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Adverse Childhood Experiences (ACEs) are associated with poor health yet, we know little about how distinct patterns of ACE types are associated with cardiovascular (cardiovascular (CVD)) risk factors. The current study 1) examined associations of latent ACE classes with modifiable CVD risk factors including high cholesterol, smoking, diabetes, hypertension, high triglycerides, physical inactivity, overweight/obesity, and lifetime depression; and 2) examined the impact of socioeconomic status-related (SES) factors on these relationships. Using a cross-sectional analysis of the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309) data, four latent classes of ACEs were previously identified: 1) low adversity, 2) primarily household dysfunction, 3) primarily maltreatment, and 4) multiple adversity types. We examined the association of these classes with CVD risk factors in adulthood and subsequently, the same model accounting for SES-related factors. Tobacco smoking, overweight/obesity, and lifetime depression were each associated with higher odds of being in classes 2, 3, and 4 than class 1, respectively. These relationships held after adjusting for SES-related factors. Class 4 was associated with the most CVD risk factors, including high triglycerides and high cholesterol after controlling for SES-related factors. The consistent associations between tobacco smoking, overweight/obesity, and lifetime depression with each adverse ACE profile, even after controlling for SES, suggest behavioural CVD prevention programs should target these CVD risk factors simultaneously.

Our current knowledge of host-virus interactions in biofilms is limited to computational predictions based on laboratory experiments with a small number of cultured bacteria. However, natural biofilms are diverse and chiefly composed of uncultured bacteria and archaea with no viral infection patterns and lifestyle predictions described to date. Herein, we predict the first DNA sequence-based host-virus interactions in a natural biofilm. Using single-cell genomics and metagenomics applied to a hot spring mat of the Cone Pool in Mono County, California, we provide insights into virus-host range, lifestyle and distribution across different mat layers. Thirty-four out of 130 single cells contained at least one viral contig (26%), which, together with the metagenome-assembled genomes, resulted in detection of 59 viruses linked to 34 host species. Analysis of single-cell amplification kinetics revealed a lack of active viral replication on the single-cell level. These findings were further supported by mapping metagenomic reads from different mat layers to the obtained host-virus pairs, which indicated a low copy number of viral genomes compared to their hosts. Lastly, the metagenomic data revealed high layer specificity of viruses, suggesting limited diffusion to other mat layers. Taken together, these observations indicate that in low mobility environments with high microbial abundance, lysogeny is the predominant viral lifestyle, in line with the previously proposed "Piggyback-the-Winner" theory.

BackgroundDyads that view illnesses as shared stressors ("shared appraisal"), and collaboratively respond to it, have better outcomes. This process, known as communal coping, has received little attention in heart failure (HF).ObjectivesTo examine communal coping among patient-caregiver dyads managing HF.MethodsWe conducted semi-structured interviews with 34 dyads. Shared appraisal was measured using we-ratio, as calculated with Linguistic Inquiry Word Count. We-ratio was divided into "high" and "low" for patients and caregivers, and concordance was examined. Thematic analyses were used to explore collaboration.ResultsCaregivers had higher we-ratios than patients (p=.005); 29.6% and 33.3% dyads were concordant on high and low "we-ratio," respectively. In thematic analyses, we found that 1) dyads collaborated around diet, appointments, and medications, but less around physical activity; 2) dyads collaborated across all illnesses, not just HF; and 3) dyads concordant on high we-ratio reported stronger collaborations.ConclusionsCommunal coping varied by shared appraisal and collaboration. Understanding this variability may help develop tailored self-management interventions.

• What is the primary question addressed by this study? Using a unique combination of comprehensive survey data and Veterans Affairs health care records encompassing 12 years, we used mixed effects logistic regression models to examine the association between receiving any in-home caregiving assistance and likelihood of mental health utilization in a sample of community-dwelling older veterans. • What is the main finding of this study? After accounting for demographics, caregiver availability, health factors, and socioeconomic status, caregiving receipt was associated with two-fold odds of MH utilization, compared to receiving no assistance. Being classified as having dementia and reporting less severe depressive symptoms potentiated the relationship between caregiving receipt and using mental health care. • What is the meaning of the finding? We found that for this group of community-dwelling older adults, having a caregiver is associated with increased odds of using mental health care, suggesting that caregivers may represent an underutilized resource to reduce age-related disparities in mental health access. There exist significant age disparities in mental health (MH) utilization, such that older adults, including older veterans, are much less likely to use MH services. In-home caregivers represent a novel, yet understudied, pathway to increase appropriate utilization. We sought to examine the association between receiving caregiving assistance and MH utilization and test moderation effects of cognitive status and depression severity in a sample of older veterans. Cross-sectional, mixed effects logistic regression with moderation analyses was used with a unique data resource combining survey data from the 2000–2012 U.S. Health and Retirement Study with Veterans Affairs (VA) healthcare administrative records. The analytic sample included N=1,957 Community-dwelling veterans (mean age 68.2 [9.7]), primarily male (96.5%) and non-Hispanic white (77.0%). Measures included MH utilization extracted from VA records or self-report; CESD-8 for depressive symptoms; and the Langa-Weir cognitive status classification using the modified TICS. After accounting for demographics, spousal caregiver availability, health factors, and socioeconomic status, caregiving receipt was associated with two-fold odds of MH utilization, compared to receiving no assistance (8,839 person-year observations; OR = 2.02; 95% CI 1.54–2.65) and remained similar following VA policy changes to enhance MH access. Exploratory analyses revealed that categories of cognition and depressive symptoms may moderate the association. Receipt of any in-home caregiving is associated with increased likelihood of MH use by older adults. Caregivers may represent an underutilized resource to reduce age-related mental health access disparities. [ABSTRACT FROM AUTHOR]

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Background: Heart failure (HF) management can be improved by involving framily (family and friends) who provide valuable support. Less is known about how dyadic interactions or interactions between dyads and their extended care networks positively impact life with HF. Objectives: This study aimed to understand the positive behavioral, cognitive, and social factors through which patient-framily dyads manage health together. Methods: Heart failure patient-framily dyads were recruited through Stanford heart failure clinics. Participants completed a 45-minute semistructured interview that elicited their experiences with managing HF. Interviews were audio recorded, transcribed for analysis, and independently coded by 2 team members using thematic analyses. Results: Seventeen dyads (n = 34) participated in the study; 47% of patients and 78% of framily were women. Mean (SD) age of patients was 66 (14) years, and mean (SD) age of framily caregivers was 59 (12.3) years. Three themes showcased the positive contributions of dyadic HF management: (1) management of HF was perceived as successful when individuals in a dyad both received support from a shared care network; (2) when strength of the interpersonal relationship and love were the main motivators for care, dyads reported a positive outlook on quality of life with HF; and (3) the framily caregivers' own health conditions affected the dyadic relationship and perceived success with HF management. Conclusions: Social support by an external network and mutual support within a patient-framily dyad both create an environment of optimism and effective coping, making successful HF management possible. A dyad's success with these factors may result in better condition management and perceived quality of life. [ABSTRACT FROM AUTHOR]