Judging Communicative Competence: Investigating Age-Related Stereotypes in Speech-Language Pathology Students

The proportion of the US population over age 65 is projected to reach almost 80 million by the year 2040, doubling the numbers from 2000 (Administration on Aging, 2012). With the aging of the population, the incidence of age-related diseases and disorders like stroke and dementia is expected to increase, adding to the caseloads of speech-language pathologists (SLPs). Most SLPs, by contrast, are younger adults; over a quarter of SLPs in the US are under age 35 (ASHA, 2012). Thus, as the elderly population grows, more intergenerational communication encounters will occur between SLPs and their aging clients, increasing demands for cultural competence, specifically with regard to ageism. However, the field of speech-language pathology has seen little research into the impact of age-related stereotypes on service delivery (Armstrong & McKechnie, 2003). One’s interactions with people are implicitly shaped by stereotypes, widely held unconscious representations of groups of people (Devine, 1989). According to the Age Stereotypes in Interaction model (Hummert, 2012), there are three main factors that trigger stereotypes: the perceiver’s self-system, the context of the interaction, and physical traits. ‘Self-system’ refers to one’s beliefs and attitudes, which are themselves determined by one’s age, cognitive complexity, and past experiences (Hummert, 2012; Ryan, 2007). Stereotypes can be reinforced by the context in which intergenerational encounters occur. To illustrate, Hummert and colleagues (1998) found that younger adults used different language when speaking to older adults in the hospital vs an apartment. Aspects of physical appearance (e.g. grey hair, stooped posture) create an immediate impression of the older individual (Adams et al., 2012). Using photographs, Hummert and colleagues (1997) found that adults perceived to be older were stereotyped more negatively than younger-looking adults. Negative stereotypes may, in turn, affect older adult’s responses, resulting in a cycle of reinforced stereotypes and negative interactions (Ryan, 2007). Williams and colleagues (2009) found that nurses who used ‘elderspeak’ met with more resistance to care in their patients with dementia. To prevent such negative interactions, SLPs must become aware of the potential impact of implicit age-related stereotypes. The purpose of this study was to determine whether SLP students are influenced by age-related stereotypes when judging the communication of older adults

Plasmacytoid dendritic cells promote systemic sclerosis with a key role for TLR8

Systemic sclerosis (SSc) is a multisystem life-threatening fibrosing disorder that lacks effective treatment. The link between the inflammation observed in organs such as the skin and profibrotic mechanisms is not well understood. The plasmacytoid dendritic cell (pDC) is a key cell type mediating Toll-like receptor (TLR)-induced inflammation in autoimmune disease patients, including lupus and skin diseases with interface dermatitis. However, the role of pDCs in fibrosis is less clear. We show that pDCs infiltrate the skin of SSc patients and are chronically activated, leading to secretion of interferon-α (IFN-α) and CXCL4, which are both hallmarks of the disease. We demonstrate that the secretion of CXCL4 is under the control of phosphatidylinositol 3-kinase δ and is due to the aberrant presence of TLR8 on pDCs of SSc patients, which is not seen in healthy donors or in lupus pDCs, and that CXCL4 primarily acts by potentiating TLR8-but also TLR9-induced IFN production by pDCs. Depleting pDCs prevented disease in a mouse model of scleroderma and could revert fibrosis in mice with established disease. In contrast, the disease was exacerbated in mice transgenic for TLR8 with recruitment of pDCs to the fibrotic skin, whereas TLR7 only partially contributed to the inflammatory response, indicating that TLR8 is the key RNA-sensing TLR involved in the establishment of fibrosis. We conclude that the pDC is an essential cell type involved in the pathogenesis of SSc and its removal using depleting antibodies or attenuating pDC function could be a novel approach to treat SSc patients

Cardiac metabolomics and autopsy in a patient with early diffuse systemic sclerosis presenting with dyspnea: a case report

Introduction Diffuse systemic sclerosis is associated with high mortality; however, the pathogenesis of cardiac death in these patients is not clear. Case presentation A 56-year-old Caucasian female patient presented with dyspnea and requested to donate her body to science in order to improve understanding of diffuse systemic sclerosis pathogenesis. She had extensive testing for dyspnea including pulmonary function tests, an echocardiogram, cardiac magnetic resonance imaging, and right heart catheterization to characterize her condition. Her case highlights the morbidity seen in this disease, including the presence of extensive skin thickening, digital ulcerations, and scleroderma renal crisis. Conclusion In this case report, we present the finding of cardiac tissue metabolomics, which may indicate a problem with vasodilation as a contributor to cardiac death in diffuse systemic sclerosis. The use of autopsy and tissue metabolomics in rare disease may help clarify disease pathogenesis

Detection of Magnesium-Rich Ejecta in the Middle-Aged Supernova Remnant N49B

The middle-aged supernova remnant (SNR) N49B in the Large Magellanic Cloud has been observed with the {\it Chandra X-Ray Observatory}. The superb angular resolution of {\it Chandra} resolves the complex structure of X-ray emitting filaments across the SNR. All observed features are soft ($E <$ 3 keV) and we find no evidence for either point-like or extended hard emission within the SNR. Spectral lines from O, Ne, Mg, Si, S, and Fe are present. Equivalent width images for the detected elemental species and spatially-resolved spectral analysis reveal the presence of Mg-rich ejecta within the SNR. We find no such enrichment in O or Ne, which may reflect details of the nucleosynthesis process or the heating and cooling of the ejecta as it evolved. The bright circumferential filaments are emission from the shocked dense interstellar medium (ISM). We detect faint diffuse X-ray emission that extends beyond the X-ray bright filaments toward the west and southeast. These features appear to be the blast wave shock front expanding into lower density portions of the ISM seen in projection. We set an upper limit of $\sim$$2\times 10^{33}$ ergs s$^{-1}$ on the 0.5 $-$ 5 keV band X-ray luminosity of any embedded compact object.Comment: 3 text pages (ApJ emulator style), 3 figures, 1 table, Accepted for the publication in Ap J Letter

Clinical and serological features of systemic sclerosis in a multicenter African American cohort: Analysis of the genome research in African American scleroderma patients clinical database.

Racial differences exist in the severity of systemic sclerosis (SSc). To enhance our knowledge about SSc in African Americans, we established a comprehensive clinical database from the largest multicenter cohort of African American SSc patients assembled to date (the Genome Research in African American Scleroderma Patients (GRASP) cohort).African American SSc patients were enrolled retrospectively and prospectively over a 30-year period (1987-2016), from 18 academic centers throughout the United States. The cross-sectional prevalence of sociodemographic, clinical, and serological features was evaluated. Factors associated with clinically significant manifestations of SSc were assessed using multivariate logistic regression analyses.The study population included a total of 1009 African American SSc patients, comprised of 84% women. In total, 945 (94%) patients met the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for SSc, with the remaining 64 (6%) meeting the 1980 ACR or CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) criteria. While 43% were actively employed, 33% required disability support. The majority (57%) had the more severe diffuse subtype and a young age at symptom onset (39.1 ± 13.7 years), in marked contrast to that reported in cohorts of predominantly European ancestry. Also, 1 in 10 patients had a severe Medsger cardiac score of 4. Pulmonary fibrosis evident on computed tomography (CT) chest was present in 43% of patients and was significantly associated with anti-topoisomerase I positivity. 38% of patients with CT evidence of pulmonary fibrosis had a severe restrictive ventilator defect, forced vital capacity (FVC) ≤50% predicted. A significant association was noted between longer disease duration and higher odds of pulmonary hypertension, telangiectasia, and calcinosis. The prevalence of potentially fatal scleroderma renal crisis was 7%, 3.5 times higher than the 2% prevalence reported in the European League Against Rheumatism Scleroderma Trials and Research (EUSTAR) cohort.Our study emphasizes the unique and severe disease burden of SSc in African Americans compared to those of European ancestry

Phosphorylation regulates targeting of cytoplasmic dynein to kinetochores during mitosis

Cytoplasmic dynein functions at several sites during mitosis; however, the basis of targeting to each site remains unclear. Tandem mass spectrometry analysis of mitotic dynein revealed a phosphorylation site in the dynein intermediate chains (ICs) that mediates binding to kinetochores. IC phosphorylation directs binding to zw10 rather than dynactin, and this interaction is needed for kinetochore dynein localization. Phosphodynein associates with kinetochores from nuclear envelope breakdown to metaphase, but bioriented microtubule (MT) attachment and chromosome alignment induce IC dephosphorylation. IC dephosphorylation stimulates binding to dynactin and poleward streaming. MT depolymerization, release of kinetochore tension, and a PP1-γ mutant each inhibited IC dephosphorylation, leading to the retention of phosphodynein at kinetochores and reduced poleward streaming. The depletion of kinetochore dynactin by moderate levels of p50(dynamitin) expression disrupted the ability of dynein to remove checkpoint proteins by streaming at metaphase but not other aspects of kinetochore dynein activity. Together, these results suggest a new model for localization of kinetochore dynein and the contribution of kinetochore dynactin

Performance Characteristics of Pulmonary Function Tests for the Detection of Interstitial Lung Disease in Adults With Early Diffuse Cutaneous Systemic Sclerosis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163424/2/art41415.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163424/1/art41415_am.pd