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1.
JAMA Netw Open ; 7(6): e2418460, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38941096

RESUMO

Importance: Air pollution is a recognized risk factor associated with chronic diseases, including respiratory and cardiovascular conditions, which can lead to physical and cognitive impairments in later life. Although these losses of function, individually or in combination, reduce individuals' likelihood of living independently, little is known about the association of air pollution with this critical outcome. Objective: To investigate associations between air pollution and loss of independence in later life. Design, Setting, and Participants: This cohort study was conducted as part of the Environmental Predictors Of Cognitive Health and Aging study and used 1998 to 2016 data from the Health and Retirement Study. Participants included respondents from this nationally representative, population-based cohort who were older than 50 years and had not previously reported a loss of independence. Analyses were performed from August 31 to October 15, 2023. Exposures: Mean 10-year pollutant concentrations (particulate matter less than 2.5 µm in diameter [PM2.5] or ranging from 2.5 µm to 10 µm in diameter [PM10-2.5], nitrogen dioxide [NO2], and ozone [O3]) were estimated at respondent addresses using spatiotemporal models along with PM2.5 levels from 9 emission sources. Main Outcomes and Measures: Loss of independence was defined as newly receiving care for at least 1 activity of daily living or instrumental activity of daily living due to health and memory problems or moving to a nursing home. Associations were estimated with generalized estimating equation regression adjusting for potential confounders. Results: Among 25 314 respondents older than 50 years (mean [SD] baseline age, 61.1 [9.4] years; 11 208 male [44.3%]), 9985 individuals (39.4%) experienced lost independence during a mean (SD) follow-up of 10.2 (5.5) years. Higher exposure levels of mean concentration were associated with increased risks of lost independence for total PM2.5 levels (risk ratio [RR] per 1-IQR of 10-year mean, 1.05; 95% CI, 1.01-1.10), PM2.5 levels from road traffic (RR per 1-IQR of 10-year mean, 1.09; 95% CI, 1.03-1.16) and nonroad traffic (RR per 1-IQR of 10-year mean, 1.13; 95% CI, 1.03-1.24), and NO2 levels (RR per 1-IQR of 10-year mean, 1.05; 95% CI, 1.01-1.08). Compared with other sources, traffic-generated pollutants were most consistently and robustly associated with loss of independence; only road traffic-related PM2.5 levels remained associated with increased risk after adjustment for PM2.5 from other sources (RR per 1-IQR increase in 10-year mean concentration, 1.10; 95% CI, 1.00-1.21). Other pollutant-outcome associations were null, except for O3 levels, which were associated with lower risks of lost independence (RR per 1-IQR increase in 10-year mean concentration, 0.94; 95% CI, 0.92-0.97). Conclusions and Relevance: This study found that long-term exposure to air pollution was associated with the need for help for lost independence in later life, with especially large and consistent increases in risk for pollution generated by traffic-related sources. These findings suggest that controlling air pollution could be associated with diversion or delay of the need for care and prolonged ability to live independently.


Assuntos
Poluição do Ar , Exposição Ambiental , Material Particulado , Humanos , Masculino , Idoso , Feminino , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Material Particulado/análise , Material Particulado/efeitos adversos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/efeitos adversos , Estudos de Coortes , Ozônio/análise , Ozônio/efeitos adversos , Vida Independente/estatística & dados numéricos , Dióxido de Nitrogênio/análise , Dióxido de Nitrogênio/efeitos adversos , Idoso de 80 Anos ou mais , Fatores de Risco
2.
Polymers (Basel) ; 16(10)2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38794569

RESUMO

In this work, we use density functional theory to investigate the electronic structure of poly(3,4-ethylenedioxythiophene) (PEDOT) oligomers with co-located AlCl4- anions, a promising combination for energy storage. The 1980s bipolaron model remains the dominant interpretation of the electronic structure of PEDOT despite recent theoretical progress that has provided new definitions of bipolarons and polarons. By considering the influence of oligomer length, oxidation or anion concentration and spin state, we find no evidence for many of the assertions of the 1980s bipolaron model and so further contribute to a new understanding. No self-localisation of positive charges in PEDOT is found, as predicted by the bipolaron model at the hybrid functional level. Instead, our results show distortions that exhibit a single or a double peak in bond length alternations and charge density. Either can occur at different oxidation or anion concentrations. Rather than representing bipolarons or polaron pairs in the original model, these are electron distributions driven by a range of factors. Distortions can span an arbitrary number of nearby anions. We also contribute a novel conductivity hypothesis. Conductivity in conducting polymers has been observed to reduce at anion concentrations above 0.5. We show that at high anion concentrations, the energy of the localised, non-bonding anionic orbitals approaches that of the system HOMO due to Coulombic repulsion between anions. We hypothesize that with nucleic motion in the macropolymer, these orbitals will interfere with the hopping of charge carriers between sites of similar energy, lowering conductivity.

3.
ACS Appl Energy Mater ; 7(6): 2299-2308, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38550300

RESUMO

Two-dimensional (2D) transition-metal dichalcogenides have shown great potential for energy storage applications owing to their interlayer spacing, large surface area-to-volume ratio, superior electrical properties, and chemical compatibility. Further, increasing the surface area of such materials can lead to enhanced electrical, chemical, and optical response for energy storage and generation applications. Vertical silicon nanowires (SiNWs), also known as black-Si, are an ideal substrate for 2D material growth to produce high surface-area heterostructures, owing to their ultrahigh aspect ratio. Achieving this using an industrially scalable method paves the way for next-generation energy storage devices, enabling them to enter commercialization. This work demonstrates large surface area, commercially scalable, hybrid MoS2/SiNW heterostructures, as confirmed by Raman spectroscopy, with high tunability of the MoS2 layers down to the monolayer scale and conformal MoS2 growth, parallel to the silicon nanowires, as verified by transmission electron microscopy (TEM). This has been achieved using a two-step atomic layer deposition (ALD) process, allowing MoS2 to be grown directly onto the silicon nanowires without any damage to the substrate. The ALD cycle number accurately defines the layer number from monolayer to bulk. Introducing an ALD alumina (Al2O3) interface at the MoS2/SiNW boundary results in enhanced MoS2 quality and uniformity, demonstrated by an order of magnitude reduction in the B/A exciton photoluminescence (PL) intensity ratio to 0.3 and a reduction of the corresponding layer number. This high-quality layered growth on alumina can be utilized in applications such as for interfacial layers in high-capacity batteries or for photocathodes for water splitting. The alumina-free 100 ALD cycle heterostructures demonstrated no diminishing quality effects, lending themselves well to applications that require direct electrical contact with silicon and benefit from more layers, such as electrodes for high-capacity ion batteries.

4.
Artigo em Inglês | MEDLINE | ID: mdl-37209409

RESUMO

BACKGROUND: Little is known about how depressive symptoms and glial fibrillary acid protein (GFAP) concentrations taken together may influence cognitive functioning. Understanding this relationship may inform strategies for screening and early intervention to decrease the rate of cognitive decline. METHODS: This study sample includes 1 169 participants from the Chicago Health and Aging Project (CHAP), consisting of 60% Black participants and 40% White participants, and 63% female participants and 37% male participants. CHAP is a population-based cohort study of older adults with a mean age of 77 years. Linear mixed-effects regression models tested the main effects of depressive symptoms and GFAP concentrations and their interactions on baseline cognitive function and cognitive decline over time. Models included adjustments for age, race, sex, education, chronic medical conditions, body mass index, smoking status, alcohol use, and their interactions with time. RESULTS: The interaction of depressive symptomology and GFAP (ß = -0.105 [standard error = 0.038], p = .006) on global cognitive function was statistically significant. Participants with depressive symptoms including and above the cutoff and high log of GFAP concentrations had more cognitive decline over time, followed by participants with depressive symptoms below the cutoff and high log of GFAP concentrations, depressive symptom scores including and above the cutoff and low log of GFAP concentrations, and depressive symptom scores below the cutoff and low log of GFAP concentrations. CONCLUSIONS: Depressive symptoms have an additive effect on the association between the log of GFAP and baseline global cognitive function.


Assuntos
Disfunção Cognitiva , Depressão , Humanos , Masculino , Feminino , Idoso , Estudos de Coortes , Depressão/epidemiologia , Depressão/psicologia , Proteína Glial Fibrilar Ácida , Disfunção Cognitiva/diagnóstico , Cognição
5.
J Alzheimers Dis ; 96(4): 1339-1352, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37980674

RESUMO

The population of Nepal is rapidly aging, as in other low and middle-income countries, and the number of individuals living with Alzheimer's Disease and related dementias (ADRD) is expected to increase. However, information about the neuropsychological assessment of ADRD in Nepal is lacking. We first aimed to examine the needs, challenges, and opportunities associated with the neuropsychological assessment of older adults in Nepal for population-based ADRD ascertainment. Second, we introduce the Chitwan Valley Family Study-Study of Cognition and Aging in Nepal (CVFS-SCAN), which is poised to address these needs, and its collaboration with the Harmonized Cognitive Assessment Protocol (HCAP) international network. We reviewed the existing literature on the prevalence, risk factors, available neuropsychological assessment instruments, and sociocultural factors that may influence the neuropsychological assessment of older adults for ADRD ascertainment in Nepal. Our review revealed no existing population-based data on the prevalence of ADRD in Nepal. Very few studies have utilized formal cognitive assessment instruments for ADRD assessment, and there have been no comprehensive neuropsychological assessment instruments that have been validated for the assessment of ADRD in Nepal. We describe how the CVFS-SCAN study will address this need through careful adaptation of the HCAP instrument. We conclude that the development of culturally appropriate neuropsychological assessment instruments is urgently needed for the population-based assessment of ADRD in Nepal. The CVFS-SCAN is designed to address this need and will contribute to the growth of global and equitable neuropsychology and to the science of ADRD in low- and middle-income countries.


Assuntos
Doença de Alzheimer , Demência , Humanos , Idoso , Demência/diagnóstico , Demência/epidemiologia , Nepal/epidemiologia , Doença de Alzheimer/epidemiologia , Envelhecimento , Testes Neuropsicológicos
6.
J Aging Health ; : 8982643231209351, 2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37863092

RESUMO

OBJECTIVES: Findings on the effect of network size and support on functional health are mixed. We examine whether network types, that simultaneously incorporate multiple network characteristics, are associated with functional health in late life. METHODS: Data are from the National Social Life, Health, and Aging Project (N = 3005). We estimated the longitudinal effect of membership in five multidimensional network types on disability in six activities of daily living using negative binomial regression, and on mobility (assessed using a timed walk test) using a generalized linear mixed model. RESULTS: Compared to those in the large without strain network, older adults in the small, restricted, high contact network had fewer disabilities but worse mobility, while those in the large network with strain also had worse mobility. DISCUSSION: Care plans focusing on function and mobility should consider multiple aspects of older adults' social networks including network size, diversity, and relationship strain.

7.
JAMA Netw Open ; 6(9): e2333470, 2023 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-37728927

RESUMO

Importance: Fine particulate matter air pollution (PM2.5) has been consistently associated with cardiovascular disease, which, in turn, is associated with an increased risk of dementia. As such, vascular dysfunction might be a mechanism by which PM2.5 mediates dementia risk, yet few prior epidemiological studies have examined this potential mechanism. Objective: To investigate whether hypertension and stroke serve as mediators and modifiers of the association of PM2.5 with incident dementia. Design, Setting, and Participants: As part of the Environmental Predictors of Cognitive Health and Aging (EPOCH) Project, this cohort study used biennial survey data collected between 1998 and 2016 from respondents of the Health and Retirement Study (HRS), a nationally representative, population-based, cohort in the US. Eligible participants were those over 50 years of age who were free of dementia at baseline and had complete exposure, mediator, outcome, and demographic data from the HRS. Data analysis was conducted from August to November 2022. Exposures: Exposure to PM2.5, calculated for the 10 years preceding each person's baseline examination according to residential histories and spatiotemporal models. Main Outcomes and Measures: Incident dementia was identified using a validated algorithm based on cognitive testing and informant reports. The 4-way decomposition causal mediation analysis method was used to quantify the degree to which hypertension and stroke mediated or modified the association of PM2.5 with incident dementia after adjustment for individual-level and area-level covariates. Results: Among 27 857 participants (mean [SD] age at baseline, 61 [10] years; 15 747 female participants [56.5%]; 19 249 non-Hispanic White participants [69.1%]), 4105 (14.7%) developed dementia during the follow-up period (mean [SD], 10.2 [5.6] years). Among participants with dementia, 2204 (53.7%) had a history of hypertension at baseline and 386 (9.4%) received a diagnosis of hypertension during the follow up. A total of 378 participants (9.2%) had a history of stroke at baseline and 673 (16.4%) developed stroke over the follow-up period. The IQR of baseline PM2.5 concentrations was 10.9 to 14.9 µg/m3. In fully adjusted models, higher levels of PM2.5 (per IQR) were not associated with increased risk of incident dementia (HR, 1.04; 95% CI, 0.98 to 1.11). Although there were positive associations of prevalent stroke (HR, 1.67; 95% CI, 1.48 to 1.88) and hypertension (HR, 1.15; 95% CI, 1.08 to 1.23) with incident dementia compared with those free of stroke and hypertension during follow-up, there was no statistically significant association of PM2.5 with stroke (odds ratio per IQR increment in PM2.5, 1.08; 95%CI, 0.91 to 1.29) and no evidence of an association of PM2.5 with hypertension (odds ratio per IQR increment in PM2.5, 0.99; 95%CI, 0.92 to 1.07). Concordantly, there was no evidence that hypertension or stroke acted as mediators or modifiers of the association of PM2.5 with incident dementia. Although the nonmediated interaction between PM2.5 and hypertension accounted for 39.2% of the total excess association (95% CI, -138.5% to 216.9%), the findings were not statistically significant. Conclusions and Relevance: These findings suggest that although hypertension may enhance the susceptibility of individuals to air pollution, hypertension and stroke do not significantly mediate or modify the association of PM2.5 with dementia, indicating the need to investigate other pathways and potential mediators of risk.


Assuntos
Poluição do Ar , Demência , Hipertensão , Acidente Vascular Cerebral , Feminino , Humanos , Pessoa de Meia-Idade , Criança , Estudos de Coortes , Hipertensão/epidemiologia , Hipertensão/etiologia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Poluição do Ar/efeitos adversos , Material Particulado/efeitos adversos , Demência/epidemiologia , Demência/etiologia
8.
JAMA Intern Med ; 183(10): 1080-1089, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37578757

RESUMO

Importance: Emerging evidence indicates that exposure to fine particulate matter (PM2.5) air pollution may increase dementia risk in older adults. Although this evidence suggests opportunities for intervention, little is known about the relative importance of PM2.5 from different emission sources. Objective: To examine associations of long-term exposure of total and source-specific PM2.5 with incident dementia in older adults. Design, Setting, and Participants: The Environmental Predictors of Cognitive Health and Aging study used biennial survey data from January 1, 1998, to December 31, 2016, for participants in the Health and Retirement Study, which is a nationally representative, population-based cohort study in the US. The present cohort study included all participants older than 50 years who were without dementia at baseline and had available exposure, outcome, and demographic data between 1998 and 2016 (N = 27 857). Analyses were performed from January 31 to May 1, 2022. Exposures: The 10-year mean total PM2.5 and PM2.5 from 9 emission sources at participant residences for each month during follow-up using spatiotemporal and chemical transport models. Main Outcomes and Measures: The main outcome was incident dementia as classified by a validated algorithm incorporating respondent-based cognitive testing and proxy respondent reports. Adjusted hazard ratios (HRs) were estimated for incident dementia per IQR of residential PM2.5 concentrations using time-varying, weighted Cox proportional hazards regression models with adjustment for the individual- and area-level risk factors. Results: Among 27 857 participants (mean [SD] age, 61 [10] years; 15 747 [56.5%] female), 4105 (15%) developed dementia during a mean (SD) follow-up of 10.2 [5.6] years. Higher concentrations of total PM2.5 were associated with greater rates of incident dementia (HR, 1.08 per IQR; 95% CI, 1.01-1.17). In single pollutant models, PM2.5 from all sources, except dust, were associated with increased rates of dementia, with the strongest associations for agriculture, traffic, coal combustion, and wildfires. After control for PM2.5 from all other sources and copollutants, only PM2.5 from agriculture (HR, 1.13; 95% CI, 1.01-1.27) and wildfires (HR, 1.05; 95% CI, 1.02-1.08) were robustly associated with greater rates of dementia. Conclusion and Relevance: In this cohort study, higher residential PM2.5 levels, especially from agriculture and wildfires, were associated with higher rates of incident dementia, providing further evidence supporting PM2.5 reduction as a population-based approach to promote healthy cognitive aging. These findings also indicate that intervening on key emission sources might have value, although more research is needed to confirm these findings.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Demência , Humanos , Feminino , Idoso , Pessoa de Meia-Idade , Masculino , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Poeira/análise , Demência/epidemiologia , Demência/etiologia
9.
J Gerontol A Biol Sci Med Sci ; 78(7): 1204-1211, 2023 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-36934331

RESUMO

BACKGROUND: Cognitive impairment is associated with increased mortality rates in late life, but it is unclear whether worse cognition predicts working-age mortality. METHODS: The data come from a U.S. national survey (N = 3 973 aged 32-84 at cognitive testing in 2004-06, mean age 56.6, 56.3% female; N = 3 055 retested in 2013-18 at ages 42-94, mean age 64.6, 56.6% female; mortality follow-up through 2019). We use Cox hazard models to investigate whether cognition is associated with mortality below age 65, how the magnitude of this risk compares with the risk in later life, and whether the association persists after adjusting for potential confounders. RESULTS: Worse cognition is associated with mortality, but the demographic-adjusted hazard ratio (HR) diminishes with age from 2.0 per standard deviation (SD; 95% confidence interval [CI], 1.7-2.4) at age 55-1.4 (95% CI, 1.3-1.6) at age 85. In the fully adjusted model, the corresponding HRs are 1.4 (95% CI, 1.2-1.7) and 1.3 (95% CI, 1.1-1.4), respectively. The absolute differences in mortality by level of cognition, however, are larger at older ages because mortality is rare at younger ages. The fully adjusted model implies a 2.7 percentage point differential in the estimated percentage dying between ages 55 and 65 for those with low cognition (1 SD below the overall mean, 5.7%) versus high cognition (1 SD above the mean, 3.0%). The corresponding differential between ages 75 and 85 is 8.4 percentage points (24.6% vs 16.2%, respectively). CONCLUSIONS: Cognitive function may be a valuable early warning sign of premature mortality, even at working ages, when dementia is rare.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Transtornos Cognitivos/diagnóstico , Cognição , Disfunção Cognitiva/complicações , Mortalidade Prematura , Fatores de Risco
10.
Psychosom Med ; 85(3): 231-237, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36626598

RESUMO

OBJECTIVE: This study aimed to examine race and apolipoprotein E-e4 allele (APOE-e4) status differences in the longitudinal associations between loneliness and cognitive decline. METHODS: The study sample is composed of participants ( N = 7696, 64% Black participants and 36% White participants) from the Chicago Health and Aging Project, a population-based cohort study. Mixed-effects regression models were conducted to examine the longitudinal associations between loneliness on global cognitive function and individual tests of cognitive function. Models were also stratified by race and APOE-e4. RESULTS: A greater percentage of Black participants (17%) reported loneliness at baseline visit compared with White participants (12%). Black and White participants who were lonely individuals had a similar rate of decline in global cognitive function at 0.075 (95% confidence interval [CI] = -0.082 to -0.068) standard deviation unit (SDU) per year for Black participants and at 0.075 (95% CI = -0.086 to -0.063) SDU per year for White participants. Lonely participants with APOE-e4 had a higher rate of global cognitive decline at -0.102 (95% CI = -0.115 to -0.088) SDU per year than for lonely participants without APOE-e4 at -0.052 (95% CI = -0.059 to -0.045) SDU per year. CONCLUSIONS: The burden of loneliness and its relation to cognitive decline is higher among participants with APOE-e4 compared with those without APOE-e4. Loneliness is associated with cognitive decline in both Black and White participants.


Assuntos
Apolipoproteína E4 , Disfunção Cognitiva , Humanos , Estudos de Coortes , Apolipoproteína E4/genética , Alelos , Solidão , Apolipoproteínas E/genética , Disfunção Cognitiva/genética
11.
Popul Res Policy Rev ; 41(3): 801-810, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35833110

RESUMO

The combined effects of declining fertility and increased longevity have accelerated population aging in different parts of the world. Unlike other countries, Puerto Rico is also experiencing unprecedented levels of working-age out-migration. The full impact of high out-migration on Puerto Rican demography is not fully understood. Placing Puerto Rico's aging process in an international context is useful in identifying the role out-migration is having on the accelerated aging of the Puerto Rican society. Using the World Population Prospects 2019 estimates, we compared the pattern of rapid aging found for Puerto Rico with the trajectories of six other countries with the highest population of 65+ in the World, Europe, and the Caribbean from 1960 to 2020. Prior to 2010, the aging process in Puerto Rico was comparable to the other countries. After 2010, the percent of the population over 65 years in Puerto Rico nearly doubled from 11% to 21%. The nearly doubling of the percent of older adults is not observed in any of the comparison countries. We find that the rapid aging of Puerto Rico, changing from a linear trend to an exponential one, is a result of accelerating levels of out-migration, which is concentrated in the working-age population.

12.
Gerontologist ; 62(7): 964-973, 2022 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-35696667

RESUMO

Puerto Rico is aging more rapidly than almost any country, with 2020 estimates placing its population share of adults older than 65 as being the 10th highest in the world. Unlike most locales, Puerto Rico's aging is driven by both (a) the culmination of long-running fertility and mortality trends and (b) high levels of outmigration of working-age adults, which contributes both directly (removal of young people) and indirectly (reduced births) to its pace of population aging. This article offers an overview of the main issues surrounding population aging in Puerto Rico. Policymakers and government leaders must plan for Puerto Rico's unconventional population aging, which will exacerbate traditional concerns about the sustainability of government services and long-term economic prospects. Additional concerns emerge related to reduced social support networks and their impact on caregiving dynamics and implications for health. Puerto Rico's unique history and political relationship with the United States present challenges and benefits for its aging population. Research on aging in Puerto Rico and public health policies must adapt to the needs of the country's aging society.


Assuntos
Emigração e Imigração , Serviços de Saúde , Adolescente , Idoso , Envelhecimento , Humanos , Porto Rico , Estados Unidos
13.
Resuscitation ; 174: 9-15, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35257834

RESUMO

OBJECTIVE: Fire and police first responders are often the first to arrive in medical emergencies and provide basic life support services until specialized personnel arrive. This study aims to evaluate rates of fire or police first responder-initiated cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, as well as their associated impact on out-of-hospital cardiac arrest (OHCA) outcomes. METHODS: We completed a secondary data analysis of the MI-CARES registry from 2014 to 2019. We reported rates of CPR initiation and AED use by fire or police first responders. Multilevel modeling was utilized to evaluate the relationship between fire/police first responder-initiated interventions and outcomes of interest: ROSC upon emergency department arrival, survival to hospital discharge, and good neurologic outcome. RESULTS: Our cohort included 25,067 OHCA incidents. We found fire or police first responders initiated CPR in 31.8% of OHCA events and AED use in 6.1% of OHCA events. Likelihood of sustained ROSC on ED arrival after CPR initiated by a fire/police first responder was not statistically different as compared to EMS initiated CPR (aOR 1.01, CI 0.93-1.11). However, fire/police first responder interventions were associated with significantly higher odds of survival to hospital discharge and survival with good neurologic outcome (aOR 1.25, 95% CI 1.08-1.45 and aOR 1.40, 95% CI 1.18-1.65, respectively). Similar associations were see when examining fire or police initiated AED use. CONCLUSIONS: Fire or police first responders may be an underutilized, potentially powerful mechanism for improving OHCA survival. Future studies should investigate barriers and opportunities for increasing first responder interventions by these groups in OHCA.


Assuntos
Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Socorristas , Parada Cardíaca Extra-Hospitalar , Humanos , Parada Cardíaca Extra-Hospitalar/terapia , Polícia
14.
Innov Aging ; 6(1): igab053, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35036584

RESUMO

BACKGROUND AND OBJECTIVES: Social support networks of older adults have been linked to their health and well-being; however, findings regarding the effects of specific network characteristics have been mixed. Additionally, due to demographic shifts increasing numbers of older adults live outside of traditional family structures. Previous studies have not systematically examined the resulting complexity and heterogeneity of older adults' social networks. Our objectives were to examine this complexity and heterogeneity by developing a multidimensional typology of social networks that simultaneously considers multiple structural and functional network characteristics, and to examine differences in network type membership by sociodemographic characteristics, health characteristics, and birth cohort. RESEARCH DESIGN AND METHODS: Participants included 5,192 adults aged 57-85 years in the National Social Life, Health, and Aging Project at rounds 1 (2005-2006) and 3 (2015-2016). Data were collected on social relationships including network size, diversity, frequency of contact, and perceived support and strain in relationships. We used latent class analysis to derive the network typology and multinomial logistic regression to examine differences in network type membership by sociodemographic characteristics, health characteristics, and birth cohort. RESULTS: Older adults were classified into 5 distinct social network types: (i) large, with strain; (ii) large, without strain; (iii) small, diverse, low contact; (iv) small, restricted, high contact; and (v) medium size and support. Membership in these network types varied by age, gender, marital status, race/ethnicity, education, mental health, and birth cohort. DISCUSSION AND IMPLICATIONS: Network typologies can elucidate the varied interpersonal environments of older adults and identify individuals who lack social connectedness on multiple network dimensions and are therefore at a higher risk of social isolation.

15.
J Aging Phys Act ; 30(2): 187-195, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34303310

RESUMO

This study examined the relationship between walking and cognitive function among Chicago Health and Aging Project participants. Data collection occurred during six 3-year cycles, of which Cycles 4-6 were used for this specific analysis. Information was obtained regarding walking frequency and duration, demographics, chronic conditions, cognitive activities, apolipoprotein E4, physical function, and cognitive function (global and domains). A composite walking measure was developed and categorized as follows: no walking, ≤105 min/week, and >105 min/week. Mixed-effects regression analyses tested associations between walking and global cognitive function, episodic memory, and perceptual speed. The sample consisted of 4,320 participants (African American/Black: 65%; female: 65%; mean education: 13 years; mean age: 75 years). Composite or total walking had a statistically significant association with global cognitive function and perceptual speed, after adjustments were made.


Assuntos
Envelhecimento , Cognição , Idoso , Chicago , Escolaridade , Feminino , Humanos , Caminhada
16.
ChemSusChem ; 15(4): e202102137, 2022 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-34935302

RESUMO

Electrochemical synthesis of hydrogen peroxide (H2 O2 ), via the two-electron water oxidation reaction (2e- WOR), is an attractive method for the sustainable production of valuable chemicals in place of oxygen during water electrolysis. While the majority of 2e- WOR studies have focussed on electrocatalyst design, little research has been carried out on the selection of the supporting electrolyte. In this work, we investigate the impact of potassium carbonate (K2 CO3 ) electrolytes, and their key properties, on H2 O2 production. We found that at electrolyte pH values (>9.5) where the carbonate anion (CO3 2- ) was prevalent in the mixture, a 26.5 % increase in the Faraday efficiency (%FE) for H2 O2 production was achieved, compared to bicarbonate (HCO3 - ) dominant solutions. Utilising boron-doped diamond (BDD) in highly concentrated K2 CO3 solutions, current densities of up to 511 mA cm-2 (in 4 m) and %FEs of 91.5 % (in 5 m) could be attained. The results presented in this work highlight the influence of CO3 2- on electrochemical H2 O2 generation via the 2e- WOR and provide novel pathways to produce desirable commodities at the anode during electrochemical water splitting.

18.
Faraday Discuss ; 230(0): 375-387, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34259693

RESUMO

The electrochemical reduction of CO2 continues to see significant interest as a viable means of both producing important chemical materials and lowering carbon emissions. The primary challenge to making this process economically viable is the design of catalyst, electrode and reactor components that can selectively produce just one of the many possible CO2 reduction products. In this work, we report the use of hydrophobic 1-octadecanethiol coatings at copper coated gas diffusion electrodes to enhance the production of ethylene. This thiol coating gives a substantial increase in the production of ethylene at low current densities as well as a change in the rate determining step, as indicated by the substantial reduction in the Tafel slope. The observed changes to the CO2 reduction reaction indicate that the thiol layer provides a triphasic interface within the gas diffusion electrode catalyst layer.

19.
Soc Sci Med ; 268: 113371, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32980678

RESUMO

Grandparenthood constitutes a significant role for older adults and may have important health implications. Our study examines the grandparenthood-mortality nexus, controlling for an array of potentially confounding variables. Longitudinal survey data from the Health and Retirement Study (HRS) were used, comprising twelve biennial waves from 1992 to 2014 with linked data on vital status derived from the National Death Index. The sample included 27,463 participants aged ≥51 years with at least one child. Cox proportional hazard models tested the association between grandparenthood and mortality risk with adjustment for socio-demographic variables, for social variables including characteristics of and contact with children, and for health variables, including measures of general, functional and mental health. Grandparenthood overall was unassociated with mortality risk in both women and men. However, the subpopulation of younger, partnered grandmothers with a larger number of grandchildren tended to exhibit a substantial increase in mortality risk as compared to women without grandchildren.


Assuntos
Avós , Aposentadoria , Idoso , Criança , Feminino , Humanos , Relação entre Gerações , Estudos Longitudinais , Masculino , Saúde Mental , Pessoa de Meia-Idade , Mortalidade
20.
Alzheimers Dement ; 17(3): 525-533, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33084241

RESUMO

INTRODUCTION: Exposure to noise might influence risk of Alzheimer's disease (AD) dementia. METHODS: Participants of the Chicago Health and Aging Project (≥65 years) underwent triennial cognitive assessments. For the 5 years preceding each assessment, we estimated 5227 participants' residential level of noise from the community using a spatial prediction model, and estimated associations of noise level with prevalent mild cognitive impairment (MCI) and AD, cognitive performance, and rate of cognitive decline. RESULTS: Among these participants, an increment of 10 A-weighted decibels (dBA) in noise corresponded to 36% and 29% higher odds of prevalent MCI (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.15 to 1.62) and AD (OR = 1.29, 95% CI, 1.08 to 1.55). Noise level was associated with worse global cognitive performance, principally in perceptual speed (-0.09 standard deviation per 10 dBA, 95% CI: -0.16 to -0.03), but not consistently associated with cognitive decline. DISCUSSION: These results join emerging evidence suggesting that noise may influence late-life cognition and risk of dementia.


Assuntos
Cognição/fisiologia , Disfunção Cognitiva/psicologia , Demência/epidemiologia , Ruído/efeitos adversos , Características de Residência , Idoso , Idoso de 80 Anos ou mais , Chicago/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco
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