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"Amano, Takashi"
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Application of the Bethesda System for Reporting Thyroid Cytopathology in the Pediatric Population
Abstract
Objectives
We aimed to provide the Asian experience with the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) in pediatric thyroid nodules.
Methods
Consecutive thyroid fine-needle aspirates (patient age, ≤18 years) were retrospectively collected from 7 tertiary centers in 5 Asian countries.
Results
Of 194,364 thyroid aspirates, 0.6% were pediatric cases (mean age, 15.0 years). Among 827 nodules with accessible follow-up, the resection rate and risk of malignancy (ROM) were 36.3% and 59.0%, respectively. Malignant nodules (n = 179) accounted for 59.7% of resected nodules and 21.6% of all thyroid nodules with available follow-up. Compared with the published adult series, pediatric nodules had a higher resection rate and ROM, particularly in the indeterminate categories.
Conclusions
Our study demonstrates that Asian pediatric thyroid nodules had higher ROM than those from adults. The prototypic outputs of TBSRTC may need to be adjusted in the pediatric population.
Journal Article
Domestication Process of the Goat Revealed by an Analysis of the Nearly Complete Mitochondrial Protein-Encoding Genes
Goats (Capra hircus) are one of the oldest domesticated species, and they are kept all over the world as an essential resource for meat, milk, and fiber. Although recent archeological and molecular biological studies suggested that they originated in West Asia, their domestication processes such as the timing of population expansion and the dynamics of their selection pressures are little known. With the aim of addressing these issues, the nearly complete mitochondrial protein-encoding genes were determined from East, Southeast, and South Asian populations. Our coalescent time estimations suggest that the timing of their major population expansions was in the Late Pleistocene and significantly predates the beginning of their domestication in the Neolithic era (≈10,000 years ago). The ω (ratio of non-synonymous rate/synonymous substitution rate) for each lineage was also estimated. We found that the ω of the globally distributed haplogroup A which is inherited by more than 90% of goats examined, turned out to be extremely low, suggesting that they are under severe selection pressure probably due to their large population size. Conversely, the ω of the Asian-specific haplogroup B inherited by about 5% of goats was relatively high. Although recent molecular studies suggest that domestication of animals may tend to relax selective constraints, the opposite pattern observed in our goat mitochondrial genome data indicates the process of domestication is more complex than may be presently appreciated and cannot be explained only by a simple relaxation model.
Journal Article
Resource and Network Predictors of Multiple Volunteering Cessations: Implications for Social Policy and Practice
The benefits of volunteering are well-documented, however, studies specifically investigating the cessation of volunteering in old age are relatively limited, especially on multiple stops of volunteering. The present study explores the number of times older people stop volunteering over 14 years, and examines its association with financial resources, health, family demands, social networks, neighborhood environment as well as the sociodemographic characteristics. Using eight-wave data from the Health and Retirement Study, the sample included 3914 volunteers who were 50 + in 1998 and were alive throughout 2012. Among the sample, 32.75% never stopped volunteering, 41.47% stopped once, 20.77% stopped twice, and 5.01% stopped three times. Findings from Poisson regression models indicated that respondents who were older, less educated, less religious, had lower income at baseline, later developed cognitive problems, became caregivers, and had no friends living nearby were more likely to stop volunteering multiple times. Findings from the present study suggest retaining volunteers by adjusting volunteering responsibilities for older volunteers who are more vulnerable to volunteering cessation and encouraging continued commitment by maximizing their friendship and religious networks.
Journal Article
PLACE OF DEATH FOR PEOPLE WITH DEMENTIA: EVIDENCE FROM THE CDC WONDER MORTALITY DATA
Abstract
Previous studies have found that patients with dementia experience poorer end-of-life care compared to patients with cancer. Dying in the preferred place has become a common measure of the quality of end-of-life care, and it has been consistently reported that the majority of people prefer to die at home. Thus, this study examines whether dying from dementia is a significant determinant of the place of death in mortalities among older adults. The Mortality Data on Center for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) between 2010 and 2019 were utilized. This study examined whether dying from dementia was associated with place of death (hospital, home, hospice facility, nursing home/long-term care facility) among deaths at 65 years or older. A multinomial logistic regression analysis was performed to estimate the association adjusted for covariates. We analyzed a total of 15,855,034 death records of which 12.34% were dementia deaths. The percentage of deaths at nursing homes was higher in deaths from dementia (56.5%) than other deaths (21.85%), whereas percentages of death at home were similar (20.7% for dementia death and 29.1% for other deaths). Multinomial logistic regression revealed that dementia deaths were 2.74 times more likely to occur at nursing homes than at hospitals compared to other deaths. Results suggest that dementia deaths are more likely to occur at nursing homes/long-term care facilities than other deaths. Further research should investigate the ways to improve the quality of end-of-life care for people with dementia in nursing homes/long-term care facilities.
Journal Article
EFFECTS OF DISCLOSING DIAGNOSES AND BIOMARKER RESULTS FOR ALZHEIMER’S DISEASE AND RELATED DISORDERS
Abstract
Early diagnosis of mild cognitive impairment (MCI) and Alzheimer’s disease and related dementias (ADRD) has been recognized as a key strategy to improve health-related outcomes. However, given that these conditions are highly stigmatized, receiving a diagnostic label or knowing about biomarkers related to MCI or ADRD may have a profound impact on the person’s life. As the impacts of disclosure of diagnostic information related to MCI and ADRD on the well-being of people living with these conditions are not well understood, this symposium attempts to address this knowledge gap. The first presenter will describe a study that examined racial/ethnic variations in the effects of diagnostic labeling of ADRD on social aspects of the person’s life. The second presenter will discuss findings from a systematic review of the effects of ADRD and cognitive impairment on social engagement. The third presenter will present the findings of the study on the effect of amyloid PET results disclosure on health-related behaviors of people with MCI. The fourth presenter will describe the results of an online vignette study on the outcomes of a preclinical Alzheimer disease diagnosis. The fifth presenter will discuss the use of blood biomarkers to aid in the diagnosis of ADRD in primary care (PC). At the end of the presentation, the discussant will highlight implications for future research and policy development to alleviate negative impacts and maximize the positive impacts of a diagnostic label of MCI and ADRD.
Journal Article
East Meets West: Home and Community Based Care to Enhance Aging in Place
Abstract
Although the magnitude and rate of aging in Japan and the United States differ, the drastic change in population structure has resulted in common challenges in both countries. One challenge is assisting older people in staying in the community. Enhancement of home- and community-based care allows older people to remain in their homes or spaces of their choice without moving into an institution to receive necessary care. This symposium includes four presentations (two from Japan and two from the U.S.) examining various efforts surrounding home- and community-based care designed to strengthen older people's abilities to stay in the community. The presenters will cover a wide range of strategies that have been implemented in both countries. The first presenter will describe the development and delivery of a project to expand Arizona's dementia capable system. The second presenter will describe initiatives of a professional association of geriatrics to promote the concept of aging in place. The third presenter will discuss the Home Hazard Removal Program (HARP), a new home hazard removal and fall risk self-management program delivered in the home by occupational therapists. The fourth presenter will discuss Japan's national policy priority of promoting the use of home health care within the community-based integrated care system. The symposium will conclude with a review of similarities and differences of various efforts, summarize common goals and challenges, and identify best practices.
Journal Article
Assessing Implementation Strategy Reporting in the Mental Health Literature: A Narrative Review
Inadequate implementation strategy reporting restricts research synthesis and replicability. We explored the implementation strategy reporting quality of a sample of mental health articles using Proctor et al.’s (Implement Sci 8:139, 2013) reporting recommendations. We conducted a narrative review to generate the sample of articles and assigned a reporting quality score to each article. The mean article reporting score was 54% (range 17–100%). The most reported domains were: name (100%), action (82%), target (80%), and actor (67%). The least reported domains included definition (6%), temporality (26%), justification (34%), and outcome (37%). We discuss limitations and provide recommendations to improve reporting.
Journal Article
An outcome‐wide analysis of the effects of diagnostic labeling of Alzheimer's disease and related dementias on social relationships
INTRODUCTION
This study examines how receiving a dementia diagnosis influences social relationships by race and ethnicity.
METHODS
Using data from the Health and Retirement Study (10 waves; 7,159 observations) of adults 70 years and older predicted to have dementia using Gianattasio‐Power scores (91% accuracy), this study assessed changes in social support, engagement, and networks after a dementia diagnosis. We utilized quasi‐experimental methods to estimate treatment effects and subgroup analyses by race/ethnicity.
RESULTS
A diagnostic label significantly increased the likelihood of gaining social support but reduced social engagement and one measure of social networks. With some exceptions, the results were similar by race and ethnicity.
DISCUSSION
Results suggest that among older adults with assumed dementia, being diagnosed by a doctor may influence social relationships in both support‐seeking and socially withdrawn ways. This suggests that discussing services and supports at the time of diagnosis is important for healthcare professionals.
Journal Article
EAST MEETS WEST: INNOVATIVE APPROACHES TO GERONTOLOGY EDUCATION AND TRAINING
Abstract
The global population is aging at an increasingly fast pace compared to past generations. Although the magnitudes and rates of aging in the United States and Japan differ, the drastic change in population structure has resulted in common challenges for both countries. One challenge is preparing people and society for living a long life while promoting well-being in old age for everyone. Combating ageism, delivering accurate information about aging, and encouraging people to have a balanced view of the aging process are all important topics for living in an aging society. Therefore, gerontology education and training plays a critical role. In this symposium, we will present examples of current efforts and research findings on aging education and training in both the United States and Japan. The first presenter will discuss their efforts on promoting gerontology education through redesigning communities with interdisciplinary collaboration in Japan. The second presenter will explain gerontology curriculum and degree programs in Japan. The third presenter will introduce an international gerontology education course designed for United States graduate students. The last presenter will report findings from a scoping review on intergenerational activities in higher education. Implications for future gerontology education will also be discussed.
Journal Article