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BACKGROUND Older African and Hispanic Americans are disproportionately more likely than older White Americans to have dementia. OBJECTIVE To assess social support needs among African American and Hispanic dementia caregivers to establish a foundation that can inform designs for culturally sensitive social support interventions. METHODS Design: This mixed-methods study applied natural language processing (NLP) on qualitative data. Setting: Academic medical center in New York Participants: Volunteer sample of seven experts participated together in the series of in-depth expert panels. The four dementia caregivers were recruited from the dementia caregiver registry, as well as via flyers posted within and outside of the institution. Health professionals were recruited from Columbia University Irving Medical Center. Eligible caregivers included those who had been a primary family dementia caregiver for at least three years, spoke English or Spanish, and used text messaging. Eligible professionals included those with at least 5 years of experience and publication on dementia caregiving. An eligible health communication specialist included one with a degree in health literacy. RESULTS A total of 72 topics (38 needs, 34 strategies, 2,322 terms) were identified through the NLP process: 1) 21 topics regarding disease, medication and communication from the information support corpus (coherence: 0.470, 38.77%); 2) 20 topics regarding care coordination and social services from the instrumental support corpus (coherence: 0.513, 23.97%); 3) 21 topics regarding psychological distress and copying from the emotional support corpus (coherence: 0.509, 21.25%); 4) 9 topics regarding self-evaluations on caregiving from the appraisal support corpus (coherence: 0.461, 15.99%). CONCLUSIONS This study is among the first to use NLP on qualitative data gathered from expert panels. New findings on unmet needs include for providers to disclose disease prognosis, to understand cultural norms on seizure treatment as a result of side effect of donepezil, and to familiarize with culturally sensitive terminologies and routine medications for dementia to reduce distrust. CLINICALTRIAL NCT03865498

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aim to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the first of two that provide an update on urinary incontinence and its management in older adults. The second article will contain an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the articles first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. In this article, the videos can be found in Resources for Nurses.

The purpose of this study was to describe the burden and educational needs of informal caregivers of care-dependent older adults with urinary incontinence (UI).A cross-sectional, descriptive survey of informal caregivers recruited through Google Ads was performed.An online survey, including the Overactive Bladder-Family Impact Measure, was used to assess five areas of the experience of the informal caregiver that may be affected by caring for a person with UI and their educational needs.Respondents (n = 77) reported a substantial impact of their care recipients' UI on their lives, with concern, travel, and social subscales most affected. However, 42% never sought treatment on behalf of their care recipient. Educational needs included UI treatment strategies and guidance to select appropriate supplies.Caregivers underreported their care recipient's UI and need substantially more support from healthcare providers to manage the condition.Nurses should assess for UI among care-dependent older adults and, if present, provide information and strategies to lessen the impact on caregiver lives.

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the second of two that provide an update on urinary incontinence and its management in older adults. It includes an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the articles first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.

Epidemiological studies in women have revealed an association between caffeine intake and urinary incontinence, although evidence among men is limited. Therefore, we evaluated the association between caffeine intake and urinary incontinence in United States men.Data were used from male NHANES (National Health and Nutrition Examination Surveys) 2005-2006 and 2007-2008 participants. Urinary incontinence was defined using a standard questionnaire with Incontinence Severity Index scores 3 or greater categorized as moderate to severe. Structured dietary recall was used to determine caffeine consumption (mg per day), water intake (gm per day) and total dietary moisture (gm per day). Stepwise multivariable logistic regression models were used to assess the association between caffeine intake at or above the 75th and 90th percentiles and moderate to severe urinary incontinence, controlling for potential confounders, urinary incontinence risk factors and prostate conditions in men age 40 years or older.Of the 5,297 men 3,960 (75%) were 20 years old or older with complete data. Among these men the prevalence of any urinary incontinence was 12.9% and moderate to severe urinary incontinence was 4.4%. Mean caffeine intake was 169 mg per day. Caffeine intake at the upper 75th percentile (234 mg or more daily) and 90th percentile (392 mg or more per day) was significantly associated with having moderate to severe urinary incontinence (1.72, 95% 1.18-2.49 and 2.08, 95% 1.15-3.77, respectively). In addition, after adjusting for prostate conditions, the effect size for the association between caffeine intake and moderate to severe urinary incontinence remained.Caffeine consumption equivalent to approximately 2 cups of coffee daily (250 mg) is significantly associated with moderate to severe urinary incontinence in United States men. Our findings support the further study of caffeine modification in men with urinary incontinence.

Alzheimer disease (AD) accounts for most dementia diagnoses. Acetylcholinesterase inhibitors and antipsychotics are first-line drug therapies for cognitive decline and to manage neuropsychiatric symptoms, respectively. Because AD is relentlessly progressive, NPs will need to provide long-term support to patients and their caregivers.

In the asymmetric predivisional cell of Caulobacter crescentus, TipF and TipN mark the cellular pole for future flagellar development. TipF is essential for motility and contains a cyclic-di-GMP phosphodiesterase-like (EAL) domain that is necessary for proper function. TipN is localized to the flagellar pole before TipF and is essential for the proper placement of the flagellum in C. crescentus. Using β-galactosidase promoter-probe assays and quantitative chromatin immunoprecipitation, we investigated the influence of the C. crescentus flagellar assembly regulator TipF on flagellar gene transcription. We compared the transcriptional activity of class II-fliF-lacZ, class III-flgE-lacZ, and class IV-fljL-lacZ fusions in a ΔtipF mutant with that of other flagellar mutants and the wild-type strain. We subsequently verified the in vivo occupancy of the fliF, flgE, and fljL flagellar promoters by the flagellar regulators CtrA, FlbD, and FliX in addition to RNA polymerase. We deduce that TipF contributes to proper expression of flagellar genes in C. crescentus by acting both within and outside of the canonical flagellar gene expression hierarchy.

This project was funded by the Department of Veterans Affairs (VA) as a part of a national pilot program to design interventions that would support caregivers of older veterans. The specific project described here employed in-home messaging units, which are already widely used by the VA in disease-management programs, as a device to educate and support family caregivers (CGs) of older, functionally impaired veterans. The primary goal of the pilot program was to improve the well-being of both family CGs and their veteran care recipients (CRs) by (a) engaging CGs more actively and effectively in their veterans’ care, and (b) directly addressing the emotional needs of caregivers themselves. A three-group quasi-experimental design (instrumental support, instrumental+emotional support, wait-list control) was employed. Outcomes from the perspective of the caregiver, care recipient, and the health system were evaluated. In this paper, we further describe the experimental design of the program, the role o...

Eukaryotic morphogenesis is seeded with the establishment and subsequent amplification of polarity cues at key times during the cell cycle, often using (cyclic) nucleotide signals. We discovered that flagellum de- and repolarization in the model prokaryote Caulobacter crescentus is precisely orchestrated through at least three spatiotemporal mechanisms integrated at TipF. We show that TipF is a cell cycle-regulated receptor for the second messenger—bis-(3′–5′)-cyclic dimeric guanosine monophosphate (c-di-GMP)—that perceives and transduces this signal through the degenerate c-di-GMP phosphodiesterase (EAL) domain to nucleate polar flagellum biogenesis. Once c-di-GMP levels rise at the G1 → S transition, TipF is activated, stabilized, and polarized, enabling the recruitment of downstream effectors, including flagellar switch proteins and the PflI positioning factor, at a preselected pole harboring the TipN landmark. These c-di-GMP-dependent events are coordinated with the onset of tipF transcription in early S phase and together enable the correct establishment and robust amplification of TipF-dependent polarization early in the cell cycle. Importantly, these mechanisms also govern the timely removal of TipF at cell division coincident with the drop in c-di-GMP levels, thereby resetting the flagellar polarization state in the next cell cycle after a preprogrammed period during which motility must be suspended.