Diabetes, Depression, and Cognition: a Recursive Cycle of Cognitive Dysfunction and Glycemic Dysregulation.

PURPOSE OF REVIEW: The study aims to examine the effects of diabetes and depression on executive functioning (EF) and to review the effects of EF deficits on diabetes management. RECENT FINDINGS: Both type 2 diabetes and depression influence EF, and in turn, EF has an impact on diabetes management. Individuals with both comorbidities (i.e., diabetes and depression) experience greater deficits in EF than individuals with just one of the morbidities (i.e., depression or diabetes). The disruption in EF results in poor diabetes management and poor emotion regulation which ultimately increases the probability of a recursive cycle of depression and hyperglycemia. This recursive cycle can ultimately lead to diabetes-related complications.

Community engagement with African American clergy: faith-based model for culturally competent practice.

OBJECTIVE: The intent of this exploratory qualitative study was to examine African American Baptist clergy's pastoral care to older congregants with mental disorders. Critical Race Theory was the guiding framework in this study. METHOD: A purposive sample of 18 African American clergy participated in one-on-one interviews. RESULTS: Collectively, all participants were active in the provision of mental health to older congregants with mental disorders. The primary emergent theme 'shepherding the flock' the central phenomenon uncovered in the data, was used to organize a model of pastoral care, which is presented in this paper. Findings from this study supported results from previous studies on the integral role of the Church and clergy in the African American community. CONCLUSION: Moreover, this study highlights the importance of internal ministries in the Church and the need for further study and potential partnership opportunity.

Support groups for Alzheimer's caregivers: Creating our own space in uncertain times.

Older men are often excluded from family caregiving research despite the steady increase in the number of husbands assuming primary caregiving roles. We explored perceptions of older, male caregivers' experiences with caring for a wife with Alzheimer's Disease (AD) and examined what aspects of the support group were beneficial. Our qualitative research methods invited six caregivers ranging in age from 74 to 85 years to narratively construct their perspectives on caring for their wives with Alzheimer's Disease and benefits of participation in an all-male support group. Thematic analyses revealed care-givers faced several transitions. "Losses related to their personal relationships with their wife, family, and self," captured as loss of golden years. The second area, benefits and improvements of support groups, were captured in the following theme: "creating our own space," which included two sub-themes: "releasing our frustration" and "developing coping strategies." There was also "Gendered experience of caregiving." This study revealed that male caregivers benefited from the support and company of other men in similar caregiving situations. Results from this study have implications for health care professionals for the development of psychosocial educational groups aimed at providing support to male caregivers.

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences.

In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers' self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers' self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers' self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.

Racial/Ethnic Differences in Emotional Health: A Longitudinal Study of Immigrants' Adolescent Children.

First, discrimination was conceptualized as a major source of stress for immigrants' adolescent children. Next, such children's emotional health (indicated by measures of self-esteem and depression) was examined for possible associations with discrimination, psychosocial supports, and social structure; additionally, race/ethnicity's possible moderating role in such associations was evaluated. Data from the first 2 waves of the Children of Immigrants Longitudinal Study (1991-2006) were employed, focusing on 3 groups: Asians, Hispanics, and Whites. Linear regression analyses were used to weigh how discrimination, psychosocial supports, and social structure measured at Wave 1 and Wave 2 related to self-esteem and depression measured at Wave 2. Asians exhibited the highest level of depression and were most likely to perceive discrimination; Asians' self-esteem was also low, compared to other groups'. Discrimination and psychosocial supports appeared to operate differentially in explaining the 3 groups' emotional health.

Marital status and work-related health limitation: a longitudinal study of young adult and middle-aged Americans.

OBJECTIVES: The literature establishes clearly the health benefit of marriage. Much less clear from published data is whether work-related health (dis)advantages accruing to marital transitions persist over time or are limited to the short term. Informed by the marital resources and marital crisis perspectives, this study sought links between marital status measured via three approaches and work-related health limitation, exploring these relationships across genders. METHODS: The study employed data from eight recent waves (1996-2010) of the National Longitudinal Survey of Youth. It applied generalized estimating equations to estimate the impacts, on work-related health limitation, of current marital status; of marital transition 2 years in the past; and of marital transition 8 years in the past. RESULTS: Our gender-specific results indicated that lower likelihood of work-related health limitation was associated with a married status, a stable married status, and an entry into marriage. CONCLUSIONS: Results are consistent overall with the marital resources perspective. The use of three different approaches to evaluate the relationship of marital status to work-related health limitation may explain the gender-specific results.

Strategies for research recruitment and retention of older adults of racial and ethnic minorities.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.4 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Strategies for Research Recruitment and Retention of Older Adults of Racial and Ethnic Minorities" found on pages 14-23, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until April 30, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVE 1. Identify strategies and barriers for the recruitment and retention of older adults of racial and ethnic minorities in cognitive aging research. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. The numbers of Hispanic and African American older adults in the United States are expected to increase by 86% and more than 31%, respectively. African American and Hispanic American individuals are more likely than Caucasian individuals to have chronic health conditions, and researchers have argued that these health disparities may contribute to their higher rates of dementia-related illnesses. The current article explores strategies to improve participation in cognitive aging research by older adults, particularly minority older adults. The cultural aspects of cognitive aging are examined, especially the role of stigma and stereotype threat. The perceptions of cognitive aging of African American and Hispanic older adults are also described. Specific strategies are presented that have been successfully implemented to improve recruitment and retention in research targeting minority older adults. Strategies that yielded retention of minority older adults included advertising and marketing a randomized clinical trial, media relations, intervention tailoring, and adaptation of psychometric instruments.

Eating as a cultural expression of caring among Afro-Caribbean and African American women: understanding the cultural dimensions of obesity.

BACKGROUND: Previous studies focused on obesity and weight management have ignored the cultural uniqueness of Afro-Caribbean individuals. The purpose of this study was to examine the cultural context for notions of good health and health practices, and perception of obesity and weight management, among African American and Caribbean American women. METHODS: Four focus groups of Afro-Caribbean and African American women (age 40 and older) were conducted between May and July of 2007 to explore cultural factors related to physical activity, healthy eating and weight management. RESULTS: Cultural variation was observed among Afro-Caribbean and African American woman in terms of indigenous traditions of food and food preparation, and perceptions of obesity. CONCLUSIONS: In the development of community-based interventions to counter trends towards obesity among people of African descent, it may be important not to assume that 'one size fits all' cultures.

A qualitative perspective of family resources among low income, African American grandmother-caregivers.

This ethnographic study describes a group of 7 low-income, African American, grandmother-caregivers' perceptions of family resources. An ethnographic design, enhanced by a genogram, captured those who were available and unavailable to provide support to the grandmother. The analysis used a constant comparative method to thematically capture grandmothers' perceptions of family support resources as absent, unavailable, dependent, and reliable support, and the circumstances that led to that status. The findings reveal that many African American grandmothers are rearing children with little family support, owing mainly to the devastation of negative social and economic conditions. The results suggest areas for improvement in social work assessment and intervention.

What factors hinder women of color from obtaining preventive health care?

This commentary examines how women of color fare on the use of preventive care. Logistic regression models of women's use of preventive care were computed with data from the 1994 Commonwealth Fund Minority Health Survey. It was found that having a regular doctor was the most consistent predictor of the use of preventive care, irrespective of the women's racial/ethnic background, socioeconomic circumstances, or place of residence. These findings reinforce the importance of physicians in the delivery of preventive care. Suggestions for improving the use of preventive services by women of color are provided.