Long-term supports and services planning for the future: implications from a statewide survey of Baby Boomers and older adults.

Purpose Of The Study: Little is known about adults' future planning for long-term supports and services (LTSS), and no studies have examined how LTSS planning compares between Baby Boomers and their parents' generation. The primary aim of this study is to examine the potential influences of birth cohort and gender on LTSS planning. Drawing on Andersen's Behavioral Model of Health Services Use, birth cohort and gender are viewed as predisposing characteristics, and several additional predisposing, enabling, and need characteristics are included as independent variables.

Medical conditions and medication use in adults with Down syndrome: a descriptive analysis.

Background: We examined the presence of medical conditions and medication use within a sample of adults with Down syndrome.

Methods: Retrospective chart review using a sample of 141 adults with Down syndrome and age range of 30 to 65 years.

Results: We identify 23 categories of commonly occurring medical conditions and 24 categories of medications used by adults with Down syndrome.

Factors associated with skilled nursing facility transfers in dementia-specific assisted living.

Background: Medical, functional, and behavioral problems are associated with transitions from assisted living (AL), but limited information is available on those at highest risk for transition.

Methods: We conducted a multidisciplinary geriatric team assessment of individuals newly admitted to 2 dementia-specific AL communities from January 2000 to March 2002. Transitions of individuals to permanent skilled nursing facilities (SNF) was assessed for 9 months.

Efficacy of a geriatrics team intervention for residents in dementia-specific assisted living facilities: effect on unanticipated transitions.

Objectives: To determine whether a multidisciplinary team intervention minimizes unanticipated transitions from assisted living for persons with dementia.

Design: Randomized trial.

Setting: Two dementia-specific assisted living facilities in Connecticut owned and managed by the same corporation.

Partners in caregiving in a special care environment: cooperative communication between staff and families on dementia units.

Purpose: This article reports the results of a randomized, controlled evaluation of Partners in Caregiving in a Special Care Environment, an intervention designed to improve communication and cooperation between staff and families of residents in nursing home dementia programs.

Design And Methods: Participants included 388 family members and 384 nursing staff members recruited from 20 nursing homes, randomly assigned to treatment and control conditions. Project staff conducted training sessions on communication and conflict-resolution techniques with two groups at the intervention sites: staff and residents' family members, followed by a joint meeting with facility administrators.

Nursing home complaints: who's complaining and what's gender got to do with it?

Long Term Care Ombudsman Complaint data from one state's 261 nursing homes are examined in the study. We assessed differences between male and female groups, including chiefly residents, but also ombudsmen, the residents' relatives or friends, administrators, legal representatives, and others regarding types and rates of complaints as reported in the Administration on Aging (AoA) major categories of: Resident Care, Resident Rights, Administration, Quality of Life, and Complaints Not Against Facility. Proportionately, male residents lodged more complaints than females.

Physicians-in-training attitudes toward caring for and working with patients with alcohol and drug abuse diagnoses.

Introduction: Physicians in all specialties commonly encounter patients who abuse alcohol or illegal drugs. Working with these patient populations can be challenging and potentially engender negative attitudes. This study is designed to identify the progression of attitudinal shifts over time of physicians-in-training toward caring for substance abusing patients.

Long-term care insurance: care management practice issues.

There are numerous articles about the pros and cons of long-term care insurance. However, for many people it is a solution for funding long-term care when they are in need of these services. The provision of appropriate care management to individuals, providers, and insurers results in a "win-win" for everyone.

Case-finding for depression in elderly people: balancing ease of administration with validity in varied treatment settings.

Background: Little is known about the performance of brief and ultrabrief (1- and 2-question) depression screens in older patients across varied treatment sites. This study (1) assesses their validity in clinics, hospitals, and nursing homes and (2) assesses cut-points for optimal clinical application.

Methods: 360 patients aged 60 years and older from 2 urban primary care practices (n = 125), 1 general hospital (n = 150), and 8 nursing homes (n = 85) were assessed using the Yale 1-question screen, the 2-question instrument derived from the Primary Care Evaluation of Mental Disorders, and long and short versions of the Center for Epidemiologic Studies Depression (CES-D) scale and Geriatric Depression Scale (GDS).

Depression in later-life Puerto Rican primary care patients: the role of illness, stress, social integration, and religiosity.

Background: Older Puerto Ricans belong to two rapidly growing demographic groups known to have high rates of depression: the aging and Hispanic populations. Studies of depression in Puerto Ricans have primarily focused on the impact of demographic factors and health. This study expands previous research, examining the relationships between depression and social stressors, social support, and religiosity, for Puerto Rican primary care patients aged 50 and older.

Depression and substance use in a middle aged and older Puerto Rican population.

This study focuses on depression and substance use in Puerto Rican primary care patients, age 50 and older, recruited from five clinics in Hartford, CT (n = 303). One-third of the participants screened positive for depression using the Center for Epidemiologic Studies-Depression scale, and 16 percent either reported excessive alcohol use, prescription drug abuse, and/or illegal drug use in the past year. Correlates of depression include younger age, female gender, being separated or divorced, low perceived adequacy of income, poor health status, functional limitations, few emotional supports, and a history of an "ataque de nervios.

Understanding the components of publication success: a survey of academic award recipients.

Purpose: This study examines predictors of publication number in career development awardees. We examined whether daily writing predicted publication number among junior faculty.

Design And Methods: We surveyed 94 career development awardees; the survey consisted of 28 questions in four domains: characteristics, environment, writing practices, and attitudes about writing.

Improving patient care outcomes by teaching quality improvement to medical students in community-based practices.

Purpose: As part of the Undergraduate Medical Education for the 21st Century (UME-21) project, the University of Connecticut School of Medicine developed and implemented a quality improvement curriculum. This study examined its impact on educational outcomes and the effect of the students' continuous quality improvement (CQI) projects on the quality of care delivered at community practice sites.

Method: Seventy-seven second-year students working in groups of two to four conducted CQI projects on diabetes mellitus at 24 community-based primary care practices.

The Performance Enhancement Project: improving physical performance in older persons.

Objective: To determine the effects of center-based exercise on physical performance in older persons at risk for decline in physical functioning.

Design: Randomized controlled trial.

Setting: Senior centers.

Effects of transdermal testosterone on lipids and vascular reactivity in older men with low bioavailable testosterone levels.

Background: Sex hormones are known to affect cholesterol levels and vascular tone in women. The effects of testosterone on cholesterol and vascular tone in men are less well understood. Low testosterone levels have been associated with higher cholesterol levels in epidemiologic studies, but testosterone replacement has resulted in variable changes in cholesterol levels.

Effects of transdermal testosterone on cognitive function and health perception in older men with low bioavailable testosterone levels.

Background: Many men older than 50 years have bioavailable testosterone levels below the reference range for young adult men. The impact of the decreased androgen levels on cognition and health perception has received little attention.

Methods: Sixty-seven men (mean age 76 +/- 4 years, range 65-87) with bioavailable testosterone levels below 128 ng/dl (lower limit for adult normal range) were randomized to receive transdermal testosterone (2-2.

Screening for depression in middle-aged and older puerto rican primary care patients.

Background: Brief depression screens have recently been developed, but their use in older or minority populations has not been studied. To date, optimal depression screens and optimal cutpoints have not been identified for middle-aged and older Hispanic primary care patients.

Methods: This study compares multiple versions of four depression screening tools--Center for Epidemiologic Studies-Depression Scale (CES-D), Geriatric Depression Scale, Yale 1-question screen, and PRIME-MD 2-question screen--to the Composite International Diagnostic Interview (CIDI), the World Health Organization's diagnostic interview, which has been validated in adult Latino populations, to assess convergent validity.