Introduction: Rhetoric/Composition/Play through Video Games

Colby, Richard; Johnson, Matthew S.; Colby, Rebekah Shultz

doi:10.1057/9781137307675_1

Cited by 4 publications

(4 citation statements)

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“…Although prominent organizations recommend improved BP treatment and control in black individuals to reduce cardiovascular disease risk and disparities between black and white individuals in cardiovascular outcomes, our results suggest that improved BP control may also reduce black individuals’ risk of accelerated cognitive decline and racial disparities in cognitive outcomes. Between 2014 and 2060, the number of black individuals in the United States is expected to increase from 42 million to 60 million . Along with early life interventions to improve racial differences in baseline cognitive performance, our results suggest that effective interventions to improve BP control in black individuals may also be strategies to reduce racial disparities in cognitive decline .…”

Section: Discussionmentioning

confidence: 88%

Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals

et al. 2020

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IMPORTANCE Black individuals are more likely than white individuals to develop dementia. Whether higher blood pressure (BP) levels in black individuals explain differences between black and white individuals in dementia risk is uncertain.OBJECTIVE To determine whether cumulative BP levels explain racial differences in cognitive decline. DESIGN, SETTING, AND PARTICIPANTS Individual participant data from 5 cohorts (January 1971 to December 2017) were pooled from the Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, Cardiovascular Health Study, Framingham Offspring Study, and Northern Manhattan Study. Outcomes were standardized as t scores (mean [SD], 50 [10]); a 1-point difference represented a 0.1-SD difference in cognition. The median (interquartile range) follow-up was 12.4 (5.9-21.0) years. Analysis began September 2018. MAIN OUTCOMES AND MEASURESThe primary outcome was change in global cognition, and secondary outcomes were change in memory and executive function. EXPOSURES Race (black vs white).RESULTS Among 34 349 participants, 19 378 individuals who were free of stroke and dementia and had longitudinal BP, cognitive, and covariate data were included in the analysis. The mean (SD) age at first cognitive assessment was 59.8 (10.4) years and ranged from 5 to 95 years. Of 19 378 individuals, 10 724 (55.3%) were female and 15 526 (80.1%) were white. Compared with white individuals, black individuals had significantly faster declines in global cognition (−0.03 points per year faster [95% CI, −0.05 to −0.01]; P = .004) and memory (−0.08 points per year faster [95% CI, −0.11 to −0.06]; P < .001) but significantly slower declines in executive function (0.09 points per year slower [95% CI, 0.08-0.10]; P < .001). Time-dependent cumulative mean systolic BP level was associated with significantly faster declines in global cognition (−0.018 points per year faster per each 10-mm Hg increase [95% CI, −0.023 to −0.014]; P < .001), memory (−0.028 points per year faster per each 10-mm Hg increase [95% CI, −0.035 to −0.021]; P < .001), and executive function (−0.01 points per year faster per each 10-mm Hg increase [95% CI, −0.014 to −0.007]; P < .001). After adjusting for cumulative mean systolic BP, differences between black and white individuals in cognitive slopes were attenuated for global cognition (−0.01 points per year [95% CI, −0.03 to 0.01]; P = .56) and memory (−0.06 points per year [95% CI, −0.08 to −0.03]; P < .001) but not executive function (0.10 points per year [95% CI, 0.09-0.11]; P < .001). CONCLUSIONS AND RELEVANCEThese results suggest that black individuals' higher cumulative BP levels may contribute to racial differences in later-life cognitive decline.

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Section: Discussionmentioning

confidence: 88%

Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals

et al. 2020

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“…Findings of this cross-sectional study suggest that older Americans with VI use digital devices less than peers without VI. Approximately 30% of Americans 71 years or older have VI, and as the US population continues to age, it is crucial to identify trends in use patterns among older adults with disabilities that could further prevent them from engaging with telehealth. The recent COVID-19 pandemic has illuminated the potential of telehealth in delivering health care to this population by eliminating in-person barriers .…”

Section: Discussionmentioning

confidence: 99%

Digital Technology Use Among Older Adults With Vision Impairment

Thomas,

Almidani,

Swenor

et al. 2024

JAMA Ophthalmol

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ImportanceTelehealth has the potential to improve health for older adults, but many access disparities exist, including for those with vision impairment (VI).ObjectiveTo examine the associations between VI and digital technology access measures in US older adults.Design, Setting, and ParticipantsThis was a cross-sectional study that included Medicare beneficiaries 65 years and older. Beneficiary data were obtained from the National Health and Aging Trends Study (NHATS) 2021; data collection was conducted from June 2020 through January 2021. Data were analyzed September 2023.ExposureVI, measured on categorical (distance and near VI [&gt;0.30 logMAR], contrast sensitivity impairment [CSI; &lt;1.55 logCS], and any VI [distance VI, near VI, or CSI]), and continuous (distance and near acuity [logMAR] and contrast sensitivity [logCS]) scales.Main OutcomesSelf-reported outcomes of digital technology access from the technological environment component of the NHATS.ResultsOf the 2822 Medicare beneficiaries (mean [SD] age, 78.5 [5.6] years; 1605 female [54.7%]) included in this study, patients self-identified with the following race and ethnicity categories (weighted percentages): 575 non-Hispanic Black (8.0%), 132 Hispanic (7.0%), 2019 non-Hispanic White (81.7%), and 63 non-Hispanic other race (3.4%), which included American Indian, Alaska Native, Asian, multiracial, Native Hawaiian, Pacific Islander, or other specified race. A total of 1077 of 2822 patients (32.3%) had any VI. In multivariable logistic regression models, older adults with any VI had lower odds of having or knowing how to use a cellphone (odds ratio [OR], 0.58; 95% CI, 0.38-0.88), computer (OR, 0.61; 95% CI, 0.47-0.79), or tablet (OR, 0.68, 95% CI = 0.54-0.85) than peers without VI. In other models, near VI was associated with lower odds of having and knowing how to use a phone (OR, 0.56; 95% CI, 0.36-0.87), computer (OR, 0.57; 95% CI, 0.44-0.75), or tablet (OR, 0.65; 95% CI, 0.52-0.81) compared with no near VI. CSI was associated with lower odds of having and knowing how to use a phone (OR, 0.66; 95% CI, 0.45-0.99) or computer (OR, 0.72; 95% CI, 0.55-0.93) compared with no CSI. Distance VI was only associated with lower odds of having and knowing how to use a cellphone (OR, 0.63; 95% CI, 0.41-0.95). Any VI and individual categorical VI measures were not associated with other outcomes of digital health– and nonhealth-related experiences. Similar associations were noted when vision was examined on a continuous scale. However, worse distance acuity (per 0.1 logMAR) was associated with being less likely to visit with family or friends on a video call (OR, 0.91; 95% CI, 0.84-0.98) and to order or refill prescriptions online (OR, 0.90; 95% CI, 0.83-0.97).Conclusions and RelevanceResults suggest that older US adults with VI were less likely to have access to digital technology than peers without VI, although no differences were noted in the report of digital health– and nonhealth-related activities. These findings highlight the potential for inequities that may arise in telehealth for older adults with VI and the necessity to develop strategies to improve accessibility of telemedicine for all.

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“…The population of the United States becomes more diverse daily. By 2055, the United States will no longer have a single race or ethnic majority 1 . Fostering diverse racial, ethnic, and gender representation in academic medical faculty of all specialties is crucial for our medical establishment to adapt to serve evolving patient populations.…”

Section: Problemmentioning

confidence: 99%

Increasing Diversity in Academic Medicine Via a Strategic Intermural Housestaff Leadership Development Program

Galvan,

Ahn,

Hansen

et al. 2024

Acad Med

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Problem By 2055, the United States will no longer have a single race or ethnic majority. As the nation’s demographics change, the field of medicine must also change to meet the needs of diverse patients. Approach In 2013, UT Southwestern Medical Center implemented the Housestaff Emerging Academy of Leaders (HEAL) program, which provides leadership development skills and training to underrepresented in medicine physician residents in preparation for academic medicine careers. Program leaders hypothesized that by providing housestaff with structured mentorship, career coaching, and individualized development plans, HEAL would increase interest in pursuing academic careers and prepare residents for faculty positions. HEAL has since expanded to graduate medical education programs nationwide. Outcomes From 2013 to 2018, HEAL included housestaff at UT Southwestern and other Texas medical centers, totaling 392 enrollees. In 2019, the program increased to include housestaff from around the country. The first HEAL USA program had 39 housestaff, which increased to 173 in 2019, including 60 faculty from 31 U.S. academic medical centers. The 2019 HEAL USA preassessment survey (32 trainee responses) revealed that 10 (31%) of the housestaff were “extremely interested” in academic medicine, but only 1 (3%) felt “extremely confident” to pursue an academic medicine career. Postassessment responses to these same items (5 trainee responses) were 3 (60%) and 1 (20%), respectively, with 3 (60%) also feeling “extremely prepared” (1 [20%]) or “very prepared” (2 [40%]) to pursue an academic medicine career. Of 70 evaluable participants who attended at least 2 sessions and have graduated from residency, 47 (67%) have attained academic faculty positions, whereas 23 (33%) have pursued positions at nonacademic centers. Next Steps The next steps for HEAL USA will be continued expansion to additional medical centers and effective delivery of career development and leadership training to encourage participants to pursue academic medical careers.

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Introduction: Rhetoric/Composition/Play through Video Games

Cited by 4 publications

References 0 publications

Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals

Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals

Digital Technology Use Among Older Adults With Vision Impairment

Increasing Diversity in Academic Medicine Via a Strategic Intermural Housestaff Leadership Development Program

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