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The ESP Coordinating Center (ESP CC) is responding to a request from VA Health Services Research and Development Service (HSR&D) for an evidence brief on patient outcomes following long-term opioid dose reduction or discontinuation. Findings from this evidence brief will be used to inform prioritization of questions for a State-of-the-Art conference in September 2019.

Advance care planning. --- Caregiver.

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The book 'Dementia and Learning: The Use of Tablet Computers in Joint Activities' by Elias Ingebrand explores the potential for novel learning in individuals living with dementia, with a particular focus on the use of tablet computers. The author challenges the negative presumptions about people with dementia being incapable of learning, showcasing how, over time, dementia patients can familiarize themselves with new technology and participate in joint activities. The book emphasizes the importance of social interaction and collaborative efforts in facilitating learning in dementia patients, highlighting how caregivers and peers can provide effective support. The research findings underscore the potential for dementia patients to actively engage, contribute, and learn in their everyday lives.

Dementia. --- Gerontechnology. --- Medical personnel-caregiver relationships. --- Dementia --- Gerontechnology --- Medical personnel-caregiver relationships

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Parents play a crucial role in the promotion of early childhood development, and understanding parental perceptions of early childhood development may help enhance parental investments early in life. To explore this question, caregivers were asked to rank their child's intelligence in comparison with other children in the community, and the rankings were compared with children's scores on an assessment of developmental abilities across multiple domains. Using cross-sectional data on children ages 16-42 months in rural Madagascar, this paper documents the discordance between caregivers' perceived early childhood development with an interviewer-based measure of early childhood development. The paper examines the determinants of caregivers' under- and over-estimation of child development using multinomial logistic regressions. The study finds that caregiver perceptions of early childhood development in Madagascar do not align consistently with an interviewer-based measure. Approximately 8 percent of the caregivers under-estimated and almost 50 percent over-estimated their children's abilities. Better child nutritional status, caregivers with a greater belief in their influence on child intelligence, and higher socioeconomic status were associated with lower odds of under- or over-estimation of early childhood development. Further research is needed to understand the common cues that caregivers use to identify child development milestones, to inform the design of parenting interventions.

Caregiver Perceptions --- Early Child Development --- Early Childhood Development --- Education

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Patient Education as Topic. --- Caregivers. --- Geriatrics. --- Gerontology --- Care Givers --- Carers --- Family Caregivers --- Spouse Caregivers --- Care Giver --- Caregiver --- Caregiver, Family --- Caregiver, Spouse --- Caregivers, Family --- Caregivers, Spouse --- Carer --- Family Caregiver --- Spouse Caregiver --- Education, Patient --- Education of Patients --- Patient Education --- Patients --- Patient Participation --- Health Literacy --- education --- Caregiver Burden

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The number of older subjects is rapidly increasingly worldwide. As a consequence, the nature of clinical conditions is also changing. Traditional medicine and models of care have been based on the evaluation and treatment of single and usually acute conditions occurring in relatively young individuals. Today, the usual clinical manifestation of diseases is characterized by multiple and often chronic conditions affecting older people. In this scenario, frailty and dementia have been triggering special interest both in research and clinical settings due to their high prevalence, impact on the individual’s quality of life, and consequences for public health worldwide. These conditions aptly reflect the complexity of age-related pathological conditions, finding as causal factor a myriad of heterogeneous, interacting, and often still unclear pathophysiological processes. Indeed, their study is strongly affected by the difficulty to differentiate the effects of a normal aging process from eventual pathological deviations of the underlying systems. Their occurrence and trajectories over time are strongly affected by a wide array of factors and determinants that can be hardly attributed to the deficit/involvement of single biological systems and/or health domains. Moreover, environment and social factors also play a key role in the determination of phenotypes. The present Research Topic is aimed at widening our understanding of the frailty and dementia phenomena occurring with aging, in order to improve the clinical and public health approaches to these burdening conditions.

Dementia. --- Aging --- Psychological aspects. --- cognition --- caregiver --- Frailty --- dementia --- mild cognitive impairment --- aging --- cognitive frailty --- Alzheimer