Psychiatric history and later-life cognitive change: effect modification by sex, race and ethnicity.

Objective: We explored associations between psychiatric history and cognitive functioning, and differences by sex and race/ethnicity (SRE) in 20,155 Health and Retirement Study (1995-2014) participants aged 65 or older.Methods: Multi-level growth curve models examined cognition scores and their trajectories over time by SRE.Results: A history of psychiatric, emotional, or nervous problems was significantly related to cognition scores and rates of decline. Hispanic and Black participants had significantly lower cognition scores at age 75 and steeper rates of decline than White females, and Black race and the Hispanic race/ethnicity-sex interaction erased the protective effects of being female.Conclusions: Future research should include specific psychiatric diagnoses. Population level findings as reported here, along with aggregate findings from similar studies, can inform interventions and policies regarding support for populations that are vulnerable to mental illness and to subsequent cognitive decline.

Intergenerational solidarity with digital communication and psychological well-being among older parents during the COVID-19 pandemic.

We aimed to identify intergenerational solidarity (emotional closeness, in-person contact, phone contact, geographic proximity, consensus, and conflict) with digital communication (texting, video call, and social media interaction) with adult children among older parents during the COVID-19 pandemic. In addition, we aimed to investigate whether intergenerational solidarity with digital communication latent classes were associated with older parents' psychological well-being. We used the 2022 survey of the Longitudinal Study of Generations (LSOG). The sample consisted of 519 older parents who reported about 1245 adult children. Two-level latent class analysis identified six classes at the child level (Level 1: distant but digitally connected, tight-knit and digitally connected, tight-knit traditional, detached, intimate but distant, and sociable). In addition, the analysis identified three classes at the parent level (Level 2: digitally connected, mixed, and intimate but distant). Results of multivariate regression showed that older parents in the digitally connected latent class had better psychological well-being than those in the mixed latent class. Consequently, our finding indicates that digital solidarity with adult children can be beneficial for older parents' psychological well-being during the COVID-19 pandemic.

Intergenerational solidarity and digital communication during the Covid-19 pandemic in South Korea: Implications for dyadic well-being.

Previous research has not considered how digital communication fits with the established intergenerational solidarity paradigm, although the paradigm has undergone other refinements over time. Consequently, less is known about how the use of digital communication creates new types of intergenerational solidarity between parents and adult children, and how they are associated with their well-being. With this foundation, we aimed to identify new dyadic patterns of intergenerational solidarity between parents and adult children during the COVID-19 pandemic in South Korea, with an emphasis on digital communication (texting, video call, and social media interaction), its intersection with other dimensions of solidarity, and its association with parents' and children's well-being (depressive symptoms, self-esteem, and life satisfaction). Using an online survey method, we collected data from 407 parent-adult child dyads between April and June 2022 from the Seoul Metropolitan area in South Korea. Three-step latent class analysis was used for data analysis. We identified four classes describing intergenerational solidarity between parents and adult children (tight-knit, distant-but-digitally-connected, conflictual, and independent). We found that among dyads of parents and adult children who had tight-knit and distant-but-digitally-connected relationships with each other, parents reported better well-being on all three outcomes, and children reported better life satisfaction compared to dyads who had conflictual relationships. Our findings suggest that incorporating digital communication into the intergenerational solidarity paradigm is useful to better understand the multidimensional characteristics of intergenerational relationships between older parents and their adult children.

Effectiveness and Predictors of Outcomes in a Psychiatric Day Treatment Program for Elementary-Age.

OBJECTIVE: In this study, we aimed to (1) assess the effectiveness of an intensive multimodal day treatment program in improving externalizing problems and function in elementary-age children and (2) examine 3 predictors of the treatment outcome (i.e., family functioning, baseline severity, and comorbid disorders). METHODS: The sample included 261 children (80.9% boys) between ages of 5 and 12. A retrospective chart review, from 2013 to 2018, and a prospective chart review, from 2018 to 2019, were conducted to extract all relevant data for the present study. Parents and teachers provided reports on children's externalizing problems (i.e., aggressive behavior, attention problems, and rule-breaking behavior) and their level of function across different domains. The level of family functioning was also reported by parents, while clinicians assessed children's severity of disturbance and their diagnoses at intake. RESULTS: Based on both parents' and teachers' reports, children showed significant improvement in their externalizing problems. Moreover, children showed functional improvement at home, at school, with peers, and in hobbies by the end of the program. Based on teacher's reports, children with lower level of severity showed less improvement in their attention problems, and those with comorbid developmental problems showed less improvement in their aggressive and rule-breaking behaviors. Family functioning did not predict any treatment outcome. CONCLUSION: An intensive multimodal day treatment program was effective in reducing the symptoms of externalizing problems in elementary-age children. However, children with less severe difficulties and comorbid developmental problems showed less improvement in their externalizing problems.

Reciprocal associations between affectual, associational, and normative solidarity with parents during children's early to established adulthood.

Intergenerational solidarity has become increasingly important to understand, as close family members mobilize the provision of social support across generations and contribute to family wellbeing. However, less is known about continuity and change in normative (eldercare norms), affectual, and associational solidarity with mothers and fathers as children emerge into full or established adulthood. Therefore, we focused on reciprocal associations between three dimensions of intergenerational solidarity (normative, affectual, and associational) as reported by young-adult children from their early twenties to late thirties. Data were derived from respondents in the Longitudinal Study of Generations: daughters reported about relationships with 291 mother-father pairs and sons reported about relationships with 309 mother-father pairs in 2000, 2005, and 2016. Autoregressive cross-lagged models prospectively predicted mutual influences among the three dimensions of solidarity across daughter-parent and son-parent relationships. In addition, multiple group analysis was conducted to examine the children's gender difference. We found that normative solidarity and emotional closeness with mothers were mutually reinforcing in daughters' and sons' parental relationships. However, normative solidarity predicted emotional closeness with fathers in both daughter-parent and son-parent relationships. The study concludes that sons and daughters establish eldercare norms based on emotional components of solidarity with mothers, and suggest that filial duty is a key reason why mother-child relations become close over the family life course.

La solidaridad intergeneracional se ha vuelto cada vez más importante de comprender, ya que los familiares cercanos movilizan el apoyo social entre las generaciones y contribuyen al bienestar familiar. Sin embargo, se sabe poco acerca de la continuidad y el cambio en la solidaridad normativa (las normas de cuidado de los adultos mayores), afectiva y asociativa con las madres y los padres a medida que los hijos entran en la adultez completa o definitiva. Por lo tanto, nos centramos en las asociaciones recíprocas entre las tres dimensiones de solidaridad intergeneracional (normativa, afectiva y asociativa) según lo informado por los hijos jóvenes-adultos desde sus veinte hasta sus cuarenta años. Los datos se tomaron de personas encuestadas en el Estudio Longitudinal de Generaciones: las hijas informaron acerca de las relaciones con 291 pares de madres y padres y los hijos informaron acerca de las relaciones con 309 pares de madres y padres en los años 2000, 2005 y 2016. Los modelos autorregresivos de retardo cruzado predijeron prospectivamente influencias mutuas entre las tres dimensiones de solidaridad en las relaciones entre la hija y el padre/la madre y las relaciones entre el hijo y el padre/la madre. Además, se realizaron análisis multigrupo para analizar la diferencia de género de los hijos. Descubrimos que la solidaridad normativa y la cercanía emocional con las madres se reforzaron mutuamente en las relaciones parentales de las hijas y los hijos. Sin embargo, la solidaridad normativa predijo la cercanía emocional con los padres tanto en las relaciones entre la hija y el padre/la madre como en las relaciones entre el hijo y el padre/la madre. En el estudio se llega a la conclusión de que los hijos y las hijas establecen normas de cuidado de los adultos mayores basándose en los componentes emocionales de la solidaridad con las madres, y se sugiere que el deber filial es un motivo clave por el cual las relaciones entre madre e hijos se vuelven cercanas durante el transcurso de la vida familiar.

Religious Transitions Among Baby Boomers From Young Adulthood to Later Life: Associations with Psychological Well-Being Over 45 Years.

We used classification analysis to examine change in religiosity among baby boomers from young adulthood to early old age and how religiosity transition patterns are associated with psychological well-being in later life. In addition, we tested the gender difference in the above association. We applied latent class and latent transition analysis to 392 baby boomers who participated in the Longitudinal Study of Generations in Wave-1 (1971) and Wave-9 (2016). We identified three classes describing religiosity at each wave (strongly religious, doctrinally religious, and weakly religious), and considered five types of change or stability in religious class membership from Wave-1 to Wave-9. Multiple regression with gender interactions revealed that men who stayed strongly religious over the period reported better psychological well-being compared to men who declined in their religiosity; no such pattern was found for women. Our findings suggest that maintaining strong religiosity over the life course was beneficial for baby boom men in later life.

Intergenerational Solidarity With Grandparents in Emerging Adulthood: Associations With Providing Support to Older Parents in Established Adulthood.

We examined the link between types of intergenerational solidarity with grandparents among young adults in emerging adulthood and whether they provided instrumental and emotional support to their older parents in established adulthood. We used the 2000 and 2016 waves of the longitudinal study of generations and a sample of 229 grandmother-child and 175 grandfather-child dyads. Latent class analysis identified three classes describing intergenerational solidarity with grandparents (tight-knit, detached, and intimate-but-geographically distant) in grandmother-child and grandfather-child dyads in emerging adulthood. Path analyses showed that young adults who had a tight-knit relationship with their grandparents in emerging adulthood provided more instrumental and emotional support to their parents in established adulthood, compared with those who had a detached relationship with their grandparents in emerging adulthood. Results are interpreted in contexts of multigenerational interdependence within families and the sensitivity of young adults to the needs of older parents through their earlier connection to grandparents.

Frequent follow-up of suicidal youth assessed in the emergency room: Long-term trajectory and predictors of suicidality.

Suicide was the second­leading cause of US deaths in 2018 among 15-24-year-olds. Suicide attempts, a risk factor for completions, and suicide ideation have doubled among pediatric emergency room (ER) patients during the past decade. Borderline Personality Disorder (BPD), a comorbid condition, has a 10% suicide rate. We examined the 4-year outcome of a cohort of suicidal adolescents, many also suffering from BPD and having undergone some form of treatment, to identify baseline factors which could inform intervention that would minimize suicidality 4 years post-discharge. METHODS: We conducted a prospective longitudinal study of suicidality at twelve points (four assessment occasions) for 286 suicidal youth presenting to a pediatric ER, most suffering from BPD, with 36 suicide ratings from baseline to 2-, 6- and 48-month follow-up evaluations. We examined the trajectory and predictors of persisting suicidality. RESULTS: Suicidality rapidly decreased within 2 months post-ER-discharge, subsequently remaining low throughout 48 months. Baseline functioning, female sex, stressful life events and BPD impulsiveness were most predictive of persisting suicidality at 48-month follow-up. CONCLUSION: Most suicidal youth, many meeting BPD criteria, no longer feel suicidal 2 months after ER discharge. Management of participants' baseline poor functioning stressful life events and the impulsiveness component of BPD specifically in females could impact suicidality 4 years later, and guide treatment options. The absence of the BPD cognitive and affective subscales as predictors of suicidality at 4-year follow-up may reflect treatment received. Further investigation of treatment effects is warranted and under way.

New insights into patterns and rates of tooth replacement in serrasalmid and characid fishes, with implications for the subsistence fishery of Peru's remote ribereños villages.

We explored patterns, rates and unexpected socio-ecological consequences of tooth replacement in serrasalmids and characids of the Peruvian Amazon using microcomputed tomography. Of 24 specimens collected in February 2019, representing a mix of red-bellied piranha Pygocentrus nattereri, redeye piranha Serrasalmus rhombeus, silver dollar fish Ctenobrycon hauxwellianus and mojara Astyanax abramis, six individuals possessed edentulous jaw quadrants. On average, 22.9% of fish collected per day from these species featured incomplete dentition, a value three to five times higher than anticipated based on replacement rates estimated from captive fish, differences that may be driven by ontogeny, seasonality or environmental quality.

Addressing elder abuse: service provider perspectives on the potential of restorative processes.

Older adults often rely on family and friends for care and support. Individuals providing support can take advantage of their vulnerabilities, resulting in neglect, physical, emotional, or sexual abuse, or financial exploitation. Conventional approaches, which older adults are often reluctant to pursue, utilize social service interventions, criminal justice responses, civil litigation, and case review multi-disciplinary teams. This project explored providers' perspectives on using restorative processes, alternative approaches that bring together the person harmed, the person committing the harm, and the community to address the harm and repair relationships. Researchers recruited and interviewed providers working with abused older adults, as referred by a community-based elder justice working group. Providers perceived that restorative processes have the potential to address and prevent social isolation, which often leads to elder abuse. We recommend providers explore restorative processes to address elder abuse, paying attention to implementation barriers and identifying appropriate methods for supporting and maintaining outcomes.

Breaking bad news of a breast cancer diagnosis over the telephone: an emerging trend.

PURPOSE: This study evaluated how breast cancer diagnoses were shared with patients. METHODS: Current members of the Dr. Susan Love Research Foundation's Army of Women cohort were sent one email with a link to a survey assessing how their breast cancer diagnosis was communicated, a description of their support system during treatment, basic demographic information, and breast cancer diagnosis details. RESULTS: Participants (n = 2896) were more likely to be given their diagnosis over the telephone in more recent years (OR 1.07, 95% CI 1.06-1.08). Up until about 10 years ago (1967-2006), breast cancer diagnoses were communicated in person more often than by telephone. Since 2006, more than half of participants learned about their diagnosis over the telephone. From 2015 to 2017, almost 60% of participants learned about their diagnosis over the telephone. Among those who heard the news in person, a steady 40% were alone. Characteristics of those who received the news over the telephone included having identified support members, heterosexual identity, and a diagnosis of in situ breast cancer. CONCLUSIONS: Receiving a telephone call about breast cancer diagnosis may be the norm rather than the exception in health care today. Trends in practice, as well as current best practices based primarily on expert opinion, may not provide optimal care for women diagnosed with breast cancer. Patient outcome research to guide future practice, such as the impact of modes of delivery of bad news, is urgently needed to determine appropriate patient-centered approaches for notification of breast cancer diagnoses.

Building Bridges between Gerontology and Elder Law.

BACKGROUND: Academics have long called for greater interaction between gerontologists and legal scholars. However, prior studies have suggested that disciplinary borders remain a barrier to such interaction, hampering gerontology's ability to function as a truly multi- or interdisciplinary field. OBJECTIVE: This study was designed to understand the nature of current interactions between legal scholars and gerontologists, and to identify opportunities to advance scientific dialogue and cooperation between the two. METHODS: Semi-structured, open-ended interviews with 27 participants (12 elder law scholars, 15 gerontologists) were conducted by phone, recorded, and analyzed by an interdisciplinary team. RESULTS: Both elder law scholars and gerontologists indicate that their field would benefit from research collaboration and cross-disciplinary teaching with the other field, but the fields remain distinct with little cross-disciplinary learning. Participants identified a series of opportunities, however, for increasing such learning and collaboration. CONCLUSIONS: The authors identify ways gerontologists can be encouraged to integrate elder law into their teaching and research, and suggest how this integration could enhance understanding of the aging experience.

Developing ocean climate change indicators for the north-central California coast and ocean.

The Ocean Climate Indicators Project, developed for the Greater Farallones National Marine Sanctuary (GFNMS), yielded the first set of physical and biological ocean climate indicators specifically developed for the north-central California coast and ocean region, which extends from Point Arena to Point Año Nuevo and includes the ocean shorelines of the San Francisco metropolitan area. This case study produced a series of physical and biological indicator categories through a best professional judgment (BPJ) process with an interdisciplinary group of over 50 regional research scientists and marine resource managers from a wide range of state and federal agencies, NGOs, and universities. A working group of research scientists and marine resource managers used this set of ocean climate indicators to develop the Ocean Climate Indicators Monitoring Inventory and Plan. The Plan includes monitoring goals and objectives common for eight physical and four biological indicators; specific goals for each indicator; monitoring strategies and activities; an inventory of available monitoring data; opportunities for expanding or improving existing or new monitoring approaches; and case studies with specific examples of the indicators' utility for natural resource management and basic scientific research. Beyond developing indicators that support effective science-based management decisions, this scalable process established and strengthened mutually beneficial connections between scientists and managers, resulting in indicators that had broad support of project participants, were quickly adopted by the GFNMS, and could be used by managers and scientists from this region and beyond.

Unmet support needs of sexual and gender minority breast cancer survivors.

PURPOSE: This study explored sources of stress and support experienced by sexual and gender minority (SGM) breast cancer survivors and the impact of treatment on their lives. METHODS: SGM breast cancer survivors were identified through purposive and referral sampling and invited to participate in a web-based survey containing both closed- and open-ended items. Sixty-eight SGM breast cancer survivors aged 18-75 years completed the survey between May 2015 and January 2016. RESULTS: Bivariate analyses of quantitative data reveal that queer-identified (in either sexual orientation or gender identity (SOGI)) SGM survivors are more likely to report having bilateral mastectomy without reconstruction and to think that disclosing SOGI to providers affected their care. Queer-identified SGM survivors are also more likely to use LGBT-specific support groups and to report that their current level of social support is below average. Thematic analysis of qualitative comments revealed themes related to self-disclosure of SOGI to providers, need for recognition and support of partners, need for appropriate social supports for patients and partners, and impact of breast cancer treatment on intimate relationships. CONCLUSION: This study provides quantitative and qualitative evidence that many SGM breast cancer patients face a dearth of appropriate social supports, both from breast cancer survivor organizations and from within the medical system. These findings confirm the need for research on the physical and emotional effects of breast cancer treatment on SGM breast cancer survivors, as well as further exploration of the social support needs and experiences of SGM breast cancer patients and their partners.

Sexual and gender minority breast cancer patients choosing bilateral mastectomy without reconstruction: "I now have a body that fits me".

Sexual and gender minority (SGM) breast cancer patients have begun embracing the choice to "go flat" or opt out of reconstruction after bilateral mastectomy, though little is known about this population. SGM breast cancer survivors were identified through purposive and referral sampling and invited to participate in a web-based survey containing both closed- and open-ended items. Of the sixty-eight SGM breast cancer survivors aged 18-75 years who completed the survey between May 2015 and January 2016, 25 percent reported "going flat" (flattoppers®). Bivariate analyses revealed that flattoppers® were significantly more likely to have been diagnosed in the past five years, to identify as genderqueer, to have disclosed their sexual orientation or gender identity (SOGI) to providers, and to report participating in lesbian, gay, bisexual, or transgender cancer support groups, compared to other participants. More flattoppers® believed that SOGI mattered in terms of getting the support they needed regarding their cancer; this difference was not statistically significant. Thematic analysis of qualitative comments from flattoppers® revealed themes related to reasons for making this treatment choice, interactions with health-care providers around treatment choice, and physical and emotional outcomes of treatment choice. Providers would benefit from training about SOGI as they relate to treatment choices.

Impact of allele-level HLA matching on outcomes after myeloablative single unit umbilical cord blood transplantation for hematologic malignancy.

We studied the effect of allele-level matching at human leukocyte antigen (HLA)-A, -B, -C, and -DRB1 in 1568 single umbilical cord blood (UCB) transplantations for hematologic malignancy. The primary end point was nonrelapse mortality (NRM). Only 7% of units were allele matched at HLA-A, -B, -C, and -DRB1; 15% were mismatched at 1, 26% at 2, 30% at 3, 16% at 4, and 5% at 5 alleles. In a subset, allele-level HLA match was assigned using imputation; concordance between HLA-match assignment and outcome correlation was confirmed between the actual and imputed HLA-match groups. Compared with HLA-matched units, neutrophil recovery was lower with mismatches at 3, 4, or 5, but not 1 or 2 alleles. NRM was higher with units mismatched at 1, 2, 3, 4, or 5 alleles compared with HLA-matched units. The observed effects are independent of cell dose and patient age. These data support allele-level HLA matching in the selection of single UCB units.

Same-sex sexual relationships in the national social life, health and aging project: making a case for data collection.

This study describes the previously unexplored subsample of respondents who reported at least 1 same-sex sexual relationship (SSSR) in the National Social Life, Health, and Aging Project (NSHAP). The NSHAP collected data from 3,005 adults (aged 57-85). Approximately 4% (n = 102) of respondents reported at least one SSSR. These sexual minority elders were younger, more educated, were more likely to be working, had fewer social supports, and better physical health. Results may indicate crisis competence in sexual minority elders. Collecting sexual orientation and gender identity data in larger, US-based probability samples would inform the development of appropriate community-based services and supports.

Association of Epigenetic Age and Everyday Discrimination With Longitudinal Trajectories of Chronic Health Conditions in Older Adults.

We investigated the strength of the association between baseline epigenetic age, everyday discrimination, and trajectories of chronic health conditions (CHCs) across 3 study waves, among adults 50 years of age and older. We used 2016-2020 data from the Health and Retirement Study (HRS). Data for the PhenoAge and DNAm GrimAge second-generation epigenetic clocks were from the 2016 HRS Venous Blood Study. CHC trajectories were constructed using latent class growth curve models. Multinomial logistic regression models assessed the strength of the association between accelerated epigenetic age, everyday discrimination, and the newly constructed CHC trajectories for participants with complete data (n = 2 893). In the fully adjusted model, accelerated PhenoAge (relative risk ratios [RRR] = 2.53, 95% confidence interval [95% CI] = 1.81, 3.55) and DNAm GrimAge (RRR = 2.79, 95% CI = 1.95, 4.00) were associated with classification into the high CHC trajectory class. Racial disparities were evident, with increased risk of classification into the high trajectory class for Black (PhenoAge: RRR = 1.69, 95% CI = 1.07, 2.68) and reduced risk for Hispanic (PhenoAge: RRR = 0.32, 95% CI = 0.16, 0.64; DNAm GrimAge: RRR = 0.34, 95% CI = 0.17, 0.68), relative to White participants. Everyday discrimination was associated with classification into the medium-high (RRR = 1.28, 95% CI = 1.00, 1.64) and high (RRR = 1.52, 95% CI = 1.07, 2.16) trajectory classes in models assessing DNAm GrimAge. More research is needed to better understand the longitudinal health outcomes of accelerated aging and adverse social exposures. Such research may provide insights into vulnerable adults who may need varied welfare supports earlier than the mandated chronological age for access to federal and state resources.

Does nasogastric tube decompression get used less often with laparoscopic and hand-assisted compared with open colectomy?

INTRODUCTION: Laparoscopic surgery is associated with well-known benefits, one of which is earlier return of bowel function. Since the laparoscopic approach to colon resections was introduced in the early 1990s, it has become the standard of care. Hand-assisted laparoscopic surgery (HALS) is a surgical approach in which dissection is facilitated by the surgeon's hand within the abdominal cavity during laparoscopy. The purpose of this study was to compare the incidence of postoperative ileus and the need for nasogastric tube (NGT) decompression in patients undergoing elective colon resections. METHODS AND PROCEDURES: Following institutional review board approval, we performed a retrospective review of a prospectively collected database. Included were patients who underwent elective left-sided large bowel resections between 2009 and 2012. Exclusion criteria were urgent operation, stoma creation, ASA IV classification, NGT left in place at the end of surgery, and postoperative anastomotic leakage. Patients were divided into three groups: laparoscopic surgery, HALS, and open surgery. We evaluated the incidence of postoperative ileus and the use of nasogastric decompression in each group. RESULTS: A total of 243 patients were included in this study; 73 patients underwent open surgery, 89 patients underwent HALS, and 81 patients underwent laparoscopic surgery. The proportion of patients who needed postoperative nasogastric decompression was significantly reduced in patients undergoing laparoscopic surgery (3.7%) or HALS (4.5%) compared with those who underwent open resection (17.8%). The time from surgery to first flatus and first bowel movement, the time to tolerate solid diet, and the total length of postoperative hospital stay also were all significantly reduced in the laparoscopic and HALS groups compared with the open surgery group. There were no significant differences in any of these measures between the laparoscopic group and the hand-assisted group. CONCLUSIONS: Like laparoscopy, HALS is associated with less postoperative ileus and necessitates less NGT decompression than does open surgery.