Perceptions of Aging Among Rural,Midwestern Senior Citizens: Signs of Women's Resiliency

ABSTRACT

This study utilized both quantitative and qualitative approaches to examine perceptions of aging among rural-dwelling senior citizens (203 women and 112 men), ages 65 and older. Quantitative results revealed that, despite no significant gender differences in the total number of medical conditions reported, women were less likely than men to report that health problems interfered with their daily functioning. Qualitative analyses revealed that women were particularly like to identify relationships, frame of mind, participating in activities, and religion/spirituality as important contributors to successful aging.     

Assessment of Cardiovascular Risk in Collegiate Football Players and Nonathletes

Abstract

Collegiate American football players may be at risk for cardiovascular disease. Objective: To compare cardiovascular disease risk factors and cardiovascular structure and function parameters of football players, stratified by position, to a group of sedentary, nonathletes. Participants: Twenty-six collegiate football players and 13 nonathletes participated in this study. Methods: Blood pressures, anthropometrics, and blood chemistries were obtained and analyzed using standardized procedures. Resting echocardiography was used to evaluate cardiac morphology and function. Brachial artery flow-mediated dilation was assessed using high-resolution ultrasonography. Results: The prevalence of the metabolic syndrome was significantly higher amongst the linemen compared to the skill-position players (46% versus 0%, p < .05). Mildly abnormal wall thickness was noted in 20% of the football players. No significant differences in vascular function were observed between the groups. Conclusions: The increased prevalence of the metabolic syndrome and its components in the collegiate linemen may increase cardiovascular disease risk.     

Active Commuting Patterns at a Large,Midwestern College Campus

Abstract

Objective: To understand patterns and influences on active commuting (AC) behavior. Participants: Students and faculty/staff at a university campus. Methods: In April–May 2008, respondents answered an online survey about mode of travel to campus and influences on commuting decisions. Hierarchical regression analyses predicted variance in walking and biking using sets of demographic, psychological, and environmental variables. Results: Of 898 respondents, 55.7% were female, 457 were students (50.4%). Students reported more AC than faculty/staff. For students, the models explained 36.2% and 29.1% of the variance in walking and biking, respectively. Among faculty/staff, the models explained 45% and 25.8% of the variance in walking and biking. For all models, the psychological set explained the greatest amount of variance. Conclusions: With current economic and ecological concerns, AC should be considered a behavior to target for campus health promotion.     

Neuropsychological Correlates of Performance Based Functional Status in Elder Adult Protective Services Referrals for Capacity Assessments

We have previously described high rates of executive function impairment in clients referred by Adult Protective Services (APS) to geriatric psychiatry for decision-making capacity assessments. The purpose of this study was to determine the independent relationship between neuropsychological screening instruments, particularly instruments sensitive to executive function, and performance-based functional tasks in elder referrals. Our retrospective medical review (n = 75/157 referrals completed all neuropsychological and functional assessments) revealed that only the Executive Interview (EXIT25) contributed independent variance to money management performance (R² = 0.29, p < 0.001), telephone use ability (R² = 0.39, p < 0.001), and summed performance (R² = 0.45, p < 0.001). Executive instruments may specifically inform decision-making capacity assessments.     

Least Restrictive or Least Understood? Waist Restraints,Provider Practices,and Risk of Harm

Since implementation of The Omnibus Budget Reconciliation Act of 1987, restraint use in American nursing homes has reduced dramatically. The reduction in vest restraints has resulted in an increase in “least restrictive” devices such as waist restraints. Although this analysis of U.S. Food and Drug Administration Adverse Event Reporting Data Files found that waist devices pose the same potential risk for asphyxial death as vest restraints, few health professionals and consumers are aware of this outcome. Post-marketing device reporting needs better data quality and surveillance, which can certainly benefit the Centers for Medicare and Medicaid Services in their efforts to regulate and enforce standards of care that reduce deaths and injuries to vulnerable nursing home residents.     

Gender,Racial, and Ethnic Disclosure in NIH K-Award Funded Diabetes and Obesity Clinical Trials∗

In 1993, the National Institutes of Health (NIH) passed The Revitalization Act (Subtitle B) which mandated that all NIH funded clinical trials have “appropriate representation” of minority and women subjects. Our aim was to evaluate the impact of the mandate by examining the reporting and inclusion of minority and female subjects into NIH K-Award funded clinical trials, addressing the minority predominant diagnoses of diabetes and clinical obesity. Using the CRISP search engine and PUBMED, we selected publications published by the National Institute on Aging (NIA) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) K-grant recipients during 1989–2004, associated with all the diabetes and obesity clinical trials. Studies were stratified into three timeline categories (1989–1993, pre-mandate; 1993–1996, post-mandate, and 1997–present, well past mandate) to evaluate trends in the recruiting of minorities and women before, during, and after the passing of the Revitalization Act. Of the 165 papers, only 37% disclosed race, a number that did not improve over time (p = .15), whereas 92% disclosed gender. Clinical trials that focused on females increased across the 3 timeframes (p < .001) for diabetes studies but not obesity studies. Overall, disclosure of race declined over the 3 timeframes whereas individually, the disclosure of African Americans improved.     

Birth Mothers' Perceptions of Their Parented Children's Knowledge of and Involvement in Adoption

An examination of birth mothers' perceptions of the relationship between the children she is parenting and the children she placed for adoption offers unique insight into the life course of openness. In the present study, 94 birth mothers from the United States participated in a semi-structured interview, discussing their oldest parented children's knowledge of and experience with their siblings placed for adoption. Results show that 59 birth mothers have an oldest parented child who is aware of their adopted sibling, although 4 of these do not know their true relationship with the adopted sibling. Of these, 27 had direct contact with the adopted sibling, 4 had indirect contact through the birth mother, and 1 had previous contact that has since ceased. A majority of birth mothers indicated that their oldest parented child would like more contact, direct contact, or more information about the adopted youth. Implications for research and practice with birth mothers and their children separated by adoption are discussed.     

Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

Abstract

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

Conventional and expanded adverse childhood experiences (ACEs) and maternal functioning among low-income Black mothers

A paucity of research has examined the individual and cumulative effects of conventional and expanded adverse childhood experiences (ACEs) on maternal functioning, especially among low-income Black mothers. Using self-report data from a subsample of Black mothers (N = 157) who participated in a larger study to evaluate the effectiveness of an urban public prekindergarten program in the mid-Atlantic region of the United States, we examined the prevalence of ACEs and the individual and cumulative effects of conventional (i.e., family trauma and dysfunction) and expanded (i.e., community stressors) ACEs on depression and health among low-income Black mothers. Findings indicated that Black mothers had more exposure to expanded than conventional ACEs. Hierarchical regression analyses revealed that experience of physical neglect was significantly associated with depression and physical abuse with compromised health, and perceived experience of racism was a predictor of depression and compromised health. More conventional and expanded ACEs were associated with clinical levels of depression and compromised health. Findings highlight the need for more research related to the impact of ACEs, especially expanded ACEs, on mental and behavioural health outcomes. Additionally, our findings indicate the need for more trauma-informed care to reduce and address the impact of individual and community-level adversities on low-income Black mothers.