Home Interviews Research Articles

Anthony Johnson Showalter: A Pioneer in Southern Gospel Music Education

Anthony Johnson Showalter (c. 1853–1924) was a music educator, gospel composer, publisher, and considered a pioneer in gospel music and education in the late nineteenth century and early twentieth century. Showalter is notably mentioned in numerous texts and studies related to gospel music; however, little data has been collected regarding the tools he used in singing schools—namely, the rudiment books he wrote and the schools where he used the curriculum. The purpose of this study is to discover Showalter’s possible motivation to begin his career, his determination in writing music education curriculum, organizing singing schools, his reasonings for focusing on seven-shape note style, and his influence into the twenty-first century. Materials analyzed included Showalter’s rudiment books, extant copies of his periodical, “The Music Teacher and Home Magazine,” and interviews at present-day gospel singing schools. Extant research related to four-shape and seven-shape hymnody and education was also reviewed. Findings indicate that Showalter was a progressive student-centered educator who utilized alternate tools in helping many with literacy by organizing the Southern Normal Musical Institute. Showalter created materials and opportunities which were accessible to the advanced and the beginner, hence providing a future for gospel singing schools well into the twenty-first century.

Surfacing consumer psychosensory perceptions of a nonendemic food: The case of coffee in a tea culture

AbstractIntroducing a culturally unfamiliar food to a new market requires understanding local meaning. Local psychological associations with nonendemic food often remain masked from common research methods such as surveys and home interviews. We apply a localized adaptation of the Zaltman Metaphor Elicitation Technique to explore consumer psychosensory perceptions of nonendemic foods—the contemporary phenomenon of coffee's acceptance in Taiwan's tea‐dominated market. A purposive sample of 10 trial and 20 full study participants, avid coffee drinkers, ranged in age from 19 to 52. Participants were supplied with single‐use film‐based cameras that they carried about in everyday life to snap photos later used in structured interviews. Over 120 concepts were generated from a total count of 95,472 transcribed words. This resulted in six top‐level categories: emotions/feelings, flavor/taste/color, cultural integration, nature, eat/drink, and coffee type organized in hierarchies of meaning. Participants consistently associated coffee with the desire for relaxation, enjoyment, and nature.Practical ApplicationsThe revealed psychometric themes unearthed in this study suggest practical applications including informing market positioning segmentation strategies. In Taiwan's tea culture, findings show coffee plays a strong metaphorical role in consumers' psychology of escape and retreat from hectic daily life. Marketers of coffee should align with this theme rather than the standard Western messaging of energy and motivation boosting. This local metaphor provides coffee with a better opportunity for market adoption. Building on locally meaningful representations is key to market penetration and a strategy of glocalization that is fundamental to marketing of nonendemic food products. Successful diffusion of a nonendemic food product begins from a core group of dedicated loyal users, like the participants in the current study. By understanding the values these consumers associate with the nonendemic product, marketing managers can identify and select key features and meanings to emphasize in the product's design and marketing communications.

Individual quality of life in spousal ALS patient-caregiver dyads

BackgroundQuality of life is a basic goal of health and social care. The majority of people with Amyotrophic Lateral Sclerosis (ALS) are cared for at home by family caregivers. It is important to recognize the factors that contribute to quality of life for individuals to better understand the lived experiences in a condition for which there is currently no curative treatment.AimTo explore individual quality of life of people with ALS and their informal caregivers over time.MethodsOver three semi-structured home interviews, 28 patient-caregiver dyads provided information on a range of demographic and clinical features, psychological distress, caregiver burden, and individual quality of life. Quality of life data were analysed using quantitative and qualitative methods with integration at the analysis and interpretation phases.ResultsIndividual Quality of Life was high for patients and caregivers across the interviews series, and higher among patients than their care partners at each time point. Family, hobbies and social activities were the main self-defined contributors to quality of life. The importance of health declined relative to other areas over time. Friends and finances became less important for patients, but were assigned greater importance by caregivers across the illness trajectory. Psychological distress was higher among caregivers. Caregiver burden consistently increased.ConclusionThe findings from this study point to the importance of exploring and monitoring quality of life at an individual level. Self-defined contributory factors are relevant to the individual within his/her context. As an integrated outcome measure individual quality of life should be assessed and monitored as part of routine clinical care during the clinical encounter. This can facilitate conversations between health care providers, patients and families, and inform interventions and contribute to decision support mechanisms. The ascertainment of self-defined life quality, especially in progressive neurodegenerative conditions, mean health care professionals are in a better position to provide person-centred care.

Ambient intelligence: Placement of Kinect sensors in the home of older adults with visual disabilities

BACKGROUND: Although a number of research studies on sensor technology for smart home environments have been conducted, there is still lack of consideration of human factors in implementing sensor technology in the home of older adults with visual disabilities. OBJECTIVE: This paper aims to advance knowledge of how sensor technology (e.g., Microsoft Kinect) should be implemented in the home of those with visual disabilities. METHODS: A convenience sample of 20 older adults with visual disabilities allowed us to observe their home environments and interview about the activities of daily living, which were analyzed via the inductive content analysis. RESULTS: Sensor technology should be integrated in the living environments of those with visual disabilities by considering various contexts, including people, tasks, tools, and environments (i.e., level-1 categories), which were further broken down into 22 level-2 categories and 28 level-3 categories. Each sub-category included adequate guidelines, which were also sorted by sensor location, sensor type, and data analysis. CONCLUSIONS: The guidelines will be helpful for researchers and professionals in implementing sensor technology in the home of older adults with visual disabilities.

A biopsychosocial interpretation of the Neuropsychiatric Inventory - Nursing Home assessment: reconceptualising psychiatric symptom attributions.

The Neuropsychiatric Inventory (NPI) is predicated on the assumption that psychiatric symptoms are manifestations of disease. Biopsychosocial theories suggest behavioural changes viewed as psychiatric may also arise as a result of external behavioural triggers. Knowing the causes of psychiatric symptoms is important since the treatment and management of symptoms relies on this understanding. This study sought to understand the causes of psychiatric symptoms recorded in care home settings by investigating qualitatively described symptoms in Neuropsychiatric Inventory-Nursing Home (NPI-NH) interviews. The current study examined the NPI-NH interviews of 725 participants across 50 care homes. The qualitatively described symptoms from each of the 12 subscales of the NPI were extracted: 347 interviews included at least one qualitatively described symptom (n = 651 descriptions). A biopsychosocial algorithm developed following a process of independent researcher coding (n = 3) was applied to the symptom descriptions. This determined whether the description had predominantly psychiatric features, or features that were cognitive or attributable to other causes (i.e. issues with orientation and memory; expressions of need; poor care and communication; or understandable reactions). Our findings suggest that the majority (over 80%) of descriptions described symptoms with features that could be attributable to cognitive changes and external triggers (such as poor care and communication). The finding suggest that in its current form the NPI-NH may over attribute the incidence of psychiatric symptoms in care homes by overlooking triggers for behavioural changes. Measures of psychiatric symptoms should determine the causes of behavioural changes in order to guide treatments more effectively.

Depressive symptoms and developmental change in mothers' emotion scaffolding: Links to children's self-regulation and academic readiness.

This study examined whether the mechanism linking changes in Mexican-origin adolescent mothers' depressive symptoms to children's subsequent self-regulation and academic readiness was via their emotion scaffolding when their children were 2, 3, 4, and 5 years of age. Data included home interviews with adolescent mothers (N = 204), observations of mother-child interactions during a task that challenged children's abilities to manage their emotional arousal, and assessments of children's performance on measures of self-regulation and academic readiness. Adolescent mothers' higher depressive symptoms at child age 2 years were associated with a greater decline in mothers' emotion scaffolding from child age 2 to 5 years, which was subsequently linked to children's lower self-regulation and academic readiness at age 5. Possible implications from this line of work for adolescent mothers and their children are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Potentially inappropriate medications for the elderly: Incidence and impact on mortality in a cohort ten-year follow-up.

IntroductionPharmacological therapy plays an important role in disease control in the elderly; unfortunately, this comes with a high prevalence in the use of medications classified as potentially inappropriate.ObjectiveTo analyze the incidence, risk factors, and survival of elderly people using potentially inappropriate medications (PIM).MethodA ten-year follow-up assessment of elderly participants residing in a capital of Central Brazil was conducted. The initial assessment (baseline) included 418 elderly people. Data were collected through home interviews guided by a questionnaire covering socioeconomic, demographic, living conditions, and health variables. The medication information obtained comprised active ingredient, dosage, route, and regimen for the medications. The PIMs were classified according to 2019 Beers Criteria. The analyses were performed using STATA 15.0. For survival analysis, a Cox Regression was performed with the respective Kaplan Meier curve.ResultsThe incidence of PIM was 44.1 cases (95% CI: 35.2–54.7) per 1,000 people a year. The most used PIMs were nifedipine, glibenclamide, and sodium diclofenac. The risk factors were polypharmacy (aRR: 3.00; 95% CI: 1.31–6.88) and diabetes mellitus (aRR: 1.57; 95% CI: 1.03–2.39). We identified no statistically significant association between survival and the use of PIM.ConclusionThe study highlights the high consumption of PIM among the elderly causing polypharmacy risks. Health professionals working in drug treatment need to be alert to polypharmacy risks to ensure the rational use of medications to prevent adverse reactions and other health problems.

Association of Environmental Tobacco Smoke Exposure and Infant Neurodevelopmental Achievements and Effect Modification by Maternal Overweight and Obesity: Results from the Taiwan Birth Cohort Study

Background: Environmental tobacco smoke (ETS) is a common indoor air pollutant associated with multiple adverse health effects, but it remains unclear regarding effect modifiers and susceptible groups for detrimental neurodevelopmental effect of ETS. We examine the associations between ETS exposure and infant neurodevelopmental parameters in a national-wide representative population. Methods: We extracted the information via structured questionnaires upon home interview from Taiwan Birth Cohort Study (TBCS). The associations between ETS exposure and infant neurodevelopmental milestones were evaluated with multivariate conditional logistic regression and the Cox model and with propensity score (PS) weighting and matching based upon preselected covariates. Results: In this study, 15 987 term singletons were included, and 3598 mother-infant pairs were further selected to PS-matched subpopulation. Higher ETS exposure was associated with increased likelihood of delay in caregiver-reported fine motor (adjusted odds ratio (aOR)=1.29, 95% CI=1.07-1.55; adjusted hazard ratio (aHR)=1.06, 95% CI=1.01-1.11 for clapping hands; aOR=1.21, 95% CI=1.03-1.43; aHR=1.05, 95% CI=1.00-1.10 for scribbling), language-related (aOR=1.25, 95% CI=1.03-1.50; aHR=1.08, 95% CI=1.03-1.13 for waving goodbye; aOR=1.22, 95% CI=1.01-1.47; aHR=1.08, 95% CI=1.04-1.14 for calling a parent meaningfully), and it was consistent in PS-weighted, PS-matched, and among non-smoking families. We also detected positive interaction for both maternal overweight and obesity before pregnancy and after delivery upon the association between high ETS exposure and delayed milestone achievement in scribbling. Conclusions: Maternal peripartum ETS exposure was associated with delayed neurodevelopmental milestone achievement at eighteen months among non-smoking families, and effect modification by maternal overweight and obesity status indicated possible intervention targets for pregnant women.

Strengthening Urban-Rural Resource Flow through Regional Circular and Ecological Sphere (R-CES) Approach in Nagpur, India

Urban and rural areas within a regional space are closely linked through a variety of linkages including the flow of people. The increasing pace of development transformations with discrete planning of urban and rural areas has raised serious concerns for achieving coordinated development at the regional level. In that regard, the concept of Regional Circular and Ecological Sphere (R-CES) has recently been introduced by the Government of Japan to localize the flow of resources between urban and rural areas. To understand the applicability of the R-CES approach, this study aims to visualize the flow of people within a defined cluster of Nagpur Metropolitan Area (NMA) in India. A “home interview method” Origin-Destination survey was adopted to analyze the flow patterns of people and their key purposes. Based on the collected information, flows of people were represented using a desire line diagram in ArcGIS 10.4.1. The study results revealed that the maximum flow of the rural and forest population is directed towards nearby or distant urban settlements to avail the higher-order urban services. Based on the key R-CES principles of a low-carbon society, circular economy, and harmony with nature, the authors suggest feasible directions for localizing the urban–rural flow of people in NMA.

Perceptions of Pacific children's academic performance at age 6 years: A multi-informant agreement study.

PurposeIn New Zealand, Pacific immigrants are among the fastest growing ethnic minorities but, as a group, they are also at most risk of not realising their literacy and educational aspirations critical for achieving their human potential and wellbeing. This may be due, in part, to a misalignment in the shared understanding of academic success between students, parents and their teachers within largely non-Pacific school environments. This study aims to report levels of agreement in child-mother, child-teacher, and mother-teacher perceptions of Pacific children’s academic performance at age 6 years.MethodA cohort of Pacific infants born during 2000 in Auckland, New Zealand, was followed as part of the Pacific Islands Families study. Maternal home interviews were conducted at 6-weeks and 6-years postpartum, together with separate child and teacher elicitations at 6-years. Pairwise agreement of academic performance responses was assessed using Cohen’s weighted κ statistic, along with symmetry and marginal homogeneity tests.ResultsAt 6-years, information was available for 1,001 children and their mothers, and teachers’ evaluations for 549 children. Negligible to slight agreements and significant asymmetry were found between the child-mother (κ = 0.03, 95% CI: -0.03, 0.09), child-teacher (κ = 0.04, 95% CI: 0.01, 0.08), and mother-teacher (κ = 0.07, 95% CI: 0.03, 0.11) pairwise assessments–with children and mothers more likely to rate Pacific children’s academic performance higher than their teachers. Significantly higher concordances with teacher assessments were found among mothers with post-secondary education, proficiency in English, and stronger alignment with New Zealand culture and for children who performed strongly on a standardised measure of performance relative to their peers.ConclusionStrategies are needed to align Pacific students’ and parental perceptions with documented educational achievement outcomes and to facilitate more effective and timely feedback on achievement results and home-school communication. The importance of removing language, cultural and socio-economic barriers to achieving shared understanding of academic performance between teachers and families is highlighted.

Father Involvement in Infant Parenting in an Ethnically Diverse Community Sample: Predicting Paternal Depressive Symptoms.

Early paternal involvement in infant care is beneficial to child and maternal health, and possibly for paternal mental health. The purpose of the present study was to examine the relationship between fathers’ involvement in early infant parenting and their depressive symptoms during the infant’s first year in a sample of 881 low-income Black, Hispanic, and White fathers recruited from five sites in the United States (urban, mixed urban/suburban, rural). Home interviews at 1 month after birth assessed three concepts based on prior research and community input: (1) time spent with the infant, (2) parenting self-efficacy, (3) material support for the baby. Paternal depressive symptoms at 1, 6, and 12 months after the birth of a child were assessed with the Edinburgh Postpartum Depression Scale. Generalized estimating equations tested whether the three indicators of father involvement at 1 month after birth predicted lower subsequent paternal depressive symptoms controlling for social and demographic variables. For fathers, greater time spent with the infant, parenting self-efficacy, and material support were all significantly associated with lower paternal depressive symptoms during the first year. When risk of depression (scores > 9) was examined, only parenting self-efficacy among fathers was associated with higher likelihood of clinical depression. Findings have implications for future research on mechanisms linking paternal involvement and paternal mental health, and for possible paid paternal leave policies in the future.

Decision-Making During Early Intervention Home Visits: From Minimal to Meaningful Parent Participation

ABSTRACT Family-early educator partnerships are foundational to early childhood and early childhood special education, and collaborative decision-making regarding child and family need is recognized as a critical component of these partnerships. This study investigated how two Part C early intervention home visitors and four parents communicated during home visits, and discursively selected strategies to promote children’s development. The following research questions were addressed: (1) How is decision-making constructed through discourse by parents and home visitors during home visits? (2) How do decision-making structures contribute to parent participation in decision-making? Analysis of home visit transcripts and interviews with home visitors indicated that how home visitors introduced the opportunity to make a decision and addressed options with families played an essential role in the extent to which parents meaningfully participated in decision-making. Although home visitors intended to provide parents with opportunities for full participation, this was not consistently realized during home visits. Home visitors predominantly initiated and controlled discussion topics. Features of words spoken and actions taken through language contributed to interactional construction of home visitors as assessors and advice givers, with parents in more passive roles, such as informants and advice followers. Implications for research and practice are discussed.

People living with dementia and their family carers' adherence to home-based Tai Chi practice.

ObjectivesThe aim of this study was to understand what influenced people living with dementia and their family carers’ adherence to the home-based component of a Tai Chi exercise intervention.MethodDyads, of people living with dementia and their family carers, who participated in the intervention arm of the Tai Chi for people living with dementia trial, were invited to join weekly Tai Chi classes for 20 weeks and practice at home. Semi-structured dyadic home interviews were conducted on average after 16 weeks of classes. The views of 15 dyads with a range of home practice adherence were sought in semi-structured interviews. The interviews were analysed using an inductive thematic approach.ResultsMost participants found time to practise Tai Chi at home and practised for 18 hours on average. Amongst the barriers to adherence were participants’ competing commitments and a booklet not sufficiently conveying the Tai Chi movements. Hence, a video or DVD was requested by participants. Facilitators of their adherence to the home-based component of the intervention were their enjoyment of the practice and the development of a habit, which was supported by their commitment to the study and their willingness to benefit from Tai Chi.ConclusionEnjoyment and perceived benefits had a great impact on participants living with dementia and their carers’ adherence to home-based Tai Chi practice. However, difficulties to perceive the Tai Chi movements through images might be hindering sustained participation. Hence, alternative aids such as videos and DVDs should be explored to facilitate adherence.

Effectiveness of an app for perinatal home visitation by nurses in preventing infant abuse in Japan

Abstract Background In Japan, public health nurses provide home visitation with pregnant women who are at high risk for child maltreatment, but its effectiveness in preventing child maltreatment has not been evaluated because contents and quality of home visitation vary from municipality to municipality. This study aims to evaluate whether the tablet app developed to standardize and assist perinatal home visitation by public health nurses is effective in preventing child maltreatment. Methods An intervention study was conducted in 2018 in Adachi City, Tokyo, Japan. Public health nurses at two public health centers used the tablet app when they support high-risk pregnant women through home visitation and interviews, while public health nurses at the other three public health centers provided support as in the past. Because two public health centers were different in usage of the app, the treatment group was further divided into two groups: active and inactive. As fatal abuse among infants, frequency of shaking and smothering was assessed as an outcome through a self-reported questionnaire at the 4-month health check, and compared between the active treatment group, inactive treatment group, and control group, using multiple logistic regression (N = 5,651). Results Prevalence of infant abuse was 0.82% in the active treatment group, 1.34% in the inactive treatment group, and 1.50% in the control group. When adjusted for parental demographics and parenting situations, mothers in the active treatment group were less likely to shake or smother their baby than those in the control group (Odds ratio: 0.51, p = 0.093). Conclusions It possibly suggests that the tablet app developed to assist perinatal home visitation by public health nurses was effective in preventing infant abuse. Key messages An intervention study was conducted at public health centers in Adachi City, Tokyo, Japan, using the tablet app developed to standardize and assist perinatal home visitation by public health nurses. The finding suggested that the tablet app may be effective in preventing shaking and smothering among 4-month old infants.

The Relationship Of Habitual Physical Activity With All-cause Mortality Among Obese Adults In US.

Obesity is associated with increased risk for all-cause mortality. It is unclear if obese individuals need to engage in the same or more levels of physical activity in order to reap the benefits of an active lifestyle. PURPOSE: We test the hypothesis that regular habitual physical activity of 5 or more times a week among obese individuals, regardless of duration, intensity or mode, will be associated with lower all-cause mortality when compared to sedentary obese adults. METHODS: We used data from the Third National Health and Nutrition Examination Survey (NHANES III) conducted from 1988 to 1994. Participant records were linked to mortality data from the National Death Index to establish all-cause mortality. Detailed health information was obtained via a home interview and a medical examination. Measured weight and height were used to calculate obesity with a body mass index (kg/m2) > 30. Self-reported participation in leisure time physical activity was used to classify participants as inactive (0 times/wk), infrequently active (1-4 times/wk) and habitually active (5+times/wk). Cox proportional hazard was used to study the association of physical activity and all-cause mortality after controlling for age, socioeconomic status, smoking and chronic diseases. RESULTS: We studied 16,573 adults aged 20+ years. Both obesity and physical inactivity were independent risk factors of all-cause mortality. The prevalence of obesity in this group was 22.23%. We then studied the relationship between frequency of physical activity and all-cause mortality among obese persons. Obese individuals who exercised during leisure time habitually (5+ times/wk) had significantly lower risk (HR=0.74, 95% CI: 0.62,0.89) of all-cause mortality than the physically inactive obese group. CONCLUSION: For obese individuals, exposure to habitual physical activity 5+ times/wk is associated with lower all-cause mortality. All people should engage in habitual physical activity regardless of body weight.

Cuidado e acompanhamento do lactente de alto risco no primeiro ano de vida

Objetivo: conhecer a percepção de familiares quanto ao cuidado e acompanhamento ao lactente de alto risco, pelos profissionais de saúde ao longo do primeiro ano de vida. Materiais e Método: estudo de natureza qualitativa, realizado com sete cuidadores familiares de lactentes estratificadas como alto risco, em um município do interior do Brasil. Os dados foram coletados por meio de entrevista audiogravadas no domicilio, no período de agosto a setembro de 2018. Posteriormente a transcrição, as falas foram submetidas a análise modalidade temática. Resultados: Os participantes apontaram que as orientações oferecidas no momento da alta, favoreceram a insegurança frente as ações de cuidados básicos. Ademais, o acompanhamento na Atenção Primária a Saúde foi referido como fator facilitador do cuidado, embora a visita domiciliar tenha se apresentado como uma lacuna de atuação dos profissionais. Conclusão: O cuidado ao lactente de alto risco trás desafios para a família e a necessidade da oferta de informações quanto a realização de cuidados básicos e a necessidade de acompanhamento pelos profissionais de saúde

Hypertension Prevalence Increasing Among Mexican Americans: NHANES 1999–2016

Abstract Objectives The objective of this project was to determine current and past hypertension prevalence trends among Mexican Americans (MAs) and non-Hispanic whites (NH-whites) using NHANES data from 1999 to 2016 using the current American Heart Association (AHA) and American College of Cardiology (ACC) blood pressure guidelines of 2017. Methods This project included 28,000 NHANES adult participants above the age of 20 who participated in both the home interview and the physical examination in the mobile examination center. Results Using the 2017 AHA/ACC Blood Pressure Guidelines, the actual prevalence of hypertension in 2005–16 was 39.6% in MAs and 48.6% in NH-whites. Since 2005, the prevalence of hypertension increased significantly among MAs, but not for NH-whites. The age-adjusted prevalence is now higher in MAs (51%) than NH-whites (49%). Hypertension risk factors (age, obesity prevalence, abdominal obesity, and acculturation) have significantly increased among MAs. Conclusions Hypertension is a major and increasing health problem for MAs. Detection and control of hypertension among MAs should be a healthcare priority for this population. Funding Sources None.

High prevalence of patellofemoral osteoarthritis in China: a multi-center population-based osteoarthritis study.

To describe the prevalence and risk factors of patellofemoral osteoarthritis (PFOA) among Chinese residents. A multi-center population-based osteoarthritis study was conducted in 2014. Residents aged ≥ 50years old were recruited using a cluster sampling method. Subjects completed a home interview and physical examination and had skyline view of radiographs at patellofemoral (PF) joints. Radiographs were read by two trained musculoskeletal researchers, and discordance of a subject's PFOA status between two readers was adjudicated with a third musculoskeletal researcher present. Radiographic OA at PF joint was defined if osteophytes (OST) score was ≥ 2 or if joint space narrowing (JSN) score was ≥ 2 with concurrent grade 1 OST in the PF joint. Of 3446 subjects (63.0% women) included in this analysis, the prevalence of radiographic PFOA was 23.9% (20.5% men vs. 25.8% women). Prevalence of lateral radiographic OA was higher than medial radiographic OA at PF joint. Grades of both osteophytes and joint space narrowing in the lateral patellofemoral compartment were higher than those in the medial patellofemoral compartment (all P values < 0.001). Women, older age, higher BMI, and fewer years of education were significantly associated with higher prevalence of radiographic PFOA, osteophytes, and joint space narrowing. Prevalence of radiographic PFOA was high among Chinese population. Key Points • The multi-center population-based osteoarthritis study shows the prevalence of radiographic PFOA was high among Chinese population. • Older age, female gender, obesity, and few years of education were associated with a high risk of PFOA. • Prevalence of lateral radiographic OA was higher than medial radiographic OA at PF joint.

Multiple Measures of Mineral Metabolism Were Associated With Renal Function in Chinese Centenarians: A Cross-Sectional Study.

Background: Chronic kidney disease (CKD) constitutes a public health issue that is estimated to affect more than 10% of global population. Over 100 million people have CKD in China. For the first time, this cross-sectional study was designed to determine whether multiple measures of mineral metabolism had a significant association with renal function in Chinese centenarians.Methods: China Hainan Centenarian Cohort Study was conducted in 18 cities and counties of Hainan Province, China. It utilized the standard methodology for home interview and blood analyses in 750 centenarians including 608 females and 142 males.Results: All centenarians have a median (range) age of 102 (100–115) years, and median (range) level of estimated glomerular filtration rate (eGFR) was 63 (16–138) ml/min/1.73 m2. There were 318 centenarians (42.4%) with eGFR levels <60 ml/min/1.73 m2. In simple correlation and multivariate linear regression analyses, serum phosphorus, osteocalcin, β-crosslaps, total procollagen type 1 N-terminal propeptide (TP1NP), and parathyroid hormone (PTH) levels were negatively associated with eGFR levels (P < 0.05 for all).Conclusion: The current study supported that serum phosphorus, osteocalcin, β-crosslaps, TP1NP, and PTH levels were negatively associated with eGFR levels, and demonstrated a significant association between multiple measures of mineral metabolism and renal function in Chinese centenarians.

The role of sex hormones and inflammation in the causal pathway of high bmi to knee oa the role of sex hormones and inflammation in the causal pathway of high bmi to knee OA

Purpose: There is consistent evidence of the high impact of increased BMI on knee OA and knee pain. There is also some evidence that hormone levels are associated to OA, though this relationship is influenced by BMI. We hypothesized that the decreasing hormone levels may play a role in the causal pathway that leads to a higher prevalence and incidence of knee OA and pain at least in women. Therefore, we tested this hypothesis by using Structural Equation Modeling (SEM) in men and women independently. The aim of this study was to explore the causal relationships between sex hormones, inflammation factors and BMI in radiographic knee OA (RKOA) and chronic knee pain (CKP). Methods: We used the Rotterdam Study cohort, a population based prospective study with participants aged 45 and older. The participants underwent an interview on pain questionnaire, blood and radiographic measurements at baseline as well as follow-up radiographic measurements. In our study for prevalent radiographic knee OA (RKOA) we included a total of 12,546 observed knees of which 606 were knee OA cases. For incident radiographic knee OA, from the 11,940 knees without OA, 4,090 were lost to follow-up, so we included 7,850 knees without knee OA at baseline from which 533 developed knee OA during a median follow-up time of 5 years. RKOA was defined as a KL score of 2 or higher. Participants provided answers during a home interview about current musculoskeletal pain in the knees, hips, hands and lower back. If present, the duration was also recorded. We included 5,897 participants in our analysis for prevalent chronic knee pain (CKP). There were 2,349 participants with CKP and 3,548 with no pain in either of their knee joints. CKP was defined as having pain in the knee joint for more than 3 months. We estimated the direct and indirect effects of BMI, CRP, estradiol and sex hormone binding globulin (SHBG) on prevalence and incidence of RKOA and CKP by using SEM. SEM is a multivariate statistical analysis technique that is used to analyze structural relationships. Results: Our results from the SEM analysis on the prevalence of RKOA (Figure 1), show that BMI has a significant association with an effect estimate of 0.1 on RKOA in women. The indirect effects from BMI through estradiol or through SHBG to RKOA were also present only in women but with a much smaller effect estimate (estimate=0.004 through estradiol, estimate=0.01 through SHBG) compared to the direct effect of BMI. In contrast, we found an indirect effect from BMI through CRP to RKOA (estimate=-0.01) only in men. In case of CKP, we did not find indirect effects of BMI though the sex hormones or CRP in neither women nor men. BMI has a strong direct effect on CKP in both women (estimate = 0.18) and men (estimate = 0.15) as shown in Figure 2. The SEM models showed good indices of fit: CFI (Comparative Fit Index) and the RMSEA (Root Mean Square Error of Approximation). CFI should be above 0.95 and RMSEA below 0.05. For the RKOA model: CFI=0.98 and RMSEA=0.046. For the CKP model: CFI=0.98 and RMSEA=0.038. Conclusions: We found indeed indirect effects of BMI on RKOA through estradiol and SHBG in women, but not in men. However, the contribution of the path through sex hormones is negligible to the total effect of BMI on RKOA. In men we found a (small) indirect effect of BMI on RKOA through CRP, a well-known inflammation factor. Curiously, this effect was protective.View Large Image Figure ViewerDownload Hi-res image Download (PPT)