Race and Sex Differences in Correlates of Systolic Blood Pressure in Community-Dwelling Older Adults

Objectives: To describe correlates of measured systolic blood pressure (SBP) among community-dwelling older African American and White Medicare beneficiaries. Methods: Participants completed an in-home assessment and factors significantly correlated with SBP were tested using multivariable models. Results: Among the 958 participants (mean age= 75.3 [SD = 6.8]; 49% African American; 49% female; 52% rural) African Americans were more often diagnosed with hypertension, more likely on anti-hypertensives, and on more anti-hypertensive medications. SBP was 2.7 mmHg higher in African Americans than Whites (p=.03). SBP was higher in women than men. Multivariable models revealed differences in the factors associated with SBP by race/sex specific groups. Having a history of smoking and reports of being relaxed and free of tension were associated with higher SBP among African American men. Discussion: Although more likely prescribed anti-hypertensives, mean SBP was higher for older African Americans than Whites. Results support the hypothesis that behavioral and psychosocial factors are more important correlates of SBP levels among older African Americans than among Whites

Patent Human Infections with the Whipworm, Trichuris trichiura, Are Not Associated with Alterations in the Faecal Microbiota

Background: The soil-transmitted helminth (STH), Trichuris trichiura colonises the human large intestine where it may modify inflammatory responses, an effect possibly mediated through alterations in the intestinal microbiota. We hypothesised that patent T. trichiura infections would be associated with altered faecal microbiota and that anthelmintic treatment would induce a microbiota resembling more closely that observed in uninfected individuals. Materials and Methods: School children in Ecuador were screened for STH infections and allocated to 3 groups: uninfected, T. trichiura only, and mixed infections with T. trichiura and Ascaris lumbricoides. A sample of uninfected children and those with T. trichiura infections only were given anthelmintic treatment. Bacterial community profiles in faecal samples were studied by 454 pyrosequencing of 16 S rRNA genes. Results: Microbiota analyses of faeces were done for 97 children: 30 were uninfected, 17 were infected with T. trichiura, and 50 with T. trichiura and A. lumbricoides. Post-treatment samples were analyzed for 14 children initially infected with T. trichiura alone and for 21 uninfected children. Treatment resulted in 100% cure of STH infections. Comparisons of the microbiota at different taxonomic levels showed no statistically significant differences in composition between uninfected children and those with T. trichiura infections. We observed a decreased proportional abundance of a few bacterial genera from the Clostridia class of Firmicutes and a reduced bacterial diversity among children with mixed infections compared to the other two groups, indicating a possible specific effect of A. lumbricoides infection. Anthelmintic treatment of children with T. trichiura did not alter faecal microbiota composition. Discussion: Our data indicate that patent human infections with T. trichiura may have no effect on faecal microbiota but that A. lumbricoides colonisation might be associated with a disturbed microbiota. Our results also catalogue the microbiota of rural Ecuadorians and indicate differences with individuals from more urban industrialised societies

A Novel Immunological Assay for Hepcidin Quantification in Human Serum

Contains fulltext : 81054.pdf (publisher's version ) (Open Access)BACKGROUND: Hepcidin is a 25-aminoacid cysteine-rich iron regulating peptide. Increased hepcidin concentrations lead to iron sequestration in macrophages, contributing to the pathogenesis of anaemia of chronic disease whereas decreased hepcidin is observed in iron deficiency and primary iron overload diseases such as hereditary hemochromatosis. Hepcidin quantification in human blood or urine may provide further insights for the pathogenesis of disorders of iron homeostasis and might prove a valuable tool for clinicians for the differential diagnosis of anaemia. This study describes a specific and non-operator demanding immunoassay for hepcidin quantification in human sera. METHODS AND FINDINGS: An ELISA assay was developed for measuring hepcidin serum concentration using a recombinant hepcidin25-His peptide and a polyclonal antibody against this peptide, which was able to identify native hepcidin. The ELISA assay had a detection range of 10-1500 microg/L and a detection limit of 5.4 microg/L. The intra- and interassay coefficients of variance ranged from 8-15% and 5-16%, respectively. Mean linearity and recovery were 101% and 107%, respectively. Mean hepcidin levels were significantly lower in 7 patients with juvenile hemochromatosis (12.8 microg/L) and 10 patients with iron deficiency anemia (15.7 microg/L) and higher in 7 patients with Hodgkin lymphoma (116.7 microg/L) compared to 32 age-matched healthy controls (42.7 microg/L). CONCLUSIONS: We describe a new simple ELISA assay for measuring hepcidin in human serum with sufficient accuracy and reproducibility

Does race moderate social support and psychological distress among rural older adults?

Psychological distress (PD) among older adults is prevalent but undertreated, especially in minorities. Most of what is known about late-life PD in African Americans comes from studies comparing them to Caucasians, but results are contradictory, with some concluding that African Americans have more symptoms, and others demonstrating that differences disappear when sociodemographic factors are controlled. One consistent finding among all older adults is that greater social support is associated with decreased PD. African American cultural values of collectivism may act as a buffer for PD, potentially making race an important moderator of the relationship between social support and PD. Participants were aged 60 and older (N=100) and part of the Project to Enhance Aged Rural Living (PEARL). Multiple regression analyses controlling for health, income, education, and gender were conducted to determine whether race moderates the relationship between different types of social support and PD. Results showed that race moderated satisfaction with social support and PD, but Caucasians benefitted from increases in satisfaction more than African Americans. Emotional support, quality of social support, and physical health were significant negative predictors of PD. Being male also significantly predicted PD. More research including religion is needed to understand racial differences in social support and PD. Interventions for African Americans experiencing PD may be best designed by targeting males; focusing on improving emotional support, quality social support, and satisfaction with social support; and promoting physical health, perhaps by enlisting the church as middle-man. (Published By University of Alabama Libraries

An investigation of the association between cognition and depression with sleep quality as a mediator among older adults

Persons aged 65 and over account for an estimated 13% of the U.S. population, and, by 2030, they are predicted to account for almost 20% of the population. It is important to focus on the mental health of this segment of the population, because mental health issues frequently affect older adults. In addition, older adults commonly have co-morbid psychological disorders. In particular, older adults often experience issues with cognition, depression, and sleep, and the co- occurrence of these disorders results in greater negative outcomes for older adults. Therefore, this study investigated the relationship between depressive symptoms and cognitive performance with sleep quality as a mediating variable among older adults aged 65 and above. A secondary data analysis was performed using data from the Midlife in the United States Study II (MIDUS II). Specifically, wave two data from the Cognitive and Biomarkers Projects was analyzed using the Center for Epidemiologic Depression Scale, the Pittsburgh Sleep Quality Inventory, and the Brief Test of Adult Cognition by Telephone measures. Results suggest that being older and having more depressive symptoms was associated with worse cognitive performance, R2 = 0.12, F(4, 242) = 8.70, p .05). Future research is needed to further investigate the role of sleep in the association between depression and cognitive performance in older adults. (Published By University of Alabama Libraries

Social network and cognitive function in Appalachian older adults

The present study examined the association between social network and cognitive function in 268 Appalachian older adults without dementia who had a mean age of 78.5. Cognitive functioning was assessed in two ways using results data from an extensive neuropsychological battery: an overall composite score of all the tests and an overall composite score for tests in specified cognitive domains (working memory, visuospatial ability, semantic memory, and episodic memory). Social networks were measured from structured questions using the Lubben Social Network Scale-6 (LSNS-6). The associations of social network to cognitive function were assessed in two hierarchical linear regression models: Model B controlled for age, education and Geriatric Depression Scores (GDS), whereas Model A did not. Results suggest a significant main effect and positive association with social network and global cognitive function, episodic memory, working memory, semantic memory and visuospatial ability. Therefore, these findings confirm that larger social networks in older adults are associated with better cognitive functioning and this remains true across varied cognitive domains. (Published By University of Alabama Libraries

Disability as a risk factor for psychological distress among asian-american elders

Research has shown a strong association between disability and psychological distress (PD) among older adults. However, little is known about how this relation varies among different subgroups of Asian-American elders. The present study aims to examine the relation between disability and PD within five subgroups of Asian Americans age 60 and older (N=1398): Chinese (n = 291), Japanese (n = 175), Koreans (n =383), Filipinos (n = 149), and Vietnamese (n = 400). Data were drawn from the 2009 California Health Interview Survey (CHIS). A generalized linear model (GzLM) analysis was conducted to assess the overall relations of disability with PD, as well as how these effects were moderated by ethnicity. The three types of disabilities being examined (vision/hearing, cognitive, and ADL functional disabilities) were all associated with increased PD. It was also found that the effects of having cognitive or ADL functional disabilities depended on the elder's ethnicity. Having a cognitive or an ADL functional disability led to notably more distress among Filipinos than among those from other Asian subgroups. In addition, the effect of having an ADL functional disability was not significant for Japanese, even though it was significant for all of the other ethnicities. This current study sheds light on understanding disability as a risk factor for poor mental health among the five subgroups of Asian-American elders. The findings can be applied to enhance the psychological wellbeing of disabled Asian American elders by providing culturally-sensitive mental health services tailored to their specific needs. (Published By University of Alabama Libraries

Race, power, & workforce diversity: awareness, perceptions, & experiences among nursing home leaders

In response to the changing demographic profile of the U.S., there is an increasing presence of minorities in the workforce. Nursing homes, in particular, are facing issues on how to manage such a diverse workforce. Furthermore, nursing homes have a bureaucratic structure with limited diversity at the administrative level, yet significant diversity at the direct-care levels. While workforce diversity (WD) is well research among large corporations, little to no information is known about the state of WD in nursing homes. This research focused on how nursing home leaders understand WD and how diversity is managed in the nursing home. The researcher interviewed 10 administrators from a community nursing home to discuss the following concepts: diversity and leadership experiences, perceptions of WD and diversity management, and influences of WD on work process. The data analysis revealed a model for how diversity manifests in the nursing home. The results revealed that while issues of race were not openly discussed in this racially diverse facility, WD in nursing homes manifests through a focus on fairness, teamwork, and trust. There were reports of subtle forms of racial discrimination across the interviews; however, higher-level administrators were less likely to be aware of these issues. There were individual and organizational level influences that effected how WD was enacting in the home. Some of the individual factors included, personal racial experiences, the leaders' understanding of WD, and their managerial philosophies. Organizational initiatives and hiring practices were among the organizational influences. The results of this research will aid in developing diversity promotion strategies and improve work-life in nursing homes. (Published By University of Alabama Libraries