Advancing Research on Psychological Stress and Aging with the Health and Retirement Study: Looking Back to Launch the Field Forward

Objectives The Health and Retirement Study (HRS) was designed as an interdisciplinary study with a strong focus on health, retirement, and socioeconomic environment, to study their dynamic relationships over time in a sample of mid-life adults. The study includes validated self-report measures and individual items that capture the experiences of stressful events (stressor exposures) and subjective assessments of stress (perceived stress) within specific life domains. Methods This paper reviews and catalogs the peer-reviewed publications that have used the HRS to examine associations between psychological stress measures and psychological, physical health, and economic outcomes. Results We describe the research to date utilizing HRS measures of the following stress types: traumatic and life events, childhood adversity, caregiving and other chronic stressors, discrimination, social strain and loneliness, work stress, and neighborhood disorder. We highlight how to take further advantage of the longitudinal study to test complex biopsychosocial models of healthy aging. Discussion The HRS provides one of the most comprehensive assessments of psychosocial stress in existing population-based studies and offers the potential for a deeper understanding of how psychosocial factors are related to healthy aging trajectories. The next generation of research examining stress and trajectories of aging in the HRS should test complex longitudinal and mediational relationships, include contextual factors in analyses, and include more collaboration between psychologists and population health researchers

Satisfaction with a Vacuum Constriction Device for Erectile Dysfunction among Middle-Aged and Older Veterans

Objectives: To investigate satisfaction with a vacuum constriction device for middle-aged and older male Veterans with erectile dysfunction and their female partners. Methods: Patients (N = 57; mean age\ua0= 64.28\ua0years; SD\ua0= 8.7) received comprehensive education and training and ongoing follow-up of device use, which included a semi-structured interview. Female partners (n = 41) also rated their satisfaction with the device. Results: Over 96% of patients (n = 53/56 responses) endorsed the ability to maintain an erection with the device and 100% (n = 56/56 responses) indicated they would recommend the device to others. Female partners generally rated sex as better with the device (83.8%; n = 31/37 responses). Physical discomfort using the device was reported among 23% of patients (n = 16), and often due to difficulty or pain with the constriction bands. Difficulty obtaining erections with the device, though infrequently reported, was more common with older age. Conclusions: The majority of male patients and their female partners receiving comprehensive training for vacuum constriction device use reported satisfaction with the device. Clinical Implications: Vacuum constriction devices can be highly effective in improving the sexual health and intimacy of Veterans of all ages experiencing erectile dysfunction

Prospective evaluation of the diagnostic performance of a new Helicobacter pylori stool antigen immunochromatographic test

Introduction: Stool-based immunochromatographic test (ICT) requires validation for use in regional setups. Hence, this study was carried out to evaluate the diagnostic performance of a newly developed ICT kit (Pylori-Strip/Pylori K-Set, Corisbio). Materials and Methods: This was a prospective analytical study on patients who underwent upper gastrointestinal endoscopy. The combination of histology and urease was used as gold standard. Stool specimens were subjected to immunochromatographic stool antigen test using Corisbio stool antigen kit. The diagnostic performance of cassette and dipstick method and combination both was compared to the gold standard. Correlation of test efficacy with endoscopic, histological, and demographic parameters was carried out. Results: A total of 143 patients were included in the study. The diagnostic performance of cassette method and dipstick method was sensitivity, 73.3% (22/30) and 73.3% (22/30); specificity, 97.3% (110/113) and 98.23% (111/113); positive predictive value (PPV), 88% (22/25) and 91.66% (22/24); negative predictive value (NPV), 93.22% (110/118) and 93.27% (111/119); and overall accuracy, 92.3% (132/143) and 93% (133/143), respectively, when compared with the gold standard. The combination of the tests had a sensitivity of 73.3% (22/30), specificity of 97.3% (110/113), PPV of 88% (22/25), NPV of 93.22% (110/118), and accuracy of 92.3% (132/143). The diagnostic performance of the kit was unaffected by various demographic, endoscopic, or histological characteristics. Conclusions: The stool-based ICT is rapid and noninvasive diagnostic test with a high specificity, PPV and NPV, and overall accuracy. However, as the sensitivity is low, it should be primarily used as a rapid office test to determine eradication of Helicobacter pylori

Poor Sleep Quality, Psychological Distress, and the Buffering Effect of Mindfulness Training During Pregnancy.

Objective/backgroundPoor sleep quality is common in pregnancy and associated with increased psychological distress, which has adverse consequences for families. Emerging theory suggests that mindfulness-based interventions may help reduce cognitive and emotional reactivity to stressful events. The current study examines the effects of a mindfulness-based intervention on the relationship between poor sleep quality and increased depression symptom severity and perceived stress during pregnancy. Additionally, we explored the prevalence of poor sleep quality in this unique sample and the impact of intervention on sleep quality.ParticipantsParticipants were 215 ethnically diverse, overweight and obese, predominantly low-income pregnant women drawn from a study examining the impact of an 8-week mindfulness-based program (Mindful Moms Training; MMT) to reduce excessive gestational weight gain, stress, and depression compared to treatment as usual (TAU).MethodsParticipants reported global sleep quality, depressive symptoms, and perceived stress at baseline and postintervention.ResultsMost participants (63%) were categorized as poor sleepers at baseline. MMT participants did not experience significantly greater improvement in sleep quality compared to TAU participants. Baseline poor global sleep quality predicted increased depression symptom severity for all participants. Baseline poor global sleep quality predicted increased perceived stress for the TAU group only; this association was not evident in the MMT group.ConclusionsPoor sleep quality is prevalent in overweight and obese predominantly low-income pregnant women. Poor sleep quality was associated with worsening psychological distress, but mindfulness training significantly attenuated the influence of poor sleep on perceived stress

Learning to PERSEVERE: A pilot study of peer mentor support and caregiver education in Lewy body dementia

Background:Lewy Body Disease (LBD) is the second most common neurodegenerative disorder. Despite high family caregiver strain and adverse patient and caregiver outcomes, few interventions exist for LBD family caregivers. Based on a successful peer mentoring pilot study in advanced Parkinson\u27s Disease, we revised the curriculum of this peer-led educational intervention incorporating LBD caregiver input. Objective:We assessed feasibility of a peer mentor-led educational intervention and its impact on LBD family caregivers\u27 knowledge, dementia attitudes, and mastery. Methods:Using community-based participatory research, we refined a 16-week peer mentoring intervention and recruited caregivers online through national foundations. Experienced LBD caregiver mentors were trained and matched with newer caregiver mentees with whom they spoke weekly for 16 weeks, supported by the intervention curriculum. We measured intervention fidelity biweekly, program satisfaction, and change in LBD knowledge, dementia attitudes, and caregiving mastery before and after the 16-week intervention. Results:Thirty mentor-mentee pairs completed a median of 15 calls (range: 8-19; 424 total calls; median 45 min each). As satisfaction indicators, participants rated 95.3% of calls as useful, and at week 16, all participants indicated they would recommend the intervention to other caregivers. Mentees\u27 knowledge and dementia attitudes improved by 13% (p \u3c 0.05) and 7% (p \u3c 0.001), respectively. Training improved mentors\u27 LBD knowledge by 32% (p \u3c 0.0001) and dementia attitudes by 2.5% (p \u3c 0.001). Neither mentor nor mentee mastery changed significantly (p = 0.36, respectively). Conclusions:This LBD caregiver-designed and -led intervention was feasible, well-received, and effective in improving knowledge and dementia attitudes in both seasoned and newer caregivers. Trial registration:https://clinicaltrials.gov/ct2/show/NCT04649164ClinicalTrials.gov Identifier: NCT04649164 ; December 2, 2020

Poor Sleep Quality, Psychological Distress, and the Buffering Effect of Mindfulness Training During Pregnancy

Objective/backgroundPoor sleep quality is common in pregnancy and associated with increased psychological distress, which has adverse consequences for families. Emerging theory suggests that mindfulness-based interventions may help reduce cognitive and emotional reactivity to stressful events. The current study examines the effects of a mindfulness-based intervention on the relationship between poor sleep quality and increased depression symptom severity and perceived stress during pregnancy. Additionally, we explored the prevalence of poor sleep quality in this unique sample and the impact of intervention on sleep quality.ParticipantsParticipants were 215 ethnically diverse, overweight and obese, predominantly low-income pregnant women drawn from a study examining the impact of an 8-week mindfulness-based program (Mindful Moms Training; MMT) to reduce excessive gestational weight gain, stress, and depression compared to treatment as usual (TAU).MethodsParticipants reported global sleep quality, depressive symptoms, and perceived stress at baseline and postintervention.ResultsMost participants (63%) were categorized as poor sleepers at baseline. MMT participants did not experience significantly greater improvement in sleep quality compared to TAU participants. Baseline poor global sleep quality predicted increased depression symptom severity for all participants. Baseline poor global sleep quality predicted increased perceived stress for the TAU group only; this association was not evident in the MMT group.ConclusionsPoor sleep quality is prevalent in overweight and obese predominantly low-income pregnant women. Poor sleep quality was associated with worsening psychological distress, but mindfulness training significantly attenuated the influence of poor sleep on perceived stress