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Although research has demonstrated the long-term health consequences of childhood adversities, less is known about the long-term impact of positive childhood experiences, such as parental affection.Using longitudinal data (1995–2014) from the Midlife in the United States (MIDUS) study, we analyze structural equation models estimating direct and indirect pathways from early-life parental affection to changes in later-life cognitive function through relationship quality in adulthood among Black and White older adults (N = 1983).Analyses revealed significant indirect effects of parental affection on better cognitive function through higher levels of social support (both average social support and family social support) in adulthood in the full sample and among Black respondents. Indirect pathways through relationship strain and through friend support were not significant.This work elevates the importance of promoting positive parental relationships during childhood, with implications for better social relationships in adulthood and cognitive function in later life. [ABSTRACT FROM AUTHOR]

Objectives Sibling loss is understudied in the bereavement and health literature. The present study considers whether experiencing the death of siblings in mid-to-late life is associated with subsequent dementia risk and how differential exposure to sibling losses by race/ethnicity may contribute to racial/ethnic disparities in dementia risk. Methods We use discrete-time hazard regression models, a formal mediation test, and a counterfactual simulation to reveal how sibling loss in mid-to-late life affects dementia incidence and whether unequal exposures by race/ethnicity mediate the racial/ethnic disparities in dementia. We analyze data from the Health and Retirement Study (2000–2016). The sample includes 13,589 respondents (10,670 non-Hispanic White, 1,761 non-Hispanic Black, and 1,158 Hispanic adults) aged 65 years and older in 2000 who show no evidence of dementia at baseline. Results Discrete-time hazard regression results show that sibling loss in mid-to-late life is associated with up to 54% higher risk for dementia. Sibling loss contributes to Black–White disparities in dementia risk. In addition, a simulation analysis shows that dementia rates would be 14% lower for Black adults if they experienced the lower rates of sibling loss experienced by White adults. This pattern was not observed among Hispanic adults. Discussion The death of a sibling in mid-to-late life is a stressor that is associated with increased dementia risk. Black adults are disadvantaged in that they are more likely than Whites to experience the death of siblings, and such losses contribute to the already substantial racial/ethnic disadvantage in dementia. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates direct and indirect influences of childhood social, behavioral, and health exposures on later-life osteoarthritis and rheumatoid arthritis development. Methods: Drawing from cumulative inequality theory and six waves of the Health and Retirement Study (2004–2014), we estimate structural equation modeling-based discrete-time survival analysis of the association between six childhood exposure domains and both osteoarthritis and rheumatoid arthritis incidence for men (n = 2720) and women (n = 2974). Using the delta method to test for mediation, we examine indirect effects via selected health-related risks and resources. Results: Risky adolescent behavior is associated with rheumatoid arthritis incidence for women (h.O.R. = 1.883, 95% C.I. [1.016, 3.490]), whereas several types of childhood exposures are associated with later-life osteoarthritis development for both men and women. Experiencing two or more childhood socioeconomic disadvantages is indirectly associated with osteoarthritis (men: coef. = 0.024, 95% C.I. [0.003, 0.045]; women: coef. = 0.111, 95% C.I. [0.071, 0.150]) and rheumatoid arthritis (men: coef. = 0.037, 95% C.I. [0.000, 0.074]; women: coef. = 0.097, 95% C.I. [0.035, 0.159]) development through adult body mass index. Discussion: Findings highlight the importance of childhood contexts in understanding the development of later-life osteoarthritis and rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

The Sacramento-San Joaquin Delta in central California is particularly susceptible to damage in a large earthquake due to the vulnerability of the levees that protect cities, farms, and infrastructure. The Delta is located adjacent to the seismically active San Andreas fault system and is also subject to strong ground shaking from numerous other seismic sources in central California, including faults within the Delta. We performed a probabilistic seismic hazard analysis (PSHA) to provide seismic design ground motions for the Metropolitan Water District (MWD) Emergency Freshwater Pathway. We have evaluated the appropriateness of the Next Generation of Attenuation (NGA)-West2 ground motion models for use in our analyses of the Delta, evaluated shear-wave velocity (VS) data in the vicinity of the Pathway, and performed site response analyses. The latter was performed to compute the probabilistic hazard at the top of the peat at five sites along the Pathway. The sixth site was located outside the Delta and on firm soil. The probabilistic hazard for the six sites and for a range of return periods of engineering relevance were computed in the PSHA. For a return period of 2500 years, the peak horizontal ground acceleration (PGA) values on peat ranged from 0.40 g to 0.53 g. The seismic sources that control the hazard at these sites vary as a function of return period and spectral frequency, but in general, the closer the sites are to faults within the San Andreas fault system, the higher the hazard. [ABSTRACT FROM AUTHOR]

Electronic health records (EHR) are designed to promote patient safety, workflow efficiency, and communication (HealthIT.gov). Competency in the use of an EHR is essential for both undergraduate and graduate nursing students. Masters prepared nurse educator students may become clinical faculty in schools of nursing or clinical nurse educators in hospitals or out-patient settings after graduation. A gap exists in preparing future nurse educators to teach EHR-specific skills to their future nursing student populations and in promoting patient safety through quality improvement initiatives. The purpose of this observational study is to evaluate experiential learning activities for Master of Science in Nursing (MSN) nurse educator students aimed at preparing them to teach EHR-specific skills to undergraduate nursing students and in utilizing an EHR query activity to develop quality improvement plans. [ABSTRACT FROM AUTHOR]

Most academic promotion committees in US medical schools rate teaching and mentoring skills very highly when considering physician faculty for promotion. Of 115 US medical schools surveyed, half had a promotion track specifically for physician educators. Teaching skills, clinical skills, mentoring and the ability to develop educational programs were rated more highly than research. Awards, peer reports, student evaluations and teaching portfolio were used to assess teaching ability. Physician educators were not expected to have as many publications as researchers., Context. -- clinician-educators have concerns about their ability to be promoted and the criteria used by medical school promotion committees. Objective. -- to discover the criteria and methods that medical school promotion committees use to make decisions about the promotion of clinician-educators. Methods. -- in June 1996 we mailed a questionnaire to chairpersons of all medical school promotion committees in the United States and Canada. Results. -- Of 142 schools surveyed, 115 (81%) responded; 451% of respondents had a clinician-educator promotion track. On a scale from 1 (minimally important) to 7 (extremely important), the mean importance ratings of aspects of clinician-educators' performance were the following: teaching skills (6.3), clinical skills (5.8), mentoring (5.7), academic administration (5.3), developing educational programs (5.3), nonresearch scholarship (5.1), clinical research (4.8), service coordination (4.7), and education research (4.5). Methods to evaluate each aspect of performance were rated by respondents for importance and frequency of use. The 4 most important methods for evaluating teaching were awards, peer evaluation, learner evaluation, and teaching portfolio; 70% or more of schools used these frequently or always. The 4 most important methods of evaluating clinical skills were peer evaluation, awards, trainee evaluation, and objective measures, which were used frequently or always by 78%, 65%, 58%, and 29% of schools, respectively. Clinician-educators were expected to have fewer peer-reviewed publications to be promoted than investigators (5.7 vs 10.6, P[less than].001). Schools with separate clinician-educator tracks differed little in survey responses from schools without such tracks. Conclusion. -- Most, but not all, promotion committees now assign high importance to the special contributions of clinician-educators and use a variety of methods to assess these, regardless of whether they have a separate clinician-educator promotion track.

In 1987, a Dallas (Texas) elementary school principal developed a Writing to Read to the Principal program to motivate students' mastery of reading and writing in a school where over 80 percent of the students are economically disadvantaged. The program has strengthened the bond among students, parents, teachers, and the principal. Includes six references. (MLH)

Doctors should consider domestic violence when taking histories. A 41-year-old divorced woman was admitted to the hospital with symptoms of a stroke. A computed tomographic scan found a cerebral blood clot. A clot in a woman of this age is unusual in the absence of a clotting disorder. The next day the patient's mother told doctors the woman's ex-husband had strangled her three months previously. Doctors decided the strangling had damaged the carotid artery, a clot had formed, and a piece had broken off, causing a stroke. Treatment dissolved the clot, but the patient remained paralyzed on one side. Domestic violence is common and happens to women of all races and socioeconomic groups. Associated medical problems include death, injury, suicide attempts, and premature labor. Children are also likely to be victims and to suffer adverse physical and emotional consequences. Doctors should question patients about domestic violence, and they should be prepared to counsel patients and provide referrals.

The majority of thyroid nodules in pediatric patients appear to be non-cancerous. Thyroid nodules are small, rounded masses that may be either cancerous or non-cancerous. Fine-needle aspiration biopsy was performed on 57 patients younger than 18 years old. Sixty-six samples were taken and evaluated. Seventy-seven percent of the samples were non-cancerous. Twelve percent of the samples were not able to be classified definitively. Eighteen percent of the nodules were cancerous. One cancerous nodule was initially misdiagnosed as non-cancerous. Fine-needle aspiration biopsy appears to be useful in determining whether thyroid nodules are cancerous or non-cancerous., Objective. The prevalence of thyroid nodularity in children has been estimated to be 1.8%. The reported prevalence of specific diseases which comprise these nodules is conflicting as evidenced by a reported range of malignancy of 2 to 50% in solitary nodules. In order to better classify pediatric (

Following September 11th, The Century Foundation began its Homeland Security Project to help inform the public and policymakers about complex challenges related to terrorism. One facet of this project is [...]

A study was conducted to compare the willingness of Hispanics, Blacks, and non-Hispanic whites to relocate for their jobs. All three groups were found to be willing to tansfer provided high incentives are given. Hispanics indicated stronger intentions when the prospective destination has a high population of Hispanics. Only the latter group showed concern for the said factor. This could be due to the group's need for social support from within the race.

Dietary restriction (DR) has been shown to increase lifespan in organisms ranging from yeast to mammals. This suggests that the underlying mechanisms may be evolutionarily conserved. Indeed, upstream signalling pathways, such as TOR, are strongly linked to DR-induced longevity in various organisms. However, the downstream effector proteins that ultimately mediate lifespan extension are less clear. To shed light on this, we used a proteomic approach on budding yeast. Our reasoning was that analysis of proteomewide changes in response to DR might enable the identification of proteins that mediate its physiological effects, including replicative lifespan extension. Of over 2500 proteins we identified by liquid chromatography-mass spectrometry, 183 were significantly altered in expression by at least 3-fold in response to DR. Most of these proteins were mitochondrial and/or had clear links to respiration and metabolism. Indeed, direct analysis of oxygen consumption confirmed that mitochondrial respiration was increased several-fold in response to DR. In addition, several key proteins involved in mating, including Ste2 and Ste6, were down-regulated by DR. Consistent with this, shmoo formation in response to a-factor pheromone was reduced by DR, thus confirming the inhibitory effect of DR on yeast mating. Finally, we found that Hsp26, a member of the conserved small heat shock protein (sHSP) family, was up-regulated by DR and that overexpression of Hsp26 extended yeast replicative lifespan. As overexpression of sHSPs in Caenorhabditis elegans and Drosophila has previously been shown to extend lifespan, our data on yeast Hsp26 suggest that sHSPs may be universally conserved effectors of longevity. [ABSTRACT FROM AUTHOR]