Links between early-life contextual factors and later-life cognition and the role of educational attainment

OBJECTIVE

Educational attainment is a well-documented predictor of later-life cognition, but less is known about upstream contextual factors. This study aimed to identify which early-life contextual factors uniquely predict later-life global cognition and whether educational attainment mediates these relationships.

METHOD

Participants were drawn from the Michigan Cognitive Aging Project (N = 485; Mage = 63.51; SDage = 3.13; 50% non-Hispanic Black). Early-life exposures included U.S. region of elementary school (Midwest, South, Northeast), average parental education, household composition (number of adults (1, 2, 3+), number of children), school racial demographics (predominantly White, predominantly Black, diverse), self-reported educational quality, and school type (public/private). Later-life global cognition was operationalized with a factor score derived from a comprehensive neuropsychological battery. Sequential mediation models controlling for sociodemographics estimated total, direct, and indirect effects of early-life contextual factors on cognition through educational attainment (years).

RESULTS

Higher educational quality, higher parental education, and attending a private school were each associated with better cognition; attending a predominantly Black or diverse school and reporting three or more adults in the household were associated with lower cognition. After accounting for educational attainment, associations remained for educational quality, school type, and reporting three or more adults in the household. Indirect effects through educational attainment were observed for school region, educational quality, school racial demographics, and parental education.

CONCLUSIONS

School factors appear to consistently predict later-life cognition more than household factors, highlighting the potential long-term benefits of school-level interventions for cognitive aging. Future research should consider additional mediators beyond educational attainment such as neighborhood resources and childhood adversity.

Caregiving Strain, family functioning, and effort to change diet for patients with gastrointestinal cancer: A cross-sectional descriptive study

PURPOSE

Among patients with cancer, it has been found that the family system influences health-related behaviors and may promote a healthy diet. This study assessed the associations among cancer patients between family caregiver strain, family functioning, and efforts to change diet.

METHODS

This cross-sectional descriptive study was conducted in gastrointestinal outpatient units at two tertiary university hospitals in South Korea. This study included 401 main family caregivers of patients with gastrointestinal cancer. The caregivers were evaluated using structured, face-to-face questionnaires measuring family strain, family functioning, and effort to change diet.

RESULTS

Greater effort to change diet was associated with higher family functioning, having a spouse, and more caregiving time per week. Less effort to change diet was associated with greater levels of caregiving strain and with a son providing caregiving.

CONCLUSION

The efforts of family caregivers to alter diet are influenced by family strain and family functioning, as well as family caregivers' characteristics, such as marital status, health problems due to caregiving, care time and duration, and relationship with the patient. This study suggested that reducing family strain and improving family functioning in clinical settings facilitate the success to change dietary strategies for cancer families.

Hereditary Paraganglioma in an Omani Family

Pheochromocytomas are tumors derived from chromaffin cells within the medulla of adrenal glands, whereas paragangliomas are tumors derived from extra-adrenal chromaffin cells of the sympathetic prevertebral and paravertebral ganglia. The growing deployment of genetic testing has shown that approximately 30% of pheochromocytoma and paraganglioma (PPGL) patients carry familial pathogenic germline mutations in known PPGL-susceptibility genes. This prompts genetic screening of their family members and leads to an increase in the detection of asymptomatic PPGLs or non-secreting tumors reported in familial cases discovered after the index patient work-up. Here, we present three case reports of affected members of a single Omani family with a history of paraganglioma and highly variable clinical presentations among the affected members. Eight out of the 16 siblings (50.0%) in the second generation of the reported family pedigree were carriers of the succinate dehydrogenase B:c.574T>C mutation, reflecting the autosomal dominant inheritance risk of paraganglioma and other associated tumors. This report highlights the complexity of managing such families and encourages further discussion regarding the management of asymptomatic PPGL-associated mutation carriers. Genetic screening has enabled the early detection of PPGLs, for which early surgical intervention can significantly impact prognosis and treatment strategies to reduce morbidity and mortality. Although PPGLs are similar tumors, they warrant distinction from each other with respect to their differences in locations, manifestations, secretory functions, genetic syndromes, and propensity to metastasize. While current guidelines are clear concerning symptomatic PPGL cases, the management of asymptomatic mutation carriers requires further elucidation.

Comparative Analysis of Health Behaviors, Health Status, and Medical Needs among One-Person and Multi-Person Household Groups: Focused on the Ageing Population of 60 or More

Background

Among the issues caused by the increase of one-person households the health problems and primary medical needs of one-person elderly households among the issues with the increase in one-person households is very important. The purpose of this study was to identified health care needs and problems of one-person elderly households by comparing health behavior, health status, disease prevalence rate, and medical needs to one-person elderly households and multi-person households.

Methods

Data were obtained from the 2017 Community Health Survey. In this study, 66,211 people who were over 60 years of age without missing variables were included in the final analysis.

Results

One-person households showed poorer overall health behaviors, such as nutritional behaviors, exercise behaviors, drinking and smoking behaviors, and poorer subjective and objective health status than multi-person households. Furthermore, albeit the high requirement of medical services for mental health outcomes such as suicide attempts, the rate of not receiving services was also high indicating high barriers to receive and access health care.

Conclusion

Comprehensive and direct comparison of health and medical factors revealed the medical vulnerability and unmet needs in terms of health promotion in the single-person elderly households. These results can be applied as the basic information to understand the needs and medical problems of these risk groups by primary medical doctors who predominantly treat single-person elderly households and can also be used as basic data for policy development in order to solve these unmet medical care needs.

Relationships between household smoking restrictions and intention to quit smoking among Korean American male smokers in California

This cross-sectional study examined the relationships between household smoking restrictions and intentions to quit smoking among Korean American male smokers in California. We used data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted in 2004 using computer-assisted telephone interviewing. Among the 2,545 respondents who participated in the CKATUS, the 387 male smokers who answered a question assessing their intention to quit smoking were included in the final analyses. In univariable analyses, smokers who reported having household smoking restrictions were more likely to intend to quit smoking as compared with those who did not (P<0.01). Other independent correlates of having an intention to quit smoking were being less than 50 yr of age, having spent more than 50% of one's life in the US, being assimilated, and having other smokers in the household. In a multiple logistic regression analysis, the significant correlates of having an intention to quit smoking were household smoking restrictions (complete or partial restriction vs. no restriction on smoking; odds ratio, 2.54; 95% confidence interval, 1.22-5.28) and absence of other smokers in the household. In conclusion, smoking restrictions in the household are associated with an intention to quit smoking among Korean American male smokers in California.

Tobacco smoking and twinning

In a case-control study an association was found between mothers' smoking habits and the frequency of dizygotic twinning. As cases were included all twins born in Denmark in 1984 and 1985. A random sample of 1.5% of mothers to singletons, born in the same period were selected as controls. Only live-borns, conceived after no hormonal treatment, were included in the study. The finding may be due to the well-known anti-estrogen effect of smoking.

Living arrangements after divorce: cohabitation versus remarriage

"The purpose of this paper is to examine the characteristics of all [U.S.] couple households in which one or both partners were previously married. In this examination, we will consider not only households maintained by married couples...; we will also consider households formed by cohabiting couples. In addition, we will examine the living arrangements of children in these households, with particular attention to whether children are from the current union or a previous union."

A multistate Markov chain model for evaluating a sterilization policy

"A multistate Markov chain model corresponding to varying fertility and mortality rates at different levels of surviving children of a couple was developed. Asymptotic probabilities of having a fixed number of children have been worked out." The implied geographical focus is on India.

Timing of the decision to remain voluntarily childless: evidence for continuous socialization

This study contrasts different types of voluntary childlessness. Women who decided to remain childless relatively early in life, before marriage ( early articulators) were compared with women who did not decide until after they had married and developed a preferred life style that did not include children ( postponers). The comparison centered on a previously formulated model that explained the decision to remain childless in terms of family background factors, autonomy and achievement orientation in adulthood, and reference group support. The major difference disclosed by this research was with respect to family background factors. In addition to the early versus later decision to remain childless, socialization patterns in the family of orientation differentiate the two types of voluntarily childless women.

Judgment, 14 December 1987

The Court held that a "father" has a right to visit a child born to his wife while they were married even if the child was conceived as the result of artificial insemination with the semen of another man. It reasoned that any decision on this issue had to be decided by taking into account the best interests of the child and that the child needed two parents. It noted that a legal motion brought by the child through the mother to have the child declared not to be the off-spring of the "father" had been denied.

One-parent families in Europe: a review

"One parent families form about 10-15 percent of all families in most industrialized countries. This review examines a selected number of European studies related to one-parent families completed during the 1985-1992 period. The major findings are presented, and implications for further research are included."

A comparative analysis of infant mortality in major Ohio cities: significance of socio-biological factors

"Using linked birth and infant death records for Ohio for the 1984-87 birth cohorts, this paper examines differentials in neonatal, postneonatal, and infant mortality rates in four major Ohio cities....It was found that, compared to Toledo, Cleveland had 51% higher risk of infant death, Cincinnati had 45% higher risk, [and] Columbus had 13% higher risk of infant death. Although in each of these cities, black infants had significantly higher risk of death than white infants, controlling for race alone reduced but did not eliminate the infant mortality differentials among the cities. The results of the hazards analyses reveal that maternal education, marital status, maternal age, birth order, prenatal care, gestational age, and birth weight had a profound net impact on the risk of infant death and that, even after controlling for these and other maternal and infant characteristics, significant city differentials persisted in infant mortality."

Living conditions of young families in Poland (1991-1992)

"The article presents the results of a survey carried out by [Poland's] Institute of Social Economy in the last quarter of 1991. It included 1,716 women and their families.... The research gathered much information about the functioning of young Polish families at the end of 1991 and at the beginning of 1992; about their material situation as well as their living problems and needs."