Co-occurrence of psychotic experiences and common mental health conditions across four racially and ethnically diverse population samples.

BACKGROUND: Prior research with racially/ethnically homogeneous samples has demonstrated widespread co-occurrence of psychotic experiences (PEs) and common mental health conditions, particularly multi-morbidity, suggesting that psychosis may be related to the overall severity of psychiatric disorder rather than any specific subtype. In this study we aimed to examine whether PEs are associated with the presence of specific disorders or multi-morbidity of co-occurring disorders across four large racially/ethnically diverse samples of adults in the USA. METHOD: Data were drawn from the National Comorbidity Survey Replication (NCS-R), the National Survey of American Life (NSAL) and separately from the Asian and Latino subsamples of the National Latino and Asian American Study (NLAAS). Logistic regression models were used to examine the relationship between PEs and individual subtypes of DSM-IV disorder, and to test for a linear dose-response relationship between the number of subtypes and PEs. RESULTS: Prevalence of PEs was moderately greater among individuals with each subtype of disorder in each data set [odds ratios (ORs) 1.8-3.8], although associations were only variably significant when controlling for clinical and demographic variables. However, the sum of disorder subtypes was related to odds for PEs in a linear dose-response fashion across all four samples. CONCLUSIONS: PEs are related primarily to the extent or severity of psychiatric illness, as indicated by the presence of multiple psychiatric disorders, rather than to any particular subtype of disorder in these data. This relationship applies to the general population and across diverse racial/ethnic groups.

Polyglycylation of tubulin is essential and affects cell motility and division in Tetrahymena thermophila.

We analyzed the role of tubulin polyglycylation in Tetrahymena thermophila using in vivo mutagenesis and immunochemical analysis with modification-specific antibodies. Three and five polyglycylation sites were identified at glutamic acids near the COOH termini of alpha- and beta-tubulin, respectively. Mutants lacking all polyglycylation sites on alpha-tubulin have normal phenotype, whereas similar sites on beta-tubulin are essential. A viable mutant with three mutated sites in beta-tubulin showed reduced tubulin glycylation, slow growth and motility, and defects in cytokinesis. Cells in which all five polyglycylation sites on beta-tubulin were mutated were viable if they were cotransformed with an alpha-tubulin gene whose COOH terminus was replaced by the wild-type COOH terminus of beta-tubulin. In this double mutant, beta-tubulin lacked detectable polyglycylation, while the alpha-beta tubulin chimera was hyperglycylated compared with alpha-tubulin in wild-type cells. Thus, the essential function of polyglycylation of the COOH terminus of beta-tubulin can be transferred to alpha-tubulin, indicating it is the total amount of polyglycylation on both alpha- and beta-tubulin that is essential for survival.

Physical and emotional well-being of custodial grandparents in Latino families.

This study of 74 Latino grandparents rearing their grandchildren in New York City, found poverty rates to be roughly three times those of grandparent caregivers nationwide and rates of self-reported poor health and depression to be twice as high. Correlates of depression included young age, poor health, greater life stress, few informal supports, and rearing grandchildren with special needs. Intervention needs and directions for future research are discussed.

Physician utilization by Hispanic elderly persons: national perspective.

BACKGROUND: The number of elderly Hispanic Americans is projected to more than double by 2010 and account for 16% of all elders by 2050. The complex health needs and diversity of that growing population poses challenges for planning and delivery of health services. OBJECTIVES: The behavioral model of health services utilization was used to examine predisposing, enabling, and need factors associated with physician use by Hispanic elders and to assess whether Mexican American, Cuban American, and Puerto Rican elders differ in their likelihood of use. RESEARCH DESIGN: Data are from the 1988 National Survey of Hispanic Elderly People, which is a nationally representative sample of Hispanic elders living within telephone exchanges with at least 30% concentration of Hispanics. SUBJECTS: There were 2,299 completed interviews. Analyses are based on a subsample of 773 Mexican Americans, 714 Cuban Americans, and 368 Puerto Ricans. MEASURES: The dependent variable, physician utilization, was self-reported number of visits in the previous year. It was dichotomized because of skewness. Independent variables include predisposing, enabling, and need factors. RESULTS: Using hierarchical logistic regression, all three sets of factors contributed to the likelihood of a visit. Enabling factors, especially insurance coverage and adult children, had the greatest impact. Cuban Americans and Puerto Ricans were 2.3 and 2.6 times more likely, respectively, to have seen a physician than were Mexican Americans. CONCLUSIONS: In seeking to improve access and use of physician services, health care providers and policy makers should consider the role of social and economic factors and national origin group.

Social relationships of Latino grandparent caregivers: a role theory perspective.

This article uses a role theory perspective to examine the social relationships of 74 Latinos, mostly middle-aged and older Puerto Rican and Dominican women, rearing their grandchildren in New York City. Fully 81% of households were below poverty level. Most grandparents had large families and were socially connected, but two thirds of households were skipped-generational and many grandparents lacked reliable help with child rearing. Most relied on a focal secondary caregiver, usually an adult daughter, and extrafamilial supports. These and other sources of strain and support for the grandparent caregiver role in Latino families are discussed, as is the impact of this role on their social relationships.

Custodial grandparents in Latino families: patterns of service use and predictors of unmet needs

This article examines patterns of service use and predictors of unmet needs among a purposive sample of 74 Latino grandparent caregivers in New York City. Study participants tended to be unmarried, middle-aged, and older women who were monolingual Spanish speaking and had very low levels of educational attainment and income. Nearly all respondents were connected to the formal service system, yet they still reported substantial unmet needs. Lack of knowledge was the major barrier to service use, and predictors of unmet needs included low education, poor health, high levels of life stress, and lack of reliable help with child rearing. Implications for policy and practice strategies that focus on role-related needs of Latino custodial grandparents are discussed.

Long-term care service use by frail elders: is ethnicity a factor?

Using data from the 1982-84 National Long-Term Care Channeling Demonstration, this study examines factors associated with long-term care service use by African American, Hispanic, and white frail elders living in the community. Findings indicate that in addition to predisposing, enabling, and need factors, race/ethnicity is a significant predictor of each type of service use.

Living alone with Alzheimer's disease: effects on health and social service utilization patterns.

Subjects with possible or probable Alzheimer's disease who live alone are more likely to be women, and more likely to be poor than those living with others. They are also older and have milder cognitive impairments and a shorter disease duration. Living arrangement is a significant predictor of service utilization even with other factors held constant. Subjects living alone were less likely to use medical services such as physicians and hospitals, and more likely to use services such as homemaker chore and home-delivered meals. In addition, they were more likely to use no services than those living with others.

Aortico-pulmonary paraganglioma: report of a case with ultrastructural study and review of the literature.

The light microscopic and ultrastructural features of an aortico-pulmonary paraganglioma (A-PP) are presented. The tumor was characterized by organoid clustering of neoplastic chief cells to form Zellballen. Argyrophilic granules were demonstrated within chief cell cytoplasm using a modified Grimelus technique. Ultrastructurally, three distinct cell types were present within the tumor: endothelial cells, pericytes and neoplastic chief cells. Membrane-bound neurosecretory granules were present and measured 100 to 2000 nm in diameter. "Light" and "dark" chief cells were less distinct than previously reported in other head and neck paragangliomas. Analysis of the 36 documented A-PP reported in the English literature reveals that the tumor has been either incompletely excised or has been considered unresectable in one-third of the cases. The reported surgical mortality is 9%, or approximately equal to the incidence of malignant behavior. The treatment of choice is surgical resection but when this is not possible, radiation may be a useful adjunct in therapy.