Engagement in social and leisure activities is an indicator of quality of life and well-being in nursing homes. There are few studies in which nursing home residents with dementia self-reported their experiences in activity engagement. This qualitative study describes types of current activity involvement and barriers to activities as perceived by nursing home residents with dementia. Thirty-one residents participated in short, open-ended interviews and six in in-depth interviews. Thematic content analysis showed that participants primarily depended on activities organized by their nursing homes. Few participants engaged in self-directed activities such as walking, visiting other residents and family members, and attending church services. Many residents felt they had limited opportunities and motivation for activities. They missed past hobbies greatly but could not continue them due to lack of accommodation and limitation in physical function. Environmental factors, along with a fixed activity schedule, further prevented them from engaging in activities. Residents with dementia should be invited to participate in activity planning and have necessary assistance and accommodation in order to engage in activities that matter to them. Based on the findings, a checklist for individualizing and evaluating activities for persons with dementia is detailed.

This study examines race- and income-based disparities in cancer risks from air toxics in Cancer Alley, LA, USA. Risk estimates were obtained from the 2005 National Air Toxics Assessment and socioeconomic and race data from the 2005 American Community Survey, both at the census tract level. Disparities were assessed using spatially weighted ordinary least squares (OLS) regression and quantile regression (QR) for five major air toxics, each with cancer risk greater than 10⁻⁶. Spatial OLS results showed that disparities in cancer risks were significant: People in low-income tracts bore a cumulative risk 12% more than those in high-income tracts (p < 0.05), and those in black-dominant areas 16% more than in white-dominant areas (p < 0.01). Formaldehyde and benzene were the two largest contributors to the disparities. Contributions from emission sources to disparities varied by compound. Spatial QR analyses showed that magnitude of disparity became larger at the high end of exposure range, indicating worsened disparity in the poorest and most highly concentrated black areas. Cancer risk of air toxics not only disproportionately affects socioeconomically disadvantaged and racial minority communities, but there is a gradient effect within these groups with poorer and higher minority concentrated segments being more affected than their counterparts. Risk reduction strategies should target emission sources, risk driver chemicals, and especially the disadvantaged neighborhoods.

To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category–other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse.

Aims: The aim of this study was to explore perspectives on motivations for treatment engagement from substance use disorder (SUD) clients in a long-term residential rehabilitation program. Design and Methods: A convenience sample of 30 clients who were enrolled in a year-long SUD treatment program at a residential rehabilitation facility took part in in-depth interviews. Interview transcripts were analyzed using the directed content analysis approach. Results: Participant accounts indicated that their treatment engagement was motivated by factors that aligned with the six primary constructs of the Health Belief Model: (i) perceived susceptibility (eg, believing that their substance use required intervention and that they were prone to relapse), (ii) perceived severity (eg, substance use negatively impacted their health and harmed their close relationships), (iii) perceived benefits (eg, opportunities for a better life, reconnecting with family members and close friends, & avoiding legal consequences), (iv) perceived barriers (eg, the length of the treatment program), (v) cues to actions (eg, decisive moments, elements of the treatment program, & faith and spirituality), and (vi) self-efficacy in remaining abstinent (eg, treatment program provided them with skills and experiences to maintain long-term sobriety). Discussion: Our analysis indicates that participants’ treatment engagement was linked to their beliefs regarding the severity of their substance use disorder, their treatment program’s ability to help them avoid future relapse, and their own capability to act upon the strategies and resources provided by the treatment program. A theoretical understanding of these aspects can contribute to the future planning of precision interventions.