Related Changes Research Articles

What explains the growth in hospital assets from 2000 through 2019? A decomposition analysis.

Understanding disparities in hospital finances is essential for ensuring equitable systems of care. One understudied element is total assets, which include both financial and capital resources that hospitals acquire. We evaluated changes and drivers of variation in US hospital assets from 2000 through 2019 using data from the Centers for Medicare and Medicaid Services and American Hospital Association Annual Survey. We decomposed overall variation in total assets to determine the level (hospital, health system, or health care market) that contributed most to variation, and examined the extent to which asset growth was associated with changes in common inputs to hospital wealth vs changing relationships with these inputs or other unmeasured factors. Total assets held by US hospitals increased from $750 billion in 2000 to $1.6 trillion in 2019. Most variation occurred between hospitals, such that high-asset hospitals tended to remain high-asset and low-asset hospitals remained low-asset. Most of the increase in assets was due to unmeasured factors (ie, not patient revenue). We conclude that hospital wealth in the form of assets has grown substantially over time and accrued primarily to wealthy hospitals. Policymakers should consider broader measures of hospital wealth when targeting financial resources and efforts to strengthen data on hospital financing.

Change in Metabolic Markers and the Risk of Skin Cancer: Results from the Lifelines Cohort Study in the Netherlands.

Skin-cancers are the most common cancers in Caucasians, and their incidence is rising. Although metabolic and anthropometric markers play a role in cancer development, the relationship of metabolic and anthropometric changes with skin-cancer remains unclear. This study aimed to examine possible associations between these changes and the risk of skin-cancer. Participants without prior skin-cancer history from the Northern-Netherlands representative of the general population were included. Histopathology data were obtained from the Dutch Nationwide Pathology-Database. Adjusted-Cox-regression analyzed associations between metabolic changes and time to pathology-confirmed skin-cancer incidence over a 7-year follow-up, assessing overall skin-cancer risk and subtypes, including melanoma and non-melanoma skin-cancer. Out of 97,106 participants, 4,195 (4.3%) developed skin-cancer. Body-mass-index (BMI) decrease and increase were both associated with lower skin-cancer risk: adjusted-hazard-ratios(aHR) of 0.88(0.80-0.98) and 0.78(0.72-0.86), respectively. Triglyceride and waist-to-hip ratio (WHR)decreases were also associated with lower risk: aHR: 0.89(0.80-0.98) and 0.89(0.83-0.98), respectively. Increase in HbA1c was associated with higher risk in individuals under 45 years at baseline: aHR: 1.21(1.01-1.45). Subtype-analysis showed an increase in BMI was associated with lower melanoma risk: aHR: 0.72(0.58-0.91). Changes in BMI and decrease in triglycerides and WHR are related to lower skin-cancer risk, whereas increase in HbA1c may elevate risk in individuals younger than 45 at baseline. These findings highlight the importance of non-sunlight-related risk factors for skin-cancer prevention and the need for further research into underlying mechanisms. This study contributes to the broader understanding of how metabolic health impacts skin-cancer development, offering potential avenues for targeted prevention strategies.

Relationship between influenza-related experience and current vaccination outcome

BackgroundThis study investigated how a person’s influenza-related experience, together with demographic, socioeconomic, and health-related factors, was associated with their current vaccination decisions.MethodsThe analysis used ten panels of the Medical Expenditure Panel Survey (MEPS) from 2006 to 2016. Linear and logistic probability models were estimated to predict influenza vaccination using a person’s vaccination status in the previous year and history of influenza infection, adjusting for demographics, socioeconomic variables, general health status, and healthcare access. The models used two-way and three-way interactions with race/ethnicity, income, education, health status, and elderly status to examine changing relationships of flu-related experience across these variables.ResultsPrevious vaccination was the most important predictor, with an increase of 63.0–71.8% probability of vaccination in the next year. Infection history could either increase or decrease the impact of past vaccination depending on race/ethnicity, income, education level, health status, and age. There were significant disparities across demographic, socioeconomic, and health-related variables.ConclusionVaccination promotion efforts could focus on those who have not been vaccinated in the past and on specific sub-populations, such as people who are Hispanic, people with lower education levels, the population aged 65 and above, and families with low-income levels. Although past infection is a predictor for some population groups, its magnitude is small and is often not a significant determinant.

Lipid Changes 10-15 Years After Roux-en-Y Gastric Bypass: A Prospective Observational Study.

Several studies have documented a beneficial short-term effect on lipid profile after Roux-en-Y gastric bypass (RYGB), but there is limited data on long-term changes. To describe long-term (> 10years) changes in lipid profile after RYGB and to explore the relationship of lipid changes to changes in weight and baseline and demographic parameters. The BAROBS study is a prospective observational study post RYGB conducted at three different hospitals. Surgical procedures were performed between 2003 and 2009, and the collection of data was in 2018-2020. Data on lipid profile, weight, body mass index (BMI), percentage of total weight loss (%TWL), and pre- and postoperative type II diabetes mellitus (DMII) was collected at baseline, 1-2, 5, and 10years post-surgery and was available for 314 of 546 patients in the study. The mean (SD) follow-up was 11.5(± 1.5) years, with a mean reduction of 11.7% for LDL, 29.7% for TG, and 7.7% for total cholesterol compared to baseline. Except for HDL and total-/HDL-cholesterol-ratio, all lipid variables reached their greatest change after 1-2years with an attenuation of changes at end of study. HDL and total-/HDL-cholesterol-ratio had stable values from 5 to 10years post-surgery. Lipid profile improved more in patients with greater weight loss. There was a 59% reduction in DMII at end of study, and there was a significant relation between preoperative DMII and long-term lipid values. There is an improvement of all lipid parameters after 10years post RYGB related to both the magnitude of weight loss and the presence of DMII.

Cerebral Hemodynamic Responses to Disease-Modifying and Curative Sickle Cell Disease Therapies.

Sickle cell disease (SCD) is a hemoglobinopathy resulting in hemoglobin-S production, hemolytic anemia, and elevated stroke risk. Treatments include oral hydroxyurea, blood transfusions, and hematopoietic stem cell transplantation (HSCT). Our objective was to evaluate the neurologic relevance of these therapies by characterizing how treatment-induced changes in hemoglobin (Hb) affect brain health biomarkers. In this interventional study, adults with and without SCD underwent a 3T-MRI at Vanderbilt University Medical Center at 2 time points before and after clinically indicated transfusion or HSCT or at 2 time points without the introduction of a new Hb-altering therapy (adult controls and patients with SCD on hydroxyurea). Cerebral blood flow (CBF; mL/100 g/min) and cerebral venous blood relaxation rate (s-1; a marker of Hb and blood oxygen content) responses were assessed to understand how these markers of brain health vary with Hb modulation. CBF was assessed with arterial spin labeling MRI, and blood relaxation rate was assessed using T2 relaxation under spin tagging MRI. Measures were pairwise compared within each cohort using a 2-tailed Wilcoxon signed-rank test, and regression was applied to evaluate the parameter and Hb change relationships. The significance criterion was 2-sided p < 0.05. Adults with (n = 43; age 28.7 ± 7.7 years; 42% male) and without (n = 13; age 33.5 ± 12.2 years; 46% male) SCD were evaluated. In adults receiving hydroxyurea (n = 10), neither Hb, CBF, nor venous relaxation rate changed between time 1 (Hb = 8.6 ± 1.2 g/dL) and time 2 (Hb = 9.0 ± 1.8 g/dL) (all p > 0.05). In transfusion patients (n = 19), Hb increased from 8.2 ± 1.4 g/dL to 9.3 ± 1.3 g/dL before vs after transfusion (p < 0.001), paralleling a CBF decrease of 14.2 mL/100 g/min (p < 0.001) toward control levels. The venous relaxation rate did not change after transfusion (p = 0.71). In HSCT patients (n = 14), Hb increased from 8.9 ± 1.9 g/dL to 12.9 ± 2.7 g/dL (p < 0.001) before vs after transplant, paralleling CBF decreases from 68.16 ± 20.24 to 47.43 ± 12.59 mL/100 g/min (p < 0.001) and increase in venous relaxation rate (p = 0.004). Across the Hb spectrum, a CBF decrease of 5.02 mL/100 g/min per g/dL increase in Hb was observed. Findings demonstrate improvement in cerebral hemodynamics after transfusion and transplant therapies compared with hydroxyurea therapy; quantitative relationships should provide a framework for using these measures as trial end points to assess how new SCD therapies affect brain health.

Shift in the Relationship Between Summer Extreme Humid‐Heat Events in Eastern China and Tropical Sea Surface Temperature in the Mid‐1990s

AbstractThe social losses associated with extreme humid‐heat events (EHHE) increased sharply in recent decades. This study has explored the changing relationship between EHHE in eastern China and tropical sea surface temperature (SST) anomalies. Results show that the monopolar mode of EHHE is significantly associated with spring SST anomalies in Northwest Pacific (NWP) before the mid‐1990s, which can impact humid‐heat conditions in eastern China through an atmospheric meridional overturning circulation extending from NWP to eastern China. Then, the associated eastward shift of convection center after the mid‐1990s weakens connection between NWP SST anomalies and the monopolar mode. Further analysis reveals that the weakened Kelvin waves, induced by persistent SST anomalies from spring in tropical Indian Ocean after the mid‐1990s, cause the westward‐shifted anomalous convection in western Pacific, and then reinforce formation of the dipolar mode via exciting zonal wave trains. Numerical simulations via linear baroclinic model further validate atmospheric response to displacement of diabatic forcings.

Associations between parent and adolescent weight outcomes within two parent approaches to family-based adolescent obesity treatment: Secondary analyses from the TEENS+ pilot trial.

To examine associations between parent and adolescent weight change within two parent approaches to adolescent obesity treatment. Adolescent (Mage = 13.7 ± 1.2 years; MBMI = 34.9 ± 7.0 kg/m2) and parent (MBMI = 36.4 ± 7.3 kg/m2) dyads (N = 82) were randomized to TEENS+Parents as Coaches (PAC) or TEENS+parent weight loss (PWL). Anthropometrics were assessed at baseline (0-month), 4 months (post) and 7 months (after 3-month maintenance period). Regression analyses examined associations between parent and adolescent ΔBMI0-4m and ΔBMI4-7m, with parent group as a moderator. Post-treatment, parent and adolescent ∆BMI0-4m were positively related (β = 0.68, p < 0.001), with no group interaction. Parent and adolescent ΔBMI4-7m were related (β = 0.48, p = 0.012) during maintenance, moderated by parent group (β = -0.49, p = 0.010): positive relationships persisted in PAC (β = 0.39, p = 0.011), but not PWL (β = -0.19, p = 0.211). Parent and adolescent weight changes were positively related during treatment in both parent groups. During maintenance, weight change associations persisted only in PAC. These patterns prompt further exploration of parent factors driving weight change relationships.

Caregivers' Experiences of Nursing Home Restrictions During the COVID-19 Pandemic.

Pandemic-related restrictions in nursing homes have undermined the critical role that family and friend caregivers play in enhancing resident quality of life. We examined how family caregiver access restrictions in nursing homes were implemented and how they impacted the mutual well-being of and relationships between residents and their caregivers over time. Methods Between March 2021 and march 2022, 24 'designated caregivers' in Atlantic Canada were interviewed three times. We identified changes in family relationships and activities over time, constricted support networks, the increasing need for advocacy and monitoring, and the generally negative cumulative impacts of restrictions, especially during residents' end-of-life. Subsequent adaptations to access restrictions allowed caregivers to contribute to essential monitoring, care relationships, and advocacy roles. We argue that the role of designated caregivers in nursing homes must be maintained during public health emergencies to ensure resident's supportive family relationships and general well-being.

Longitudinal investigation of neuroimaging changes related to memory decline in multiple sclerosis: Testing a mechanistic model

Background: Memory decline is common in multiple sclerosis (MS), although pathophysiological mechanisms are not fully understood. Objective: The objective was to investigate the relationship of changes in structural and functional neuroimaging markers to memory decline over 3-year follow-up. Methods: Participants with MS underwent cognitive evaluation and structural, diffusion, and functional 3T magnetic resonance imaging (MRI) scans at baseline and 3-year follow-up. Changes in neuroimaging metrics from baseline to follow-up were compared between memory stable and memory decline groups. Our hypothesis that structural and functional connectivity changes mediate the association of atrophy to memory decline was tested. Results: A total of 249 MS patients completed baseline visit; 169 (67.8%) returned at 3-year follow-up. Based on ⩾10% decline, memory decline was observed in 44.4% ( n = 75). Those with memory decline showed marginally greater whole-brain volume loss over time compared with those with stable memory performance ( p = 0.08). In those with memory decline, changes in white matter tract integrity were related to regional cortical thinning ( p &lt; 0.01). Exploratory mediation analysis revealed structural and functional connectivity to mediate the relationship of atrophy to verbal and visual memory decline. Conclusion: Further work is needed to characterize complex interrelationships of atrophy and structural/functional connectivity changes to memory decline in MS.

Age and sex differences in the relationship of body weight changes with colon cancer risks: A nationwide cohort study

Colon cancer is a significant health concern, and obesity is a well-established risk factor. However, previous studies have mainly focused on assessing body weight as a risk factor for colon cancer at a specific time point. This nationwide cohort study investigated the association between body weight changes, which can fluctuate throughout an individual’s lifespan, and the incidence of colon cancer using the South Korean population database provided by the National Health Insurance Service (NHIS). Participants who underwent biennial health screenings between 2004 and 2006, and had follow-up health check-ups between 2014 and 2016, were included in this study. Body weight changes were categorized as follows: < 5%, decrease 5–20%, decrease > 20%, increase 5–20%, or > 20%. The primary outcome was the incidence of newly diagnosed colon cancer. Statistical analysis was used to examine the relationship between body weight changes and the incidence of colon cancer stratified according to age and sex. The Kaplan–Meier method estimated the cumulative incidence of colon cancer, and Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for confounding factors. The analysis included data from 10,332,397 individuals, with a mean (± SD) age of 45.5 ± 13.1 years, and 54.9% were male. In males with a body mass index (BMI) range of 18–30 kg/m2, both a weight gain of 5–20% (HR 1.07, P > z 0.01 [95% CI 1.02–1.13]) and weight gain > 20% (HR 1.27, P > z 0.03 [95% CI 1.03–1.56]) were associated with an increased risk for colon cancer. In addition, males < 40 years of age exhibited a higher risk for colon cancer with > 20% weight gain (HR 1.65, P > z < 0.001 [95% CI 1.18–2.30]). Whereas, females within the BMI range of 18–30 kg/m2 who exhibited > 20% weight loss demonstrated a reduced risk (HR 0.77, P > z 0.04 [95% CI 0.60–0.98]). Moreover, females ≥ 40 years of age, who experienced weight loss > 20%, exhibited a decreased risk for colon cancer (HR 0.76; P > 0.02 [95% CI 0.60–0.96]). This nationwide cohort study demonstrated a relationship between body weight changes and the incidence of colon cancer, with differences based on sex and age. In particular, avoiding weight gain is crucial for males < 40 years of age, whereas weight loss could be beneficial for females > 40 years of age in reducing the risk of colon cancer.

Increased structural covariance of cortical measures in individuals with an at-risk mental state.

An anomalous pattern of structural covariance has been reported in schizophrenia, which has been suggested to represent connectome changes during brain maturation and neuroprogressive processes. It remains unclear whether similar differences exist in a clinical high-risk state for psychosis, and if they are associated with a prodromal phenotype and/or later psychosis onset. This multicenter magnetic resonance imaging study cross-sectionally examined structural covariance in a large at-risk mental state (ARMS) sample with different outcomes. The whole-brain structural covariance of four cortical measures (thickness, area, volume, and gyrification) was assessed in 155 individuals with ARMS, who were subclassified into 26 (16.8%) with a later psychosis onset (ARMS-P), 44 with persistent subthreshold psychotic symptoms, and 53 with the remission of psychotic symptoms (ARMS-R) during the clinical follow-up, and 191 healthy controls. The relationships of changes in structural covariance with clinical symptoms and cognitive impairments were also investigated in the ARMS subsample. Structural covariance was significantly higher in widespread cortical regions in the ARMS group than in the controls, with each cortical measure having a different pattern in affected cortical regions. The higher structural covariance of the cortical area was partly related to severe suspiciousness-persecutory ideation. Structural covariance was significantly higher, mainly in fronto-parietal gyrification, in the ARMS-P group than in the ARMS-R group. The present results suggest that changes in structural covariance result in psychosis vulnerability and the excessive structural covariance of brain gyrification in ARMS subjects may contribute to their later clinical course.

Relationships for Social Change: The Value of the Promotora Framework in Navigating Systems of Employment.

In the United States, socioeconomic disparities are a reality that shapes the challenges many communities of color experience. Throughout the globe, community-based initiatives have been explored as a way to reduce several barriers that contribute to social inequalities. One in particular, the Promotora framework, has been widely used to improve health outcomes. However, it has yet to be explored to maximize socioeconomic opportunities. The Launch Program, a pre-COVID-19 pilot study, aimed to investigate the experiences of LatinX people in one of the first community programs designed to offer a Promotora-led intervention supporting socioeconomic goals. Researchers collected qualitative data via focus groups from 25 LatinX participants who completed the program. Using narrative thematic analysis, the study explored the potential of a liberatory framework to address employment barriers. Results from this study highlight the benefits of adopting a culturally responsive intervention as a valuable tool in reducing socioeconomic disparities within LatinX populations.

Comparative Analyses and Phylogenetic Dependence in Traits and Trends of the Dipterocarpaceae.

The role of trait evolution in shaping the functional and ecological diversity of tropical forests remains poorly understood. Analyses of trait variation as a function of evolutionary history and environmental variables should reveal the drivers of species distributions, as well as generate insights valuable to conservation. Here, we focus on the Dipterocarpaceae, the key plant family underpinning the hyperdiversity of South-East Asian tropical forest canopies and of major conservation concern due to over-exploitation for timber, cultivation, and climate change. Our objectives are to (i) assess whether dipterocarp species traits are phylogenetically conserved through a phylogenetic signal, indicating phylogenetic niche conservatism (PNC); (ii) determine the drivers of dipterocarp species distribution; (iii) examine the relationship between morphological traits with habitat factors; and (iv) assess the correlation between conservation status and phylogeny. We compiled a dataset of species-level plant traits of the Dipterocarpaceae together with population-level ecological trends. We found substantial evidence of phylogenetic conservatism of plant traits in dipterocarp species, with a moderate to strong phylogenetic signal, and that the elevational gradient shapes dipterocarp species distribution pan-tropically. Morphological traits including height and diameter show phylogenetically dependent relationships with soil type, while shade tolerance traits are related to survival. We find that conservation status is related to phylogeny and correlated with population trend status, suggesting that decreasing population trends correlated with conservation status. Overall, our analyses show that functional traits and ecological trends of dipterocarp species are shaped by the phylogenetic history. Our study highlights that conservation strategies require consideration of the consequences of these relationships for long-term population changes.

Does Improvement in Respiratory Function after Hemodialysis Correlate with Ultrafiltration Volume?

Objectives: To evaluate the effect of mechanical ultrafiltration on improvement in respiratory functions among patients of end-stage renal disease dependent on hemodialysis. Study design: Cross-sectional analytical study. Place and Duration of Study: Dialysis Unit, Combined Military Hospital Peshawar, Pakistan, from Sep to Nov 2021 Methodology: Patients on maintenance hemodialysis for at least three months were included. Patients with altered mental status and gross rheumatological abnormalities and unwilling patients were excluded. Spirometry was done before and after mid-week dialysis sessions thrice at two minutes intervals and the best values recorded. Different spirometry parameters before and after dialysis session were compared. The relationship of changes in these parameters with ultrafiltration volumes was also examined. Results: A total of 50 patients were enrolled of which 36(72%) were females and 14(28%) were males. The mean age was 48.76±11.72 years. Low and high ultrafiltration groups included 26 and 24 patients, respectively. The median ultrafiltration volume was 1.5(1.00-2.80) liters. The majority of the patients showed restrictive pattern. The mean FEV1 percentage was 48.87±17.35 and 57.94±75.34 before and after hemodialysis respectively (p=0.387). The mean FVC percentage was 50.62±19.28 and 46.04±18.73 before and after the hemodialysis respectively (p=0.056). FEV1/FVC percentage was significantly different before and after hemodialysis i.e.106.7±24.0 and 113.30±16.94, respectively (p=0.014). Conclusion: Lung parameters improved slightly in patients after dialysis. However, ultrafiltration volume did not have significant change on any of the measured parameters.

UNDERSTANDING OLDER AMERICANS’ DEBT: INSIGHTS FROM COGNITIVE AND IN-DEPTH INTERVIEWS

Abstract Debt is a common and important factor in older adults’ financial lives and balance sheets. According to the Survey of Consumer Finances, in 2022, 63 percent (31.3 million) of households headed by adults ages 60 and older held debt. In total, they held over $4.1 trillion in debt. Existing research and data suggest that there is also a strong relationship between debt and aging. This relationship is growing and changing. Despite the importance of debt in older adults’ financial lives, there are foundational gaps in qualitative data that limit researchers, policymakers, and educators’ ability to understand and monitor the level of debt held by older adults and the risk that debt poses to older adults. To address this gap, and provide insights into the growing and changing relationship between aging and debt, the Consumer Financial Protection Bureau (CFPB), an agency of the United States government, conducted cognitive and in-depth interviews with 54 participants, a majority (81 percent) of whom were age 62 or older, in June and July 2023. The findings revealed important gaps in the completeness of existing data sources that serve as a tool for monitoring trends and risks related to older adults’ debt. Moreover, the study findings also have important implications for areas where greater focus on consumer protection may be warranted.

Effect of Metformin on Obesity, Hyperandrogenism and Insulin Resistance in Population with PCOS: A Clinical Analysis

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder in women, therapeutic methods include reducing obesity, hyperandrogenism and insulin resistance. This paper sorts out data from a clinical study that contains 83 Chinese PCOS patients in Control group, and 87 in Metformin group and analyzes the variation of parameters between baseline and after 4-month treatment. The Wilcoxon signed-rank test shows Metformin has a significant effect on obesity, hyperandrogenism and insulin resistance. They are measured by BMI, FAI and HOMA-IR respectively. The Spearman correlation analysis shows ΔFAI (variation after 4 months) is a mediator that is strongly correlated with ΔBMI and ΔHOMA-IR variation in PCOS patients. Linear regression concludes it as 10.64ΔBMI~ΔFAI~10.20ΔHOMA-IR. Metformin treatment has a stronger effect on decreasing HOMA-IR and BMI than FAI, as the relationship turns to 4.17ΔBMI~ΔFAI~5ΔHOMA-IR. This study fills the gap left by previous research which rarely focused on relationship of characteristic changes in PCOS patients, further explains Metformin treatment mechanism in evidence-based medicine perspective and provides strategy for new use of old medicine.

Testing the monitor and acceptance theory: the role of training-induced changes in monitoring- and acceptance-related capacities after attention-based, socio-emotional, or socio-cognitive mental training in reducing cortisol stress reactivity

Mindfulness-based interventions have become a popular means to reduce stress. However, the specific mechanisms driving observed stress reduction remain understudied. The Monitor and Acceptance Theory suggests that the cultivation of monitoring and acceptance skills are necessary moderators of practice-induced stress reduction. In the context of the ReSource Project, a large healthy adult sample underwent three 3-month mental training modules targeting either attentional (Presence module), socio-affective (Affect module) or socio-cognitive skills (Perspective module). In the current study, the development of a range of inter-individual differences in mindfulness-, interoception- and compassion-related traits - which mapped to either monitoring or acceptance categories - was tracked. The relationship of these training-induced changes with cortisol stress reactivity after the three distinct 3-month training modules was explored. We found that stress sensitivity was particularly modulated by a differential adaptivity of one cultivated attentional capacity - Attention regulation - which predicted higher cortisol reactivity after mere attention training (Presence) but was associated with lower stress-induced cortisol release after additional socio-affective and socio-cognitive practice (Affect and Perspective). However, this effect did not survive multiple comparisons correction, and analyses were limited by the sample size available. We conclude that our study provides preliminary support of the Monitor and Acceptance Theory, lending weight to the advantage of primary attentional increases in order to fully harness the beneficial effects of socio-affective training, ultimately leading to stress reduction. Although training-induced increases in acceptance were not directly shown to contribute to lowering cortisol stress reactivity, the data suggest an additional benefit of socio-affective and socio-cognitive training that is not directly captured within the current analyses. Our study corroborates the importance of going beyond the training of attention monitoring to foster stress resilience, and highlights that mental training relies on the co-development of several interacting processes to successfully attenuate stress. Further exploring the overarching concept of acceptance in future research may prove beneficial to the theoretical framework of MAT, and in understanding the processes by which stress reduction occurs.

INTERGENERATIONAL PLAY AND LEARNING: OPPORTUNITIES FOR ENGAGING PRESCHOOLERS, COLLEGE STUDENTS, AND OLDER ADULTS

Abstract The U.S. Census notes that the population age demographic is rapidly changing, with approximately 10,000 individuals a day crossing the age threshold of 65, the mismatch between the number of individuals over the age of 65 and those under the age of 65 will have lasting implications in the coming decades. So, how can we take advantage of this resource? How can we benefit multiple generations? Intergenerational Play &amp; Learning was a new course offered at Connecticut College during the Spring 2024 semester that introduced students to the intergenerational (IG) studies field and engaged them in experiential learning activities with older adults and preschool children. These students studied the changing relationships between young children and older adults through readings, videos, and personal observations. Through journals, interviews, and observation, students gained insights into the benefits of intergenerational learning (IL) and how IL can challenge discrimination. Course participants designed activities to promote social ties across age groups. The main goals for the course were: (1) provide a venue for young children, young adults, and older adults in the New London area to learn from and engage with each other; (2) encourage young and older adult participants to reevaluate stereotypes and discover how generations different from one’s own can provide an opportunity for learning; (3) evaluate the importance of family and community ties; and (4) develop a model for future intergenerational programming.

The changing relationship between racial identity and skin color in Brazil

In recent years, Brazil's non-White (Brown and Black) population became a numerical majority for the first time since the 19th century. Although we know this change was mostly due to racial reclassification, we do not know how such changes are related to skin color, the primary marker of race in Brazil. Using data from six Latin American Public Opinion Project (LAPOP), or America's Barometer, surveys from 2010 to 2023, we examine how changes in racial self-identification (White, Brown, or Black) are related to respondent skin color (light, medium, or dark). We ask how the association between self-identified race and skin color changed over the 13-y period and to what extent these trends varied by educational level. We found a "darkening" of racial identification over time, especially among those with medium and dark skin, who increasingly identified as Black. Brazilians with light skin increasingly identified as Brown, but this was partly explained by changes in interviewer reporting of skin color in the same period. We found only minor evidence that education level was related to changing racial classification over time. Our findings further understanding of recent trends in racial reclassification, which may reflect growing Black consciousness and the extension of racial quotas to both Brown and Black Brazilians in federal universities and public sector jobs.

Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders.

Employment and relationship are crucial for social integration. However, individuals with major psychiatric disorders often face challenges in these domains. We investigated employment and relationship status changes among patients across the affective and psychotic spectrum - in comparison with healthy controls, examining whether diagnostic groups or functional levels influence these transitions. The sample from the longitudinal multicentric PsyCourse Study comprised 1260 patients with affective and psychotic spectrum disorders and 441 controls (mean age ± s.d., 39.91 ± 12.65 years; 48.9% female). Multistate models (Markov) were used to analyse transitions in employment and relationship status, focusing on transition intensities. Analyses contained multiple multistate models adjusted for age, gender, job or partner, diagnostic group and Global Assessment of Functioning (GAF) in different combinations to analyse the impact of the covariates on the hazard ratio of changing employment or relationship status. The clinical group had a higher hazard ratio of losing partner (hazard ratio 1.46, P < 0.001) and job (hazard ratio 4.18, P < 0.001) than the control group (corrected for age/gender). Compared with controls, clinical groups had a higher hazard of losing partner (affective group, hazard ratio 2.69, P = 0.003; psychotic group, hazard ratio 3.06, P = 0.001) and job (affective group, hazard ratio 3.43, P < 0.001; psychotic group, hazard ratio 4.11, P < 0.001). Adjusting for GAF, the hazard ratio of losing partner and job decreased in both clinical groups compared with controls. Patients face an increased hazard of job loss and relationship dissolution compared with healthy controls, and this is partially conditioned by the diagnosis and functional level. These findings underscore a high demand for destigmatisation and support for individuals in managing their functional limitations.