BACKGROUND:It is well documented that many adults with intellectual disabilities live with ageing parents, often without concrete plans for transitioning to alternative living arrangements. Little is known about transition experiences once they occur. This study explores the experiences of adults with intellectual disabilities and their family members of this transition through a relational lens. METHOD:Semi-structured interviews were conducted with 25 people: 8 adults with intellectual disabilities, 13 parents, and 4 siblings. RESULTS:Three themes were constructed from the data: 'Gaining independence and letting go', 'negotiating unfamiliar relationships' and 'social inclusion and making new connections.' CONCLUSION:Adults with intellectual disabilities discussed numerous benefits associated with moving out of the family home, including increased autonomy and opportunities for new relationships. Family members also described benefits of the transition, but some grappled with needing to 'let go' whilst at the same time retaining some degree of control over their family members' lives.

As people age, they often need home modifications to remain living in the community. This review sought to identify outcomes from home modifications for adults aged ≥50 years living in the community and their family carers. Peer-reviewed literature was reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Five databases were search (Ageline, CINAHL, Emcare, Medline, Scopus) from 2011 to 2023. N = 38 articles meeting the criteria. Sixteen outcomes were identified (14 positive, two negative) including reduction in falls and falls risk and enhanced quality of life. In addition, five outcomes for family carers were identified (all positive). Only four studies reported costs of home modifications installed. Home modifications can provide substantial benefit to adults aged ≥50 years, supporting their independence and allowing them to remain in their own home.

How people experience their own ageing may impact how likely they are to remain engaged with life. This study examined (1) biologically based risk factors in the form of self-reported health and cognition, and (2) age-related stereotypes and frequency of perceived ageism as predictors of engagement with life and number of ‘close’ social connections in older adulthood. We aimed to move beyond studies focusing on direct links between ageism and psychosocial functioning by examining the extent to which ageism could act as a moderating factor, amplifying negative associations between established risk factors and engagement with life. Data were obtained from a community-based sample of 287 South Australians aged 65–103 years ( M = 76.41, SD = 7.13; 54.4 per cent female) who participated in a telephone survey. Hierarchical multiple linear regressions were run using Stata v15.1. Overall, frequency of perceived ageism in this community sample was low. More positive age-related stereotypes were related to more ‘close’ social connections, but not greater engagement with life. Counter to expectations, an interaction of frequency of perceived ageism with health indicated that higher engagement with life was associated with more frequent perceived ageism, but only among those in poorer health. No other moderating effects were observed. The findings are discussed in terms of possible underlying mechanisms linking ageism, stereotypes and engagement, including the likelihood that our results in part reflect reverse causality, with those with both greater physical limitations and who remain broadly engaged being at greater risk of experiencing ageism.

Dementia is a global health issue. For adults with intellectual disabilities living with dementia, diagnosis and support pose unique challenges. For those who reside in shared disability supported accommodation (group homes), there are additional considerations regarding support and ageing in place. Semi-structured interviews with twelve staff from three disability service providers in Australia were conducted to explore the experiences of disability service providers supporting adults with intellectual disabilities and dementia. The study found that delays in diagnosis hampered timely and effective interventions and, consequently, the care and support received by those adults with intellectual disabilities living with dementia. This impacted organisations’ ability to adequately staff accommodation and remunerate disability support workers. This had implications for those in group homes, where the needs of other residents were affected. Lastly, while ageing in place was considered desirable, none of the provider organisations had guidelines for remaining in the home. This study highlights the need for further investigation into this growing population, including those living in the community.

Renting a privately owned home in Australia is becoming more common; however, tenants often experience short-term leases, high rent and housing stress, and as a consequence unstable housing. Mid-life is a time when women, in particular, experience significant social change, and many rent in the private rental sector. Yet little is known about the experiences of single mid-life women living in private rental accommodation. This study draws on face-to-face semi-structured interviews with 14 single mid-life (40-65 years) women living in private rental housing in Australia to gain insights into their experiences and the potential housing implications for older age. Applying a Bourdieusian analysis alongside markers of precarity, we identified three descriptions of private rental housing experiences, as well as three social structures that impacted the collective experiences of the women. We make policy recommendations aimed at addressing housing precarity broadly, and specifically for women in mid-life.

Background Non-proliferative and proliferative diabetic retinopathy are common complications of diabetes and a major cause of sight loss. Anti-vascular endothelial growth factor drugs represent a treatment option for people with diabetic retinopathy and are routinely used to treat various other eye conditions. However, anti-vascular endothelial growth factor drugs are expensive relative to current care options, and it is unclear whether this additional cost is justified when the immediate risk of vision loss is lower compared to patients with more aggressive ophthalmological conditions. Objective To systematically review the evidence supporting the cost-effectiveness of alternative treatments for diabetic retinopathy. Methods A systematic review of all comparative cost-effectiveness studies evaluating any treatment for diabetic retinopathy was conducted. Bibliographic searches were carried out to identify studies reporting on the cost-effectiveness of treatments for diabetic retinopathy; the latest searches were conducted on 28 April 2023. Included studies were synthesised narratively and evaluated with reference to UK decision-making. Studies were grouped by population into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Results The review identified five studies in the proliferative diabetic retinopathy population, all of which examined the cost-effectiveness of anti-vascular endothelial growth factor treatments compared to pan-retinal photocoagulation. Results of these studies suggest that anti-vascular endothelial growth factor treatments offer some additional benefits in terms of preserved visual acuity but also incur substantial additional costs relative to pan-retinal photocoagulation. Most authors agreed that the additional costs outweigh the limited benefits, especially in certain patient subgroups without pre-existing oedema. As most of the identified evidence considered a US perspective, it is unclear how these results would translate to a UK setting. Two studies were identified in the non-proliferative diabetic retinopathy population. There was limited evidence to support the early use of anti-vascular endothelial growth factor treatment. However, one UK study suggested that early treatment of non-proliferative diabetic retinopathy with pan-retinal photocoagulation is cost-effective compared to delayed pan-retinal photocoagulation. Conclusions Overall, there is a dearth of cost-effectiveness evidence considering the UK context. The identified studies raised doubts about the cost-effectiveness of anti-vascular endothelial growth factor treatments for proliferative diabetic retinopathy. No conclusions can be made regarding the cost-effectiveness of anti-vascular endothelial growth factor treatments for non-proliferative diabetic retinopathy. Future research should focus on developing rigorous model-based cost-effectiveness analyses integrating all available evidence. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132948.

Background:Proliferative diabetic retinopathy is a major cause of sight loss in people with diabetes, with a high risk of vitreous haemorrhage, tractional retinal detachment and other complications. Panretinal photocoagulation is the primary established treatment for proliferative diabetic retinopathy. Anti-vascular endothelial growth factor drugs are used to treat various eye conditions and may be beneficial for people with proliferative diabetic retinopathy. Objective:To investigate the efficacy and safety of anti-vascular endothelial growth factor therapy for the treatment of proliferative diabetic retinopathy when compared to panretinal photocoagulation. Methods:A systematic review and network meta-analysis of randomised controlled trials comparing anti-vascular endothelial growth factor (alone or in combination) to panretinal photocoagulation in people with proliferative diabetic retinopathy. The database searches were updated in May 2023. Trials where the primary focus was treatment of macular oedema or vitreous haemorrhage were excluded. Key outcomes were best corrected visual acuity, diabetic macular oedema and vitreous haemorrhage. Individual participant data were obtained and analysed for three large, high-quality trials in combination with published data from other trials. Network meta-analyses of best corrected visual acuity and meta-analyses of other outcomes combined individual participant data with published data from other trials; regression analyses against patient covariates used just the individual participant data. Results:Twelve trials were included: one of aflibercept, five of bevacizumab and six of ranibizumab. Individual participant data were available from 1 aflibercept and 2 ranibizumab trials, representing 624 patients (33% of the total). When considered together, anti-vascular endothelial growth factors produced a modest, but not clinically meaningful, benefit over panretinal photocoagulation in best corrected visual acuity, after 1 year of follow-up (mean difference in logarithm of the minimum angle of resolution -0.116, 95% credible interval -0.183 to -0.038). There was no clear evidence of a difference in effectiveness between the anti-vascular endothelial growth factors. The benefit of anti-vascular endothelial growth factor appears to decline over time. Analysis of the individual participant data trials suggested that anti-vascular endothelial growth factor therapy may be more effective in people with poorer visual acuity, in those who have vitreous haemorrhage and, possibly, in people with poorer vision generally. Anti-vascular endothelial growth factor was superior to panretinal photocoagulation at preventing macular oedema after 1 year (relative risk 0.48, 95% confidence interval 0.28 to 0.83) and possibly at preventing vitreous haemorrhage (relative risk 0.72, 95% confidence interval 0.47 to 1.10). Anti-vascular endothelial growth factor reduced the incidence of retinal detachment when compared to panretinal photocoagulation (relative risk 0.41, 95% confidence interval 0.22 to 0.77). Data on other adverse events were generally too limited to identify any differences between anti-vascular endothelial growth factor and panretinal photocoagulation. Conclusions:Anti-vascular endothelial growth factor has no clinically meaningful benefit over panretinal photocoagulation for preserving visual acuity. However, anti-vascular endothelial growth factor therapy appears to delay or prevent progression to macular oedema and vitreous haemorrhage. The possibility that anti-vascular endothelial growth factor therapy may be more effective in patients with poorer health and poorer vision merits further clinical investigation. The long-term effectiveness and safety of anti-vascular endothelial growth factor treatment are unclear, particularly as additional panretinal photocoagulation and anti-vascular endothelial growth factor treatment will be required over time. Funding:This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132948.

Background:Diabetic retinopathy is a major cause of sight loss in people with diabetes. The most severe form, proliferative diabetic retinopathy, carries a high risk of vision loss, vitreous haemorrhage, macular oedema and other harms. Panretinal photocoagulation is the primary treatment for proliferative diabetic retinopathy. Anti-vascular endothelial growth factor drugs are used to treat various eye conditions and may be beneficial for people with diabetic retinopathy. Objective:To investigate the efficacy and safety of anti-vascular endothelial growth factor therapy for the treatment of diabetic retinopathy when compared to panretinal photocoagulation. Methods:A systematic review and network meta-analysis of all published randomised controlled trials comparing anti-vascular endothelial growth factor (alone or in combination with panretinal photocoagulation) to panretinal photocoagulation in people with diabetic retinopathy. The database searches were updated in May 2023. Trials where the primary focus was treatment of macular oedema or vitreous haemorrhage were excluded. Results:A total of 14 trials were included: 3 of aflibercept, 5 of bevacizumab and 6 of ranibizumab. Two trials were of patients with non-proliferative diabetic retinopathy; all others were in proliferative diabetic retinopathy. Overall, anti-vascular endothelial growth factor was slightly better than panretinal photocoagulation at preventing vision loss, measured as best corrected visual acuity, at up to 2 years follow-up [mean difference in the logarithm of the minimum angle of resolution -0.089 (or 3.6 Early Treatment Diabetic Retinopathy Study letters), 95% confidence interval -0.180 to -0.019]. There was no clear evidence of any difference between the anti-vascular endothelial growth factors, but the potential for bias complicated the comparison. One trial found no benefit of anti-vascular endothelial growth factor over panretinal photocoagulation after 5 years. Anti-vascular endothelial growth factor was superior to panretinal photocoagulation at preventing macular oedema (relative risk 0.29, 95% confidence interval 0.18 to 0.49) and vitreous haemorrhage (relative risk 0.77, 95% confidence interval 0.61 to 0.99). There was no clear evidence that the effectiveness of anti-vascular endothelial growth factor varied over time. Conclusions:Anti-vascular endothelial growth factor injections reduce vision loss when compared to panretinal photocoagulation, but the benefit is small and unlikely to be clinically meaningful. Anti-vascular endothelial growth factor may have greater benefits for preventing complications such as macular oedema. Observational studies extending follow-up beyond the 1-year duration of most trials are needed to investigate the longer-term effects of repeated anti-vascular endothelial growth factor injections. Funding:This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132948.

Housing and future planning have been key areas of interest in intellectual and development disabilities research for a number of decades. However, the voices of adults with intellectual disabilities are underrepresented in this area of research. Furthermore, the use of inclusive research methods remains limited in the literature. This study sought to pilot the use of inclusive research approaches to investigate the viability of these methods and to begin to build an evidence base of inclusive research in this area of work. Inclusive data analysis and co-authorship approaches were used on a small qualitative dataset from a larger study investigating future planning and transitions out of the family home by adults with intellectual disabilities and their families in Australia. Three semi-structured interviews with adults with intellectual disabilities and family members regarding their housing preferences and planning were analysed using an inclusive data analysis approach following the principles of Interpretative Phenomenological Analysis. These were then further analysed using a plain language version of the housing pathways framework. The results of the pilot study will be used to inform the inclusive research methods used for the remainder of the project dataset. Overall, the use of inclusive methods to pilot a conceptual model to better understand qualitative data was found to be feasible. Small adjustments to the process and accessibility to better support engagement with the research process are recommended. Lastly, greater investigation into co-authorship approaches and options is suggested as a fruitful avenue of inquiry for future research.

Previous research has indicated the suitability of behavioural activation (BA) as an intervention for reducing depression in older adults. However, little research has investigated the potential of BA to increase active engagement and well-being in older adults. The current pilot study sought to investigate the usefulness and acceptability of BA to promote well-being in a group of non-clinical older adults. Participants (N = 18) aged between 65 and 86 (M = 77.82, SD = 5.59) who were retired and living independently in the community were provided a 6-week BA program predominantly delivered online. Treatment retention, self-ratings, and participants’ compliance to treatment principles indicate preliminary feasibility for the use of BA as an approach for increasing active engagement in older adult populations. Participants also provided feedback on their experiences with the program post-intervention via individual structured interviews. Thematic analysis of these data revealed that participants found the program to be beneficial in terms of increased self-awareness and social engagement, and provided several recommendations for improving acceptability of the program and workbook. The unexpected events relating to the first wave of the novel coronavirus (COVID-19) led to necessary adaptations to delivery modalities, and provided the researchers with an opportunity to investigate the use of a structured well-being program on a high-risk population during a pandemic. Our findings support the proposition that BA is a suitable intervention for increasing engagement and well-being in older adults, provide insight into adapting programs for older adults, and suggest next steps for testing intervention efficacy.

OBJECTIVES:Self-compassion has been identified as a psychological resource for aging well. To date, self-compassion among older adults has typically been conceptualized as a trait variable. This study examined whether day-to-day (state) variability in self-compassion was associated with negative affective reactivity to daily stressors. METHODS:Daily diary assessment methods were used to examine the potential moderating role of between- and within-person self-compassion on the relationship between daily stressors and negative affect. A community-based sample of 107 older adults aged 65+ completed questionnaires once daily over 14 days. RESULTS:Multilevel modeling revealed that 37% of the variance in self-compassion occurred within persons. Daily self-compassion moderated the relationship between daily stressor exposure and daily negative affect. On days with greater stressor exposure than usual, older adults showed less negative affective reactivity on days when self-compassion was higher, compared with days when self-compassion was lower. No moderating effects were observed for between-person (trait) self-compassion. DISCUSSION:These findings suggest that self-compassion in older adults should be conceptualized as both state and trait variables and that state self-compassion may be protective in the stress-reactivity pathway. Future research should investigate whether brief self-compassion interventions might help older adults to avoid or downregulate negative emotions in response to stressors.

People with intellectual disability use social media; however, there are barriers preventing them from using and benefiting from social media to the same extent as others. Some barriers include lack of knowledge, limited skills and inaccessibility. This pilot study used a sequential mixed method design to explore the outcomes of a social media training program for adults with intellectual disability aimed at social media use and increased social networks of participants. Six participants (mean age 35.7 years) participated in training focused on cyber safety and support to use individualised social media use goals. The Canadian Occupational Performance Measure, Goal Attainment Scale, and Circles of Communication Partners tools were used to examine the outcomes of training and changes in the participants' social networks. Semi-structured interviews with participants and one staff member provided insight into participants' experiences and perceptions of training outcomes. Findings indicated that participants achieved some of their goals and communicated with more people online after training compared to before training. Preliminary outcomes suggest that social media use training may assist adults with intellectual disability to strengthen social connections, gain digital literacy skills, and increase self-confidence online. Further research is needed with a larger sample, including a control group.

Objectives: This study aimed to evaluate the cost-effectiveness of anti-vascular endothelial growth factor drugs (anti-VEGFs) compared with panretinal photocoagulation (PRP) for treating proliferative diabetic retinopathy (PDR) in the United Kingdom. Methods: A discrete event simulation model was developed, informed by individual participant data meta -analysis. The model captures treatment effects on best corrected visual acuity in both eyes, and the occurrence of diabetic macular edema and vitreous hemorrhage. The model also estimates the value of undertaking further research to resolve decision uncertainty. Results: Anti-VEGFs are unlikely to generate clinically meaningful benefits over PRP. The model predicted anti-VEGFs be more costly and similarly effective as PRP, generating 0.029 fewer qualityadjusted life -years at an additional cost of 3688 pound, with a net health benefit of 20.214 at a 20 pound 000 willingness -to -pay threshold. Scenario analysis results suggest that only under very select conditions may anti-VEGFs offer potential for cost-effective treatment of PDR. The consequences of loss to follow-up were an important driver of model outcomes. Conclusions: Anti-VEGFs are unlikely to be a cost-effective treatment for early PDR compared with PRP. Anti-VEGFs are generally associated with higher costs and similar health outcomes across various scenarios. Although anti-VEGFs were associated with lower diabetic macular edema rates, the number of cases avoided is insufficient to offset the additional treatment costs. Key uncertainties relate to the long-term comparative effectiveness of anti-VEGFs, particularly considering the real -world rates and consequences of treatment nonadherence. Further research on long-term visual acuity and rates of vision -threatening complications may be beneficial in resolving uncertainties.

Background Magnetic resonance imaging localises cancer in the prostate, allowing for a targeted biopsy with or without transrectal ultrasound-guided systematic biopsy. Targeted biopsy methods include cognitive fusion, where prostate lesions suspicious on magnetic resonance imaging are targeted visually during live ultrasound, and software fusion, where computer software overlays the magnetic resonance imaging image onto the ultrasound in real time. The effectiveness and cost-effectiveness of software fusion technologies compared with cognitive fusion biopsy are uncertain. Objectives To assess the clinical and cost-effectiveness of software fusion biopsy technologies in people with suspected localised and locally advanced prostate cancer. A systematic review was conducted to evaluate the diagnostic accuracy, clinical efficacy and practical implementation of nine software fusion devices compared to cognitive fusion biopsies, and with each other, in people with suspected prostate cancer. Comprehensive searches including MEDLINE, and Embase were conducted up to August 2022 to identify studies which compared software fusion and cognitive fusion biopsies in people with suspected prostate cancer. Risk of bias was assessed with quality assessment of diagnostic accuracy studies-comparative tool. A network meta-analysis comparing software and cognitive fusion with or without concomitant systematic biopsy, and systematic biopsy alone was conducted. Additional outcomes, including safety and usability, were synthesised narratively. A de novo decision model was developed to estimate the cost-effectiveness of targeted software fusion biopsy relative to cognitive fusion biopsy with or without concomitant systematic biopsy for prostate cancer identification in biopsy-naive people. Scenario analyses were undertaken to explore the robustness of the results to variation in the model data sources and alternative assumptions. Results Twenty-three studies (3773 patients with software fusion, 2154 cognitive fusion) were included, of which 13 informed the main meta-analyses. Evidence was available for seven of the nine fusion devices specified in the protocol and at high risk of bias. The meta-analyses show that patients undergoing software fusion biopsy may have: (1) a lower probability of being classified as not having cancer, (2) similar probability of being classified as having non-clinically significant cancer (International Society of Urological Pathology grade 1) and (3) higher probability of being classified at higher International Society of Urological Pathology grades, particularly International Society of Urological Pathology 2. Similar results were obtained when comparing between same biopsy methods where both were combined with systematic biopsy. Evidence was insufficient to conclude whether any individual devices were superior to cognitive fusion, or whether some software fusion technologies were superior to others. Uncertainty in the relative diagnostic accuracy of software fusion versus cognitive fusion reduce the strength of any statements on its cost-effectiveness. The economic analysis suggests incremental cost-effectiveness ratios for software fusion biopsy versus cognitive fusion are within the bounds of cost-effectiveness (£1826 and £5623 per additional quality-adjusted life-year with or with concomitant systematic biopsy, respectively), but this finding needs cautious interpretation. Limitations There was insufficient evidence to explore the impact of effect modifiers. Conclusions Software fusion biopsies may be associated with increased cancer detection in relation to cognitive fusion biopsies, but the evidence is at high risk of bias. Sufficiently powered, high-quality studies are required. Cost-effectiveness results should be interpreted with caution given the limitations of the diagnostic accuracy evidence. Study registration This trial is registered as PROSPERO CRD42022329259. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: 135477) and is published in full in Health Technology Assessment; Vol. 28, No. 61. See the NIHR Funding and Awards website for further information.

Sexual grooming, exacerbated by increased internet and social media usage , is a growing concern. Past researchers have found differences in perceptions of sexual grooming based on gender-pairing, perpetrator attractiveness, as well as perpetrator and victim age and gender. Our study extends this research by exploring how the attractiveness of the perpetrator and their relationship to the victim - specifically, whether they are a teacher, religious leader, or family friend - affects perceived grooming severity and recommended legal response. Contrary to expectations, relationship type, but not attractiveness, impacted perceptions. Vignettes involving family friends were perceived as less harmful compared to those involving teachers or religious leaders, highlighting nuanced responses based on the perpetrator's role. These findings suggest that grooming perceptions are heavily influenced by the nature of the relationship rather than the attractiveness of the perpetrator, indicating a need for policies and educational initiatives that address these complexities to enhance the detection and prevention of sexual grooming.

Quality of life is a critically important outcome measure in aged care. However, few studies have provided a detailed examination of what quality of life means to older adults living in residential care. In the current study, N = 43 older adults (67 to 99 years) living in six residential aged care facilities in four Australian states took part in semi-structured interviews. Participants had normal cognition through to mild /moderate cognitive impairment as measured by the PAS-Cog, were able to provide informed consent, and could participate in an interview conducted in English. Interviews were transcribed, and data was analyzed in NVivo using thematic analysis. Both physical and psycho-social aspects were identified as important for older adults' quality of life with six key quality of life domains identified: independence, mobility, pain management, social connections, emotional well-being, and activities. More research is needed to test these domains with a more diverse sample of older adults living in residential aged care, in particular older adults from culturally and linguistically diverse communities. Such qualitative work is essential for the development of suitable quality of life measures for this population and provides valuable information to inform improvements to care practices and service provision. Some ways in which the identified quality of life domains could be used to enhance care provision are discussed.

The current study focuses on the potential benefits of intergenerational dialogue, which broadly refers to the sharing of experience, values, and knowledge between members of different generations through conversation. To investigate the benefits of intergenerational dialogue for young adults, college students partnered with older adults to engage in two semi-structured conversations. Students completed three reflections along with the dialogue sessions. After conducting a thematic analysis of student reflections, we found they reported themes of relationship building, character building, hearing older adults' stories, enjoyable experience, and perceived intergenerativity. Results from this study highlight some of the immediate and integrative benefits of intergenerational dialogue.

INTRODUCTION:Engagement with life is central to aging well. There is currently a lack of flexible programs for promoting engagement that tailor to the unique interests, capacities, and life circumstances of individuals. We designed and evaluated a new program for promoting engagement with later life based on principles of behavioral activation. METHODS:A total of 135 adults aged 65 years and older who scored at or below the median on the Life Engagement Test were randomly assigned to either a 6-week behavioral activation program (n = 69) or a 6-week well-being program based on brief positive psychology interventions (the active control; n = 66). Participants completed assessments at baseline, 1-week follow-up, and 3-month follow-up. The primary outcome was engagement with life, and secondary outcome measures included social network characteristics, measures of mental health, well-being, and psychological and self-regulatory resources. RESULTS:Participants in both conditions showed improvements in engagement with life post-intervention that were sustained at 3 months. Post-intervention improvements in both conditions were observed across most secondary outcomes; however, for several outcomes, participants with more limited functional and cognitive resources benefitted from participation in the positive psychology (active control) condition, but not the treatment condition. CONCLUSION:Similar levels of improvement in engagement with life and well-being were evident for participants who completed a behavioral activation-focused intervention, compared with participants who completed a positive psychology-focused intervention. The positive psychology approach may confer greater benefits for emotional well-being among those with poorer functional and cognitive abilities.

This qualitative exploratory study provides insight into experiences of end-of-life care for adults with long-standing physical disability from the perspectives of bereaved family members. The challenges and positives for their family member at end of life, as well as their own support needs were explored. In-depth semi-structured interviews were conducted with four family members: three mothers and a sister. Three themes were constructed from the data: Firstly, the need for a 'united front', regarding the importance of supportive relationships and communication between professionals and family members. Secondly, issues around responsibilities for care leading to fragmented care and skill gaps in professionals working at the intersection of disability and end-of-life care, and thirdly, advocacy and having a voice, regarding the need for professionals to recognise and value the important role of family members. These findings underscore the necessity for further research to understand the needs of this cohort and their families.Points of interestLittle is known about the experiences of individuals with long-standing physical disability at end of life.This study used a qualitative methodology to investigate the experiences of individuals with long-standing physical disability at end of life, through talking to their bereaved family carers.The findings suggest that regardless of where end-of-life care takes place, the type of disability or the age of the person, what is important is the way care is provided.Family carers valued open and clear communication between health professionals, themselves, and their family member with disability, coordinated care provided by skilled staff, and care in which they feel their role is included and valued.

Introduction: In an increasingly diverse world, there has been a call for psychology educators to make efforts to integrate diversity into the psychology curriculum. Statement of the Problem: Researchers who have surveyed psychology faculty have found the amount of time devoted to diversity content in nondiversity-focused courses is limited, with faculty citing barriers to integration such as a lack of relevance and time constraints. Literature Review: Educators who have worked to incorporate diversity topics into their courses have found positive outcomes. Teaching Implications: We describe our approach to integrating diversity into an introductory statistics course, highlight lessons learned, and provide special considerations for psychology educators. Conclusion: Integrating diversity-related content into statistics is challenging; however, the effort is worth it, particularly if integrating diversity content into required courses may be the only exposure to diversity students get.