Does coping mediate the relationship between familism and caregiver outcomes?

Objectives: The sociocultural model of stress and coping, which despite receiving support from several studies conducted with diverse ethnic groups, has yet to be tested longitudinally or used within the context of positive caregiver outcomes. The aim of the current study was to test a specific component of the model, which posits that caregiver coping will be influenced by the cultural value of familism (feelings of solidarity and loyalty among family members), which will in turn affect caregiver outcomes.

Method: A questionnaire was completed by 123 family caregivers in the UK assessing familism, use of coping strategies, caregiver gains, anxiety and depression at three time points over nine months.

Results: Mediation analysis followed guidelines proposed by Baron and Kenny. Religious coping and positive reframing at time 2 (T2) were found to significantly mediate between familism values at time 1 (T1) and caregiver gains at time 3 (T3). Behavioural disengagement at T2 was found to mediate between familism at T1 and caregiver depression atT3. Additionally familism was found to be positively associated with both negative and positive aspects of caregiving.

Conclusion: Our longitudinal findings suggest that interventions and services acknowledging caregiver values and the associated coping responses may prove beneficial.     

Long‐term neuromuscular outcomes of west nile virus infection: A clinical and electromyographic evaluation of patients with a history of infection

Introduction: Neuromuscular clinical manifestations during acute West Nile virus (WNV) infection are well documented; however, long‐term neurologic outcomes still require investigation. Methods: We conducted a long‐term follow‐up study in patients with history of WNV infection. Of the 117 patients who participated in neurologic and neurocognitive evaluations, 30 were referred for neuromuscular and electrodiagnostic evaluation based on abnormal findings. Results: We found that 33% of these patients (10 of 30) showed abnormalities on nerve conduction and/or needle electromyography due to primary or secondary outcomes of WNV infection. Most common electrodiagnostic findings and causes of long‐term disability were related to anterior horn cell poliomyelitis (WNV poliomyelitis). Electrical data on these patient populations were similar to those observed in chronic poliomyelitis. Discussion: With more than 16,000 cases of WNV neuroinvasive disease reported across the USA since 1999, understanding clinical outcomes from infection will provide a resource for physicians managing long‐term care of these patients. Muscle Nerve 57 : 77–82, 2018     

Association of lipoprotein-associated phospholipase A(2) and endothelial function in the Multi-Ethnic Study of Atherosclerosis (MESA)

Mechanisms underlying the role of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) in atherosclerotic development are not completely understood. We evaluated the relationship of Lp-PLA(2) with endothelial dysfunction, an early manifestation of atherosclerosis, in a cohort without known clinical cardiovascular disease. A total of 2809 participants in the Multi-Ethnic Study of Atherosclerosis underwent plasma Lp-PLA(2) mass and activity measurement and brachial artery flow-mediated vasodilation testing. In adjusted linear regression models, higher Lp-PLA(2) mass and activity levels were not associated with lower endothelial function (-0.04%, p = 0.51 and -0.09%, p = 0.10, respectively). Among individuals with subclinical atherosclerosis based on ankle-brachial index (ABI) or carotid intima-media thickness (IMT), Lp-PLA(2) mass and activity were not associated with lower endothelial function (-0.03%, p = 0.88 and -0.31%, p = 0.16 for ABI < 1.00; 0.01%, p = 0.94 and -0.15%, p = 0.20 for abnormal carotid IMT). In summary, Lp-PLA(2) is not associated with endothelial dysfunction, suggesting its role in atherosclerosis development is primarily related to other factors.