Using community engagement with : Framework for reporting adaptations and modifications to evidence-based interventions.

Community engagement is increasingly considered a key component of intervention development, as it can leverage community members' knowledge, experiences, and insights to create a nuanced intervention which meets the needs, preferences, and realities of the population of interest. Community engagement exists along a spectrum from outreach to the community to partnership with community members and organizations, and all levels of community engagement can benefit from systematic documentation of community feedback and decision-making processes. This paper demonstrates how we utilized the "Framework for Reporting Adaptations and Modifications to Evidence-based Interventions" (FRAME; Wiltsey Stirman et al.

End-of-Life Doulas: A Systematic Integrative Review and Redirection.

Background And Objectives: End-of-life (EOL) doulas (EOLD) are an emerging role providing nonmedical support and advocacy for the dying and their families. Research about EOLD is new and currently highlights a need for more clarity in role definition and application. This review aims to comprehensively analyze existing knowledge regarding EOLD and their role in EOL care.

The association of religion with advance care planning.

Personal preferences influence end-of-life (EOL) decision-making and are commonly associated with engagement in the advance care planning process. Completing an advance directive (AD) allows individuals to formally document and legally report their EOL care preferences. This study explored how two aspects of religion-personal religious beliefs and formal religion practices-may be associated with advance care planning.

Evaluating the Efficacy of Time for Living and Caring: An Online Intervention to Support Dementia Caregivers' Use of Respite.

Background And Objectives: Respite, defined as time away from caregiving, is the most requested type of caregiver support. Time for Living and Caring (TLC) is a virtual coaching "app" that helps caregivers schedule and plan their respite time-use. The objectives of this analysis are: (1) to assess the efficacy of the TLC intervention on respite time-use and on caregiver well-being and (2) to identify the key features of the intervention that serve as the likely mechanism of action.

Comparison of recruitment methodologies for clinical trials: Results from the time for living and caring (TLC) intervention study.

Background: Recruiting participants for research studies is a critical yet challenging task. Community-engaged recruitment strategies have gained prominence as effective means to engage diverse populations and ensure the representativeness of study samples. This case study aims to investigate the cost and effectiveness of various recruitment methods in enhancing research participation.

Mortality risk following end-of-life caregiving: A population-based analysis of hospice users and their families.

Experiencing the death of a family member and providing end-of-life caregiving can be stressful on families - this is well-documented in both the caregiving and bereavement literatures. Adopting a linked-lived theoretical perspective, exposure to the death and dying of one family member could be conceptualized as a significant life stressor that produces short and long-term health consequences for surviving family members. This study uses familial-linked administrative records from the Utah Population Database to assess how variations in family hospice experiences affect mortality risk for surviving spouses and children.

Advance Care Planning in the Context of Dementia: Defining Concordance.

Background And Objectives: Individuals with dementia may require a surrogate decision maker as their disease progresses. To prepare for this potential role, dementia care partners need to develop a thorough understanding of their care recipient's end-of-life values and preferences, or care dyad advance care planning (ACP) concordance. As part of our pilot study implementing the LEAD intervention with dementia care dyads, we conducted a multimethod investigation to define care dyad ACP concordance.

The Anthropogenic Salt Cycle.

Increasing salt production and use is shifting the natural balances of salt ions across Earth systems, causing interrelated effects across biophysical systems collectively known as freshwater salinization syndrome. In this Review, we conceptualize the natural salt cycle and synthesize increasing global trends of salt production and riverine salt concentrations and fluxes. The natural salt cycle is primarily driven by relatively slow geologic and hydrologic processes that bring different salts to the surface of the Earth.

Using Digital Inequality Framework to Evaluate a Technology-Delivered Intervention for Caregivers: Age, Education, and Computer Proficiency.

Using "digital inequality" as a conceptual framework, this study evaluates the feasibility and usability of a technology-delivered intervention (an "app") for Alzheimer's and related dementia family caregivers. Time for Living and Caring (TLC) is an on-line intervention that provides virtual coaching and self-administered education and resources. A sample of family caregivers ( = 163) used the tool for 16 weeks, which included completing the Computer Proficiency Questionnaire (CPQ-12) at baseline.

Dying with dementia in nursing homes: A population-based study of decedents and their families.

Background: Families play a critical role in end-of-life (EOL) care for nursing home (NH) residents with dementia. Despite the important role of family, little is known about the availability and characteristics of families of persons with dementia who die in NHs.

Methods: This is a retrospective cohort study of 18,339 individuals 65 years and older with dementia who died in a Utah NH between 1998 and 2016, linked to their first-degree family (FDF) members (n = 52,566; spouses = 11.

Family caregiver experiences and needs across health conditions, relationships, and the lifespan: a Qualitative analysis.

Purpose: The purpose of this study was to understand the lived experiences of family caregivers who provide care to individuals across a broad range of ages, caregiving relationships, and health conditions and/or disabilities. Family caregiver research is typically siloed by health condition or by caregiving relationship, leaving gaps in understanding similarities and differences among caregivers.

Methods: We hosted three virtual focus groups with diverse family caregivers ( = 26) caring for an individual with a long-term disability and/or health condition(s).

Family Ties at End-of-Life: Characteristics of Nursing Home Decedents With and Without Family.

Background: Little is known about nursing home (NH) residents' family characteristics despite the important role families play at end-of-life (EOL).

Objective: To describe the size and composition of first-degree families (FDFs) of Utah NH residents who died 1998-2016 ( = 43,405).

Methods: Using the Utah Population Caregiving Database, we linked NH decedents to their FDF ( = 124,419; spouses = 10.

Establishing a Spanish-Focused Advance Care Planning Educational Session for Latina Breast Cancer Survivors.

Minoritized groups including Latinos are less engaged in awareness and discussion of advance care planning (ACP) due to the United States English-dominated healthcare system that contributes to systemic inequities related to language and cultural barriers. Explicit interventions, such as a sole Spanish-speaking educational session, may begin discussions of ACP among Latina breast cancer survivors. However, what constitutes a culturally sensitive Spanish-language ACP educational session is currently unknown.

Promoting Advance Care Planning for Persons with Dementia: Study Protocol for the LEAD (Life-Planning in Early Alzheimer's and Other Dementias) Clinical Trial.

Due to the insidious progression of Alzheimer's disease and related dementias (ADRD), surrogate decision-makers typically make medical and long-term-care decisions for a care recipient, most often a family care partner. Unfortunately, many care recipient/care partner dyads have failed to engage in advance care planning or have lost the opportunity to do so due to the cognitive decline of the care recipient. To address this need, our team created a validated dementia-focused advance care planning tool known as the LEAD Guide (Life-Planning in Early Alzheimer's and Other Dementias).

Disparities and determinants of place of death: Insights from the Utah Population Database.

To better understand determinants and potential disparities in end of life, we model decedents' place of death with explanatory variables describing familial, social, and economic resources. A retrospective cohort of 204,041 decedents and their family members are drawn from the Utah Population Database family caregiving dataset. Using multinomial regression, we model place of death, categorized as at home, in a hospital, in another location, or unknown.

Cleaning Up without Messing Up: Maximizing the Benefits of Plastic Clean-Up Technologies through New Regulatory Approaches.

As the global plastics crisis grows, numerous technologies have been invented and implemented to recover plastic pollution from the environment. Although laudable, unregulated clean-up technologies may be inefficient and have unintended negative consequences on ecosystems, for example, through bycatch or removal of organic matter important for ecosystem functions. Despite these concerns, plastic clean-up technologies can play an important role in reducing litter in the environment.

Health Disparities in Advance Care Planning: Development of a Spanish-Language LEAD Guide (Life-Planning in Early Alzheimer's and Other Dementias).

Introduction: The LEAD (Life-Planning in Early Alzheimer's and Other Dementias) Guide is an advance care planning (ACP) tool for use within the context of dementia. To meet the needs of diverse communities, we sought to create a culturally sensitive and translated Latin American Spanish version of the guide.

Methods: First, the guide was translated into Spanish.

Herbarium specimens reveal century-long trait shifts in poison ivy due to anthropogenic CO emissions.

Premise: Previous experimental studies have shown that poison ivy (Toxicodendron radicans; Anacardicaceae) responds to elevated CO with increased leaf production, water-use efficiency, and toxicity (allergenic urushiol). However, long-term field data suggest no increase in poison ivy abundance over time. Using herbarium specimens, we examined whether poison ivy and other species shifted leaf traits under natural conditions with increasing atmospheric CO (pCO ) over the past century.

Beyond Patient-Provider Relationships: Expanding the Roles and Boundaries of Families during Patient End-of-Life.

Role conflict and strain occur when healthcare providers are required to cross boundaries, either voluntarily or involuntarily, to meet the needs of their dying patients. This research is an unobtrusive digital ethnography of a publicly accessible online forum for healthcare providers ( = 242 posts); it explores the boundaries set by families and healthcare providers, and identifies how healthcare providers navigate and which circumstances require them to sometimes cross these professional boundaries. Results indicate that patient-and-family-centered care may not be fully achieved due to the ambiguity in the expected roles played by both families and healthcare providers during patient death and dying.

Urbanization drives geographically heterogeneous freshwater salinization in the northeastern United States.

Rising trends in freshwater salinity, collectively termed the Freshwater Salinization Syndrome (FSS), constitute a global environmental concern. Given that the FSS has been observed in diverse settings, key questions regarding the causes, trend magnitudes, and consequences remain. Prior work hypothesized that FSS is driven by state factors, such as human-centered land use change, geology, and climate.

Caregiver burden among diverse caregivers.

Caregivers are diverse. Research needs to focus on understanding the similarities and differences of diverse caregivers, in order to develop the most supportive policies and programs.