Associations of Social Support and 8-Year Follow-Up Depressive Symptoms: Differences in African American and White Caregivers

The present study used data from the Alzheimer’s Study of Emotions in Caregivers (ASEC) to evaluate perceptions of social support assessed at baseline, as well as changes in social support assessed at a follow-up eight-years later, as predictors of symptoms of change in depression, with a focus on race as a potential moderator of these relationships. Specifically, multiple regression analyses adjusted for age, sex, income, education, race, living arrangement of care recipient at baseline, death of care recipient, the cultural justification for caregiving scale (CJCS), and baseline depressive symptoms were conducted to assess baseline social support ratings, as well as the change in social support over time as a predictor of depression at follow-up—with a focus on moderation by race. Baseline social support (F(1,77) = 7.60, p=.008) was associated with fewer depressive symptoms at follow-up for all participants. The change in social support over time was also related to depressive symptoms, with effects moderated by race (F(1,77) = 7.97, p = .007), such that when support decreased over time depressive symptoms at follow-up were higher for Whites, as compared with African Americans, whereas, when social support increased over time depressive symptoms tended to be similar for both groups. These findings indicate that research designed to plan interventions in caregivers must not ignore potential racial differences with regard to the effects of caregiving on mental health

Influence of Clinical and Demographic Variables on Mycophenolic Acid Pharmacokinetics in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Mycophenolic acid (MPA) is used off-label to treat many forms of glomerulonephritis

Pharmacokinetics of Mycophenolic Acid in Patients with Lupus Nephritis

Lupus nephritis is associated with urinary protein excretion, hypoalbuminemia, and renal function declines, which may impact the pharmacokinetics (PK) of mycophenolic acid (MPA)

CYP2C9 genotype and pharmacodynamic responses to losartan in patients with primary and secondary kidney diseases

Losartan is used for anti-proteinuric as well as blood pressure effects in chronic kidney disease (CKD). It is metabolized by cytochrome P450 2C9 to active E-3174. Single nucleotide polymorphisms in CYP2C9 that reduce catalytic activity could reduce clinical benefits. The study aims were to determine whether CYP2C9 variant alleles (*2 and *3) altered urinary protein excretion, glomerular filtration rate, and blood pressure in Caucasians prescribed losartan. Differences between baseline and six-month follow-up outcomes were compared by CYP2C9 genotypes in 59 patients using unpaired T-test or Mann Whitney U test. Primary renal disease patients had a trend toward less favorable antiproteinuric response (−31.7±156 vs −125±323%; p=0.123) when carrying variant alleles. Patients with secondary renal diseases had less favorable diastolic blood pressure (9.8±16.0 mm Hg vs −3.2±10.6 mm Hg; p=0.043) and systolic blood pressure (16.2±27.1 mm Hg vs −5.5±17.5 mm Hg; p=0.044) with CYP2C9 variants. Preliminary results suggest a possible influence of CYP2C9 genotype on proteinuria and blood pressure in Caucasian CKD patients treated with losartan

Social Justice, Health Disparities, and Culture in the Care of the Elderly

Abstract available at publisher's web site

Organizational Readiness to Implement the Chronic Disease Self-Management Program in Dialysis Facilities

A gap exists between the development and uptake of evidence-based health promotion programs in health care settings. One reason for this gap is lack of attention to organizational readiness. The objective of this study was to assess organizational readiness to implement the Chronic Disease Self-Management Program in dialysis facilities. Survey data were collected from dialysis staff using a semi-structured Organizational Readiness for Implementing Change questionnaire. Change efficacy and change commitment scale ratings were all above 3.0, indicating a moderate level of readiness among staff. Profession and level of education were significantly associated with mean change efficacy scale ratings. Textual data revealed benefits to patients, implementation barriers and facilitators, and the influence of facility environment and culture. The findings of the current study suggest that additional efforts to advance the implementation of evidence-based health promotion programs in dialysis facilities are needed