Purpose: Specific stressors associated with caregiving in Mexican American (MA) families are not well documented, yet caregiving issues are paramount because informal care for parents is central to ...their culture. Although MA families who band together to provide care for one member are not unique, the literature does not describe the phenomenon of collective caregiving, which may be widespread but unrecognized. This article describes these understudied families who are poorly served by contemporary health systems because their characteristics are unknown. Design: Descriptive, multisite, longitudinal mixed-methods study of MA caregiving families. Findings: We identified three types of collective caregivers: those providing care for multiple family members simultaneously, those providing care successively to several family members, and/or those needing care themselves during their caregiving of others. Discussion and Conclusions: Collective caregiving of MA elders warrants further investigation. Implications for Practice: Exploration of collective caregiving may provide a foundation for tailored family interventions.
Daily Rhythm in Plasma N-acetyltryptamine Backlund, Peter S.; Urbanski, Henryk F.; Doll, Mark A. ...
Journal of biological rhythms,
06/2017, Letnik:
32, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Normal physiology undergoes 24-h changes in function that include daily rhythms in circulating hormones, most notably melatonin and cortical steroids. This study focused on N-acetyltryptamine, a ...little-studied melatonin receptor mixed agonist-antagonist and the likely evolutionary precursor of melatonin. The central issue addressed was whether N-acetyltryptamine is physiologically present in the circulation. N-acetyltryptamine was detected by LC-MS/MS in daytime plasma of 3 different mammals in subnanomolar levels (mean ± SEM: rat, 0.29 ± 0.05 nM, n = 5; rhesus macaque, 0.54 ± 0.24 nM, n = 4; human, 0.03 ± 0.01 nM, n = 32). Analysis of 24-h blood collections from rhesus macaques revealed a nocturnal increase in plasma N-acetyltryptamine (p < 0.001), which varied from 2- to 15-fold over daytime levels among the 4 animals studied. Related RNA sequencing studies indicated that the transcript encoding the tryptamine acetylating enzyme arylalkylamine N-acetyltransferase (AANAT) is expressed at similar levels in the rhesus pineal gland and retina, thereby indicating that either tissue could contribute to circulating N-acetyltryptamine. The evidence that N-acetyltryptamine is a physiological component of mammalian blood and exhibits a daily rhythm, together with known effects as a melatonin receptor mixed agonist-antagonist, shifts the status of N-acetyltryptamine from pharmacological tool to candidate for a physiological role. This provides a new opportunity to extend our understanding of 24-h biology.
Suicidal ideation (SI) often precedes and predicts suicide attempt and death, is the most common suicidal phenotype and is over-represented in veterans. The genetic architecture of SI in the absence ...of suicide attempt (SA) is unknown, yet believed to have distinct and overlapping risk with other suicidal behaviors. We performed the first GWAS of SI without SA in the Million Veteran Program (MVP), identifying 99,814 SI cases from electronic health records without a history of SA or suicide death (SD) and 512,567 controls without SI, SA or SD. GWAS was performed separately in the four largest ancestry groups, controlling for sex, age and genetic substructure. Ancestry-specific results were combined via meta-analysis to identify pan-ancestry loci. Four genome-wide significant (GWS) loci were identified in the pan-ancestry meta-analysis with loci on chromosomes 6 and 9 associated with suicide attempt in an independent sample. Pan-ancestry gene-based analysis identified GWS associations with DRD2, DCC, FBXL19, BCL7C, CTF1, ANNK1, and EXD3. Gene-set analysis implicated synaptic and startle response pathways (q's<0.05). European ancestry (EA) analysis identified GWS loci on chromosomes 6 and 9, as well as GWS gene associations in EXD3, DRD2, and DCC. No other ancestry-specific GWS results were identified, underscoring the need to increase representation of diverse individuals. The genetic correlation of SI and SA within MVP was high (rG = 0.87; p = 1.09e-50), as well as with post-traumatic stress disorder (PTSD; rG = 0.78; p = 1.98e-95) and major depressive disorder (MDD; rG = 0.78; p = 8.33e-83). Conditional analysis on PTSD and MDD attenuated most pan-ancestry and EA GWS signals for SI without SA to nominal significance, with the exception of EXD3 which remained GWS. Our novel findings support a polygenic and complex architecture for SI without SA which is largely shared with SA and overlaps with psychiatric conditions frequently comorbid with suicidal behaviors.
Objectives An abridged version of the 25-item Male Sexual Health Questionnaire (MSHQ) was developed and validated (MSHQ-EjD Short Form) for assessing ejaculatory dysfunction (EjD). Methods The MSHQ ...was administered to 1245 men in the Men’s Sexual Health Population Survey, 179 gay/bisexual men in the Urban Men’s Health Study, and 6909 men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) in the BPH Registry & Patient Survey. Factor analysis, scale reliability, construct and discriminant validity, and the correlation between the MSHQ-EjD Short Form and the MSHQ ejaculatory function domain were assessed. Results Factor loadings of greater than 0.5 were demonstrated for four ejaculatory function items (force, volume, frequency, and delay). The force and volume of ejaculation had the greatest factor loadings (range 0.77 to 0.81), followed by frequency of ejaculation (0.64 and 0.66). These three ejaculatory function items had a high degree of internal consistency (Cronbach alpha ≥0.78) and test-retest reliability ( r = 0.72). The three items discriminated between men with none/mild LUTS and those with moderate/severe LUTS ( P <0.001). After adjusting for age, depression, and erectile function, the odds ratio for a diagnosis of moderate/severe LUTS was 0.68 (95% confidence interval 0.49 to 0.96; P <0.05). The three items had a correlation coefficient of 0.95 with the 7-item MSHQ ejaculatory function domain. The MSHQ ejaculation bother item, an independent domain, showed moderate correlation with the three ejaculatory function items ( r = −0.41 and r = −0.45). Conclusions The results of our study have shown that the MSHQ-EjD Short Form, with three ejaculatory function items and one ejaculation bother item, has excellent psychometric properties and should be a useful instrument for assessing EjD in clinical and research settings.
Abstract We recently reported evidence for an association between the individual variation in normal human episodic memory and a common variant of the KIBRA gene, KIBRA rs17070145 (T-allele). Since ...memory impairment is a cardinal clinical feature of Alzheimer's disease (AD), we investigated the possibility of an association between the KIBRA gene and AD using data from neuronal gene expression, brain imaging studies, and genetic association tests. KIBRA was significantly over-expressed and three of its four known binding partners under-expressed in AD-affected hippocampal, posterior cingulate and temporal cortex regions ( P < 0.010, corrected) in a study of laser-capture microdissected neurons. Using positron emission tomography in a cohort of cognitively normal, late-middle-aged persons genotyped for KIBRA rs17070145, KIBRA T non-carriers exhibited lower glucose metabolism than did carriers in posterior cingulate and precuneus brain regions ( P < 0.001, uncorrected). Lastly, non-carriers of the KIBRA rs17070145 T-allele had increased risk of late-onset AD in an association study of 702 neuropathologically verified expired subjects ( P = 0.034; OR = 1.29) and in a combined analysis of 1026 additional living and expired subjects ( P = 0.039; OR = 1.26). Our findings suggest that KIBRA is associated with both individual variation in normal episodic memory and predisposition to AD.
The relationships between social and physical activities in older adulthood deserve further attention. This study explores the relationship of social leisure activity (SLA) and the psychological ...construct, valuation of life (VOL), to physical activity among the young, middle, and oldest old. Significant differences and relationships were observed. Oldest old showed significant drops in ability and activity, both physical and leisure activity. VOL is connected to SLA and physical activities specific to improving flexibility. The study findings suggest SLA and VOL are important points of leverage for helping older adults forestall decreases in physical activity, especially for the oldest old.
Only recently has research focused on families and social support systems of lesbian, gay, bisexual, and transgender (LGBT) older adults; to date, this research is limited. This article highlights ...new findings and insights on the changing American family, with an emphasis on LGBT families
and caregiving, and explores the importance of recognizing the diversity in family types and roles- especially when considering the care provided by and for LGBT individuals.
Palliative and end-of-life care (PEOLC) in Mexican American (MA) caregiving families remains unexplored. Its onset was uncovered in our mixed methods, multisite, interdisciplinary, qualitative ...descriptive study of 116 caregivers, most of whom had provided long-term informal home care for chronically ill, disabled older family members. This subanalysis used Life Course Perspective to examine the “point of reckoning” in these families, where an older person is taken in for care, or care escalates until one recognizes oneself as the primary caregiver. Ninety-three of 116 caregivers recognized and spontaneously reported a “reckoning point” that initiated the caregiving trajectory, while eight cited “gradual decline” into caregiving for elders in their homes. This “reckoning point,” which marks the assumption of this role, may afford a fertile opportunity for referral to community resources or initiation of formal PEOLC, thereby improving the quality of life for these older individuals and their families.
The purpose of this article is to describe the Longevity Study: Learning From Our Elders, a research program on healthy aging that began in 2007 at the Center for Healthy Aging at Banner Sun Health ...Research Institute. As of June 2015, 1139 participants (age range of 50–110 years) completed baseline assessments with the majority living in the Sun Cities retirement communities northwest of Phoenix, Arizona but expanding throughout the state. The registry includes over 830 currently active participants with 450 aged 80 years and older, 188 aged 90 and older, and 27 centenarians. Data from in-person interviews at the Center for Healthy Aging in Sun City or in the participants’ residences which includes sociodemographic, medical, cognitive, physical and psychosocial variables have been collected since the study’s inception. This paper outlines some of the key demographic and clinical characteristics of the Longevity Study, its progress, and future directions. It also reflects on how exceptional aging individuals function psychosocially, cognitively and physically, particularly among individuals aged 85 and older.
This mixed methods, multi-site, National Institute of Nursing Research (NINR)-funded, interdisciplinary, descriptive study aimed to identify expressions of worry in qualitative data obtained from ...caregiving Mexican American (MA) families assisting older adults. The purpose of this portion of the inquiry was to determine how worry is expressed, what happens to caregivers when they worry, and what adaptive strategies they used. We examined semi-structured interviews completed during six in-home visits with 116 caregivers. We identified 366 worry quotations from 639 primary documents in ATLAS.ti, entered them into matrices, and organized findings under thematic statements. Caregivers expressed cultural and contextual worries, worried about transitions and turning points in care, and identified adaptive strategies. Despite these strategies, worry persisted. Constant worry may be an allied, important aspect of caregiver burden. We need additional longitudinal research to better understand the experience of MA caregivers for older adults and to provide empirically supported interventions, programs, and services that reduce worry.