Understanding Alzheimer’s Disease Knowledge in Low-Income, Richmond, VA Community Dwelling Older Adults

Background: Different populations of individuals demonstrate varying levels of Alzheimer’s disease (AD) knowledge, as well as commonly held misconceptions about the nature of the disease and its risk factors. Older adults often demonstrate lower scores on Alzheimer’s disease knowledge scales and African American adults are often specifically not aware of their higher Alzheimer’s risk status compared to other racial groups. In addition, African American older adults are more likely to receive the fewest AD interventions. Methods: We measured the Alzheimer’s knowledge of twenty community-dwelling elders at two separate time points (baseline and 6 month follow-up) as part of a larger study on AD health coaching. Participants (n=20) were recruited from low-income communities within the Richmond, Virginia (RVA) area; the sample was 85% African American individuals (n=17), 45% female (n=9) and 55% male (n=11). Participants completed demographic measures, true/false AD knowledge measures, a relational ageism scale, and questions about their health and habits. Results: Similar to previous research, this population of older adults held common misconceptions about AD, including the ideas that mental exercise can prevent Alzheimer’s disease (20% answered correctly) and individuals with Alzheimer’s are incapable of making decisions about their care (30% answered correctly). In this sample, the majority of African American older adults were aware of the fact that they make up the population at the highest risk for developing Alzheimer’s disease (80% answered correctly). Analyses also found no significant relationship between AD knowledge and health outcomes, alcohol consumption, or education. Conclusion: AD knowledge needs to be better addressed in low-income, racially diverse older adults.https://scholarscompass.vcu.edu/gradposters/1073/thumbnail.jp

Comparing the Personal Lives of Psychotherapists and Research Psychologists

Although the personal life of the therapist has been a topic of interest for nearly sixty years there is still a paucity of research in this area. There is also a lack of research into the personal lives of researcher psychologists. In this study 282 psychologists (151 researchers and 131 therapists) who attended regional meetings and seminars sponsored by professional psychological associations in Texas were sampled. Job stressors, personal problems and health concerns, relaxation techniques, life satisfaction, and work impact on personal life were some of the areas examined. The most important stressors associated with research were excessive teaching responsibilities, pressures associated with funding and lack of time for a personal life. For therapists the most important stressors associated with work were suicide attempts by clients, clients showing resistance, and clients being angry. Therapists reported more concerns related to anxiety, depression, and family problems than researchers. Both groups chose exercise/sports and movies/television as their most common methods for relaxation. Therapists were three times more likely to have been in therapy than researchers and once in therapy reported six times the number of hours. Researchers reported less childhood abuse than therapists. However, therapists were more satisfied with their current life, indicating having good friends and liking where they lived more than researchers. Therapists were also more likely to feel that their work had impacted their lives and that these benefits were mostly positive. The array of positive benefits ranged from being a better person to enjoying life more. Overall, results showed that, although therapists generally began life in less happy circumstances, and experienced greater personal problems and health concerns currently, they reported feeling more satisfied with their lives than researchers

Update in hormone therapy use in menopause

The original report from the Women's Health Initiative (WHI) changed our understanding of the benefits and risks of hormone therapy. Since that time, reanalysis of the WHI and additional data from other studies have further refined these concepts. Here we provide an update on recent advances in the field. Menopausal hormone therapy continues to have a clinical role in the management of vasomotor symptoms. However, our understanding of the role of hormones in cardiovascular disease and breast cancer continues to evolve. Further analyses of the effect of age and proximity to menopause at the time of initiation of therapy, duration of treatment, dose, route of administration, and the persistence of risks and benefits after stopping hormone therapy are described. In addition, recent data have emerged suggesting that there may be a link between hormone therapy and cancers of the lung and ovary. Finally, we discuss new advances in hormone therapy that will likely lead to a more favorable benefit-to-risk ratio, enabling safer effective menopausal symptom relief. O ver the past several decades, a large number of observational studies suggested that the use of hormone therapy in menopause not only relieved vasomotor symptoms, but also reduced the risk of several chronic medical conditions such as osteoporosis and cardiovascular disease. However, in 2002, the results of a prospective randomized trial, the Women's Health Initiative (WHI), demonstrated that many of the benefits identified in observational studies were not present in a population randomized to treatment; some hypothesized that the previously purported benefits may have been due not to the therapy but rather to confounding and selection biases, as well as other methodological limitations. In response to the findings of the WHI and other randomized trials, menopausal hormone therapy (MHT) use declined dramatically. The WHI confirmed a decreased risk of osteoporosis and fractures in menopausal women assigned to hormone therapy; it also confirmed an increased risk of breast cancer previously identified in women who use combination estrogen plus progestin (E ϩ P) hormone therapy. However, the WHI trial also revealed that women assigned to MHT had an increase in coronary disease, stroke, and venous thromboembolic events. In the past few years, there has been renewed interest in the risks of MHT, especially that of breast cancer as well as the apparent elevation, rather than reduction, in the risk of coronary events. Since the original publication of the WHI results in 2002, a large number of subsequent studies have looked at these concepts in detail. In addition, recent data have emerged suggesting that there may be a link between hormone therapy and cancers of the lung and ovary. Further analyses of the effect of age and proximity to menopause at the time of initiation of therapy, duration of treatment, dose, route of administration, and the persistence of risks and benefits after stopping hormone therapy have all recently been described. Here we provide an overview of recent developments in this field, including the central role of timing of initiation. Coronary Heart Disease (CHD) The original report from the WHI demonstrated that women randomized to conjugated equine estrogens (CEEs) combined with medroxyprogesterone acetat

Training University Students About Autism Spectrum Disorder Through Outreach to School-Based Speech-Language Pathologists

Training preprofessional students about autism spectrum disorder (ASD) is crucial, particularly since students with ASD are represented on the caseloads of approximately 90% of school-based speech-language pathologists (SLPs). When this training can occur within the context of an outreach program, the results of such programming can be mutually beneficial for the individuals served as well as the students. Through the present program, six graduate students and four undergraduate students created materials for 15 SLPs working in the schools in a significantly underserved region of the United States. Students created nearly 800 materials for the SLPs to use in therapy with children with ASD. These included visual schedules and picture/icon cards and social stories. Students completed a survey and wrote a reflection paper about what they learned. Survey data from all participants indicated that the program met the needs of the SLPs and furthered students’ skills in creating materials and understanding more about the demands of working as an SLP in the schools. Implications for undergraduate and graduate training including increasing student knowledge and confidence as well as gaining student perspectives on the experience and collaboration are discussed. Future directions for extensions of this training program are proposed

Training Students Through a Community Outreach Program to Support Families of Children with Autism Spectrum Disorder

This outreach program involved training eight graduate and 19 undergraduate students to create evidence-based communication supports for families of children with autism spectrum disorder (ASD) within the context of a two-course sequence on ASD. During the training program, ten families in rural Appalachia benefited from our services. Student and family satisfaction data with the outreach program was highly positive. Undergraduate and graduate university students participating in the program met or partially met 97% of their goals set at the beginning of each semester. Undergraduate students’ self-ratings of their own knowledge about material covered in the course were significantly higher than their confidence in applying their knowledge about the materials. Thematic analyses of students’ comments about their experiences revealed that the hands-on experience and opportunities to create materials and collaborate with each other were among the aspects of the program they liked most. The value of outreach programs to foster training of undergraduate and graduate students through community connections will be discussed

Ezidi voices: The communication of COVID-19 information amongst a refugee community in rural Australia- a qualitative study

Background: There is growing evidence that government health information related to COVID-19 has failed to adequately reach culturally and linguistically diverse (CALD) populations in Australia. Refugees are a unique sub-set of the CALD communities and are subject to numerous barriers preventing adequate health care, both pre- and post-migration. The barriers are accentuated during emergencies, such as a pandemic, as a result of an intersection of various social and economic inequalities. The recently resettled Ezidi refugee community in a regional area of Australia is an example of a community sitting at the intersection of various inequities and thus at greater risk from COVID-19. The purpose of this study is to describe the experiences of the Ezidi in a regional area with COVID-19 information and how this has been communicated to and shared within this group; what barriers the community may experience in accessing COVID-19 information; and how the government-led COVID-19 information communication could be improved. Methods: This qualitative study was designed to explore the perceptions and views of the Ezidi and service providers regarding COVID-19 messaging. Multicultural and Refugee Health staff facilitated interviews with four local service providers and ten Ezidi community members, including seven influential leaders. Thematic analysis was employed across individual, pair and group data analysis. Similar categories were grouped into themes. Results: The main findings of the study are: the refugee experience influences the communication of COVID-19 messages; cultural, social and gender norms influence responses to COVID-19; trusted individuals and service providers are key in communities’ uptake of COVID-19 messages; currently available governmental COVID-19 information resources and sharing strategies were found unhelpful and inappropriate; COVID-19 communiqués and message delivery for this regional minority refugee community can be improved. Conclusion: The recently resettled Ezidi community, and likely other similar communities, would benefit from tailored engagement by government organisations, as well as settlement services to improve the communication of COVID-19 health information and reduce related inequities

Factors contributing to the sharing of COVID-19 health information amongst refugee communities in a regional area of Australia: a qualitative study

Background: The COVID-19 pandemic has had a disproportionate impact on culturally and linguistically diverse (CALD) groups worldwide. Newly emerging CALD populations formed by recently arrived refugees are predisposed to even greater health disadvantages due to complexities of the refugee experience. The aim of this study was to explore how culture, refugee experiences and existing relationships shaped what COVID-19 messages were listened to and shared during the early-mid phases of the pandemic. The work focused on three newly emerging refugee groups in the Hunter New England region, Australia: Afghan, Congolese and Syrian communities. Methods: Qualitative, semi-structured interviews were conducted to explore the experiences and stories of 15 adult community members, nine influential members and six service providers. All community members arrived in Australia on or after January 2014. Interpreter-assisted interviews were conducted with small groups or individuals, audio-recorded and transcribed verbatim in English. Three levels of thematic data analysis were employed to uncover the important issues and experiences of the participants. Results: Three key themes and several subthemes were identified. The themes were: 1) Experience as a refugee uniquely influences COVID-19 message communication; 2) Refugee groups use diverse practices when accessing and sharing COVID-19 messages; and 3) Official government messages could be improved by listening and tailoring to community needs. Conclusions: Effective health messaging relies on reaching communities in a culturally acceptable and meaningful way. Official COVID-19 messages can be tailored to engage newly emerging communities by improving the quality of the content, delivery and format whilst working collaboratively with communities and trusted service providers. Further mutual research is needed to understand emerging communities’ viewpoints. The use of culturally informed approaches is recommended

Functional Interaction between Herpes Simplex Virus Type 2 gD and HVEM Transiently Dampens Local Chemokine Production after Murine Mucosal Infection

Herpes virus entry mediator (HVEM) is one of two principal receptors mediating herpes simplex virus (HSV) entry into murine and human cells. It functions naturally as an immune signaling co-receptor, and may participate in enhancing or repressing immune responses depending on the natural ligand used. To investigate whether engagement of HVEM by HSV affects the in vivo response to HSV infection, we generated recombinants of HSV-2(333) that expressed wild-type gD (HSV-2/gD) or mutant gD able to bind to nectin-1 (the other principal entry receptor) but not HVEM. Replication kinetics and yields of the recombinant strains on Vero cells were indistinguishable from those of wild-type HSV-2(333). After intravaginal inoculation with mutant or wild-type virus, adult female C57BL/6 mice developed vaginal lesions and mortality in similar proportions, and mucosal viral titers were similar or lower for mutant strains at different times. Relative to HSV-2/gD, percentages of HSV-specific CD8+ T-cells were similar or only slightly reduced after infection with the mutant strain HSV-2/gD-Δ7-15, in all tissues up to 9 days after infection. Levels of HSV-specific CD4+ T-cells five days after infection also did not differ after infection with either strain. Levels of the cytokine IL-6 and of the chemokines CXCL9, CXCL10, and CCL4 were significantly lower in vaginal washes one day after infection with HSV-2/gD compared with HSV-2/gD-Δ7-15. We conclude that the interaction of HSV gD with HVEM may alter early innate events in the murine immune response to infection, without significantly affecting acute mortality, morbidity, or initial T-cell responses after lethal challenge