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Despite routine detection of coseismic acoustic‐gravity waves (AGWs) in Global Navigation Satellite System (GNSS) total electron content (TEC) observations, models of the earthquake‐atmosphere‐ionosphere dynamics, essential for validating data‐driven studies, remain limited. We present the results of three‐dimensional numerical simulations encompassing the entire coupling from Earth's interior to the ionosphere during the Mw ${M}_{w}$ 7.8 2016 Kaikoura earthquake. Incorporating the impact of data/model uncertainties in estimating the ionospheric state, the results show a good agreement between observed and simulated slant TEC (sTEC) signals, assessed through a set of metrics. The signals exhibit intricate waveforms, resulting from the integrated nature of TEC and phase cancellation effects, emphasizing the significance of direct signal comparisons along realistic line‐of‐sight paths. By comparing simulation results initialized with kinematic and dynamic source models, the study demonstrates the quantifiable sensitivity of sTEC to AGW source specifications, pointing to their utility in the analysis of coupled dynamics. Plain Language Summary: Earthquakes launch acoustic‐gravity waves (AGWs) into the atmosphere, spanning periods from seconds to minutes, that can reach the ionosphere at ∼ ${\sim} $100–400 km altitude. The majority of AGW detections in the ionosphere are performed with the use of GNSS signals collected with ground‐based receivers that nowadays comprehensively cover seismically active regions. However, the modeling of earthquake‐atmosphere‐ionosphere processes together, essential for validating and supporting data‐driven studies, remains rare. We present the outcomes of three‐dimensional numerical modeling of interconnected processes, spanning from Earth's interior to the ionosphere. We conducted a case study focused on the 2016 Mw ${M}_{w}$ 7.8 earthquake in New Zealand, renowned for its complexity and comprehensive observations of coseismic AGWs recorded with GNSS signals. Our results demonstrate a high level of accuracy of simulated GNSS signals, also revealing the high sensitivity to the chosen earthquake model and the complexity of resulting ionospheric signals, highlighting the necessity of attributing realistic geometries of GNSS TEC observations. The findings highlight the potential for using GNSS signals to investigate coseismic AGWs to infer characteristics of earthquakes. Key Points: Acoustic‐gravity wave‐driven slant total electron content (sTEC) signals are analyzed in terms of amplitude, waveform, and onset timeIntricate sTEC signal waveforms result from ionospheric fluctuations measured along lines‐of‐sight between satellites and receiversHigh sensitivity of sTEC signals to acoustic‐gravity wave source specification provides additional basis for earthquake characterization [ABSTRACT FROM AUTHOR]

Evidence of hydrothermal activity is reported for the Mesozoic pre‐ and syn‐rift successions of the western Adriatic palaeomargin of the Alpine Tethys, preserved in the Western Southalpine Domain (NW Italy). The products of hydrothermal processes are represented by vein and breccia cements, as well as dolomitization and silicification of the host rocks. In the eastern part of the study area, interpreted as part of the necking zone of the continental margin, Middle Triassic dolostones and Lower Jurassic sediments are crossed by veins and hydrofracturing breccias cemented by saddle dolomite. The precipitation of dolomite cements occurred within the stratigraphic succession close to the sediment–water interface. Despite the shallow burial depth, fluid inclusion microthermometry and clumped isotopes show that hydrothermal fluids were relatively hot (80–150°C). In the western part of the study area, interpreted as part of the hyperextended distal zone, a polyphase history of host‐rock fracturing is recorded, with at least two generations of veins cemented by calcite, dolomite and quartz. Vein opening and cementation occurred at shallow burial depth around the time of deposition of the syn‐rift clastic succession. Fluid inclusion microthermometry on both quartz and dolomite cements indicates a fluid temperature of 90–130°C, again pointing to hydrothermal fluids. Both in Fenera‐Sostegno and Montalto Dora areas, O, C and Sr isotope values, coupled with fluid inclusion and clumped isotope data, indicate that hydrothermal fluids derived from seawater interacted with crustal rocks during hydrothermal circulation. Stratigraphic and petrographic evidence, and U–Pb dating of dolomitized clasts within syn‐rift sediments, document that hydrothermal fluids circulated through sediments from the latest Triassic to the Toarcian, corresponding to the entire syn‐rift evolution of the western portion of the Adriatic palaeomargin. The documented hydrothermal processes are temporally correlated with regional‐scale thermal events that took place in the same time interval at deeper crustal levels. [ABSTRACT FROM AUTHOR]

The measurements of acoustic waves created by a quake are of great interest for planets with hot and dense atmospheres, like Venus, because surface deployments of seismometers will last only a few hours, whereas freeflying balloons could fly many days. Infrasound sensors can also be used to constrain subsurface properties during active seismic experiments. This study presents a controlled source seismo-acoustic experiment using infrasonic sensors and accelerometers mounted on a tethered helium balloon. Both the acoustic waves generated below the balloon by seismic surface waves, and the ones generated by strong ground motions above the seismic source are clearly observed and separated on the records of the various instruments. This data set allows various validations and investigations. First, it validates the ground to air coupling theory and our numerical modelling tools. Then, it allows us to demonstrate that antenna processing of infrasound sensors deployed below the balloon can estimate the arrival incidence angle of the acoustic waves within 10°. Finally, a polarization analysis of the accelerometers taped on the balloon envelope is presented. It demonstrates that accelerometer records are strongly dependent on their location on the balloon due to its deformations and rotations. However, the different acoustic signals can be distinguished through their polarization, and a best sensor location is estimated at the bottom of the balloon envelope. These results are a first step towards detecting and locating seismic activity using airborne acoustic sensors on Venus and elsewhere. However, some observations of earthquake signals in a more realistic geometry are still missing. [ABSTRACT FROM AUTHOR]

The evolution of hyperextended rift systems is linked to complex tectonic processes in which fluid activity is much more important than previously thought. This study sheds light on the fluid-sediment interactions within the distalmost parts of the Mauléon-Arzacq hyperextended basin (Western Pyrenees) focusing on the post-depositional modifications of pre- to syn-hyperextension sediments due to hydrothermal fluids. Strong field- and petrography-based evidence demonstrates the presence of fluid-related products affecting the Jurassic to Cretaceous sediments exposed in the Chaînons Béarnais (easternmost Mauléon basin). These are supported by new U–Pb dating of carbonates and microthermometry of fluid inclusions showing temperatures of up to 250 °C and highly depleted δ18O and strongly enriched 87Sr/86Sr values. Two main stages of fluid activity can be defined: (i) a carbonate-rich stage leading to fabric-destructive replacement dolomitization of the pre-rift carbonates, widespread hydro-fracturation giving rise to different types of hydraulic breccias cemented by multi-phase dolomite and calcite dated at ~ 96 Ma; and (ii) a Na-SiO2-rich stage associated with authigenic albite and quartz, mainly affecting syn-rift deposits. Finally, the occurrence of dolomitic marbles and mylonites provide evidence for strong recrystallization and ductile shearing affecting the sediments during the latest stages of hyperextension at ~ 94 Ma. The Chaînons Béarnais represent a primary target to investigate fluid-rock interactions linked to extensional tectonics that can be used as an analogue to compare to other fossil rift systems (e.g. Adriatic paleo-rifted margin) or present-day magma-poor, hyperextended rifted margins (e.g. Iberia-Newfoundland). [ABSTRACT FROM AUTHOR]

Eight volcanic ash layers, linked to large explosive events caused by subduction-related volcanism from the Vardar Ocean back-arc, interbedded with marine limestones and cherts, have been identified in the Rosso Ammonitico Veronese Formation (northeastern Italy). The thickest ash layer, attributed to the Gregoryceras transversarium ammonite Biozone (Oxfordian Stage), yields a precise and reliable 40Ar–39Ar date of 156.1 ± 0.89 Ma, which is in better agreement with GTS2004 boundaries than with the current GTS2012. This first biostratigraphically well-constrained Oxfordian date is proposed as a new radiometric tie-point to improve the Geologic Time Scale for the Late Jurassic, where ammonite-calibrated radiometric dates are particularly scarce. [ABSTRACT FROM PUBLISHER]

The purpose of this article is to review and critique the published literature examining the relationships between religion/spirituality and caregiver well-being and to provide directions for future research. A systematic search was conducted using bibliographic databases, reference sections of articles, and by contacting experts in the field. Articles were reviewed for measurement, theoretical, and design limitations. Eighty-three studies were retrieved. Research on religion/spirituality and caregiver well-being is a burgeoning area of investigation; 37% of the articles were published in the last five years. Evidence for the effects of religion/spirituality were unclear; the preponderance (n = 71, 86%) of studies found no or a mixed association (i.e., a combination of positive, negative, or non-significant results) between religion/spirituality and well-being. These ambiguous results are a reflection of the multidimensionality of religion/spirituality and the diversity of well-being outcomes examined. They also partially reflect the frequent use of unrefined measures of religion/spirituality and of atheoretical approaches to studying this topic. Investigators have a fairly large number of studies on religion/spirituality and caregiver well-being on which to build. Future studies should be theory driven and utilize psychometrically sound measures of religion/spirituality. Suggestions are provided to help guide future work. [ABSTRACT FROM AUTHOR]

Context: Most deaths in the United States occur among older persons who have 1 or more disabling conditions. As a result, many deaths are preceded by an extended period during which family members provide care to their disabled relative.Objective: To better understand the effect of bereavement on family caregivers by examining predeath vs postdeath changes in self-reported and objective health outcomes among elderly persons providing varying levels of care prior to their spouse's death.Design and Setting: Prospective, population-based cohort study conducted in 4 US communities between 1993 and 1998.Participants: One hundred twenty-nine individuals aged 66 to 96 years whose spouse died during an average 4-year follow-up. Individuals were classified as noncaregivers (n = 40), caregivers who reported no strain (n = 37), or strained caregivers (n = 52).Main Outcome Measures: Changes in depression symptoms (assessed by the 10-item Center for Epidemiological Studies-Depression [CES-D] scale), antidepressant medication use, 6 health risk behaviors, and weight among the 3 groups of participants.Results: Controlling for age, sex, race, education, prevalent cardiovascular disease at baseline, and interval between predeath and postdeath assessments, CES-D scores remained high but did not change among strained caregivers (9.44 vs 9.19; P =.76), while these scores increased for both noncaregivers (4.74 vs 8.25; F(1,116) = 14.33; P<.001) and nonstrained caregivers (4.94 vs 7.13; F(1,116) = 4.35; P =.04). Noncaregivers were significantly more likely to be using nontricyclic antidepressant medications following the death than the nonstrained caregiver group (odds ratio [OR], 12.85; 95% confidence interval [CI], 1.02-162.13; P =.05). The strained caregiver group experienced significant improvement in health risk behaviors following the death of their spouse (1.47 vs 0.66 behaviors; F(1,118) = 20.23; P<.001), while the noncaregiver and nonstrained caregiver groups showed little change (0.27 vs 0.27 [P =.99] and 0.46 vs 0.27 [P =.39] behaviors, respectively). Noncaregivers experienced significant weight loss following the death (149.1 vs 145.3 lb [67.1 vs 65.4 kg]; F(1,101) = 8.12; P =.005), while the strained and nonstrained caregiving groups did not show significant weight change (156.2 vs 155.2 lb [70.3 vs 69.8 kg] [P =.41] and 156.2 vs 154.0 lb [70.3 vs 69.3 kg] [P =.12], respectively).Conclusions: These data indicate that the impact of losing one's spouse among older persons varies as a function of the caregiving experiences that precede the death. Among individuals who are already strained prior to the death of their spouse, the death itself does not increase their level of distress. Instead, they show reductions in health risk behaviors. Among noncaregivers, losing one's spouse results in increased depression and weight loss. [ABSTRACT FROM AUTHOR]

The article reports on the results of a study showing that cholinesterase inhibitors provide little benefits for informal carers of community dwelling people with Alzheimer's disease. In future Alzheimer's disease clinical trials, carer specific outcomes should be included to investigate the effects of cholinesterase inhibitors.

Difficulties in dating Mississippi Valley-type (MVT) mineral deposits and the often closely associated dolomitization have led to controversy regarding their origin. We report the first radiometric ages for the Gorno mining district in northern Italy, an example of the Alpine subclass of MVT deposits. U-Pb ages of hydrothermal carbonates pre- and postdating the ore-forming event show that base-metal mineralization occurred shortly after the deposition of the Carnian host rocks. This implies that the Gorno ore deposits formed at shallow burial depth prior to the Early Jurassic western Tethys rifting phase. Contemporaneous Triassic magmatism and extensional tectonics likely contributed to the high geothermal heat fluxes required to drive the mineralizing system. Our study reinforces the need for reliable geochronological data for metallogenic models and warns against a general application of classic North American MVT models to similar deposits worldwide. [ABSTRACT FROM AUTHOR]

Abstract: Two types of methane-derived carbonates, each with different lithological and paleontological signatures, have been distinguished in the Oligocene–Miocene sediments of Monferrato (NW Italy): [1)] Irregularly-shaped, metre-sized rock bodies characterized by the widespread occurrence of remains of large bivalves (Lucina sp.). These bodies include two subtypes, differing in the lithological characteristics of the cemented sediments: [a)] Lucina-rich marly limestones, encased in Langhian outer shelf marls. They document a slow seepage of CH4-rich fluids at the paleo-sea floor; [b)] Lucina-bearing cemented mud breccias, found either as cemented masses in the original stratigraphic position or as redeposited blocks within Upper Messinian chaotic (block-in-matrix) sediments. These carbonate bodies document the activity of submarine mud volcanoes during the late Messinian. In particular, they document intermittent fluid emission ranging from violent eruptive phases, responsible for the extrusion of soft mud breccias at the sea floor, to quiet degassing phases, that promoted colonization by chemosymbiotic communities and localized cementation. [2)] Very irregularly shaped strongly cemented, mainly coarse-grained, clastic sediments, reaching the lateral extent of few hundred meters and the thickness of few tens of meters. They occur within Oligocene to Messinian sediments, lack remains of chemosymbiotic taxa and are highly fractured, with fractures filled with sediments and cements. These carbonate-cemented masses, here referred to as macroconcretions, result from the precipitation of carbonate cements within buried sediments flushed by ascending CH4-rich fluids. They document a complex fluid circulation pattern in the sedimentary column, in which SO4-rich waters were drawn from surrounding sediments by the fast and prolonged flow of CH4-rich fluids and promoted anaerobic oxidation of methane and the precipitation of carbonate cements. The polyphase network of clastic dykes and veins that characterize macroconcretions is related to an intermittent fluid flow regime: dykes formed during fast upward flows of sediment-rich fluids whereas carbonate-filled veins formed during slower, degassing phases. The local lithostratigraphic and structural framework allow to correlate genetically and chronologically the macroconcretions to Lucina-bearing mud breccias. Consequently, macroconcretions are here regarded as the result of cementation along fluid conduits feeding Messinian mud volcanoes at the sea floor. The massive release of fluids could have played a role in triggering large-scale mass wasting events responsible for the emplacement of sedimentary mélanges including CH4-derived rocks in the Messinian. [Copyright &y& Elsevier]

Theorists have proposed that greater centrality (personal importance) of a social role is associated with better psychological well-being but that role centrality exacerbates the negative effects of stress in that same social role on well-being. The present study found evidence to support both hypotheses in a sample of 296 women who simultaneously occupied the roles of parent care provider, mother, wife, and employee. Greater centrality of all four roles was related to better psychological well-being. As predicted, wife centrality exacerbated the effects of wife stress on life satisfaction, and employee centrality exacerbated the effects of employee stress on depressive symptoms. Contrary to prediction, centrality of the mother role buffered women from the negative effects of mother stress on depressive symptoms. These findings point to an aspect of role identity that can benefit well-being but that has complex effects in the context of role stress. [ABSTRACT FROM AUTHOR]

This study examined the relationships among emotional support, mastery, and well-being for 258 women who simultaneously occupied the roles of wife, mother, parent care provider, and employee. Its primary aim was to determine if a greater sense of mastery in each of these 4 roles could explain the relationship between emotional support from the partner or partners in the same role (the husband, children, impaired parent, or work supervisor) and better psychological well-being (less depressive symptomatology and more life satisfaction). Findings revealed that more emotional support from each of the 4 role partners was related to a greater sense of mastery in that same role. Furthermore, for each of the roles of wife, mother, and employee, role-specific mastery was a mediating mechanism in the relationship between support from the role partner or partners and better well-being. [ABSTRACT FROM AUTHOR]

We study, for the first time, the physical coupling and detectability of meteotsunamis in the earth's atmosphere. We study the June 13, 2013 event off the US East Coast using Global Navigation Satellite System (GNSS) radio occultation (RO) measurements, Sounding of the Atmosphere using Broadband Emission Radiometry (SABER) temperatures, and ground-based GNSS ionospheric total electron content (TEC) observations. Hypothesizing that meteotsunamis also generate gravity waves (GWs), similar to tsunamigenic earthquakes, we use linear GW theory to trace their dynamic coupling in the atmosphere by comparing theory with observations. We find that RO data exhibit distinct stratospheric GW activity at near-field that is captured by SABER data in the mesosphere with increased vertical wavelength. Ground-based GNSS-TEC data also detect a far-field ionospheric response 9 h later, as expected by GW theory. We conclude that RO measurements could increase understanding of meteotsunamis and how they couple with the earth's atmosphere, augmenting ground-based GNSS TEC observations., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s) 2023.)

We introduce GUARDIAN, a near-real-time (NRT) ionospheric monitoring software for natural hazards warning. GUARDIAN's ultimate goal is to use NRT total electronic content (TEC) time series to (1) allow users to explore ionospheric TEC perturbations due to natural and anthropogenic events on earth, (2) automatically detect those perturbations, and (3) characterize potential natural hazards. The main goal of GUARDIAN is to provide an augmentation to existing natural hazards early warning systems (EWS). This contribution focuses mainly on objective (1): collecting GNSS measurements in NRT, computing TEC time series, and displaying them on a public website (https://guardian.jpl.nasa.gov). We validate the time series obtained in NRT using well-established post-processing methods. Furthermore, we present an inverse modeling proof of concept to obtain tsunami wave parameters from TEC time series, contributing significantly to objective (3). Note that objectives (2) and (3) are only introduced here as parts of the general architecture, and are not currently operational. In its current implementation, the GUARDIAN system uses more than 70 GNSS ground stations distributed around the Pacific Ring of Fire, and monitoring four GNSS constellations (GPS, Galileo, BDS, and GLONASS). As of today, and to the best of our knowledge, GUARDIAN is the only software available and capable of providing multi-GNSS NRT TEC time series over the Pacific region to the general public and scientific community., Supplementary Information: The online version contains supplementary material available at 10.1007/s10291-022-01365-6., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s) 2022.)

The 15 January 2022 climactic eruption of Hunga volcano, Tonga, produced an explosion in the atmosphere of a size that has not been documented in the modern geophysical record. The event generated a broad range of atmospheric waves observed globally by various ground-based and spaceborne instrumentation networks. Most prominent was the surface-guided Lamb wave (≲0.01 hertz), which we observed propagating for four (plus three antipodal) passages around Earth over 6 days. As measured by the Lamb wave amplitudes, the climactic Hunga explosion was comparable in size to that of the 1883 Krakatau eruption. The Hunga eruption produced remarkable globally detected infrasound (0.01 to 20 hertz), long-range (~10,000 kilometers) audible sound, and ionospheric perturbations. Seismometers worldwide recorded pure seismic and air-to-ground coupled waves. Air-to-sea coupling likely contributed to fast-arriving tsunamis. Here, we highlight exceptional observations of the atmospheric waves.

To highlight the revolving door (RD) phenomenon in an acute psychiatric ward, we retrospectively identified the patients hospitalized three or more times in a calendar year from 1/1/2009 to 31/12/2013 as RD patients (RDP). We collected sociodemographic and clinical variables of RDP and statistically analyzed the potential RD risk factors. We divided RDP into "high" and "extremely high" utilizers and evaluated the variables related to more frequent readmissions. RDP represented 5.68% of all patients and their hospitalizations (RDH) 25% of all admissions. The statistically significant risk factors for all RDH were "disability pension," "substance abuse/dependence," "mild/severe aggressiveness," and "psychiatric and social rehabilitative programs". The comparison between "high" and "extremely high" utilizers showed that "manic episodes" and "personality disorders," among the diagnoses, "familial relational conflicts" and "violence/suicidality", among the hospitalization reasons, were statistically significant risk factors for more frequent readmissions. RD phenomenon was greatly affected by severe clinical conditions with social disability.

Objectives: Spousal caregivers of patients with dementia are in need of interventions to bolster their quality of life. Computer-based, self-administered cognitive training is an innovative approach to target spousal caregiver distress and coping. We tested the feasibility of administering one such intervention with minimal clinician intervention., Methods: Twenty-seven elderly adults (>64 years old), who each were the primary caregiver for a spouse with dementia, were recruited through the Memory Disorders Clinic of the Alzheimer Disease Research Center in Pittsburgh, PA. Spousal caregivers were instructed to use a handheld computer version of the Adaptive Paced Visual Serial Attention Task (APVSAT) at least three times per week for four weeks as part of a larger caregiver intervention trial (P01 AG020677). Feasibility was explored by examining the frequency of APVSAT usage., Results: Results suggest that self-directed cognitive training is feasible for spousal caregivers of dementia patients. The mean usage of the APVSAT was 42 (SD = 28.58). Performance increased from the beginning to the end of the trial, and usage was not affected by stress, worry, or poor sleep quality., Conclusion: Findings suggest the potential utility of cognitive training via handheld computer for spousal caregivers of dementia patients to improve problem solving, coping and adaptation, planning, and persevering with goal-directed tasks.

Objective: To analyse life-threatening obstetric complications that occurred in public hospitals in Argentina., Design: Multicentre collaborative cross-sectional study., Setting: Twenty-five hospitals included in the Perinatal Network of Buenos Aires Metropolitan Area., Population: Women giving birth in participating hospitals during a 1-year period., Methods: All cases of severe maternal morbidity (SMM) and maternal mortality (MM) during pregnancy (including miscarriage and induced abortion), labour and puerperium were included. Data were collected prospectively., Main Outcome Measures: Identification criteria, main causes and incidence of SMM; case-fatality rates, morbidity-mortality index and effective intervention's use rate., Results: A total of 552 women with life-threatening conditions were identified: 518 with SMM, 34 with MM. Identification criteria for SMM were case-management (48.9%), organ dysfunction (15.2%) and mixed criteria (35.9%). Incidence of SMM was 0.8% (95% confidence interval [95% CI] 0.73-0.87%) and hospital maternal death ratio was 52.3 per 100 000 live births (95% CI 35.5-69.1). Main causes of MM were abortion complications and puerperal sepsis; main causes of SMM were postpartum haemorrhage and hypertension. Overall case-fatality rate was 6.2% (95% CI 4.4-8.6): the highest due to sepsis (14.8%) and abortion complications (13.3%). Morbidity-mortality index was 15:1 (95% CI 7.5-30.8). Use rate of known effective interventions to prevent or treat main causes of MM and SMM was 52.3% (95% CI 46.9-57.7)., Conclusions: This study describes the importance of life-threatening obstetric complications that took place in public hospitals with comprehensive obstetric care and the low utilisation of known effective interventions that may decrease rates of SMM and MM. It also provides arguments that justify the need to develop a surveillance system for SMM., (© 2013 RCOG.)

Objective: Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life., Methods: One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10 mg/d of open-label escitalopram and were divided into full (n = 55; 31%), partial (n = 75; 42.9%), and non-responder (n = 45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups., Results: Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks., Conclusion: Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment., (Copyright 2007 John Wiley & Sons, Ltd.)

This study evaluated a novel intervention for older osteoarthritis (OA) patients and their spousal caregivers that consisted of standard patient education supplemented by information related to effectively managing arthritis as a couple. Twenty-four female OA patients and their husbands were randomly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient. Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention. In addition, patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms. The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life.

Provision of care to an older adult with dementia is an important societal resource. This resource may also come at a high cost to informal caregivers, most of whom are family members. In this paper we provide an overview of recent research on dementia caregiving and caregiver interventions. First, we provide background information on the prevalence and costs of Alzheimer's disease and related disorders. Second, we describe the specific stressors and broader mental and physical health outcomes of dementia caregiving. Third, recent evidence of the efficacy of caregiver interventions for both caregiver and patient outcomes is reviewed. Throughout the paper, we describe promising new directions for future research in this area, including assessment and intervention with family caregivers of older patients with comorbid dementia and depression, and the focus on sleep disturbance as a critical health consequence of dementia caregiving.

Background: Prior research suggests that elderly patients are less likely to respond to antidepressant treatment if they have low self-rated health. However, successful treatment for depression has been associated with improvement in self-rated health and other health measures., Objectives: To examine measures of self-rated health, physical disability, and social function as predictors of treatment response in late-life depression, and to assess these same health measures as treatment outcomes. We hypothesized that greater impairment in these measures would predict poorer treatment response, and that these measures would show significant improvements with recovery from depression., Method: Subjects were enrolled in a depression intervention study for people aged 60 and older with recurrent unipolar major depression; they were assessed with measures of self-rated health, physical disability, and social functioning at baseline and at the end of treatment. Baseline measures were compared between the 88 remitters, 11 non-remitters, and seven dropouts. Additionally, changes in the measures were examined in subjects who recovered from the index depressive episode., Results: Subjects with poorer self-rated health at baseline were more likely both to drop out of treatment and to not respond to adequate treatment. This relationship was independent of demographic measures, severity of depression, physical and social functioning, medical illness, personality, hopelessness, overall medication use, and side effects or non-compliance with treatment., Conclusion: Although this finding is preliminary because of the small number of dropouts and non-remitters, it suggests that lower self-rated health may independently predict premature discontinuation of treatment for depression. Additionally, subjects who recovered from depression showed significant improvements in self-rated health, physical disability, and social functioning., (Copyright 2001 John Wiley & Sons, Ltd.)

Depression and anxiety disorders are associated with excess disability. The authors searched the recent geriatric literature for studies associating late-life depression or anxiety with physical disability. Studies showed depression in old age to be an independent risk factor for disability; similarly, disability was found to be a risk factor for depression. Anxiety in late life was also found to be a risk factor for disability, although not necessarily independently of depression. Increased disability due to depression is only partly explained by differences in socioeconomic measures, medical conditions, and cognition. Physical disability improves with treatment for depression; comparable studies have not been done for anxiety. The authors discuss how these findings inform current concepts of physical disability and discuss the implications for future intervention studies of late-life depression and anxiety disorders.

This study examined interrole conflict experienced by 278 women who simultaneously occupied 4 roles: parent care provider, mother to children at home, wife, and employee. Compared with women who experienced no conflict between parent care and their other roles, women reporting parent care conflict tended to have fewer socio-economic resources, to have older children, and to be caring for parents with greater impairment. Women who reported conflicts between parent care and employment were older; had more education; had marriages of longer duration; and had older, more self-sufficient children than women who reported conflict between the parent care role and the mother role. Some evidence was found for the hypothesis that interrole conflict between parent care and other roles mediates the relationship between parent care stress and psychosocial well-being. Results suggest that one way parent care stress exerts its deleterious effects on the well-being of adult daughters is through the incompatible pressures of parent care and other roles.

Background: Studies of the association between depressive symptoms and mortality in elderly populations have yielded contradictory findings. To address these discrepancies, we test this association using the most extensive array of sociodemographic and physical health control variables ever studied, to our knowledge, in a large population-based sample of elderly individuals., Objective: To examine the relation between baseline depressive symptoms and 6-year all-cause mortality in older persons, systematically controlling for sociodemographic factors, clinical disease, subclinical disease, and health risk factors., Methods: A total of 5201 men and women aged 65 years and older from 4 US communities participated in the study. Depressive symptoms and 4 categories of covariates were assessed at baseline. The primary outcome measure was 6-year mortality., Results: Of the 5201 participants, 984 (18.9%) died within 6 years. High baseline depressive symptoms were associated with a higher mortality rate (23.9%) than low baseline depression scores (17.7%) (unadjusted relative risk [RR], 1.41; 95% confidence interval [CI], 1.22-1.63). Depression was also an independent predictor of mortality when controlling for sociodemographic factors (RR, 1.43; 95% CI, 1.23-1.66), prevalent clinical disease (RR, 1.25; 95% CI, 1.07-1.45), subclinical disease indicators (RR, 1.35; 95% CI, 1.15-1.58), or biological or behavioral risk factors (RR, 1.42; 95% CI, 1.22-1.65). When the best predictors from all 4 classes of variables were included as covariates, high depressive symptoms remained an independent predictor of mortality (RR, 1.24; 95% CI, 1.06-1.46)., Conclusions: High levels of depressive symptoms are an independent risk factor for mortality in community-residing older adults. Motivational depletion may be a key underlying mechanism for the depression-mortality effect.

Objectives: The aim of this study was to examine the degree of individual change in structural indicators of social support (family network contact and close friend network contact) and functional indicators of social support (belonging, appraisal, and tangible support) during late life., Methods: Using a large population-based sample of older adults, hierarchical linear modeling was applied to examine the extent of change in social contact and support as well as sociodemographic characteristics (age, race, gender, and education) that might explain individual variability in contact and support at baseline and over time., Results: Consistent with predictions, small yet significant increases were observed in belonging support and tangible support. Contrary to predictions, no evidence was found for significant individual change in family network contact, close friend network contact, or appraisal support. Sociodemographic characteristics were more consistent predictors of variability in contact and support at baseline than variability over time., Discussion: The findings of this study add to a growing literature suggesting that late life is not typically characterized by a decline in important social resources.

This study applied theory from the general work and family literature to the dual roles of work and caregiving, in order to examine whether level of satisfaction and time involvement in each of these roles moderate the effects of stress in the other role on well-being. Respondents were 118 employed women who were providing care to an impaired parent or parent-in-law. As predicted, greater time involvement in work was found to buffer women from the negative effects of caregiving stress. Satisfaction with caregiving and satisfaction with work were directly associated with better well-being, beyond the effects of stress in both roles. However, women who experienced high levels of caregiving stress and who were highly satisfied with work were especially vulnerable to depression. These findings illustrate the importance of examining the effects of caregiving stress on well-being in the context of work-related experiences.