Prosocial activities, such as volunteering, predict better mental and physical health in late adulthood, but their proximal links to well-being in daily life are largely unknown. The current study examined day-to-day associations of prosocial activities with emotional and physical well-being, and whether these associations differ with age. We used daily diary data from the National Study of Daily Experiences (NSDE) II (n ϭ 2,016; ages 33-84) and NSDE Refresher Study (n ϭ 774; ages 25-75). Participants completed telephone interviews on 8 consecutive evenings regarding their prosocial activities (formal volunteering, providing unpaid assistance, providing emotional support), well-being (negative affect, stressors, positive events), and physical symptoms. On days when individuals participated in more formal volunteering or provided more unpaid assistance than usual, they experienced more stressors and positive events but no difference in the number of physical symptoms. Negative affect was reduced on volunteering days for older adults but increased for younger adults (NSDE Refresher). Providing emotional support was associated with higher same-day negative affect, more stressors, more positive events, and elevated physical symptoms. Compared to younger and middle-aged adults, older adults experienced less of an increase in stressors and positive events (NSDE II) and negative affect (NSDE Refresher) on days when they provided more emotional support than usual. These findings demonstrate that prosocial activities are associated with both costs (negative affect, stressors, physical symptoms) and benefits (positive events) for same-day well-being. Older age may protect against negative ramifications associated with prosocial activities.

OBJECTIVES: To increase the number of essential consult elements (ECEs) included in initial inpatient consultation requests between pediatric residents and fellows through implementation of a novel consult communication tool. METHODS: Literature review and previous needs assessment of pediatric residents and fellows were used to identify 4 specific ECEs. From February to June 2018, fellows audited verbal consult requests at a medium-sized, quaternary care children’s hospital to determine the baseline percentage of ECE components within consults. A novel consult communication tool containing all ECEs was then developed by using a modified situation-background-assessment-recommendation (SBAR) format. The SBAR tool was implemented over 3 plan-do-study-act cycles. Adherence to SBAR, inclusion of ECEs, and consult question clarity were tracked via audits of consult requests. A pre- and postintervention survey of residents and fellows was used to examine perceived miscommunication and patient care errors and overall satisfaction. RESULTS: The median percentage of consults containing ≥3 ECEs increased from 50% preintervention to 100% postintervention with consult question clarity increasing from 52% to 92% (P < .001). Overall perception of consult miscommunication frequency decreased (52% vs 18%; P < .01), although there was no significant change in resident- or fellow-reported patient errors. SBAR maintained residents’ already high consult satisfaction (96% vs 92%; P = .39) and increased fellows’ consult satisfaction (51% vs 91%; P < .001). CONCLUSIONS: Implementation of a standardized consult communication tool resulted in increased inclusion of ECEs. Use of the tool led to greater consult question clarity, decreased perceived miscommunication, and improved overall consult satisfaction.

ACC/AHA guidelines recommend a structured preparation for and transfer to adult-oriented cardiac care for adult survivors of pediatric onset heart disease (POHD). Given this, we sought to describe the transition and transfer practices for a cohort of young adults with POHD and to determine factors associated with successful transfer to adult-oriented cardiac care. We performed a single-center, retrospective chart review on patients ≥18 years of age, with POHD likely to require lifelong cardiac care, who were seen in outpatient pediatric cardiology (PC) between 2008 and 2011. Successful transfer was defined as the subsequent attendance at adult cardiology (AC) within 2 years of PC visit. We identified 118 patients who met study criteria. Mean age 22.4 ± 2.0 years, 59 % male, 64 % white and 40 % Hispanic. Mean transition education topics noted was 3.3 ± 1.8 out of 20 and covered the underlying cardiac disease (89 %), follow-up and current medications (56 %) and exercise limitations (34 %). Recommendations for follow-up were AC (57 %) and PC (33 %). Of those told to transfer to AC, 79 % successfully transferred. Characteristics of successful transfer included: prior cardiac surgery (p = 0.008), cardiac medication use (p = 0.006) and frequency of follow-up ≤1 year (p = 0.037). One-quarter of all subjects did not follow-up within at least 2 years. Despite published guidelines, transition education appears lacking and the approach to transfer to adult cardiac care is not consistent. Given the increased risk of morbidity and mortality in this patient population, standardization of transition education and transfer processes appear warranted.

With the increasing availability of integrated PET/MR scans the utility and need for MR contrast agents for combined scans is questioned. The purpose of our study was to evaluate if the administration of gadolinium chelates is necessary for evaluation of pediatric tumors on 18F-FDG-PET/MR scans. Methods First, we compared the diagnostic accuracy of pre-contrast T2-weighted fast spin echo (FSE), diffusion-weighted imaging (DWI) and T1-weighted MR scans with post-contrast gadolinium chelate enhanced T1-weighted MR scans for the evaluation of 14 diagnostic criteria in 119 pediatric patients with primary and secondary tumors. We next fused 18F-FDG PET scans with either unenhanced T2-weighted MR scans or gadolinium chelate enhanced T1-weighted MR scans in a subset of 36 pediatric patients. We compared the same 14 diagnostic criteria between fused 18F-FDG PET/T2-FSE and fused 18F-FDG PET/Gd-LAVA scans of 123 tumors in this subgroup and evaluated the concordance or discordance of 18F-FDG PET and gadolinium chelate enhancement, using McNemar’s test. Histopathology, surgical notes and follow up imaging served as the standard of reference. Results Pre- and post-contrast MR scans did not show significant differences in diagnostic accuracies of 14 diagnostic criteria that evaluated image quality and tumor origin, extent, composition and differential diagnosis. Accordingly, there was no significant difference in diagnostic accuracy of integrated 18F-FDG PET/T2-FSE and 18F-FDG PET/Gd-LAVA scans. The 18F-FDG PET/MR subgroup showed concordant gadolinium chelate enhancement and 18F-FDG avidity in 30 of 36 patients and 106 of 123 tumors. Conclusion Gadolinium chelate contrast administration is not necessary for accurate diagnostic characterization of most solid pediatric malignancies on integrated 18F-FDG-PET/MR scans. Exceptions may include focal liver lesions.

Emotion and prosocial giving in older adultsA new study provides broad evidence that older people are more generous than their younger counterparts, but that they favor local over global giving. In light of population aging and the relative wealth controlled by older citizens, it is important to identify the factors that contribute to these differences.

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The present study examined the causal role of time horizons in age differences in worker motivation. Based on socioemotional selectivity theory (SST), we hypothesized that under unspecified time horizons, older workers prefer to engage in emotionally meaningful work activities more so than younger workers. We further hypothesized that when time horizons at work are expanded or limited, age differences are eliminated. We recruited a sample of employees (N = 555) and randomly assigned them to one of three experimental conditions: a no-instruction condition in which time horizons were not specified, an expanded time horizons condition, or a limited horizons condition. We asked participants to choose from among three options for work-related activities: Helping a colleague or a friend, working on a career-advancing project, or working on a project which may take the company in a new direction. Consistent with SST postulates, we found that age was associated with preferences for helping colleagues in the unspecified horizons condition, and that age differences were eliminated when time horizons were extended or limited. As hypothesized, expanding time horizons reduced employees’ likelihood of choosing to help colleagues. Contrary to our hypothesis, limiting time horizons also reduced the likelihood of choosing to help colleagues. Alternative explanations are considered. Findings suggest that age differences in worker motivation are shaped by time horizons and that modification of time horizons can alter work preferences.

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