Explanatory role of sociodemographic, clinical, behavioral, and social factors on cognitive decline in older adults with diabetes

Background The aim of the study was to examine the explanatory role of sociodemographic, clinical, behavioral, and social factors on racial/ethnic differences in cognitive decline among adults with diabetes. Methods Adults aged 50+ years with diabetes from the Health and Retirement Survey were assessed for cognitive function (normal, mild cognitive impairment [MCI], and dementia). Generalized estimating equation (GEE) logistic regression models were used to account for repeating measures over time. Models were adjusted for sociodemographic (gender, age, education, household income and assets), behavioral (smoking), clinical (ie. comorbidities, body mass index), and social (social support, loneliness, social participation, perceived constraints and perceived mastery on personal control) factors. Results Unadjusted models showed non-Hispanic Blacks (NHB) and Hispanics were significantly more likely to progress from normal cognition to dementia (NHB OR: 2.99, 95%CI 2.35–3.81; Hispanic OR: 3.55, 95%CI 2.77–4.56), and normal cognition to MCI (NHB OR = 2.45, 95%CI 2.14–2.82; Hispanic OR = 2.49, 95%CI 2.13–2.90) compared to non-Hispanic Whites (NHW). Unadjusted models for the transition from mild cognitive decline to dementia showed Hispanics were more likely than NHW to progress (OR = 1.43, 95%CI 1.11–1.84). After adjusting for sociodemographic, clinical/behavioral, and social measures, NHB were 3.75 times more likely (95%CI 2.52–5.56) than NHW to reach dementia from normal cognition. NHB were 2.87 times more likely (95%CI 2.37–3.48) than NHW to reach MCI from normal. Hispanics were 1.72 times more likely (95%CI 1.17–2.52) than NHW to reach dementia from MCI. Conclusion Clinical/behavioral and social factors did not explain racial/ethnic disparities. Racial/ethnic disparities are less evident from MCI to dementia, emphasizing preventative measures/interventions before cognitive impairment onset are important.

Universities of World-Class Scientific and Educational Centers and Their Importance in the Performance Indicators and Development of Regions

The article considers the sphere of education as one of the directions of political and managerial practices for the development of regions. The importance of educational institutions of higher education as part of world-class scientific and educational centers (RECs) created in the context of the implementation of the national project “Science” is evaluated. The task assigned to the centers to activate interregional interaction, as expected, will contribute to the innovative development of the subjects of the Russian Federation and the economic and technological connectivity of the territories. In the context of the task, data from the official REC websites, data from the international rating THE, the Moscow international rating MosIUR for 2020, regulatory legal acts, as well as secondary data on the problem under study are analyzed. It is shown that RECs have become a kind of superstructure (construction), uniting several groups of actors under one sign of the center: universities, scientific organizations, organizations from the real sector of the economy, supported by the subject of the Russian Federation under the personal control of the governors. The peculiarity of such centers was not only the association of universities with high international ratings from different regions, but also the participation of the same university in several RECs. Such an organizational technique, by pulling together the north and south, the west and the east, the inclusion of the same universities in different RECs, suggests that this, on the one hand, strengthens interregional interaction, increases the values of the performance indicators of the project participants, but on the other hand, complicates the objective assessment of the REC activities themselves. Based on the study, the hypothesis is expressed that the existing approaches to assessing the effectiveness of REC generate a variety of imitation forms of activity, including reporting, and need to be improved. It is concluded that the activities of RECs will contribute to the breakthrough development of those regions on the territory of which they are formed, but at the same time strengthen interregional imbalances.

If You Believe, It May Come True: The Relationship and Mechanism Between Self-Occupation Stereotypes of Private Kindergarten Teachers and Their Turnover Intention in China-Mainland

In China-Mainland, the turnover rate of private kindergarten teachers remains high for a long time. With 692 Chinese private kindergarten teachers as subjects, we applied a questionnaire survey to examine the relationship between self-occupation stereotypes held by private kindergarten teachers and their turnover intention and the underlying mechanisms. The structured equation model (SCM) was conducted to analyze data and revealed a significantly positive correlation between self-occupation stereotypes and turnover intention. Further analyses showed that on the individual level, personal control sense mediated the relationship between self-occupation stereotypes and turnover intention, and on the organization level, professional identity mediated the relationship between them. Additionally, self-occupation stereotypes were also related to turnover intention via the chain-mediating role of personal control sense and professional identity. The current research firstly clarified the acting paths between self-occupation stereotypes of private kindergarten teachers and turnover intention on both the individual and the organization levels. In practice, the research provided a novel perspective for policy makers to alleviate the turnover tendency of private kindergarten teachers.

One-Year Change in Locus of Control among People with Dementia

<b><i>Introduction:</i></b> Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia. <b><i>Method:</i></b> The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score. <b><i>Results:</i></b> The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, <i>p</i> = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), <i>p</i> = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), <i>p</i> = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (<i>p</i> = 0.002), an increase in dependence in daily activities (<i>p</i> = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (<i>p</i> = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (<i>p</i> = 0.001). <b><i>Conclusion:</i></b> Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.

Perspectives on Aging Well Among Older Black Women in the US

Despite changes in the demography of older Black women who are living longer, there is limited research on how older Black women conceptualize and understand successful and healthy aging. The objective of this presentation is to interrogate the meaning and cultural aspects of aging among older Black women, gaining insight into how gender and race operate and intersect to shape experiences and perceptions of aging. Using an intersectionality framework, this qualitative study was conducted with three older Black women. The women ranged in age from 58-65 years old, each residing in an US urban city (Detroit, St. Louis, Atlanta). Data were collected between October and November 2020, using a semi-structured, open-ended interview protocol to encourage participants to provide in-depth descriptions of how they conceptualized aging. Interviews were between 2 – 2.5 hours, conducted via videoconferencing, and audio-recorded for transcription. Participants discussed: the life experiences that have shaped their ability to age well; what it means to age well, and factors that might hinder someone from aging well. Transcripts were coded using a constructivist grounded theory approach. Results revealed six themes Black women in later life identify: aging well, aging as a mindset, independence and freedom, authenticity, personal control and preparation, and aging role models. This extends the knowledge base on how older Black women view aging and factors that enhance or diminish their ability to age well. Results from this study can be used to enhance the development of public health and social work interventions with older Black women.

Relationship Between Illness Representations and Symptoms of Internet Gaming Disorder Among Young People: Cross-Lagged Model

Background The common-sense model of illness suggests that mental representations of health threats may affect one’s behavioral reactions to them and health status. Internet gaming disorder is a newly defined mental disorder. Illness representations of internet gaming disorder may affect one’s risk of internet gaming disorder. In turn, symptoms of internet gaming disorder may affect one’s perceptions of the disorder. Objective This study aimed to investigate the relationships between illness representations and symptoms of internet gaming disorder in college students. Methods A 1-year longitudinal study was conducted with a convenience sample of Chinese college students (n=591; 342/591, 57.9% female). Results Of the participants, 10.1% (60/591) and 9.1% (54/591) were classified as having probable internet gaming disorder at baseline (T1) and follow-up (T2), respectively. The correlations between some dimensions of illness representations regarding internet gaming disorder (ie, consequence, timeline, personal control, treatment control, and concern) at T1 and symptoms of internet gaming disorder at T2 and between symptoms of internet gaming disorder at T1 and the dimensions of illness representations at T2 (ie, consequence, timeline, personal control, and emotional response) were statistically significant. The cross-lagged model fit the data well ((χ2/df=2.28, comparative fit index=.95, root mean square error of approximation=.06) and showed that internet gaming disorder at T1 was positively associated with unfavorable illness representations at T2. Conclusions Individuals with more severe symptoms of internet gaming disorder had more pessimistic perceptions about the disorder. Such cognitive perceptions may affect one’s emotional and behavioral reactions towards the disorder (eg, greater levels of depression and low self-control intention) and should be modified by educational programs and psychological interventions.

Changes in Self-Regulation and the Predictors of Quality of Life 3 Months After Extremity Injury: A Prospective Study

This prospective study aimed to examine self-regulation’ changes (illness representations and coping strategies) and predictors of quality of life 3 months after hospital discharge. A total of 157 patients with extremity injuries from two hospitals in Indonesia completed the survey 3 months post-discharge. The results showed that patients demonstrated more positive illness representations, better coping strategies, and better quality of life 3 months post-discharge than prior discharge. Hierarchical multiple regression analysis revealed that patients’ symptom identity, personal control, and treatment control were significant predictors of quality of life 3 months after extremity injury. Patients with negative perceptions of their injury-related symptoms, personal control, and treatment control at hospital discharge were at higher risk of impaired quality of life 3 months post-discharge than those with positive perceptions. Therefore, clinicians should assess and modify patients’ illness representations before discharge from the hospital to achieve a better prognosis for post-injury quality of life.

Analysing Gender Issues in the Australian Construction Industry through the Lens of Empowerment

Gender equality at work in male-dominated industries is conditioned by intrinsic systemic issues which established policies have, to a significant extent, failed to address, as women’s participation remains under-represented. This study argues for the reappraisal of the issue through a different lens and carries out a systematic and thematic review of the literature on women in construction in Australia through a women’s empowerment framework. Despite its usual application in gender inequality at work in development studies, the concept of empowerment lacks attention in the context of developed countries, particularly regarding the construction industry. Empowerment has been proved a useful overarching framework to analyse personal, relational, and environmental factors affecting women’s ability to be or do. In the examined studies, there is significant focus on external barriers to women in construction, such ‘organisational practices’ (environmental), ‘support’ and ‘others’ attitudes and behaviour’ (relational). There is, however, limited attention to more active stances of power, such as one’s attitude (personal), control and capacity, in shifting power dynamics. The paper draws seven major findings, covering personal, relational and environmental dimensions, supported and supplemented by some international studies, and suggests the way forward for empowering women in construction.

What influences people’s responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations

BackgroundIndividual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond.ObjectiveTo synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people’s responses to messages.DesignA rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704.Data sourcesElectronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020.Study selectionAll study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded.SynthesisDue to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging.ResultsSixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility.DiscussionThere are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics.