scholarly journals Changes in Subjective Age During COVID-19

2020 ◽  
Author(s):  
Antonio Terracciano ◽  
Yannick Stephan ◽  
Damaris Aschwanden ◽  
Ji Hyun Lee ◽  
Amanda A Sesker ◽  
...  
Keyword(s):  
The United States ◽  
Rate Of Change ◽  
Older Age ◽  
Subjective Age ◽  
Health Crisis ◽  
Coping Process ◽  
Modeling Analysis ◽  
Stratified Sample ◽  
Design And Methods

Abstract Background and Objectives To examine the change in subjective age with the emergence of coronavirus disease 2019 (COVID-19). Two competing hypotheses were tested: (a) people felt increasingly older due to the stress generated by the pandemic and (b) people felt increasingly younger due to psychological distancing from older age, a vulnerability to COVID-19. Research Design and Methods An age- and sex-stratified sample of adults from across the United States (baseline N = 3,738) was assessed on 3 occasions: before the COVID-19 outbreak in late January/early February and during the outbreak in late March and again in late April. Multilevel modeling analysis examined the change in subjective age and tested potential moderators of individual differences in the trajectory of subjective age. Results The average trajectory of subjective age followed a concave curve, with a nadir (feeling younger) during the second assessment in late March. Older age, negative expectations about aging, absence of preexisting conditions, and less stress during COVID-19 were associated with feeling younger but did not predict the rate of change. The only significant predictor of change in subjective age was the belief that the “coronavirus is only a threat to older adults”: The more individuals agreed with this statement, the more likely it was that they felt increasingly younger at follow-up. Discussion and Implications Subjective age changed during a global health crisis, with people feeling younger with the emergence of COVID-19. The findings support the hypothesis that subjective age partly reflects a coping process of psychological distancing from older age, the age group most vulnerable to COVID-19.

Abstract WP365: STARS PLUS Patient Transition Pilot Program

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Alexandra Graves ◽  
Angie West ◽  
Miranda N Bretz ◽  
Marie Welch ◽  
Lynn Toth ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Stroke Prevention ◽  
Recurrent Stroke ◽  
Age Groups ◽  
The United States ◽  
Lifestyle Changes ◽  
Older Age ◽  
Stroke Survivors ◽  
Pilot Program

Background: As the leading cause of adult disability and the fourth leading cause of death in the United States, stroke prevention strategies are imperative. Arguably equal attention should be given towards both primary and secondary prevention of stroke. While much is known about medications and lifestyle changes to prevent recurrent stroke, additional research is needed to effectively ensure stroke survivors are following the recommended guidelines. Research shows that support after discharge from the hospital post-stroke is frequently inadequate. Purpose: The purpose of the Steps Against Recurrent Stroke (STARS) Plus Patient Transition Pilot Program was to design and deliver a program to facilitate optimal recovery for stroke survivors and prevent recurrent stroke. The program began at discharge from the hospital and continued through the first year of rehabilitation and recovery. Patients could opt in based on perceived benefits of support with medication management, timed educational mailings and calls about stroke recovery and recurrent stroke prevention. Results: Twelve hospitals participated; 261 patients enrolled and contact was established with 193. Outcomes were gathered based on patient self-report of health status using the Standard Form 12 (SF-12) Health Survey at 30, 90, 180 and 360 days. A total of 72 patients completed each follow-up in the full 12 months of the program. A dependent sample t-test was completed comparing participants’ 30 and 360 day follow-up scores. Results demonstrated an overall increase in subjective pain. A repeated MANOVA was conducted to compare 30 and 360 day SF-12 scores across age and subscales. Results revealed that those in the younger and older age groups reported poorer health outcomes. Conclusion: STARS Plus Program found no statistically significant change in perceived health benefits, although the majority found the program to be beneficial. Future programs should consider targeting pain management in all ages and education targeted at younger and older age groups, as they reported poorer health outcomes. The findings from this program should contribute to the guidance and insight for others developing transitional interventions for stroke survivors.

scholarly journals Integrase Strand Transfer Inhibitors and Weight Gain in Children and Youth with Perinatal HIV in the DC Cohort

2021 ◽  
Author(s):  
Wei Li A Koay ◽  
Sahera Dirajlal-Fargo ◽  
Matthew E Levy ◽  
Paige Kulie ◽  
Anne Monroe ◽  
...  
Keyword(s):  
United States ◽  
Weight Gain ◽  
The United States ◽  
Rate Of Change ◽  
Children And Youth ◽  
Strand Transfer ◽  
Z Score ◽  
Perinatal Hiv ◽  
Integrase Strand Transfer Inhibitors

Abstract We conducted a retrospective analysis of 38 children and youth with HIV (aged 0-<20 years) in the United States and report an increased rate of change of BMI-for-age z-score after initiating integrase strand transfer inhibitors (+0.19 z-score units/year, 95% CI 0.01, 0.37, p=0.036) for a median follow-up of 527.5 days.

scholarly journals Monitoring BMI Trends in a Midwest Regional Head Start Population: The Results of a Healthy Lifestyle Intervention

2020 ◽  
Vol 11 ◽  
pp. 215013272096286
Author(s):  
Antonela Miccoli ◽  
Loren L. Toussaint ◽  
Carina K. Hansen ◽  
Latasha M. Smith ◽  
Brian A. Lynch
Keyword(s):  
Head Start ◽  
The United States ◽  
Community Action ◽  
Overweight And Obesity ◽  
First Year ◽  
Wellness Program ◽  
Health Crisis ◽  
Second Year ◽  
The Impact

Background Childhood obesity represents a public health crisis in the United States. Thus, focusing on early childhood is crucial to modify the consequences associated with obesity. The Food and Fitness Initiative (FFI) is a community-based wellness program implemented in Northeast Iowa since 2009. FFI focuses on healthy eating and physical activity. Our aim is to describe the impact on body mass index (BMI) after implementing FFI in a Northeast Iowa Community Action Head Start (HS) population. Methods Retrospective BMI data was collected from all children attending 14 HS sites from 2012 to 2018. Children with BMI measurements during July to December of the first year in HS were included in the study. Follow-up data the second year in HS was obtained. Overweight and obesity prevalence, as well as, BMI changes between year 1 and 2 in HS were analyzed. Results Data from 1013 children were collected, 850 (84%) had qualifying BMI measurements during their first year in HS and 352 of those children (41%) had follow-up data in their second year. There was a decrease in BMI between years 1 and 2 in HS that approached statistical significance ( t = 1.83, P = .07, d = .10). There were no statistically significant changes in the percent of overweight (Wald χ2 = .50, P = .48) or obese (Wald χ2 = 1.71, P = .19) children between the first and second year. Conclusion The FFI wellness program can be feasibly integrated into the HS curriculum and shows promising short-term results in improving BMI, but not to a statistically significant level when evaluated over 1 year.

scholarly journals Subjective Age Changes During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 593-593
Author(s):  
Antonio Terracciano
Keyword(s):  
Older Age ◽  
Morbidity And Mortality ◽  
Psychosocial Predictors ◽  
Multilevel Analyses ◽  
Subjective Age ◽  
Age Changes ◽  
Social Distancing ◽  
Coping Process ◽  
Increased Risk ◽  
Alternative Hypotheses

Abstract Aging is associated with an increased risk of COVID-19 morbidity and mortality. In this study, we tested whether the pandemic influenced how old individuals felt by examining longitudinal within-person changes in subjective age. We tested two alternative hypotheses: (a) people felt increasingly older in response to the stress generated by COVID-19; (b) people felt increasingly younger due to psychological distancing from older age. We tested these hypotheses in a large US sample of adults assessed once before and twice during the COVID-19 pandemic. Multilevel analyses indicated that people reported feeling younger with the emergence of COVID-19. We further tested demographic, health, and psychosocial predictors of changes in subjective age. Overall, the findings supported the hypothesis that subjective age partly reflects a coping process of psychological distancing from older age, a process that parallels physical and social distancing.

A Population Based Study of 408 Cases of Acute Promyelocytic Leukemia Showing Changes in Epidemiology and Prognosis During Two Decades: Impact of Oral Arsenic Trioxide,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3597-3597
Author(s):  
Wing-Yan Au ◽  
Dennis Ip ◽  
Oscar Mang ◽  
Kit Fai Wong ◽  
Margaret Ng ◽  
...  
Keyword(s):  
Hong Kong ◽  
Arsenic Trioxide ◽  
Acute Promyelocytic Leukemia ◽  
Early Death ◽  
The United States ◽  
Population Based ◽  
Promyelocytic Leukemia ◽  
Male Gender ◽  
Older Age

Abstract Abstract 3597 Background. The incidence of acute promyelocytic leukemia (APL) shows racial variations. Population based epidemiologic studies are feasible because of common diagnostic criteria and treatment. The prognosis of APL has substantially improved since the advent of all trans-retinoic acid (ATRA) and arsenic trioxide (As2O3). Material and methods. Data on survival and relapse of consecutive APL patients in Hong Kong from 1991 to 2011 were obtained from the Hong Kong Cancer Registry (with at least 98% reporting and complete follow-up), and verified by hospital records. Data were censored at the end of July 2011. Potential factors impacting on survival including age, platelet count (Plat), white blood cell count (WBC), gender; 5-year cohort and As2O3 maintenance were analyzed by logistic regression. Results. Four hundred and eight cases of APL (198 men, 210 women) at a median age of 41 (3–89) years were registered. There was a rise in cases number with successive 5-year cohorts, but the WHO standardized age incidence rate (WSIR) was unchanged (Table 1). At diagnosis (Dx), the median hemoglobin was 8.4 (2.9–14.9) g/dL, WBC 17.7 (0.3–250) × 109/L (>10 × 109/L in 129 cases) and Plat 35 (3–270) × 109/L (< 40 × 109/L in 282 cases). Early death (within 30 days of Dx) occurred in 88 cases. Complete remission (CR) was achieved in 318 cases. Outcome was unknown in 2 cases. The incidence of early death decreased progressively with each 5-year cohort (p=0.035), but was positively correlated with older age (p<0.001), high WBC (p<0.001) and male gender (trend only, p=0.06). From CR1, the median follow-up was 83 (0–249) months. Relapse occurred in 108 cases. The 5-year relapse rate fell from 54% (no maintenance) to 16% (p<0.001) with the adoption of ATRA (n=110) and oral As2O3 (n=88; since 2001) maintenance. Relapse rates were lower in patients receiving As2O3 than ATRA maintenance (17% versus 38%; p=0.008). Risk factors predicting relapse were older age (p=0.001), no oral-As2O3 maintenance (p=0.003), high WBC (p=0.023) and male gender (trend only, p=0.056). For relapsed patients, 5-year overall survival (OS) from CR1 was improved from 67% with ATRA (1993–1998) to 96% with oral-As2O3 (since 1999–2011) treatment. The causes of deaths after CR1 were APL relapse (n=35), second cancer (n=8), bone marrow transplantation (BMT, n=7), chemotherapy (n=3) and unrelated causes (n=6). Allogeneic BMT was not performed since 1999. For the last 5-year cohort (2006–2011), there were no APL related deaths after CR1. With reduction of induction death, and improvement in treatment and prevention of relapses, the 5-year OS from diagnosis increased from 44% for the first 5-year cohort to 80% for the last 5-year cohort. On multivariate analysis, age (p<0.001) and cohort period (p=0.031) were determinants of OS. Conclusions. Population based incidence data showed that APL in Hong Kong was more prevalent than the United States (0.15–0.18/100000/year). Oral-As2O3 has markedly changed the outcome of APL patients. Early death is now the greatest problem curtailing survival of APL patients. Disclosures: No relevant conflicts of interest to declare.

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

scholarly journals Natural History and Evolution of Anti-Interferon-γ Autoantibody-Associated Immunodeficiency Syndrome in Thailand and the United States

2019 ◽  
Vol 71 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Gloria H Hong ◽  
Ana M Ortega-Villa ◽  
Sally Hunsberger ◽  
Ploenchan Chetchotisakd ◽  
Siriluck Anunnatsiri ◽  
...  
Keyword(s):  
United States ◽  
Natural History ◽  
The United States ◽  
Interferon Γ ◽  
Mycobacterium Abscessus ◽  
Annual Data ◽  
Persistent Infections ◽  
Ifn Γ ◽  
Immunodeficiency Syndrome

Abstract Background The natural history of anti-interferon-γ (IFN-γ) autoantibody-associated immunodeficiency syndrome is not well understood. Methods Data of 74 patients with anti-IFN-γ autoantibodies at Srinagarind Hospital, Thailand, were collected annually (median follow-up duration, 7.5 years). Annual data for 19 patients and initial data for 4 patients with anti-IFN-γ autoantibodies at the US National Institutes of Health were collected (median follow-up duration, 4.5 years). Anti-IFN-γ autoantibody levels were measured in plasma samples. Results Ninety-one percent of US patients were of Southeast Asian descent; there was a stronger female predominance (91%) in US than Thai (64%) patients. Mycobacterium abscessus (34%) and Mycobacterium avium complex (83%) were the most common nontuberculous mycobacteria in Thailand and the United States, respectively. Skin infections were more common in Thailand (P = .001), whereas bone (P &lt; .0001), lung (P = .002), and central nervous system (P = .03) infections were more common in the United States. Twenty-four percent of Thai patients died, most from infections. None of the 19 US patients with follow-up data died. Anti-IFN-γ autoantibody levels decreased over time in Thailand (P &lt; .001) and the United States (P = .017), with either cyclophosphamide (P = .01) or rituximab therapy (P = .001). Conclusions Patients with anti-IFN-γ autoantibodies in Thailand and the United States had distinct demographic and clinical features. While titers generally decreased with time, anti-IFN-γ autoantibody disease had a chronic clinical course with persistent infections and death. Close long-term surveillance for new infections is recommended.

scholarly journals How Family Physicians Practice the Principle of Remission Along the Glycemic Continuum

2020 ◽  
Vol 11 ◽  
pp. 215013272097774
Author(s):  
Stephanie T. Fulleborn ◽  
Paul F. Crawford ◽  
Jeremy T. Jackson ◽  
Christy J.W. Ledford
Keyword(s):  
Type 2 Diabetes ◽  
Medical Record ◽  
The United States ◽  
Case Scenario ◽  
Cross Sectional ◽  
Normal Glucose ◽  
Normal Glucose Regulation

Introduction Recent evidence reveals that diabetes and prediabetes (preDM) can be reversed to normal glucose regulation (NGR) through significant weight loss, but how physicians clinically identify the principles of partial and complete remission of diabetes is largely unknown. Methods As part of the cross-sectional omnibus survey conducted in March 2019 at a professional annual meeting in the United States, physician participants answered case scenario questions about the diagnosis and documentation of patients with preDM and type 2 diabetes (T2DM). Results Of the registered conference attendees, 387 (72.7%) responded. When presented with the initial case of preDM, 201 physicians (70.8%) selected R73.03 Prediabetes. In a follow-up encounter with improved lab results, 118 physicians (58.7%) indicated that they would not chart any diabetes-related code and 62 (30.8%) would chart preDM again. When presented with the case of T2DM, 256 physicians (90.1%) indicated E11.0–E11.9 Type 2 Diabetes. In the follow-up encounter, only 38 (14.8%) coded a diagnosis reflecting remission from T2DM to prediabetes and 211 (82.4%) charted T2DM. Conclusion Physicians may be reluctant to document diabetes regression as there is little evidence for long-term outcomes and “downgrading” the diagnosis in the medical record may cause screenings to be missed. Documenting this regression in the medical record should communicate the accurate point on the continuum of glucose intolerance with both the patient and the care team.

scholarly journals Testing telediagnostic thyroid ultrasound in Peru: a new horizon in expanding access to imaging in rural and underserved areas

2021 ◽  
Author(s):  
T. J. Marini ◽  
S. L. Weiss ◽  
A. Gupta ◽  
Y. T. Zhao ◽  
T. M. Baran ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Standard Of Care ◽  
The United States ◽  
Epidemiological Studies ◽  
Thyroid Ultrasound ◽  
Target Region ◽  
Experienced Radiologist ◽  
Significant Difference ◽  
Size Evaluation

Abstract Purpose Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide. Methods The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard. Results Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen’s kappa 0.91, P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care. Conclusion Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.

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