Correlates of depression in self-neglecting older adults: A cross-sectional study examining the role of alcohol abuse and pain in increasing vulnerability

ABSTRACT

Self-neglect among older adults results in increased morbidity and mortality rates. Depression is strongly linked to self-neglect and when untreated, severely complicates management of health and functional outcomes. The study aims to identify factors correlated with depression to inform approaches to service recruitment and retention that improve long-term outcomes. The sample included urban community-dwelling older adults (n = 96) 65 years of age and older with Adult Protective Services-substantiated self-neglect. All participants completed a range of validated cognitive, functional, and self-report demographic and clinical measures around health and mental health functioning. A secondary data analysis using multivariable logistic regression revealed that a positive screen for alcohol abuse, low self-rated health, and higher self-reported pain were associated with significantly higher odds of self-reported depression. Further research is needed to understand the temporality between these correlates and depression and to inform prevention and intervention practices for self-neglecting older adults.     

Switching labels: The role of Weberian ideas in market change. A case study of the German wine market

How do cultural ideas shape market construction? What do ideas ‘do’ to actors in markets? The paper presents an empirical case study of the reconstitution of the German wine market following an EU legislative intervention. I use Bourdieu's theory of fields to analyse the actors’ economic, social and cultural capitals and the impact of these capitals on the actors’ positioning in the political debate. Sensitised by recurring problems in the empirical data analysis, I then, however, argue that Weber's notion of ideas, as presented in his famous switchmen metaphor, is better suited than, or indeed should serve as a complement to, Bourdieu's frame of analysis. It is better suited, I argue, because it refers to a unique and irreducible source of culture while Bourdieu's capitals remain ‘tools' in a struggle for power and dominance in the field.     

A new role for imaging in the diagnosis of physical elder abuse: results of a qualitative study with radiologists and frontline providers

Pediatric radiologists play a key role in the detection of child abuse through the identification of characteristic injury patterns. Emergency radiologists have the potential to play an equally important role in the detection of elder physical abuse; however, they currently play little to no part in this effort. We examine the reasons behind this limited role, and potential strategies to expand it, by interviewing attending faculty from Emergency Radiology, Geriatrics, Emergency Medicine, Pediatric Radiology, and Pediatrics. Our interviews revealed that radiologists’ contribution to elder abuse detection is currently limited by gaps in training, gaps in knowledge about imaging correlates, and gaps in inter-team clinical communication. Specifically, radiographic interpretation of elder trauma is severely restricted by lack of communication between frontline providers and radiologists about patients’ injury mechanism and functional status. Improving this communication and re-conceptualizing ED workflow is critical to expanding and optimizing radiologists’ role in elder abuse detection.