Frontiers in public health
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Front Public Health · Jan 2016
"The Right Way at the Right Time": Insights on the Uptake of Falls Prevention Strategies from People with Dementia and Their Caregivers.
Strong evidence exists for effective falls prevention strategies for community-dwelling older people. Understanding the translation of these strategies into practice for people with dementia has had limited research focus. People with dementia desire to have their voice heard, to engage meaningfully in the health-care decision-making process, making it a priority for researchers and practitioners to better understand how to engage them in this process. ⋯ Five themes were identified at baseline: perceptions of falls; caregivers navigating the new and the unpredictable; recognition of decline; health services - the need for an appropriate message; and negotiating respectful relationships. At 6 months, caregivers and people with dementia decided on "what we need to know" with firm views that the information regarding falls risk reduction needed to be in "the right way … at the right time." Rather than caregivers and people with dementia being only recipients of knowledge, they felt they were "more than just empty vessels to be filled" drawing on a "variety of resources" within their circle of influence to be able to positively "adapt to change." The voices of people with dementia and their caregivers add an important dimension to understanding the translation of falls prevention knowledge for this population. Insights from this study will enable community care health professionals to understand that people with dementia and their caregivers can, and wish to, contribute to implementing falls prevention strategies through their resourcefulness and inclusion in the therapeutic partnership.
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Front Public Health · Jan 2016
Race, Depressive Symptoms, and All-Cause Mortality in the United States.
Despite the well-established association between baseline depressive symptoms and risk of all cause-mortality, limited information exists on racial differences in the residual effects of baseline depressive symptoms above and beyond socioeconomic status (SES) and physical health on this link. The current study compared Blacks and Whites for the residual effects of depressive symptoms over SES and health on risk of long-term all-cause mortality in the U.S. ⋯ The effect of depressive symptoms on increased risk of all-cause mortality, which existed among Whites, could not be found for Blacks. In addition, race may modify the roles that SES and health play regarding the link between depressive symptoms and mortality over a long period of time.
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Front Public Health · Jan 2016
TNF-α/IL-10 Ratio Correlates with Burn Severity and May Serve as a Risk Predictor of Increased Susceptibility to Infections.
Severe burn injury renders patients susceptible to multiple infection episodes; however, identifying specific patient groups at high risk remains challenging. Burn-induced inflammatory response dramatically modifies the levels of various cytokines. Whether these changes could predict susceptibility to infections remains unknown. ⋯ Plasma TNF-α and IL-10 levels were measured to explore the association between the TNF-α/IL-10 ratio, hypersusceptibility to infections, burn size (TBSA), and common severity scores (Acute Physiology and Chronic Health Evaluation II (APACHEII), Baux, modified Baux (R-Baux), Ryan Score, and Abbreviated Burn Severity Index (ABSI)). TNF-α/IL10 plasma ratio measured shortly after burn trauma was inversely correlated with burn size and the injury severity scores investigated, and was predictive of repeated infections (≥3 infection episodes) outcome (AUROC [95%CI] of 0.80 [0.63-0.93]). Early measures of circulating TNF-α/IL10 ratio may be a previously unidentified biomarker associated with burn injury severity and predictive of the risk of hypersusceptibility to repeated infections.