Feasibility of intervention in elder self-neglecters: Setting the stage for future research

Objectives: Interventions are critical to improving clinical outcomes in elder self-neglecters. This study assessed feasibility of a randomized controlled trial of oral vitamin D in Adult Protective Services-substantiated self-neglect clients ≥65 years.

Methods: Participants were directly observed to consume ergocalciferol 50,000 IU (treatment) or ergocalciferol 400 IU (control), once a month, for 10 months. For months 6–10, half the control group randomly crossed into the treatment group (crossover). Intervention feasibility was measured by number of potential participants who agreed to participate and by retention rates during the study.

Results: Ninety-four referrals were received and 59 (63%) agreed to participate. Forty-nine participants were enrolled after prescreening and 35 completed the two-phase trial for a 72% retention rate. The participants’ average age was 75.2 ± 6.8 years, mainly female (59%), African-American (47%), and living alone (41%).

Discussion: Despite assumptions that self-neglecters are resistant to care, we have successfully conducted the first clinical intervention in this vulnerable population.     

Health Limitations Among Mothers and Fathers: Implications for Parenting

Despite the good reasons in which poor health could impede parenting, relatively little research considers this possibility. This study uses data from the Fragile Families and Child Wellbeing Study (N = 3,376) and propensity score matching to examine the relationship between maternal and paternal health limitations—health conditions that limit the amount or type of work one can do—and mother‐ and father‐reported parenting stress, cooperation in parenting, and engagement with children. First, the authors find that mothers' and fathers' health limitations are associated with greater parenting stress. Second, they find evidence of spillover associations; when compared with their counterparts, parents with health limitations report that their child's other parent exhibits less cooperation. Third, they find that the associations between health and parenting are not moderated by parents' coresidential status. Taken together, these findings inform the stress process perspective and its implications for family life.     

Working collectively in competitive times: case studies from New Zealand and Australia

Collectives offer an alternative organisational structure toservice delivery organisations that seek to embody criticalsocial change. This model is challenging to implement as itsassumptions and values are contrary to the dominant socio-politicalclimate of economic rationalism. This paper explores experiencesof two workers employed as coordinators in collective-basedorganisations in Australia and New Zealand. They share the joysand challenges of these experiences, and conclude with fivekey reflections about implementing this model: keeping reflectiveand honest about philosophical assumptions, keeping processcentral, having robust conflict resolution processes, reflectabout the external factors influencing organisational structure,and finding ways to value workers.     

Household Structure and Short‐Run Economic Change in Nicaragua

During the economic crises Nicaragua suffered between 2000 and 2002, a conditional cash transfer program targeting poor households began operating. Using panel data on 1,397 households from the program's experimentally designed evaluation, we examined the impact of the program on household structure. Our findings suggest that the program enabled households to avoid reagglomeration during the economic crises, with households in control communities growing more than treated households. These changes were driven primarily by shifts in residence of relatively young men and women with close kinship ties to the household head. In contrast, households that received transfers continued to send off young adult members, suggesting that the program provided resources to overcome the short‐term economic pressures on household structure.     

Risk of Antibiotic-Resistant Staphylococcus aureus Dispersion from Hog Farms: A Critical Review

The World Health Organization has declared antibiotic resistance “one of the biggest threats to global health.” Mounting evidence suggests that antibiotic use in industrial-scale hog farming is contributing to the spread of antibiotic-resistant Staphylococcus aureus. To capture available evidence on these risks, we searched peer-reviewed studies published before June 2017 and conducted a meta-analysis of these studies’ estimates of the prevalence of swine-associated, antibiotic-resistant S. aureus in animals, humans, and the environment. The 166 relevant studies revealed consistent evidence of livestock-associated methicillin-resistant S. aureus (MRSA) in hog herds (55.3%) raised with antibiotics. MRSA prevalence was also substantial in slaughterhouse pigs (30.4%), industrial hog operation workers (24.4%), and veterinarians (16.8%). The prevalence of swine-associated, multidrug-resistant S. aureus (MDRSA)—with resistance to three or more antibiotics—is not as well documented. Nonetheless, sufficient studies were available to estimate MDRSA pooled prevalence in conventional hog operation workers (15.0%), workers’ household members (13.0%), and community members (5.37%). Evidence also suggests that antibiotic-resistant S. aureus can be present in air, soil, water, and household surface samples gathered in or near high-intensity hog operations. An important caveat is that prevalence estimates for humans reflect colonization, not active infection, and the health risks of colonization remain poorly understood. In addition, these pooled results may not represent risks in specific locations, due to wide geographic variation. Nonetheless, these results underscore the need for additional preventive action to stem the spread of antibiotic-resistant pathogens from livestock operations and a streamlined reporting system to track this risk.     

Cardiometabolic risks associated with work-to-family conflict: findings from the Work Family Health Network

ABSTRACT

Objective: Work and family stressors may be associated with elevated cardiovascular risk factors.

Methods: To assess the effects of work-to-family conflict (WTFC) on biomarkers of cardiometabolic risk, we examined 1524 extended care employees over 18 months and estimated multilevel linear models that accounted for the nested nature of the data.

Results: WTFC was positively associated with BMI [β?=?0.53, CI?=?(0.08, 0.98), p?=?.02 at baseline and β?=?0.59, CI?=?(0.12, 1.04), p?=?.01 across the 18-month study period] and negatively with HDL cholesterol [β?=??0.32, CI?=?(?0.57, ?0.08), p?=?.01 across the 18-month study period]. The rate of change in BMI from baseline to 18 months increased with higher levels of WTFC as well (β?=?0.08, CI?=?(0.03, 0.15), p?=?.0007). However, WTFC was not associated with other variables reflecting cardiometabolic risk, such as including blood pressure, cholesterol, glycosylated hemoglobin and cigarette smoking status.

Conclusion: Findings suggest that BMI, which is linked to potentially malleable health behaviors, is more closely related to inter-role conflict than biological markers reflecting longer-term physiologic processes. These effects are exacerbated over time and may be particularly detrimental to already overweight and obese individuals.     

Parent–Adolescent Dyads as Temporal Interpersonal Emotion Systems

Research on the role of parent–adolescent relationships in psychosocial adjustment needs a conceptual approach that specifies the processes by which development is nested in the relationship. I forward a new approach and emphasize the need to consider the unique elements that individuals bring to the dyadic system. I also emphasize the need to examine processes at multiple time scales. I highlight the complexity of dyadic system dynamics: Biological predispositions set the foundation for the parent–adolescent relationship and the emotion dynamics that emerge during interactions. As the system gets entrained through repeated interactions over longer time scales, real‐time dynamics coalesce into psychosocial adjustment, which in turn constrains real‐time dynamics. I review the evidence for each of these processes and discuss the implications.