan utför bör lyftas fram och tillåtas utvecklas eftersom antalet äldre med vård- och omsorgsbehov ökar. / Abstract Titel: Patients' experiences of contact with elder nurses in primary health care. Background: The proportion of elderly people in Sweden will increase due to longer life span. With age susceptibility to disease increases. Both disease- and agerelated changes can cause impairments even though many elderly people with health needs live at home, without enrollment in the municipal home care. Objective: The aim was to illuminate patients´experiences of contact with the elder nurse in primary health care. Method: The study uses a qualitative design with inductive approach. Five patients participated individually in a semi-structured interview. Data analysis was performed by qualitative manifest content analysis. Results: The interviewees felt that the conversation is the most important experience of contact with the nurseproviding elder care. Patients feel that the contact give them support and reduced anxiety in daily life. Their safety is enhanced by the continuity and availability provided by the elder nurse. Conclusion: The work that elder nurse perform should be emphasized and allowed to evolve as the number om elderly people with health and care needs increase.