EXPERIENCING POSITIVE ASPECTS IN BEING A SPOUSAL CAREGIVER IN PARKINSON’S AND ALZHEIMER’S DISEASE

poster abstractAim: A primary aim of this study was to describe caregiver appraisal and coping strategies in caregivers of family members with Parkinson’s (PD) or Alzheimer’s disease (AD). This study was part of a larger randomized clinical trial of a skill building intervention for caregivers. Method: To achieve this aim, 84 spousal caregivers who were consecutively enrolled in the study were interviewed at baseline. The interview focused on specific caregiving situations where the caregiver was asked to describe a positive or meaningful caregiving event. Interviews were semi-structured and included probes to elicit the full narrative of the events. Interviews were transcribed verbatim and analyzed by the research team utilizing a thematic analysis. Results: Of the 84 caregivers, 48% (N=44) were PD caregivers and 52% (N=40) were AD caregivers. Male caregivers comprised 17% (N=14) of the sample. The mean age of the caregivers was 63.7 years (SD ±26.8) with the mean age of their spouses being 75.5 years (SD ± 7.2). The core theme identified was “time spent together”. Within this core theme were several relational sub-themes including turning back the hands of time, being able to rely on the caregiver, and experiencing moments of joy when the family member can participate. Conclusions: Differences existed in both how easily caregivers could identify positive or meaningful aspects to caregiving and how many aspects they could identify. However, the majority of caregivers were able to identify a positive or a meaningful aspect to spousal caregiving. Future intervention studies with spousal caregivers might consider developing targeted interventions based on positive meaningful caregiving situations and building on this relational aspect

Efficacy of treatments against garlic mustard (Alliaria petiolata) and effects on forest understory plant diversity

Garlic mustard, an invasive exotic biennial herb, has been identified in the Upper Peninsula of Michigan, but is not yet widely distributed. We tested the effectiveness and impact of management tools for garlic mustard in northern hardwood forests. Six treatment types (no treatment control, hand-pull, herbicide, hand-pull/herbicide, scorch, and hand-pull/scorch) were applied within a northern hardwood forest invaded by garlic mustard. We sampled understory vegetation within plots to compare garlic mustard abundance (distinguishing first and second year plants) and native plant diversity before and after treatment. Results immediately following treatment indicated that garlic mustard seedling abundance was significantly reduced by herbicide, hand-pull/herbicide, scorch, and hand-pull/scorch treatments, and that adult abundance was reduced by all treatments. However, sampling of treatment sites one year later showed an increase in seedling abundance in herbicide and hand-pull/herbicide plots. Adult garlic mustard abundance after one year was lower than the control with the exception of the hand-pull plots where adult abundance did not differ. After one year, understory species richness and Shannon’s Diversity were lower in the herbicide and pull/herbicide treatments. Based on these results, we conclude that single-year treatment of garlic mustard with hand-pulling, herbicide, and/or scorching is ineffective in reducing garlic mustard abundance and may inadvertently increase the success of garlic mustard, while negatively impacting native understory species

Most of the cases are very similar. : Documenting and corroborating conflict-related sexual violence affecting Rohingya refugees

BACKGROUND: In August 2017, a large population of Rohingya from northern Rakhine state in Myanmar fled to Bangladesh due to clearance operations by the Myanmar security forces characterized by widespread and systematic violence, including extensive conflict-related sexual violence (CRSV). This study sought to document the patterns of injuries and conditions experienced by the Rohingya, with a specific focus on sexual violence. METHODS: Qualitative interviews were conducted with 26 health care professionals who cared for Rohingya refugees after their arrival in Bangladesh between November 2019 and August 2020. RESULTS: Health care workers universally reported hearing accounts and seeing evidence of sexual and gender-based violence committed against Rohingya people of all genders by the Myanmar military and security forces. They observed physical and psychological consequences of such acts against the Rohingya while patients were seeking care. Health care workers shared that patients faced pressure not to disclose their experiences of CRSV, likely resulted in an underreporting of the prevalence of sexual violence. Forced witnessing of sexual violence and observed increases in pregnancy and birth rates as a result of rape are two less-reported issues that emerged from these data. CONCLUSIONS: Healthcare workers corroborated previous reports that the Rohingya experienced CRSV at the hands of the Myanmar military and security forces. Survivors often revealed their experiences of sexual violence while seeking care for a variety of physical and psychological conditions. Stigma, cultural pressure, and trauma created barriers to disclosing experiences of sexual violence and likely resulted in an underreporting of the prevalence of sexual violence. The findings of this research emphasize the importance of offering universal and comprehensive trauma-informed services to all refugees with the presumption of high rates of trauma in this population and many survivors who may never identify themselves as such

Adherence to the Planetary Health Diet Index and Correlation with Nutrients of Public Health Concern: An analysis of NHANES 2003-2018:Planetary Health Diet Index: Trends in the US

Background: The Planetary Health Diet Index (PHDI) is a novel measure adapted to quantify alignment with the dietary evidence presented by the EAT-Lancet Commission on Food, Planet Health.Objectives: To examine how population-level health and sustainability of diet as measured by the PHDI changed from 2003-2018, and to assess how PHDI correlated with inadequacy for nutrients of public health concern (iron, calcium, potassium, and fiber) in the US.Methods: We estimated survey-weighted trends in PHDI scores and median intake of PHDI components in a nationally-representative sample of 33,859 adults aged 20+ years from eight cycles (2003–2018) of the National Health and Nutrition Examination Survey with two days of dietary recall data. We used the NCI method to examine how PHDI correlated with inadequate intake of iron, calcium, potassium, and fiber.Results: Out of a theoretical range of 0 to 140, median PHDI value increased by 4.2 points over the study period, from 62.7 (95% CI: 62.0, 63.4) points in 2003-2004 to 66.9 (66.2, 67.7) points in 2017-2018 (ptrend<0.001), although most of this change occurred before 2011-2012 and plateaued thereafter. For adequacy components that are encouraged for consumption, non starchy vegetable intake significantly decreased over time, while whole grains, nuts and seeds, and unsaturated oils increased. For moderation components with recommended limits for consumption, poultry and egg intake increased, but red and processed meat, added sugars, saturated fats, and starchy vegetables decreased over time. Higher PHDI values were associated with lower probability of iron, fiber, and potassium inadequacy.Conclusions: Although there have been positive changes over the past 20 years, there is substantial room for improving the health and sustainability of the US diet. Shifting diets towards EAT-Lancet recommendations would improve nutrient adequacy for iron, fiber and potassium. Policy action is needed to support healthier, more sustainable diets in the US and globally

Dietary quality and cardiometabolic indicators in the USA: A comparison of the Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension

Background. The Planetary Health Diet Index (PHDI) measures adherence to the sustainable dietary guidance proposed by the EAT-Lancet Commission on Food, Planet, Health. To justify incorporating sustainable dietary guidance such as the PHDI in the US, the index needs to be compared to health-focused dietary recommendations already in use. The objectives of this study were to compare the how the Planetary Health Diet Index (PHDI), the Healthy Eating Index34 2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to cardiometabolic risk factors.Methods and Findings. Participants from the National Health and Nutrition Examination Survey (2015-2018) were assigned a score for each dietary index. We examined disparities in dietary quality for each index. We used linear and logistic regression to assess the association of standardized dietary index values with waist circumference, blood pressure, HDL-C, fasting plasma glucose (FPG) and triglycerides (TG). We also dichotomized the cardiometabolic indicators using the cutoffs for the Metabolic Syndrome and used logistic regression to assess the relationship of the standardized dietary index values with binary cardiometabolic risk factors. We observed diet quality disparities for populations that were Black, Hispanic, low-income, a low-education. Higher diet quality was associated with improved continuous and binary cardiometabolic risk factors, although higher PHDI was not associated with high FPG and was the only index associated with lower TG. These patterns remained consistent in sensitivity analyses.Conclusions. Sustainability-focused dietary recommendations such as the PHDI have similar cross-sectional associations with cardiometabolic risk as HEI-2015 or DASH. Health-focused dietary guidelines such as the forthcoming 2025-2030 Dietary Guidelines for Americans can consider the environmental impact of diet and still promote cardiometabolic health

Dietary Quality and Dietary Greenhouse Gas Emissions in the USA: A Comparison of the Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension

BackgroundThe Planetary Health Diet Index (PHDI) measures adherence to the dietary pattern presented by the EAT-Lancet Commission, which aligns health and sustainability targets. There is a need to understand how PHDI scores correlate with dietary greenhouse gas emissions (GHGE) and how this differs from the carbon footprints of scores on established dietary recommendations. The objectives of this study were to compare how the PHDI, Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to (a) dietary GHGE and (b) to examine the influence of PHDI food components on dietary GHGE.MethodsWe used life cycle assessment data from the Database of Food Recall Impacts on the Environment for Nutrition and Dietary Studies to calculate the mean dietary GHGE of 8,128 adult participants in the 2015–2016 and 2017–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Poisson regression was used to estimate the association of (a) quintiles of diet score and (b) standardized dietary index Z-scores with dietary GHGE for PHDI, HEI-2015, and DASH scores. In secondary analyses, we used Poisson regression to assess the influence of individual PHDI component scores on dietary GHGE.ResultsWe found that higher dietary quality on all three indices was correlated with lower dietary GHGE. The magnitude of the dietary quality-dietary GHGE relationship was larger for PHDI [-0.4, 95% CI (-0.5, -0.3) kg CO2 equivalents per one standard deviation change] and for DASH [-0.5, (-0.4, -0.6) kg CO2-equivalents] than for HEI-2015 [-0.2, (-0.2, -0.3) kg CO2-equivalents]. When examining PHDI component scores, we found that diet-related GHGE were driven largely by red and processed meat intake.ConclusionsImproved dietary quality has the potential to lower the emissions impacts of US diets. Future efforts to promote healthy, sustainable diets could apply the recommendations of the established DASH guidelines as well as the new guidance provided by the PHDI to increase their environmental benefits