Good social connections are proposed to positively influence the course of cognitive decline by stimulating cognitive reserve and buffering harmful stress-related health effects. Prior meta-analytic research has uncovered links between social connections and the risk of poor health outcomes such as mild cognitive impairment, dementia, and mortality. These studies have primarily used aggregate data from North America and Europe with limited markers of social connections. Further research is required to explore these associations longitudinally across a wider range of social connection markers in a global setting.

We examined the associations between social connection structure, function, and quality and the risk of our primary outcomes (mild cognitive impairment, dementia, and mortality).

Individual participant-level data were obtained from 13 longitudinal studies of ageing from across the globe. We conducted survival analysis using Cox regression models and combined estimates from each study using two-stage meta-analysis. We examined three social constructs: connection structure (living situation, relationship status, interactions with friends/family, community group engagement), function (social support, having a confidante) and quality (relationship satisfaction, loneliness) in relation to the risks of three primary outcomes (mild cognitive impairment, dementia, and mortality). In our partially adjusted models, we included age, sex, and education and in fully adjusted models used these variables as well as diabetes, hypertension, smoking, cardiovascular risk, and depression.

In our fully adjusted models we observed: a lower risk of mild cognitive impairment was associated with being married/in a relationship (vs. being single), weekly community group engagement (vs. no engagement), weekly family/friend interactions (vs. not interacting), and never feeling lonely (vs. often feeling lonely); a lower risk of dementia was associated with monthly/weekly family/friend interactions and having a confidante (vs. no confidante); a lower risk of mortality was associated with living with others (vs. living alone), yearly/monthly/weekly community group engagement, and having a confidante.

Good social connection structure, function, and quality are associated with reduced risk of incident MCI, dementia, and mortality. Our results provide actionable evidence that social connections are required for healthy ageing.

Personal care interactions can provide important opportunities for caregivers to engage with a person living with advanced dementia but may also prove to be a difficult experience; why this so is not completely understood. We aimed to examine the person’s engagement and refusals of care in personal care interactions and identify both successful and difficult interpersonal dynamics to enable learning from each setting to inform educational resources.

One-off video-recorded observations of personal care interactions between caregivers (care-home staff or family carers) and people with advanced dementia in the UK (total observation time 03:01:52). Observations were analysed using the Menoh Park Engagement Scale (MPES) (Camp et al., 2015) and the Resistance-to-Care scale (RTC-DAT) (Mahoney, 2015) to score 5-minute video sections, and inductively with qualitative content analysis.

Active engagement of people with dementia was observed in 66% of observations. Refusals of care were present in 32% of observation time. Generally, caregivers emanated a nurturing attentiveness and people with dementia were focused and engaged throughout care activities. Rare difficult interactional components were characterised by the person with dementia appearing to show uneasiness and caregivers being flustered and uncertain. However, caregivers from both family and care-home settings were predominantly attuned to the person and skilled in effortlessly supporting them through the care activity.

Findings provide real-world empirical evidence which reenergises the concept of person-centredness in dementia care. Personal care activities typically created opportunities of engagement, rather than sites of conflict, for people with advanced dementia. The findings provide much needed insight into ways to improve care experiences for people with advanced dementia. Appropriate training/guidance for care-home staff and family carers could support more engaged and pleasurable care experiences for people with dementia.

Observer rating scales are necessary to evaluate the risk of suicide because individuals at risk for suicide are often unwilling to seek help on their own. Reliability and validity were evaluated for the newly developed Suicide Screening Questionnaire-Observer Rating (SSQ-OR).

Preliminary items were assessed by 251 experts online and 25 questions were selected. 328 individuals at high-risk and 661 controls from 12 Crisis Response Centers and 5 university counseling centers were recruited to complete SSQ-OR, Beck Scale for Suicide Ideation (BSSI) and Patient Health Questionnaire-9 (PHQ-9). In a 6 months follow-up, we reached out to 176 participants to ask whether they had experienced a suicidal thought, plan, or attempt since the baseline assessment. Cronbach's 慣, Mann-Whitney U test, Spearman's correlation, factor analyses, Receiver operating characteristic (ROC) analysis and logistic regression analysis were used to verify the SSQ-OR.

Structural validity was supported by a two-factor solution using exploratory and confirmatory factor analyses. Excellent model fit indices for the two-factor structure using exploratory factor analysis were confirmed (RMSEA = 0.033, TLI = 0.980, CFI = 0.983). The SSQ-OR demonstrated strong internal consistency. The concurrent validity based on the correlations with other self-reported indicators of suicidal potential-BSSI and PHQ-9- revealed substantial relationships. The high-risk group was effectively characterized by a cut-off point of 4, with a sensitivity of 0.73 and a specificity of 0.79. The SSQ-OR scores were significant predictors of suicidal thoughts and behaviors within 6 months.

The SSQ-OR exhibits sound psychometric properties, and could be used as a complement to a self-report or clinical-administered scale to screen suicide risk comprehensively.

In 2015, the outbreak of Middle East Respiratory Syndrome (MERS) in South Korea affected 186 patients and led to 38 bereaved families. This study aimed at investigating the nature and related factors of the psychological responses of MERS victims during the acute phase of disaster.

The MERS Psychological Support Team under the Korean Ministry of Health and Welfare provided counseling services to MERS survivors and bereaved families for 4 weeks, based on crisis intervention. In this study, we reviewed the counseling records of 109 survivors and 80 bereaved family members, and analyzed their epidemiological and MERS-related information along with psychological responses.

Somatic symptoms and anxiety related to social stigmatization or disease transmission were common in MERS survivors, whereas grief reactions such as sadness, and anger were frequently observed in bereaved families. Bereaved MERS survivors showed more avoidance/isolation than non-bereaved MERS survivors. Females, those with an underlying physical or psychiatric health condition, and those having experienced longer duration of hospitalization and non-healthcare workers were more at risk of suffering from psychological problems.

Survivors and bereaved families of epidemics can experience various psychological distresses depending on individual characteristics and the inherent features of the epidemic. Therefore, mental health in epidemics should be approached and considered more seriously.

Cancer patients may encounter psychological distress, change of emotional status, and lowered quality of life. It is predicted that similar changes will be shown during the Endoscopic Submucosal Dissection (ESD) of early stomach cancer. The objective of this study is to evaluate changes of emotional status and quality of life over time depending on baseline level of psychological distress.

Ninety-seven patients indicated with ESD who visited National Health Insurance Service Ilsan Hospital in Korea between May 2015 and June 2016 were evaluated. Psychological distress, emotional status, and quality of life were evaluated at the day before ESD. Follow-up evaluations of them were done at the day after ESD, 2 and 10 weeks later.

The group with high psychological distress showed higher female ratio, more depressive and anxiety symptoms than those of the group with low psychological distress. Psychological distress was related to stress level and lowered quality of life. Repeated measures ANOVA analysis showed that significant differences of depression (MADRS), anxiety (HAM-A), level of stress (GARS), and quality of life (EORTC QLQ-C30) were sustained over time, but the decreasing tendency of the differences between the groups was also noticed.

The study revealed that patients who feel more psychological distress may experience more depressive and anxiety symptoms, increased level of stress, and lowered quality of life. We recommend screening of patients with early stomach cancer for psychological distress before ESD, which may improve subjective life satisfaction of patients during ESD.

The authors have not supplied their declaration of competing interest.

Behavioral and psychological symptoms of dementia (BPSD) are often considered to be the greatest challenge in dementia care, leading to increased healthcare costs, caregiver burden, and placement into care facilities. With potential for pharmacological intervention to exacerbate behaviors or even lead to mortality, the development and rigorous testing of non-pharmacological interventions is vital. A pilot of the Tailored Activities Program (TAP) for reducing problem behaviors in people with dementia was conducted in the United States with promising results. This randomized trial will investigate the effectiveness of TAP for reducing the burden of BPSD on persons with dementia and family caregivers within an Australian population. This trial will also examine the cost-effectiveness and willingness to pay for TAP compared with a control group.

This randomized trial aims to recruit 180 participant dyads of a person with dementia and their caregivers. Participants will have a diagnosis of dementia, exhibit behaviors as scored by the Neuropsychiatric Inventory, and the caregiver must have at least 7 h per week contact. Participants will be randomly allocated to intervention (TAP) or control (phone-based education sessions) groups, both provided by a trained occupational therapist. Primary outcome measure will be the revised Neuropsychiatric Inventory – Clinician rating scale (NPI-C) to measure BPSD exhibited by the person with dementia.

This trial investigates the effectiveness and cost-effectiveness of TAP within an Australian population. Results will address a significant gap in the current Australian community-support base for people living with dementia and their caregivers.

To define the clinical and audiological features of normal-hearing tinnitus patients with spontaneous otoacoustic emissions, and to evaluate the role of spontaneous otoacoustic emissions in tinnitus generation.

Thirty-two patients with spontaneous otoacoustic emissions were compared with 29 patients without spontaneous otoacoustic emissions, regarding clinical and audiological aspects.

The mean age of the study group subjects was significantly lower, and they experienced the kindling effect less frequently than the control group. The mean tinnitus handicap inventory score of the study group was considerably higher than that of the controls, although the difference was not statistically significant. The study group had significantly quieter tinnitus, and higher transient evoked and distortion product otoacoustic emission responses, compared with the control group.

Normal-hearing tinnitus patients with spontaneous otoacoustic emissions have different clinical and audiological characteristics, compared with those without spontaneous otoacoustic emissions. Appropriate evaluation and treatment should be considered at an early stage in these patients.

Local extension of thyroid carcinoma can result in massive invasion of the trachea, causing severe airway compromise. The pre- and peri-operative management of such airway compromise is difficult but critical. We report the use of extracorporeal oxygenation support as an alternative peri-operative airway management option in such a situation. This approach facilitated curative surgery in a patient with papillary thyroid carcinoma invading the trachea.

We present a case report regarding extracorporeal oxygenation support in a patient with locally advanced thyroid carcinoma.

The patient was a 68-year-old woman with aggressive thyroid papillary carcinoma invading the trachea. The airway was almost totally obstructed, and tracheal resection and end-to-end anastomosis was planned. A venovenous bypass catheter was placed for cardiopulmonary bypass, using the bilateral femoral veins. Curative surgery and reconstruction were then performed successfully, under general anaesthesia assisted by cardiopulmonary bypass oxygenation.

Cardiopulmonary bypass oxygenation is a safe and effective alternative airway management option in patients with locally aggressive thyroid cancer.