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OBJECTIVE: To identify if depression, resilience, and perceived control of health are related to 2.5-year mortality and instrumental activities of daily living (IADL) decline among older adults after surgery. SUMMARY BACKGROUND DATA: The relationships of psychosocial factors with postoperative mortality and IADL decline among older adults are understudied. METHODS: We identified 3778 community-dwelling older adults in the Health and Retirement Study (HRS) with Medicare claims for surgery (mean [SD] age: 75.4 [7.8] years, 53.9% women, and 86.0% non-Hispanic White). We assessed associations of depression, resilience, and perceived control of health with 2.5-year postoperative mortality and IADL decline using cox and modified Poisson regression analyses, adjusting for sociodemographic and health variables. RESULTS: The incidence of 2.5-year postoperative mortality was 18.5% and IADL decline was 9.4%. Depression was associated with a higher incidence and adjusted hazard [95% CI] of mortality (26% vs. 16%, aHR:1.2[0.9, 1.5]), but high resilience was associated with a lower incidence and adjusted hazard of mortality (9% vs. 21%, aHR:0.6[0.5, 0.8]). Those with depression had higher incidence and adjusted relative risk [95% CI] of IADL decline (17% vs. 7%, aRR:1.6[1.2, 2.2]), but lower incidence and adjusted relative risk of IADL decline was identified for those with high resilience (4% vs. 11%, aRR:0.6[0.4, 1.0]) and high perceived control of health (7% vs. 10%, aRR:0.6[0.4, 1.0]). CONCLUSION: While depression confers greater risk of mortality and IADL decline, higher resilience and perceived control of health may be protective. Addressing psychosocial factors in the peri-operative period may improve outcomes among older adults.
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BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) can progress to cirrhosis and hepatic decompensation, but whether genetic variants influence the rate of progression to cirrhosis or are useful in risk stratification among patients with NAFLD is uncertain. METHODS: We included participants from 2 independent cohorts, they Michigan Genomics Initiative (MGI) and UK Biobank (UKBB), who had NAFLD defined by elevated alanine aminotransferase (ALT) levels in the absence of alternative chronic liver disease. The primary predictors were genetic variants and metabolic comorbidities associated with cirrhosis. We conducted time-to-event analyses using Fine-Gray competing risk models. RESULTS: We included 7893 and 46,880 participants from MGI and UKBB, respectively. In univariable analysis, PNPLA3-rs738409-GG genotype, diabetes, obesity, and ALT of ≥2× upper limit of normal were associated with higher incidence rate of cirrhosis in both MGI and UKBB. PNPLA3-rs738409-GG had additive effects with clinical risk factors including diabetes, obesity, and ALT elevations. Among patients with indeterminate fibrosis-4 (FIB4) scores (1.3-2.67), those with diabetes and PNPLA3-rs738409-GG genotype had an incidence rate of cirrhosis comparable to that of patients with high-risk FIB4 scores (>2.67) and 2.9-4.8 times that of patients with diabetes but CC/CG genotypes. In contrast, FIB4 <1.3 was associated with an incidence rate of cirrhosis significantly lower than that of FIB4 of >2.67, even in the presence of clinical risk factors and high-risk PNPLA3 genotype. CONCLUSIONS: PNPLA3-rs738409 genotype and diabetes identified patients with NAFLD currently considered indeterminate risk (FIB4 1.3-2.67) who had a similar risk of cirrhosis as those considered high-risk (FIB4 >2.67). PNPLA3 genotyping may improve prognostication and allow for prioritization of intensive intervention.
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Diabetes Mellitus , Hepatopatia Gordurosa não Alcoólica , Humanos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/genética , Predisposição Genética para Doença , Genótipo , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Cirrose Hepática/genética , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/genética , Obesidade/complicações , Polimorfismo de Nucleotídeo ÚnicoRESUMO
BACKGROUND: Electronic consultations (eConsults) enable asynchronous consultation between primary care providers (PCPs) and specialists. eConsults have been used successfully to manage a variety of conditions and have the potential to help PCPs manage polypharmacy and promote deprescribing. OBJECTIVE: To elicit clinician perspectives on barriers/facilitators of using eConsults for deprescribing among older adults within a university health network. DESIGN: Semi-structured interviews. PARTICIPANTS: PCPs, geriatricians, and pharmacists. APPROACH: We used the COM-B (Capability, Opportunity, Motivation, and Behavior) model to structure the interview guide and qualitative analysis methods to identify barriers/facilitators of (1) deprescribing and (2) use of eConsults for deprescribing. KEY RESULTS: Of 28 participants, 19 were PCPs (13 physicians, 4 residents, 2 nurse practitioners), 7 were geriatricians, and 2 were pharmacists. Barriers and facilitators to deprescribing: PCPs considered deprescribing important but identified myriad barriers (e.g., time constraints, fragmented clinical care, lack of pharmacist integration, and patient/family resistance). Use of eConsults for deprescribing: Both PCPs and geriatricians highlighted the limits of contextual information available through electronic health record (vs. face-to-face) to render specific and actionable eConsults (e.g., knowledge of prior deprescribing attempts). Participants from all groups expressed interest in a targeted process whereby eConsults could be offered for select patients based on key factors (e.g., polypharmacy or certain comorbidities) and accepted or declined by PCPs, with pithy recommendations delivered in a timely manner relative to patient appointments. This was encapsulated by one PCP: "they need to be crisp and to the point to be helpful, with specific suggestions of something that could be discontinued or switched not, 'hey, did you know your patient is on over 12 medicines?'". CONCLUSIONS: Clinicians identified multifaceted factors influencing the utility of eConsults for deprescribing among older adults in primary care. Deprescribing eConsult interventions should be timely, actionable, and mindful of limitations of electronic chart review.
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BACKGROUND & AIMS: Ferritin has been investigated as a biomarker for liver fibrosis and iron in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, whether metabolic hyperferritinaemia predicts progression of liver disease remains unknown. In this study, we sought to understand associations between hyperferritinaemia and (1) adverse clinical outcomes and (2) common genetic variants related to iron metabolism and liver fibrosis. METHODS: This was a retrospective analysis of adults with MASLD seen at the University of Michigan Health System, where MASLD was defined by hepatic steatosis on imaging, biopsy or vibration-controlled transient elastography, plus metabolic risk factors in the absence of chronic liver diseases other than hemochromatosis. The primary predictor was serum ferritin level, which was dichotomized based on a cut-off of 300 or 450 mcg/L for women or men. Primary outcomes included (1) incident cirrhosis, liver-related events, congestive heart failure (CHF), and mortality and (2) distribution of common genetic variants associated with hepatic fibrosis and hereditary hemochromatosis. RESULTS: Of 7333 patients with MASLD, 1468 (20%) had elevated ferritin. In multivariate analysis, ferritinaemia was associated with increased mortality (HR 1.68 [1.35-2.09], p < .001) and incident liver-related events (HR 1.92 [1.11-3.32], p = .019). Furthermore, elevated ferritin was associated with carriage of cirrhosis-promoting alleles including PNPLA3-rs738409-G allele (p = .0068) and TM6SF2-rs58542926-T allele (p = 0.0083) but not with common HFE mutations. CONCLUSIONS: In MASLD patients, metabolic hyperferritinaemia was associated with increased mortality and higher incidence of liver-related events, and cirrhosis-promoting alleles but not with iron overload-promoting HFE mutations.
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Fígado Gorduroso , Hemocromatose , Adulto , Masculino , Humanos , Feminino , Hemocromatose/complicações , Hemocromatose/genética , Alelos , Estudos Retrospectivos , Fígado Gorduroso/complicações , Fígado Gorduroso/genética , Fígado Gorduroso/patologia , Fígado/patologia , Cirrose Hepática/complicações , Cirrose Hepática/genética , Cirrose Hepática/patologia , Fibrose , Ferro , FerritinasRESUMO
OBJECTIVE: To estimate readiness of older rehabilitation users in the United States to participate in video-based telerehabilitation and assess disparities in readiness among racial and ethnic minoritized populations, socioeconomically disadvantaged populations, and rural-dwelling older adults. DESIGN: Retrospective cohort study using nationally representative survey data from the National Health and Aging Trends Study from 2015 and 2020. Survey-weighted regression models, accounting for complex survey design, were used to generate estimates of readiness and evaluate disparities across racial and ethnic, socioeconomic, and geographic subgroups. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated for each comparison. SETTING: Home or community rehabilitation environments. PARTICIPANTS: A cohort of 5274 home or community-based rehabilitation users aged 70 years or older (N=5274), representing a weighted 33,576,313 older adults in the United States. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Video-based telerehabilitation readiness was defined consistent with prior work; unreadiness was defined as lacking ownership of internet-enabled devices, limited proficiency of use, or living with severe cognitive, visual, or hearing impairment. Telerehabilitation readiness was categorized as "Ready" or "Unready". RESULTS: Approximately 2 in 3 older rehabilitation users were categorized as ready to participate in video-based rehabilitation. Significantly lower rates of readiness were observed among those living in rural areas (OR=0.75, 95% CI: 0.60-0.94), financially strained individuals (OR=0.37, 95% CI: 0.26-0.53), and among individuals identifying as Black or Hispanic (as compared with non-Hispanic White older adults: Non-Hispanic Black [OR=0.23, 95% CI: 0.18-0.30]; Hispanic [OR=0.17, 95% CI: 0.11, 0.27]). CONCLUSIONS: Our findings highlight significant disparities in the readiness to uptake video-based telerehabilitation. Policy and practice interventions to address telerehabilitation readiness should focus not only on improving broadband access but also on technology ownership and training to ensure equitable adoption in populations with lower baseline readiness.
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Exclusão Digital , Disparidades em Assistência à Saúde , Telerreabilitação , Humanos , Idoso , Masculino , Feminino , Estados Unidos , Estudos Retrospectivos , Idoso de 80 Anos ou mais , População Rural/estatística & dados numéricos , Etnicidade , Fatores SocioeconômicosRESUMO
Parallel evolution can be expected among closely related taxa exposed to similar selective pressures. However, parallelism is typically stronger at the phenotypic level, while genetic solutions to achieve these phenotypic similarities may differ. For polygenic traits, the availability of standing genetic variation (i.e., heterozygosity) may influence such genetic nonparallelism. Here, we examine the extent to which high-elevation adaptation is parallel-and whether the level of parallelism is affected by heterozygosity-by analyzing genomes of 19 Paridae species distributed across East Asia with a dramatic east-west elevation gradient. We find that western highlands endemic parids have consistently lower levels of heterozygosity-likely the result of late-Pleistocene demographic contraction-than do parids found exclusively in eastern lowlands, which remained unglaciated during the late Pleistocene. Three widespread species (east to west) have high levels of heterozygosity similar to that observed in eastern species, although their western populations are less variable than eastern ones. Comparing genomic responses to extreme environments of the Qinghai-Tibet Plateau, we find that the most differentiated genomic regions between each high-elevation taxon and its low-elevation relative are significantly enriched for genes potentially related to the oxygen transport cascade and/or thermogenesis. Despite no parallelism at particular genes, high similarity in gene function is found among comparisons. Furthermore, parallelism is not higher in more heterozygous widespread parids than in highland endemics. Thus, in East Asian parids, parallel functional response to extreme elevation appears to rely on different genes, with differences in heterozygosity having no effect on the degree of genetic parallelism.
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Altitude , Distribuição Animal , Mudança Climática , Genômica , Aves Canoras/genética , Aves Canoras/fisiologia , Animais , Evolução Biológica , Ásia Oriental , Variação Genética , GenomaRESUMO
The Journal of Counseling Psychology serves as the premier journal for critical and rigorous research within the field and beyond. In their inaugural editorial for Journa, Liu is joined by their associated editors and inaugural JCP fellows who have agreed to share authorship and their positionalities. In considering the Journal of Counseling Psychology for research, the editors encourage authors to reflect on these positionalities and how they might integrate their own into their publications. The editorial provides direction and some suggestions on submitted articles and research directions for JCP in the following areas: positionality and critical reflexivity; theoretical and conceptual advancement and clarity; body ideas, frameworks, and conceptualization; data clarity; and cultural validity of research instruments. The editors look forward to working with their communities as they transform their scholarship. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Formação de Conceito , Aconselhamento , Humanos , PsicologiaRESUMO
After establishing secondary contact, recently diverged populations may remain reproductively isolated or may hybridize to a varying extent depending on factors such as hybrid fitness and the strength of assortative mating. Here, we used genomic and phenotypic data from three independent contact zones between subspecies of the variable seedeater (Sporophila corvina) to examine how coloration and genetic divergence shape patterns of hybridization. We found that differences in plumage coloration are probably maintained by divergent selection across contact zones; however, the degree of plumage differentiation does not match overall patterns of hybridization. Across two parallel contact zones between populations with divergent phenotypes (entirely black vs. pied plumage), populations hybridized extensively across one contact zone but not the other, suggesting that plumage divergence is not sufficient to maintain reproductive isolation. Where subspecies hybridized, hybrid zones were wide and formed by later-generation hybrids, suggesting frequent reproduction and high survivorship for hybrid individuals. Moreover, contemporary gene flow has played an important role in shaping patterns of genetic structure between populations. Replicated contact zones between hybridizing taxa offer a unique opportunity to explore how different factors interact to shape patterns of hybridization. Overall, our results demonstrate that divergence in plumage coloration is important in reducing gene flow but insufficient in maintaining reproductive isolation in this clade, and that other factors such as divergence in song and time since secondary contact may also play an important role in driving patterns of reduced hybridization and gene flow.
Al establecer contacto secundario, las poblaciones que divergieron recientemente pueden permanecer reproductivamente aisladas o pueden hibridarse en distintos grados, dependiendo de factores como la aptitud (fitness) y la fuerza del apareamiento selectivo. Aquí, utilizamos datos genómicos y fenotípicos de tres zonas de contacto independientes entre subespecies del Semillero Variable (Sporophila corvina), para examinar cómo la coloración y la divergencia genética regulan los patrones de hibridación. A través de las zonas de contacto, encontramos que las diferencias en la coloración del plumaje posiblemente se mantienen por selección divergente, pero el grado de diferenciación no coincide con los patrones generales de hibridación. En dos zonas de contacto análogas entre poblaciones con fenotipos divergentes (totalmente negro vs plumaje de varios colores), las poblaciones hibridaron ampliamente en una zona de contacto, pero no en la otra, lo que sugiere que la divergencia del plumaje no es suficiente para mantener el aislamiento reproductivo. Donde las subespecies hibridaron, las zonas híbridas eran amplias y estaban formadas por híbridos de generaciones posteriores, lo que sugiere reproducción frecuente y alta sobrevivencia de los híbridos. Además, el flujo génico ha desempeñado un papel importante en la configuración de patrones de estructura genética entre poblaciones. Las réplicas de zonas de contacto entre taxones que hibridan ofrecen una oportunidad para explorar cómo interactúan diversos factores para dar forma a los patrones de hibridación. En general, nuestros resultados demuestran que la divergencia en la coloración del plumaje es importante para reducir el flujo génico, pero insuficiente para mantener el aislamiento reproductivo en este clado, y que otros factores, como la divergencia en el canto y el tiempo transcurrido desde el contacto secundario, también pueden desempeñar un papel importante en la reducción del flujo génico e hibridación.
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Passeriformes , Isolamento Reprodutivo , Animais , Passeriformes/genética , Deriva Genética , Hibridização Genética , Fluxo GênicoRESUMO
In this article, we aim to unpack some of the hidden curriculum in publishing successfully in the Journal of Counseling Psychology (JCP) and other academic outlets. The many unspoken and implicit considerations behind writing a successful academic article can reinforce epistemic exclusions around class, gender, race, sexuality, and other axes of power that ultimately limit who gets to publish in academic journals and about what. Thus, we work to articulate the processes behind writing an academic article. Specifically, we offer suggestions for (a) writing compelling, precise, and parsimonious introductions, (b) clearly addressing the goals of the study via an accurate and detailed description of the method, (c) aligning analytic decisions with the research questions or hypotheses and the data parameters at hand, and (d) discussing the story of data in the context of prior scholarship, study limitations, and real-world implications. Where applicable, we provide concrete examples of published studies to "unhide" writing processes and to illustrate the invisible narratives and intentions behind key writing practices. We also present a checklist as an easy-to-reference companion to this article to help demystify the writing process. This article aligns with the commitment of JCP's editorial leadership to play an active role in opening up the scholarly publication process so that the pipeline of manuscripts submitted to and accepted by JCP shapes a more inclusive future for the field. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Editoração , Redação , Humanos , Aconselhamento , Currículo , Bases de Dados FactuaisRESUMO
Anti-Blackness and systemic racism are long-standing pressing social issues that have received increasing attention in the counseling psychology literature. However, the past few years have demonstrated what can only be described as an emboldening of anti-Blackness-the brutal individual and systemic threats of emotional and physical violence and loss of life that Black individuals and communities face on a daily basis-and a harsh reminder of the systemic racism that continues to threaten the well-being of Black, Indigenous, and People of Color. In this introduction for the special section on Dismantling and Eradicating Anti-Blackness and Systemic Racism, we provide readers an opportunity to pause and reflect on the ways in which those of us in the field can more intentionally seek to disrupt anti-Blackness and systemic racism. We believe that counseling psychology has an opportunity to increase its real-world relevance as an applied specialty area of psychology to the degree to which it evolves its ways of disrupting anti-Blackness and systemic racism in every content area and domain of the field. In this introduction, we review exemplars of work that helps the field re-envision its approaches to anti-Blackness and systemic racism. We also offer our perspectives on additional ways in which the field of counseling psychology can increase its relevance and real-world impact in 2023 and beyond. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Racismo , Humanos , Racismo/prevenção & controle , Racismo/psicologia , Racismo Sistêmico , Aconselhamento , Emoções , Coleta de DadosRESUMO
Disentangling the evolutionary relationships of rapidly radiating clades is often challenging because of low genetic differentiation and potentially high levels of gene flow among diverging taxa. The genus Sporophila consists of small Neotropical birds that show, in general, relatively low genetic divergence, but particularly high speciation rates and pronounced variation in secondary sexual traits (e.g., plumage color), which can be important in generating premating reproductive isolation. In cases like these, the use of genome-wide sequence data can increase the resolution to uncover a clade's evolutionary history. Here, we used a phylogenomic approach to study the evolutionary history and genetic structure of the Variable Seedeater superspecies complex, which includes S. corvina, S. intermedia, and S. americana. Using â¼25,000 genome-wide single nucleotide polymorphisms (SNPs), we confirmed that the Variable Seedeater superspecies complex is monophyletic. However, a phylogenetic reconstruction based on a mitochondrial marker (ND2) resulted in a discordant tree topology, particularly in the position of Wing-barred Seedeater S. americana, which might be due to a mitochondrial capture event. Our results suggest historical gene flow among lineages, particularly between species with conflicting topologies. Among the four phenotypically variable S. corvina subspecies, our structure analyses identified three main distinct genetic groups (K = 3), and that the entirely black subspecies, S. c. corvina, is derived from within a pied-colored clade. Further, we inferred widespread gene flow across the whole species' distribution, including between subspecies. However, gene flow was about 100 times lower at the geographic boundaries of the entirely black and the pied subspecies, suggesting an important role for plumage divergence in limiting gene flow. Overall, our findings suggest that the early diversification of the Sporophila genus occurred rapidly despite historical gene flow between lineages and that divergence in plumage color possibly influences the extent of gene flow among taxa.
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Fluxo Gênico , Passeriformes , Animais , Evolução Biológica , DNA Mitocondrial/química , DNA Mitocondrial/genética , Passeriformes/genética , FilogeniaRESUMO
Activating transcription factor 4 (ATF4) is a multifunctional transcription regulatory protein in the basic leucine zipper superfamily. ATF4 can be expressed in most if not all mammalian cell types, and it can participate in a variety of cellular responses to specific environmental stresses, intracellular derangements, or growth factors. Because ATF4 is involved in a wide range of biological processes, its roles in human health and disease are not yet fully understood. Much of our current knowledge about ATF4 comes from investigations in cultured cell models, where ATF4 was originally characterized and where further investigations continue to provide new insights. ATF4 is also an increasingly prominent topic of in vivo investigations in fully differentiated mammalian cell types, where our current understanding of ATF4 is less complete. Here, we review some important high-level concepts and questions concerning the basic biology of ATF4. We then discuss current knowledge and emerging questions about the in vivo role of ATF4 in one fully differentiated cell type, mammalian skeletal muscle fibers.
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Fator 4 Ativador da Transcrição , Atrofia Muscular , Fator 4 Ativador da Transcrição/genética , Fator 4 Ativador da Transcrição/metabolismo , Animais , Biologia , Diferenciação Celular , Humanos , Mamíferos , Fibras Musculares Esqueléticas/metabolismo , Atrofia Muscular/etiologiaRESUMO
OBJECTIVE: To compare characteristics between middle-aged and older prosthesis users with and without cognitive impairment and determine whether cognitive impairment contributes to variability in perceived physical function. DESIGN: Cross-sectional, observational study SETTING: General community. PARTICIPANTS: Adults 45 years or older, at least 1-year post lower limb amputation (LLA) who were walking independently with a prosthesis (N=119). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: We identified cognitive impairment using an education-adjusted Telephone Interview for Cognitive Status-modified score. Perceived physical function was measured using the Prosthesis Mobility Questionnaire. RESULTS: Of 119 participants (mean age, 62.6±8.2 years; male: 89.1%; vascular etiology: 82.4%; years since amputation: 4.9±4.7 years), 28 (23.5%) had cognitive impairment. Compared with participants without cognitive impairment, those with cognitive impairment were more likely to use an assistive device (60.7% vs 25.3%, P=.002); were older (66.3±7.3 vs 61.5±8.1 years, P=.006) and had more chronic conditions (7.1±3.4 vs 5.4±2.5, P=.004), more depressive symptoms (6.6±5.1 vs 4.2±3.8, P=.008), and worse perceived physical function (2.0±0.6 vs 2.6±0.7, P<.001). Using backward stepwise linear regression, we found that participants with cognitive impairment had worse perceived physical function (standardized parameter estimate [ß]=-0.15, P=.02), even after adjusting for depressive symptoms (ß=-0.31, P<.001), prosthesis satisfaction (ß=0.34, P<.001), number of chronic conditions (ß=-0.19, P=.006), and assistive device use (ßcane=0.01, P=.93; ßother=-0.20, P=.003). Together, these variables explained 59% of perceived physical function variability. CONCLUSIONS: Cognitive impairment is common and associated with worse perceived physical function post LLA, even after controlling for physical and mental health differences. Tailored rehabilitation interventions may be needed to improve perceived physical function in prosthesis users with cognitive impairment.
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Membros Artificiais , Disfunção Cognitiva , Idoso , Amputação Cirúrgica/reabilitação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , CaminhadaRESUMO
BACKGROUND: Persons with cognitive impairment without dementia are at high risk of adverse health outcomes. Tailored intervention targeting moderate-vigorous physical activity (MVPA) may reduce these risks. AIMS: To identify the prevalence and predictors of physical inactivity among older adults with cognitive impairment, no dementia (CIND); and estimate the proportion of inactive people with CIND who are capable of greater MVPA. METHODS: We studied 1875 community dwelling participants (over age 65) with CIND in the Health and Retirement Study. Physical inactivity was defined as MVPA ≤ 1x/week. Associations of physical inactivity with sociodemographic, health, and physical function were examined using chi-square and modified Poisson regression. We considered physically inactive participants capable of greater MVPA if they reported MVPA at least 1-3x/month, no difficulty walking several blocks, or no difficulty climbing several flights of stairs. RESULTS: Fifty-six percent of participants with CIND were physically inactive. Variables with the highest age, sex, and race/ethnicity adjusted risk ratio (ARR) for physical inactivity were self-rated health (poor [76.9%]vs. excellent [34.2%]; ARR [95% CI] 2.27 [1.56-3.30]), difficulty walking (across the room [86.5%] vs. none [40.5%]; ARR [95% CI] 2.09 [1.87-2.35]), total assets (lowest quartile [62.6%] vs. highest quartile [43.1%]; ARR [95% CI] 1.54 [1.29-1.83]), and lower education attainment (less than high school [59.6%] vs college graduate [42.8%]; ARR [95% CI] 1.46 [1.17-1.83]). Among physically inactive older adults with CIND, 61% were estimated to be capable of greater MVPA. CONCLUSIONS: Although physical inactivity is prevalent among older adults with CIND, many are capable of greater MVPA. Developing tailored physical activity interventions for this vulnerable population may improve cognitive, health, and quality of life outcomes.
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Disfunção Cognitiva , Demência , Idoso , Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Demência/psicologia , Exercício Físico , Humanos , Qualidade de Vida , Comportamento SedentárioRESUMO
Despite evidence that species' traits affect rates of bird diversification, biogeographic studies tend to prioritise earth history in Neotropical bird speciation. Here we compare mitochondrial genetic differentiation among 56 co-distributed Neotropical bird species with varying ecologies. The trait 'diet' best predicted divergence, with plant-dependent species (mostly frugivores and nectivores) showing lower levels of genetic divergence than insectivores or mixed-diet species. We propose that the greater vagility and demographic instability of birds whose diets rely on fruit, seeds, or nectar  known to vary in abundance seasonally and between years  relative to birds that eat primarily insects, drives episodic re-unification of otherwise isolated populations, resetting the divergence 'clock'. Testing this prediction using coalescent simulations, we find that plant-dependent species show stronger signals of recent demographic expansion compared to insectivores or mixed-diet species, consistent with this hypothesis. Our study provides evidence that localised ecological phenomena scale up to generate larger macroevolutionary patterns.
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Aves , Insetos , Animais , Aves/genética , Demografia , Ecologia , Fenótipo , FilogeniaRESUMO
The Ground Tit (Pseudopodoces humilis) has lived on the Qinghai-Tibet Plateau for â¼5.7 My and has the highest altitudinal distribution among all parids. This species has evolved an elongated beak in response to long-term selection imposed by ground-foraging and cavity-nesting habits, yet the genetic basis for beak elongation remains unknown. Here, we perform genome-wide analyses across 14 parid species and identify 25 highly divergent genomic regions that are significantly associated with beak length, finding seven candidate genes involved in bone morphogenesis and remolding. Neutrality tests indicate that a model allowing for a selective sweep in the highly conserved COL27A1 gene best explains variation in beak length. We also identify two nonsynonymous fixed mutations in the collagen domain that are predicted to be functionally deleterious yet may have facilitated beak elongation. Our study provides evidence of adaptive alleles in COL27A1 with major effects on beak elongation of Ps. humilis.
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Bico/anatomia & histologia , Evolução Biológica , Colágenos Fibrilares/genética , Aves Canoras/genética , Adaptação Biológica , Substituição de Aminoácidos , Animais , Genômica , Filogeografia , Seleção Genética , Aves Canoras/anatomia & histologiaRESUMO
The scientific rigor and computational methods of causal inference have had great impacts on many disciplines but have only recently begun to take hold in spatial applications. Spatial causal inference poses analytic challenges due to complex correlation structures and interference between the treatment at one location and the outcomes at others. In this paper, we review the current literature on spatial causal inference and identify areas of future work. We first discuss methods that exploit spatial structure to account for unmeasured confounding variables. We then discuss causal analysis in the presence of spatial interference including several common assumptions used to reduce the complexity of the interference patterns under consideration. These methods are extended to the spatiotemporal case where we compare and contrast the potential outcomes framework with Granger causality and to geostatistical analyses involving spatial random fields of treatments and responses. The methods are introduced in the context of observational environmental and epidemiological studies and are compared using both a simulation study and analysis of the effect of ambient air pollution on COVID-19 mortality rate. Code to implement many of the methods using the popular Bayesian software OpenBUGS is provided.
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Cerbera odollam or "pong-pong" tree contains cardiac glycosides similar to digoxin, oleander and yellow oleander. Cerbera odollam is a common method of suicide in South East Asia and has also been used as a weight loss supplement. We present a case of a 33-year-old female presenting with lethargy, vomiting, bradycardia, severe hyperkalemia of 8.9 mEq/L, slow atrial fibrillation followed by cardiovascular collapse following the ingestion of "pong-pong", the kernel of Cerbera odollam, as a weight loss supplement. Despite the administration of a total of nine vials of digoxin-specific Fab the patient could not be resuscitated. Clinicians should be aware of natural cardiac glycosides being uses as weight-loss agents and consider acute cardiac glycoside poisoning in patients with hyperkalemia, abnormal cardiovascular signs, symptoms and abnormal ECG findings.
Assuntos
Fármacos Antiobesidade/toxicidade , Apocynaceae/toxicidade , Glicosídeos Cardíacos/toxicidade , Suplementos Nutricionais/toxicidade , Adulto , Fármacos Antiobesidade/provisão & distribuição , Glicosídeos Cardíacos/provisão & distribuição , Suplementos Nutricionais/provisão & distribuição , Evolução Fatal , Feminino , Humanos , InternetRESUMO
Counseling psychologists have voiced the importance of nurturing social justice principles in the training of psychologists to better meet diverse people's psychological and social needs. Much of the research on training, however, has been focused on individual factors (e.g., self-efficacy, spirituality). Little empirical evidence exists on the mutual support among students and the role of shared social justice principles in counseling psychology training programs. Thus, we used the group actor-partner interdependence model (GAPIM) to test whether the advocacy intentions of a given student in the program (actor) would be related to the actor's and partner's (other students' aggregate scores in the program) social justice attitudes and perceptions of social justice norms in the training program (social justice norms among students and faculty). Peer relationship was also tested as a moderator of the associations. Structural equation modeling was used to test a series of GAPIMs with data from 178 doctoral students across 19 American Psychological Association accredited counseling psychology Ph.D. programs. Other students' collective attitudes and perceptions of the training program were stronger positive indicators of an individual student's advocacy intentions than actor variables (individual-level attitudes and perceptions). At the individual level, only actor social justice attitudes were significantly related to intentions with very small effect. Peer relationship was a significant moderator such that students in programs with closer peer relationships, who collectively perceived higher social justice norms, reported greater advocacy intentions. Implications for research and training are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Assuntos
Aconselhamento/educação , Intenção , Grupo Associado , Justiça Social/educação , Justiça Social/psicologia , Estudantes/psicologia , Adulto , Atitude , Aconselhamento/métodos , Docentes/psicologia , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Parceiros Sexuais/psicologia , Adulto JovemRESUMO
The Republic of Panama has the second most unequally distributed wealth in Central America, has recently entered the list of countries affected by the COVID-19 pandemic, and has one of the largest testing rate per inhabitant in the region and consequently the highest incidence rate of COVID-19, making it an ideal location to discuss potential scenarios for assessing epidemic preparedness, and to outline research opportunities in the Region of the Americas. We address two timely important questions: What are the unique risks of COVID-19 in Panama that could help other countries in the Region be better prepared? And what kind of scientific knowledge can Panama contribute to the regional and global study of COVID-19? This paper provides suggestions about how the research community could support local health authorities plan for different scenarios and decrease public anxiety. It also presents basic scientific opportunities about emerging pandemic pathogens towards promoting global health from the perspective of a middle income country.
La República de Panamá es el segundo país de Centroamérica con la distribución más desigual de la riqueza, ha resultado afectado recientemente por la pandemia de COVID-19 y tiene una de las mayores tasas de pruebas diagnósticas por habitante de la región y, por consiguiente, la mayor tasa de incidencia de COVID-19. Estos aspectos la convierten en un lugar ideal para examinar posibles escenarios de evaluación de la preparación para la epidemia y para plantear oportunidades de investigación en la Región de las Américas. Se abordan dos preguntas importantes y oportunas: ¿Cuáles son los riesgos singulares de la COVID-19 en Panamá que podrían ayudar a otros países de la Región a estar mejor preparados? y ¿Qué tipo de conocimiento científico puede aportar Panamá al estudio regional y mundial de la COVID-19? En este artículo se presentan sugerencias sobre la forma en que la comunidad de investigadores podría apoyar a las autoridades sanitarias locales a planificar medidas ante diferentes escenarios y disminuir la ansiedad de la población. También se presentan oportunidades científicas básicas sobre patógenos pandémicos emergentes para promover la salud mundial desde la perspectiva de un país de ingresos medios.