Disparities in Oral Nutritional Supplement Usage and Dispensing Patterns across Primary Care in Ireland: ONSPres Project

When treating malnutrition, oral nutritional supplements (ONSs) are advised when optimising the diet is insufficient; however, ONS usage and user characteristics have not been previously analysed. A retrospective secondary analysis was performed on dispensed pharmacy claim data for 14,282 anonymised adult patients in primary care in Ireland in 2018. Patient sex, age, residential status, ONS volume (units) and ONS cost (EUR) were analysed. The categories of ‘Moderate’ (<75th centile), ‘High’ (75th–89th centile) and ‘Very High’ ONS users (≥90th centile) were created. The analyses among groups utilised t-tests, Mann–Whitney U tests and chi-squared tests. This cohort was 58.2% female, median age was 76 years, with 18.7% in residential care. The most frequently dispensed ONS type was very-high-energy sip feeds (45% of cohort). Younger males were dispensed more ONSs than females (<65 years: median units, 136 vs. 90; p < 0.01). Patients living independently were dispensed half the volume of those in residential care (112 vs. 240 units; p < 0.01). ‘Moderate’ ONS users were dispensed a yearly median of 84 ONS units (median cost, EUR 153), ‘High’ users were dispensed 420 units (EUR 806) and ‘Very High’ users 892 yearly units (EUR 2402; p < 0.01). Further analyses should focus on elucidating the reasons for high ONS usage in residential care patients and younger males.

The Subjective Well-Being of Children in Residential Care: Has It Changed in Recent Years?

The subjective well-being of children in residential care is a relevant issue given the practical implications for improving the lives of these children who live in contexts of vulnerability. The question addressed in this respect was: “How does this well-being change over the years”? Thus, the aim of this study was to compare the subjective well-being displayed by adolescents aged 11–14 in residential care in Catalonia (north-eastern Spain) in 2014 to that displayed by adolescents in residential care in 2020. To this end, 572 responses to a questionnaire adapted from the Children’s Worlds project (364 from 2014 and 208 from 2020) were analysed with respect to the life satisfaction items. In both 2014 and 2020, the questionnaires had the same wording, and data were disaggregated by gender. No significant differences in means were observed between most of the life satisfaction items in 2014 and 2020, with the exception of satisfaction with friends and classmates and the area where you live, with lower means for these items in 2020. There is a discussion of the possible influence of COVID-19 on these results, while the overall stability of these children’s subjective well-being over the years is highlighted.

Use and alternatives to coercive measures in inpatient residential care facilities for adults with disabilities: study protocol of a mixed-methods study

BackgroundIn Germany, the use of coercive measures such as physical or chemical restraints in certain settings has been the focus of high court decisions, political debates, and scientific research in areas like psychiatric care. Such encroachments on fundamental rights could easily be overlooked in the case of residents in inpatient residential care facilities for adults with disabilities. However, little data are available on this issue. This study aims to investigate the types, frequencies, and characteristics of the use of coercive measures as well as the reasons and justifications of their use. Possible alternatives to these measures and contextual conditions will also be identified.MethodsThe study is based on an explorative, multi-phase, cross-sectional design, which consists of a mixed-methods approach including several forms of data collection and analysis bringing together forensic, sociological, pedagogical and medical perspectives and expertise. First, the entirety of the approximately n = 880 residential care facilities for adults with disabilities in the study area will be surveyed by an online questionnaire. Participating passive observations will be carried out in n = 5 selected residential care facilities (24 hours per facility), with an approximate total of n = 150 residents. In these facilities, organizational documents such as house rules and residential documents such as medication plans will also be collected and analysed. Focus groups will be conducted in each of the five facilities including residents, staff, and legal guardians of the residents.DiscussionThis study will address important gaps in the current research by providing different forms of empirical data on the use or avoidance, causes, contexts, and alternatives to coercive measures in inpatient residential care facilities for adults with disabilities. This study is the first in Germany to combine a general overview (survey) and detailed insight (observations, document analysis, focus groups) approach to this issue. These findings will provide a basis for further research in the field as well as for the management of coercive measures in practical settings.

Long-term exposure to air pollution and COVID-19 incidence: a prospective study of residents in the city of Varese, Northern Italy

ObjectivesTo investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city.MethodsCitizens of Varese aged ≥18 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM2.5, PM10, NO2, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1 µg/m3 increase in air pollutants from single- and bi-pollutant Poisson regression models.ResultsThe 62 848 residents generated 4408 cases. Yearly average PM2.5 exposure was 12.5 µg/m3. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM2.5 was associated with a 5.1% increase in the rate of COVID-19 (95% CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM10, NO2 and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models.ConclusionsLong-term exposure to low levels of air pollutants, especially PM2.5, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue.

Strategies To Support Older Adults’ Mental Health During the Transition Into Residential Aged Care: A Qualitative Study of Multiple Stakeholder Perspectives

BackgroundThe move from home into residential care is one of the most stressful life experiences for older adults. ‘Relocation stress’ is a significant risk factor for anxiety and/or depression in aged care residents. Whether long-term or recently diagnosed, these mood disorders are associated with a decline in overall well-being, daily functioning and independence. The mental health needs of older adults are often poorly recognised and supported, including during the transition into residential care. Despite growing interest in how to facilitate this major life transition, few studies have taken the perspective of multiple stakeholders. The aim of this study was to explore resident, relative and staff experiences of the transition into residential aged care, and to identify strategies to support the mental health of older adults at this time. MethodsSemi-structured interviews were conducted with 35 aged care residents, relatives and staff, between January and April 2021. Participants were selected using purposive and convenience sampling. Interviews were audio recorded and transcribed verbatim. Data were analysed inductively and grouped into themes. ResultsResults were distilled into three main categories related to the overall transition experience, residents’ mental health needs and strategies to support residents’ mental health. A novel contribution of this study relates to the need to address a broad misunderstanding of the role of pastoral care and subsequent under-utilisation of a potentially valuable resource. ConclusionsBy describing transition experiences and the resources to support residents’ mental health, findings of this study provide practical, ‘real world’ suggestions for reducing relocation stress. New resources developed from the findings include guides, checklists and short question-and-answer films, in which current residents and staff describe strategies to support mental health and overall quality of life. Similar resources could be used to support transitions in other care settings.

Dating Violence in Adolescence: Comparison between Scholars and Adolescents in Residential Care

(1) Background: Dating violence (DV) among adolescents constitutes a serious problem, not only because of the magnitude of the phenomenon, but also because of the seriousness of the personal and social consequences derived from it. The objectives of this study were the following: to analyze the prevalence of DV among adolescents in residential care and in schools, according to sex, age and origin, and to analyze the prevalence of the types of violence and victimization, according to the residential care resource and the school. (2) Methods: The sample consisted of adolescents in residential care in the Autonomous Community of the Basque Country (Spain) (n = 271) and adolescents in schools (n = 268) aged between 12 and 17 years. (3) Results: The results showed a higher prevalence of DV in adolescents in residential care than that found in other studies with a normative sample. (4) Conclusions: These results support the need for work and research with these minors in residential care. It also gives an important weight to sociodemographic variables, such as age and sex, and also to the types of violence and victimization, i.e., variables to be taken into account in the intervention with adolescents. Future educational programs should consider DV prevention and children in residential care.

Poverty and Crime in Young People From Children Protection Centers

Young people who are in a situation of residential care are considered to be in a condition of multidimensional poverty. Research aims to achieve the following general objectives: first, to identify the level of delinquency of young people and its determining factors and, second, to propose strategies and programs. This research will follow a two-stage research process in which different research methods will be applied. Along with the main results, the authors point out that the most frequent crimes refer to these youngsters getting involved in gang fights; alcohol consumption; in attacking classmates, parents, and teachers; they steal money and or other objects from the collaborating family; they consume pornography and go out to discotheques, pubs, and nightclubs. In the educational field, although they are dedicated to their education, they obtain very low grades. They only participate moderately in sports activities and have very low participation in religious services; furthermore, the young men have a moderately high level of belief in the legal system.