Miracle-dz/UniFAR-FTUs huggingface dataset:
On the origins of ageism among older and younger adults

ABSTRACT Background: Ageism is apparent in many social structures and contexts and in diverse forms over the life cycle. This review discusses the development and consequences of ageism toward elderly people by others of any age, according to the Terror Management Theory (TMT) and the Social Identity Theory (SIT). Method: A systematic search of the literature was carried out on the social and psychological origins of ageism in younger and older adults. Results: Studies on the reasons for ageism among older adults point to attitudes that older adults have toward their own age group, while studies on ageism in young adults explain it as an unconscious defensive strategy which younger adults use against death anxiety. In other words, TMT can serve as a suitable framework for ageism in younger adults, and SIT appears to explain ageism in older adults. Conclusions: A dissociation of the linkage between death and old age in younger adults can be achieved by changing the concepts of death and old age. For older adults, it is recommended to improve self-worth by encouraging social contacts in which older adults contribute to younger adults, weaken the effects of age stereotypes in TV programs, and prepare middle-aged adults for living healthy lives as older adults. However, these conclusions should be regarded with caution, because several key areas (age related cues, activated cognitive processes, impact of death awareness on ageism) need to be investigated in order to validate this understanding of the origins of ageism among younger and older adults.
Impact of socioeconomic status on the prevalence of dementia in an inner city memory disorders clinic

ABSTRACT Background: Socioeconomic status (SES) has been identified as a possible risk factor for the development of dementia, with low SES shown to be associated with a higher prevalence of dementia, increased psychiatric comorbidity and worse baseline cognitive functioning. Few studies have actually looked at the impact of SES within a clinical population using multiple measures of SES and cognition. Methods: Data on 217 patients seen in an Inner City Memory Disorders Clinic were analyzed with respect to demographic status, clinical status and SES. Correlations were then examined looking at the relationship of SES to clinical variables and neurocognitive status. Regression analysis was undertaken to examine the relative contribution of individual sociodemographic factors to a diagnosis of dementia. Results: In general, there was wide variation in the sample examined with respect to most measures of SES. Approximately one third (36%) of the sample had a diagnosis of dementia, the mean age was 66.1 years and the mean Mini-mental State Examination score was relatively high (25.4). There was a strong association between age, individual annual income range, education, medical comorbidity and a diagnosis of dementia, with increased age and medical comorbidity being the strongest predictors. Conclusion: Increased age, low education, high medical comorbidity and low annual income are all associated with a diagnosis of dementia in an inner city setting. Age and medical comorbidity appear to be more strongly associated with a diagnosis of dementia than SES in an inner city setting.
TOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6a. QUALITY OF LIFE FOR PEOPLE WITH DEMENTIA LIVING IN RESIDENTIAL AND NURSING HOME CARE: THE IMPACT OF PERFORMANCE ON ACTIVITIES OF DAILY LIVING, BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS, LANGUAGE SKILLS, AND PSYCHOTROPIC DRUGS

The majority of people with dementia develop behavioral and psychological symptoms of dementia (BPSD) at some point during their illness (Jeste et al., 2008). These symptoms, which are especially common among care home residents, are frequently distressing for the patients who experience them (Gilley et al., 2006; Jeste et al., 2008) and problematic for their professional and/or family caregivers. The starting point for our paper “Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs” (Ballard et al., 2001) was to try and understand the impact of BPSD, function and language skills on quality of life in care home residents with dementia. Although there were frequent statements in previous work referring to the capacity of psychiatric and behavioral symptoms to reduce quality of life, we had been unable to identify any empirical evidence to support this clinical impression in a thorough literature review. The parallel validation of Dementia Care Mapping (DCM), predominantly a practice development tool, as an observational measure of well-being/quality of life (Kitwood and Bredin, 1997; Fossey et al., 2002) provided an excellent opportunity to examine this issue in a care home setting. The study focused on 209 people with dementia living in residential and nursing home care in north-east England in the U.K., who received a detailed assessment of BPSD, function and cognition. A DCM evaluation was completed for 112 of these individuals, providing a detailed observational measure of well-being, activities and social withdrawal as indices of quality of life over a six-hour daytime period. To our surprise, there was actually no association between well-being, social withdrawal or activities and BPSD. In contrast, there was a significant association between antipsychotic medication and reduced well-being, social withdrawal and activities respectively, even after controlling for the severity of behavioral disturbance. Using an arbitrary definition of “ill-being”, defined as a well-being score of less than zero, 5% of people not taking antipsychotics, 10% of people taking atypical antipsychotics and 22% of people taking typical antipsychotics were defined as having ill-being. Lower levels of functional ability were also associated with significantly lower well-being, less activities and more social withdrawal. At first this latter finding appears to be contrary to one of the central principles of DCM – namely, that the assessment should be independent of dementia severity. Although high levels of well-being and engagement are possible for people with severe dementia, this probably requires higher staff numbers and a workforce with more specialized skills in order to achieve this.
Aggregation Modulators Interfere with Membrane Interactions of b 2-Microglobulin Fibrils

Amyloid fibril accumulation is a pathological hallmark of several devastating disorders, including Alzheimer’s disease, prion diseases, type II diabetes, and others. Although the molecular factors responsible for amyloid pathologies have not been deciphered, interactions of misfolded proteins with cell membranes appear to play important roles in these disorders. Despite increasing evidence for the involvement of membranes in amyloid-mediated cytotoxicity, the pursuit for therapeutic strategies has focused on preventing self-assembly of the proteins comprising the amyloid plaques. Here we present an investigation of the impact of fibrillation modulators upon membrane interactions of b2-microglobulin (b2m) fibrils. The experiments reveal that polyphenols (epigallocatechin gallate, bromophenol blue, and resveratrol) and glycosaminoglycans (heparin and heparin disaccharide) differentially affect membrane interactions of b2m fibrils measured by dye-release experiments, fluorescence anisotropy of labeled lipid, and confocal and cryo-electron microscopies. Interestingly, whereas epigallocatechin gallate and heparin prevent membrane damage as judged by these assays, the other compounds tested had little, or no, effect. The results suggest a new dimension to the biological impact of fibrillation modulators that involves interference with membrane interactions of amyloid species, adding to contemporary strategies for combating amyloid diseases that focus on disruption or remodeling of amyloid aggregates.
Anxiety and Quality of Life in ESRD

The hallmark features of an Anxiety Disorder are overwhelming feelings of fearfulness, dread, and uncertainty (1). Unlike relatively mild brief anxiety caused by a stressful event, anxiety disorders last at least 6 months and often get worse if not treated. Anxiety disorders are characterized by alterations in a diverse range of neurochemical systems. Recent neuroanatomical and neuroimaging research has focused on the role of the amygdala, reciprocal connections between the amygdala and the prefrontal cortex, and, most recently, alterations in interoceptive processing by the anterior insula (2). Anxiety disorders affect approximately 40 million American adults, accounting for a substantial psychological toll. Additionally, the World Health Organization rates anxiety as a major cause of years lost to disability in theUnited States (3). There is a strong negative impact of anxiety disorders on quality of life (QOL) (4) and disability across multiple illnesses (5). Patients with end-stage renal disease (ESRD)may exhibit anxiety through a range of symptoms. See Table 1 for a list of common anxiety symptoms. The Diagnostic and Statistical Manual (DSM-IV) lists the following as anxiety disorders: panic disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), social phobia, generalized anxiety disorder, and specific phobias (1). Interestingly, the current proposal for DSM-V removes OCD and PTSD and instead lists them as separate chapters on ObsessiveCompulsive and Related Disorders and Traumaand Stressor-Related Disorders (6). Table 2 provides a brief description of the anxiety disorders listed in the DSM-IV. The precise prevalence of anxiety disorders within the US dialysis population remains unclear in the absence of large, nationally representative studies. Numerous smaller studies have examined the rate of anxiety within dialysis patients, but have used a variety of different measures to assess anxiety. A review of 55 studies that examined anxiety symptoms in ESRD patients revealed an average prevalence rate of 38% with levels for individual studies ranging from 12% to 52% (7). Studies that have used the SCID-I to diagnose DSM-IV anxiety disorders report prevalence rates ranging from 0% to 45.7% (8–10). Cukor et al. found a prevalence rate of 45.7% in a sample of predominately Black hemodialysis patients, with the most common anxiety disorders being specific phobias (26.6%) and panic disorder (21.0%) (9). A different study reported a 30% prevalence of anxiety disorders in HD patients using the Primary Care Evaluation of Mental Disorders (PRIME-MD), which indicated a 19% prevalence of anxiety disorders in 2316 general medical patients (11,12). Studies using self-report measures screen for anxiety symptoms rather than actual diagnoses and have found a wide range of prevalence in ESRD patients as well, spanning from 39% (13) to 53% (14). Some of the variation may well be due to anxiety scale used, population parameters, and the natural course of anxiety. Rates of moderate-to-severe symptoms have ranged from 13% to 28% (14,15) in dialysis patients.
Minimal impact of nutrition education and fruit and vegetable consumption on biomarkers of inflammation and oxidative stress.

Aims: To determine the effectiveness of a community-based fruit and vegetable education program and provision of fruits and vegetables on consumption of fruits, vegetables, antioxidants, and changes in biomarkers of inflammation and oxidative stress among overweight and obese adults. Study Design: Randomized controlled design. Place and Duration of Study: North Dakota State University, Fargo, North Dakota; 14 weeks. Methodology: Forty-seven adults (31 women; 45.9 ± 11.8 y; body mass index 32.7 kg/m 2 ) were randomly assigned to one of three intervention groups. The control group received no intervention, the education group attended weekly nutrition education lessons, the fruit and vegetable group attended weekly nutrition education lessons and received one serving of fruits and two servings of vegetables per day for 10 weeks. Fasting blood was drawn and consumption of fruits, vegetables, Original Research Article Wagner et al.; EJNFS, 5(3): 179-189, 2015; Article no.EJNFS. 2015.017 180 and antioxidants was assessed using three-day food records. Results: Increased consumption of fruit from preto post-test was indicated among fruit and vegetable group participants, P = . 01, and among education group participants, although this difference was not significant, P = . 11. In contrast, a significant decrease in fruit servings consumed from preto post-test for control group participants was observed, P = . 02. Vegetable consumption was the same for control group participants, decreased by 0.3 serving among education group participants, and increased by 0.4 serving among fruit and vegetable group participants. No significant differences in plasma TNF-α, TBARS, or CRP concentrations from preto post-test were indicated among the three groups, although the largest decrease was observed among fruit and vegetable group participants, P = . 07. Conclusion: Changes in fruit and vegetable consumption among participants were minimally associated with improvements in inflammation and oxidative stress biomarkers. Adequate and varied fruit and vegetable consumption is recommended to aid in the prevention and regulation of inflammation and oxidative stress.
Bone Mass Loss in Patients With Human Immunodeficiency Virus Type 1 Infection: Association With Male Sex and Protease Inhibitor Therapy

The aim of our study was to evaluate the prevalence of osteopenia/osteoporosis in patients with human immunodeficiency virus (HIV) type 1 infection and to assess their possible correlation with antiretroviral therapy. Patients were enrolled among adult subjects with HIV type 1 infection referring to our tertiary care outpatient center. Bone mineral density was measured in the lumbar spine and femoral proximal head by dual-energy x-ray absorptiometry. A total of 95 HIV-infected patients (45 men) were enrolled: 12 subjects were naive to antiretroviral therapy, 18 received 3 nucleoside reverse-transcriptase inhibitors (NRTIs), 28 were treated with 2 NRTIs plus 1 non-NRTI, and 37 received 2 NRTIs plus 1 protease inhibitor (PI). Prevalence of osteopenia and osteoporosis according to lumbar T score was 37.9% and 9.5%, respectively, and osteoporosis was significantly more frequent in men than in women (20% vs. 0%; P < 0.001). The mean value of lumbar T score was significantly lower in PI-treated patients (−1.32 ± 0.48) than in naive subjects (−0.62 ± 0.24) or in those receiving 3 NRTIs (−0.68 ± 0.34) or 1 non-NRTI (−0.86 ± 0.44) (P < 0.05). Bone metabolism alterations associated with HIV infection probably have a multifactorial pathogenesis, but in our study, bone mass loss seems prompted by the male sex and a PI-based therapy.
PD First: Peritoneal Dialysis as the Default Transition to Dialysis Therapy

Peritoneal dialysis (PD) and in‐center hemodialysis (HD) are accepted as clinically equivalent dialysis modalities, yet in‐center HD is the predominant renal replacement therapy (RRT) modality offered to new end‐stage renal disease (ESRD) patients in the United States and most other industrialized nations. This predominance has little to do with clinical outcomes, patient choice, cost, or quality of life. It has been driven by ease of HD initiation, physician experience and training, inadequate pre‐ESRD patient education, ample in‐center HD capacity, and lack of adequate infrastructure for PD‐related care. As compared with in‐center HD, PD is a widely applicable, yet underutilized modality of RRT that provides comparable clinical outcomes, superior quality of life measures, significant cost savings, and many other unmeasured advantages. A “PD First” approach not only has advantages for patients but also physicians, healthcare systems, and society. In this review, we will summarize evidence demonstrating that PD should be the default modality when new ESRD patients are transitioning to dialysis therapy when preemptive transplantation is not an option and highlight the essential infrastructural requirements to allow for a “PD First” model.
Do Ketoanalogues Still Have a Role in Delaying Dialysis Initiation in CKD Predialysis Patients?

Early versus later start of dialysis is still a matter of debate. Low‐protein diets have been used for many decades to delay dialysis initiation. Protein‐restricted diets (0.3–0.6 g protein/kg/day) supplemented with essential amino acids and ketoanalogues (sVLPD) can be offered, in association with pharmacological treatment, to motivated stage 4–5 chronic kidney disease (CKD) patients not having severe comorbid conditions; they probably represent 30–40% of the concerned population. A satisfactory adherence to such dietary prescription is observed in approximately 50% of the patients. While the results of the studies on the effects of this diet on the rate of progression of renal failure remain inconclusive, they are highly significant when initiation of dialysis is the primary outcome. The correction of uremic symptoms allows for initiation of dialysis treatment at a level of residual renal function lower than that usually recommended. Most of the CKD‐associated complications of cardiovascular and metabolic origin, which hamper both lifespan and quality of life, are positively influenced by the diet. Lastly, with regular monitoring jointly assumed by physicians and dietitians, nutritional status is well preserved as confirmed by a very low mortality rate and by the absence of detrimental effect on the long‐term outcome of patients once renal replacement therapy is initiated. On account of its feasibility, efficacy and safety, sVLPD deserves a place in the management of selected patients to safely delay the time needed for dialysis.
Use of nurse-observed symptoms of delirium in long-term care: effects on prevalence and outcomes of delirium

ABSTRACT Background: Previous studies have reported that nurse detection of delirium has low sensitivity compared to a research diagnosis. As yet, no study has examined the use of nurse-observed delirium symptoms combined with research-observed delirium symptoms to diagnose delirium. Our specific aims were: (1) to describe the effect of using nurse-observed symptoms on the prevalence of delirium symptoms and diagnoses in long-term care (LTC) facilities, and (2) to compare the predictive validity of delirium diagnoses based on the use of research-observed symptoms alone with those based on research-observed and nurse-observed symptoms. Methods: Residents aged 65 years and over of seven LTC facilities were recruited into a prospective study. Using the Confusion Assessment Method (CAM), research assistants (RAs) interviewed residents and nurses to assess delirium symptoms. Delirium symptoms were also abstracted independently from nursing notes. Outcomes measured at five month follow-up were: death, the Hierarchic Dementia Scale (HDS), the Barthel ADL scale, and a composite outcome measure (death, or a 10-point decline in either the HDS or the ADL score). Results: The prevalence of delirium among 235 LTC residents increased from 14.0% (using research-observed symptoms only) to 24.7% (using research- and nurse-observed symptoms). The relative risks (and 95% confidence intervals) for prediction of the composite outcome, after adjustment for covariates, were: 1.43 (0.88, 1.96) for delirium using research-observed symptoms only; 1.77 (1.13, 2.28) for delirium using research- and nurse-observed symptoms, in comparison with no delirium. Conclusions: The inclusion of delirium symptoms observed by nurses not only increases the detection of delirium in LTC facilities but improves the prediction of outcomes.
Trends in Toxic Alcohol Exposures in the United States from 2000 to 2013: A Focus on the Use of Antidotes and Extracorporeal Treatments

Morbidity and mortality from toxic alcohols like ethylene glycol and methanol remain prevalent worldwide. The introduction of fomepizole, a potent blocker of alcohol dehydrogenase, has modified current practice over the last 15 years. The aim of the study was to describe the characteristics of toxic alcohol poisoning reported to US poison centers, the trends in the incidence of antidote use and hemodialysis treatment, as well as the related mortality. A retrospective study of all electronic entries from the AAPCC National Poison Data System database, from the years 2000 to 2013 was reviewed. When considering all exposures, the great majority of patients had a benign outcome. Major effects (e.g., life threatening) occurred in 2.1% and 4.9% of methanol and ethylene glycol cases, respectively. Mortality rates were similar for both toxic alcohols, approximately 0.6%. When only considering ingestions reported to healthcare facilities, a major effect was reported in 9.5% and 20.5%, and the mortality rate was 2.9% and 2.4% for methanol and ethylene glycol exposures, respectively, and remained constant over time. The use of fomepizole increased statistically over the study period while that of ethanol decreased, until it became proportionally negligible by 2012‐2013. The use of hemodialysis significantly decreased in “Early” ethylene glycol exposures during the study period. Similar to other reports, it appears that the use of fomepizole has largely supplanted ethanol as the antidote of choice in toxic alcohol exposures and may decrease the requirements for hemodialysis in patients poisoned with ethylene glycol who have no acidosis and normal kidney function.
Verification of a Dynamic Scaling for the Pair Correlation Function during the Slow Drainage of a Porous Medium.

In this Letter we give experimental grounding for the remarkable observation made by Furuberg et al. [Phys. Rev. Lett. 61, 2117 (1988)PRLTAO0031-900710.1103/PhysRevLett.61. 2117] of an unusual dynamic scaling for the pair correlation function N(r,t) during the slow drainage of a porous medium. Those authors use an invasion percolation algorithm to show numerically that the probability of invasion of a pore at a distance r away and after a time t from the invasion of another pore scales as N(r,t)∝r^{-1}f(r^{D}/t), where D is the fractal dimension of the invading cluster and the function f(u)∝u^{1.4}, for u≪1 and f(u)∝u^{-0.6}, for u≫1. Our experimental setup allows us to have full access to the spatiotemporal evolution of the invasion, which is used to directly verify this scaling. Additionally, we connect two important theoretical contributions from the literature to explain the functional dependency of N(r,t) and the scaling exponent for the short-time regime (t≪r^{D}). A new theoretical argument is developed to explain the long-time regime exponent (t≫r^{D}).
Relationships between appraisals of caregiver communication strategies and burden among spouses and adult children

ABSTRACT Background: The purpose of this study was to investigate the impact of caregivers’ appraisals of the effectiveness of their own communication strategies on caregiver burden when caring for family members with Alzheimer's disease (AD). Methods: Family caregivers (N = 84) of participants with AD completed questionnaires appraising communication strategies, problem behaviors, and levels of three types of burden. Results: Hierarchical linear regression models revealed that effective strategies and kinship status were significantly linked with stress burden, whereas effective strategies and problem behaviors were significantly related to relationship burden. Cognitive status of participants with AD significantly predicted objective burden. Caregivers who rated effective strategies as helpful were more likely to experience lower levels of stress and relationship burden. Conclusions: Findings provide preliminary support for understanding mechanisms by which the appraisals of communication strategies influence caregiver burden and justify testing empirically derived communication interventions.