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In North American society driving is closely linked with independence. Unfortunately, the freedom to operate a motor vehicle may be lost when an individual develops a specific medical diagnosis. The complex issue of dementia and driving safety is frequently encountered by health care professionals. Physicians are required, by law, to report any medical diagnosis such as dementia, that may affect driving safety. Physicians often refer to occupational therapists to assist them in determining if an individual's impairment significantly impacts driving safety. Unfortunately many health care professionals are not using reliable, valid and sensitive tests to determine the point at which an individual with dementia will become an unsafe driver. Through a review of the literature, the authors explore the effects of normal aging and cognitive impairment on driving safety. Specific assessment tools used to assess driving ability are examined and the role of health professionals in driver assessment is discussed. Some suggestions to improve the overall approach to evaluating driving safety are offered in the conclusion. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity has been associated with prenatal exposure to maternal hyperglycaemia, but we lack understanding about maternal insulin physiologic components that contribute to this association., Objectives: Evaluate the association between maternal insulin sensitivity during pregnancy and adiposity measures in childhood., Methods: In 422 mother-child pairs, we tested associations between maternal insulin sensitivity measures at ~26 weeks of pregnancy and child adiposity measures, including dual-energy X-ray absorptiometry body composition and anthropometry (body mass index and waist circumference) at ~5 years. We used linear regression analyses to adjust for maternal age, ethnicity, gravidity, first-trimester body mass index, and child sex and age at mid-childhood., Results: In early pregnancy, maternal mean age was 28.6 ± 4.3 years and median body mass index was 24.1 kg/m 2 . Lower maternal insulin sensitivity indices were correlated with greater child adiposity based on anthropometry measures and on dual-energy X-ray absorptiometry total and trunk % fat in univariate associations (r = -0.122 to -0.159). Lower maternal insulin sensitivity was specifically associated with higher dual-energy X-ray absorptiometry trunk % fat (n = 359 for Matsuda; β = -0.034 ± 0.013; p = 0.01) after adjustment for covariates, including maternal body mass index., Conclusions: Maternal insulin sensitivity during pregnancy may contribute to increased risk for higher offspring central adiposity in middle childhood., (© 2022 World Obesity Federation.)

Lower cord blood leptin levels have been associated with lower and higher adiposity in childhood and associations seem to differ according to the child’s age, methods of adiposity assessment and sex. Our aim was to investigate sex-specific associations of cord blood leptinemia with childhood adiposity at birth, 3 and 5 years of age. We measured cord blood leptin using Luminex immunoassays in 520 offspring from the Gen3G cohort. We tested associations between cord blood leptin and body mass index (BMI) z-score, skinfolds thicknesses (SFT), and body composition using dual-energy X-ray absorptiometry, adjusted for confounders. At birth, girls had almost twice as much leptin in cord blood as boys (15.5 [8.9; 25.6] vs. 8.6 [4.9; 15.0] ng/mL; p < 0.0001) as well as significantly greater adiposity. Lower levels of cord blood leptin were associated with higher sum of SFT (β = −0.05 ± 0.02; p = 0.03) and higher BMI z-score (β= −0.22 ± 0.08; p = 0.01) in 3-year-old boys only. We did not observe these associations at age 5, or in girls. Our results suggest a sexual dimorphism in the programming of leptin sensitivity and childhood adiposity, but further observational and functional studies are needed to better understand the role of leptin in early life.

Background: Exposure to maternal hyperglycaemia in pregnancy has been associated with childhood obesity. Leptin regulation might be involved in this 'adiposity programming' and may depend on timing of exposure., Objectives: To investigate associations of maternal glycaemia at different periods in pregnancy with childhood adiposity and leptin levels at 5 years of age., Methods: In a prospective pre-birth cohort, we measured maternal glucose levels after a 50 g oral glucose challenge test at first trimester (9.8 ± 2.3 weeks) and during a 75 g oral glucose tolerance test at second trimester (26.5 ± 0.9 weeks). We followed up children at 5 years; we measured anthropometry and body composition using dual-energy X-ray absorptiometry (DXA). We measured fasting leptin levels using immunoassays (Luminex) in 328 children. We conducted linear regression analyses, adjusting for potential confounders., Results: Maternal glycaemia at first trimester was associated with childhood leptin levels at 5 years, independently of maternal pre-pregnancy BMI and other confounders (β = .09 ± .04; P = .03). Higher post-load glucose levels at second trimester were associated with greater total body fat percentage measured by DXA (1 hour-glucose: β = .010 ± .004; P = .03 and 2 hours-glucose: β = .016 ± .005; P = .002), but not with leptin levels., Conclusions: Our results suggest that programming of leptin regulation may be sensitive to maternal hyperglycaemia specifically in early pregnancy., (© 2021 World Obesity Federation.)

Transcriptional modulation of the process of autophagy involves the transcription factor HLH-30/TFEB. In order to systematically determine the regulatory network of HLH-30/TFEB, we performed a genome-wide RNAi screen in C. elegans and found that silencing the nuclear export protein XPO-1/XPO1 enhances autophagy by significantly enriching HLH-30 in the nucleus, which is accompanied by proteostatic benefits and improved longevity. Lifespan extension via xpo-1 silencing requires HLH-30 and autophagy, overlapping mechanistically with several established longevity models. Selective XPO1 inhibitors recapitulated the effect on autophagy and lifespan observed by silencing xpo-1 and protected ALS-afflicted flies from neurodegeneration. XPO1 inhibition in HeLa cells enhanced TFEB nuclear localization, autophagy, and lysosome biogenesis without affecting mTOR activity, revealing a conserved regulatory mechanism for HLH-30/TFEB. Altogether, our study demonstrates that altering the nuclear export of HLH-30/TFEB can regulate autophagy and establishes the rationale of targeting XPO1 to stimulate autophagy in order to prevent neurodegeneration., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Exposure to arsenic is a global health concern. We previously documented an inhibitory effect of inorganic Arsenite on IgE-mediated degranulation of RBL-2H3 mast cells (Hutchinson et al., 2011; J. Appl. Toxicol. 31: 231-241). Mast cells are tissue-resident cells that are positioned at the host-environment interface, thereby serving vital roles in many physiological processes and disease states, in addition to their well-known roles in allergy and asthma. Upon activation, mast cells secrete several mediators from cytoplasmic granules, in degranulation. The present study is an investigation of Arsenite's molecular target(s) in the degranulation pathway. Here, we report that arsenic does not affect degranulation stimulated by either the Ca(2) (+) ionophore A23187 or thapsigargin, which both bypass early signaling events. Arsenic also does not alter degranulation initiated by another non-IgE-mediated mast cell stimulant, the G-protein activator compound 48/80. However, arsenic inhibits Ca(2) (+) influx into antigen-activated mast cells. These results indicate that the target of arsenic in the degranulation pathway is upstream of the Ca(2) (+) influx. Phospho-Syk and phospho-p85 phosphoinositide 3-kinase enzyme-linked immunosorbent assays data show that arsenic inhibits early phosphorylation events. Taken together, this evidence indicates that the mechanism underlying arsenic inhibition of mast cell degranulation occurs at the early tyrosine phosphorylation steps in the degranulation pathway. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Bombesin, a pan agonist of the bombesin-like peptide receptor family, elicits potent hypothermia when applied centrally. The signaling mechanisms involved are not known. Here we report that GABAergic preoptic neurons express gastrin-releasing peptide (GRP) receptors and are directly excited by GRP or bombesin. This effect was abolished by a GRP receptor antagonist. A partially overlapping group of preoptic GABAergic neurons express bombesin-like receptor 3 (BRS3), however their activation results in a decrease in firing rate. The excitatory effects of bombesin or GRP were not affected by BRS3 antagonist. GRP activated a Ca 2+ -dependent inward nonselective cationic current and Ca 2+ release from intracellular stores. Our data indicate that GRP receptors mediate the excitatory effects of bombesin in preoptic neurons., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

This cross-sectional study examined the physical and mental health, grief and role functioning of 136 grandparents in the first year after death of their young grandchild (newborn through 6 years). Grandparents were 36-77 years old; 73% female; 24% Hispanic, 38% Black/African American, and 38% White. Mean age of the 115 deceased grandchildren was 12.8 months (SD = 20.71) with 37% <1 month old; 65% were male, 77% died in the hospital. Grandparents were recruited through state death records and interviewed by telephone. Grandparents experienced: clinical depression (31%), PTSD (35%); illnesses (28%), hospitalizations, new chronic health conditions (mental disorders, hypertension, angina, cancer), and medication changes. Grandparents who provided care for the deceased grandchild had more intense symptoms of grief, depression and PTSD and more trouble focusing at their jobs. Severity of depressive and/or PTSD symptoms were more likely to be at clinically important levels for grandparents who had provided childcare for the deceased grandchild than for non-caregiving grandparents. Black grandparents had more severe symptoms of PTSD and thought more about their deceased grandchild on the job than White grandparents. The interaction effect of race/ethnicity and provision of child care was significant for PTSD and Blame and Anger. Hispanic grandparents who provided some child care for their deceased grandchild had less severe PTSD symptoms than caregiving Black and White grandparents. Caregiving Hispanic grandparents also experienced less Blame and Anger than White caregiving grandparents.

Purpose: Hispanic Americans are at risk for health-related problems. Disparities in diseases such as diabetes and obesity, poor access to health services, and lack of health insurance have placed Hispanic Americans at a disadvantage. Sociocultural factors such as acculturation and its relationship to health require further investigation. The primary purpose of this study was to identify the relationship between acculturation and health in Hispanic American elders and examine the interrelationships of acculturation, health status, age, gender, education, years in the United States, and income., Design: This descriptive correlational study was a secondary analysis of data from a large study titled Culture Bias in Testing Expressive Ability in Dementia., Methods: A total sample of 132 community-dwelling Hispanic American elders was used. The Cross Cultural Measure of Acculturation was used to measure acculturation, and health status was measured using the SF-8® Health Survey. Correlation and multiple linear regressions were used to analyze the data., Discussion/conclusions: Findings from the study revealed that participants who were more acculturated to mainstream American culture reported their mental health to be better but not their physical health. This is an important contribution to advancing knowledge about cultural and health issues among Hispanic American elders, with implications for the clinical setting and for providing more culturally competent care.

Transitin is a nestin-like intermediate filament protein co-expressed with vimentin in the precursor cells of the myogenic and neurogenic lineages of the avian embryo. To understand its role in myogenesis, stable cell lines expressing transitin-targeted siRNAs were derived from the quail muscle cell line QM7. When cells were cultured in differentiation medium, we found that transitin knockdown prevented myoblast fusion and myotube formation. MyoD mRNA could be detected in transitin siRNA-transfected cells, but upregulation of myogenin and desmin expression was impaired compared to control cells. In addition, transitin siRNA cells maintain high levels of Pax7 expression suggesting that QM7 myoblasts into which transitin expression has been attenuated display a muscle progenitor cell phenotype (Pax7(+)/MyoD(+)/myogenin(-)/desmin(-)). These observations indicate that transitin plays an important role in the initiation of the myogenic program in avian muscle progenitor cells in acting downstream of MyoD and upstream of myogenin during the lineage progression., (© 2010 Wiley-Liss, Inc.)

Approximately 160,000 grandparents experience the death of a grandchild each year; this represents a permanent, irrevocable loss for the grandparent, resulting in physical and emotional responses. Grandparents who lose a grandchild experience increased alcohol and drug use, thoughts of suicide, and pain for their adult child who is also grieving. Supportive resources available to grieving grandparents, the effects of the grandchild's death on the grandparent-parent relationship, and the influence of race and ethnicity on grandparent grieving are discussed. Despite approximately 40,000 child and infant deaths each year, knowledge about grandparent health and functioning after the death of a grandchild is limited., (Copyright © 2010 Elsevier Inc. All rights reserved.)

To prepare nurses in providing competent care to older adults, schools of nursing at the Otterbein College and the Florida International University, supported by American Association of Colleges of Nursing/John A. Hartford Foundation, developed innovative strategies for incorporation of gerontological content into their BSN curricula. Both nursing programs integrated these innovative gerontological learning experiences into sophomore-, junior-, and senior-level baccalaureate courses; developed independent gerontology courses, including online courses; supported the development of faculty expertise and sensitivity in elder care; and established new and/or enhanced existing community partnerships. The program objectives, planning, and implementation procedures for each of the two schools evolved similarly. Faculty development strategies and examples of community and international partnerships are presented. Finally, lessons learned from the implementation of these projects and recommendations based on these initiatives are presented.

Purpose: To examine: (a) frequency and focus of APN-physician collaborations in a clinical trial in which half of physician prenatal care for women with high-risk pregnancies was substituted with APN prenatal care delivered in women's homes; and (b) characteristics of women requiring greater numbers of collaborations., Design and Methods: Descriptive study with secondary analysis of data from 83 of the original trial's 85 intervention participants followed by APNs prenatally through 8 weeks postpartum. APN practices, recorded in logs, included APN interactions with the women and the physician, and type of APN contact (e.g., home visit, telephone call). Each APN-physician collaboration was coded for type, timing, and focus., Findings: Total number of APN-physician collaboration contacts was 351, with a mean of 4.5 and a range of 1 to 16 per woman. Focus of collaborations was: status updates (59%), new physical findings (21%), change in treatment (8%), patient concerns (7%) and medication adjustment (5%). No significant differences in numbers of collaborations were found according to age, primary diagnosis, marital status, type of health insurance, race, or income. Women with high school education received more collaborations than did those not completing high school or those with some postsecondary education. Prenatally, women with a first pregnancy required more collaborations than did multipara participants., Conclusions: Most APN-physician collaborative contacts were focused on monitoring women's physical and emotional status and discussing new physical findings. These collaborations were important in the original trial's successful pregnancy and infant outcomes and savings in health care dollars.

Cysteine was shown to be toxic to Salmonella typhimurium. The mechanism of this toxicity may be due, at least in part, to cysteine's ability to cause deoxyribonucleic acid strand scissions.

With the current emphasis on developing nursing leaders, many developing countries are looking outside for a broader perspective and expertise upon which they can proceed with continuing education and higher-learning programmes for nurses. The possibilities are vast, yet not all models are appropriate for all countries. Nurses and educational institutions are thus constantly on the lookout for the answer to fit their particular needs. Below, two educators explore several models for continuing education programmes in developing countries. It is hoped that their recommendations will be but the start of the presentation in INR of other solutions (e.g. networking and sharing) and other models that use the expertise available in developing countries. To do this, INR is depending upon you, its readers (particularly from developing countries), to send in ideas and experience in this field. Your response--whether 30 or 300 lines--is welcome.