Is Acculturation Associated with the Cognitive Performance of Older Hispanics?

2021 ◽  
pp. 1-10
Author(s):  
Rifat B. Alam ◽  
Chelsea R. Singleton ◽  
Susan Aguiñaga ◽  
Wojtek Chodzko-Zajko ◽  
Nilufer A. Jahan ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Digit Symbol Substitution Test ◽  
Cross Sectional ◽  
English Only ◽  
Language Acculturation ◽  
The Us ◽  
Symbol Substitution ◽  
English Speaking ◽  
Performance Results ◽  
The Impact

Background: Hispanics in the United Statues are disproportionately affected by Alzheimer’s disease and related dementias. Little is known about the impact of acculturation on cognitive performance. Objective: This study examined the association between acculturation and cognitive performance among older Hispanics. Methods: We analyzed cross-sectional data of 616 Hispanic participants in the National Health and Nutrition Examination Survey (NHANES) 2011–2014 [average age = 67.15 years, %Female = 51.46, %less than high-school graduate = 52.60]. Cognitive performance was measured by two neuropsychological tests: Animal Fluency Test (AFT) and Digit Symbol Substitution Test (DSST). We used two single-item proxy measures to quantify acculturation: nativity status (non-US-born residing <  15 years in the US (low acculturation), non-US-born residing ≥15 years in the US, and US-born (high acculturation)); and language acculturation (only/mostly Spanish (low acculturation), Spanish and English, only/mostly English (high acculturation)). We used adjusted linear regression to evaluate associations between acculturation and cognitive performance. Results: Results indicated poorer cognitive performance among the low-acculturated groups for both nativity and linguistic measures. Participants who were non-US-born living ≥15 years (p = 0.02) and speaking only/mostly Spanish or Spanish and English (p = 0.01 and 0.006 respectively) had significantly lower AFT scores compared to US-born and only/mostly English-speaking groups. Participants who were non-US-born living <  15 years (p <  0.0001) or non-US-born living ≥15 years (p <  0.0001) and speaking only/mostly Spanish (p = 0.0008) scored lower on the DSST than the US-born and only/mostly English-speaking participants. Conclusion: In summary, low acculturation is associated with poorer cognitive performance among older Hispanics. Acculturation might be an important attribute to help understand cognitive decline and dementias among Hispanics.

scholarly journals Regional Innovation Systems of Medical Technology

REGION ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 57-81
Author(s):  
Rucha Vadia ◽  
Katharina Blankart
Keyword(s):  
Knowledge Production ◽  
Spillover Effects ◽  
External Funding ◽  
Regional Innovation ◽  
Cross Sectional ◽  
Horizon 2020 ◽  
Product Categories ◽  
The Us ◽  
Number Of Publications ◽  
The Impact

We investigated the role of external funding in cardiovascular device innovation across 31 countries in Europe. We rely on the knowledge production function (KPF) framework that establishes the knowledge output of a region as a function of innovatory effort and other characteristics of that region. In a cross-sectional analysis, we investigated regional variation in knowledge production by the number of publications in cardiovascular device research obtained from the bibliometric data of the world’s largest biomedical library, the US National Library of Medicine, 2014‒2017. We mapped these publications to product categories of medical devices approved for cardiovascular diseases by the US Food and Drug Administration. Considering spatial correlation across regions of Europe in our estimates of the KPF, we investigated the impact of two types of funding mechanisms: grants reported in the publications and the volume of European Union Horizon 2020 funding received by the innovating regions. We obtained 123,487 cardiovascular device-related publications distributed across 1,051 (75% of total) regions (NUTS-3 level). Receiving external funding strongly contributes to a region’s knowledge output. The estimated elasticities of innovatory effort range between 0.51 and 0.64. These estimates were consistently larger than the elasticities of other characteristics in the region measured by gross domestic product (0.14‒0.56). We also documented spillover effects from neighboring regions when the funding was measured by the grants reported in the publications, concluding that innovatory efforts in the form of external research investments are effective for promoting innovation in the medical device industry at the regional level.

Indication-Specific Generic Uptake of Imatinib Demonstrates the Impact of Skinny Labeling

2022 ◽  
Author(s):  
Bryan S. Walsh ◽  
Aaron S. Kesselheim ◽  
Ameet Sarpatwari ◽  
Benjamin N. Rome
Keyword(s):  
Patent Protection ◽  
Cross Sectional Study ◽  
Myelogenous Leukemia ◽  
Brand Name ◽  
Generic Competition ◽  
Cross Sectional ◽  
The Us ◽  
Lower Drug ◽  
The Impact ◽  
Brand Name Drugs

PURPOSE Generic competition can be delayed if brand-name manufacturers obtain additional patents on supplemental uses. The US Food and Drug Administration allows generic drug manufacturers to market versions with skinny labels that exclude patent-protected indications. This study assessed whether use of generic versions of imatinib varied between indications included and excluded from the skinny labels. METHODS In this cross-sectional study, we identified adult patients covered by commercial insurance or Medicare Advantage plans who initiated imatinib from February 2016 (first generic availability) to September 2020. Generic versions were introduced with skinny labels that included indications covering treatment of chronic myelogenous leukemia (CML) but excluded treatment of gastrointestinal stromal tumors (GISTs) because of remaining patent protections. Logistic regression was used to determine whether use of generic versus brand-name imatinib differed between patients with a diagnosis of CML or GIST, adjusting for demographics, insurance type, prior use of brand-name drugs, and calendar month. RESULTS Among 2,000 initiators, 934 (47%) had CML and 686 (34%) had GIST. Within 3 years after generics entered the market, more than 90% of initiators in both groups used generic imatinib. Initiation of generic imatinib was slightly lower among patients with GIST than among patients with CML (85% v 88%; adjusted odds ratio 0.56; 95% CI, 0.39 to 0.80; P ≤ .001). CONCLUSION Generic versions of imatinib were dispensed frequently for indications both included (CML) and excluded (GIST) from the skinny labeling, although patients with GIST were slightly less likely to receive a generic version. The skinny labeling pathway allowed generics to enter the market before patent protection for treating patients with GIST expired, facilitating lower drug prices.

scholarly journals Declining mental health among disadvantaged Americans

2018 ◽  
Vol 115 (28) ◽  
pp. 7290-7295 ◽  
Author(s):  
Noreen Goldman ◽  
Dana A. Glei ◽  
Maxine Weinstein
Keyword(s):  
Mental Health ◽  
Psychological Health ◽  
Positive Emotions ◽  
Well Being ◽  
The United States ◽  
Opioid Epidemic ◽  
Cross Sectional ◽  
Modest Improvement ◽  
The Us ◽  
The Impact

Although there is little dispute about the impact of the US opioid epidemic on recent mortality, there is less consensus about whether trends reflect increasing despair among American adults. The issue is complicated by the absence of established scales or definitions of despair as well as a paucity of studies examining changes in psychological health, especially well-being, since the 1990s. We contribute evidence using two cross-sectional waves of the Midlife in the United States (MIDUS) study to assess changes in measures of psychological distress and well-being. These measures capture negative emotions such as sadness, hopelessness, and worthlessness, and positive emotions such as happiness, fulfillment, and life satisfaction. Most of the measures reveal increasing distress and decreasing well-being across the age span for those of low relative socioeconomic position, in contrast to little decline or modest improvement for persons of high relative position.

The Impact of Custodial Grandparenting on Cognitive Performance in a Longitudinal Sample of Grandparents Raising Grandchildren

2020 ◽  
pp. 0192513X2097672
Author(s):  
Ian T. McKay ◽  
Danielle K. Nadorff
Keyword(s):  
Cognitive Performance ◽  
Longitudinal Research ◽  
The United States ◽  
Word Recall ◽  
Grandparents Raising Grandchildren ◽  
Custodial Grandparents ◽  
Cross Sectional ◽  
Custodial Grandparenting ◽  
Sectional Analysis ◽  
The Impact

There are currently 2.7 million grandparents raising grandchildren in the United States. As grandparent caregiving has become more prevalent, concerns have surfaced regarding the effect of additional caregiving responsibilities placed on an aging population. The following study uses an existing dataset of individuals who graduated from Wisconsin high schools in 1957. The present study examined the impact of grandparenting on measures of cognition, both cross-sectionally and longitudinally. Findings from the cross-sectional analysis show that custodial grandparents outperformed their noncustodial grandparent counterparts on the cognitive tests of word recall, category fluency, letter fluency, and cognitive similarities. Findings from the longitudinal analysis show that though custodial grandparents had initially performed worse on the digit ordering task, their scores declined at a much slower rate than non-custodial grandparents. By using a cross-sectional and longitudinal research design, this study provides a unique opportunity to examine the impact of grandparenting on cognitive performance.

scholarly journals Associations of Brain Pathology Cognitive and Physical Markers With Age in Cognitively Normal Individuals Aged 60–102 Years

2019 ◽  
Vol 75 (9) ◽  
pp. 1609-1617 ◽  
Author(s):  
Nienke Legdeur ◽  
Betty M Tijms ◽  
Elles Konijnenberg ◽  
Anouk den Braber ◽  
Mara ten Kate ◽  
...  
Keyword(s):  
Handgrip Strength ◽  
Hippocampal Volume ◽  
Digit Symbol Substitution Test ◽  
Brain Pathology ◽  
Amyloid Aggregation ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
Normal Individuals ◽  
Symbol Substitution ◽  
Physical Functions

Abstract The prevalence of brain pathologies increases with age and cognitive and physical functions worsen over the lifetime. It is unclear whether these processes show a similar increase with age. We studied the association of markers for brain pathology cognitive and physical functions with age in 288 cognitively normal individuals aged 60–102 years selected from the cross-sectional EMIF-AD PreclinAD and 90+ Study at the Amsterdam UMC. An abnormal score was consistent with a score below the 5th percentile in the 60- to 70-year-old individuals. Prevalence of abnormal scores was estimated using Generalized Estimating Equations (GEE) models. The prevalence of abnormal handgrip strength, the Digit Symbol Substitution Test, and hippocampal volume showed the fastest increase with age and abnormal MMSE score, muscle mass, and amyloid aggregation the lowest. The increase in prevalence of abnormal markers was partly dependent on sex, level of education, and amyloid aggregation. We did not find a consistent pattern in which markers of brain pathology cognitive and physical processes became abnormal with age.

scholarly journals Time-of-Day Could Affect Cognitive Screening Performance in Older Patients with TIA and Stroke

2017 ◽  
Vol 43 (5-6) ◽  
pp. 290-293 ◽  
Author(s):  
Sara Mazzucco ◽  
Linxin Li ◽  
Maria A. Tuna ◽  
Sarah T. Pendlebury ◽  
Rhoda Frost ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Older Patients ◽  
Time Of Day ◽  
Minor Stroke ◽  
Cognitive Screening ◽  
Repeated Testing ◽  
Cross Sectional ◽  
Ischemic Attack ◽  
The Impact ◽  
Moca Score

Background and Purpose: The impact of time-of-day on the cognitive performance of older patients with limited cognitive reserve after a transient ischemic attack (TIA) or stroke, and on short cognitive tests, such as the Montreal Cognitive Assessment (MoCA), is unknown. We retrospectively studied whether morning versus afternoon assessment might affect the classification of patients aged 70 or older as severe (SCI), mild (MCI), and no (NCI) cognitive impairment by the MoCA. Methods: Morning (12 p.m. or earlier) versus afternoon (later than 12 p.m.) proportions of SCI (MoCA score <20), MCI (MoCA score 25-20) and NCI (MoCA score ≥26) were compared in a cohort of patients aged ≥70, attending a rapid-access TIA/stroke clinic. Results: Of 278 patients, 113 (40.6%) were tested in the morning and 165 (59.4%) in the afternoon. The proportion with SCI was greater in the afternoon than in the morning (10.9 vs. 1.8%, respectively, p = 0.004), with no difference in age, education, diagnosis, disability, or vascular risk factors. Conclusions: Time-of-day appears to affect cognitive performance of older patients after they undergo TIA and minor stroke. If our cross-sectional findings are confirmed in cross-over studies with repeated testing, timing of assessments should be considered in clinical practice and in research studies.

The Impact of Publishing and Patenting Activities on New Product Development and Firm Performance: The Case of the US Pharmaceutical Industry

2003 ◽  
Vol 07 (02) ◽  
pp. 213-221 ◽  
Author(s):  
G. Steven McMillan ◽  
Alfredo Mauri ◽  
Robert D. Halmilton
Keyword(s):  
Firm Performance ◽  
Pharmaceutical Industry ◽  
Product Development ◽  
New Product Development ◽  
New Product ◽  
The Us ◽  
Managerial Implications ◽  
Performance Results ◽  
The Impact

This paper studies the role of publishing and patenting activities as predictors of new product development for a sample of companies in the U.S. pharmaceutical industry. The research also examines the relation between new product development and firm performance. Hypotheses are developed based on the well-established absorptive capacity literature. The results show that publishing scientific articles and stock of patents are both significant predictors of the number of new molecular entities (NMEs) for which a firm receives approval. In addition, the degree to which a firm builds on its own technology (measured as self-citations in its patents) also predicts NMEs, but the regression coefficient had an unexpected negative sign. Finally, the performance results confirm that the approval of NMEs is significantly associated with the market-to-book ratio of a firm. The managerial implications of these findings and study limitations are also discussed.

scholarly journals Real-World Functioning in Patients With Schizophrenia: Beyond Negative and Cognitive Symptoms

2021 ◽  
Vol 12 ◽  
Author(s):  
María Paz García-Portilla ◽  
Leticia García-Álvarez ◽  
Leticia González-Blanco ◽  
Francesco Dal Santo ◽  
Teresa Bobes-Bascarán ◽  
...  
Keyword(s):  
Real World ◽  
Ad Hoc ◽  
Social Performance ◽  
Pearson Correlation ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Digit Symbol Substitution Test ◽  
Symptom Scale ◽  
Cross Sectional ◽  
Symbol Substitution

Introduction: Interest in the idea of recovery for certain patients with schizophrenia has been growing over the last decade. Improving symptomatology and functioning is crucial for achieving this. Our study aims to identify those factors that substantially contribute to real-world functioning in these patients.Methods: We carried out a cross-sectional study in stable outpatients with schizophrenia on maintenance antipsychotic monotherapy. Patients: We studied 144 outpatients with schizophrenia (DSM-IV-TR criteria) meeting the following criteria: (1) 18–65 years of age; (2) being clinically stable for at least the previous three months; (3) on maintenance antipsychotic monotherapy (prescriptions ≤ 10 mg olanzapine, ≤200 mg quetiapine, or ≤100 mg levomepromazine as hypnotics were also allowed); and (4) written informed consent. Assessment: We collected information on demographic and clinical variables by using an ad hoc questionnaire. For psychopathology, we employed the Spanish versions of the following psychometric instruments: the Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS-Sp), and the Calgary Depression Scale (CDS). In addition, cognitive domains were assessed using the Verbal Fluency Test (VFT), the Digit Symbol Substitution Test (DSST), and the Trail Making Test, parts A and B (TMT-A and TMT-B). Finally, we employed the Spanish versions of the University of California San Diego Performance-based Skills Assessment (Sp-UPSA) and the Personal and Social Performance (PSP) for assessing functional capacity and real-world functioning, respectively. Statistical analysis: A forward stepwise regression was conducted by entering those variables significantly associated with PSP total score into the univariate analyses (Student's t-test, ANOVA with Duncan's post-hoc test, or bivariate Pearson correlation).Results: A total of 144 patients; mean age 40 years, 64% males, mean length of illness 12.4 years, PSP total score 54.3. The final model was a significant predictor of real-world functioning [F(7, 131) = 36.371, p &lt; 0.001] and explained 66.0% of the variance. Variables retained in the model: BNSS-Sp abulia, asociality, and blunted affect, PANSS general psychopathology, Sp-UPSA transportation, TMT-B, and heart rate.Conclusion: Our model will contribute to a more efficient and personalized daily clinical practice by assigning specific interventions to each patient based on specific impaired factors in order to improve functioning.

scholarly journals Cognitive and self-care changes in patients with heart failure in the Amazon Region

2020 ◽  
Vol 9 (6) ◽  
pp. e98963321
Author(s):  
Adriana de Oliveira Lameira Veríssimo ◽  
Juniel Pereira Honorato ◽  
Silvio Douglas Medeiros Costa ◽  
João Victor Moura Garcia ◽  
Isis Jaspe Reis da Silva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Public Health Problem ◽  
Clinical Aspects ◽  
Digit Symbol Substitution Test ◽  
Cognitive Changes ◽  
Cross Sectional ◽  
Significance Level ◽  
Symbol Substitution ◽  
The Individual

Heart failure is characterized as the lack of blood pumping capacity performed by the heart, which is considered a public health problem worldwide. Due to HF, the individual can develop clinical aspects that impact cognitive function and, consequently, self-care. Therefore, this study aimed to investigate cognitive changes and self-care in patients affected by HF and compare it with the cognitive and self-care changes of healthy participants. This is a quantitative, epidemiological, cross-sectional case-control study carried out at an institution in the city of Belém, Pará, Brazil. The following tests were used for data collection: Montreal Cognitive Assessment, Digit Symbol Substitution Test, European Heart Failure Self-care Behavior Scale (EHFScBS). Data were tabulated in Microsoft Excel 2010 and statistically treated by Epi Info version 3.5.2 with a 5% significance level and considering a 95% confidence interval in all analyzes. It was observed that patients with HF have slightly better self-care compared to patients without HF with scores obtained by EHFScBS equal to 29.7 ± 6.9 and 31.8 ± 8.2, respectively. Additionally, patients with HF showed impairments in the three cognitive domains, and women with HF demonstrated greater cognitive impairment compared to the other participants. The present study provides data to help build new approaches to interventions by the multidisciplinary team to promote better self-care and avoid cognitive impairments in patients with HF.

scholarly journals Clustering and Healthcare Costs With Multiple Chronic Conditions in a US Cross-Sectional Study

2020 ◽  
Author(s):  
cother hajat ◽  
yakir siegal ◽  
amalia adler-waxman
Keyword(s):  
Mental Health ◽  
Chronic Conditions ◽  
Healthcare Costs ◽  
Multiple Chronic Conditions ◽  
Cross Sectional ◽  
The Us ◽  
Health Related ◽  
Insured Patients ◽  
The Impact ◽  
Hiv Aids

Objective To investigate healthcare costs and contributors to costs for multiple chronic conditions (MCCs), common clusters of conditions and their impact on cost and utilisation. Methods This was a cross-sectional analysis of US financial claims data representative of the US population, including Medicare, Medicaid and Commercial insurance claims in 2015. Outcome measures included healthcare costs and contributors; ranking of clusters of conditions according to frequency, strength of association and unsupervised (k-means) analysis; the impact of clustering on costs and contributors to costs. Results Of 1,878,951 patients, 931,045(49.6%) had MCCs, 56.5% weighted to the US population. Mean age was 53.0 years(SD16.7); 393,121(42.20%) were male. Mean annual healthcare spending was $12,601, ranging from $4,385 (2 conditions) to $33,874 (11 conditions), with spending increasing by 22-fold for inpatient services, 6-fold for outpatient services, 4.5-fold for generic drugs and 4.2-fold for branded drugs. Cluster ranking using the 3 methodologies yielded similar results: highest ranked clusters included metabolic syndrome(12.2% of US insured patients), age related diseases(7.7%), renal failure(5.6%), respiratory disorders(4.5%), cardiovascular disease(CVD)(4.3%), cancers(4.1-4.3%), mental health-related clusters(1.0-1.5%) and HIV/AIDS(0.2%). Highest spending was in HIV/AIDS clusters ($48,293), mental health-related clusters ($38,952-$40,637), renal disease ($38,551) and CVD ($37,155); with 89.9% of spending on outpatient and inpatient care combined, and 10.1% on medication. Conclusion and Relevance Over 57% of insured patients in the US may have MCCs. MCC Clustering is frequent and is associated with healthcare utilisation. The findings favour health system redesign towards a multiple condition approach for clusters of chronic conditions, alongside other cost-containment measures for MCCs.

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