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Streptococcus suis, a zoonotic pathogen found primarily in pigs, can cause serious infection in humans. Most cases in human occur in Southeast Asia, where pig rearing is common (1). In [...]

Background This study examined associations of actigraphy-estimated sleep parameters with concurrent and future cognitive performance in adults aged ≥ 50 years and explored interactions with race. Methods Participants were 435 cognitively normal adults in the Baltimore Longitudinal Study of Aging who completed wrist actigraphy at baseline (mean = 6.6 nights) and underwent longitudinal testing of memory, attention, executive function, language, and visuospatial ability. On average, participants with follow-up data were followed for 3.1 years. Primary predictors were baseline mean total sleep time, sleep onset latency, sleep efficiency (SE), and wake after sleep onset (WASO). Fully adjusted linear mixed-effects models included demographics, baseline health-related characteristics, smoking status, sleep medication use, APOE e4 carrier status, and interactions of each covariate with time. Results In adjusted models, higher SE (per 10%; B  = 0.11, p  = .012) and lower WASO (per 30 minutes; B  = −0.12, p  = .007) were associated with better memory cross-sectionally. In contrast, higher SE was associated with greater visuospatial ability decline longitudinally (B  = −0.02, p  = .004). Greater WASO was associated with poorer visuospatial ability cross-sectionally (B  = −0.09, p  = .019) but slower declines in visuospatial abilities longitudinally (B  = 0.02, p  = .002). Several sleep-cognition cross-sectional and longitudinal associations were stronger in, or limited to, Black participants (compared to White participants). Conclusions This study suggests cross-sectional sleep-cognition associations differ across distinct objective sleep parameters and cognitive domains. This study also provides preliminary evidence for racial differences across some sleep-cognition relationships. Unexpected directions of associations between baseline sleep and cognitive performance over time may be attributable to the significant proportion of participants without follow-up data and require further investigation. [ABSTRACT FROM AUTHOR]

Objectives: To determine the association of napping intention, frequency, and duration with cognition in a nationally-representative sample of US older adults.Methods: We performed a cross-sectional analysis of community-dwelling Medicare beneficiaries aged ≥65 years from Rounds 3 or 4 (2013-2014) of the National Health and Aging Trends Study (N = 2549). Participants reported past-month napping intention (intentional/unintentional), napping frequency (rarely/never [non-nappers], some days [infrequent nappers], most days/every day [frequent nappers]), and average nap duration (we categorized as ≤30 minutes [short]; 31-60 minutes [moderate]; and > 60 minutes [long]). Cognitive outcomes were performance on immediate and delayed word recall tests (IWR and DWR, respectively), the Clock Drawing Test (CDT), and self-rated memory (score: 1[excellent]-5[very poor]).Results: After adjustment for potential confounders, unintentional nappers had poorer immediate word recall test performance than non-nappers (B = -0.23, P < 0.01) and intentional nappers (B = -0.26, P < 0.01). After further adjustment for daytime sleepiness, frequent nappers reported poorer self-rated memory than non-nappers (B = 0.14, P < 0.05). Compared with short nappers, long nappers had poorer IWR (B = -0.26, P < 0.05) and CDT scores (B = -0.17, P < 0.05). Except for the association of nap duration with IWR and CDT, these associations remained after excluding participants with dementia and/or proxy respondents. Among participants undiagnosed with dementia or proxies, moderate-duration naps were associated with better DWR than short naps (B = 0.24, P < 0.05). Neither napping intentionality nor frequency was associated with CDT performance.Conclusions: Among older adults, distinct aspects of napping are associated with cognitive performance. Prospective research, with objective measures of napping, is needed to elucidate the link between napping and cognitive trajectories. [ABSTRACT FROM AUTHOR]

In 2008, the world experienced the worst financial crisis since the Great Depression. The crisis is often described in relation to its proximal risk factors such as the proliferation of risky loans and mortgage-based securities, but the root causes of the Great Recession include distal risk factors such as indiscriminate capital flow, excessive financial deregulation, and high concentration of wealth in the top distribution. Ultimately, the crisis is a byproduct of neoliberal policies and the ‘self-correcting market’ ideology that guided national and global macroeconomic reforms since the 1970s. Evidence indicates that the Great Recession led to increases in unemployment and suicides, especially in Europe and in the US. Estimates based on the effects of previous economic downturns suggest that the crisis produced negative health and nutritional outcomes in developing countries. Data, however, also show that recessions can be characterized by increases in life expectancy at birth. These favorable trends seem associated with policy regimes favoring a more egalitarian distribution of income and stronger social protections that can decouple the link between unemployment and suicides during crises (‘healthy de-growth’.). New rules and regulations at the national and global level are needed to prevent future financial crises. The crisis also provides an opportunity to challenge neoliberalism, the ideology of the ‘self-correcting market’ and envision a new model of economic development where GDP growth is longer the main national policy priority. Governments can achieve a regime of ‘healthy de-growth’ if they step in with appropriate policy interventions toward a more egalitarian distribution of income and stronger social protections. [ABSTRACT FROM PUBLISHER]

Background: Depression is frequently observed in patients with untreated sleep-disordered breathing (SDB) in the general population. Pregnant women are particularly vulnerable since pregnancy increases the risk of both SDB and depressive symptoms. However, no study has investigated whether SDB symptoms prior to or in early pregnancy are associated with such mood problems. Methods: A retrospective chart review of pregnant women. Women were included if they attended prenatal clinics between June 2007 and July 2010, were ⩾18 years old, pregnant with a single fetus, and had been screened for habitual snoring as well as depressive symptoms using the Edinburgh Postnatal Depression Scales (EPDS). Results: In total, 362 women were included and 32.3% reported habitual snoring. Twenty-nine percent of women had an EPDS score ⩾10. Significantly more snoring women, compared to non-snorers, had an EPDS score ⩾10 (42.7% vs. 22.9%, p < 0.001) despite the mean EPDS values not reaching statistical significance (6.1 ± 4.9 vs. 5.4 ± 5.0, p = 0.2). In a logistic regression model controlling for parity, the presence of pre-pregnancy obesity, presence of a partner, sleep quality, African American race, maternal educational level, pre-eclampsia, and diabetes, snoring was independently associated with a prenatal EPDS score ⩾10 (O.R. 2.0, 95%CI 1.13-3.46; p = 0.023). Conclusion: Maternal snoring may be a risk factor for prenatal depressive symptoms. Further investigation of the temporal relationship between maternal snoring and depressive symptoms is warranted. [ABSTRACT FROM AUTHOR]

Purpose of the Study Interest in cognitive training for healthy older adults to reduce cognitive decline has grown considerably over the past few decades. Given the shift toward a more diverse society, the purpose of this review is to examine the extent of race/ethnic minority participation in cognitive training studies and characteristics of studies that included race/ethnic minority participants. Design and Methods This review considered peer-reviewed studies reporting cognitive training studies for cognitively healthy, community-dwelling older adults (age 55+) in the United States published in English before December 31, 2015. A total of 31 articles published between 1986 and 2015 meeting inclusion criteria were identified and included in the review. Results A total of 6,432 participants were recruited across all of the studies, and ranged in age from 55 to 99 years. Across all studies examined, 39% reported racial/ethnic background information. Only 3 of these studies included a substantial number of minorities (26.7% in the ACTIVE study; 28.4% in the SeniorWISE study; 22.7% in the TEAM study). Race/ethnic minority older adults were disproportionately underrepresented in cognitive training studies. Implications Further research should aim to enroll participants representative of various race/ethnic minority populations. Strategies for recruitment and retention of ethnic minority participants in cognitive training research are discussed, which could lead to the development of more culturally appropriate and perhaps more effective cognitive interventions. [ABSTRACT FROM AUTHOR]

Introduction: Prior studies have supported the effectiveness of blended interventions for anxiety and depression; however, outcomes research of large-scale blended interventions for these conditions is limited. Objective : To investigate the outcomes of scaled-up blended care (BC) cognitive behavioral therapy (CBT), a program that combined video-based psychotherapy with internet CBT, for symptoms of anxiety and depression. Materials and Methods : Participants were 6,738 U.S.-based adults with elevated symptoms of anxiety (Generalized Anxiety Disorder-7 [GAD-7] ≥ 8) and/or depression (Patient Health Questionnaire-9 [PHQ-9] ≥ 10) at baseline who received BC-CBT as an employer-offered mental health benefit. The primary outcomes, anxiety (GAD-7) and depression (PHQ-9) symptoms, were routinely measured in the program. Recovery and reliable improvement in outcomes were calculated, and growth curve models evaluated change in outcomes during treatment and the effects of engaging in psychotherapy sessions on outcomes. Results : On average, participants received treatment for 7.6 (standard deviation = 6.2) weeks. By the end of care, 5,491 (81.5%) participants had reliable improvement in either anxiety or depression symptoms; in addition, 5,535 (82.1%) fell below the clinical threshold for either anxiety or depression symptoms (i.e., recovered). Declines in anxiety and depression symptoms were statistically significant over the course of BC-CBT (both p 's < 0.01), with the rate of decline significantly decreasing for each outcome as treatment progressed (both p 's < 0.01). Each psychotherapy session completed was significantly associated with lower anxiety and depression symptoms during the week of the session and the subsequent week (all p 's < 0.01). Conclusions : This real-world study provides evidence that scaled-up BC-CBT can be effective in the treatment of symptoms of anxiety and depression.