Background ACC/AHA guidelines caution against the use of antihypertensive therapy in the setting of

Among nursing home (NH) residents with Alzheimer’s disease (AD) and AD-related dementias (AD/ADRD), racial/ethnic disparities in quality of care exist. However, little is known about quality of life (QoL). This study examines racial/ethnic differences in self-reported QoL among NH residents with AD/ADRD. Methods: Validated, in-person QoL surveys from 12,562 long-stay NH residents with AD/ADRD in Minnesota (2012–2015) were linked to Minimum Data Set assessments and facility characteristics. Hierarchical linear models assessed disparities in resident-reported mean QoL score (range, 0–100 points), adjusting for case-mix and facility factors. Results: Compared to White residents, racially/ethnically minoritized residents reported significantly lower total mean QoL scores (75.53 points vs. 80.34 points, p <.001). After adjustment for resident- and facility-level characteristics, significant racial/ethnic differences remained, with large disparities in food enjoyment, attention from staff, and engagement domains. Discussion: Policy changes and practice guidelines are needed to address racial/ethnic disparities in QoL of NH residents with AD/ADRD.

A three-armed drinking cessation trial in Vietnam found that both a brief and intensive version of an intervention effectively reduced hazardous drinking in people living with HIV. We used group-based trajectory modeling (GBTM) to assess the extent to which findings may vary by latent subgroups distinguished by their unique responses to the intervention. Using data on drinking patterns collected over the 12 months, GBTM identified five trajectory groups, three of which were suboptimal [“non-response” (17.2%); “non-sustained response” (15.7%), “slow response” (13.1%)] and two optimal [“abstinent” (36.4%); “fast response” (17.6%)]. Multinomial logistic regression was used to determine that those randomized to any intervention arm were less likely to be in a suboptimal trajectory group, even more so if randomized to the brief (vs. intensive) intervention. Older age and higher baseline coping skills protected against membership in suboptimal trajectory groups; higher scores for readiness to quit drinking were predictive of it. GBTM revealed substantial heterogeneity in participants’ response to a cessation intervention and may help identify subgroups who may benefit from more specialized services within the context of the larger intervention.

Are children from “Eastern” cultures less emotionally expressive and reactive than children from “Western” cultures? To answer this, we used a multi-level and multi-contextual approach to understand variations in emotion displays and cortisol reactivity among preschoolers living in China and the United States. One hundred two preschoolers from China (N = 58; 55% males) and the United States (N = 44, 48% males) completed three (i.e., control, interpersonal-related, and achievement-related) emotion-challenging paradigms over 3 days. Behavioral emotion expressions were coded, and salivary cortisol was sampled 30 minutes before and across 90 minutes post-task. Without considering context, Chinese preschoolers displayed fewer levels of positive and negative emotion expressions relative to their United States counterparts. However, Chinese preschoolers displayed similar levels of expressions as their United States counterparts during an achievement-related challenge that is more salient to their sociocultural emphases and showed higher negative emotion expressions in this challenge, relative to other contexts. Moreover, only the achievement-related challenge elicited increased cortisol levels among Chinese preschoolers, and this was correlated with higher levels of negative expressions. For US preschoolers, no cortisol increase was observed in any challenging paradigms, nor was cortisol associated with emotional expressions. Findings counter prior notions that East Asian children are generally less emotionally expressive. Instead, an achievement-related challenge elicited higher emotion expression and cortisol reactivity among Chinese preschoolers, suggesting that children's emotion expression and biological reactivity may be most responsive to contexts salient to their socio-cultural environments. We discuss the importance of considering cultural contexts when studying emotion regulation. RESEARCH HIGHLIGHTS: Chinese preschoolers displayed lower overall positive and negative expressions relative to their US counterparts without considering situational contexts. Chinese preschoolers displayed similar levels of emotion expressions as their US counterparts during an achievement-related challenge salient to their social-cultural environment. Chinese preschoolers are particularly responsive to achievement-related challenges, relative to other emotion-challenging situations that are less culturally salient. No cortisol increase was observed in any of the emotion-challenging paradigms among US preschoolers. Children's emotion expression and biological reactivity may be most responsive to challenges relevant to their socio-cultural environments.

The All of Us Research Program's Data and Research Center (DRC) was established to help acquire, curate, and provide access to one of the world's largest and most diverse datasets for precision med...

<p>Although recent studies have demonstrated associations between nonchromosomal birth defects and several pediatric cancers, less is known about their role on childhood leukemia susceptibility. Using data from the Childhood Cancer and Leukemia International Consortium, we evaluated associations between nonchromosomal birth defects and childhood leukemia. Pooling consortium data from 18 questionnaire‐based and three registry‐based case‐control studies across 13 countries, we used multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between a spectrum of birth defects and leukemia. Our analyses included acute lymphoblastic leukemia (ALL, n = 13 115) and acute myeloid leukemia (AML, n = 2120) cases, along with 46 172 controls. We used the false discovery rate to account for multiple comparisons. In the questionnaire‐based studies, the prevalence of birth defects was 5% among cases vs 4% in controls, whereas, in the registry‐based studies, the prevalence was 11% among cases vs 7% in controls. In pooled adjusted analyses, there were several notable associations, including (1) digestive system defects and ALL (OR = 2.70, 95% CI: 1.46‐4.98); (2) congenital anomalies of the heart and circulatory system and AML (OR = 2.86, 95% CI: 1.81‐4.52) and (3) nervous system defects and AML (OR = 4.23, 95% CI: 1.50‐11.89). Effect sizes were generally larger in registry‐based studies. Overall, our results could point to novel genetic and environmental factors associated with birth defects that could also increase leukemia susceptibility. Additionally, differences between questionnaire‐ and registry‐based studies point to the importance of complementary sources of birth defect phenotype data when exploring these associations.</p>

We report on the successful completion of a project to upgrade the positional accuracy of every response to the 1990, 2000, and 2010 U.S. decennial censuses. The resulting data set, called Optimized Spatial Census Information Linked Across Time (OSCILAT), resides within the restricted-access data warehouse of the Federal Statistical Research Data Center (FSRDC) system where it is available for use with approval from the U.S. Census Bureau. OSCILAT greatly improves the accuracy and completeness of spatial information for older censuses conducted prior to major quality improvements undertaken by the Bureau. Our work enables more precise spatial and longitudinal analysis of census data and supports exact tabulations of census responses for arbitrary spatial units, including tabulating responses from 1990, 2000, and 2010 within 2020 block boundaries for precise measures of change over time for small geographic areas.

There is ample literature on interventions to reduce human immunodeficiency virus (HIV) stigma and discrimination and extant theory around intersectionality. However, the integration of intersectionality into the design and implementation of stigma reduction interventions is nascent. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we reviewed 23 studies from six countries to examine the state of the evidence on interventions to reduce intersectional stigma in the context of HIV. Thirteen studies made explicit reference to intersectionality, 11 of which addressed all three stigma domains: drivers, facilitators, and manifestations. Most interventions were multilevel and multistrategy, yet only five included a structural component. Thirteen studies focused on four or more intersections (e.g., HIV, race, sexual identity, gender), five on three intersections, and five on two intersections. Twenty studies (87%) reported medium ( n = 5) to high ( n = 15) community engagement. The majority of studies (19/23) assessed HIV-related (e.g., antiretroviral therapy [ART] adherence) and/or empowerment-based outcomes (e.g., self-esteem, coping), with 91% reporting some positive intervention effects. Of 13 studies that measured stigma outcomes, only seven (54%) documented some improvement in the stigma measures assessed. Our review revealed a range of sophisticated, intersectionality-informed interventions that were mostly successful at improving HIV, sexual health, and empowerment-based outcomes, but less successful at reducing the aspects of stigma measured. Future research should encompass wider geographical regions, use validated measures of intersectional stigma, and test structural interventions and approaches that challenge the systems of power and oppression that fuel stigma, inequality, and poor health outcomes among multiply marginalized populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Source: journal abstract)

Research suggests a disparity in the prevalence of dementia, with Black older adults having double the risk compared to their White counterparts. African immigrants are a fast-growing segment of the U.S. Black population, but the dementia care needs and resources of this population are not fully understood. In this paper, we describe the process of working collaboratively with a community partner and project advisory board to conduct a culturally informed project. Specifically, we describe the process of developing culturally informed instruments to collect data on dementia care needs and resources among African immigrants. Working together with a diverse project advisory board, a guide was developed and used to conduct community conversations about experiences with dementia/memory loss. Transcripts from six conversations with 24 total participants were transcribed and analyzed thematically by two independent coders in Nvivo. These qualitative findings were used to inform the development of a survey for quantitative data collection that is currently ongoing. Themes (e.g., cultural attitudes, challenges, and current resources) from the community conversations that informed the survey are described briefly. Despite the challenges of conducting research during a global pandemic, having trusting relationships with a partnering community organization and project advisory board facilitated the successful development of instruments to conduct preliminary dementia care research in an underserved population. We anticipate that survey results will inform interventions that increase education, outreach, and access to dementia care and caregiving resources for this population. It may serve as a model for community–university partnerships for similar public health efforts in dementia as well as other chronic disease contexts.

Racial/ethnic composition of nursing home (NH) plays a particularly important role in NH quality. A key methodological issue is defining when an NH serves a low versus high proportion of racially/ethnically diverse residents. Using the Minimum Data Set from 2015 merged with Certification and Survey Provider Enhanced Reports, we calculated the racial/ethnic composition of U.S.-based NHs for Black or Hispanic residents specifically, and a general Black, Indigenous, and People of Color (BIPOC) grouping for long-stay residents. We examined different definitions of having a high racial/ethnic composition by varying percentile thresholds of composition, state-specific and national thresholds, and restricting composition to BIPOC residents as well as only Black and Hispanic residents. NHs with a high racial/ethnic composition have different facility characteristics than the average NH. Based on this, we make suggestions for how to identify NHs with diverse racial/ethnic resident compositions.

A three-armed drinking cessation trial in Vietnam found that both a brief and intensive version of an intervention effectively reduced hazardous drinking in people living with HIV. We used group-based trajectory modeling (GBTM) to assess the extent to which findings may vary by latent subgroups distinguished by their unique responses to the intervention. Using data on drinking patterns collected over the 12 months, GBTM identified five trajectory groups, three of which were suboptimal [“non-response” (17.2%); “non-sustained response” (15.7%), “slow response” (13.1%)] and two optimal [“abstinent” (36.4%); “fast response” (17.6%)]. Multinomial logistic regression was used to determine that those randomized to any intervention arm were less likely to be in a suboptimal trajectory group, even more so if randomized to the brief (vs. intensive) intervention. Older age and higher baseline coping skills protected against membership in suboptimal trajectory groups; higher scores for readiness to quit drinking were predictive of it. GBTM revealed substantial heterogeneity in participants’ response to a cessation intervention and may help identify subgroups who may benefit from more specialized services within the context of the larger intervention.

Objective: Little is known about sexual minority (SM) older adults’ activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations and their subsequent access to lo...

Labor unions might have various effects beyond the workplace. We link data on mothers from the National Longitudinal Survey of Youth (NLSY79) to data on their children from the NLSY79 Child Survey to analyze whether a mother's unionization history while a child is growing up affects two childhood outcomes-cognitive skill and behavior-and two adult outcomes-educational attainment and earnings. We similarly use the Panel Study of Income Dynamics (PSID) to analyze the effect of the unionization history of the household heads on similar childhood and adult outcomes. As these outcomes are likely the product of cumulative childhood experiences, we emphasize the use of unique, cumulative measures of mother or household head union status. We do not find a strong pattern of results indicative of a significant union influence on these measures of the quality of a child's life course.

Background and Objectives: Abundant evidence documents racial/ethnic disparities in

<p>Most older adults reside in low- and middle-income countries (LMICs) but most research dollars spent on interventions to improve the lives of older adults are awarded to researchers in High-Income Countries (HICs). One approach to improve implementation of evidence-based innovations for older adults in LMICs is designing interventions that are relevant to LMICs and HICs simultaneously. We propose that researchers in HICs could partner with stakeholders in an LMIC throughout the intervention design process to better position their intervention for implementation in that LMIC. We provide an example study from an adaptation of the Resources for Enhancing Caregiver Health (REACH) II in Vietnam, which did not use this strategy but may have benefited from this strategy. We then turn to several considerations that are important for researchers to contemplate when incorporating this strategy. Finally, we explore incentives for creating interventions that are relevant to both HICs and LMICs for funders, intervention designers, and intervention receivers. Although this is not the only strategy to bring interventions to LMICs, it may represent another tool in researchers’ toolboxes to help expedite implementation of efficacious interventions in LMICs.</p>

The U.S. Census Bureau plans to use a new disclosure avoidance technique based on differential privacy to protect respondent confidentiality for the 2020 Decennial Census of Population and Housing. Their new technique injects noise based on a number of parameters into published statistics. While the noise injection does protect respondent confidentiality, it achieves the protection at the cost of less accurate data. To better understand the impact that differential privacy has on accuracy, we compare data from the complete-count 1940 Census with multiple differentially private versions of the same data set. We examine the absolute and relative accuracy of population counts in total and by race for multiple geographic levels, and we compare commonly used measures of residential segregation computed from these data sets. We find that accuracy varies by the global privacy-loss budget and the allocation of the privacy-loss budget to geographic levels (e.g., states, counties, enumeration district) and queries. For measures of segregation, we observe situations where the differentially private data indicate less segregation than the original data and situations where the differentially private data indicate more segregation than the original data. The sensitivity of accuracy to the overall global privacy-loss budget and its allocation highlight the fundamental importance of these policy decisions. Data producers like the U.S. Census Bureau must collaborate with users not only to determine the most useful set of parameters to receive allocations of the privacy-loss budget, but also to provide documentation and tools for users to gauge the reliability and validity of statistics from publicly released data products. If they do not, producers may create statistics that are unusable or misleading for the wide variety of use cases that rely on those statistics.

Purpose: Comprehensive sexuality education (CSE) has been shown to reduce sexual risk-taking behaviors and promote healthy sexual development, and studies have shown high support for this approach. However, the past decade has seen many changes in the political landscape and social controversies. The present study reports on an updated survey and analysis of changes in support from 2006 to 2021. Methods: Survey data were collected by telephone in 2006 (N = 1,605) and online and in-person in 2021 (N = 719) from separate samples of Minnesota parents of school-age children. Parents responded to items regarding preferences for CSE, support for teaching numerous specific sexuality education topics, and the grade level at which topics should be introduced. Chi-square tests and logistic regression (with weighted 2021 data) were used to detect differences in support between survey years and across demographic and personal characteristics. Results: At both time points, approximately 90% of parents thought that CSE should be taught in schools, with significant increases in support within several demographic categories. Support for including all specific topics was high, including for topics typically considered highly controversial (e.g., gender identity, 68.7%; abortion, 77.7% in 2021). Parents endorsed introducing most topics in elementary or middle school years. Discussion: Findings suggest that policy makers and educators in Minnesota can be confident of strong parental support for CSE covering a wide range of content to meet students’ needs. Advocacy and action to advance the use of national sexuality education standards are in keeping with the views of the overwhelming majority of parents of school-age children.

Doubling in size since the 1970s, the aging needs of the African immigrant population are not fully understood. This qualitative study examined experiences of aging and retirement planning for African immigrant older adults in the United States (U.S.). Specifically, it explored the factors, processes, and ultimate decision of where these older adults planned to retire. Secondary analysis of semi-structured interviews with 15 older African immigrants in the Baltimore–Washington Metropolitan area was conducted. Data was analyzed using thematic analyses in NVivo. The majority of participants were women, with a mean age of 64. Three overarching themes with ten sub-themes were identified. The themes included: (1) cultural identity, which indicated the participant’s comfort with the U.S. society and culture; (2) decision making, meaning factors that impact participants’ choice of retirement location; and (3) decision made, meaning the final choice of where participants would like to retire. Age-friendliness for immigrant older adults in the U.S. is complex and it includes traditional domains such as physical and sociocultural environment (e.g., housing, transportation, and income). However, immigrant age-friendliness also needs to include wider contextual aspects such as political climate of their country of origin, immigrant status, family responsibilities, and acculturation in the U.S. More research is needed to better understand and facilitate age-friendly environments and transnational aging of immigrant older adults.

BACKGROUND AND OBJECTIVES: Despite research documenting gender differences in numerous outcomes in later life, we know little about gender differences in quality of life (QoL) for nursing home (NH) residents. This study examines the relationship between gender and residents' QoL, including possible reasons for differences observed. RESEARCH DESIGN AND METHODS: We used a mixed methods design including surveys with a random sample of Minnesota NH residents using a multidimensional measure of QoL (n=9,852), resident clinical data, facility-level characteristics (n=364), interviews with residents (n=64), and participant observations. We used linear mixed models and thematic analysis of resident interviews and observations to examine possible gender-related differences in residents' QoL. RESULTS: After controlling for individual and facility characteristics, men reported lower overall QoL than women, including significantly lower ratings in several QoL domains. In interviews, men noted being less satisfied with activities than women, having fewer friends, and being less able to rely on family for support. Some women described the NH as a place of respite, but men more often described being dissatisfied with life in the NH and undesirable for long-term living. Our observations were consistent with interview findings but provide additional nuances, such as that some men organized their own social groups. DISCUSSION AND IMPLICATIONS: Our findings suggest men and women experience QoL differently in NHs, with men reporting lower QoL in several domains. Tailoring more activities for men and finding ways to strengthen relationships for men in NHs could help reduce the gender differences in QoL we observed.