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1 Associations between social determinants of health and 10-year change in everyday functioning within Black and White older adults from the ACTIVE study
- Alexandra L. Clark, Alexandra J. Weigand, Olivio J. Clay, Michael Marsiske, Joshua Owens, Jacob Fiala, Michael Crowe, Kelsey R. Thomas
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 783-784
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Objective:
Social determinants of health (SDoH) are structural elements of our living and working environments that fundamentally shape health risks and outcomes. The Healthy People 2030 campaign delineated SDoH into five distinct categories that include: economic stability, education access/quality, healthcare access, neighborhood and built environment, and social and community contexts. Recent research has demonstrated that minoritized individuals have greater disadvantage across SDoH domains, which has been linked to poorer cognitive performance in older adulthood. However, the independent effects of SDoH on everyday functioning across and within racial groups remains less clear. The current project explored the association between SDoH factors and 10-year change in everyday functioning in a large sample of community-dwelling Black and White older adults.
Participants and Methods:Data from 2,505 participants without dementia enrolled in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (age M=73.5; 76% women; 28% Black/African American). Sociodemographic, census, and industry classification data were reduced into five SDoH factors: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community contexts. The Observed Tasks of Daily Living, a performance-based measure of everyday functioning with tasks involving medication management, finances, and telephone use, was administered at baseline, 1-, 2-, 3-, 5, and 10-year follow up visits. Mixed-effects models with age as the timescale tested (1) racial group differences in OTDL trajectories, (2) race x SDOH interactions on OTDL trajectories, and (3) associations between SDoH and OTDL trajectories stratified within Black and White older adults. Covariates included sex/gender, vocabulary score, Mini-Mental Status Examination, depressive symptoms, visual acuity, general health, training group status, booster status, testing site, and recruitment wave.
Results:Black older adults had a steeper decline of OTDL performance compared to Whites (linear: b = -.25, quadratic b=-.009, ps < .001). There was a significant race x social and community context interaction on linear OTDL trajectories (b =.06, p=.01), but no other significant race x SDoH interactions were observed (bs =-.007-.05, ps=.73-.11). Stratified analyses revealed lower levels of social and community context were associated with steeper age-related linear declines in OTDL performance in Black (b = .08, p=.001), but not White older adults (b =.004, p=.64). Additionally, lower levels of economic stability were associated with steeper age-related linear declines in OTDL performance in Black (b =.07, p=.04), but not White older adults (b =.01, p=.35). Finally, no significant associations between other SDoH and OTDL trajectories were observed in Black (bs = -.04-.01, ps =.09-.80) or White (bs = -.02-.003, ps=.07-.96) older adults.
Conclusions:SDoH, which measure aspects of structural racism, play an important role in accelerating age-related declines in everyday functioning. Lower levels of economic and community-level social resources are two distinct SDoH domains associated with declines in daily functioning that negatively impact Black, but not White, older adults. It is imperative that future efforts focus on both identifying and acting upon upstream drivers of SDoH-related inequities. Within the United States, this will require addressing more than a century of antiBlack sentiment, White supremacy, and unjust systems of power and policies designed to intentionally disadvantage minoritized groups.
Borderline personality disorder symptom networks across adolescent and adult clinical samples: examining symptom centrality and replicability
- Jessica R. Peters, Michael L. Crowe, Theresa Morgan, Mark Zimmerman, Carla Sharp, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Mary C. Zanarini, Thomas H. McGlashan, Leslie C. Morey, Andrew E. Skodol, Shirley Yen
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- Journal:
- Psychological Medicine / Volume 53 / Issue 7 / May 2023
- Published online by Cambridge University Press:
- 31 January 2022, pp. 2946-2953
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Background
Numerous theories posit different core features to borderline personality disorder (BPD). Recent advances in network analysis provide a method of examining the relative centrality of BPD symptoms, as well as examine the replicability of findings across samples. Additionally, despite the increase in research supporting the validity of BPD in adolescents, clinicians are reluctant to diagnose BPD in adolescents. Establishing the replicability of the syndrome across adolescents and adults informs clinical practice and research. This study examined the stability of BPD symptom networks and centrality of symptoms across samples varying in age and clinical characteristics.
MethodsCross-sectional analyses of BPD symptoms from semi-structured diagnostic interviews from the Collaborative Longitudinal Study of Personality Disorders (CLPS), the Methods to Improve Diagnostic Assessment and Service (MIDAS) study, and an adolescent clinical sample. Network attributes, including edge (partial association) strength and node (symptom) expected influence, were compared.
ResultsThe three networks were largely similar and strongly correlated. Affective instability and identity disturbance emerged as relatively central symptoms across the three samples, and relationship difficulties across adult networks. Differences in network attributes were more evident between networks varying both in age and in BPD symptom severity level.
ConclusionsFindings highlight the relative importance of affective, identity, and relationship symptoms, consistent with several leading theories of BPD. The network structure of BPD symptoms appears generally replicable across multiple large samples including adolescents and adults, providing further support for the validity of the diagnosis across these developmental phases.
Identification of Mild Cognitive Impairment in ACTIVE: Algorithmic Classification and Stability
- Sarah E. Cook, Michael Marsiske, Kelsey R. Thomas, Frederick W. Unverzagt, Virginia G. Wadley, Jessica B.S. Langbaum, Michael Crowe
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- Journal:
- Journal of the International Neuropsychological Society / Volume 19 / Issue 1 / January 2013
- Published online by Cambridge University Press:
- 25 October 2012, pp. 73-87
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Rates of mild cognitive impairment (MCI) have varied substantially, depending on the criteria used and the samples surveyed. The present investigation used a psychometric algorithm for identifying MCI and its stability to determine if low cognitive functioning was related to poorer longitudinal outcomes. The Advanced Cognitive Training of Independent and Vital Elders (ACTIVE) study is a multi-site longitudinal investigation of long-term effects of cognitive training with older adults. ACTIVE exclusion criteria eliminated participants at highest risk for dementia (i.e., Mini-Mental State Examination < 23). Using composite normative for sample- and training-corrected psychometric data, 8.07% of the sample had amnestic impairment, while 25.09% had a non-amnestic impairment at baseline. Poorer baseline functional scores were observed in those with impairment at the first visit, including a higher rate of attrition, depressive symptoms, and self-reported physical functioning. Participants were then classified based upon the stability of their classification. Those who were stably impaired over the 5-year interval had the worst functional outcomes (e.g., Instrumental Activities of Daily Living performance), and inconsistency in classification over time also appeared to be associated increased risk. These findings suggest that there is prognostic value in assessing and tracking cognition to assist in identifying the critical baseline features associated with poorer outcomes. (JINS, 2012, 18, 1–15)
Contributors
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- By Maricela Alarcón, Laura A. Baker, Trygve Bakken, Serena Bezdjian, Andrew W. Bergen, Laura J. Bierut, Andrew C. Chen, C. Robert Cloninger, David W. Craig, Anibal Cravchik, Raymond R. Crowe, Carlos Cruchaga, Joseph F. Cubells, Marcella Devoto, Stephen H. Dinwiddie, Howard J. Edenberg, Josephine Elia, Craig A. Erickson, Thomas V. Fernandez, Xiaowu Gai, Elliot Gershon, Daniel H. Geschwind, Alison M. Goate, Hugh M. D. Gurling, Hakon Hakonarson, Sarah M. Hartz, Akiko Hayashi-Takagi, Jinger Hoop, Hanna Jaaro-Peled, Atsushi Kamiya, John S. K. Kauwe, Walter H. Kaye, John R. Kelsoe, Karestan C. Koenen, Mary Jeanne Kreek, Francesca Lantieri, James F. Leckman, Ondrej Libiger, Falk W. Lohoff, Michael J. Lyons, Christopher J. McDougle, Andrew McQuillin, Kathleen Ries Merikangas, Maria G. Motlagh, Pablo R. Moya, Dennis L. Murphy, Eric J. Nestler, Alexander B. Niculescu, David A. Nielsen, Khendra I. Peay, Bernice Porjesz, James B. Potash, R. Arlen Price, Dmitri Proudnikov, Adrian Raine, Madhavi Rangaswamy, William Renthal, Akira Sawa, Nicholas J. Schork, Saurav Seshadri, Shelley D. Smith, Wanli W. Smith, Toshinobu Takeda, Ardesheer Talati, Yi-Lang Tang, Kiara Timpano, Ali Torkamani, Catherine Tuvblad, Myrna M. Weissman, Jens R. Wendland, Jennifer Wessel, Peter S. White, Vadim Yuferov, Tyler Zink
- Edited by John I. Nurnberger, Jr, Wade Berrettini, University of Pennsylvania School of Medicine
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- Book:
- Principles of Psychiatric Genetics
- Published online:
- 05 October 2012
- Print publication:
- 13 September 2012, pp vii-x
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20 - Landscape ecology and forest management
- from PART V - Applications of landscape ecology
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- By Thomas R. Crow, USDA Forest Service North Central Research Station USA
- Edited by John A. Wiens, The Nature Conservancy, Washington DC, Michael R. Moss, University of Guelph, Ontario
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- Book:
- Issues and Perspectives in Landscape Ecology
- Published online:
- 20 November 2009
- Print publication:
- 14 April 2005, pp 201-207
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Summary
Almost all activities associated with forest management affect the composition and structure of the landscapes in which they occur. For example, forest harvesting profoundly affects the composition, size, shape, and configuration of patches in the landscape matrix (Table 20.1). Even-age regeneration techniques such as clearcut harvesting have been applied in blocks of uniform size, shape, and distribution, and as strip cuts with alternating leave and cut strips or as progressive cutting of strips, or as patches with variable sizes, shapes, and distributions. In contrast to the coarse-grained pattern (Table 20.1) produced on the landscape by even-age management, uneven-aged regeneration techniques produce small openings in the canopy where individual trees or small groups of trees are periodically harvested.
Roads, another important landscape feature associated with forest management, are essential for a variety of activities including timber and wildlife management, recreation, and the management of fire, insects, and pathogens. Once in place, however, roads greatly alter the ecological character as well as the amount, type, and distribution of human activity on the landscape. At the landscape scale (Table 20.1), roads form a network and road density is closely correlated with the level of forest fragmentation, the amount of forest edge, and, conversely, the amount of forest interior available in the landscape (Forman and Alexander, 1988; Forman, 2000). In addition to maintained or improved roads that are often viewed as external to the forest, every managed forest has a network of unimproved haul roads and skid trails within the forest.
18 - Bridging the gap between landscape ecology and natural resource management
- Edited by Jianguo Liu, Michigan State University, William W. Taylor, Michigan State University
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- Book:
- Integrating Landscape Ecology into Natural Resource Management
- Published online:
- 14 January 2010
- Print publication:
- 01 August 2002, pp 433-460
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Summary
Introduction
In every respect, the valley rules the stream.
Noel Hynes (1975)The challenges facing natural resource managers occur over entire landscapes and involve landscape components at many scales. Many resource managers are shifting their approach from managing resources such as fish, wildlife, and water separately to managing for the integrity of entire ecosystems (Christensen et al., 1996). Indeed, nearly all resource management agencies in the USA have recognized that informed management decisions cannot be made exclusively at the level of habitat units or local sites. It is generally accepted that ecological patterns and processes must be considered over large areas when biodiversity and ecological function must be maintained while the goods and services desired by the public are provided. For example, forest managers must determine the patterns and timing of tree harvesting while maintaining an amount and arrangement of habitats that will sustain many species. Managers of parks and nature reserves must be attentive to actions occurring on surrounding lands outside their jurisdiction. Aquatic resource managers must broaden their perspective to encompass the terrestrial and human landscape to manage stream and lake resources effectively (Hynes, 1975, widely regarded as the father of modern stream ecology and quoted above; Naiman et al., 1995). Landscape ecology also is implicit in the paradigm of ecosystem management (Grumbine,1994; Christensen et al., 1996).
Despite the acknowledged importance of a landscape perspective by both scientists and resource managers, determining how to implement management at broader scales is very much a work in progress.
14 - Putting multiple use and sustained yield into a landscape context
- Edited by Jianguo Liu, Michigan State University, William W. Taylor, Michigan State University
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- Book:
- Integrating Landscape Ecology into Natural Resource Management
- Published online:
- 14 January 2010
- Print publication:
- 01 August 2002, pp 349-365
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Summary
Introduction
When managing natural resources, foresters, wildlife biologists, and other practitioners need to consider a vast array of technical information, along with a multitude of values, opinions, and perspectives – many of which may be in conflict and therefore difficult to resolve. Ongoing discussions about ecosystem management, conserving biological diversity, adaptive management, and sustainable development reflect heightened concerns about sustaining natural resources and resolving conflicts among competing interests and demands (e.g., Walters, 1986; Rowe, 1992; Grumbine, 1997; Bunnell, 1998; Tollefson, 1998; Yaffee, 1999).
In response to these and related concerns, the Secretary-General of the United Nations established the World Commission on Environment and Development in 1983, headed by Gro Harlem Brundtland, then Prime Minister of Norway. In their landmark assessment – commonly known as the Brundtland Report – the Commission firmly connected environmental degradation with diminished economic opportunity, human health, and quality of life. In addition, they proposed long-term strategies for achieving sustainable development in a world characterized by great extremes in resource availability and utilization. They suggested multilateral approaches to transcend national sovereignties, political ideologies, and scientific disciplines so that common problems could be identified and common goals pursued.
There is increasing recognition that a more comprehensive and integrated approach is needed to resource planning and management (Boyce and Haney, 1997; Kohm and Franklin, 1997; Vogt et al., 1997). In this chapter, I begin with the premise that principles and concepts from landscape ecology can contribute in a significant way to practicing integrated resource management.