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Gonzalez-Guarda RM, Gross D, Lowe JR, Taylor JL. Sociocultural and contextual influences on mental health. Res Nurs Health 2024; 47:107-109. [PMID: 38400551 DOI: 10.1002/nur.22378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Affiliation(s)
| | - Deborah Gross
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - John R Lowe
- School of Nursing, University of Texas at Austin, Austin, Texas, USA
| | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Drazich BF, Crane BM, Taylor JL, Szanton SL, Moored KD, Eldreth D, Ahmad O, Krakauer JW, Resnick B, Carlson MC. OLDER ADULTS' SUBJECTIVE WELL-BEING EXPERIENCING THE EXERGAME "I AM DOLPHIN". Int J Qual Stud Health Well-being 2023; 18:2170013. [PMID: 36730308 PMCID: PMC9897765 DOI: 10.1080/17482631.2023.2170013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023] Open
Abstract
The objective of this study was to understand older adults' perceptions of the connections between an exergame intervention, "I Am Dolphin," and their subjective well-being. Researchers conducted three focus groups with 14 older adults who participated in the exergame feasibility study. The semi-structured focus groups were transcribed, coded, and analysed using deductive and inductive techniques. Three themes were constructed related to playing the exergame and participants' subjective well-being: 1) elevated mood (through scheduled activity, immersion, and socialization), 2) feelings of achievement (especially following frustration and competition), and 3) perceived cognitive or physical changes. These findings will help researchers better understand how exergames may relate to the well-being of older adults. Future investigators could use these findings to create and implement new exergame interventions.
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Affiliation(s)
- Brittany F. Drazich
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Breanna M. Crane
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Janiece L. Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sarah L. Szanton
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kyle D. Moored
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dana Eldreth
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Omar Ahmad
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - John W. Krakauer
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Barbara Resnick
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Michelle C. Carlson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Hamilton KR, Hughes AJ, Campbell CM, Owens MA, Pester BD, Meints SM, Taylor JL, Edwards RR, Haythornthwaite JA, Smith MT. Perioperative insomnia trajectories and functional outcomes after total knee arthroplasty. Pain 2023; 164:2769-2779. [PMID: 37343150 PMCID: PMC10733550 DOI: 10.1097/j.pain.0000000000002977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 05/09/2023] [Indexed: 06/23/2023]
Abstract
ABSTRACT Longitudinal total knee arthroplasty (TKA) studies indicate that a substantial percentage of patients continue to experience clinically significant pain and functional impairment after surgery. Insomnia has been associated with poorer surgical outcomes; however, previous work has largely focused on long-term postsurgical insomnia. This study builds on previous work by examining sleep and pain outcomes about perioperative insomnia trajectories. Insomnia symptoms (using the Insomnia Severity Index) during the acute perioperative period (2 weeks pre-TKA to 6 weeks post-TKA) were used to classify participants into perioperative insomnia trajectories: (1) No Insomnia (ISI < 8), (2) New Insomnia (baseline < 8; postoperative ≥ 8 or ≥6-point increase), (3) Improved Insomnia (baseline ≥ 8, postoperative < 8 or ≥6-point decrease), and (4) Persistent Insomnia (ISI ≥ 8). Insomnia, pain, and physical functioning were assessed in participants with knee osteoarthritis (n = 173; M age = 65 ± 8.3, 57.8% female) at 5 time points: 2 weeks pre-TKA, post-TKA: 6 weeks, 3 months, 6 months, and 12 months. Significant main effects were seen for insomnia trajectory and time, and trajectory-by-time interactions for postoperative insomnia, pain severity, and physical functioning ( P' s < 0.05). The Persistent Insomnia trajectory had the worst postoperative pain at all follow-ups and marked insomnia and physical functioning impairment post-TKA ( P' s < 0.05). The New Insomnia trajectory had notable long-term insomnia (6 weeks to 6 months) and acute (6 weeks) postoperative pain and physical functioning ( P' s < 0.05). Findings indicated a significant relationship between perioperative insomnia trajectory and postoperative outcomes. Results of this study suggest that targeting presurgical insomnia and preventing the development of acute postoperative insomnia may improve long-term postoperative outcomes, with an emphasis on persistent perioperative insomnia due to poorer associated outcomes.
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Affiliation(s)
- Katrina R. Hamilton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Abbey J. Hughes
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Claudia M. Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael A. Owens
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bethany D. Pester
- Department of Anesthesiology & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Samantha M. Meints
- Department of Anesthesiology & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Janiece L. Taylor
- Johns Hopkins Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Robert R. Edwards
- Department of Anesthesiology & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Jennifer A. Haythornthwaite
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael T. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Wright R, Regier NG, Booth A, Cotter VT, Hansen BR, Taylor JL, Won S, Witham G. Considerations of Intersectionality for Older Adults with Palliative Care Needs in the Emergency Department: An Integrative Review. Curr Geriatr Rep 2023; 12:195-204. [PMID: 38313361 PMCID: PMC10836610 DOI: 10.1007/s13670-023-00399-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 02/06/2024]
Abstract
Purpose of Review We sought to identify current interventions, research, or non-research evidence that has direct or indirect consideration of intersectionality in the care of older adults in the emergency department (ED). An integrative review informed by Crenshaw's Theory of Intersectionality was conducted in accordance with Whittemore and Knafl's five-stage methodology. A rigorous review process determined appropriateness for inclusion, and articles were analyzed for areas related to direct or indirect relationship to intersectionality. Recent Findings Older adults aged 60 and above in the United States (US) account for more than 20% of ED visits annually, and half of older adults will visit the ED in their last year of life. There has been a growing focus on adapting the ED to meet the palliative care needs of older adults, but relatively little consideration has been given to older adults' intersectional identities. Summary Six articles were identified that provided indirect insights into the status of intersectionality in ED-based palliative care for older adults. Two areas of interest were identified: (1) intersectional elements or reference to such elements embedded within the studies; and (2) the challenges of adapting quantitative methodologies to incorporate variables and approaches that would allow for intersectional analysis. This review highlights areas for future research along with recommendations for adopting an intersectional framing into commonly used methodologies.
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Affiliation(s)
- Rebecca Wright
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Principal Faculty, Johns Hopkins Center for Equity in Aging, Baltimore, MD, USA
| | - Natalie G. Regier
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Principal Faculty, Johns Hopkins Center for Equity in Aging, Baltimore, MD, USA
| | - Ashley Booth
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Valerie T. Cotter
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Principal Faculty, Johns Hopkins Center for Equity in Aging, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bryan R. Hansen
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Principal Faculty, Johns Hopkins Center for Equity in Aging, Baltimore, MD, USA
| | - Janiece L. Taylor
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Principal Faculty, Johns Hopkins Center for Equity in Aging, Baltimore, MD, USA
| | - Sarah Won
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Gary Witham
- School of Nursing and Public Health, Manchester Metropolitan University, Manchester, UK
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Bergman AJ, Szanton SL, LaFave SE, Fashaw-Walters SA, Taylor JL, Thorpe RJ, Nkimbeng M. Older Black Americans' Perspectives on Structural Racism-Resilience as a Form of Resistance. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01870-5. [PMID: 38019372 DOI: 10.1007/s40615-023-01870-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/14/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE The purpose of this study was to develop a deep understanding of the lived experiences of structural racism and discrimination among older Black Americans' and their perceptions of structural racism across their lives. We also considered individual and community resilience capacity and response in the face of systemic racism. METHODS In-depth interviews were conducted with Black community-dwelling adults aged 55 and older in and around Baltimore City. The interview guide used nine contexts to explore perceptions and experiences with structural racism over the life course. Two researchers used reflexive thematic analysis to code and analyze the data. RESULTS Participants endorsed structural racism to varying degrees across contexts of education, employment, neighborhood, healthcare, and income/wealth. Participants who denied structural racism placed blame for Black underachievement on factors such as personal and community deficiencies, unsafe neighborhoods, and institutional indifference. There was broad agreement about the existence of structural racism within the domains of policing and violence but participants were largely ambivalent about other domains such as environment, media, and civics. Resilience factors that helped individuals to resist and rebound from racism emerged as an unexpected and important theme. CONCLUSIONS We used Public Health Critical Race Praxis and the Cells to Society frameworks to contextualize these findings. Due to the ubiquitous nature of racism, individuals may not fully appreciate the impact of structural racism and its impact on Black well-being. This ordinariness of racism is harmful but may simultaneously contribute to resilience within Baltimore's Black community.
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Affiliation(s)
- Alanna J Bergman
- Johns Hopkins University School of Nursing, Baltimore, MD, USA.
- Center for Infectious Disease and Nursing Innovation - Johns Hopkins University School of Nursing, Baltimore, MD, USA.
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | | | | | - Roland J Thorpe
- Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Manka Nkimbeng
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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Taylor JL, Clair CA, Gitlin LN, Atkins S, Bandeen-Roche K, Abshire Saylor M, Hladek MD, Riser TJ, Thorpe RJ, Szanton SL. Acceptability and Feasibility of a Pain and Depressive Symptoms Management Intervention in Middle-Aged and Older African American Women. Innov Aging 2023; 7:igad096. [PMID: 38094930 PMCID: PMC10714909 DOI: 10.1093/geroni/igad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Indexed: 02/01/2024] Open
Abstract
Background and Objectives The intersection of race, gender, and age puts older African American women at high risk of experiencing comorbid pain and depressive symptoms. The purpose of this study was to assess the feasibility and acceptability of a 12-week behavioral activation intervention to target self-selected goals related to pain and depressive symptoms in middle-aged and older African American women. Research Design and Methods This randomized waitlist control study included 34 self-identified African American women, 50 years of age or older, with moderate-to-severe chronic pain and depressive symptoms. The intervention consisted of 8 in-person or virtual 1-hour visits with a nurse. Follow-up acceptability assessments were conducted with 10 participants. Results The average age of the participants was 64.8 (standard deviation [SD] 10.5). They reported an average pain intensity score of 7.0 (SD 1.9) out of 10 and an average Patient Health Questionnaire-9 depressive symptoms score of 11.9 (SD 4.0) at baseline. Of the 34 participants who consented, 28 (82.4%) women started the intervention and 23 (82.1%) completed the intervention. Participants described the study as useful and beneficial. Participants recommended including a group component in future iterations. Effect sizes at 12 weeks were -0.95 for depressive symptoms indicating a substantial decrease in experienced depressive symptoms, but pain intensity was virtually unchanged (+0.09). Discussion and Implications The findings of this study demonstrate that the intervention is acceptable among middle-aged and older African American women and their personal goals were met. Including a group component and identifying effective ways to decrease attrition rates will be key in the next steps of development for this intervention. It is crucial to provide tailored, nonpharmacological approaches to pain, and depression symptom management in older adult populations who experience inequities in pain and mental health outcomes. This study emphasizes the importance of participant-driven goal-setting interventions.
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Affiliation(s)
- Janiece L Taylor
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Catherine A Clair
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Shelbie Atkins
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Karen Bandeen-Roche
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | - Tiffany J Riser
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Roland J Thorpe
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Lee JW, Jeong S, Han HR, Boyd CM, Perrin N, Simmons SF, Green AR, Taylor JL, Boucher HR, Szanton SL. Barriers and facilitators to deprescribing before surgery: A qualitative study of providers and older adults. Geriatr Nurs 2023; 53:135-140. [PMID: 37540907 PMCID: PMC10528381 DOI: 10.1016/j.gerinurse.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023]
Abstract
INTRODUCTION Deprescribing, the collaborative process between providers and patients to streamline medication regimen, may reduce the risk of adverse events following surgery among older adults with multimorbidity. However, barriers and facilitators to deprescribing for surgery has not been explored. METHODS We conducted a qualitative study of Primary Care Providers (PCP) and patients aged 65 and older who were scheduled for surgery. We used the Theoretical Domains Framework, which informed the interview guide and analysis. RESULTS A total of 16 participants (n=8 providers, n=8 patients) were included. Themes were regarding: 1) attitudes towards deprescribing before surgery, 2) perceived benefits of deprescribing before surgery, 3) patient-provider relationship and shared decision-making, 4) hope for surgery, 5) barriers to deprescribing before surgery, and 6) preferences for deprescribing follow-up. CONCLUSION Our study findings regarding provider- and patient-related barriers and facilitators for deprescribing and desired processes before surgery may inform future deprescribing intervention targets before surgery.
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Affiliation(s)
- Ji Won Lee
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205.
| | - Suin Jeong
- Medstar Georgetown University, 3800 Reservoir Road NW, Washington, DC, 20007, USA
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205
| | - Cynthia M Boyd
- Johns Hopkins School of Medicine, Center for Transformative Geriatric Research, 5200 Eastern Avenue, MFL Building, 3(rd) Floor, Baltimore, MD, 21224
| | - Nancy Perrin
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205
| | - Sandra Faye Simmons
- Vanderbilt Center for Quality Aging, Vanderbilt University Medical Center, Division of Geriatrics, Nashville, TN, USA; VA Tennessee Valley Healthcare System, Geriatric Research Education and Clinical Center, Nashville, TN, USA
| | - Ariel R Green
- Johns Hopkins School of Medicine, Center for Transformative Geriatric Research, 5200 Eastern Avenue, MFL Building, 3(rd) Floor, Baltimore, MD, 21224
| | - Janiece L Taylor
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205
| | - Henry R Boucher
- Medstar Union Memorial Hospital, 3333 N. Calvert St. Suite 400, Baltimore, MD, 21218
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD, 21205
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Taylor JL, Clair CA, Lee JW, Atkins S, Riser TJ, Szanton SL, McCoy MC, Thorpe RJ, Wang C, Gitlin LN. A protocol for a wait list control trial of an intervention to improve pain and depressive symptoms among middle-aged and older African American women. Contemp Clin Trials 2023; 132:107299. [PMID: 37478967 PMCID: PMC10527967 DOI: 10.1016/j.cct.2023.107299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/09/2023] [Accepted: 07/15/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Pain and depression frequently co-occur among older adults with comorbidities and can exacerbate one another. The intersection of race, gender and age puts older African American women at high risk of experiencing comorbid pain and depression. The purpose of this study is to test the feasibility and acceptability of a 12-week behavioral activation intervention called DAPPER (Depression and Pain Perseverance through Empowerment and Recovery) that uses non-pharmacological, tailored strategies to target pain and mood symptoms. We will measure pain intensity and depressive symptoms as outcomes, although we are not powered to test differences. METHODS We describe the protocol for this study that uses a randomized waitlist control design to examine acceptability and feasibility of an intervention. The study population is comprised of self-identified African American women, 50 years of age or older with chronic pain and who self-report of depressive symptoms. Participants must also be pre-frail or frail and have an ADL or IADL limitation. The intervention consists of eight 1-2-h visits with a nurse interventionist via in-person or virtual telecommunication methods and two visits for non-invasive specimen collection. The primary outcomes include goal attainment, pain and depressive symptoms. Secondary outcomes include stress, frailty, and communication with providers. Follow-up qualitative interviews are conducted with participants to assess intervention acceptability. DISCUSSION Findings from this pilot study will provide further evidence supporting the use of non-pharmacological techniques to intervene in the cycle of pain and depression among an at-risk sub-population.
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Affiliation(s)
| | - Catherine A Clair
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ji Won Lee
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Shelbie Atkins
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Tiffany J Riser
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, Baltimore, MD, United States; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Megan C McCoy
- Northern Arizona University College of Social and Behavioral Sciences, Flagstaff, AZ, United States
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Claire Wang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Laura N Gitlin
- Drexel University College of Nursing and Health Professions, Philadelphia, PA, United States
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Nkimbeng M, Malaika Rumala BB, Richardson CM, Stewart-Isaacs SE, Taylor JL. The Person Beneath the Hair: Hair Discrimination, Health, and Well-Being. Health Equity 2023; 7:406-410. [PMID: 37638116 PMCID: PMC10457631 DOI: 10.1089/heq.2022.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 08/29/2023] Open
Abstract
Discrimination toward black hair is pervasive in today's society. Hair discrimination is negative bias manifested toward black natural or textured hair styles typically worn by persons of African descent. This commentary discusses the potential effects of hair discrimination on the health and well-being of persons of African descent. Specifically, it explores the mental and physical health implications of hair discrimination and situates it within the broader context of social determinants of health. The Creating a Respectful and Open World for Natural Hair Act has been recently passed in the United States House of Representatives, but more work is needed to eliminate hair discrimination and its negative effects.
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Affiliation(s)
- Manka Nkimbeng
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- CROWNCampaign.com, California, USA
| | | | - Crystal M. Richardson
- CROWNCampaign.com, California, USA
- The Law Office of Crystal M. Richardson PLLC, High Point, North Carolina, USA
| | - Shemekka Ebony Stewart-Isaacs
- CROWNCampaign.com, California, USA
- People with Lived Experience Institute, California, USA
- I Am Brilliant, Raleigh, North Carolina, USA
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Harrison TC, Taylor JL, Johnson A, Ortega LC, Lowe J, Blozis S. The Life-Course Perspectives of Mexican American Men With Mobility Limitation. Qual Health Res 2023; 33:897-910. [PMID: 37420336 PMCID: PMC10564382 DOI: 10.1177/10497323231170157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
The life-history narratives of 10 Mexican American men with mobility limitations, age 55-77 years (mean = 63.8, SD = 5.8), were explored using a qualitatively driven, life-history mixed-methods study to understand perceptions of mobility limitations over the life course. Within that methodological and paradigmatic framework, conceptualizations of alterity and masculinity guided interpretation of data. Through an iterative, thematic analysis, we detail the way the men's lives were influenced by growing familial responsibility with age. Quantitative data were integrated into themes of narrative inheritance, family, and masculinity. It was posited that masculinity with mobility limitations shaped and was shaped by ethnic identity and responsibility. This has implications for understanding the experience of Mexican American men over the life course.
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Crane BM, Drazich BF, Taylor JL, Moored KD, Ahmad O, Krakauer JW, Carlson MC. Older Adults and Three-Dimensional Exergaming: Motivators and Barriers to Participation and Retention. Games Health J 2023; 12:150-157. [PMID: 36706426 PMCID: PMC10325799 DOI: 10.1089/g4h.2022.0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background: Cognitive and physical activity are important for daily functioning. However, limited research exists on the motivators and barriers associated with older adults participating and adhering to exergame studies that promote physical and cognitive activity. Our objective was to examine older adults' motivators and barriers to joining and completing a three-dimensional exergame study. Methods: Fourteen older adults who participated in the exergame study contributed to one of three focus group discussions. Inductive and deductive methods were used to analyze the qualitative data. Results: Motivators for joining were generativity, peer referrals, self-improvement, and curiosity. Accomplishment, immersion, and exercise were motivators for retention. Participants also cited the structured schedule and adaptive difficulty features as motivators for retention. Barriers to participation included frustration due to lack of level advancement and fatigue/pain during gameplay. Some (n = 3) reported camera tracking issues as a barrier. Unanticipated gender-based trends arose when examining perceptions of the study team's role and motivators for retention. Conclusion: These findings will inform future research strategies for participant recruitment, enrollment, and retention, in addition to providing insights into the design of motivating, enjoyable, and sustainable exergames for older adults.
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Affiliation(s)
- Breanna M. Crane
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Janiece L. Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kyle D. Moored
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Omar Ahmad
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - John W. Krakauer
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michelle C. Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Drazich BF, Lee JW, Bowles KH, Taylor JL, Shah S, Resnick B, Kim N, Szanton SL. Pandemic Related Changes in Technology Use Among a Sample of Previously Hospitalized Older Adult New Yorkers: An Observational Study. JMIR Aging 2023; 6:e41692. [PMID: 36881528 PMCID: PMC10131656 DOI: 10.2196/41692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 02/06/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic increased the importance of technology for all Americans, including older adults. Although a few studies have indicated that older adults might have increased their technology use during the COVID-19 pandemic, further research is needed to confirm these findings, especially among different populations, and using validated surveys. In particular, research on changes in technology use among previously hospitalized community-dwelling older adults, especially those with physical disability, is needed because older adults with multimorbidity and hospital associated deconditioning were a population greatly impacted by COVID-19 and related distancing measures. Obtaining knowledge regarding previously hospitalized older adults' technology use, before and during the pandemic, could inform the appropriateness of technology-based interventions for vulnerable older adults. OBJECTIVE In this paper, we 1) described changes in older adult technology-based communication, technology-based phone use, and technology-based gaming during the COVID-19 pandemic, compared to before the COVID-19 pandemic and 2) tested whether technology use moderated the association between changes in in-person visits and well-being, controlling for covariates. METHODS Between December 2020 and January 2021 we conducted a telephone-based objective survey with 60 previously hospitalized older New Yorkers with physical disability. We measured technology-based communication through three questions pulled from the National Health and Aging Trends Study COVID-19 Questionnaire. We measured technology-based smart phone use and technology-based video gaming through the Media Technology Usage and Attitudes Scale. We used paired t tests and interaction models to analyze survey data. RESULTS This sample of previously hospitalized older adults with physical disability consisted of 60 participants, 63.3% of whom identified as female, 50.0% of whom identified as White, and 63.8% of whom reported an annual income of $25,000 or less. This sample had not had physical contact (such as friendly hug or kiss) for a median of 60 days and had not left their home for a median of 2 days. The majority of older adults from this study reported using the internet, owning smart phones, and nearly half learned a new technology during the pandemic. During the pandemic, this sample of older adults significantly increased their technology-based communication (mean difference=.74, P=.003), smart phone use (mean difference=2.9, P=.016), and technology-based gaming (mean difference=.52, P=.030). However, this technology use during the pandemic did not moderate the association between changes in in-person visits and well-being, controlling for covariates. CONCLUSIONS These study findings suggest that previously hospitalized older adults with physical disability are open to using or learning technology, but that technology use might not be able to replace in-person social interactions. Future research might explore the specific components of in-person visits that are missing in virtual interactions, and if they could be replicated in the virtual environment, or through other means.
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Affiliation(s)
- Brittany F Drazich
- School of Nursing, University of Maryland, 655 W Lombard St, Baltimore, US
| | - Ji Won Lee
- School of Nursing, Johns Hopkins University, Baltimore, US
| | - Kathryn H Bowles
- School of Nursing, University of Pennsylvania, Philadelphia, US.,Center for Home Care Policy & Research, VHS Heath, New York City, US
| | | | - Shivani Shah
- Center for Home Care Policy & Research, VHS Heath, New York City, US
| | - Barbara Resnick
- School of Nursing, University of Maryland, 655 W Lombard St, Baltimore, US
| | - Nayeon Kim
- School of Nursing, University of Maryland, 655 W Lombard St, Baltimore, US
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, US.,School of Public Health, Johns Hopkins University, Baltimore, US
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13
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Nkimbeng M, Nmezi NA, Baker ZG, Taylor JL, Commodore-Mensah Y, Shippee TP, Szanton SL, Gaugler JE. Depressive Symptoms in Older African Immigrants with Mobility Limitations: A Descriptive Study. Clin Gerontol 2023; 46:14-26. [PMID: 34528489 PMCID: PMC9283084 DOI: 10.1080/07317115.2021.1976893] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Before, during, and after their immigration to the United States, immigrants face stressful life circumstances that may render them at risk for depressive symptoms. However, there is a dearth of research on the mental health of African immigrants. We performed secondary data analyses of two studies in the Baltimore-Washington area to describe and identify correlates of depressive symptoms in older African immigrants. METHODS Chi square tests, one-way ANOVAs, and linear regressions were used to describe and examine associations between depressive symptoms and immigrant-related risk factors. RESULTS This sample included 148 participants who had a mean age of 62 (SD ± 8.2). Clinical depressive symptoms were present in 8.1% of participants, and trouble falling asleep for more than half of the days was the most prevalent symptom (20%). Levels of education, income, and migration reasons differed significantly from clinical depressive symptoms, but these were not significantly associated with more depressive symptoms after controlling for covariates. CONCLUSIONS Longitudinal designs may further elucidate incidence, correlates, and long-term effects of depressive symptoms within this population. CLINICAL IMPLICATIONS Knowledge of depressive symptom burden and risk factors can inform timely assessment, referral, and treatment of depressive symptoms and other mental health outcomes in older African immigrants.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
- Physical Medicine and Rehabilitation Division of Rehabilitation Psychology and Neuropsychology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Nwakaego A Nmezi
- Physical Medicine and Rehabilitation Division of Rehabilitation Psychology and Neuropsychology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Zachary G Baker
- Division of Health Policy and Management, University of Minnesota School of Public Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | | | | | - Tetyana P Shippee
- Division of Health Policy and Management, University of Minnesota School of Public Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | | | - Joseph E Gaugler
- Division of Health Policy and Management, University of Minnesota School of Public Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
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14
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Drazich BF, Li Q, Perrin NA, Szanton SL, Lee JW, Huang CM, Carlson MC, Samuel LJ, Regier NG, Rebok GW, Taylor JL. The relationship between older adults' technology use, in-person engagement, and pandemic-related mental health. Aging Ment Health 2023; 27:156-165. [PMID: 35243945 PMCID: PMC9440957 DOI: 10.1080/13607863.2022.2046695] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 02/18/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objectives of this study are to 1) describe changes in in-person communication/activity and changes in older adult technology use during the COVID-19 pandemic and 2) examine whether less in-person communication/activity mediates the relationship between pandemic-related mental health and technology use. METHOD Linear regressions (stratified by age and financial strain) and structural equation modeling were employed using a nationally representative, cross-sectional survey of 3,188 older adults from the 2020 National Health and Aging Trends Study's COVID-19 Questionairre. RESULTS Older adults engaged in more technology-based activity (b = 0.24; p<.001), more technology-based health care communication (b = 0.22; p<.001), and more technology-based food acquisition (b = 0.21; p<.001) during the COVID-19 pandemic, as compared to before the pandemic. Results indicate that adults <80 years old demonstrated greater increases in technology-based activity, technology-based health communication, and technology-based food acquisition, compared to adults ≥80 years old. Change in in-person communication significantly mediated the relationship between pandemic-related mental health and technology-based communication (standardized coefficient= -0.012; p=.005), and change in in-person activity significantly mediated the relationship between pandemic-related mental health and technology-based activity (standardized coefficient= -0.017; p=.020). CONCLUSIONS This study suggests that older adults are utilizing technology more, and therefore should be considered in technology design and dissemination. Technology use could be an important positive response to help those with pandemic related worries stay safely engaged with friends and family. Technologies should be produced that are modifiable for older adults with disabilities and affordable for older adults with fixed incomes.
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Affiliation(s)
| | - Qiwei Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Nancy A Perrin
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Department of Health Policy, Johns Hopkins University, Baltimore, MD, USA
- School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - Ji Won Lee
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Chien-Ming Huang
- School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | | | - Laura J Samuel
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - Natalie G Regier
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - George W Rebok
- School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
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15
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Clair CA, Melvin TJ, Taylor JL, Saylor MA. "Researcher" bias: How our assumptions on technology affect research of older adults. Front Public Health 2022; 10:1034497. [PMID: 36407974 PMCID: PMC9666877 DOI: 10.3389/fpubh.2022.1034497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/17/2022] [Indexed: 01/29/2023] Open
Affiliation(s)
- Catherine A. Clair
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States,*Correspondence: Catherine A. Clair
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16
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Nkimbeng M, Han HR, Szanton SL, Alexander KA, Davey-Rothwell M, Giger JT, Gitlin LN, Joo JH, Koeuth S, Marx KA, Mingo CA, Samuel LJ, Taylor JL, Wenzel J, Parisi JM. Exploring Challenges and Strategies in Partnering With Community-Based Organizations to Advance Intervention Development and Implementation With Older Adults. Gerontologist 2022; 62:1104-1111. [PMID: 34958098 PMCID: PMC9451017 DOI: 10.1093/geront/gnab190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Indexed: 12/30/2022] Open
Abstract
Minoritized older adults face multiple health inequities and disparities, but are less likely to benefit from evidence-based health care interventions. With the increasing diversity of the U.S. aging population, there is a great promise for gerontology researchers to partner with racial/ethnic minority organizations and underrepresented communities to develop and implement evidence-based health interventions. Community-Based Participatory Research and Implementation Science offer guidance and strategies for researchers to develop and sustain community partnerships. However, researchers partnering with community organizations continue to face challenges in these collaborations, study outcomes, and sustainability. This may be especially true for those junior in their career trajectory or new to community-engaged research. The purpose of this forum article is to detail critical challenges that can affect gerontology researcher-community partnerships and relationships from the perspective of researchers. Seven challenges (pre- or mid-intervention design, implementation, and postimplementation phases) described within the Equity-focused Implementation Research for health programs framework are identified and discussed. Potential solutions are also presented. Planning for potential obstacles of the researcher-community partnerships can inform innovative solutions that will facilitate successful partnerships, thereby promoting the advancement of collaborative research between academic institutions and community organizations to improve older adult health outcomes.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
| | | | - Melissa Davey-Rothwell
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jarod T Giger
- University of Kentucky College of Social Work, Lexington, Kentucky, USA
| | - Laura N Gitlin
- Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA
| | - Jin Hui Joo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sokha Koeuth
- Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA
| | - Katherine A Marx
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chivon A Mingo
- Georgia State University, College of Arts & Sciences, Atlanta, Georgia, USA
| | - Laura J Samuel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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17
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Taylor JL, Regier NG, Li Q, Liu M, Szanton SL, Skolasky RL. The impact of low back pain and vigorous activity on mental and physical health outcomes in older adults with arthritis. Front Pain Res 2022; 3:886985. [PMID: 35935669 PMCID: PMC9355128 DOI: 10.3389/fpain.2022.886985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022] Open
Abstract
Background Nearly 50% of Americans aged 65 and above have been diagnosed with arthritis and an estimated 80% of adults experience low back pain (LBP). Little is known about the experience of LBP in older adults with arthritis and its relationships with mental and physical health. Objective In this study, we examined the relationships between LBP and four physical and mental health conditions (psychological distress, insomnia, mobility limitations, and self-rated health) in older adults with arthritis in the National Health and Aging Trends Study (NHATS). We also examined whether vigorous exercise mediated the relationships between LBP and these four conditions. Materials and Methods The data from this study comes from waves five through nine of the NHATS. The sample size ranged from 3,490 to 2,026 across these waves. All variables in this study are based on self-report. We used descriptive analyses including means and standard deviations for continuous variables or frequencies and proportions for demographic data. We used structural equation modeling (SEM) to examine if vigorous activity mediated the relationship between LBP with the four conditions. Results The age range of the sample was 65 years of age and older. Among those with back pain 78.53% had no mobility limitations. There was a significant relationship between LBP with insomnia (B = 0.48, p < 0.001), perceived health status (B = −0.38, p < 0.0010), and psychological distress (0.67, p < 0.001). Activity mediated the relationship between LBP and insomnia, psychological distress and physical health in adjusted models. Discussion The presence of low back pain in older adults with arthritis increases the risk of insomnia, psychological distress, mobility limitations, and poorer self-rated health. Consequently, targeting comorbid LBP may be an important component of the treatment plans of older adults with arthritis. In addition, providers of patients with arthritis and LBP should conduct routine assessments of mental and physical health to ensure the LBP is being adequately addressed.
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Affiliation(s)
- Janiece L. Taylor
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Johns Hopkins School of Nursing Center for Innovative Care in Aging, Baltimore, MD, United States
- *Correspondence: Janiece L. Taylor
| | - Natalie G. Regier
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Johns Hopkins School of Nursing Center for Innovative Care in Aging, Baltimore, MD, United States
| | - Qiwei Li
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Minhui Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Sarah L. Szanton
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Johns Hopkins School of Nursing Center for Innovative Care in Aging, Baltimore, MD, United States
| | - Richard L. Skolasky
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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18
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Thompson OJ, Powell-Roach K, Taylor JL, Terry EL, Booker SQ. Pain catastrophizing: A patient-centered approach to assessment. Nursing 2022; 52:26-30. [PMID: 35358988 PMCID: PMC9106311 DOI: 10.1097/01.nurse.0000823252.50782.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Pain is a subjective experience and its perception and expression vary widely. Pain catastrophizing, which refers to patients' thoughts or feelings about their pain, may impact their communication of pain and nurses' subsequent response. This article discusses how nurses can more readily recognize, assess, and manage pain catastrophizing.
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Affiliation(s)
- Osheeca J Thompson
- Osheeca Thompson is a clinical research coordinator at the University of Florida (UF) College of Medicine. Keesha Powell-Roach is an assistant professor at the University of Tennessee Health Science Center College of Nursing. Janiece Taylor is an assistant professor on the research/education track at the Johns Hopkins School of Nursing. Ellen Terry and Staja Booker are assistant professors at UF's College of Nursing and the Pain Research and Intervention Center of Excellence in the College of Dentistry
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19
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Drazich BF, Jenkins E, Nkimbeng M, Abshire Saylor M, Szanton SL, Wright R, Beach MC, Taylor JL. Exploring the Experiences of Co-morbid Pain and Depression in Older African American Women and Their Preferred Management Strategies. Front Pain Res (Lausanne) 2022; 3:845513. [PMID: 35295801 PMCID: PMC8915555 DOI: 10.3389/fpain.2022.845513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
The intersection of race, gender, and age places older African American women at an increased risk for untreated physical pain and depression that can significantly diminish their quality of life. The objectives of this study were to (1) explore older African American women's perceptions of pain and depressive symptoms and how these symptoms influence each other, and (2) explore effective pain and depression alleviation strategies used by the women. We conducted five focus groups with older African American women (N = 18). We used deductive coding to analyze focus group transcripts and qualitative description to summarize themes. We identified five major themes: (1) Spiritual Suffering from Linked Pain and Depression, (2) Lack of Understanding from Healthcare Providers, (3) Push Through and Live Through, (4) Medications Not Worth the Risk and, (5) Strategies for Pain and Depression. This study offers insight into the experiences of pain and depression in older African American women, and alleviation strategies they perceive as effective. These qualitative findings may be used to inform interventions for older African American women who experience pain and depressive symptoms.
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Affiliation(s)
| | - Emerald Jenkins
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Manka Nkimbeng
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | | | - Sarah L. Szanton
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Rebecca Wright
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | | | - Janiece L. Taylor
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
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20
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Nkimbeng M, Turkson-Ocran RA, Thorpe RJ, Szanton SL, Cudjoe J, Taylor JL, Commodore-Mensah Y. Prevalence of functional limitations among foreign and US-born Black older adults: 2010-2016 National Health Interview Surveys. Ethn Health 2022; 27:61-73. [PMID: 31489830 PMCID: PMC7058511 DOI: 10.1080/13557858.2019.1661357] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine whether the prevalence of functional limitations in United States (US) born differs from that of foreign-born Black older adults. DESIGN We performed a cross-sectional analysis of data from 14,438 US-born and 1583 foreign-born Black older adults (≥50 years) in the 2010-2016 National Health Interview Surveys (NHIS). Functional limitations were defined by upper and lower extremity limitations, and global functional limitations. Generalized linear modeling using a Poisson distribution and logarithmic link function was used to compare the predicted probabilities of functional limitations in both groups. RESULTS The mean age (SE) of US-born Blacks was 63.56 (0.12) years and foreign-born Blacks was 62.06 (0.32). The majority (92%) of foreign-born Blacks had resided in the US for ≥10 years. US-born older adults were more likely to have upper (46% vs. 29%, p < .001) and lower (61% vs. 40%, p < .001) extremity limitations than foreign-born Blacks. The prevalence of lower extremity limitations was 22% less in foreign-born Blacks compared to US-born Blacks after adjusting for sociodemographic and health profiles (Prevalence Ratio [PR]: 0.78, 95% CI:0.73-0.84). The adjusted prevalence of upper extremity limitations in foreign-born Blacks was 27% (PR: 0.73, 95% CI: [0.68-0.79]), compared to US-born Black older adults. And that of global functional limitations was 22% less (PR: 0.78, 95% CI [0.73-0.83]) in foreign-born compared to US-born Blacks. CONCLUSION Compared to their US-born counterparts, foreign-born Black older adults had a markedly lower prevalence of upper and lower extremity functional limitations. Future comparative studies should examine reasons for this apparent health advantage among foreign-born adults to inform social and medical interventions to prevent functional decline in Black older adults in the US.
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Abstract
ABSTRCTBackground: Parents continue to support to autistic university students, and consequently, experience considerable stress.Aim: To explore the experiences of parents of specialist peer mentored university students and to examine these using the ICF as a theoretical framework.Method: Thirteen semi-structured interviews were completed and analyzed using thematic analysis. Directive content analysis linked the data to the ICF core set for autism spectrum disorders (ASD).Results: Five interrelated themes emerged: The mentoring relationship is a facilitator, Developing skills for university, Mentoring changes lives, Mentoring is not a substitute for other supports, and University is an emotional rollercoaster. Specialist peer mentoring was linked to Activity and Participation (44%) and Environmental factors (32%) of the ICF core set for ASD.Conclusion: These results add to the specialist peer mentoring evidence-base, and indicate perceived benefits for autistic university students and their parents. An unintended consequence was that parents broadened their participation in activities.
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Affiliation(s)
- C Thompson
- Cooperative Research Centre for Living with Autism (Autism CRC), Queensland, Australia.,School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - B Milbourn
- Cooperative Research Centre for Living with Autism (Autism CRC), Queensland, Australia.,School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - J L Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, USA
| | - T Falkmer
- Cooperative Research Centre for Living with Autism (Autism CRC), Queensland, Australia.,School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - S Bölte
- Cooperative Research Centre for Living with Autism (Autism CRC), Queensland, Australia.,School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Department of Women's and Children's Health, Center for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - K Evans
- Cooperative Research Centre for Living with Autism (Autism CRC), Queensland, Australia.,School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - S Girdler
- Cooperative Research Centre for Living with Autism (Autism CRC), Queensland, Australia.,School of Allied Health, Curtin University, Perth, Western Australia, Australia
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22
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Jenkins E, Koirala B, Rodney T, Lee JW, Cotter VT, Szanton SL, Taylor JL. Home/community-based interventions to improve function in persons with mild cognitive impairment/early dementia. Geriatr Nurs 2021; 42:1109-1124. [PMID: 34280736 DOI: 10.1016/j.gerinurse.2021.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
Persons with mild cognitive impairment/early dementia have a possible 20-year trajectory of disability and dependence with little information on the effectiveness of interventions to improve function. This review investigates the literature of home/community-based interventions for physical and executive function in persons with mild cognitive impairment/early dementia. A 2007-2020 systematic literature search was conducted through PubMed, CINAHL Plus with Full Text and PsycINFO. Of the 1749 articles retrieved, 18 eligible studies were identified and consisted of three types of interventions: cognitive training-only (n = 7), multicomponent (n = 9), and physical activity-only (n = 2). Results showed that the interventions impacting function in persons with cognitive impairment incorporated a visual/written element, technology-based training, caregiver support, and modified duration/increased frequency of interventions. In studies improving function, participants simulated Instrumental Activities of Daily Living. They addressed cognitive function using both objective and subjective cognitive measures. We found gaps in the literature in incorporating race/ethnicity and appropriate socioeconomic status measures.
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Affiliation(s)
- Emerald Jenkins
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA.
| | - Binu Koirala
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Tamar Rodney
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Ji Won Lee
- Johns Hopkins University School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205 USA
| | - Valerie T Cotter
- Johns Hopkins University School of Nursing, 929 N Wolfe St. Room 403, Baltimore, MD 21205 USA
| | - Sarah L Szanton
- Health Equity and Social Justice Endowed Professor, Director, Center on Innovative Care in Aging, Johns Hopkins School of Nursing, Joint Appointment with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, 525 North Wolfe Street #424, Baltimore, MD 21205 USA
| | - Janiece L Taylor
- Johns Hopkins University School of Nursing, 525 N. Wolfe St. Room 422, Baltimore, MD 21205 USA
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23
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Parker LJ, Fabius C, Rivers E, Taylor JL. Is Dementia-Specific Caregiving Compared With Non-Dementia Caregiving Associated With Physical Difficulty Among Caregivers for Community-Dwelling Adults? J Appl Gerontol 2021; 41:1074-1080. [PMID: 34041929 DOI: 10.1177/07334648211014352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The purpose of this study is to identify whether dementia caregiving is associated with physical difficulty among informal caregivers. METHODS This cross-sectional retrospective cohort study design used data from the 2015 National Health and Aging Trends Study and the National Study of Caregiving. Binary logistic regression was used to examine the association between substantial physical difficulty and dementia caregiving among 1,871 caregivers. RESULTS Nearly 14% of the caregivers reported substantial physical difficulty. Dementia caregivers were 1.5 times more likely to report caregiving-related substantial physical difficulty (adjusted odds ratio [AOR] = 1.58, p = .04) than non-dementia caregivers. Factors associated with substantial physical difficulty included caregiver gender, self-rated health, depressive symptoms, pain, and caring for someone receiving assistance with three or more self-care or mobility activities. DISCUSSION Future studies should identify strategies to mitigate the physical demands on dementia caregivers. Early monitoring of caregivers' self-rated health, depressive symptoms, and pain may identify those more likely to experience physical difficulty.
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Affiliation(s)
- Lauren J Parker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chanee Fabius
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Manca A, Hortobágyi T, Carroll TJ, Enoka RM, Farthing JP, Gandevia SC, Kidgell DJ, Taylor JL, Deriu F. Contralateral Effects of Unilateral Strength and Skill Training: Modified Delphi Consensus to Establish Key Aspects of Cross-Education. Sports Med 2021; 51:11-20. [PMID: 33175329 PMCID: PMC7806569 DOI: 10.1007/s40279-020-01377-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background Cross-education refers to increased motor output (i.e., force generation, skill) of the opposite, untrained limb following a period of unilateral exercise training. Despite extensive research, several aspects of the transfer phenomenon remain controversial. Methods A modified two-round Delphi online survey was conducted among international experts to reach consensus on terminology, methodology, mechanisms of action, and translational potential of cross-education, and to provide a framework for future research. Results Through purposive sampling of the literature, we identified 56 noted experts in the field, of whom 32 completed the survey, and reached consensus (75% threshold) on 17 out of 27 items. Conclusion Our consensus-based recommendations for future studies are that (1) the term ‘cross-education’ should be adopted to refer to the transfer phenomenon, also specifying if transfer of strength or skill is meant; (2) functional magnetic resonance imaging, short-interval intracortical inhibition and interhemispheric inhibition appear to be promising tools to study the mechanisms of transfer; (3) strategies which maximize cross-education, such as high-intensity training, eccentric contractions, and mirror illusion, seem worth being included in the intervention plan; (4) study protocols should be designed to include at least 13–18 sessions or 4–6 weeks to produce functionally meaningful transfer of strength, and (5) cross-education could be considered as an adjuvant treatment particularly for unilateral orthopedic conditions and sports injuries. Additionally, a clear gap in views emerged between the research field and the purely clinical field. The present consensus statement clarifies relevant aspects of cross-education including neurophysiological, neuroanatomical, and methodological characteristics of the transfer phenomenon, and provides guidance on how to improve the quality and usability of future cross-education studies. Electronic supplementary material The online version of this article (10.1007/s40279-020-01377-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A Manca
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy
| | - T Hortobágyi
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - T J Carroll
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - R M Enoka
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, USA
| | - J P Farthing
- University of Saskatchewan College of Kinesiology, Saskatoon, SK, Canada
| | - S C Gandevia
- Neuroscience Research Australia (NeuRA), The University of New South Wales, Sydney, Australia
| | - D J Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - J L Taylor
- School of Medical and Health Sciences, Edit Cowan University, Joondalup, Australia
| | - F Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, 07100, Sassari, Italy.
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Liu M, Hou T, Nkimbeng M, Li Y, Taylor JL, Sun X, Tang S, Szanton SL. Associations between symptoms of pain, insomnia and depression, and frailty in older adults: A cross-sectional analysis of a cohort study. Int J Nurs Stud 2021; 117:103873. [PMID: 33621722 PMCID: PMC9940903 DOI: 10.1016/j.ijnurstu.2021.103873] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Frailty is prevalent in older adults and has adverse effects on multiple health outcomes. Pain, insomnia, and depressive symptoms are commonly seen and treatable symptoms in older adults and are associated with frailty. However, it is unknown whether these symptoms are independently associated with frailty and how they interact with each other creating a greater impact on frailty than individual symptoms. It is important to understand these associations for nurses to provide high-quality patient-centered care for older adults with frailty. OBJECTIVES To determine independent associations of pain, insomnia, and depressive symptoms with frailty and examine their synergistic impact on frailty among older adults. DESIGN A cross-sectional analysis of a cohort study. SETTING Communities in the United States. PARTICIPANTS Community-dwelling older adults from the National Health and Aging Trend Study (N = 7,609), a nationally representative survey of Medicare Beneficiaries in the United States. METHODS Frailty status was determined by five criteria of the Physical Frailty Phenotype: exhaustion, low physical activity, weakness, slowness, and shrinking. Pain was determined by self-reports of bothersome pain in the last month. Insomnia included self-reports of difficulty initiating sleep and difficulty maintaining sleep. Depressive symptom was assessed by the Patient Health Questionnaire-2. Logistic regression models were used adjusting for sociodemographic, health-related and behavioral covariates. RESULTS The sample was mainly under 80 years old (72%), female (57%), and non-Hispanic White (81%). Approximately 53% experienced bothersome pain, 11% had difficulty initiating sleep, 6% had difficulty maintaining sleep, and 15% had depressive symptom; 46% were pre-frail and 14% were frail. Independent associations with pre-frailty and frailty were found in pain (odds ratio [OR]: 1.81, 95% CI: 1.60, 2.04), difficulty initiating sleep (OR: 1.23, 95% CI: 1.04, 1.46) and depressive symptom (OR: 2.29, 95% CI: 1.85, 2.84). Interaction terms between pain and depressive symptom (OR: 1.87, 95% CI: 1.14, 3.07), and between difficulty initiating sleep and depressive symptom (OR: 2.66, 95% CI: 1.15, 6.13) were significant, suggesting a synergistic impact on pre-frailty and frailty. CONCLUSIONS Pain, difficulty initiating sleep, and depressive symptoms are independent risk factors of frailty and may have a synergistic impact on frailty. Interventions should be developed to address these symptoms to reduce the adverse effects of frailty.
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Affiliation(s)
- Minhui Liu
- Central South University, Xiangya School of Nursing, 172 Tongzipo Road of Yuelu District, Changsha 410013, Hunan, China; Johns Hopkins University School of Nursing, Baltimore, MD, USA.
| | - Tianxue Hou
- Central South University, Xiangya School of Nursing, 172 Tongzipo Road of Yuelu District, Changsha 410013, Hunan, China.
| | - Manka Nkimbeng
- University of Minnesota School of Public Health, Minneapolis, MN, USA.
| | - Yuxiao Li
- Central South University, Xiangya School of Nursing, 172 Tongzipo Road of Yuelu District, Changsha 410013, Hunan, China.
| | | | - Xiaocao Sun
- Central South University, Xiangya School of Nursing, 172 Tongzipo Road of Yuelu District, Changsha 410013, Hunan, China.
| | - Siyuan Tang
- Central South University, Xiangya School of Nursing, 172 Tongzipo Road of Yuelu District, Changsha 410013, Hunan, China.
| | - Sarah L. Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD, USA,Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Regier NG, Taylor JL, Szanton SL, Parmelee PA, Perrin N, Liu M, Jenkins E, Hodgson NA, Gitlin LN. Pain in persons with dementia and the direct and indirect impacts on caregiver burden. Geriatr Nurs 2021; 42:366-371. [PMID: 33571930 DOI: 10.1016/j.gerinurse.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/14/2021] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Unresolved pain is related to neuropsychiatric symptoms (NPS) in persons living with dementia (PLWD), and an increase in NPS is distressing for PLWD and their caregivers. Hence, we examined whether pain in PLWD was related to caregiver burden and whether caregiver upset with NPS mediated this relationship. METHOD We examined, cross-sectionally, the relationships among pain in PLWD, caregiver burden, and upset with NPS. Data from 272 PLWD and their caregivers who participated in the Advancing Caregiver Training (ACT) trial were analyzed using structural equation modeling (SEM). RESULTS Model fit was satisfactory, and caregiver upset with NPS fully mediated the association between pain in PLWD and caregiver burden. CONCLUSION Caregiver upset with NPS helps explain the relationship between pain in PLWD and burden in their caregivers. Pain and NPS are amenable to modification, as is caregiver burden, suggesting great opportunity to impact the lives of PLWD and their caregivers.
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Affiliation(s)
- Natalie G Regier
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA.
| | - Janiece L Taylor
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patricia A Parmelee
- The University of Alabama, Alabama Research Institute on Aging, Tuscaloosa, AL, USA
| | - Nancy Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Minhui Liu
- Johns Hopkins University School of Nursing, Baltimore, MD, USA; Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA
| | - Emerald Jenkins
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Nancy A Hodgson
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Laura N Gitlin
- Johns Hopkins Center for Innovative Care in Aging, Baltimore, MD, USA; Drexel College of Nursing and Health Professions, Philadelphia, PA, USA
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Baptiste DL, Turner S, Josiah N, Arscott J, Alvarez C, Turkson-Ocran RA, Rodney T, Commodore-Mensah Y, Francis L, Wilson PR, Starks S, Alexander K, Taylor JL, Ogungbe O, Byiringiro S, Fisher MC, Charlemagne-Badal SJ, Marseille B, Delva S, Akomah J, Jenkins E, Dangerfield DT, Ramsey G, Sharps P, Hamilton J. Hidden figures of nursing: The historical contributions of Black nurses and a narrative for those who are unnamed, undocumented and underrepresented. J Adv Nurs 2021; 77:1627-1632. [PMID: 33565132 DOI: 10.1111/jan.14791] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 01/23/2023]
Affiliation(s)
| | - Sasha Turner
- Johns Hopkins Krieger School of Arts & Science Department of History, Baltimore, MD, USA
| | - Nia Josiah
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Joyell Arscott
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Tamar Rodney
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing, Baltimore, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins Center for Health Equity, Baltimore, MD, USA
| | | | | | | | | | | | | | | | | | | | - Beatrice Marseille
- Johns Hopkins School of Nursing, Baltimore, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabianca Delva
- Boston College, Connell School of Nursing, Boston, MA, USA
| | | | | | | | | | | | - Jill Hamilton
- Emory Nell Hodgson School of Nursing, Atlanta, GA, USA
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Regier NG, Cotter VT, Hansen BR, Taylor JL, Wright RJ. Place of Death for Persons With and Without Cognitive Impairment in the United States. J Am Geriatr Soc 2021; 69:924-931. [PMID: 33474723 DOI: 10.1111/jgs.16979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES There is increasing recognition that place of death is an important component of quality of end-of-life care (EOLC) and quality of death. This study examined where older persons with and without cognitive impairment die in the United States, what factors contribute to place of death, and whether place of death influences satisfaction with EOLC. DESIGN Cross-sectional secondary data analysis. SETTING In-person interviews with community-dwelling proxy respondents. PARTICIPANTS Data were collected from 1,500 proxies for deceased participants in the National Health and Aging Trends Study (NHATS), a nationally-representative sample of community-dwelling Medicare beneficiaries aged 65 and older. MEASUREMENTS Study variables were obtained from the NHATS "last month of life" interview data. Survey weights were applied to all analyses. RESULTS Persons with cognitive impairment (CI) most often died at home, while cognitively healthy persons (CHP) were equally likely to die at home or in a hospital. Persons with CI who utilized the Medicare Hospice Benefit were 14.5 times more likely to die at home than in a hospital, and 3.4 times more likely to die at home than a nursing home. CHP who use this benefit were over six times more likely to die at home than in a hospital, and more than twice as likely to die at home than a nursing home. Place of death for CHP was also associated with age and race. Proxies of persons with CI who died at home rated EOLC as more favorable, while proxies of CHP rated in-home and hospital care equally. CONCLUSION Findings add to the scant literature identifying factors associated with place of death for older adults with and without CI and results suggest that place of death is a quality of care indicator for these populations. These findings may inform EOLC planning and policy-making and facilitate greater well-being at end-of-life.
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Affiliation(s)
- Natalie G Regier
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins Center for Innovative Care in Aging, Baltimore, Maryland, USA
| | - Valerie T Cotter
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins Center for Innovative Care in Aging, Baltimore, Maryland, USA
| | - Bryan R Hansen
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins Center for Innovative Care in Aging, Baltimore, Maryland, USA
| | - Janiece L Taylor
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins Center for Innovative Care in Aging, Baltimore, Maryland, USA
| | - Rebecca J Wright
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.,Johns Hopkins Center for Innovative Care in Aging, Baltimore, Maryland, USA
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29
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Nkimbeng M, Taylor JL, Roberts L, Winch PJ, Commodore-Mensah Y, Thorpe RJ, Han HR, Szanton SL. "All I know is that there is a lot of discrimination": Older African immigrants' experiences of discrimination in the United States. Geriatr Nurs 2020; 42:196-204. [PMID: 33283756 DOI: 10.1016/j.gerinurse.2020.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022]
Abstract
Discrimination is implicated in the disproportionate burden of disease and health disparities in racial/ethnic minorities. This qualitative descriptive study explored the experiences of discrimination and its impact on the health of older African immigrants. Semi-structured interviews were conducted with 15 participants. Three main themes and six sub-themes were identified. These included: (1) types of discrimination which were: (a) accent-based, (b) unfair treatment during routine activities, (c) experience with systems; (2) consequences of discrimination; and (3) surviving and thriving with discrimination: (a) "blind eye to it", (b) reacting to it, (c) avoiding it. These themes described common experiences of discrimination, current strategies used to deal with discrimination, and the impact of discrimination on this sample. Health care providers should be aware of discrimination experiences, how to assess for it, and identify when to refer patients to appropriate community resources that include mental health, employment, cultural groups and legal services.
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Affiliation(s)
- Manka Nkimbeng
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America.
| | - Janiece L Taylor
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America
| | - Laken Roberts
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America
| | - Peter J Winch
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America; Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America; Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America; Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
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Granbom M, Nkimbeng M, Roberts LC, Gitlin LN, Taylor JL, Szanton SL. "So I am Stuck, but it´s OK": Residential Reasoning and Housing Decision-Making of Low-Income Older Adults with Disabilities in Baltimore, Maryland. ACTA ACUST UNITED AC 2020; 48:43-59. [PMID: 33731975 DOI: 10.1080/08882746.2020.1816782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Housing preferences and housing decision-making in later life are critical aspects of aging in place, which is a public health priority in many Western countries. However, few studies have examined the economic, social, and health factors that guide older adults' preferences and decisions about where to live, and even less so among older adults with low income or disabilities who may face greater barriers to aging in place. We sought to understand what housing decision-making and residential reasoning means for low-income older adult homeowners in Baltimore, Maryland. Using a grounded theory approach, we interviewed 12 adults with disabilities in June 2017 and February 2018. Our findings revealed how the strong desire to age in place turned into the realization that they had to age in place due to limited resources and options. The core category "shifting between wanting to age in place and having to age in place" was influenced by family needs, being a homeowner, the neighborhood, and coping at home. In conclusion, for low-income older adults with disabilities, it is important to acknowledge that sometimes aging in place may be equivalent to being stuck in place.
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Affiliation(s)
- Marianne Granbom
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA.,Department of Health Sciences, Lund University, 22100 Lund, Sweden
| | - Manka Nkimbeng
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA.,School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Laken C Roberts
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA.,College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19102, USA
| | - Janiece L Taylor
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
| | - Sarah L Szanton
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
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Herbert RD, Taylor JL, Lord SR, Gandevia SC. Prevalence of motor impairment in residents of New South Wales, Australia aged 55 years and over: cross-sectional survey of the 45 and Up cohort. BMC Public Health 2020; 20:1353. [PMID: 32887600 PMCID: PMC7650517 DOI: 10.1186/s12889-020-09443-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The population prevalence of many diseases is known. However, little is known of the population prevalence of motor impairments. METHODS The aim of this study was to determine the point prevalence of specific motor impairments (weakness, fatigue, contracture, impaired balance and impaired coordination) in the population aged 55 years and older resident in New South Wales, Australia in 2018. 55,210 members of the 45 and Up cohort were invited to participate in a follow-up survey that included questions on motor impairment. Responses were received from 20,141 people (36%). Calibrated estimates of prevalence of specific motor impairments, and of having at least one motor impairment, were obtained using survey weights based on the known multivariate distributions of age, gender and geographical location (28 regions) in the population. RESULTS More than one-third of adults aged over 55 residing in New South Wales have difficulty using their hands, arms or legs. The prevalence of each motor impairment (muscle weakness, fatigue, contracture, impaired balance or impaired coordination) in this population is between 4 and 12%. The prevalence of at least one of these impairments is 21%. The prevalence of at least one impairment in people aged 85 and over is 42%. Women consistently had more difficulty using hands, arms and legs, and more motor impairment, than men. Difficulty using hands, arms and legs and the prevalence of all motor impairments, especially poor balance, greatly increased with age. CONCLUSION The prevalence of specific motor impairments in older Australian adults is high - comparable to that of the most prevalent diseases. There may be merit in considering motor impairment as a significant public health problem in its own right.
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Affiliation(s)
- R D Herbert
- Neuroscience Research Australia (NeuRA), Barker St, Randwick, NSW, 2031, Australia.
- University of New South Wales, Sydney, Australia.
| | - J L Taylor
- Neuroscience Research Australia (NeuRA), Barker St, Randwick, NSW, 2031, Australia
- Edith Cowan University, Perth, Australia
| | - S R Lord
- Neuroscience Research Australia (NeuRA), Barker St, Randwick, NSW, 2031, Australia
- University of New South Wales, Sydney, Australia
| | - S C Gandevia
- Neuroscience Research Australia (NeuRA), Barker St, Randwick, NSW, 2031, Australia
- University of New South Wales, Sydney, Australia
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Drazich BF, LaFave S, Crane BM, Szanton SL, Carlson MC, Budhathoki C, Taylor JL. Exergames and Depressive Symptoms in Older Adults: A Systematic Review. Games Health J 2020; 9:339-345. [PMID: 32551982 DOI: 10.1089/g4h.2019.0165] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
To synthesize and critique studies that examined the impact of exergames on depressive symptoms in older adults. Articles were retrieved from the databases CINAHL, Embase, PsychINFO, and Medline. Studies were included in the review if they involved a physical activity/videogame intervention and measured outcomes of depressive symptoms in older adults. The search generated 957 articles for consideration, which were narrowed to 17 articles after applying exclusion criteria. In studies that required depressive symptoms as an inclusion criterion, there was an improvement in depressive symptoms in older adults following the exergame intervention. In studies that did not require depressive symptoms as an inclusion criterion, researchers found mixed results. Future older adult exergame research should measure depression as a primary outcome, utilize control groups with random sampling, consist of larger sample sizes, and include people with disabilities.
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Affiliation(s)
| | - Sarah LaFave
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Breanna M Crane
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, Maryland.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.,Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland
| | - Michelle C Carlson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
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Abstract
PURPOSE OF REVIEW The purpose was to discuss appropriate methods for advancing our understanding of health disparities or minority aging including life-course perspectives, biological measures, pain measurement, and generational approaches. RECENT FINDINGS Life course perspectives provide an orientation for studying older minorities that concomitantly captures exposures and stressors that may lead to earlier onset of disease and premature mortality. The use of biological markers to study health disparities in older minorities is necessary in order to identify pathways between psychosocial factors and health outcomes. Work focusing on pain disparities should include explorations of relationships between psychosocial factors, and subjective and objective measures of pain. Studying families can provide insight into genetic associations and coping styles in older minorities. SUMMARY Methodological approaches that take life course, biology, and social factors into account may help identify causal pathways between social determinants of health and health outcomes among older minorities. Once these causal pathways have been identified, more strategies and interventions that strive toward health equity across older adults of all race/ethnic groups can be developed.
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Affiliation(s)
- Sarah N Forrester
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School
| | | | | | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health
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Taylor JL, Drazich BF, Roberts L, Okoye S, Rivers E, Wenzel J, Wright R, Beach MC, Szanton SL. Pain in low-income older women with disabilities: a qualitative descriptive study. J Women Aging 2020; 32:402-423. [PMID: 32475259 DOI: 10.1080/08952841.2020.1763895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this qualitative study was to identify how low-income older women with disabilities perceive pain, pain management, and communication with healthcare providers. We interviewed 26 low-income women (average age 75 years; SD 7.0), eliciting the following overarching themes: "Invisibility of Pain: Unnoticed or Undetected," "Escalating Pain Leads to Help Seeking," "Communication with Healthcare Providers and Outcomes," "Pain Management Facilitates Function and Accomplishment," and "The Intersection of Pain, Disability, and Depressive Symptoms." Study findings support the ways in which behavior changes from pain can impede pain management.
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Affiliation(s)
- Janiece L Taylor
- School of Nursing, Johns Hopkins University , Baltimore, Maryland, USA
| | | | - Laken Roberts
- School of Nursing, Johns Hopkins University , Baltimore, Maryland, USA
| | - Safiyyah Okoye
- Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland, USA
| | - Emerald Rivers
- School of Nursing, Johns Hopkins University , Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University , Baltimore, Maryland, USA
| | - Rebecca Wright
- School of Nursing, Johns Hopkins University , Baltimore, Maryland, USA
| | | | - Sarah L Szanton
- School of Nursing, Johns Hopkins University , Baltimore, Maryland, USA.,Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland, USA
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Li J, Alfini AJ, Yu F, Schrack JA, Cotter V, Taylor JL, Spira AP. 1137 Sleep Duration, Physical Activity And Cognitive Decline In Chinese Older Adults: Findings From The CHARLS. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Lack of physical activity and disturbed sleep have been linked to older adult’s poor cognitive outcomes; however, little is unknown how they interact to affect cognition long-term. The purpose of this study was to examine the association of baseline sleep duration and physical activity (PA) with change in cognition independently and interactively over four years.
Methods
The sample included 1126 community-dwelling older adults aged 60+ (mean age 67.1±5.9 years, 51% female) from the 2011 baseline and 2015 follow-up data of the China Health and Retirement Longitudinal Study (CHARLS). All variables were assessed through interviews. Sleep duration was measured with hours per 30-minute interval and categorized as very-short (<5h), short (5-6.5h), normal (7-8.5h), and long (≥9h). PA was calculated based on PA intensity, duration, and number of days. Cognition was a composite score of mental capacity, episodic memory, and visuospatial abilities. Data were analyzed using multiple regression (primary outcome: change in cognition; main independent variables: baseline sleep, PA, and sleep PA interaction).
Results
At baseline, 19% of participants had very-short sleep duration, 34.4% had short sleep, 39.2% had normal sleep, and 7.2% had long sleep. At follow-up, 57.5% of participants experienced cognitive decline (-3.5±2.5). After controlling for age, gender, education, region, body mass index, smoking, drinking, number of chronic conditions, pain, depression, and cognition at baseline, compared to participants reporting 7-8.5h sleep, those with ≥9h sleep had significantly greater decline in cognition [β=-1.4, 95% CI=2.4, -0.4], while those with <5h sleep [β=-0.5, 95% CI=-1.2, 0.2] and 5-6.5h sleep did not [β=-0.1, 95% CI=-0.7, 0.5]. PA was neither associated with cognitive decline, nor moderated the relationship between sleep duration and cognitive decline.
Conclusion
Long sleep might be a marker of cognitive decline in older adults. Prospective analysis, using objectively measured PA and sleep should be conducted to further examine these associations.
Support
National Institute of Nursing Research R00NR016484
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Affiliation(s)
- J Li
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - A J Alfini
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - F Yu
- University of Minnesota School of Nursing, Minneapolis, MN
| | - J A Schrack
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - V Cotter
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - J L Taylor
- Johns Hopkins University School of Nursing, Baltimore, MD
| | - A P Spira
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Liu M, Taylor JL, Perrin NA, Szanton SL. Distinct clusters of older adults with common neuropsychological symptoms: Findings from the National Health and Aging Trends Study. Geriatr Nurs 2020; 41:222-228. [DOI: 10.1016/j.gerinurse.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 01/29/2023]
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D'Amico JM, Rouffet DM, Gandevia SC, Taylor JL. Unlike voluntary contractions, stimulated contractions of a hand muscle do not reduce voluntary activation or motoneuronal excitability. J Appl Physiol (1985) 2020; 128:1412-1422. [PMID: 32324475 DOI: 10.1152/japplphysiol.00553.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Voluntary force declines during sustained, maximal voluntary contractions (MVC) due to changes in muscle and central nervous system properties. Central fatigue, an exercise-induced reduction in voluntary activation, is influenced by multiple processes. Some may occur independently of descending voluntary drive. To differentiate the effects associated with voluntary drive from other central and peripheral influences, we measured voluntary activation and motoneuron excitability following fatiguing contractions produced voluntarily or by electrical stimulation. On two separate days, participants performed either a 2-min MVC of adductor pollicis muscle or received 2-min continuous supramaximal electrical stimulation of the ulnar nerve. In study 1 (n = 14), the superimposed twitch elicited by ulnar nerve stimulation during brief MVCs was increased, and, hence, voluntary activation was reduced, up to 240 s after the 2-min MVC [-20 ± 12% (SD), P = 0.002] but not the 2-min stimulated contraction (-4 ± 7%), despite large reductions in MVC force (voluntary, -54 ± 18%; stimulated, -46 ± 16%). In study 2 (n = 12), F-waves recorded from the adductor pollicis were reduced in area for 150 s following the 2-min MVC (-21 ± 16%, P = 0.007) but not after the stimulated contraction (5 ± 27%). Therefore, voluntary activation and motoneuron excitability decreased only when descending voluntary drive was present during the fatiguing task. The findings do not exclude a cortical or brain stem contribution to the reduced voluntary activation but suggest that neither sensory feedback from the fatigued muscle nor repetitive activation of motoneurons underlie the changes, whereas they are consistent with motoneuronal inhibition by released factors linked to voluntary drive.NEW & NOTEWORTHY We demonstrate that reductions in voluntary activation and motoneuron excitability following 2-min isometric maximal contractions in humans occur only when fatigue is produced through voluntary contractions and not through electrically stimulated contractions. This is contrary to studies that suggest that changes in the superimposed twitch and therefore voluntary activation are explained by changes in peripheral factors alone. Thus, the interpolated twitch technique remains a viable tool to assess voluntary activation and central fatigue.
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Affiliation(s)
- J M D'Amico
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - D M Rouffet
- Kentucky Spinal Cord Injury Research Center, Department of Health and Sport Sciences, University of Louisville, Louisville, Kentucky.,Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - S C Gandevia
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - J L Taylor
- Neuroscience Research Australia, Randwick, New South Wales, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
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Boateng-Poku A, Benca-Bachman CE, Najera DD, Whitfield KE, Taylor JL, Thorpe RJ, Palmer RHC. The role of social support on the effects of stress and depression on African American tobacco and alcohol use. Drug Alcohol Depend 2020; 209:107926. [PMID: 32087470 PMCID: PMC7127941 DOI: 10.1016/j.drugalcdep.2020.107926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The current study explored whether social support (SS) from family and peers, influences the relationship between depressed mood (DM) and substance use (SU). We hypothesized that SS would have a protective effect on DM, and moderate the association between DM and SU. PARTICIPANTS AND METHODS Analyses focused on 703 individuals from the Carolina African American Twin Study on Aging (mean age = 49.78 years, STD = 14.52; 51% female). Participants reported on past year frequency of cigarettes and alcohol consumption, depressed mood, and stressful life events. Social support (SS) was assessed on two domains (i.e., emotional and instrumental), as well as for perceived quality and quantity of each type. Hypotheses were tested using ordinal logistic regression in Mplus while controlling for socioeconomic status, age, and gender. RESULTS Quality of emotional support was negatively associated with drinking. Smoking, but not drinking was associated with depressed mood. While individuals with high levels of depressed mood received more support, receiving better quality emotional support was associated with fewer mood and stress symptoms. Individuals who reported receiving better quality emotional support typically smoked fewer cigarettes. CONCLUSION Quantity of emotional support was associated with higher levels of negative emotionality, whereas the opposite was found for quality of emotional support. Emotional support may indirectly influence smoking via depressed mood. Effecting the perceived quality of support appears to be the mechanism by which emotional support helps to reduce smoking in adult African Americans.
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Affiliation(s)
- Andrew Boateng-Poku
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
| | - Chelsie E Benca-Bachman
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
| | - Dalora D Najera
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
| | - Keith E Whitfield
- Department of Psychology, Wayne State University, 5057 Woodward Ave, Detroit, MI 48202, USA
| | - Janiece L Taylor
- Johns Hopkins School of Nursing, Johns Hopkins University, 525 N Wolfe St, Baltimore, MD 21205, USA
| | - Roland J Thorpe
- Health, Behavior and Society, Johns Hopkins University, 624 N Broadway St, Baltimore, MD 21205, USA
| | - Rohan HC Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA
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Abstract
Older Blacks have higher rates of undermanaged and undertreated pain than other racial/ethnic groups. Pain can lead to disability and poor quality of life. It is essential that we identify modifiable factors related to pain in this population. This study examined if stress was associated with pain among older Blacks. Data were taken from the Baltimore Study on Black Aging, (N=602, mean age 69 [SD= 9.76]). A total of 78% of participants reported bodily pain in the past month. Women had an increased odds of reporting bodily pain (OR 1.89, 95% CI 1.17, 3.07) compared to men. Using logistic regression controlling for age, self-rated health, sex, depressive symptoms, and chronic conditions, higher levels of stress were associated with increased odds of bodily pain (OR 1.04, 95% CI 1.00, 1.07). Identification of effective coping mechanisms to combat stress may lead to pain relief among older Blacks, particularly Black women.
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Affiliation(s)
- Janiece L Taylor
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Janiece L Taylor
- Johns Hopkins School of Nursing, Baltimore, Maryland, United States
| | - Lauren Parker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Roland J Thorpe Jr.
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
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40
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Taylor JL, Roberts L, Hladek MD, Liu M, Nkimbeng M, Boyd CM, Szanton SL. Achieving self-management goals among low income older adults with functional limitations. Geriatr Nurs 2019; 40:424-430. [PMID: 30799154 DOI: 10.1016/j.gerinurse.2019.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/20/2019] [Accepted: 01/25/2019] [Indexed: 11/29/2022]
Abstract
Although self-management interventions can improve symptoms and disease among older adults, there is a dearth of literature on how self-management behaviors may improve factors related to the older adults' physical function. To fill this gap in the literature, we describe the patient-directed self-management goals in nursing visits that relate to physical function as part of a multi-component program. We analyze the self-management goals and outcomes of 367 low- income older adults with functional limitations who participated in the CAPABLE program: a program to reduce the health effects of impaired physical function in low-income older adults. We focus on the following self-management goals that participants chose with the nurses: pain management, depressive symptoms, incontinence, fall prevention, and communication with healthcare providers. The majority of participants chose pain (50%) or fall prevention (51%) as goals and partially or fully met their goals. Improvements across these areas may lead to improved physical function.
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Affiliation(s)
- Janiece L Taylor
- Johns Hopkins School of Nursing, USA; Johns Hopkins School of Nursing Center of Innovative Care in Aging, USA.
| | | | | | - Minhui Liu
- Johns Hopkins School of Nursing, USA; Johns Hopkins School of Nursing Center of Innovative Care in Aging, USA
| | | | | | - Sarah L Szanton
- Johns Hopkins School of Nursing, USA; Johns Hopkins School of Nursing Center of Innovative Care in Aging, USA
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41
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Taylor JL, Regier NG, Hanson GC, Rivers E, Hodgson NA, Parmelee PA, Szanton SL, Gitlin LN. PAIN IN PERSONS LIVING WITH DEMENTIA AND ASSOCIATED CAREGIVER BURDEN. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J L Taylor
- Johns Hopkins University School of Nursing, Baltimore, Maryland,United States
| | - N G Regier
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - G C Hanson
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - E Rivers
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - N A Hodgson
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | - S L Szanton
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - L N Gitlin
- Drexel University College of Nursing and Health Professions, Philadelphia, PA, USA
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42
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Parker LJ, Taylor JL, Szanton SL. PSYCHOSOCIAL STRESSORS AND HEALTH DURING MIDIFE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L J Parker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryl
| | - J L Taylor
- Johns Hopkins University School of Nursing, Baltimore, Maryl
| | - S L Szanton
- Johns Hopkins School of Nursing, Baltimore, Maryl
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Nkimbeng M, Taylor JL, Parker LJ, Szanton SL. THE RELATIONSHIP BETWEEN DISCRIMINATION AND PAIN IN AFRICAN AMERICANS: EVIDENCE FROM THE MIDUS MILWAUKEE COHORT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Nkimbeng
- Johns Hopkins University School of Nursing, Baltimore, Maryland, United States
| | - J L Taylor
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - L J Parker
- Johns Hopkins Bloomberg School of Public Health, Baltimore,MD,USA
| | - S L Szanton
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
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44
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Parker LJ, Taylor JL, Samuel L, Szanton SL, Gitlin LN. DISCRIMINATION AND EXECUTIVE FUNCTIONING AMONG A RACIALLY DIVERSE SAMPLE OF COMMUNITY-DWELLING ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L J Parker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - J L Taylor
- RN Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - L Samuel
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - S L Szanton
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - L N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA
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Affiliation(s)
- Alesha Heath
- a Experimental and Regenerative Neurosciences , University of Western Australia , Crawley , Australia.,b Perron Institute for Neurological and Translational Science , Nedlands , Australia
| | - J L Taylor
- c Department of Veterans Affairs Palo Alto Health Care System , Sierra Pacific MIRECC , Palo Alto , USA.,d Department of Psychiatry and Behavioral Studies , Stanford University School of Medecine , Palo Alto , USA
| | - M Windy McNerney
- c Department of Veterans Affairs Palo Alto Health Care System , Sierra Pacific MIRECC , Palo Alto , USA.,d Department of Psychiatry and Behavioral Studies , Stanford University School of Medecine , Palo Alto , USA
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46
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Taylor JL, Parker LJ, Szanton SL, Thorpe RJ. The association of pain, race and slow gait speed in older adults. Geriatr Nurs 2018; 39:580-583. [PMID: 29752144 DOI: 10.1016/j.gerinurse.2018.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/02/2018] [Accepted: 04/09/2018] [Indexed: 01/08/2023]
Abstract
Gait speed is an important indicator of mobility and quality of life in older adults. Pain is related to gait speed; however, it is unknown if this relationship varies by race in a population based national sample. The aim of this study was to examine if the association between slow gait speed and pain differed between 7,025 older African Americans and non Hispanic Whites in the National Health and Aging Trends Study. Those with pain in the last month had higher odds of slow gait speed (odds ratio = 1.38, 95% confidence interval = 1.10 - 1.73) than those without pain. The relationship between pain and slow gait speed did not vary by race (interaction p = 0.6). This is important because it points to the underlying racial disparities in pain and gait speed being factors such as disparate opportunities and living conditions, and healthcare rather than attributes intrinsic to race.
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Affiliation(s)
- Janiece L Taylor
- School of Nursing, Johns Hopkins University, 525 North Wolfe St., Baltimore, MD 21205, USA.
| | - Lauren J Parker
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, 525 North Wolfe St., Baltimore, MD 21205, USA; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA; Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Baltimore, MD 21205, USA
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47
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Nuzzo JL, Barry BK, Gandevia SC, Taylor JL. Effects of acute isometric resistance exercise on cervicomedullary motor evoked potentials. Scand J Med Sci Sports 2018; 28:1514-1522. [PMID: 29315829 DOI: 10.1111/sms.13053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 11/27/2022]
Abstract
Cervicomedullary motor evoked potentials (CMEPs) in relaxed biceps brachii have been reported to facilitate after acute isometric exercise of the elbow flexors. This facilitation, which reflects either enhanced corticospinal transmission or increased motoneurone excitability, has only been documented in the limb posture used during exercise. In Experiment 1, we tested if these spinal changes "transfer" to a second posture. Fourteen individuals completed 12 sets of high-force isometric contractions of the elbow flexors with the forearm pronated. Before and after exercise, biceps CMEPs were acquired with the forearm either pronated or supinated. CMEPs in pronation and supination were facilitated after exercise, indicating transfer (57.5 ± 55.5% and 53.9 ± 54.9%, respectively; mean ± SD). In Experiment 2, we examined if exercise posture influences the effect that exercise has on CMEPs. A different sample of 14 individuals performed isometric exercise in 2 sessions. In one, exercise was performed in supination. In the other, exercise was performed in pronation. Exercise intensity and volume were the same as in Experiment 1, as were participant characteristics. CMEPs were unchanged after exercise in supination (13.6 ± 31.2%) and pronation (7.7 ± 41.5%). The absence of an effect differs from the finding of Experiment 1. Thus, effects of acute isometric resistance exercise on corticospinal transmission and/or motoneurone excitability are not as consistent as previously thought. When exercise induces this spinal change, the effect is not specific to the posture used for exercise. However, the change does not always occur, and the reasons for this remain unknown.
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Affiliation(s)
- J L Nuzzo
- Neuroscience Research Australia, Randwick, NSW, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia
| | - B K Barry
- Neuroscience Research Australia, Randwick, NSW, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia.,School of Clinical Medicine, University of Queensland, St. Lucia, QLD, Australia
| | - S C Gandevia
- Neuroscience Research Australia, Randwick, NSW, Australia.,Prince of Wales Clinical School, University of New South Wales, Kensington, NSW, Australia
| | - J L Taylor
- Neuroscience Research Australia, Randwick, NSW, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
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48
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Zhu ZX, Yu ZM, Taylor JL, Wu YH, Ni J. [The application of yeast hybrid systems in protein interaction analysis]. Mol Biol (Mosk) 2017; 50:751-759. [PMID: 27830677 DOI: 10.7868/s0026898416050189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 12/27/2015] [Indexed: 11/23/2022]
Abstract
Yeast hybrid systems have been widely used due to their convenience and low cost. Based on these systems, many methods have been developed to analyze protein-protein, protein-DNA and protein-RNA interactions. In this paper, we are reviewing these different yeast hybrid systems. According to the number of hybrid proteins, yeast hybrid systems can be divided into three categories, yeast one-hybrid, yeast two-hybrid and yeast three-hybrid systems. Alternatively, yeast hybrid systems can be categorized according to the subcellular localization of the protein interaction process in the cell into nuclear protein-protein interactions, cytosol protein-protein interactions and membrane protein-protein interactions. Throughout the review, we focus on the progress and limitations of each yeast hybrid system over the recent years.
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Affiliation(s)
- Z-X Zhu
- Agricultural Crops Molecular Improving Lab, Liaoning Academy of Agricultural Sciences, Shenyang, 110161 China
| | - Z-M Yu
- College of Life and Environmental Sciences, Hangzhou Normal University, Hangzhou, 310018 China
| | - J L Taylor
- School of Life Sciences, Gibbet Hill Campus, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Y-H Wu
- College of Life and Environmental Sciences, Hangzhou Normal University, Hangzhou, 310018 China
| | - J Ni
- College of Life and Environmental Sciences, Hangzhou Normal University, Hangzhou, 310018 China.,
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Gandevia SC, Khan SL, Taylor JL. Reply from S. C. Gandevia, S. L. Khan and J. L. Taylor. J Physiol 2016; 594:3847-8. [PMID: 27365162 DOI: 10.1113/jp272663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- S C Gandevia
- Neuroscience Research Australia, Barker Street, Randwick, Sydney, 2031, Australia.
| | - S L Khan
- Neuroscience Research Australia, Barker Street, Randwick, Sydney, 2031, Australia
| | - J L Taylor
- Neuroscience Research Australia, Barker Street, Randwick, Sydney, 2031, Australia
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50
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Taylor JL, Sumukadas D. Should Respond Change Falls Prevention in Parkinson'S Disease? J R Coll Physicians Edinb 2016; 46:101-102. [DOI: 10.4997/jrcpe.2016.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- JL Taylor
- Specialty Registrar, Ninewells Hospital, Dundee, UK
| | - D Sumukadas
- Consultant, Department of Medicine for the Elderly, Ninewells Hospital, Dundee, UK
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