1
|
Sevi B, Gutiérrez Á, Muniz-Terrera G. Underlining neighbourhood perception: a possible risk factor for dementia that deserves more attention. Brain Commun 2024; 6:fcae037. [PMID: 38487551 PMCID: PMC10939439 DOI: 10.1093/braincomms/fcae037] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 11/24/2023] [Accepted: 02/08/2024] [Indexed: 03/17/2024] Open
Abstract
This essay highlights the interplay between the neighbourhood structural environment and neighbourhood perceptions on dementia by articulating how an individual's perception of neighbourhood, with respect to their individual differences, may provide key insights to understand the link between the neighbourhood and dementia.
Collapse
Affiliation(s)
- Barış Sevi
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Department of Psychology, MEF University, 34396 Istanbul, Turkey
| | - Ángela Gutiérrez
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
| | - Graciela Muniz-Terrera
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh EH8 9YL, UK
| |
Collapse
|
2
|
Gutiérrez Á, Thomas Tobin C. A Latent Class Analysis of Personal Coping Resources and Depressive Symptoms Among Middle-Aged and Older Latinx Adults. J Aging Health 2023; 35:790-807. [PMID: 37247389 DOI: 10.1177/08982643231176910] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Objectives: To identify coping profiles and evaluate their implications for depressive symptoms among Latinx adults. Methods: Data come from a community-dwelling sample of Latinx adults ages 45+ in Florida (N = 461). Latent class analysis was used to identify profiles of personal coping resources based on patterns across spirituality (spiritual coping, divine fate), ethnic identity (centrality, connectedness), and personal control (mastery, self-esteem). Multivariable linear regression assessed differences in depressive symptoms across coping resource classes. Results: Four coping resource profiles were identified: (1) low resources overall, yet high spiritual coping; (2) high spirituality and personal control; (3) high spirituality and ethnic identity; and (4) high resources overall. Members of Class 4 had significantly fewer depressive symptoms than members of Class 1 and Class 3, controlling for sociodemographic characteristics, p < .001. Discussion: Results elucidate nuances in personal coping resources among aging Latinx adults, identify under-resourced groups, and suggest that resource profiles characterized by few personal coping resources are linked with more depressive symptoms. Findings clarify the underpinnings of the latent coping construct and have implications for mental health promotion interventions among aging Latinx adults.
Collapse
|
3
|
Gutiérrez Á, López-Anuarbe M, Webster NJ, Mahmoudi E. Rural-Urban Health Care Cost Differences Among Latinx Adults With and Without Dementia in the United States. J Aging Health 2023:8982643231207517. [PMID: 37899581 DOI: 10.1177/08982643231207517] [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] [Indexed: 10/31/2023]
Abstract
OBJECTIVES To compare rural-urban health care costs among Latinx adults ages 51+ and examine variations by dementia status. METHODS Data are from the Health and Retirement Study (2006-2018 waves; n = 15,567). We inflation-adjusted all health care costs using the 2021 consumer price index. Geographic context and dementia status were the main exposure variables. We applied multivariate two-part generalized linear models and adjusted for sociodemographic and health characteristics. RESULTS Rural residents had higher total health care costs, regardless of dementia status. Total health care costs were $850 higher in rural ($2,640) compared to urban ($1,789) areas (p < .001). Out-of-pocket costs were $870 higher in rural ($2,677) compared to urban ($1,806) areas (p < .001). Dementia status was not an effect modifier. DISCUSSION Health care costs are disproportionately higher among Latinx rural, relative to urban, residents. Addressing health care costs among Latinx rural residents is a public health priority.
Collapse
Affiliation(s)
- Ángela Gutiérrez
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | | | - Noah J Webster
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Elham Mahmoudi
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
4
|
Gutiérrez Á, Cronin CE, Franz B, Muniz-Terrera G. Alzheimer's Centers in US Hospitals: Enough to Adequately Address Dementia Care Nationwide? J Aging Health 2023:8982643231200691. [PMID: 37699204 DOI: 10.1177/08982643231200691] [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] [Indexed: 09/14/2023]
Abstract
OBJECTIVES To investigate the availability of Alzheimer's Centers (ACs) in US hospitals. METHODS Utilizing the American Hospital Association Annual Survey, Area Health Resource File, and US Census (n = 3251), we employed multivariable logistic regression to examine hospital, county, and regional predictors of AC availability. RESULTS Large hospitals (>399 beds) had approximately 14 times higher odds of having an AC than small hospitals (<50 beds; OR = 14.0; 95% CI = 6.44 - 30.46). Counties with a higher proportion of Latino residents, relative to non-Latino Whites, had lower odds of having an AC (OR = .05; 95% CI = .01 - .41). Northeastern (OR = 1.92; 95% CI = 1.15 - 3.22) and Midwestern (OR = 2.12; 95% CI = 1.34 - 3.37) hospitals had higher odds of having an AC than Southern hospitals. DISCUSSION To address dementia needs and disparities, investment in a national infrastructure is critical.
Collapse
Affiliation(s)
- Ángela Gutiérrez
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens OH, USA
| | - Cory E Cronin
- College of Health Sciences and Professions, Ohio University, Athens OH, USA
| | - Berkeley Franz
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens OH, USA
| | - Graciela Muniz-Terrera
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Athens OH, USA
| |
Collapse
|
5
|
Thomas Tobin CS, Gutiérrez Á, Farmer HR, Erving CL, Hargrove TW. Intersectional Approaches to Minority Aging Research. CURR EPIDEMIOL REP 2023; 10:1-11. [PMID: 36644596 PMCID: PMC9830125 DOI: 10.1007/s40471-022-00317-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 01/11/2023]
Abstract
Purpose of Review Growing racial/ethnic diversity among America's older adults necessitates additional research specifically focused on health and well-being among aging minoritized populations. Although Black and Latinx adults in the USA tend to face worse health outcomes as they age, substantial evidence points to unexpected health patterns (e.g., the race paradox in mental health, the Latino health paradox) that challenge our understanding of health and aging among these populations. In this review, we demonstrate the value of intersectionality theory for clarifying these health patterns and highlight the ways that intersectionality has been applied to minority aging research. To advance the field, we also make several recommendations for incorporating intersectional approaches in future scholarship on minority aging. Recent Findings Scholars have applied intersectional approaches to health and aging to unravel how social statuses and social conditions, such as race, ethnicity, gender, nativity, incarceration history, geographic region, and age, produce distinct shared experiences that shape health trajectories through multiple mechanisms. Summary We highlight common intersectional approaches used in minority aging research and underscore the value of this perspective for elucidating the complex, and often unexpected, health patterns of aging minoritized populations. We identify several key lessons and propose recommendations to advance scholarship on minority aging.
Collapse
Affiliation(s)
- Courtney S. Thomas Tobin
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA USA
| | - Ángela Gutiérrez
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Irvine 128B 57 West Oxbow Trail, 1 Ohio University Drive, Athens, OH 45701-2979 USA
| | - Heather R. Farmer
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE USA
| | | | - Taylor W. Hargrove
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| |
Collapse
|
6
|
Cabello-Ubeda A, de Quirós JCLB, Martín Carbonero L, Sanz J, Vergas J, Mena Á, Torralba M, Hernández Segurado M, Pinto A, Tejerina F, Palmier E, Gutiérrez Á, Vázquez P, Pulido F, Górgolas M. 48-Week effectiveness and tolerability of dolutegravir (DTG) + lamivudine (3TC) in antiretroviral-naïve adults living with HIV: A multicenter real-life cohort. PLoS One 2022; 17:e0277606. [PMID: 36409695 PMCID: PMC9678299 DOI: 10.1371/journal.pone.0277606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/31/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The main international guidelines indicate DTG/3TC therapy as one of the preferred regimens for people living with HIV (PLWH), due to its observed efficacy in randomized clinical trials. However, information in real-life cohorts is relatively scarce for first-line use. METHODS A retrospective multicenter study of adult PLWH starting DTG+3TC as a first-line regimen before January 31st, 2020. Virological failure (VF) was defined as 2 consecutive HIV RNA viral load (VL) >50 copies/mL. RESULTS 135 participants were included. Treatment was started without knowing baseline drug resistance testing (bDRT) results in 71.9% of cases, with baseline resistance mutations being later confirmed in 17 patients (12.6%), two of them with presence of M184V mutation. Effectiveness at week 48 was 85.2% (CI95%: 78.1-90.7%) (ITT missing = failure [M = F]) and 96.6% (CI 95%: 91.6-99.1%) (per-protocol analysis). Six patients (4.4%) discontinued treatment. One developed not confirmed VF after discontinuing treatment due to poor adherence; no resistance-associated mutations emerged. Three discontinued treatments due to central nervous system side effects (2.2%), and two due to a medical decision after determining the M184V mutation in bDRT. Finally, 14 (10.4%) were lost to follow-up, most of them due to the COVID-19 pandemic. CONCLUSIONS In a real-life multicenter cohort of ART-naïve PLWH, treatment initiation with DTG + 3TC showed high effectiveness and favorable safety results, comparable to those of randomized clinical trials, without treatment-emergent resistance being observed through week 48. Starting treatment before receiving the results of baseline drug resistance testing did not have an impact on the regimen's effectiveness.
Collapse
Affiliation(s)
- Alfonso Cabello-Ubeda
- Division of Infectious Diseases, Fundación Jiménez Díaz University Hospital, Research Health Institute, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
- * E-mail:
| | - Juan Carlos López Bernardo de Quirós
- Gregorio Marañón University Hospital, Infectious Diseases, Madrid, Spain
- CIBERINFEC, ISCIII-CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jesús Sanz
- La Princesa University Hospital, Infectious Diseases, Madrid, Spain
| | - Jorge Vergas
- Clínico San Carlos University Hospital, Infectious Diseases, Madrid, Spain
| | - Álvaro Mena
- A Coruña University Hospital, Infectious Diseases, A Coruña, Spain
| | - Miguel Torralba
- Guadalajara University Hospital, Infectious Diseases, UAH, Guadalajara, Spain
| | - Marta Hernández Segurado
- Division of Infectious Diseases, Fundación Jiménez Díaz University Hospital, Research Health Institute, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| | - Adriana Pinto
- 12 Octubre University Hospital, imas12, UCM, CIBERINFEC, HIV Unit, Madrid, Spain
| | - Francisco Tejerina
- Gregorio Marañón University Hospital, Infectious Diseases, Madrid, Spain
- CIBERINFEC, ISCIII-CIBER of Infectious Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ángela Gutiérrez
- La Princesa University Hospital, Infectious Diseases, Madrid, Spain
| | - Pilar Vázquez
- A Coruña University Hospital, Infectious Diseases, A Coruña, Spain
| | - Federico Pulido
- 12 Octubre University Hospital, imas12, UCM, CIBERINFEC, HIV Unit, Madrid, Spain
| | - Miguel Górgolas
- Division of Infectious Diseases, Fundación Jiménez Díaz University Hospital, Research Health Institute, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, Spain
| |
Collapse
|
7
|
Gutiérrez Á, Bravo RL, Tobin CT. Loneliness Exacerbates the Association Between Bodily Pain and Depressive Symptoms Among Middle-Aged and Older Latinx Adults. J Aging Health 2022; 34:1201-1212. [PMID: 36154318 DOI: 10.1177/08982643221127327] [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] [Indexed: 11/17/2022]
Abstract
Objectives: To investigate the associations between three bodily pain dimensions (intensity, frequency, severity) and depressive symptoms among middle-aged and older Latinxs ages 40-94 and to determine whether loneliness conditioned the pain-depressive symptoms associations. Methods: Data are from a community-based study of community-dwelling residents in Florida (N = 527). Multivariable linear regression models assessed the impact of each pain dimension on depressive symptoms, controlling for sociodemographic factors. Interactions determined whether loneliness moderated the pain-depressive symptoms relationships. Results: Each pain dimension was positively associated with depressive symptoms (p < .01). Loneliness modified the impact of pain frequency and pain severity on depressive symptoms. Those with moderate and high loneliness levels experienced an amplified pain-depressive symptoms association. Discussion: Findings underscore the synergistic effects of pain and loneliness in exacerbating depressive symptomatology among middle-aged and older Latinx adults. Loneliness is an important point of intervention to improve mental health among aging Latinxs.
Collapse
Affiliation(s)
- Ángela Gutiérrez
- Department of Social Medicine, Heritage College of Osteopathic Medicine, 1354Ohio University, Athens, OH, USA
| | - Rosana L Bravo
- Department of Health Sciences Education, College of Health Sciences, 6645Western University of Health Sciences, Pomona, CA, USA
| | - Courtney Thomas Tobin
- Department of Community Health Sciences, Fielding School of Public Health, 25808University of California, Los Angeles, CA, USA
| |
Collapse
|
8
|
Montejano R, de la Calle-Prieto F, Velasco M, Guijarro C, Queiruga-Parada J, Jiménez-González M, González-Ruano P, Martínez P, Goikoetxea AJ, Ibarrola M, Ciudad M, Gutiérrez Á, Torralba M, Díaz-Brasero A, Ryan P, Marcelo C, Díez C, Ibarra S, Merino E, Estrada V, Marcos J, Novella M, Rivera MA, Ruiz-Muñoz M, de Miguel M, Soler L, del Álamo M, Moreno S, Carcas AJ, Borobia AM, Arribas JR. Tenofovir Disoproxil Fumarate/Emtricitabine and Baricitinib for Patients at High Risk of Severe Coronavirus Disease 2019: The PANCOVID Randomized Clinical Trial. Clin Infect Dis 2022; 76:e116-e125. [PMID: 35906838 PMCID: PMC9384601 DOI: 10.1093/cid/ciac628] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/15/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study was designed to evaluate if patients with high risk for severe coronavirus disease 2019 (COVID-19) would benefit from treatment with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) followed by baricitinib in case of hypoxemia and systemic inflammation. METHODS PANCOVID is an open-label, double-randomized, phase 3 pragmatic clinical trial including adults with symptomatic COVID-19 with ≥2 comorbidities or aged ≥60 years and was conducted between 10 October 2020 and 23 September 2021. In the first randomization, patients received TDF/FTC or no TDF/FTC. In the second randomization, patients with room air oxygen saturation <95% and at least 1 increased inflammatory biomarker received baricitinib plus dexamethasone or dexamethasone alone. The primary endpoint was 28-day mortality. Main secondary endpoint was 28-day disease progression or critical care unit admission or mortality. The trial was stopped before reaching planned sample size due to the decrease in the number of cases and a mortality rate substantially lower than expected. RESULTS Of the 355 included participants, 97% were hospitalized at baseline. Overall, 28-day mortality was 3.1%. The 28-day mortality relative risk (RR) for participants treated with TDF/FTC was 1.76 (95% confidence interval [CI], .52-5.91; P = .379); it was 0.42 (95% CI, .11-1.59; P = .201) for those treated with baricitinib. The 28-day RR for the main secondary combined endpoint for participants treated with TDF/FTC was 0.95 (95% CI, .66-1.40; P = .774); it was 0.90 (95% CI, .61-1.33; P = .687) for those treated with baricitinib. CONCLUSIONS Our results do not suggest a beneficial effect of TDF/FTC; nevertheless, they are compatible with the beneficial effect of baricitinib already established by other clinical trials. CLINICAL TRIALS REGISTRATION EudraCT: 2020-001156-18.
Collapse
Affiliation(s)
| | | | - María Velasco
- Infectious Diseases. Research Unit. University Hospital Fundación Alcorcón. Madrid. Spain
| | - Carlos Guijarro
- Internal Medicine Unit. University Hospital Fundación Alcorcón. Rey Juan Carlos University. Madrid. Spain
| | - Javier Queiruga-Parada
- Clinical Pharmacology Department, La Paz University Hospital, IdiPAZ. Infectious Diseases Unit. La Paz University Hospital. IdiPAZ. Madrid. Spain
| | - María Jiménez-González
- Clinical Pharmacology Department, La Paz University Hospital, IdiPAZ. La Paz University Hospital. IdiPAZ. Spanish Clinical Research Network – SCReN. Madrid. Spain
| | | | - Patricia Martínez
- Internal Medicine Department. University Hospital Infanta Sofía. Madrid. Spain
| | | | - Marta Ibarrola
- Infectious Diseases Unit. Cruces University Hospital. Barakaldo. Spain
| | - Marianela Ciudad
- Infectious Diseases Unit. Internal Medicine Department. La Princesa University Hospital, Madrid, Spain
| | - Ángela Gutiérrez
- Infectious Diseases Unit. Internal Medicine Department. La Princesa University Hospital, Madrid, Spain
| | - Miguel Torralba
- Internal Medicine Department. Guadalajara University Hospital. University of Alcalá. Spain
| | - Ana Díaz-Brasero
- Internal Medicine Department. Guadalajara University Hospital. University of Alcalá. Spain
| | - Pablo Ryan
- Infanta Leonor University Hospital. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC). School of Medicine, Complutense University. Madrid, Spain
| | | | - Cristina Díez
- Clinical Microbiology and Infectious Diseases Department. Gregorio Marañon University Hospital. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid, Spain
| | - Sofía Ibarra
- Infectious Diseases Department. Basurto University Hospital. Basurto. Spain
| | - Esperanza Merino
- Infectious Diseases Unit. Alicante General University Hospital. Alicante Institute of Health and Biomedical Research (ISABIAL). Alicante, Spain
| | - Vicente Estrada
- Infectious Diseases Unit. Internal Medicine Department. Clínico San Carlos University Hospital. IdiSSC. Madrid, Spain
| | - Javier Marcos
- Internal Medicine Department. University Hospital Fundación Alcorcón. Madrid, Spain
| | - María Novella
- Internal Medicine Department. Príncipe de Asturias University Hospital. Alcalá de Henares, Spain
| | - María A Rivera
- Emergency Department. La Paz University Hospital. Madrid, Spain
| | - Manuel Ruiz-Muñoz
- Internal Medicine Department. University Hospital Fundación Alcorcón. Madrid, Spain
| | | | - Llanos Soler
- Internal Medicine Department. University Hospital Infanta Sofía. Madrid. Spain
| | - Mikel del Álamo
- Infectious Diseases Unit. Cruces University Hospital. Barakaldo. Spain
| | - Santiago Moreno
- Infectious Diseases Department. Ramón y Cajal University Hospital. IRYCIS. University of Alcalá School of Medicine. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC). Madrid, Spain
| | | | | | - José R Arribas
- Corresponding author: José R. Arribas, MD Unidad de Enfermedades Infecciosas. Hospital Universitario La Paz. IdiPAZ. Paseo de la Castellana 261, Madrid 28046, Spain. E-mail:
| |
Collapse
|
9
|
Thomas Tobin CS, Gutiérrez Á, Bell CN, Thorpe RJ. Early Life Racial Discrimination, Racial Centrality, and Allostatic Load Among African American Older Adults. Gerontologist 2022; 62:721-731. [PMID: 34922345 PMCID: PMC9154246 DOI: 10.1093/geront/gnab185] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Prior research documents accelerated physiological aging among African Americans due to their greater lifetime exposure to social and economic adversity. Yet, less is known about the mechanisms through which early life stressors, such as early life racial discrimination (ELRD), and later life psychosocial resources, such as racial centrality (i.e., importance of Black identity to one's sense of self), interact to shape allostatic load (AL) in adulthood. We evaluate the life course processes linking ELRD, adult racial centrality, and adult AL among older African Americans. RESEARCH DESIGN AND METHODS Data from the Nashville Stress and Health Study included African Americans aged 50 and older (N = 260). Poisson regression models assessed the links between ELRD, adult centrality, and adult AL. Interactions determined whether ELRD conditions the centrality-AL association in adulthood. RESULTS Adolescent ELRD conferred significantly higher levels of adult centrality and 32% increased risk of high adult AL. Greater adult centrality was linked to high adult AL, but the ELRD-adult AL association was not explained by centrality. However, ELRD and centrality interact to shape adult AL, such that racial centrality was protective against high adult AL for those who experienced racial discrimination as children or adolescents. DISCUSSION AND IMPLICATIONS Findings highlight the multiple pathways through which racism-related stressors and psychosocial resources interact to shape physiological dysregulation in later life and underscore the health significance of racial identity for older African Americans. Clinicians and public health professionals should assess early life stressors and foster psychosocial resilience to promote healthy aging.
Collapse
Affiliation(s)
- Courtney S Thomas Tobin
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Ángela Gutiérrez
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
| | - Caryn N Bell
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, Louisiana, USA
| | - Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, John Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
10
|
Thomas Tobin CS, Gutiérrez Á, Norris KC, Thorpe RJ. Discrimination, Racial Identity, and Hypertension Among Black Americans Across Young, Middle, and Older Adulthood. J Gerontol B Psychol Sci Soc Sci 2022; 77:1990-2005. [PMID: 35512278 PMCID: PMC9683505 DOI: 10.1093/geronb/gbac068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Substantial evidence documents the protective role of racial identity-or the meaning and significance that individuals attribute to race-among Black Americans, yet the impact of racial identity on physical health outcomes beyond young adulthood is unclear. To clarify the extent to which racial identity remains influential for physical health across the life course, this study investigated (a) the direct associations between discrimination, racial identity, and hypertension, (b) whether racial identity buffered the negative effects of discrimination, and (c) the extent to which these patterns varied among young (21-35), middle-aged (36-49), and older (>50) Black adults. METHODS Data from the Nashville Stress and Health Study (N = 627) were used to examine two identity dimensions: "racial centrality" (i.e., importance of Black identity to one's sense of self) and "closeness to other Black people" (COBP). Modified Poisson models estimated relationships between racial identity, discrimination, and hypertension. Interactions determined whether racial identity moderated the discrimination-hypertension association within and across age groups. RESULTS High centrality and moderate COBP were directly linked to elevated hypertension odds among young adults, but lower odds among older adults; racial identity was not directly associated with hypertension among middle-aged adults. Results also indicated that racial identity conditioned the discrimination-hypertension relationship in distinct ways across age groups. DISCUSSION Findings underscore the significance of racial identity as sources of both psychosocial vulnerability and resilience for minority aging. Clinicians and public health professionals should consider racial identity beyond young adulthood to promote healthy aging via hypertension management among Black Americans.
Collapse
Affiliation(s)
- Courtney S Thomas Tobin
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Ángela Gutiérrez
- Address correspondence to: Ángela Gutiérrez, PhD, MPH, Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Irvine 128B 57 West Oxbow Trail, 1 Ohio University Drive, Athens, OH 45701-2979, USA. E-mail:
| | - Keith C Norris
- Divisions of Nephrology and General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Roland J Thorpe
- Program for Research on Men’s Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
11
|
Tobin CST, Gutiérrez Á, Erving CL, Norris KC, Thorpe RJ. When Resilience Becomes Risk: A Latent Class Analysis of Psychosocial Resources and Allostatic Load Among African American Men. Am J Mens Health 2022; 16:15579883221104272. [PMID: 35758236 PMCID: PMC9244943 DOI: 10.1177/15579883221104272] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
There is a well-established link between psychosocial risks and psychological health among African American (AA) men. Yet, the psychosocial sources and physical health consequences of resilience (i.e., the ability to maintain good health despite adversity) remain underexplored. Using data from 283 AA men in the Nashville Stress and Health Study, the present study investigated the links between psychosocial resilience and allostatic load (AL), a biological indicator of physiological dysregulation. Latent class analysis (LCA) identified distinct resilience profiles comprising eight psychosocial resources across four categories: coping strategies, sense of control, racial identity, and social support. Analysis of variance (ANOVA) tests determined significant class differences in men’s AL scores. LCA results confirm a four-class model was the best fit: Class 1 (high resources, 32%), Class 2 (high coping but low control, 13%), Class 3 (low resources but high racial identity, 20%), and Class 4 (low resources but high mastery, 34%). Results reveal lower AL (better health) among Classes 1 (m = 0.35) and 4 (m = 0.31) and higher AL (worse health) among Classes 2 (m = 0.44) and 3 (m = 0.44). Findings indicate that the “quality” rather than the “quantity” of psychosocial resources matters for physical health among AA men, as positive health outcomes were observed among both low- and high-resource classes. Results suggest different resource combinations produce distinct patterns of resilience among AA men and underscore the need to further elucidate complex resilience processes among this population.
Collapse
Affiliation(s)
- Courtney S Thomas Tobin
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ángela Gutiérrez
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Christy L Erving
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
| | - Keith C Norris
- Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
12
|
Moreno-Torres V, Gutiérrez Á, Valdenebro M, Ortega A, Cítores MJ, Montero E. Catastrophic antiphospholipid syndrome triggered by mRNA COVID-19 vaccine. Clin Exp Rheumatol 2022; 40:1054-1055. [PMID: 34874824 DOI: 10.55563/clinexprheumatol/s3sbgu] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Víctor Moreno-Torres
- Internal Medicine Service, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHIM) Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
| | - Ángela Gutiérrez
- Internal Medicine Service, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHIM) Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - María Valdenebro
- Department of Nephrology, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHIM) Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Alfonso Ortega
- Intensive Care Department, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHIM) Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - María-Jesús Cítores
- Internal Medicine Service, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHIM) Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Esther Montero
- Internal Medicine Service, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHIM) Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| |
Collapse
|
13
|
Gutiérrez Á, Cain R, Nadine Diaz, Aranda MP. The Digital Divide Exacerbates Disparities in Latinx Recruitment for Alzheimer’s Disease and Related Dementias Online Education During COVID-19. Gerontol Geriatr Med 2022; 8:23337214221081372. [PMID: 35252476 PMCID: PMC8891594 DOI: 10.1177/23337214221081372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 12/07/2021] [Revised: 01/14/2022] [Accepted: 02/01/2022] [Indexed: 12/24/2022] Open
Abstract
Latinx adults experience a high burden of dementia. Given that modifiable factors
drive dementia disparities, engaging Latinxs in Alzheimer’s disease and related
dementias (ADRD) education is critical to address dementia burden among this
aging population. Yet, no studies have documented the role of the COVID-19
pandemic on dementia education among Latinxs. This study: (1) elucidates the
recruitment and retention processes targeting Latinxs for online educational
events during the pandemic; (2) describes facilitators/barriers to
participation; and (3) offers lessons learned. We developed online
dementia-focused workshops (English and Spanish) and employed a cold-calling
approach to invite Latinx participants enrolled in clinical studies
(N = 209). Bivariate tests assessed demographic and
cognitive differences between those who recruiters did (n = 60)
and did not (n = 149) successfully engage. Frequency counts
assessed participants’ technological access. Only 8/209 attended the online
events; all held university degrees, most reported English as their primary
language, and none experienced cognitive impairment. Results underscore how
educational attainment, cognitive impairment, language preference, and age
intersect to shape recruitment in dementia-focused online education. To promote
healthy aging and to ameliorate dementia disparities, barriers to online
engagement among older Spanish-speaking Latinxs with cognitive impairment and
low educational attainment must be addressed.
Collapse
Affiliation(s)
| | - Rosalba Cain
- University of Southern California, Los Angeles, CA, USA
- USC Alzheimer’s Disease Research Center, Los Angeles, CA, USA
| | - Nadine Diaz
- University of Southern California, Los Angeles, CA, USA
- USC Alzheimer’s Disease Research Center, Los Angeles, CA, USA
| | - María P. Aranda
- University of Southern California, Los Angeles, CA, USA
- USC Alzheimer’s Disease Research Center, Los Angeles, CA, USA
| |
Collapse
|
14
|
Moreno-Torres V, de Mendoza C, de la Fuente S, Sánchez E, Martínez-Urbistondo M, Herráiz J, Gutiérrez A, Gutiérrez Á, Hernández C, Callejas A, Maínez C, Royuela A, Cuervas-Mons V. Bacterial infections in patients hospitalized with COVID-19. Intern Emerg Med 2022; 17:431-438. [PMID: 34406633 PMCID: PMC8371593 DOI: 10.1007/s11739-021-02824-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/02/2021] [Indexed: 02/05/2023]
Abstract
Bacterial infections may complicate the course of COVID-19 patients. The rate and predictors of bacterial infections were examined in patients consecutively admitted with COVID-19 at one tertiary hospital in Madrid between March 1st and April 30th, 2020. Among 1594 hospitalized patients with COVID-19, 135 (8.5%) experienced bacterial infectious events, distributed as follows: urinary tract infections (32.6%), bacteremia (31.9%), pneumonia (31.8%), intra-abdominal infections (6.7%) and skin and soft tissue infections (6.7%). Independent predictors of bacterial infections were older age, neurological disease, prior immunosuppression and ICU admission (p < 0.05). Patients with bacterial infections who more frequently received steroids and tocilizumab, progressed to lower Sap02/FiO2 ratios, and experienced more severe ARDS (p < 0.001). The mortality rate was significantly higher in patients with bacterial infections as compared to the rest (25% vs 6.7%, respectively; p < 0.001). In multivariate analyses, older age, prior neurological or kidney disease, immunosuppression and ARDS severity were associated with an increased mortality (p < 0.05) while bacterial infections were not. Conversely, the use of steroids or steroids plus tocilizumab did not confer a higher risk of bacterial infections and improved survival rates. Bacterial infections occurred in 8.5% of patients hospitalized with COVID-19 during the first wave of the pandemic. They were not independently associated with increased mortality rates. Baseline COVID-19 severity rather than the incidence of bacterial infections seems to contribute to mortality. When indicated, the use of steroids or steroids plus tocilizumab might improve survival in this population.
Collapse
Affiliation(s)
- Víctor Moreno-Torres
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
| | - Carmen de Mendoza
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
- CEU-San Pablo, University, Madrid, Spain.
| | - Sara de la Fuente
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Enrique Sánchez
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | - Jesús Herráiz
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Andrea Gutiérrez
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Ángela Gutiérrez
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Carlos Hernández
- Pharmacy Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Alejandro Callejas
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Carmen Maínez
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Ana Royuela
- Clinical Biostatistics Unit, Health Research Institute Puerta de Hierro-Segovia de Arana, CIBERESP, Madrid, Spain
| | - Valentín Cuervas-Mons
- Internal Medicine Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
| |
Collapse
|
15
|
Cabezón G, López J, Vilacosta I, Sáez C, García-Granja PE, Olmos C, Jerónimo A, Gutiérrez Á, Pulido P, de Miguel M, Gómez I, San Román JA. Reassessment of vegetation size as a sole indication for surgery in left-sided infective endocarditis. J Am Soc Echocardiogr 2021; 35:570-575. [PMID: 34971762 DOI: 10.1016/j.echo.2021.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 04/14/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Guidelines recommend surgery in left-sided infective endocarditis (LSIE) associated with large vegetations. Given that most patients who undergo surgery also have other indications (heart failure and/or uncontrolled infection), it is not settled whether surgery should be routinely recommended in patients with large vegetations but no other predictors of poor outcome. METHODS A total of 726 patients with definitive LSIE were included in our analysis. Mean age was 64.9 years, 61% were male. Multivariate analysis of all patients was performed to determine if vegetation size is related to death in LSIE. Then, patients were divided in two groups according to vegetation size: Group A (>10 mm, n=420) and group B (≤10 mm, n=306). Univariate and multivariate analyses of group A patients were carried out to identify the variables related to death in this group. Impact of surgery on mortality of group A patients without heart failure or uncontrolled local infection (n=139) was assessed. RESULTS Age, Staphylococcus aureus, perivalvular complications, heart failure, kidney failure and septic shock, but not vegetation size, were associated with death. Patients with large vegetations showed increased mortality (31.7% in group A vs 24.8% in group B, p=0.045). Group A had more valve rupture and valve regurgitation than group B, but heart failure (55% vs 53%, p=0.678), stroke (22% vs 17.0%, p=0.091), systemic embolism (39% vs 32%, p=0.074), perivalvular complication (28% vs 28%, p=0.865) or septic shock (15% vs 13%, p=0.288) were similar in both groups. In patients from group A without heart failure or uncontrolled infection mortality was similar with and without surgery (n=139; n=70 with surgery, n=69 without surgery; mortality 18.6% vs 11.6% respectively, p=0.251). CONCLUSIONS large vegetations identify patients with poor outcome in LSIE. However, surgery is not associated with a better prognosis in patients with large vegetations if they do not present with another predictor of poor outcome such as heart failure or uncontrolled infection. These findings challenge whether vegetation size alone should be an indication for surgery in LSIE.
Collapse
Affiliation(s)
- Gonzalo Cabezón
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico, Valladolid, Spain. Ciber de enfermedades cardiovasculares (CIBERCV).
| | - Javier López
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico, Valladolid, Spain. Ciber de enfermedades cardiovasculares (CIBERCV)
| | - Isidre Vilacosta
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Carmen Sáez
- Hospital Universitario la Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de la Princesa (IIS-IP) Madrid, Spain
| | - Pablo Elpidio García-Granja
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico, Valladolid, Spain. Ciber de enfermedades cardiovasculares (CIBERCV)
| | - Carmen Olmos
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Adrián Jerónimo
- Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), Madrid, Spain
| | - Ángela Gutiérrez
- Hospital Universitario la Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de la Princesa (IIS-IP) Madrid, Spain
| | - Paloma Pulido
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico, Valladolid, Spain. Ciber de enfermedades cardiovasculares (CIBERCV)
| | - María de Miguel
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico, Valladolid, Spain. Ciber de enfermedades cardiovasculares (CIBERCV)
| | - Itzíar Gómez
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico, Valladolid, Spain. Ciber de enfermedades cardiovasculares (CIBERCV)
| | - J Alberto San Román
- Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico, Valladolid, Spain. Ciber de enfermedades cardiovasculares (CIBERCV)
| |
Collapse
|
16
|
Gutiérrez Á, Young MEDT, Dueñas M, García A, Márquez G, Chávez ME, Ramírez S, Rico S, Bravo RL. Laboring With the Heart: Promotoras' Transformations, Professional Challenges, and Relationships With Communities. Fam Community Health 2021; 44:162-170. [PMID: 33284157 DOI: 10.1097/fch.0000000000000286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Little is known about promotoras' professional experiences engaging in Latinx health promotion. In this promotora-led community-based participatory study, we purposively recruited and interviewed 30 Spanish-speaking promotoras who worked in Los Angeles County and who had at least 5 years of experience as promotoras. Using a constructivist grounded theory approach, findings revealed promotoras self-identified as health professionals who offered unique, insider perspectives. Challenges arose as employers viewed promotoras as volunteer lay health workers, while promotoras desired opportunities for professional growth. Motivation to continue working as promotoras stemmed from their commitment to Latinx communities. We provide recommendations to strengthen community-based capacity for advancing Latinx health.
Collapse
Affiliation(s)
- Ángela Gutiérrez
- USC Edward R. Roybal Institute on Aging, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, California (Dr Gutiérrez); Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced (Dr Young); Corazón y Carácter , Los Angeles, California (Mss Dueñas, García, Márquez, Chávez, Ramírez, and Rico); and Department of Health Sciences Education, College of Health Sciences, Western University of Health Sciences, Pomona, California (Dr Bravo)
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Gutiérrez Á, Guerrero LR, McCreath HE, Wallace SP. Mentoring Experiences and Publication Productivity among Early Career Biomedical Investigators and Trainees. Ethn Dis 2021; 31:273-282. [PMID: 33883868 DOI: 10.18865/ed.31.2.273] [Citation(s) in RCA: 3] [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: 11/18/2022] Open
Abstract
Objective To identify which mentoring domains influence publication productivity among early career researchers and trainees and whether publication productivity differs between underrepresented minority (URM) and well-represented groups (WRGs). The mentoring aspects that promote publication productivity remain unclear. Advancing health equity requires a diverse workforce, yet URM trainees are less likely to publish and URM investigators are less likely to obtain federal research grants, relative to WRG counterparts. Methods A mentoring-focused online follow-up survey was administered to respondents of the NRMN Annual Survey who self-identified as mentees. Publications were identified from a public database and validated with participant CV data. Bivariate and multivariate analyses tested the associations of publication productivity with mentoring domains. Results URM investigators and trainees had fewer publications (M = 7.3) than their WRG counterparts (M = 13.8). Controlling for career stage and social characteristics, those who worked on funded projects, and received grant-writing or research mentorship, had a higher probability of any publications. Controlling for URM status, gender, and career stage, mentorship on grant-writing and funding was positively associated with publication count (IRR=1.72). Holding career stage, gender, and mentoring experiences constant, WRG investigators and trainees had more publications than their URM counterparts (IRR=1.66). Conclusions Grant-writing mentorship is particularly important for publication productivity. Future research should investigate whether grant-writing mentorship differentially impacts URM and WRG investigators and should investigate how and why grant-writing mentorship fosters increased publication productivity.
Collapse
Affiliation(s)
- Ángela Gutiérrez
- USC Roybal Institute on Aging and USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
| | - Lourdes R Guerrero
- Department of Medicine, Division of Geriatrics and Division of Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Heather E McCreath
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine
| | | |
Collapse
|
18
|
Julián C, Huybrechts I, Gracia-Marco L, González-Gil EM, Gutiérrez Á, González-Gross M, Marcos A, Widhalm K, Kafatos A, Vicente-Rodríguez G, Moreno LA. Mediterranean diet, diet quality, and bone mineral content in adolescents: the HELENA study. Osteoporos Int 2018; 29:1329-1340. [PMID: 29508038 DOI: 10.1007/s00198-018-4427-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 02/06/2018] [Indexed: 10/17/2022]
Abstract
Dietary scores, rather than individual nutrients, allow exploring associations between overall diet and bone health. The aim of the present study was to assess the associations between the Mediterranean Diet Score for Adolescents (MDS-A) and the Diet Quality Index for Adolescents (DQI-A) and bone mineral content (BMC) among Spanish adolescents. Our results do not support an association between dietary scores or indices and BMC in adolescents. INTRODUCTION To assess the associations between the MDS-A and a DQI-A with the BMC measured with dual-energy X-ray absorptiometry. METHODS The MDS-A and the DQI-A were calculated in 179 Spanish adolescents, based on two 24-h dietary recalls from the HELENA cross-sectional study. The associations between the diet scores and the BMC outcomes [total body less head (TBLH), femoral neck (FN), lumbar spine (LS), and hip] were analyzed using logistic regression models adjusting for several confounders. RESULTS Four hundred ninety-two models were included and only fruits and nuts and cereal and roots were found to provide significant ORs with regard to BMC. The risk of having low BMC reduced by 32% (OR 0.684; CI 0.473-0.988) for FN when following the ideal MDS-A, but this association lost significance when adjusting for lean mass and physical activity. For every 1-point increase in the cereal and root and the fruit and nut components, the risk of having low FN diminished by 56% (OR 0.442; CI 0.216-0.901) and by 67% (OR 0.332; CI 0.146-0.755), respectively. CONCLUSION An overall dietary score or index is not associated with BMC in our adolescent Spanish sample.
Collapse
Affiliation(s)
- C Julián
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, Zaragoza, Spain.
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain.
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - I Huybrechts
- International Agency for Research on Cancer, Lyon, France
| | - L Gracia-Marco
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, Zaragoza, Spain
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - E M González-Gil
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Á Gutiérrez
- Department of Physiology, School of Medicine, University of Granada, Granada, Spain
| | - M González-Gross
- ImFine Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - A Marcos
- Department of Metabolism and Nutrition, ICTAN Spanish National Research Council, Madrid, Spain
| | - K Widhalm
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - A Kafatos
- Preventive Medicine and Nutrition Unit, University of Crete School of Medicine, Heraklion, Greece
| | - G Vicente-Rodríguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, Zaragoza, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, Pedro Cerbuna 12, 50007, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| |
Collapse
|
19
|
Henriksson P, Henriksson H, Labayen I, Huybrechts I, Gracia-Marco L, Ortega FB, España-Romero V, Manios Y, González-Gross M, Marcos A, Moreno LA, Gutiérrez Á, Ruiz JR. Correlates of ideal cardiovascular health in European adolescents: The HELENA study. Nutr Metab Cardiovasc Dis 2018; 28:187-194. [PMID: 29241667 DOI: 10.1016/j.numecd.2017.10.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 05/10/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS The ideal cardiovascular health (iCVH) construct consists of 4 health behaviors (smoking status, body mass index, physical activity and diet) and 3 health factors (total cholesterol, blood pressure and fasting glucose). A greater number of iCVH components in adolescence are related to better cardiovascular health, but little is known about the correlates of iCVH in adolescents. Thus, the aim of the study was to examine correlates of iCVH in European adolescents. METHODS AND RESULTS The study comprised 637 European adolescents with complete iCVH data. Participants were part of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional, multicenter study conducted in 9 different European countries. Correlates investigated were sex and age, family affluence scale, maternal education, geographic location, sleep time, television viewing, duration of pregnancy, birth weight and breastfeeding. Younger adolescents, those whose mothers had medium/high education or those who watched television less than 2 h per day had a greater number of iCVH components compared to those who were older, had a mother with low education or watched television 2 h or more daily (P ≤ 0.01). CONCLUSION Since in our study older adolescents had worse iCVH than younger adolescents, early promotion of cardiovascular health may be important. Future studies may also investigate the usefulness of limiting television viewing to promote iCVH. Finally, since adolescents of mothers with low education had poorer iCVH, it may be of special interest to tailor public health promotion to adolescents from families with low socioeconomic status.
Collapse
Affiliation(s)
- P Henriksson
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.
| | - H Henriksson
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - I Labayen
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Spain
| | - I Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - L Gracia-Marco
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Children's Health and Exercise Research Centre (CHERC), Sport and Health Sciences, University of Exeter, Exeter, UK
| | - F B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - V España-Romero
- Department of Physical Education, School of Education, University of Cádiz, Spain
| | - Y Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - M González-Gross
- ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain; CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (ISCIII), Spain
| | - A Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frio, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Spain
| | - Á Gutiérrez
- Department of Medical Physiology, School of Medicine, University of Granada, Spain
| | - J R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
20
|
Olmos C, Vilacosta I, Habib G, Maroto L, Fernández C, López J, Sarriá C, Salaun E, Di Stefano S, Carnero M, Hubert S, Ferrera C, Tirado G, Freitas-Ferraz A, Sáez C, Cobiella J, Bustamante-Munguira J, Sánchez-Enrique C, García-Granja PE, Lavoute C, Obadia B, Vivas D, Gutiérrez Á, San Román JA. Risk score for cardiac surgery in active left-sided infective endocarditis. Heart 2017; 103:1435-1442. [DOI: 10.1136/heartjnl-2016-311093] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 11/03/2022] Open
|
21
|
Gutiérrez Á. Affordable Care Act. CALIF J HEALTH PROMOT 2014. [DOI: 10.32398/cjhp.v12i3.1575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
22
|
Luis G, Hernández C, Rubio C, González-Weller D, Gutiérrez Á, Revert C, Hardisson A. Trace elements and toxic metals in intensively produced tomatoes (lycopersicon esculentum). NUTR HOSP 2013; 27:1605-9. [PMID: 23478712 DOI: 10.3305/nh.2012.27.5.5944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 07/01/2012] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Tomato is considered a healthy food due to its high content in lycopene and other health-promoting natural compounds. Tomatoes have, undoubtedly, assumed the status of a food with functional properties, considering the epidemiological evidence of reducing the risk of certain types of cancers. OBJECTIVE Samples of tomatoes from Morocco were analyzed for the mineral composition. METHODS 94 tomato samples from Morocco were analyzed. Flame Atomic Absorption Spectrophotometry (FAAS) was used to determine essential elements (Copper (Cu), iron (Fe), manganese (Mn) and zinc (Zn)) and Atomic Absorption Spectrophotometry with Graphite Furnace (GAAS) was used to analyzed cadmium (Cd) and lead (Pb). RESULTS The mean concentrations were 0.17 mg/kg, 0.73 mg/kg, 0.20 mg/kg, 0.44 mg/kg, 7.58 μg/kg and 15.8 μg/kg for Cu, Fe, Mn, Zn, Cd and Pb, respectively. The highest contribution to the intakes was observed for Cu (0.67% for adults) while that Zn showed the lowest contribution (0.14% for adult males and 0.20% for adult females). CONCLUSIONS Tomatoes are a good source of essential elements for the diet, mainly iron and zinc. Tomatoes consumption does not significantly affect the intake of heavy metals.
Collapse
Affiliation(s)
- G Luis
- Department of Toxicology, University of La Laguna, Tenerife, Spain
| | | | | | | | | | | | | |
Collapse
|
23
|
Real de Asúa D, Costa R, Contreras M, Gutiérrez Á, Filigghedu M, Armas M. Clinical characteristics of patients with systemic amyloidosis from 2000–2010. Rev Clin Esp 2013. [DOI: 10.1016/j.rceng.2012.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
24
|
Real de Asúa D, Costa R, Contreras MM, Gutiérrez Á, Filigghedu MT, Armas M. Clinical characteristics of the patients with systemic amyloidosis in 2000-2010. Rev Clin Esp 2012; 213:186-93. [PMID: 23246354 DOI: 10.1016/j.rce.2012.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 08/14/2012] [Accepted: 09/10/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The epidemiology of systemic amyloidosis has been changing in the last decades. We aim to describe the clinical characteristics of the patients seen at our institution with systemic amyloidosis in 2000-2010 and compare them with previous Spanish series. PATIENTS AND METHODS An observational, retrospective study was performed on all patients admitted to a tertiary hospital in Madrid, Spain who had been diagnosed of amyloidosis from January 2000 to December 2010. Patients without a proven diagnosis of amyloidosis, with dialysis-associated, senile, or localized forms of amyloidosis were excluded from the study. A systematic review was made of the clinical records, collecting the demographic, clinical and biochemical variables at diagnosis and patients' outcome. RESULTS A total of 55 patients were studied, 24 (44%) of whom had AL amyloidosis, 30 (56%) AA amyloidosis, and 1 a familiar form. The most frequent underlying disorders were rheumatoid arthritis (9 patients, 30%) and ankylosing spondylitis (4 cases, 13%). The kidneys were the most frequently involved organ (36 patients, 67%) with nephrotic-range proteinuria at diagnosis (3.4 ± 3.7 g/24 h). Median time to diagnosis was 3 months (interquartile range [IQR]: 1-17). Median follow-up time was 24 months (IQR: 10-91). During follow-up 31 patients died; 18 of those deaths were related to amyloidosis. CONCLUSIONS Renal dysfunction dominates the course of systemic amyloidosis, which does not seem to have changed in the last decades. We have observed an important delay in the diagnosis of these processes. Therefore, it is necessary to maintain a high degree of clinical suspicion regarding these conditions.
Collapse
Affiliation(s)
- D Real de Asúa
- Servicio de Medicina Interna, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, Madrid, Spain.
| | | | | | | | | | | |
Collapse
|
25
|
Rubio C, Gutiérrez Á, Burgos A, Hardisson A. Total dietary intake of mercury in the Canary Islands, Spain. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2008; 25:946-52. [DOI: 10.1080/02652030801993597] [Citation(s) in RCA: 21] [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] [Indexed: 10/21/2022]
|