Evaluation of Community Health Education Workshops among Chinese Older Adults in Chicago: A Community-Based Participatory Research Approach

Background: Health education is one of the proven ways to improve knowledge and change health attitudes and behaviors. This study is intended to assess the effectiveness of five health workshops in a Chinese community, focusing on depression, elder abuse, nutrition, breast cancer and stroke. Methods: A community-based participatory research approach was implemented to plan and organize the workshops. A total of 236 Chinese community-dwelling older adults participated in different health workshops. Quantitative questionnaires on knowledge, risk factors and outcomes of each health topic were distributed before and after the workshop. Pre and post workshop comparison analyses were conducted to examine the effectiveness of the workshops on knowledge and learning. Results: Overall, the health workshops have significantly improved participants’ understanding throughout the five health themes (P<0.05). Whereas Chinese older adults have limited knowledge on depression, nutrition and stroke, their health knowledge regarding depression and elder abuse were significantly improved after attending the workshops. In addition, health education workshops increased older adults’ understanding of the risk factors and consequences of depression, elder abuse and breast cancer. Conclusion: This study sheds light on the importance of promoting health education, and the complexity and challenges of designing health education for community dwelling Chinese older adults. Significant implications for researchers, community service providers, health service workers and policy makers are discussed

Assessing the Health Needs of Chinese Older Adults: Findings from a Community-Based Participatory Research Study in Chicago's Chinatown

The objective of this study is to examine the cultural views of healthy aging, knowledge and barriers to services, and perception of health sciences research among community-dwelling Chinese older adults in Chicago's Chinatown. This qualitative study is guided by the Precede-Proceed conceptual model with community-based participatory research design. Data analysis is based on eight focus group interviews with Chinese older (age 60+) adults (n = 78). We used a grounded theory framework to systematically guide the thematic structure of our data. Findings show participants described cultural conception of health in terms of physical function, psychological well-being, social support, and cognitive function. The availability, affordability, and cultural barriers towards health care services were major negative enabling factors that inhibit participants from fulfilling health needs. Perception and knowledge of health sciences research were also discussed. This study has implications for the delivery of culturally appropriate health care services to the Chinese aging population

SNOSite: Exploiting Maximal Dependence Decomposition to Identify Cysteine S-Nitrosylation with Substrate Site Specificity

S-nitrosylation, the covalent attachment of a nitric oxide to (NO) the sulfur atom of cysteine, is a selective and reversible protein post-translational modification (PTM) that regulates protein activity, localization, and stability. Despite its implication in the regulation of protein functions and cell signaling, the substrate specificity of cysteine S-nitrosylation remains unknown. Based on a total of 586 experimentally identified S-nitrosylation sites from SNAP/L-cysteine-stimulated mouse endothelial cells, this work presents an informatics investigation on S-nitrosylation sites including structural factors such as the flanking amino acids composition, the accessible surface area (ASA) and physicochemical properties, i.e. positive charge and side chain interaction parameter. Due to the difficulty to obtain the conserved motifs by conventional motif analysis, maximal dependence decomposition (MDD) has been applied to obtain statistically significant conserved motifs. Support vector machine (SVM) is applied to generate predictive model for each MDD-clustered motif. According to five-fold cross-validation, the MDD-clustered SVMs could achieve an accuracy of 0.902, and provides a promising performance in an independent test set. The effectiveness of the model was demonstrated on the correct identification of previously reported S-nitrosylation sites of Bos taurus dimethylarginine dimethylaminohydrolase 1 (DDAH1) and human hemoglobin subunit beta (HBB). Finally, the MDD-clustered model was adopted to construct an effective web-based tool, named SNOSite (http://csb.cse.yzu.edu.tw/SNOSite/), for identifying S-nitrosylation sites on the uncharacterized protein sequences

Loss-of-function mutations in UDP-Glucose 6-Dehydrogenase cause recessive developmental epileptic encephalopathy

AbstractDevelopmental epileptic encephalopathies are devastating disorders characterized by intractable epileptic seizures and developmental delay. Here, we report an allelic series of germline recessive mutations in UGDH in 36 cases from 25 families presenting with epileptic encephalopathy with developmental delay and hypotonia. UGDH encodes an oxidoreductase that converts UDP-glucose to UDP-glucuronic acid, a key component of specific proteoglycans and glycolipids. Consistent with being loss-of-function alleles, we show using patients’ primary fibroblasts and biochemical assays, that these mutations either impair UGDH stability, oligomerization, or enzymatic activity. In vitro, patient-derived cerebral organoids are smaller with a reduced number of proliferating neuronal progenitors while mutant ugdh zebrafish do not phenocopy the human disease. Our study defines UGDH as a key player for the production of extracellular matrix components that are essential for human brain development. Based on the incidence of variants observed, UGDH mutations are likely to be a frequent cause of recessive epileptic encephalopathy.</jats:p

Loss-of-function mutations in UDP-Glucose 6-Dehydrogenase cause recessive developmental epileptic encephalopathy

Developmental epileptic encephalopathies are devastating disorders characterized by intractable epileptic seizures and developmental delay. Here, we report an allelic series of germline recessive mutations in UGDH in 36 cases from 25 families presenting with epileptic encephalopathy with developmental delay and hypotonia. UGDH encodes an oxidoreductase that converts UDP-glucose to UDP-glucuronic acid, a key component of specific proteoglycans and glycolipids. Consistent with being loss-of-function alleles, we show using patients’ primary fibroblasts and biochemical assays, that these mutations either impair UGDH stability, oligomerization, or enzymatic activity. In vitro, patient-derived cerebral organoids are smaller with a reduced number of proliferating neuronal progenitors while mutant ugdh zebrafish do not phenocopy the human disease. Our study defines UGDH as a key player for the production of extracellular matrix components that are essential for human brain development. Based on the incidence of variants observed, UGDH mutations are likely to be a frequent cause of recessive epileptic encephalopathy

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Making the Invisible Visible: Ageism as a Social Determinant of Elder Abuse

Background: Elder abuse affects one in six community-dwelling older adults globally every year and can lead to great bodily and psychological harm and death. Despite elder abuse has been recognized as a global health problem, there are several knowledge gaps that have impeded the development of elder abuse prevention science. At the structural level, evidence regarding the effects of broader societal attitudes, laws and policies in enabling abusive acts toward older persons is lacking but critical for tailored preventions. At the individual level, existent research has disproportionately focused on victims rather than abusers, a problematic trend given abuser characteristics can be more predictive of elder abuse than victim information and the risk that it implies victims are the cause of abuse. The exclusive use of explicit measures further limits the understanding of the role played by implicit attitudinal determinants in the etiology of elder abuse perpetration, rendering an incomplete understanding of factors that may allow for abusers’ violence propensity in the first place. In contrast, this dissertation is the first to systematically examine whether ageism, or the systematic stereotyping and discrimination against people because of their age, could be a social determinant of elder abuse perpetration. Premised by the Stereotype Embodiment Theory and its supporting empirical research, ageism operates both at the structural and individual levels to harm health. However, the assumed link between ageism and elder abuse has not been vigorously tested. To address these knowledge gaps, this dissertation aims to 1) examine the association between structural ageism and prevalence rates of violence against older persons cross-nationally; 2) investigate the role of implicit dehumanization toward older persons – one of the most hateful age stereotypes that operate without one’s awareness – in predicting family caregivers’ risks for elder abuse proclivity; and 3) address whether and if so how levels of structural and individual ageism work together to predict elder abuse perpetration. Methods: Study 1: An ecological study that examined the association between country-level structural ageism and violence against older persons across 56 countries, by merging global survey and surveillance data from the World Values Survey, Global Burden of Diseases Study 2017, global databases from the World Health Organization, United Nations, and the World Bank. Study 2: A cross-sectional survey study that examined a previously unexplored relationship between implicit and explicit dehumanization of older persons and risks for elder abuse proclivity based on a sample of 585 family caregivers of older persons. Study 3: A theoretically-informed investigation that assessed, for the first time, whether structural ageism will trickle down through individual ageism, in the form of negative age beliefs, that in turn increase risks for elder abuse proclivity and actual abusive caregiving behavior, by presenting two study samples of individuals (n=1,580) and family caregivers (n=400). Results: Study 1: There was a wide variation in levels of structural ageism across countries. As predicted, structural ageism was significantly associated with higher prevalence rates of violence against older persons in multivariate models (β =205.7, SE=96.3, p=.03), after adjusting for relevant covariates. Sensitivity analyses supported the robustness of these findings. That is, structural ageism did not predict other types of violence and other types of prejudice did not predict violence against older persons. Study 2: As predicted, dehumanization was prevalent with 51% of the caregivers implicitly and 31% explicitly dehumanizing older persons. Also as predicted, implicit and explicit dehumanization uniquely contributed to elder abuse proclivity (OR=1.23, 95% CI=1.02-1.50, p=.03) and (OR=1.26, 95% CI=1.05-1.51, p=.01), respectively, after adjusting for relevant covariates including caregiver burden, and caregivers’ and care-recipients’ health. Study 3: As hypothesized, structural ageism and individual ageism simultaneously predicted elder abuse proclivity and perpetration. Also as predicted, individual ageism significantly mediated the association between structural ageism and elder abuse in both study samples. Conclusions: This dissertation is the first to empirically establish ageism as a key mechanism in the etiology of elder abuse perpetration. As one of the most prevalent and yet invisible forms of prejudice, findings from this dissertation research call for renewed attention to integrate ageism in developing much-needed elder abuse prevention intervention strategies. These approaches may include top-down societal-level campaigns that tackle the pervasiveness of ageism across all sectors of society, and reinforced by individual-based interventions that target both explicit and implicit negative age stereotypes. Incorporating efforts to combat ageism will hold promise to complement ongoing public health prevention programs in reducing elder abuse

Personality Traits among Community-Dwelling Chinese Older Adults in the Greater Chicago Area

Objectives: Personality traits are important indicators of health and well-being. Neuroticism and conscientiousness in particular, are closely associated with morbidity and mortality in old age. However, little is known regarding the levels of these two key personality traits among U.S. Chinese older adults. This report aimed to examine the levels of personality traits among this population. Methods: Data were from the PINE study, a population-based study of U.S. Chinese older adults aged 60 and above. We measured neuroticism and conscientiousness using modified NEO personality inventory. Results: Of the 3,159 community-dwelling Chinese older adults, 58.9% were female, and mean age was 72.8 years. Compared to neuroticism, conscientiousness trait was endorsed higher among Chinese older adults in our sample. Each conscientiousness item had at least 67.8% of participant endorsement, in comparison to the lowest endorsement rate of 14.3% in the neuroticism measure. Younger age (r-neuroticism = -0.06, r-conscientiousness = -0.14) and fewer children (r-neuroticism = -0.06, r-conscientiousness = -0.06) were correlated with both traits. Female gender (r = 0.11), poorer health status (r = -0.26), poorer quality of life (r = -0.23) and worsened health over the past year (r = -0.15) were correlated with higher levels of neuroticism. In contrast, male gender (r = -0.05), better health status (r = 0.20), higher quality of life (r = 0.17) and improved health over the past year (r = 0.07) were correlated with higher levels of conscientiousness. Education level (r = 0.15) was positively correlated with higher levels of conscientiousness, but not with neuroticism; whereas income level (r = -0.04) was negatively correlated with neuroticism but not with conscientiousness. Conclusion: U.S. Chinese older adults generally possess higher agreement level on conscientiousness traits than neuroticism. Future analysis should be conducted to explore the complex associations between different personality traits among Chinese aging population, Our study also calls for further in-depth studies to understand adverse health outcomes associated with specific personality traits among minority older adults