Examining the Association of Pain and Financial Hardship Among Older Men by Race in the United States.

Pain associated with financial hardship among older men varies by race. The purpose of this study was to examine the association of financial hardship with the presence of pain in men 50 years and older by race. Using the Health and Retirement Study (HRS) 2010 wave, bivariate and multivariate logistic regression models were used to assess the association between four financial hardship indicators and total financial hardship as a composite score, and the presence of pain by race. Among White men, the association between the presence of pain and hardship controlling for demographic factors was statistically significant across four indicators and one composite score: ongoing financial hardship (OR = 1.29, 95% CI [1.02, 1.64]), food insecurity (OR = 2.55, 95% CI [1.51, 4.31]), taking less medication due to cost (OR = 2.12, 95% CI [1.40, 3.22]), difficulty paying bills (OR = 1.36, 95% CI [1.07, 1.73]), and total financial hardship (OR = 1.27, 95% CI [1.12, 1.44]). Among African American men, the association between the presence of pain and taking less medication due to cost (OR = 2.99, 95% CI [1.31, 6.85]) was significant. With increasing comorbidities among older adults, particularly African Americans, it is imperative to fully understand the mechanisms of this underexplored area in both the pain and financial hardship literature.

Differing trajectories of adversity over the life course: Implications for adult health and well-being.

BACKGROUND: Adverse childhood experiences (ACE), can give rise to long-term mental and physical health consequences as well as additional stressors later in the life course. This study aims to examine differing profiles of trajectories of adversity over the life course and investigate their association with socioeconomic and health outcomes. METHODS: We used population representative data from the Washington State 2011 Behavioral Risk Factor Surveillance System BRFSS survey n = 7953. Six ACE items were paired with six Adverse Adulthood Experience AAE items in respondents' adulthood that parallel the ACE e.g. physical abuse in childhood and physical victimization in adulthood. We applied latent class analysis to identify distinct trajectories of adversity; then tested for differences across trajectories in terms of demographic, socioeconomic, and health measures. RESULTS: Six latent classes were identified: individuals with high AAE: (1. Consistently High, 2. Substance Abuse and Incarceration, 3. Adult Interpersonal Victimization) and individuals with low AAE (4. Repeat Sexual Victimization, 5. High to Low, and 6. Consistently Low). The Consistently High group had the highest prevalence of ACE and AAE and fared poorly across wide ranging outcomes. Other groups displayed specific patterns of ACE and AAE exposures (including salient subgroups such as those with incarceration exposure) as well as differences in demographic characteristics, illustrating disparities. CONCLUSIONS: Subgroup analyses such as this are complementary to population generalized findings. Understanding differences in life course patterns of adversity can shed light on interventions in earlier life and better target service provision to promote health and well-being.

Adverse childhood experiences to adult adversity trends among parents: Socioeconomic, health, and developmental implications.

Exposures to adverse childhood experiences compromise the early developmental foundation of people long before they become parents. These exposures partly take place within the family environment - a context tightly shared by parents and children. Despite considerable evidence regarding effects of adverse childhood experiences (ACEs), differential patterns of childhood and adulthood adversity accumulation among currently parenting adults is relatively less understood. The present study helps address this gap using the 2011 Behavioral Risk Factor Surveillance System Washington State data of respondents ages 18 and older who are currently parenting a minor child. Results demonstrate the proliferative nature of adversities, increasing risk of elevated life course stress, as well as parental socioeconomic, health and functioning outcomes that affect the family environment. Findings also suggest the resilience of some parents who, despite exposures to ACEs, were able to avoid heightened adversities in later life that could pose risk to their children's developmental environments.

Pain and Hardship Among Older Men: Examining the Buffering Effect of Medicare Insurance Coverage.

To better understand the health status of men in the United States, this study aimed to assess the association of hardship on the presence of and pain severity among men 50 years of age and older. Cross-sectional multivariate logistic regression analyses were conducted using the 2010 wave of the Health and Retirement Study ( N = 3,174) to assess the association between four hardship indicators and the presence of pain and pain severity among this sample of older men. Results suggest that the association between the presence of pain and hardship was statistically significant across all four indicators: ongoing financial hardship (CI [1.05, 1.63], p < .05), difficulty paying bills (CI [1.42, 3.02], p < .001), food insecurity (CI [1.46, 3.15], p < .001), and not taking medication due to cost (CI [1.06, 1.66], p < .05), even after adjusting for all demographic factors. The associations between pain severity and ongoing financial strain (CI [1.23, 2.83], p < .01) and difficulty paying bills (CI [1.02, 3.18], p < .05) were statistically significant. Results also indicate that education was a buffer at all levels. In addition, the interactive effect of hardship and Medicare insurance coverage on pain severity was significant only for ongoing financial strain (CI [1.74, 14.33], p > .001) and difficulty paying bills (CI [1.26, 7.05], p < .05). The evidence is clear that each hardship indicators is associated with the presence of pain and across some of the indicators in pain severity among men aged 50 and older. In addition, these findings stress the importance that Medicare insurance plays in acting as a buffer to alleviate some of the hardships experienced by older men. These findings also highlight the association between the presence of pain and pain severity for the overall quality of life, health outcomes, and financial position of men in later life.

Modeling life course pathways from adverse childhood experiences to adult mental health.

Although the association between adverse childhood experiences (ACEs) and adult mental health is becoming well established, less is known about the complex and multiple pathways through which ACEs exert their influence. Growing evidence suggests that adversity early in life conveys not only early impacts, but also augments risk of stress-related life course cascades that continue to undermine health. The present study aims to test pathways of stress proliferation and stress embodiment processes linking ACEs to mental health impairment in adulthood. Data are from the 2011 Behavioral Risk Factor Surveillance Survey, a representative sample of Washington State adults ages 18 and over (N = 14,001). Structural equation modeling allowed for testing of direct and indirect effects from ACEs though low income status, experiences of adversity in adulthood, and social support. The model demonstrated that adult low income, social support and adult adversity are in fact conduits through which ACEs exert their influence on mental health impairment in adulthood. Significant indirect pathways through these variables supported hypotheses that the effect of ACEs is carried through these variables. This is among the first models that demonstrates multiple stress-related life course pathways through which early life adversity compromises adult mental health. Discussion elaborates multiple service system opportunities for intervention in early and later life to interrupt direct and indirect pathways of ACE effects.

Stress pathways to health inequalities: Embedding ACEs within social and behavioral contexts.

OBJECTIVE: This study addresses whether adverse childhood experiences (ACEs) demonstrate disproportional prevalence across demographic- and health-affecting characteristics, offer significant explanation of adult health outcomes, and show patterned association with illness susceptibility early within and across adulthood when viewed in combination with income and psychosocial resources. METHODS: Data were derived from a population-based state health survey using stratified random sampling of household adults (n=7,470): ages 18-99 (M=55), 59.9% females, and race/ethnicity, income and education levels representative of the region. We assessed ACEs by aggregating 8 adversity forms, 5 health behaviors and 3 psychosocial resources; and health outcomes (number of chronic conditions, subjective wellness). RESULTS: Disproportionality was evident in ACEs levels by demographics, adult SES, health behaviors, and psychosocial resources in expected directions. Stepped multiple regressions of health outcomes demonstrated significant betas and R2 change for each predictor block, revealing cumulative as well as unique explanatory utility. Early onset chronic illness was evident on the basis of ACEs levels. These illnesses were amplified for low income respondents. Prevalence was highest across adulthood for those also reporting low psychosocial assets. CONCLUSIONS: Findings offer novel insights as to the "long reach" of childhood adversity on health, conditioned by circumstances under which these effects may occur. Health resilience offered by health behaviors and psychosocial resources should shape thinking about preventive and remedial interventions by social work and allied professionals across a range of settings.

Hierarchical patterns of three-dimensional block-copolymer films formed by electrohydrodynamic jet printing and self-assembly.

Self-assembly of block-copolymers provides a route to the fabrication of small (size, <50 nm) and dense (pitch, <100 nm) features with an accuracy that approaches even the demanding specifications for nanomanufacturing set by the semiconductor industry. A key requirement for practical applications, however, is a rapid, high-resolution method for patterning block-copolymers with different molecular weights and compositions across a wafer surface, with complex geometries and diverse feature sizes. Here we demonstrate that an ultrahigh-resolution jet printing technique that exploits electrohydrodynamic effects can pattern large areas with block-copolymers based on poly(styrene-block-methyl methacrylate) with various molecular weights and compositions. The printed geometries have diameters and linewidths in the sub-500 nm range, line edge roughness as small as ∼45 nm, and thickness uniformity and repeatability that can approach molecular length scales (∼2 nm). Upon thermal annealing on bare, or chemically or topographically structured substrates, such printed patterns yield nanodomains of block-copolymers with well-defined sizes, periodicities and morphologies, in overall layouts that span dimensions from the scale of nanometres (with sizes continuously tunable between 13 nm and 20 nm) to centimetres. As well as its engineering relevance, this methodology enables systematic studies of unusual behaviours of block-copolymers in geometrically confined films.

Enhancement of lipid extraction from marine microalga, Scenedesmus associated with high-pressure homogenization process.

Marine microalga, Scenedesmus sp., which is known to be suitable for biodiesel production because of its high lipid content, was subjected to the conventional Folch method of lipid extraction combined with high-pressure homogenization pretreatment process at 1200 psi and 35°C. Algal lipid yield was about 24.9% through this process, whereas only 19.8% lipid can be obtained by following a conventional lipid extraction procedure using the solvent, chloroform:methanol (2:1, v/v). Present approach requires 30 min process time and a moderate working temperature of 35°C as compared to the conventional extraction method which usually requires >5 hrs and 65°C temperature. It was found that this combined extraction process followed second-order reaction kinetics, which means most of the cellular lipids were extracted during initial periods of extraction, mostly within 30 min. In contrast, during the conventional extraction process, the cellular lipids were slowly and continuously extracted for >5 hrs by following first-order kinetics. Confocal and scanning electron microscopy revealed altered texture of algal biomass pretreated with high-pressure homogenization. These results clearly demonstrate that the Folch method coupled with high-pressure homogenization pretreatment can easily destruct the rigid cell walls of microalgae and release the intact lipids, with minimized extraction time and temperature, both of which are essential for maintaining good quality of the lipids for biodiesel production.