Does toxic stress impact paediatric dental procedures? An integrative review

Toxic stress is defined as strong, repetitive stress with prolonged activation, without the child having the support of an adult caregiver. It is plausible that invasive and complex paediatric interventions produce or contribute to the development of toxic stress. This article aims to evaluate, discuss and synthesize the association between toxic stress and paediatric dental clinical practice through an integrative review of studies published in several databases. The results of this study allow us to state that this subject is little explored in the dental literature and, therefore, that it is essential to encourage clinical studies and specific research. The expansion of these studies will provide health professionals with scientific evidence regarding the implementation of proper clinical practice, thus reducing or even eliminating the development of toxic stress.

Older Adult User Feedback on Design and Functionality of EngAGE, a Voice-Activated Exercise Program

The EngAGE Alexa app is a socially motivated exercise program targeting older adult-caregiver dyads to promote mobility independence. EngAGE provides exercise routines that older adults can perform in the home in conjunction with a messaging component to facilitate motivation from caregivers and a tracking component to monitor progress. This presentation will describe the qualitative results that have informed the app’s design and evaluation of its feasibility and functionality following a 14-week feasibility study in 10 dyads of older adult exercisers and their caregivers. The presentation will cover the perceived benefits of EngAGE’s older adult users (including “real world” clinically relevant improvements, the comprehensiveness of the exercises, and exercise knowledge gained), as well as likes and dislikes that contributed to our assessment of the app’s functionality. Finally, we will discuss how the feedback contributes to future directions in the development of the app’s features, supporting materials, design and content.

Transitioning from paediatric to adult rheumatological healthcare: English summary of the Japanese Transition Support Guide

ABSTRACT Issues related to transitioning from paediatric to adult healthcare are currently receiving international attention. In Japan, 1000 patients with childhood-onset chronic rheumatological diseases reach adulthood every year and require transition from care by paediatric to care by adult rheumatologists. Here, we propose a guide for the latter, wherein the adult caregiver poses the clinical questions about transitional support that they need to have answered, and the paediatric caregiver mainly compiles the plans for the transition. To formulate the guide, we sought comments from both the Japan College of Rheumatology and the Pediatric Rheumatology Association of Japan and obtained their approval. Here, we present the outcome of this consultation in the form of a Guide for Supporting Transitional Care, aiming to provide essential knowledge to physicians in the fields of adult internal medicine and orthopaedics who may be involved in treating patients with rheumatic disease during the transition from paediatric to adult care. The features of transitional support that are common for patients with various different rheumatic diseases are presented in this guide, with the aim of informing policy and strategies to deliver optimal outcomes in transitional care by non-paediatric rheumatologists.

Development and Evaluation of an Elder Abuse Forensic Nurse Examiner e-Learning Curriculum

In Ontario, Canada, there is a need for an easily accessible training for forensic nurse examiners on the provision of care for abused older adults. In this study, our objective was to develop and evaluate a novel elder abuse nurse examiner e-learning curriculum focused on improving the care provided to older adults. The curriculum was launched on an online learning management system to forensic nurses working across Ontario’s hospital-based violence treatment centers in June 2019 and evaluated using pre- and post-training questionnaires that measured self-assessed changes in knowledge and skills-based competence related to providing elder abuse care. There were significant improvements pre- to post-training in self-reported knowledge and competence across all core content domains: Older Adults and Abuse; Documentation, Legal, and Legislative Issues; Interview with Older Adult, Caregiver, and Other Relevant Contacts; Initial Assessment; Medical and Forensic Examination; and Case Summary, Discharge Plan, and Follow-Up Care. As the curriculum enhanced the knowledge and skills associated with caring for abused older adults, it may have implications for training forensic nurse examiners and associated staff working in more than 25 countries internationally.

Young Adult Caregiver Strain and Benefits

Young adult caregivers (YACs) of older adults are an often-overlooked subset of the caregiver population, though they make up more than a quarter of all caregivers. Because of their stage in life and their economic and work status, YACs (ages 21 to 40) are likely to face different caregiving challenges than other age cohorts of caregivers. Using the life course perspective and role conflict theory as foundational frameworks, this article compares the resources and strains of YACs with those of their middle-age caregiver (MAC) (ages 41 to 60) and older adult caregiver (OAC) (ages 61 and older) counterparts. Authors used data from a cross-sectional pilot study of caregivers recruited across one western state through community agencies. Through multivariate regression analysis, findings indicated that YACs reported more financial strain than MACs and OACs, despite being more likely to be employed. In contrast, YACs reported greater positive feelings toward caregiving than both MACs and OACs. These findings remained while controlling for employment status, education, and hours per week spent caregiving. Although YACs may find great value in caregiving, they may also be in more financially precarious situations. The article concludes with recommendations for caregiver support programs to reach YACs in the workplace.

Contextual Design Theory Applied to Wearables That Facilitate Kangaroo Care by Interviewing Mothers of Hospitalized Infants

When considering how to design medical devices considering the needs of the patient and hospital staff may seem sufficient. Hospitalized infants are patients who cannot speak or advocate for their needs; the parents and the hospital staff caring for infant patients have different roles that together are integral to an infant’s recovery. Figure 1 shows how mothers, nurses, and infants form a system of care to promote infant patient healing. In particular caregiver behaviors such as kangaroo care (KC), are dependent upon the involvement of family. KC, defined as bare skin-to-skin contact between an infant and an adult caregiver, is usually done chest-to-chest. The design of wearables for the caregivers holding the infant patient can make KC easier and be part of wearable medical device design that improves infant patient outcomes.

Exploring the Factors Influencing Gifted Adolescents’ Resistance to Report Experiences of Cyberbullying Behavior: Toward an Improved Understanding

Academically gifted adolescents frequently experience cyberbullying behavior. Successful intervention and prevention of such bullying is, to a large degree, dependent on such incidents being reported to an adult caregiver. However, research shows that adolescents who have experienced cyberbullying tend not to inform parents or teachers. Despite this fact, little attention has been paid to understanding the factors underlying such reporting resistance and consequently the reasons for nonreporting remain undetermined. This study explored Irish gifted adolescents’ resistance to reporting their experiences of cyberbullying behavior. Key reasons for nonreporting included the framing of decisions based on the concepts of self-efficacy, control, perceived risks, the influence of prior reporting experiences, and influence of gender and age on reporting response. The results provide insights that will assist parents, teachers, and all those involved in the formulation of anti-bullying school policies in their attempts to increase adolescent reporting and thereby counter cyberbullying behavior.