Associations of Social, Behavioral, and Clinical Factors With Sex Differences in Stroke Recurrence and Poststroke Mortality.

Background: Few population-based studies have assessed sex differences in stroke recurrence. In addition, contributors to sex differences in recurrence and poststroke mortality, including social factors, are unclear. We investigated sex differences in these outcomes and the contribution of social, clinical, and behavioral factors to the sex differences.

Dementia Diagnosis Unawareness and Caregiver Burden in a Multi-ethnic Cohort.

Background: Previous reports suggest patient and caregiver lack of awareness of dementia. Little is known about how this varies by ethnicity and how informal (family) caregiver burden is associated with knowing a dementia diagnosis.

Objective: To investigate whether participants with probable dementia were aware of a diagnosis provided by a physician and how this differed among Mexican American and non-Hispanic White participants; whether having a primary care physician was associated with dementia diagnosis unawareness; and the association of dementia diagnosis unawareness with caregiver burden.

Ethnic Differences in the Association Between Cognitive Performance and Informant-rated Cognitive Decline.

Objectives: It is unknown whether cognitive test scores are equivalently associated with informant-rated cognitive decline across culturally and linguistically diverse older adults. We examined the association between cognitive domain scores on the Harmonized Cognitive Assessment Protocol (HCAP) and informant-rated cognitive decline in a harmonized population-based sample of older adults.

Design, Setting, And Participants: We combined data from the HCAP sub-study of the Health and Retirement Study (HRS; 2016) and the Brain Attack Surveillance in Corpus Christi-Cognitive (BASIC-C; 2018-2020) study.

Sex Differences in Nonadherence to Secondary Stroke Prevention Medications Among Patients With First-Ever Ischemic Stroke.

Background: More women than men experience recurrent strokes. Medication adherence is critical to prevent recurrence; however, studies investigating sex differences are limited. We examined sex differences in poststroke medication adherence, overall and by drug class, and identified influencing factors.

The Association Between Bilingual Animal Naming and Memory Among Bilingual Mexican American Older Adults.

Background: Monolingual cognitive assessments are standard for bilinguals; the value of bilingual assessment is unknown. Since declines in animal naming accompany memory declines in dementia, we examined the association between bilingual animal naming and memory among bilingual Mexican American (MA) older adults.

Methods: Bilingual MA (n = 155) completed the Harmonized Cognitive Assessment Protocol (HCAP) in a Texas community study.

Changes Over Time in Short-Term Stroke Outcomes by Race-Ethnicity.

Objectives: The objective of this study was to quantify trends (2008-2019) in stroke outcomes by race-ethnicity.

Methods: Patients with ischemic stroke from a population-based study were interviewed at 90 days to assess outcomes. Linear regression with multiple imputation and inverse probability weighting was used to model trends.

Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non-Hispanic White Adults.

Background: High blood pressure (BP) increases recurrent stroke risk.

Methods And Results: We assessed hypertension prevalence, treatment, control, medication adherence, and predictors of uncontrolled BP 90 days after ischemic or hemorrhagic stroke among 561 Mexican American and non-Hispanic White (NHW) survivors of stroke from the BASIC (Brain Attack Surveillance in Corpus Christi) cohort from 2011 to 2014. Uncontrolled BP was defined as average BP ≥140/90 mm Hg at 90 days poststroke.

Outcomes Among Mexican American and Non-Hispanic White Informal Stroke Caregivers.

Background: Informal home care is prevalent among Mexican American stroke survivors, but data on the impact on caregivers are not available. The aim was to assess ethnic differences in informal stroke caregiving and caregiver outcomes at 90 days poststroke.

Methods: Informal caregivers were recruited from the population-based Brain Attack Surveillance in Corpus Christi Project (2019-2023), conducted in a bi-ethnic community in Texas.

Neighborhood Resources and Health Outcomes Among Stroke Survivors in a Population-Based Cohort.

Background: Stroke survivors believe neighborhood resources such as community centers are beneficial; however, little is known about the influence of these resources on stroke outcomes. We evaluated whether residing in neighborhoods with greater resource density is associated with favorable post-stroke outcomes.

Methods And Results: We included Mexican American and non-Hispanic White stroke survivors from the Brain Attack Surveillance in Corpus Christi project (2009-2019).

Sex Differences in Trends in Stroke Recurrence and Postrecurrence Mortality 2000-2020: Population-Based Brain Attack Surveillance in Corpus Christi Project.

Objective: This study was undertaken to delineate 21-year sex-specific trends in recurrence and postrecurrence mortality.

Methods: Between 2000 and 2020, first-ever ischemic stroke (IS) patients, ascertained from the population-based BASIC (Brain Attack Surveillance in Corpus Christi) project in South Texas, were followed for recurrent stroke and all-cause mortality until December 31, 2020. Multivariable regression models with an interaction between calendar year and sex were used to estimate sex-specific trends and sex differences in recurrence and postrecurrence mortality.

Caring for Stroke Survivors: Ethnic Differences in Informal Caregiver Needs Among Mexican American and Non-Hispanic White Communities.

Background: After stroke, Mexican American (MA) individuals have worse 90-day neurological, functional, cognitive, and quality of life outcomes and a higher prevalence of poststroke depression compared with non-Hispanic White (NHW) individuals. MA individuals receive more help through informal, unpaid caregiving than NHW individuals. We examined ethnic differences in needs identified by MA and NHW stroke caregivers.

Exploring Pathways to Caregiver Health: The Roles of Caregiver Burden, Familism, and Ethnicity.

Objectives: This study examines the associations of ethnicity, caregiver burden, familism, and physical and mental health among Mexican Americans (MAs) and non-Hispanic Whites (NHWs).

Methods: We recruited adults 65+ years with possible cognitive impairment (using the Montreal Cognitive Assessment score<26), and their caregivers living in Nueces County, Texas. We used weighted path analysis to test effects of ethnicity, familism, and caregiver burden on caregiver's mental and physical health.

College preparation for a medical career in the United States.

Purpose: A college degree is required to enter medical school in the United States. A remarkably high percentage of students entering college have pre-medical aspirations but relatively few end up as medical students. As an "applied science", education about medicine is usually thought to be beyond the purview of a liberal arts curriculum.

Surrogate Decision-Making After Stroke in a Community Setting: The OASIS Project.

Background: Patients with severe stroke often rely on surrogate decision-makers for life-sustaining treatment decisions. We investigated ethnic differences between Mexican Americans (MAs) and non-Hispanic White (NHW) individuals in surrogate reports of physician quality of communication and shared decision-making from the OASIS study (Outcomes Among Surrogate Decision Makers in Stroke) project.

Methods: Patients had ischemic stroke or intracerebral hemorrhage in Nueces County, TX.

Long-Term Psychological Distress Among Surrogate Decision Makers for Mexican American and Non-Hispanic White Patients With Severe Stroke.

Background And Objectives: During acute hospitalizations, physicians often focus on the stroke patient and not family who may be traumatized by this sudden change to their loved one. We investigated long-term psychological distress among family surrogate decision makers for Mexican American (MA) and non-Hispanic White (NHW) severe stroke patients. Previous work in other diseases suggested worse psychological outcomes in MA than NHW caregivers.

A Community-Based Study of Dementia in Mexican American and Non-Hispanic White Individuals.

Background: Little information is available on the prevalence of cognitive impairment in Mexican American persons.

Objective: To determine the prevalence of mild cognitive impairment (MCI) and dementia in those 65 years and older among Mexican American and non-Hispanic white individuals in a community.

Methods: This was a population-based cohort study in Nueces County, Texas, USA.

Neighborhoods and Cardiovascular Health: A Scientific Statement From the American Heart Association.

The neighborhoods where individuals reside shape environmental exposures, access to resources, and opportunities. The inequitable distribution of resources and opportunities across neighborhoods perpetuates and exacerbates cardiovascular health inequities. Thus, interventions that address the neighborhood environment could reduce the inequitable burden of cardiovascular disease in disenfranchised populations.

Novel metrics of sleep-disordered breathing are associated with outcome after ischemic stroke.

Objective/background: Standard measures of sleep-disordered breathing (SDB) that rely on count data may not sufficiently capture SDB severity or reflect downstream consequences of SDB. We hypothesized that novel metrics derived from pulse rate, oxygen saturation, and nasal pressure would be associated with stroke outcomes.

Patients/methods: Shortly after ischemic stroke, participants in a population-based study were offered ApneaLink Plus testing.

A Community-Based Study of Cognitive Impairment Caregiving Outcomes Pre- and During the COVID-19 Pandemic.

The impact of the COVID-19 pandemic on informal caregiving was examined in a Mexican American (MA) and Non-Hispanic White (NHW) population-based cohort. 395 participants age 65 years were recruited via door-to-door and phone recruitment as part of the Brain Attack Surveillance in Corpus Christi-Cognitive (BASIC-C) project. Both recipients and caregivers answered questions regarding the recipient's health and the COVID-19 pandemic.

Mexican Americans agree to participate in longitudinal clinical research more than non-Hispanic whites.

Background: The National Institutes of Health has advocated for improved minority participation in clinical research, including clinical trials and observational epidemiologic studies since 1993. An understanding of Mexican Americans (MAs) participation in clinical research is important for tailoring recruitment strategies and enrollment techniques for MAs. However, contemporary data on MA participation in observational clinical stroke studies are rare.

Association of Neighborhood Recreation Centers and Poststroke Outcomes in a Population-Based Cohort.

Background: Higher neighborhood socioeconomic status has been favorably associated with stroke outcomes. This may be due to these areas having more beneficial resources such as recreational centers. We aimed to determine if neighborhood density of recreation centers is favorably associated with stroke outcomes.

Black Americans have worse stroke outcome compared with non-Hispanic whites.

Introduction: We studied racial differences in post-stroke outcomes using a prospective, population-based cohort of stroke survivors as part of the Brain Attack Surveillance in Corpus Christi (BASIC) project.

Methods: Neurologic (NIHSS, range of 0-42, higher scores are worse), functional (ADLs/IADLs, range 1-4, higher scores are worse), and cognitive (3MSE, range 0-100, higher scores are better) outcomes were measured 90 days after stroke. Cox proportional hazards and negative binomial linear regression models were used to examine the associations between race and 90-day all-cause mortality and NIHSS, respectively, whereas linear regression was used for ADLs/IADLs and 3MSE scores.

Patient Cognitive Status and Physician Recommendations for Cardiovascular Disease Treatment: Results of Two Nationwide, Randomized Survey Studies.

Background: Clinical guidelines recommend that older patients (65+) with mild cognitive impairment (MCI) and early-stage dementia receive similar guideline-concordant care after cardiovascular disease (CVD) events as those with normal cognition (NC). However, older patients with MCI and dementia receive less care for CVD and other conditions than those with NC. Whether physician recommendations for guideline-concordant treatments after two common CVD events, acute myocardial infarction (AMI) and acute ischemic stroke (stroke), differ between older patients with NC, MCI, and early-stage dementia is unknown.

Longitudinal Assessment of Sleep Apnea in the Year After Stroke in a Population-Based Study.

Background: The aim of this study was to characterize change in sleep-disordered breathing severity in the year following stroke, overall, and by ethnicity, within the population-based Brain Attack Surveillance in Corpus Christi Project.

Methods: First-ever ischemic strokes (n=414) were ascertained by active and passive surveillance and validated by stroke-trained physicians. Patients with stroke were invited to participate in portable sleep apnea testing (ApneaLink Plus) at baseline and 3, 6, and 12 months poststroke.

Presentation and treatment of animal and human bite injuries at a Swiss tertiary emergency department: a cross-sectional study.

Background: Animal and human bite injuries are a relevant health problem worldwide. With the increasing number of pets, bite injuries are becoming more frequent. Previous studies on animal and human bite injuries in Switzerland were completed several years ago.