Partner Reports Research Articles

Discrepancies in perceptions of PTSD symptoms among veteran couples: Links to poorer relationship and individual functioning.

Veteran and intimate partner perceptions of posttraumatic stress disorder (PTSD) may differ, and little is known about how agreement or disagreement on symptom severity is related to relationship satisfaction. Veterans and their partners (N = 199 couples) completed a baseline assessment for a clinical trial evaluating two couple-based PTSD interventions. Veterans completed the PTSD Checklist for DSM-5 (PCL-5). Partners completed the collateral PCL-5 (PCL-5-C), which asked them to rate the severity of the veteran's PTSD symptoms. Both partner and veteran completed the Couples Satisfaction Index (CSI-32). Intraclass correlations (ICC) assessed agreement between PCL-5 and PCL-5-C total and subscale scores, which was low for total PCL and for all subscales (ICC = 0.15-0.46). Actor-Partner Interdependence Models (APIMs; actor-only pattern) tested associations between relationship satisfaction and PTSD symptom severity (total PCL and subscales), and the magnitude and direction of difference between PCL-5 and PCL-5-C (total and subscales). For veterans, more severetotal PTSD and negative cognition/mood scores were associated with lower relationship satisfaction, and the direction of discrepancy for negative cognition/mood (i.e., higher veteran-rated PTSD symptoms relative to partner's collateral report) was also associated with lower satisfaction. For partners, more severe collateral-reported symptoms for total PTSD and all four subscales were associated with lower relationship satisfaction; further, a larger discrepancy between veterans' and partners' reports of total PTSD, negative cognition/mood, and hyperarousal were associated with lower satisfaction. These results suggest that partners may have different perceptions of PTSD symptoms, and support the potential of fostering a shared understanding of PTSD symptom severity in couples.

Beyond delinquency and drug use: Links of peer pressure to long-term adolescent psychosocial development.

This study examined the predictors and sequelae of exposure to peer pressure from close friends in adolescence. Adolescents (99 female; 85 male) were followed from age 13 to 24 utilizing peer, parent, and romantic partner reports and observational data. Participants who were exposed to high levels of peer pressure as teens were more likely to experience higher levels of coercive behavior from romantic partners (as reported by those partners), as well as lower levels of parent-reported functional independence. All findings held even after accounting for baseline levels of teen assertiveness. Adolescents at risk for increasing exposure to peer pressure were characterized by poor-quality parent and peer relationships, as well as baseline deficits in ability to assert autonomy. Results suggest that exposure to peer pressure, aside from its potential effects on deviant or risky behavior, may reflect a powerful threat to the autonomy development process as adolescents transition from parents to peers as primary sources of support and interaction.

Concordance of Mother and Father Reports of Intimate Partner Violence and Observed Interactions in Unmarried Black Coparents Expecting Their First Child.

Concordance between partner reports of Intimate Partner Violence (IPV) is generally low, but self-reporting of IPV and concordance between partners among expectant parents in marginalized communities has not been explored, nor have associations among each partner's reports of IPV and their behaviors in observed conflict discussions. This study will examine these gaps. One hundred and thirty-eight low-income, unmarried, Black, coparenting dyads expecting their first child together (136 mothers and 136 fathers) completed the Revised-Conflict Tactics Scale and a video recorded and coded conflict discussion. There was low concordance between parent's reports of IPV overall with moderate levels of concordance for coparents who were living together and had more harmonious relationships. Linear regression analyses indicated only mothers' reports of fathers' psychological and physical IPV but not fathers' reports of IPV were significantly associated with observed negative communication. Neither coparents' reports of psychological or physical IPV were associated with positive communication during a conflict discussion. These findings suggest that at the time of parenthood transitions, mothers' reports of fathers' IPV behaviors may be more robust in their association with negative/unhealthy couple communication patterns than fathers' reports and should be used when making safety determinations with families.

Longitudinal Trajectories of the Cognitive Function Index in the A4 Study

BackgroundThe Anti-Amyloid in Asymptomatic Alzheimer’s Disease (A4) Study failed to show a treatment benefit with solanezumab, but the longitudinal consequences of elevated amyloid were observed in study participants with objective decline on the Preclinical Alzheimer Cognitive Composite (PACC) and subjective decline on the combined Cognitive Function Index (participant + study partner CFI), during the trial period.ObjectivesWe sought to expand on previous findings by comparing longitudinal patterns of participant and study partner CFI separately and their associations with the PACC stratified by baseline amyloid tertile over the course of the A4 Study.DesignCognitively unimpaired older adult participants and their study partners were independently administered the CFI at screen prior to amyloid PET disclosure and then at 3 subsequent visits (week 48, week 168, week 240) of the study. PACC collected at visits concurrent with CFI administration were also examined longitudinally.SettingThe A4 Study was conducted at 67 sites in Australia, Canada, Japan, and the United States.Participants1,147 participants with elevated amyloid based on florbetapir PET were enrolled in the A4 Study and included in these analyses. 583 were on placebo and 564 were treated with solanezumab.MeasurementsThe PACC was used to assess objective cognitive performance and the CFI was used to assess change in everyday cognitive functioning by the participant and their study partner independently. Amyloid level was characterized by Centiloid tertiles (<46.1 CL, 46.1 to 77.2 CL, >77.2 CL). Participants were aware of their elevated amyloid status, but not their CL tertile, or specific level of amyloid. Longitudinal correlations between participant and study partner CFI and PACC were examined at all visits where assessments were available. The impact of baseline amyloid tertile on CFI and PACC associations was also examined.ResultsBoth participant and study partner CFI increased over the duration of the study indicating worsening cognitive functioning. Results did not differ by treatment group. The association between higher CFI and worse PACC for both for participant and study partner became progressively stronger over the course of the study. PACC had a significantly higher correlation with study partner CFI than with participant CFI by week 168. The stronger correlations between study partner CFI and PACC were driven by those in the highest amyloid tertile.ConclusionBoth participant and study partner report captured subtle changes in everyday cognitive functioning for participants with biomarker confirmed and disclosed preclinical AD. Moreover, study partner report was most highly aligned with cognitive decline, particularly among those with the highest amyloid load.

ALK -rearranged Mesenchymal Neoplasms With Prominent Foamy/Pseudolipogenic Cell Morphology : Expanding the Phenotypic Spectrum of ALK Fusion Neoplasms and Report of Novel Fusion Partners.

The category of ALK -rearranged mesenchymal neoplasms has been evolving rapidly, with reports of morphologically diverse lesions of cutaneous, soft tissue, and visceral origin. While some of these represent morphologically defined entities harboring recurrent ALK fusions (inflammatory myofibroblastic tumor and epithelioid fibrous histiocytoma), others are unclassified by morphology with variable overlap with the tyrosine kinase family of neoplasia and their underlying ALK fusions cannot be suspected based on morphology. We herein report 3 cases that expand the anatomic, morphologic, and genotypic spectrum of ALK -rearranged unclassified neoplasms. Patients were all adults aged 46 to 69 (median: 63) who presented with a mass located in the gingiva, subcutis of the back, and submucosal posterior pharyngeal wall. The tumor size ranged from 1 to 2.7 cm (median: 1.6). Conservative surgery was the treatment in all patients. Follow-up was available for one patient who remained disease-free at 14 months. Histologically, all tumors displayed large polygonal cells with foamy to granular and lipogenic-like microvacuolated copious cytoplasm and medium-sized round nuclei with 1 or 2 prominent nucleoli. Mitoses and necrosis were not seen. The initial diagnostic impression was PEComa, inflammatory rhabdomyoblastic tumor and unclassified pseudolipogenic neoplasm. Strong cytoplasmic ALK was detected by immunohistochemistry in all cases. Other positive markers include Cathepsin K (2/2), desmin (1/3), focal MyoD1 (1/1), focal SMA (1/3), and focal EMA (1/2). Targeted RNA sequencing revealed ALK fusions with exon 20 (2 cases) and exon 19 (one case) of ALK fused to RND3 (exon 3), SQSTM1 (exon 6), and desmin (intron 6). Methylation profiling in the desmin-fused case (initially diagnosed as inflammatory rhabdomyoblastic tumor) revealed an inflammatory myofibroblastic tumor match with a low confidence score of 0.5 and a flat copy number variation (CNV) profile. No NF1 mutation was detected in this case, altogether excluding an inflammatory rhabdomyoblastic tumor. Our study highlights and expands the morphologic and anatomic diversity of ALK- fused neoplasms and documents novel fusion partners ( RND3 and desmin).

Associations Between Self and Study Partner Report of Cognitive Decline With Regional Tau in a Multicohort Study.

Self-reported cognitive decline is an early behavioral manifestation of Alzheimer disease (AD) at the preclinical stage, often believed to precede concerns reported by a study partner. Previous work shows cross-sectional associations with β-amyloid (Aβ) status and self-reported and study partner-reported cognitive decline, but less is known about their associations with tau deposition, particularly among those with preclinical AD. This cross-sectional study included participants from the Anti-Amyloid Treatment in Asymptomatic AD/Longitudinal Evaluation of Amyloid Risk and Neurodegeneration studies (N = 444) and the Harvard Aging Brain Study and affiliated studies (N = 231), which resulted in a cognitively unimpaired (CU) sample of individuals with both nonelevated (Aβ-) and elevated Aβ (Aβ+). All participants and study partners completed the Cognitive Function Index (CFI). Two regional tau composites were derived by averaging flortaucipir PET uptake in the medial temporal lobe (MTL) and neocortex (NEO). Global Aβ PET was measured in Centiloids (CLs) with Aβ+ >26 CL. We conducted multiple linear regression analyses to test associations between tau PET and CFI, covarying for amyloid, age, sex, education, and cohort. We also controlled for objective cognitive performance, measured using the Preclinical Alzheimer Cognitive Composite (PACC). Across 675 CU participants (age = 72.3 ± 6.6 years, female = 59%, Aβ+ = 60%), greater tau was associated with greater self-CFI (MTL: β = 0.28 [0.12, 0.44], p < 0.001, and NEO: β = 0.26 [0.09, 0.42], p = 0.002) and study partner CFI (MTL: β = 0.28 [0.14, 0.41], p < 0.001, and NEO: β = 0.31 [0.17, 0.44], p < 0.001). Significant associations between both CFI measures and MTL/NEO tau PET were driven by Aβ+. Continuous Aβ showed an independent effect on CFI in addition to MTL and NEO tau for both self-CFI and study partner CFI. Self-CFI (β = 0.01 [0.001, 0.02], p = 0.03), study partner CFI (β = 0.01 [0.003, 0.02], p = 0.01), and the PACC (β = -0.02 [-0.03, -0.01], p < 0.001) were independently associated with MTL tau, but for NEO tau, PACC (β = -0.02 [-0.03, -0.01], p < 0.001) and study partner report (β = 0.01 [0.004, 0.02], p = 0.002) were associated, but not self-CFI (β = 0.01 [-0.001, 0.02], p = 0.10). Both self-report and study partner report showed associations with tau in addition to Aβ. Additionally, self-report and study partner report were associated with tau above and beyond performance on a neuropsychological composite. Stratification analyses by Aβ status indicate that associations between self-reported and study partner-reported cognitive concerns with regional tau are driven by those at the preclinical stage of AD, suggesting that both are useful to collect on the early AD continuum.

Awareness of episodic memory and meta-cognitive profiles: associations with cerebrospinal fluid biomarkers at the preclinical stage of the Alzheimer's continuum.

The lack of cognitive awareness, anosognosia, is a clinical deficit in Alzheimer's disease (AD) dementia. However, an increased awareness of cognitive function, hypernosognosia, may serve as a marker in the preclinical stage. Subjective cognitive decline (SCD) might correspond to the initial symptom in the dynamic trajectory of awareness, but SCD might be absent along with low awareness of actual cognitive performance in the preclinical stage. We hypothesized that distinct meta-cognitive profiles, both hypernosognosia and anosognosia, might be identified in preclinical-AD. This research evaluated the association between cerebrospinal fluid (CSF) AD biomarkers and the awareness of episodic memory, further exploring dyadic (participant-partner) SCD reports, in the preclinical Alzheimer's continuum. We analyzed 314 cognitively unimpaired (CU) middle-aged individuals (mean age: 60, SD: 4) from the ALFA+ cohort study. Episodic memory was evaluated with the delayed recall from the Memory Binding Test (MBT). Awareness of episodic memory, meta-memory, was defined as the normalized discrepancy between objective and subjective performance. SCD was defined using self-report, and dyadic SCD profiles incorporated the study partner's report using parallel SCD-Questionnaires. The relationship between CSF Aβ42/40 and CSF p-tau181 with meta-memory was evaluated with multivariable regression models. The role of SCD and the dyadic contingency was explored with the corresponding stratified analysis. CSF Aβ42/40 was non-linearly associated with meta-memory, showing an increased awareness up to Aβ-positivity and a decreased awareness beyond this threshold. In the non-SCD subset, the non-linear association between CSF Aβ42/40 and meta-memory persisted. In the SCD subset, higher Aβ-pathology was linearly associated with increased awareness. Individuals presenting only study partner's SCD, defined as unaware decliners, exhibited higher levels of CSF p-tau181 correlated with lower meta-memory performance. These results suggested that distinct meta-cognitive profiles can be identified in preclinical-AD. While most individuals might experience an increased awareness associated with the entrance in the AD continuum, hypernosognosia, some might be already losing insight and stepping into the anosognosic trajectory. This research reinforced that an early anosognosic profile, although at increased risk of AD-related decline, might be currently overlooked considering actual diagnostic criteria, and therefore its medical attention delayed.

Substance Use and Discrimination in a sample of U.S.-based Latinx Sexual Minority Men and their main partners.

Substance use, including drug and alcohol misuse, is associated with myriad health conditions, including higher risk for HIV infection. While preliminary evidence suggests that higher levels of relationship functioning can buffer against the deleterious health consequences of discrimination on mental health broadly, such protective associations have been understudied with respect to alcohol and drug use. The topic is particularly understudied among Latinx sexual minority men - despite the fact that they are at greater risk for problematic substance use behaviors and are likely to experience multiple forms of discrimination (e.g., racism, homophobia). To address this gap in the literature, we sampled 95 predominately Latinx sexual minority male couples to assess their drinking and drug use behaviors, relationship functioning, and experiences of discrimination. We used Actor-Partner Interdependence models to test our hypotheses. We found that having a partner who experienced discrimination and higher partner reports of relationship functioning buffered against the negative relationship between own experiences of discrimination and drug use, but not problematic drinking. Our results suggest that higher relationship functioning serves as a buffer between the negative ramifications of discrimination on drug use, but not problematic drinking. We explicate implications for policy and practice to facilitate well-being among coupled Latinx sexual minority men.

Who's Worried? Memory, Worries About Dementia, and Marital Strain in Midlife Same- and Different-Sex Marriages: A Dyadic Perspective.

Prior scholarship has highlighted the importance of marriage for cognition. However, little research has considered how cognition-related concerns may impact marriage. In this study, researchers examine how aging couples view each other's memory and worry about their potential development of dementia in the future. Additionally, researchers investigate whether these cognition-related concerns may strain marriage, and how these dynamics differ for men and women in same- and different-sex marriages. Researchers used 2 waves of dyadic data from the Health and Relationships Project (HARP; 2015-2022), including 594 respondents from 297 same- and different-sex married couples (aged 41-71 at Time 2). Researchers employed the Actor-Partner Interdependence Model (APIM) to explore associations between actor and partner reports of memory and dementia worry with marital strain. Men and women in same- and different-sex marriages were equally likely to report worries about their own potential development of dementia. However, women reported more concerns about their spouse developing dementia in the future than men did, regardless of whether they were married to a man or a woman. Both partners' reports of memory and dementia worry played a complex role in influencing marital strain, with variations observed across couple types. Concerns about cognitive decline and dementia are common in older populations, and for married couples, spouses have concerns about their own memory as well as that of their partner. Researchers finding identified the significance of concerns about a spouse's memory on marital dynamics among aging couples.

Drivers of Memory Loss Underreport in Mild Cognitive Impairment Due to Alzheimer Versus Vascular Disease.

We examined drivers of self and study partner reports of memory loss in mild cognitive impairment (MCI) from Alzheimer (AD-MCI) and vascular disease (Va-MCI). We performed retrospective cross-sectional analyses of participants with AD-MCI (n=2874) and Va-MCI (n=376) from the National Alzheimer Coordinating Center data set. Statistical analysis utilized 2-sided t test or the Fisher exact test. Compared with AD-MCI, Va-MCI subjects (24.5% vs. 19.7%, P =0.031) and study partners (31.4% vs. 21.6%, P <0.0001) were more likely to deny memory loss. Black/African Americans were disproportionately represented in the group denying memory loss in AD-MCI (20.0% vs. 13.2%, P <0.0001) and Va-MCI (33.7% vs. 18.0%, P =0.0022). Study partners of participants with these features also disproportionately denied memory loss: female (AD-MCI: 60.1% vs. 51.7%, P =0.0002; Va-MCI: 70.3% vs. 52.3%, P =0.0011), Black/African American (AD-MCI: 23.5% vs. 11.98%, P <0.0001; Va-MCI: 48.8% vs. 26.5%, P =0.0002), and <16 years of education (AD-MCI only: 33.9% vs. 16.3%, P =0.0262). In AD-MCI and Va-MCI, participants with anxiety were disproportionately represented in the group endorsing memory loss (AD: 28.2% vs. 17.4%, P <0.0001; Va: 31.5% vs. 16.1%, P =0.0071), with analogous results with depression. The findings would suggest extra vigilance in interview-based MCI detection of persons at-risk for self-based or informant-based misreport.

Correlates of Sexual Behavior Across Fatherhood Status: Finding From the National Longitudinal Study of Adolescent to Adult Health (Add Health), 2016-2018.

Amid national trends in postponed parenthood and more diverse family structures, the fatherhood identity may be important to men's sexual behaviors. This study examined factors associated with reports of consistent contraceptive use and multiple sexual partners across fatherhood status. Using public data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), Wave V (2016-2018), two sexual behaviors were examined among 1,163 men aged 32 to 42 years. Outcomes were two binary indicators: consistent contraceptive use with partner and having multiple (≥2) sexual partners in the past year. Fatherhood status was categorized as nonfather, resident father, and nonresident father. Demographic (e.g., race/ethnicity, education, income, and relationship type) and health-related (e.g., drinking, perceived stress, depressive symptoms, and insurance status) factors were considered. Logistic regression analysis produced odds ratios and 95% confidence intervals and were stratified by fatherhood categories. In the sample, 72% of men were resident fathers, 10% were nonresident fathers, and 18% were nonfathers; 28% reported consistent contraceptive use and 16% reported multiple sexual partners. For nonfathers, relationship type and race were associated with reporting multiple sexual partners. For resident fathers, relationship type was the crucial factor associated with consistent contraceptive use and reporting multiple sexual partners. In nonresident fathers, relationship type, education, and income were important factors to consistent contraceptive use and reporting multiple sexual partners. Key findings suggest that relationship type, income, and education are crucial factors to men's sexual behavior. Heterogeneous effects were observed across fatherhood status. This study adds to limited research on fatherhood and sexual behavior among men transitioning from young adulthood to middle age.

Study Partner Report of Apathy in Older Adults is Associated with AD Biomarkers: Findings from the Harvard Aging Brain Study

ObjectivesWe examined relationships between apathy (self and study-partner-reported) and markers of Alzheimer's disease (AD) in older adults. DesignThe study utilized a well-characterized sample of participants from the Harvard Aging Brain Study (HABS), a longitudinal cohort study. Participants were cognitively unimpaired without clinically significant neuropsychiatric symptoms at HABS baseline. The dependent variables, apathy evaluation scale-self (AES-S) and informant (AES-I), were administered cross-sectionally between years 6–9 and compared to the independent variables, amyloid and tau PET neuroimaging, from the same year. SettingCommunity-dwelling participants assessed at research visits in an academic medical center. ParticipantsParticipants (n = 170) completed assessments within 1.5 years of their neuroimaging visit. At the time of apathy assessment, N = 156 were cognitively unimpaired and 14 had progressed to mild cognitive impairment (n = 8) or dementia (n = 6). MeasurementsWe utilized linear regression models to assess cross-sectional associations of AES-S and AES-I with AD PET imaging measures (beta-amyloid (Pittsburgh Compound B) and tau (Flortaucipir)), covarying for age, sex, education, and the time between PET scan-apathy assessment. ResultsAES-I was significantly associated with beta-amyloid and temporal lobe tau, and the associations were retained after further adjusting for depressive symptoms. The associations between AES-S and AD biomarkers were not significant. In an exploratory subgroup analysis of cognitively unimpaired individuals with elevated Aβ, we observed an association between AES-I and inferior temporal tau. ConclusionsStudy-partner-reported, but not self-reported, apathy in older adults is associated with AD pathology, and we observed this relationship starting from the preclinical stage. Our findings highlight the importance of collateral information in capturing AD-related apathy.

Validity of Partner Reports of Recent Condomless Sex.

Prostate-specific antigen (PSA), a biomarker of vaginal semen exposure, is less susceptible to bias than self-reported condom use behaviors. We examined the agreement of self-reported recent condomless sex (RCS) within couples and how these reports related to PSA detection. We analyzed data from a study conducted in Vietnam, 2017 to 2020, of 500 different-sex couples using condoms and no other contraceptive method to prevent pregnancy for 6 months. We assessed enrollment and 6-month data from vaginal swabs and questionnaires from both partners. We calculated Prevalence-Adjusted Bias-Adjusted Kappa (PABAK) to evaluate agreement of men's and women's reports. Among couples with detected PSA, we assessed partner concordance of RCS reporting. At enrollment (n = 499), 79.8% of couples reported no RCS, 16.4% reported RCS, and 3.8% had partner-discordant reports (PABAK, 0.93; 95% confidence interval, 0.91-0.97). At 6 months (n = 472), 91.7% reported no RCS, 5.7% reported RCS, and 2.5% had partner-discordant reports (PABAK, 0.98; 95% confidence interval, 0.96-1.0). Among couples with detected PSA at baseline (11%, n = 55), 36% reported no RCS, 55% reported RCS, and 6% had discordant reports; at 6 months (6.6%, n = 31), 58% reported no RCS, 35% reported RCS, and 3% had discordant reports. We observed high agreement regarding condomless sex within couples in a population using condoms as contraception in Vietnam; however, a high proportion of couples with detected PSA had both partners reporting no RCS, indicating that concordant reporting of no RCS does not indicate lack of semen exposure.

Unique roles of adolescents' friends and fathers in predicting verbal aggression in future adult romantic relationships.

This 20-year prospective study examined verbal aggression and intense conflict within the family of origin and between adolescents and their close friends as predictors of future verbal aggression in adult romantic relationships. A diverse community sample of 154 individuals was assessed repeatedly from age 13 to 34 years using self-, parent, peer, and romantic partner reports. As hypothesized, verbal aggression in adult romantic relationships was best predicted by both paternal verbal aggression toward mothers and by intense conflict within adolescent close friendships, with each factor contributing unique variance to explaining adult romantic verbal aggression. These factors also interacted, such that paternal verbal aggression was predictive of future romantic verbal aggression only in the context of co-occurring intense conflict between an adolescent and their closest friend. Predictions remained robust even after accounting for levels of parental abusive behavior toward the adolescent, levels of physical violence between parents, and the overall quality of the adolescent's close friendship. Results indicate the critical importance of exposure to aggression and conflict within key horizontal relationships in adolescence. Implications for early identification of risk as well as for potential preventive interventions are discussed.

Unpacking Aid in Africa- The Decolonization Turn

WHERE IS THE MONEY COMING FROM? Is development aid invested in Africa a beacon of hope or an example of ‘Afro-pessimism’?[1] Today, Africa finds itself at a crucial juncture of development with a growing population, burgeoning market, expanding resource base, and, more importantly, a willingness to orchestrate a future driven by an African development vision. The vital caveat in this discussion is that Africa’s bright future is not merely privy to African nation-states or its citizens but finds itself within policy briefs of Western countries, budgets of philanthropic organizations, and audit reports of development partners. Rooted within the call to decolonize knowledge, systems, and universities, there is a growing agreement that philanthropy in Africa must be decolonized (Krauss, 2018). Development aid must be unpacked to engage with colonial and hegemonic institutions, power, and dynamics that operate or structure it. Development practitioners engaging with African development, its multiple futures, and stakes highlight essential considerations to critically analyze the colonial basis of aid invested in Africa. Firstly, scholars question the characterization of aid as a free handout or a generous investment for improving ‘unhopeful’ lives. The reality is that support in Africa is conditional, directed at strategic interest to gain influence, partners, workers, market, and resources, to name a few (Iweala, 2017). The second complexity is the investment history and the ideology that propels it. Historically, Africans were ‘helped’ to ‘liberate’ and ‘save’ them by displaying poverty and violence as the continent’s reality (Goris &amp; Magendane, 2021). This ideological basis laid the ground for humanitarian interventions and logic wherein infrastructure was built to reinforce colonial purposes, exposing the lasting overlap between aid and colonialism in its operations. Colonialism extends far beyond the occupation of ‘territory’ by force (Banerjee &amp; Shriram, 2022). Within this context, the call for decolonization means that acts of generosity cannot absolve individuals (read philanthropists) from accountability for their actions. Thirdly, the sector’s expected investment outcome from ‘capacity building’ to ‘capacity bridging’ by rooting philanthropy in social justice, equality, representation, and empowerment is a recurring debate (Peace Direct et al., 2023). An often-quoted argument is that humanitarianism historically disabled African states to not invest in their development or generate wealth for development purposes (Goris, 2021). Does the call for decolonization imply a complete withdrawal of humanitarian aid to help states find their grounding, and is a disconnected approach the solution to incoming foreign aid in an interconnected world (Krauss, 2018)? While problematizing the basis of philanthropy in Africa, this paper also engages with possible policy solutions that, rather than absolving philanthropists of responsibility, look at involving Africans as equal partners within the aid ecosystem.

DAILY NEGATIVE AND POSITIVE EVENTS AND DAILY WELL-BEING: DYADIC LINKS IN COUPLES LIVING WITH EARLY-STAGE DEMENTIA

Abstract Spouses have powerful influences on well-being in middle and later life, but we know little about how daily events impact well-being in older couples that include persons living with dementia (PLWD). We examined associations between daily negative and positive events and daily well-being (negative mood and positive mood) in 36 heterosexual married couples living with early-stage dementia. Participants included PLWD (M = 71.47 years, SD = 6.90, range = 53-82 years) and their spouses (M = 69.69 years, SD = 7.26, range = 59-87 years) who both completed brief morning and evening phone interviews over 7 consecutive days. Longitudinal actor-partner interdependence models controlled for own and partner reports of daily well-being in the previous day, whether each day was a weekend day, and the gender of PLWD. We estimated separate models for negative mood and positive mood. Both PLWD and their spouses reported higher negative mood when they reported more negative events in the same day and when their partner reported more negative events in the previous day. Over and above these associations, both partners in the couple reported lower negative mood on days when spouses of PLWD reported more positive events. Spouses of PLWD reported higher positive mood on days when they reported more positive events, but lower positive mood on days when PLWD reported more positive events. These findings highlight the importance of understanding dyadic influences on daily well-being among PLWD and their spouses.

Associations between self and study partner report on the CFI with regional tau in a multi‐cohort study

AbstractBackgroundSelf‐report of cognitive decline is an early behavioral manifestation of Alzheimer’s disease at the preclinical stage, often thought to precede study partner‐report. Prior work has shown associations between subjective cognitive decline and amyloid, but less is known about tau deposition, particularly once tau has spread to neocortex. Using a multi‐cohort study of cognitively unimpaired individuals, we examined associations between self‐ and study partner‐report, amyloid and regional tau. Specifically, we hypothesized that greater self‐ and study partner‐report of cognitive decline would be observed with tau in the medial temporal lobe (MTL), whereas study partner‐report would be more strongly associated with neocortical (NEO) tau compared to self‐report.Method698 cognitively unimpaired individuals (55% elevated‐amyloid, mean age = 72.5, 58% female) came from the A4, LEARN, HABS, and SCD/IADL Studies. All participants underwent Flortaucipir‐PET quantified by SUVr. A MTL tau composite and a NEO tau composite were derived. An internally derived amyloid cut‐off was used for each study. Participants and their study partners completed the Cognitive Function Index (CFI), a 15‐item questionnaire asking about cognitive functioning over the last year. A series of linear regression models using tau (MTL vs. NEO) to predict CFI (self vs. study partner) were conducted, adjusting for age, sex, education, amyloid status and cohort.ResultWe first examined amyloid status and CFI and found elevated‐amyloid was associated with higher self‐report (t = 2.8, p = 0.017), but not study partner‐report (t = 1.5, p = 0.12). Building on this model, greater MTL tau was associated with greater self‐report (t = 3.30, p&lt;0.001) and study partner‐report (t = 3.4, p&lt;0.001), but not amyloid status. Greater NEO tau was associated with greater self‐report (t = 3.2, p = 0.002) and study partner‐report (t = 4.1, p&lt;0.00001), but not amyloid status.ConclusionIn this multi‐cohort study of cognitively unimpaired individuals, elevated‐amyloid was associated with greater self‐report CFI, but not study partner‐report. When accounting for amyloid status, both MTL and NEO tau were significantly associated with both self and study‐partner report, but effects were numerically stronger for study partner for NEO tau. These findings suggest that CFI report both from the participants and their study partners is valuable at the preclinical stage, but may evolve with increasing tau spread.

The association between anxiety and Alzheimer’s disease plasma biomarkers across stages

AbstractBackgroundAnxiety is associated with faster progression of Alzheimer’s disease (AD) and related imaging biomarkers. However, the association of anxiety with plasma biomarkers of AD is unclear. We investigated the relationship between various plasma AD biomarkers and anxiety at different AD stages.MethodThe study included 192 older adults evaluated at the NYU Alzheimer’s Disease Research Center with a consensus diagnosis of cognitively normal (CN, n = 99), mild cognitive impairment (MCI, n = 52), and mild AD dementia (AD, n = 41). Anxiety and depression were measured by study partner report via the Neuropsychiatric Inventory Questionnaire (NPI‐Q). Plasma levels of Aβ40, Aβ42, neurofilament light (NfL) and total tau were measured using ultra‐sensitive, single‐molecule array (SIMOA) technology. Secondarily‐calculated measures included Aβ42/Aβ40 and tau/Aβ42 ratios.ResultAnxiety had a prevalence of 14%, 48%, and 24% at CN, MCI, and AD, respectively. Comparing plasma biomarkers from participants with and without anxiety within each stage, anxiety associated with a significantly higher plasma tau/Aβ42 ratio in AD (p = 0.0127). In contrast, while depression had a higher prevalence of 37% at the AD stage, it was not associated with a significant difference in tau/Aβ42 ratio (p = 0.6459). Comparing stages, plasma tau/Aβ42 was significantly elevated in AD versus CN only among participants with anxiety (p = 0.034). In contrast, plasma NfL was significantly elevated in AD versus CN among participants with (p = 0.0475) and without (p &lt; 0.0001) anxiety.ConclusionThe presence of anxiety uniquely modulates the levels of specific plasma biomarkers depending on stage, as well as the ability of specific biomarkers to distinguish AD stages. These results highlight a complex relationship between neuropsychiatric symptoms and plasma biomarkers that warrants further study.

Quality of life, satisfaction with care, and the experiences of adults with intellectual and developmental disabilities before and during COVID-19

BackgroundAdults with intellectual and developmental disabilities (IDD) experienced significant disruptions in their access to health care, support services, and essential daily activities such as work, leisure, and routine daily care during COVID-19. ObjectiveThe purpose of this study was to describe overall experiences related to COVID-19 among adults with IDD, including the vaccination process, quality of life (QoL), and service satisfaction before and during the pandemic. MethodsA longitudinal statewide survey of adults with IDD receiving long-term care support using a combination of self- and care partner report was completed prior to (2017; n = 331) and during (2021; n = 206) the pandemic. ResultsQualitative results identified specific vaccine barriers, vaccine decision influencers, and general experiences during COVID-19 for adults with IDD. The importance of support staff, vaccine availability, disruption in daily activities, social context, and mental health implications were noted in responses to all three topics. Quantitative results showed lower QoL during COVID-19 (M = 2.99 vs. 3.14, p = .028); however, when reporter (self vs. care partner) and age were added to the model, differences between pre-vs. during-COVID were no longer significant. No significant differences in satisfaction of services were noted pre-vs. during-COVID-19. Ninety-six percent of respondents reported access to the vaccine, and 16 % experienced barriers getting the vaccine. QoL was associated with receiving the COVID-19 vaccine (r = 0.15, p = .036), level of agreement that the vaccine is safe (r = 0.17, p = .024), and level of agreement that getting the vaccine will help protect other vulnerable people in the community (r = .25, p = .001). Level of satisfaction with quality of services was also associated with level of agreement that the vaccine is safe (r = 0.15, p = .048). ConclusionsOverall, a better understanding of service continuation, support practices, and experiences related to COVID-19 will prepare us for future environmental and health crises by identifying areas for improvement, intervention, and policy change to meet the ongoing needs of adults with IDD.

The Experiences of Female Partners of Patients With Erectile Dysfunction Due to Prostate Cancer Treatment in China: A Qualitative Exploration.

Because of sociocultural factors, Chinese female partners of patients with prostate cancer (PC) may have perspectives and needs that differ from the more published reports of female partners living in Western cultures. The aim of this study was to explore the experiences of female partners of patients with PC experiencing erectile dysfunction in China. In this interpretive descriptive design, qualitative data were collected from semistructured telephone interviews with purposively sampled participants from the urology outpatient unit in a hospital in South China. The interviews were audiotaped, transcribed, and analyzed using a constant comparison approach. Three themes emerged from the analysis of the participants' narratives: (a) acceptance of ceasing sex; (b) preserving intimacy through caregiving; and (c) the need for sexual health-related information. Participants in this study reported that their own sexuality and intimacy were affected by their partner's erectile dysfunction, but they adjusted to sexuality and intimacy changes through their caregiving of their husbands owing to Chinese traditional perspectives on women's obligations. They also reported having unmet informational needs in improving sexual well-being for the sake of their partners, lending further support to the likely benefit of couple-based educational interventions addressing sexual wellness in dyads affected by PC and erectile dysfunction. The present study findings highlighted the need for more research attention to the support of Chinese female partners of patients with PC regarding sexual and intimate topics.