Using Experiential and Collaborative Methods with Undergraduates and Older Persons as part of an Introduction to Gerontology Course

This study examines an Introduction to Gerontology course for undergraduate students that integrates experiential and collaborative learning experiences as part of a general course requirement. Experiential learning encourages students to go outside of the classroom and learn about aging from an older person in a field setting. The collaborative group approach is designed to have peers work together in the course. This study used qualitative methods to examine undergraduates’ learning experiences as a result of participation in a multiple-interview and groupwork-based project through their enrollment in the Introduction to Gerontology course. Content analysis was used to analyze multiple sources of data produced by the 43 students enrolled. Data were retrieved from students’ self-reflections in open-ended questionnaires and blinded course evaluations along with the authors’ own observational work. Findings indicate that students benefited from the experiential component which served to dispel stereotypes and preconceived ideas about older persons, though that did not necessarily translate into generating students’ interest in making gerontology a career path. Collaborative work, although seen generally as positive, had some mixed results based on students’ roles in the group and dynamics of a few groups. Issues of some student roles in the group unexpectedly not meeting with the older person are also discussed along with the impact of the project upon the community-partnered organization

Utilizing a Community-University Partnership to Meet Grandfamilies’ Needs: Development and Evaluation of a Grandchildren-mentoring Program

In response to the increasing rate of grandparent-headed homes and the needs of grandparents and grandchildren, we engaged in a community-university partnership to develop, implement, and evaluate a grandchildren-mentoring program. Prior to developing the grandchildren-mentoring program, a county needs assessment was conducted. The needs assessment revealed that grandparents wanted opportunities for mentorship of their grandchildren. As a result, we partnered with an undergraduate practicum course to create a new option of college students engaging with grandchildren. During our inaugural grandchildren-mentoring program, we conducted focus groups/interviews with grandparents (n = 5) and grandchildren (n = 7) at the end of the nine-month program. Data analysis of the focus group transcripts revealed that grandparents believed the two-hour weekly meetings (between the grandchildren and the student mentor) provided respite and grandparents would enjoy having a student again. Grandchildren commented they trusted their student mentors and did not like that they could not see them after the program ended. The grandchild-mentoring program was well received by grandparents and grandchildren and, although it was designed to support grandchildren, the program met a stated need of grandfamilies in our community. As a result, this program may be beneficial to both grandparents and grandchildren and other university-community partnerships should consider working with students to implement similar programming to support grandfamilies

Right-Sided Endocarditis Secondary to Aeromonas hydrophila: A Case Report

Right-sided endocarditis represents a distinct clinical condition observed in individuals with a history of parenteral drug use or those with implanted pacemakers or other intracardiac devices. Aeromonas infections, although uncommon in humans, particularly endocarditis cases, are exceedingly rare. Here, we report the case of a 72-year-old female with a medical history of arterial hypertension and chronic kidney disease undergoing hemodialysis via a tunneled permanent central venous catheter. She presented with chills and a fever of 38.3°C. Physical examination revealed a grade 3 protosystolic murmur at the tricuspid focus. Blood cultures from central and peripheral sites yielded growth of Aeromonas hydrophila. Transthoracic echocardiography demonstrated a fusiform, semi-mobile vegetation measuring 16 x 15 mm at the outlet of the superior vena cava, suggestive of endocarditis. Intravenous fluoroquinolones were initiated based on antibiogram results, leading to resolution of imaging findings after a 21-day treatment course

Hypertrophic Cardiomyopathy Diagnosis and Treatment in High- and Low-Income Countries: A Narrative Review

Hypertrophic cardiomyopathy (HCM) is a hereditary cardiac condition characterized by unexplained left ventricular hypertrophy without a hemodynamic cause. This condition is prevalent in the United States, resulting in various clinical manifestations, including diastolic dysfunction, left ventricular outflow obstruction, cardiac ischemia, and atrial fibrillation. HCM is associated with several genetic mutations, with sarcomeric mutations being the most common and contributing to a more complex disease course. Early diagnosis of HCM is essential for effective management, as late diagnosis often requires invasive treatments and creates a substantial financial burden. Disparities in HCM diagnosis and treatment exist between highincome and low-income countries. High-income countries have more resources to investigate and implement advanced diagnostic and treatment modalities. In contrast, low-income countries face challenges in accessing diagnostic equipment, trained personnel, and affordable medications, leading to a lower quality of life and life expectancy for affected individuals. Diagnostic tools for HCM include imaging studies such as 2D echocardiography, cardiovascular magnetic resonance (CMR), and electrocardiograms (ECGs). CMR is considered the gold standard but remains inaccessible to a significant portion of the world\u27s population, especially in low-income countries. Genetics plays a crucial role in HCM, with numerous mutations identified in various genes. Genetic counseling is essential but often limited in low-income countries due to resource constraints. Disparities in healthcare access and adherence to treatment recommendations exist between high-income and low-income countries, leading to differences in patient outcomes. Addressing these disparities is essential to improve the overall management of HCM on a global scale. In conclusion, this review highlights the complex nature of HCM, emphasizing the importance of early diagnosis, genetic counseling, and access to appropriate diagnostic and therapeutic interventions. Addressing healthcare disparities is crucial to ensure that all individuals with HCM receive timely and effective care, regardless of their geographic location or socioeconomic status

Screening for Sudden Cardiac Death in the Young

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Water intake, hydration status and 2-year changes in cognitive performance: a prospective cohort study

BackgroundWater intake and hydration status have been suggested to impact cognition; however, longitudinal evidence is limited and often inconsistent. This study aimed to longitudinally assess the association between hydration status and water intake based on current recommendations, with changes in cognition in an older Spanish population at high cardiovascular disease risk.MethodsA prospective analysis was conducted of a cohort of 1957 adults (aged 55-75) with overweight/obesity (BMI between >= 27 and = 300 mmol/L (dehydrated). Water intake was assessed as total drinking water intake and total water intake from food and beverages and according to EFSA recommendations. Global cognitive function was determined as a composite z-score summarizing individual participant results from all neuropsychological tests. Multivariable linear regression models were fitted to assess the associations between baseline hydration status and fluid intake, continuously and categorically, with 2-year changes in cognitive performance.ResultsThe mean baseline daily total water intake was 2871 +/- 676 mL/day (2889 +/- 677 mL/day in men; 2854 +/- 674 mL/day in women), and 80.2% of participants met the ESFA reference values for an adequate intake. Serum osmolarity (mean 298 +/- 24 mmol/L, range 263 to 347 mmol/L) indicated that 56% of participants were physiologically dehydrated. Lower physiological hydration status (i.e., greater serum osmolarity) was associated with a greater decline in global cognitive function z-score over a 2-year period (beta: - 0.010; 95% CI - 0.017 to - 0.004, p-value = 0.002). No significant associations were observed between water intake from beverages and/or foods with 2-year changes in global cognitive function.ConclusionsReduced physiological hydration status was associated with greater reductions in global cognitive function over a 2-year period in older adults with metabolic syndrome and overweight or obesity. Future research assessing the impact of hydration on cognitive performance over a longer duration is needed

HIV-1 subtype and viral tropism determination for evaluating antiretroviral therapy options: an analysis of archived Kenyan blood samples

<p>Abstract</p> <p>Background</p> <p>Infection with HIV-1 is characterized by genetic diversity such that specific viral subtypes are predominant in specific geographical areas. The genetic variation in HIV-1 <it>pol </it>and <it>env </it>genes is responsible for rapid development of resistance to current drugs. This variation has influenced disease progression among the infected and necessitated the search for alternative drugs with novel targets. Though successfully used in developed countries, these novel drugs are still limited in resource-poor countries. The aim of this study was to determine HIV-1 subtypes, recombination, dual infections and viral tropism of HIV-1 among Kenyan patients prior to widespread use of antiretroviral drugs.</p> <p>Methods</p> <p>Remnant blood samples from consenting sexually transmitted infection (STI) patients in Nairobi were collected between February and May 2001 and stored. Polymerase chain reaction and cloning of portions of HIV-1 <it>gag</it>, <it>pol </it>and <it>env </it>genes was carried out followed by automated DNA sequencing.</p> <p>Results</p> <p>Twenty HIV-1 positive samples (from 11 females and 9 males) were analyzed. The average age of males (32.5 years) and females (26.5 years) was significantly different (p value < 0.0001). Phylogenetic analysis revealed that 90% (18/20) were concordant HIV-1 subtypes: 12 were subtype A1; 2, A2; 3, D and 1, C. Two samples (10%) were discordant showing different subtypes in the three regions. Of 19 samples checked for co-receptor usage, 14 (73.7%) were chemokine co-receptor 5 (CCR5) variants while three (15.8%) were CXCR4 variants. Two had dual/mixed co-receptor use with X4 variants being minor population.</p> <p>Conclusion</p> <p>HIV-1 subtype A accounted for majority of the infections. Though perceived to be a high risk population, the prevalence of recombination in this sample was low with no dual infections detected. Genotypic co-receptor analysis showed that most patients harbored viruses that are predicted to use CCR5.</p