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Vivoda J, Cao J, Harmon A. HOW DRIVING STRESS, CONFIDENCE, AND THOUGHTS ABOUT DRIVING ALTERNATIVES AFFECT TRANSPORTATION PLANNING. Innov Aging 2019. [PMCID: PMC6846470 DOI: 10.1093/geroni/igz038.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although many older adults will eventually not be able to safely drive themselves, comprehensive planning for a non-driving future is infrequent. To better understand the factors that predict transportation planning, the role played by several different aspects of driving were assessed. We analyzed whether stress about driving, enjoyment of driving, driving confidence, recent experience with negative driving events, and thoughts about how well other transportation modes could meet one’s future needs played a role in planning. Age, gender, race, and income were also controlled for in the models. More transportation planning was significantly associated with experiencing driving as more stressful and with reporting less confidence in one’s driving skills. Level of driving enjoyment and the number of concerning driving events experienced during the past year (e.g., crash, near crash, driving conversations, health issues, etc.) were not significantly related to planning. Respondents were also asked about how well other transport modes (e.g., rides with other drivers, buses, light rail, taxis, etc.) could meet their needs when they can no longer drive. This factor explained more of the variance in the planning outcome than any of the other factors, with a larger number associated with more planning. This result suggests that engaging in more planning may be associated with an openness to non-driving options, but it is unclear if that is a result of more planning, or a precursor to this activity.
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Affiliation(s)
| | - Jiawei Cao
- Miami University, Oxford, Ohio, United States
| | - Annie Harmon
- Washington University, St. Louis, Missouri, United States
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Babulal GM, Stout SH, Williams MM, Rajasekar G, Harmon A, Vivoda J, Zuelsdorff M, Benzinger TLS, Morris JC, Ances B, Roe CM. Differences in Driving Outcomes Among Cognitively Normal African American and Caucasian Older Adults. J Racial Ethn Health Disparities 2019; 7:269-280. [PMID: 31686371 DOI: 10.1007/s40615-019-00655-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the effect of race in driving performance and behavior prospectively among cognitively normal older adults. METHODS Cognitively normal participants (Clinical Dementia Rating 0), ≥ 65 years of age (n = 177) were selected from prospective, longitudinal studies at the Knight Alzheimer Disease Research Center at Washington University. Self-reported driving behavior (Driving Habits Questionnaire) and driving performance (road test) were annually assessed. Daily driving behavior data were collected using the Driving Real World In-Vehicle Evaluation System (DRIVES). Baseline differences between African Americans and Caucasians were tested using t tests and general linear models. Amyloid imaging and cerebrospinal fluid Alzheimer disease (AD) biomarkers were compared across groups. Linear mixed models examined change in daily driving behavior over time. Survival analyses tested time to a marginal or fail rating on the road test. RESULTS There were no differences between African Americans (n = 34) and Caucasians (n = 143) in age, sex, education, or vascular risk factors. Baseline self-reported driving behavior and road test performance were largely similar for both races. Longitudinal analyses using the DRIVES data aggregated monthly showed that African Americans had a greater reduction in number of trips made per month, miles driven per month, and trips with aggressive behavior compared to Caucasians. These effects remained after controlling for AD biomarkers, age, education, and sex. CONCLUSIONS In this sample of cognitively normal older adults, African Americans had a greater reduction of daily driving behavior compared to Caucasians. Observed racial differences may reflect differences in environmental/social factors, changes in cognition, and/or physical functioning.
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Affiliation(s)
- Ganesh M Babulal
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, 660 S. Euclid Ave., Campus Box, St. Louis, MO, 8111, USA. .,Department of Neurology, Washington University, St. Louis, MO, USA.
| | - Sarah H Stout
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, 660 S. Euclid Ave., Campus Box, St. Louis, MO, 8111, USA.,Department of Neurology, Washington University, St. Louis, MO, USA
| | | | - Ganesh Rajasekar
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, 660 S. Euclid Ave., Campus Box, St. Louis, MO, 8111, USA.,Department of Neurology, Washington University, St. Louis, MO, USA
| | - Annie Harmon
- Department of Medicine, Washington University, St. Louis, MO, USA
| | | | | | - Tammie L S Benzinger
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, 660 S. Euclid Ave., Campus Box, St. Louis, MO, 8111, USA.,Department of Radiology, Washington University, St. Louis, MO, USA.,Department of Neurosurgery, Washington University, St. Louis, MO, USA
| | - John C Morris
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, 660 S. Euclid Ave., Campus Box, St. Louis, MO, 8111, USA.,Department of Neurology, Washington University, St. Louis, MO, USA.,Department of Radiology, Washington University, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA.,Department of Pathology and Immunology, Washington University, St. Louis, MO, USA.,Department of Physical Therapy, Washington University, St. Louis, MO, USA.,Department of Occupational Therapy, Washington University, St. Louis, MO, USA
| | - Beau Ances
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, 660 S. Euclid Ave., Campus Box, St. Louis, MO, 8111, USA.,Department of Neurology, Washington University, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA
| | - Catherine M Roe
- Charles F. and Joanne Knight Alzheimer's Disease Research Center, 660 S. Euclid Ave., Campus Box, St. Louis, MO, 8111, USA.,Department of Neurology, Washington University, St. Louis, MO, USA
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Babulal GM, Vivoda J, Harmon A, Carr DB, Roe CM, Zikmund-Fisher B. Older Adults' Expectations about Mortality, Driving Life and Years Left without Driving. J Gerontol Soc Work 2019; 62:912-929. [PMID: 31526111 PMCID: PMC7081168 DOI: 10.1080/01634372.2019.1663460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 05/31/2023]
Abstract
People are living and driving longer than ever before, with little preparation for transitioning to being non-drivers. We investigated driving expectations among drivers age 65 and older, including sociodemographic and driving context predictors. Cross-sectional data from 349 older drivers were explored to determine variation in how many years they expected to continue driving. General linear models examined predictors of both expectations. In this predominantly Black/African American sample, 76% of older drivers (mean age = 73 ± 5.7 years) expected a non-driving future, forecasting living an average of 5.75 ± 7.29 years after driving cessation. Regression models on years left of driving life and years left to live post-driving cessation predicted nearly half of the variance in older drivers' expectations with five significant predictors: income, current age, age expected to live to, self-limiting driving to nearby places and difficulty, visualizing being a non-driver. Many older drivers expect to stop driving before end of life.
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Affiliation(s)
- Ganesh M. Babulal
- Department of Neurology and Division of Geriatrics and Nutritional Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jonathon Vivoda
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Annie Harmon
- Department of Neurology and Division of Geriatrics and Nutritional Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - David B. Carr
- Department of Neurology and Division of Geriatrics and Nutritional Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Catherine M. Roe
- Department of Neurology and Division of Geriatrics and Nutritional Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Brian Zikmund-Fisher
- Department of Health Behavior & Health Education, University of Michigan, Ann Arbor, Michigan, USA
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Affiliation(s)
- D. Kandasamy
- University of Michigan-Flint, Flint, Michigan,
- University of Colorado-Denver, Denver, Colorado,
| | - D.B. Carr
- Washington University in St. Louis, St. Louis, Missouri,
| | - T.M. Meuser
- University of Missouri-Saint Louis, St. Louis, Missouri
| | - A. Harmon
- Washington University in St. Louis, St. Louis, Missouri,
| | - M. Betz
- University of Colorado-Denver, Denver, Colorado,
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Abstract
Purpose of the Study. Adult children are often directly affected by aging parents’ decision to limit or stop driving. This qualitative study examined the process of driving reduction and cessation (DRC) from the perspective of adult children, with a focus on family communication. Design and Methods. Four focus group interviews were conducted with 37 adult children (29/37 female; mean age = 45.5) of older parents using a structured protocol. Transcripts were analyzed by two independent coders to identify major themes. Results. Themes represented three aspects of the DRC process: family communication and dynamics (i.e., discussion, negotiation, and planning; avoidance and side stepping; resignation and refusal), taking action to end a parent’s driving career (i.e., engaging a third party; taking away the car), and post-cessation reflection (i.e., relief; social benefits; resentment and guilt). Implications. Despite the potential benefits of planning for DRC, families are unsure about how best to approach this topic. Adult children worry about assuming responsibility for their parents’ transportation needs and their parents’ reactions to restricted mobility. Despite a reluctance to communicate openly about DRC, adult children and their parents share similar and significant concerns that merit increased attention.
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Affiliation(s)
| | - Annie Harmon
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Mary R. Janevic
- University of Michigan School of Public Health, Ann Arbor, MI, USA
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Poda A, Bednar A, Kennedy A, Harmon A, Hull M, Mitrano D, Ranville J, Steevens J. Characterization of silver nanoparticles using flow-field flow fractionation interfaced to inductively coupled plasma mass spectrometry. J Chromatogr A 2011; 1218:4219-25. [DOI: 10.1016/j.chroma.2010.12.076] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 12/15/2010] [Accepted: 12/16/2010] [Indexed: 11/25/2022]
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Abstract
We report a case of stridor in a 32 year old woman. Initial laryngoscopy demonstrated adduction of the vocal cords on inspiration, which reverted to abduction on induction of general anaesthesia. The airway was structurally normal. The most likely diagnosis was paradoxical vocal cord motion, a condition in which psychological stress can precipitate respiratory symptoms and signs due to involuntary adduction of the vocal cords during inspiration. Its importance to the anaesthetist lies in its ability to masquerade as a serious airway or respiratory condition.
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Affiliation(s)
- A Harmon
- Wesley Anaesthesia and Pain Management, Wesley Hospital, Brisbane, Queensland, Australia
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Zheng Y, Prouty SM, Harmon A, Sundberg JP, Stenn KS, Parimoo S. Scd3--a novel gene of the stearoyl-CoA desaturase family with restricted expression in skin. Genomics 2001; 71:182-91. [PMID: 11161812 DOI: 10.1006/geno.2000.6429] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Stearoyl-coenzyme A (CoA) desaturase (SCD) is a key enzyme involved in the conversion of saturated fatty acids into monounsaturated fatty acids. Previously, two members of this gene family, namely, Scd1 and Scd2, have been reported. Here we report the identification and characterization of a novel member of this family, Scd3, whose expression is restricted to mouse skin, specifically to the sebaceous gland. The Scd3 gene codes for a transcript of approximately 4.9 kb with an open reading frame that results in a 359-amino-acid protein. Scd3 shares 91 and 88% identity in the protein-coding region with Scd1 and Scd2, respectively, and maps to mouse chromosome 19 in very close proximity to Scd1 and Scd2. Unlike Scd1, Scd3 expression is higher in male mouse skin than in female mouse skin. The promoter sequence of Scd3 reveals similarity with Scd1 in the proximal region but also possesses several distinctive features including the polyunsaturated fatty acid-response element. Scd3 is expressed in the skin of young asebia mutant mice (Scd1(ab2J)/Scd1(ab2J)) in the absence of Scd1. Scd3 expression changes during the mouse hair cycle but not as dramatically as Scd1. The tissue-specific and sex-dependent expression of Scd3 suggests the presence of gene- and hormonal-specific control mechanisms.
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Affiliation(s)
- Y Zheng
- Johnson & Johnson Skin Biology TRC, Grandview Road, Skillman, New Jersey 08558, USA
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Greenberg BD, Ziemann U, Corá-Locatelli G, Harmon A, Murphy DL, Keel JC, Wassermann EM. Altered cortical excitability in obsessive-compulsive disorder. Neurology 2000; 54:142-7. [PMID: 10636140 DOI: 10.1212/wnl.54.1.142] [Citation(s) in RCA: 201] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess cortical inhibitory and excitatory mechanisms in obsessive-compulsive disorder (OCD). BACKGROUND Transcranial magnetic stimulation (TMS) studies have found decreased neuronal inhibition and a reduced cortical silent period in the primary motor area in Tourette's syndrome, focal dystonia, and other disorders believed to involve dysfunction of subcortical structures, including the basal ganglia. Dysfunction of the basal ganglia and linked regions also has been implicated in OCD, which has significant clinical and familial overlap with tic disorders. METHODS We applied the TMS techniques previously used in Tourette's syndrome to a group of 16 OCD patients (seven unmedicated) and 11 age-matched healthy volunteers extensively screened for psychopathology. Measures of motor cortex excitability included resting and active motor threshold, cortical silent period duration, and intracortical inhibition and facilitation using a paired-pulse TMS technique with a subthreshold conditioning stimulus. RESULTS Similar to recent findings in Tourette's syndrome and focal dystonia, this study reports significantly decreased intracortical inhibition (ICI) relative to the volunteers at interstimulus intervals from 2 to 5 msec. We also found decreased active and resting motor evoked potential threshold in the OCD patients, another indication of increased cortical excitability. Neither abnormality appeared medication related. The decreases in ICI and motor threshold were greatest in OCD patients with comorbid tics, but remained significant in patients without tics. CONCLUSIONS The data suggest abnormal cortical excitability in obsessive-compulsive disorder. These findings are congruent with the hypothesis that Tourette's syndrome and obsessive-compulsive disorder (OCD) are analogous disorders with overlapping dysfunction in corticobasal circuits. Patients with tic-related OCD may have more abnormal motor cortex excitability than OCD patients without tics.
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Affiliation(s)
- B D Greenberg
- Adult OCD Research Unit, Laboratory of Clinical Science, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-1264, USA
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Abstract
The costs of providing oncology services in three different ways were measured. Services were provided to a peripheral hospital by: conventional clinics, in which the oncologist worked at the hospital concerned; outreach clinics, in which an oncologist was flown in periodically from a central hospital; telemedicine clinics, in which the oncologist at the central hospital practised via a video-link. During a one-year study period, 2400 patients were seen in conventional clinics, 81 in outreach clinics and 103 in telemedicine clinics. At these workloads the average costs per patient were $149, $897 and $812, respectively. However, the average costs cannot be compared directly without further information about the shape of the unit cost curves.
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Affiliation(s)
- G C Doolittle
- Division of Clinical Oncology, University of Kansas Medical Center, Kansas City 66160-7353, USA.
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Greenberg BD, Ziemann U, Harmon A, Murphy DL, Wassermann EM. Decreased neuronal inhibition in cerebral cortex in obsessive-compulsive disorder on transcranial magnetic stimulation. Lancet 1998; 352:881-2. [PMID: 9742988 DOI: 10.1016/s0140-6736(05)60009-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Costs were monitored for three different types of oncology practice: a telemedicine clinic and a fly-in outreach clinic, both held in rural areas, and a traditional clinic held in a city hospital. Total expenses were calculated over the year May 1995 to April 1996. The average cost per telemedicine visit was $812. The average cost per outreach clinic visit was $897. Flying in oncology support for this practice was therefore about 10% more costly than telemedicine. While the outreach cost may have been inappropriately high due to a slow start-up phase, it was still less expensive during this period to be seen via telemedicine. For comparison, the average cost per traditional oncology clinic visit was $149. However, this figure does not take into account the costs of access to a city-based service by rural patients.
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Affiliation(s)
- G C Doolittle
- University of Kansas Medical Center, Kansas City, USA.
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Sangster TC, Britt HC, Fields DJ, Hansen LF, Lanier RG, Namboodiri MN, Remington BA, Webb ML, Begemann-Blaich M, Blaich T, Fowler MM, Wilhelmy JB, Chan YD, Dacal A, Harmon A, Pouliot J, Stokstad RG, Kaufman S, Videbaek F, Fraenkel Z, Peilert G, Stöcker H, Greiner W, Botvina A, Mishustin IN. Intermediate mass fragment emission in Fe+Au collisions. Phys Rev C Nucl Phys 1992; 46:1404-1415. [PMID: 9968248 DOI: 10.1103/physrevc.46.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Begemann-Blaich M, Blaich T, Fowler MM, Wilhelmy JB, Britt HC, Fields DJ, Hansen LF, Lanier RG, Massoletti DJ, Namboodiri MN, Remington BA, Sangster TC, Struble GL, Webb ML, Chan YD, Dacal A, Harmon A, Pouliot J, Stokstad RG, Kaufman S, Videbaek F, Fraenkel Z. Fission from Fe and Nb reactions with heavy targets at 50-100 MeV/nucleon. Phys Rev C Nucl Phys 1992; 45:677-688. [PMID: 9967803 DOI: 10.1103/physrevc.45.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Griboff SI, Harmon A, Nester MF. The community hospital and job training. Med Times 1970; 98:116-8. [PMID: 5506733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Harmon A. The broadening scope of purchasing authority. Hospitals 1966; 40:124-30. [PMID: 5917242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Harmon A. Psychologie du Militaire Professionnel. The American Journal of Psychology 1895. [DOI: 10.2307/1411224] [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: 11/10/2022]
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