The clinical efficacy and safety of galantamine in the treatment of Alzheimer's disease

Alzheimer's disease is a progressive, neurodegenerative condition characterized by deficits in cognition, inability to perform activities of daily living, and alterations in behavior. Galantamine hydrobromide is the newest acetylcholinesterase inhibitor (AChEI) approved in the United States for the treatment of mild-to-moderate AD. The safety and efficacy of galantamine has been demonstrated in multiple randomized, Phase III trials of >2,600 patients with mild-to-moderate AD. Studies have found that galantamine improved or maintained performance in all domains of AD (cognition, function, behavior, and caregiver burden) in the short term and slowed the decline in performance or maintained baseline performance through 12 months. The dual mechanism of action may make galantamine a reasonable treatment option for both newly diagnosed patients and patients who have not benefitted from or have poorly tolerated current therapy.     

Intersectional experiences of discrimination in a low‐resource urban community: An exploratory latent class analysis

There have been increasing calls for the application of an intersectionality framework to understand and address discrimination and health inequities among diverse communities. Yet there have been theoretical debates regarding to whom intersectionality applies and how intersectional experiences of discrimination are associated with health outcomes. The current study aimed to contribute to these theoretical debates and inform practical applications to reduce health inequities. Data were drawn from a community health survey in New Haven, CT (N = 1,293 adults) and analysed using latent class analysis. Results yielded 4 classes. Members of the 4 classes were similar sociodemographically. Three classes of participants reported experiencing discrimination, and members of these classes had greater stress, higher rates of smoking and sleep disruption, and worse overall health than members of the class reporting no discrimination. Members of 2 classes made multiple, or intersectional, attributions for discrimination, and members of these classes reported the most frequent discrimination. Findings suggest that community members who are sociodemographically similar may have diverse discrimination experiences. Multilevel interventions that address multiple forms of discrimination (e.g., racism and sexism) may hold promise for reducing discrimination and, ultimately, health inequities within low‐resource urban community settings.     

Mental Health Utilization Among Diverse Parenting Young Couples

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social–personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor–Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow‐up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse’s influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.     

Masculine Ideology,Sexual Communication,and Sexual Self‐Efficacy Among Parenting Adolescent Couples

This study examined the relationship between traditional masculine role norms (status, toughness, anti‐femininity) and psychosocial mechanisms of sexual risk (sexual communication, sexual self‐efficacy) among young, low‐income, and minority parenting couples. Between 2007 and 2011, 296 pregnant adolescent females and their male partners were recruited from urban obstetrics clinics in Connecticut. Data regarding participants' beliefs in masculine role norms, frequency of general sex communication and sexual risk communication, and sexual self‐efficacy were collected via computer‐assisted self‐interviews. Generalized estimating equation (GEE) models were used to test for actor effects (whether a person's masculine role norms at baseline influence the person's own psychosocial variables at 6‐month follow‐up) and partner effects (whether a partner's masculine role norms at baseline influence an actor's psychosocial variables at 6‐month follow‐up). Results revealed that higher actor status norms were significantly associated with more sexual self‐efficacy, higher actor toughness norms were associated with less sexual self‐efficacy, and higher actor anti‐femininity norms were significantly associated with less general sex communication, sexual risk communication, and sexual self‐efficacy. No partner effects were found. These results indicate a need for redefining masculine role norms through family centered approaches in pregnant or parenting adolescent couples to increase sexual communication and sexual self‐efficacy. Further research is needed to understand partner effects in the context of a relationship and on subsequent sexual risk behavior.     

Flashbulb memory for 11 September 2001

The recollection of particularly salient, surprising or consequential events is often called ‘flashbulb memories’. We tested people's autobiographical memory for details of 11 September 2001 by gathering a large national random sample (N = 678) of people's reports immediately following the attacks, and then by contacting them twice more, in September 2002 and August 2003. Three novel findings emerged. First, memory consistency did not vary as a function of demographic variables such as gender, geographical location, age or education. Second, memory consistency did not vary as a function of whether memory was tested before or after the 1‐year anniversary of the event, suggesting that media coverage associated with the anniversary did not impact memory. Third, the conditional probability of consistent recollection in 2003 given consistent recollection in 2002 was p = .73. In contrast, the conditional probability of consistent recollection in 2003 given inconsistent recollection in 2002 was p = .18. Finally, and in agreement with several prior studies, confidence in memory far exceeded consistency in the long term. Also, those respondents who revealed evidence for consistent flashbulb memory experienced more anxiety in response to the event, and engaged in more covert rehearsal than respondents who did not reveal evidence for consistent flashbulb memory. Copyright © 2008 John Wiley & Sons, Ltd.     

CAREGIVING HISTORY AND PRENATAL DEPRESSIVE SYMPTOMS IN LOW-INCOME ADOLESCENT AND YOUNG ADULT WOMEN: MODERATING AND MEDIATING EFFECTS

Prenatal depressive symptoms have been linked to negative outcomes for mothers and children. Using attachment theory as a framework, this study examined developmental differences in the interpersonal context of prenatal depressive symptoms among adolescents (age 14 to 19 years; n = 352) and young adults (age 20 to 24 years; n = 348). Participants included low-income, single, predominantly African American and Latina women. Moderating and mediating factors were found in the relation between caregiving history (perceived unavailability and inconsistency of maternal and paternal figures during childhood) and depressive symptoms. For pregnant adolescents, maternal unavailability predicted depressive symptoms whereas maternal inconsistency did not. In contrast, for pregnant young women, only maternal inconsistency predicted depressive symptoms; and this association was mediated by perceptions of prenatal support. For both groups, paternal caregiving history had a small yet independent association with depressive symptoms. Results highlight the need to consider developmental differences in the interpersonal context of prenatal depressive symptoms in delivering mental health interventions to young women of color.     

Reduction of caregiver burden in Alzheimer's disease by treatment with galantamine

Alzheimer's disease is a progressive condition characterized by a loss of cognition, altered behavior, and a loss of functional ability, such as bathing, dressing, toileting, and organizing finances. Family and friends provide nearly three quarters of all care for patients with Alzheimer's disease. This informal care results in significant burden to caregivers. Caregiver burden is the set of physical, psychological or emotional, social, and financial problems that family members may experience when caring for impaired older adults. Caregivers of Alzheimer's disease patients report higher rates of physical symptoms, mortality, depression, and fatigue, as well as adverse effects on employment compared with those who are not caregivers for Alzheimer's disease patients. In many cases, the same family members are responsible for both out-of-pocket expenditures and caregiving duties. For this article, a MEDLINE search using the key words "caregiver and Alzheimer's disease" and "cost and Alzheimer's disease" was performed. The purpose of this article is to review the literature on caregiver burden, the components of caregiver burden, effects of caregiving on the health of caregivers, the cost of Alzheimer's disease on the caregiver and society, and the benefits attainable with treatment.     

Looking for Solutions: Gender Differences in Relationship and Parenting Challenges Among Low‐Income,Young Parents

The need for parenting and relationship strengthening programs is important among low‐income minority parents where the burden of relational and parental stressors contributes to relationship dissolution. We examine these stressors among young parents. Data were collected from four focus groups (N = 35) with young parents. Data were audio‐recorded and transcribed. Inductive coding was used to generate themes and codes, and analysis was completed using NVivo. Relationship and parenting challenges, values, and areas of need were the three major themes that emerged. Women's relationship challenges were family interference and unbalanced parenting, and men reported feeling disrespected and having limited finances. Common relationship challenges for women and men were family interference and unbalanced parenting. Both genders valued trust, communication, and honesty in relationships. Areas of need for women and men included: improving communication and understanding the impact of negative relationships on current relationships. Parenting challenges for women were unbalanced parenting, child safety, and feeling unprepared to parent; men reported limited finances. Both genders valued quality time with child to instill family morals. Areas of need for women and men included learning child discipline techniques and increasing knowledge about child development. Finally, women and men have relationship and parenting similarities and differences. Young parents are interested in learning how to improve relationships and co‐parent to reduce relationship distress, which could reduce risk behaviors and improve child outcomes.     

Divided groups need leadership: A study of the effectiveness of collective identity,dual identity,and intergroup relational identity rhetoric

Reducing intergroup conflict is a significant leadership challenge. Leaders can alleviate conflict by promoting a collective, dual, or intergroup relational identity, but they should avoid provoking subgroup identity distinctiveness threat. Drawing on intergroup leadership theory, we conducted an experiment (N = 184) examining evaluations of a leader who promoted a dual, collective, or intergroup relational identity under low or high subgroup identity distinctiveness threat. We hypothesized that identity distinctiveness threat would improve evaluations of a leader promoting an intergroup relational identity, and worsen evaluations of a leader promoting a collective identity. Although a leader promoting a dual identity is typically preferred to one promoting a collective identity, we expected a leader promoting dual identity to receive worse evaluations than a leader promoting an intergroup relational identity. These hypotheses were supported, providing additional support for intergroup leadership theory and demonstrating the utility of employing intergroup relational identity rhetoric.