Successful Aging Among African American Older Adults With Type 2 Diabetes

"As I Grew Older, My Life Got Better": Conceptions of Successful Aging among Older Women Living with or at Risk of HIV

Successful aging (SA) is an important target for HIV care. However, we have insufficient understanding of how older women living with HIV (OWLH) in the US define SA. We explored conceptions of SA by OWLH and older women at risk of HIV and examined whether SA conceptions differed by (1) HIV serostatus, and (2) participation in the Women's Interagency HIV Study (WIHS). These analyses were part of a larger mixed-methods study with a sequential design. Participants were recruited at two clinical WIHS sites. We enrolled both WIHS participants and non-WIHS clinic patients. Our sample was 84% Black and included 29 OWLH and 15 older women at risk of HIV. We conducted 21 semi-structured interviews and four focus groups. The dataset was analyzed using descriptive, comparative, and relational analysis. We found four interlinked themes: life course perspective, accepting and celebrating aging, taking care of yourself, and looking good. The life course perspective was a core theme: participants assessed their aging in comparison to their earlier life hardships. These themes were similarly present among OWLH and older women at risk of HIV, although OWLH emphasized taking care of HIV. SA conceptualizations by OWLH did not differ whether or not they participated in the WIHS. Women living with or at risk of HIV may experience severe hardships throughout their lives. Overcoming these hardships may be linked to SA. Assessing the needs and connecting women to resources and programs are critical for SA promotion.

Aging-related Resiliency Theory Development

As a dynamic developmental process, the older population further displays the capacity to resist change over time, improve resilience, and keep a basis for the continuity working and progress over positive management of detrimental consequences of life risks and difficulties. This study aims at developing a theory that endeavors to explore the process of developing aging-related resiliency in people's later in life that can lead to a successful aging experience. In the development of a theory, this study utilized a deductive reasoning approach specifically, using the axiomatic approach. Aging-related Resiliency Theory was efficaciously developed by three propositions generated from four axioms that were derived after reviewing several sets of literature and studies. This developed theory implies that various deleterious events in life activate older persons to respond, adapt, and recover effectively. Acceptance emerges as they acknowledge the natural effects of aging while taking adaptive strategies and supportive resources to be resilient to one's environment. In this sense, it impacts their optimistic outlook towards successful aging. Based on the extraction of axioms, such propositions denoted those older adults call to respond with their total capacity to accept, adapt, recover, and continuously resist deleterious life experiences while using enriched coping strategies and resources towards an optimistic outlook in achieving successful aging. Therefore, emphasizing to improve their capacity to respond to natural decline to essential processes could benefit them at promoting a healthier life span.

Utilizing the "One Health" Model to Study Human Aging in Urban Environments

The "One Health" concept has resulted in a rich research literature that integrates human and animal systems, with a focus on zoonotic diseases; however, this narrow focus is at the expense of one of the leading causes of global human mortality: non-infectious, chronic diseases. Here, we provide a viewpoint that applying the integrated One Health framework to public health issues such as the impact of stressful urban environments on the process of human aging has the potential to elucidate potential causal mechanisms that have previously gone unnoticed. Given the success of the One Health paradigm in studying human health in rural areas, we posit that this model would be a useful tool for studying human, animal, and environmental interactions in urban settings.

"I Had to Rediscover Our Healthy Food": An Indigenous Perspective on Coping with Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus (T2DM) is disproportionally prevalent among the Bedouin minority in Israel, with especially poor treatment outcomes compared to other indigenous groups. This study uses the perspective of the Bedouins themselves to explore the distinct challenges they face, as well as their coping strategies. The study is based on an interpretive interactionist analysis of 49 semi-structured interviews with Bedouin men and women. The findings of the analysis include three themes. First, physical inequality: the Bedouin community's way of coping is mediated by the transition to a semi-urban lifestyle under stressful conditions that include the experience of land dispossession and the rupture of caring relationships. Second, social inequality: they experience an inaccessibility to healthcare due to economic problems and a lack of suitable informational resources. Third, unique resources for coping with T2DM: interviewees use elements of local culture, such as religious practices or small enclaves of traditional lifestyles, to actively cope with T2DM. This study suggests that there is a need to expand the concept of active coping to include indigenous culture-based ways of coping (successfully) with chronic illness.

Preventive effect of insect tea primary leaf (Malus sieboldii (Regal) Rehd.) extract on D-galactose-induced oxidative damage in mice

Insect tea is consumed as a health beverage in China. The insect tea primary leaf (ITPL) is rich in bioactive substances, which are also used as traditional Chinese medicine. This study investigated the role of ITPL in reducing the oxidative response induced by D-galactose in mice. Mice were intraperitoneally injected with D-galactose to induce oxidative damage. The effect of ITPL was tested by pathological observation, serum detection with kits, quantitative polymerase chain reaction, and Western blot. The experimental results show that ITPL increased the thymus, brain, heart, liver, spleen, and kidney indices of oxidized mice. ITPL increased superoxide dismutase, glutathione peroxidase, and glutathione levels and reduced nitric oxide and malondialdehyde levels in the serum, liver, and spleen in oxidative damaged mice. The pathological observations show that ITPL reduced the oxidative damage of the liver and spleen in mice induced with D-galactose. Simultaneously, ITPL upregulated mRNA expression of neuronal nitric oxide synthase, endothelial nitric oxide synthase, cuprozinc-superoxide dismutase, manganese superoxide dismutase, catalase, heme oxygenase-1, nuclear factor-erythroid 2 related factor 2, γ-glutamylcysteine synthetase, and NAD(P)H dehydrogenase [quinone] 1, and downregulated the expression of inducible nitric oxide synthase in the liver and spleen of oxidized mice. ITPL had beneficial preventive effects on the oxidative damage caused by D-galactose in mice and was more effective as an antioxidant than vitamin C. The component analysis test by high-performance liquid chromatography indicated that ITPL contained the following seven compounds: neochlorogenic acid, cryptochlorogenic acid, rutin, kaempferin, isochlorogenic acid B, isochlorogenic acid A, and hesperidin. ITPL is a plant with excellent antioxidant activities derived from its bioactive substances.

Individual-, Community-, and Health System-Level Barriers to Optimal Type 2 Diabetes Care for Inner-City African Americans: An Integrative Review and Model Development

PURPOSE

The purpose of this integrative review is (1) to elucidate the unique barriers faced by inner-city African Americans for type 2 diabetes (T2DM) care; (2) to identify effective interventions/programs for optimal T2DM care at the individual, community, and health systems levels; and (3) to integrate 2 behavioral models and 1 social ecological model for framing interventions for inner-city African American to optimize T2DM care.

METHODS

PRISMA guidelines were followed to systematically search PubMed, PsychInfo, and CINAHL. Integration of models was based on underlying principles of social ecological models.

RESULTS

The search returned 1183 articles. Forty-six articles were synthesized after applying inclusion criteria. Multiple barriers for the individual level, community level, and health system level were identified. Major barriers include lack of knowledge, lack of social support, and self-management support. Interventions identified in this review show that among inner-city African Americans with T2DM, the focus is placed at the health systems level, with very limited focus toward addressing individual- and community-level barriers. Final synthesis includes development of a new integrated model that explains barriers to care across multiple levels.

CONCLUSIONS

These findings highlight the fragmentation that may be occurring between policy, research, and practice for achieving health equity and addressing health disparities for T2DM care among inner-city African Americans. The new model is an important step in the pursuit of equity in T2DM by specifying the complex barriers that occur across multiple levels. The application of this model using the 2017 National Standards for Diabetes-Self Management Education and Support are discussed.

Effect of insect tea on D-galactose-induced oxidation in mice and its mechanisms

Insect tea is a traditional Chinese drink that contains abundant bioactive substances. In this study, the preventive effect of Insect tea on D-galactose-induced oxidation in mice was studied. The serum, liver, and spleen of mice were measured by biochemical and molecular biological methods, which showed that Insect tea could increase the biochemical indexes of the thymus, brain, heart, liver, spleen, and kidney in mice with induced oxidative damage. Insect tea can increase the levels of SOD (superoxide dismutase), GSH-Px (glutathione peroxidase), and GSH (glutathione) and decrease the levels of MDA (malondialdehyde) in the serum, liver, and spleen of mice with oxidative damage. Pathological observation also confirmed that Insect tea could inhibit oxidative damage of the liver and spleen tissue caused by D-galactose in mice. Further molecular biological experiments also showed that Insect tea could upregulate the mRNA and protein expression of Cu/Zn-SOD (cuprozinc-superoxide dismutase), Mn-SOD (manganese superoxide dismutase), CAT (catalase), HO-1 (heme oxygenase-1), Nrf2 (nuclear factor-erythroid 2 related factor 2), γ-GCS (γ-glutamylcysteine synthetase), and NQO1 (NAD(P)H dehydrogenase [quinone] 1) in the liver and spleen of oxidized mice. Insect tea has a good preventive effect on D-galactose-induced oxidation in mice, and the effect is better than vitamin C, an antioxidant. Insect tea is rich in isochlorogenic acid A, quercetin, rutin, hesperidin, neochlorogenic acid, and cryptochlorogenic acid. The combination of these bioactive substances has good antioxidant effects. Thus, Insect tea is a functional food with a good antioxidant effect that has value for future development and utilization.

The preventive effect of Apocynum venetum polyphenols on D-galactose-induced oxidative stress in mice

Apocynum venetum is a traditional medicine that is rich in polyphenols. Apocynum venetum polyphenol extract (AVP) contains the active substances neochlorogenic acid, chlorogenic acid, rutin, isoquercitrin, astragaloside and rosmarinic acid. In the present study, the preventive effect of AVP against D-galactose-induced oxidative stress was studied in a mouse model. The sera, skin, livers and spleens of mice were examined using hematoxylin and eosin staining, reverse transcription-quantitative PCR and western blot analysis. The biochemical results showed that AVP improved the thymus, brain, heart, liver, spleen and kidney indices in a mouse model of oxidative stress. AVP was also able to reverse the reduction in levels of superoxide dismutase (SOD), glutathione peroxidase and glutathione, and increased the levels of nitric oxide and malondialdehyde identified in the serum, liver, spleen and brain of mice exposed to oxidative stress. Pathological observations confirmed that AVP could inhibit oxidative damage to the skin, liver and spleen of mice caused by D-galactose. Further molecular biological experiments also demonstrated that AVP increased the expression of neuronal nitric oxide synthase, endothelial nitric oxide synthase, Cu/Zn-SOD, Mn-SOD, catalase, heme oxygenase-1, nuclear factor-erythroid 2-related factor 2, γ-glutamylcysteine synthetase and NAD(P)H quinone dehydrogenase 1 and reduced the expression of inducible nitric oxide synthase in the liver and spleen of treated mice compared to controls. Notably, the preventive effect of AVP against D-galactose-induced oxidative damage in mice was better than that of the confirmed antioxidant vitamin C. In conclusion, AVP exhibited an antioxidant effect and the AVP-rich Apocynum venetum may be considered a plant resource with potential antioxidative benefits.

Preventive Effect of Small-Leaved Kuding Tea (Ligustrum robustum (Roxb.) Bl.) Polyphenols on D-Galactose-Induced Oxidative Stress and Aging in Mice

Small-leaved Kuding tea is a traditional Chinese tea that is rich in polyphenols. In the current study, we investigated the preventive effect of small-leaved Kuding tea (SLKDT) on D-galactose-induced oxidative aging in mice. Changes in serum, skin, liver, and spleen of experimental animals were determined using biochemical and molecular biology techniques. Biochemical analysis demonstrated that polyphenol extract of SLKDT (PSLKDT) improved the indices of the thymus, brain, heart, liver, spleen, and kidney function in model mice. PSLKDT prevented a decrease in the levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and glutathione (GSH) as well as an increase in nitric oxide (NO) and malondialdehyde (MDA) levels in serum, liver, and spleen. Pathological assessment also showed that PSLKDT reduced oxidative damage induced by D-galactose in skin, liver, and spleen. We further found that PSLKDT upregulated neuronal nitric oxide synthase (nNOS), endothelial nitric oxide synthase (eNOS), Cu/Zn-SOD, Mn-SOD, catalase (CAT), heme oxygenase-1 (HO-1), nuclear factor (nuclear factor-erythroid 2 related factor 2 (Nrf2), γ-glutamylcysteine synthetase (γ-GCS), and NAD(P)H dehydrogenase [quinone] 1 (NQO1) mRNA expression and downregulated inducible nitric oxide synthase (iNOS) mRNA expression. Protein levels of SOD1 (Cu/Zn-SOD), SOD2 (Mn-SOD), CAT, GSH1 (γ-glutamate-cysteine ligase), and GSH2 (glutathione synthetase) in the liver and spleen were also increased by PSLKDT treatment. Collectively, these results indicate that PSLKDT is effective in preventing D-galactose-induced oxidative aging in mice, and its efficacy is significantly higher than antioxidant vitamin C. Because PSLKDT is a potent antioxidant and antiaging polyphenol, Kuding tea rich in PSLKDT should be considered an ideal drink with antioxidative and antiaging effects.

"Health is the Ability to Manage Yourself Without Help": How Older African American Men Define Health and Successful Aging

Objective

Few studies have explored how older African American men understand the relationship between health and successful aging. The goal of this study was to examine how older African American men's conceptions and definitions of health and notions of successful aging are interrelated.

Method

Using data from 22 semistructured individual interviews with African American men ages 55-76, we examine how cultural and normative ideals about health map onto the core components of Rowe and Kahn's (1997) definition of successful aging. We also explore how these notions influence factors that have implications for health.

Results

Consistent with prior research, we found that older African American men operationalized notions of health in ways that mapped onto three elements of successful aging: (a) the absence of disease and disability, (b) the ability to maintain physical and cognitive functioning, and (c) meaningful social engagement in life. A fourth theme, what men actually do, emerged to highlight how regular health practices were key components of how men define health.

Conclusions

These findings highlight key elements of how older African American men conceptualize health in ways that are interrelated with yet expand notions of successful aging in ways that are critical for health promotion research and interventions.

Lactobacillus plantarum CQPC11 Isolated from Sichuan Pickled Cabbages Antagonizes d-galactose-Induced Oxidation and Aging in Mice

Chinese pickled cabbage is a traditional fermented food that contains abundant microbes produced during the process of fermentation. In this work, an in vivo animal study was conducted to investigate the effects of a newly isolated lactic acid bacterium (Lactobacillus plantarum CQPC11, LP-CQPC11) on d-galactose-induced oxidation and aging in mice. Analysis of the serum and tissue samples of these mice using molecular biology approaches showed that LP-CQPC11 suppressed the decrease in thymus, brain, heart, liver, spleen, and kidney indices caused by oxidation and aging. Furthermore, LP-CQPC11 increased the levels of SOD (superoxide dismutase), GSH-Px (glutathione peroxidase), and GSH (glutathione), whereas it reduced the levels of NO (nitric oxide) and MDA (malondialdehyde) in the serum, liver, and spleen of oxidation and aging mouse models. Pathological observation indicated that LP-CQPC11 alleviated the damage caused by oxidation and aging on the liver and spleen of mice. qPCR analysis indicated that LP-CQPC11 effectively upregulated the expression of nNOS (neuronal nitric oxide synthase), eNOS (endothelial nitric oxide synthase), Cu/Zn-SOD (cuprozinc-superoxide dismutase), Mn-SOD (manganese superoxide dismutase), CAT (catalase), HO-1 (heme oxygenase-1), Nrf2 (nuclear factor-erythroid 2 related factor 2), γ-GCS (γ-glutamylcysteine synthetase), and NQO1 (NAD(P)H dehydrogenase [quinone] 1), but downregulated the expression of iNOS (inducible nitric oxide synthase) in the mouse liver and spleen. Western blot analysis showed that LP-CQPC11 effectively upregulated SOD1 (Cu/Zn-SOD), SOD2 (Mn-SOD), CAT, GSH1 (c-glutamylcysteine synthetase), and GSH2 (glutathione synthetase) protein expression in mouse liver and spleen tissues. These findings suggest that LP-CQPC11 can effectively prevent d-galactose-induced oxidation and aging in mice, and the effect is even better than that of the commonly used Lactobacillus delbruechii subsp. bulgaricus (LDSB) and vitamin C in the industry. Thus, LP-CQPC11 may be potentially employed as a probiotic strain.

Ascribed Meaning of Disease Control: Perspectives of Patients With Type 2 Diabetes

Background

Contemporary treatment of type 2 diabetes mellitus (hereafter diabetes) heavily emphasizes "diabetes control," largely defined by measurable blood glucose parameters. Little is known about how people living with the condition themselves define diabetes control within the lived experience of their disease.

Methods

As part of a qualitative study investigating the subjective construction of diabetes, 83 in-depth interviews were conducted with African American and non-Hispanic white older adults. Using content analysis, 4237 pages of narrative data were analyzed to explore how informants conceptualized diabetes control.

Findings

Four themes emerged from the data, describing varied understandings of diabetes control: (a) blood sugar regulation, (b) practicable treatment adherence, (c) bodily experience, and (d) degree of pharmaceutical need. Findings demonstrate that among persons with diabetes, the term diabetes control is multifaceted.

Conclusion

While clinical guidelines have established target blood glucose parameters as the standard indicator of diabetes control, persons with diabetes conveyed varied and diverse meanings situated within personal experiences. To foster empathetic and collaborative care, health-care providers tending to this population may consider integrating the emergent themes into communicative and treatment approaches.