Identity Processes, Depression, and the Aging Self<br/>—A Norwegian Study

The Identity Process Theory is a theory of how people adapt to aging. According to this theory, older people attribute their physical functioning to a more variable state of health or to their age. Health attributions per se help older people avoid negative thoughts and feelings about themselves and their own process of aging. We explored health versus age attributions, and their effects upon depressive symptoms and negativity toward aging among 359 older Norwegians (age range = 60 - 91 years of age). Aging pertained to psychosocial loss, physical change, and psychological growth. Data collected in the 2004 WHOQOL-OLD Norwegian Field Study were analyzed by using a MANOVA and a validatory path analysis. Our findings consistently supported health attributions in relation to psychosocial loss (X2 = 20.37, df = 10, p = 0.03;GFI = 0.98, AGFI = 0.95, RMSEA = 0.05), physical change (X2 = 35.03, df = 14, p = 0.000;GFI = 0.97, AGFI = 0.94, RMSEA = 0.06), and psychological growth (X2 = 22.22, df = 13, p = 0.05;GFI = 0.98, AGFI = 0.96, RMSEA = 0.04). Health attributions increased participants’ depressive symptoms and negativity toward aging, especially toward psychosocial loss (β= -?0.45, p = 0.000) and physical change (β= - 0.48, p = 0.000). We relate these theoretically contradictory findings to Norwegian cultural beliefs and values. We make recommendations for research, including normalizing depressive symptoms and cross-cultural investigations.

The healthcare environment—The importance of aesthetic surroundings: Health professionals’ experiences from a surgical ward in Finland

There is a growing acceptance of the vital role patient centered design plays in shaping the environment. Art can be of use in every area of health care. It is within the power of each person to share and interpret experience by means of the arts, by viewing the work of others, and by using feelings and imagination. Health professionals [n = 24 of a total of n = 35], answered the Wheel Questionnaire test instrument. It measures structure, motivation/engagement, and degree of emotional investment in a situation. Participants were requested to describe, in their own words, their perception of the enrichment of the ward interiordesign and the double-sided photos with a short poetic text, and the photo-book placed at each patient room. The results demonstrate that participants are motivated, structured and emotionally engaged when describing the new enrichment. The domains and themes are: Social interaction domain;rising thoughts and conversations. Comfort domain;atmosphere. Aesthetic do main;enrichment of the working environment. It could be concluded that the surgical ward environmental enrichment stimulated conversations between health professionals and between health professionals and patients and should be regarded as an important aspect in hospital planning.

Exercise and pelvic girdle pain during pregnancy.Are there any associations?

Background: To date, there is scant knowledge and inconsistent results about physical activity, exercise and job strain in relation to pelvic girdle pain (PGP). Hence, the aims of the present study were: 1) determine prevalence of PGP and severe PGP during pregnancy and 2) compare background and lifestyle factors in addition to total physical activity level (at work, commuting, housework and recreational exercise) in those who experienced PGP and those who did not in pregnancy. Methods: Healthy pregnant women (n = 467) were allocated to the study from Oslo University Hospital, Norway. The participants filled in a validated self-administered questionnaire, Physical-Activity-Pregnancy-Questionnaire (PAPQ) in gestation-week 32 - 36. The questionnaire contained 53 questions with nine specific questions addressing PGP. The key question on PGP was asked cross-sectionally and also posed retrospectively for pre-pregnancy, 1st and 2nd trimester (During this pregnancy, did you experience any PGP?) (“Yes versus No”). Results: More than half of the women (57.5%) reported to suffer from PGP, with 18.4% reporting severe PGP. Compared the no-PGP group, women with PGP were significantly more likely to be sick-listed, multiparous, they perceived their job to be physically demanding, as well as had physically demanding household chores, including childcare. In addition, they were more prone to have experienced PGP in previous pregnancies and suffered from urinary incontinence (UI) in the current pregnancy. Most women with severe PGP reported to be sedentary in the 3rd trimester;however they performed more strengthening exercises at home than the women without PGP. Severe PGP also showed an association with standing/walking ≥50% at work. Conclusion: Women who exercised regularly in the 3rd trimester were less likely to report PGP, while job strain was associated with higher prevalence of PGP. There is a need for a prospective study with larger sample size to further evaluate if exercise has any causal association with PGP.

Voluntary Work for Public Health——Older Volunteers’ Participation in a Norwegian Society ——Motivation Factors for Participating——Enrich Life and Positive for Health

Today there is a decreasing interest in contributing to general organizations. The purpose of this study is to examine participation in volunteer work in a municipality in Norway. The main focus is determinants of motivation factors for participation as well as non-participation. A first step was to conduct a focus group interview. The second step was to make questions for a survey based on the results of the focus group interview in order to provide an overall direction for the survey. A questionnaire was sent to six local organisations in a municipality in Norway. Analysis: Multivariate logistic and linearly regression analysis. Result: The total model was statistical significant, indicating that the model was able to distinguish between volunteers who reported to be respectively happy or not happy. The model explained 36% to 62% of the variance in this variable. The variables made a statistical significant contribution to the model. The strongest predictor of being happy was the variable “energy”. The variable “positive for my health” was the second strongest predictor. “Income” has a reverse association, meaning that the volunteers are less likely to be reported to be happy when their income increases. Network and illness explain years in voluntary work. Conclusion and implications for public health nurses: The present study shows the effectiveness of volunteering for elderly. Thus, it is an important element in public health nurses work to include strategies that focus on program stimulating elderly citizens in the municipality to stay healthy physically and psychologically.

Turning up the NAD^(+)-mitophagy axis to treat Alzheimer's disease

The increase in the prevalence of individuals with Alzheimer's disease(AD)combined with the lack of a cure calls for the development of novel therapies against AD(Canter et al.,2016).The key disease-defining pathological features of AD are the accumulation of extracellular amyloid-beta(Aβ)plaques(accompanied by increasing intracellular Aβ_(1-42))and higher intracellular neu rofi brilla ry tangles,comprised mostly of hyperphosphorylated tau protein/pTau(Goedert,2015;Hardy,2017).It is evident that the elderly are more predisposed to develop AD,and thus aging is considered to be the primary risk factor for AD.By extra polation,strategies that delay aging may also slow down(if not stop)AD.

Docosahexaenoic Acid in Breast Milk Reflects Maternal Fish Intake in Iranian Mothers

To estimate essential fatty acid (FA) and long-chain polyunsaturated fatty acid (LCPUFA) concentrations in early breast milk (BM) in relation to habitual fish intake. BM was collected within 72-hours after delivery from consecutively included mothers, 60 in Guilan (coastal) and 60 in Kermanshah (inland) provinces. Mothers were interviewed to com-plete a food frequency questionnaire. The FA composition was measured with gas chromatography. Mothers in the coastal area had higher intake of fish/seafood. Consumption of saturated fat was higher in Kermanshah and olive intake was higher in Guilan. High fish/seafood intake was associated with higher docosahexaenoic acid (DHA) and lower arachidonic acid (AA)/DHA ratio in BM. There were no differences in linoleic and α-linolenic acid concentrations in BM between the provinces. N-3 FA and DHA concentration were significantly higher in Guilan than Kermanshah, but total n-6 FAs and AA did not differ and were high in both provinces. The ratios of total n-6/n-3 and AA/DHA in BM of mothers from Guilan were significantly lower than those in Kermanshah. The LCPUFA status in BM in two Iranian provinces was generally good and DHA was higher and the AA/DHA was significantly lower in mothers with high fish intake.

A visual art museum in Sweden as pedagogical scenery: Gibbs’ reflective cycle guiding student nurses in the reflective process

The pedagogy employed in health care education must continually be questioned and expanded. Student nurses must be prepared for nursing practice that continually changes, consequently alternative concepts in nurse education must be considered. The aims were to provide student nurses with reflection skills and to evaluate the potential of studying the reflective process using visual art at a museum as an enriched activity in education. A pedagogical program with Gibbs’ reflection model was used as a complement. The study was conducted at a University College of Health Sciences in Sweden in collaboration with a visual art museum. Data were collected during a period of three years. A random sample (n = 35 of n = 98 students’ reports) was selected for qualitative analysis. The painting by George-Pierre Seurat, Seated woman was used as a source of inspiration. Analysis was conducted of the excerpts generated from the steps in Gibbs’ reflection model and from students’ evaluations of the teaching-learning structure. The results show that students were able to build hypothetical situations around the character depicted in the painting. They observed and described a great many aspects of the reflective process. The chosen painting was regarded as suitable for its purpose, and a source of inspiration. It could be interpreted as a patient you might meet in clinical practice. The students′ evaluations show that they became aware of knowledge they had not thought of before, and a way of taking a step closer to clinical practice. It could be concluded that art museum could be regarded as a stimulating environment that nurtured the reflective process. Consequently, visual art museums have to be considered as possible teaching learning milieus to be used in nurse education. It is to be hoped that this study will contribute to further development of visual art museums as teaching learning settings.

Obsessive-compulsive disorder in disguise—Case report

Obsessive-compulsive disorder (OCD) may mimic other minor and major psychiatric disorders or symptoms. Psychomotor disturbances may also be seen in OCD. Symptoms and complaints could be misinterpreted. Differential diagnostic assessments would be difficult either if the person has OCD or another diagnostic entity with OCD related symptoms. If clinicians in residential or outpatient settings do not realize this, the patients may suffer from inadvertent pharmacological treatment efforts, to no avail. A representative case of the former is presented. Withdrawal of all psychotropic medications cold turkey did not increase symptom load during the following weeks, indicating little benefit from medications. Because of continued complaints from the patient, psychotropic medications were gradually reintroduced, without any improvement. OCD patients may not be helped by extensive use of psychotropics and doctors responsible for them should employ other methods of reducing OCD symptoms than lumping together diverse psychotropics. There is evidence for the value of intensive cognitive behaviour therapy, but also for addressing the social conditions of the patients.

How do Patients with Schizophrenia Perceive Relatives’ Levels of Expressed Emotions? A Brief Patient Rated Scale

Background : Patients’ perspective on relatives’ attitude and behaviour towards them (Expressed emotion—EE) may be an important addition to the current focus on relatives’ perspective only, as measured by Camberwell Family Interview (CFI) or other methods. Based on the theory of EE, we have designed a brief, three-item questionnaire completed by patients, named Felt Expressed Emotion Rating Scale (FEERS). FEERS measures the patient’s experience of criticism (Cri) and emotional over involvement (i.e. worry (Wo), and control (Con). Aims: To investigate the test-retest reliability of the FEERS and associations between the FEERS and the CFI and to which extent FEERS scores were modified by severity of psychotic symptoms, cognitive function, patient mood and amount of face-to-face contact with relatives. Methods : Forty-five patients with schizophrenia and related psychoses admitted to a psychiatric hospital and 67 relatives were included. Assessments included FEERS, CFI and Positive and Negative Syndrome Scale (PANSS). Results : FEERS-Cri test-retest intra-class correlation (ICC1,1) was 0.71 among patients with low total PANSS scores, low cognitive impairment (0.59) and depression (0.63). For low levels of cognitive impairment, the ICCs of the FEERS-Wo and the FEERS-Con were 0.62 and 0.83, respectively. The FEERS-Cri and FEERSHowWo correlated significantly with CFI-CC and CFI-positive comments, respectively. Among the relatives that the patient deemed “not at all critical” (low FEERS-Cri scores), 94% had low CFI-CC levels. Conclusions : The FEERS may be a brief, time-saving alternative for identifying relatives with low levels of criticism. However, illness severity, cognitive function and mood influence FEERS test-retest reliability and link to CFI.

Healthy lifestyle for people with intellectual disabilities through a health intervention program

There are well known gaps related to health care service and public health interventions for people with Intellectual Disabilities (ID), but there is still lack of research information of what nurses can do to reducing health disparities of persons with ID. The present study aimed at exploring the views of people with ID about a healthy lifestyle, exercise, and to take part in a health promotion program. A qualitative method was an appropriate method for capturing the informants’ points of view. Participants were adults with intellectual disability who would be able to give their consent verbally and in written form. Women (n = 7) and men (n = 6). Data were collected from focus group interviews and analysed according to a qualitative content analysis of the tape-recorded and verbatim transcribed interviews. The participants took part in four workshops about healthy food, and ten physical activities addressing the connection to physical, social and emotional health. The results of the focus group interviews show that participants have knowledge about the importance of a healthy lifestyle for good health including physical activity and healthy food. Participants also describe social interaction and self-determination as important aspects in their life. It could then be concluded that the health promotion program result point at consciousness about a healthy lifestyle. There is still lack of research information of what public health nurses can do to reducing health disparities of persons with ID. Public health nurses work in community-based services and therefore they also might support persons with ID through health intervention programs.

Seniors’ experiences of visual art environmental enrichment

The present study aimed at determining whether short-term exposure to art in shared common areas in congregate housing units could affect health and health determinants among the residents. Ten residents (mean age 80.4 years) at one block were exposed to visual art environmental enrichment in common areas over a period of three months. Thirteen persons (mean age 86.6 years) living in another block played in-house boule. Cornell’s test, Mini-Mental tests (MMT), and face recognition test were performed to assess depression, cognition, and episodic memory, respectively before and after the intervention. The results show that visual art environmental enrichment in common areas and lack of stimulating and guiding dialogues show a change in depression scores in the intervention group (p = 0.018) and the control group (p = 0.009). MMT scores improved only in the control group (p = 0.003). No changes in episodic memory in any of the groups were observed. It could be concluded that in order to obtain a positive result of short term visual art environmental enrichment, guiding art dialogues conducted by nurses, as described in previous research, should be added to visual art environmental enrichment in healthcare settings.

Seasonal fluctuation in the secretion of the antioxidant melatonin is not associated with alterations in sperm DNA damage

A high sperm DNA fragmentation index （DFI） is associated with reduced fertility. DFI is influenced by the balance between reactive oxygen species and antioxidants. A circannual variation in melatonin, an antioxidant and free radical scavenger, could thus impact semen quality and fertility. The association between the major melatonin metabolite, urine 6-sulfatoxymelatonin （aMT6s）, and DFI was analyzed in 110 Oslo men （south of the Arctic Circle） and 86 Tromsoe men （north of the Arctic Circle）. Two semen analyses, summer and winter, and four urine samples （early/late summer; early/late winter）, were analyzed. The associations between aMT6s in urine and DFI were characterized in a cross-sectional and longitudinal manner using correlation analysis and linear regression. Regardless of season and location, no significant correlations between aMT6s and DFI were observed. The correlation coefficients for associations between changes over time （early winter-early summer） in aMT6s and DFI were for the total cohort： rho = -0.08 （P = 0.322）, for the Oslo cohort： rho = -0.07 （P = 0.485）, and for the Tromsoe cohort： rho = -0.14 （P = 0.273）, respectively. Similar results were seen when comparing late winter and late summer. There was no any statistically significant correlation between changes over time in aMT6s and DFI for men with DFI below and above the median value （10%）, respectively. The seasonal variation in melatonin excretion seems not to have any impact on DFh