Neurocognitive and physical functioning in the Seveso Women's Health Study.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is neurotoxic in animals but few studies have investigated its effects on the human brain. Related dioxin-like compounds have been linked to poorer cognitive and motor function in older adults, with effects more pronounced in women, perhaps due to the loss of neuro-protective estrogen in menopause. On 10 July 1976, a chemical explosion in Seveso, Italy, resulted in one of the highest known residential exposures to TCDD.

Risk Profiles for Falls among Older Adults: New Directions for Prevention.

Objective: To address whether neighborhood factors, together with older adults' levels of health and functioning, suggest new combinations of risk factors for falls and new directions for prevention. To explore the utility of Grade-of-Membership (GoM) analysis to conduct this descriptive analysis.

Method: This is a cross-sectional, descriptive study of 884 people aged ≥65 years from Alameda County, CA, Cook County, IL, Allegheny County, PA, and Wake and Durham counties, NC.

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. : Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.

Racial/Ethnic Differences in the Impact of Neighborhood Social and Built Environment on Breast Cancer Risk: The Neighborhoods and Breast Cancer Study.

Neighborhood socioeconomic status (nSES) has been found to be associated with breast cancer risk. It remains unclear whether this association applies across racial/ethnic groups independent of individual-level factors and is attributable to other neighborhood characteristics. We examined the independent and joint associations of education and nSES with odds of breast cancer.

Recent declines in cancer incidence: related to the Great Recession?

Purpose: In recent years, cancer case counts in the U.S. underwent a large, rapid decline-an unexpected change given population growth for older persons at highest cancer risk.

Drinking and driving and perceptions of arrest risk among California drivers: Relationships with DUI arrests in their city of residence.

Objective: Addressing drinking and driving remains a challenge in the United States. The present study aims to provide feedback on driving under the influence (DUI) in California by assessing whether drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; whether this is due to perceptions that one can get arrested for this behavior; and whether this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home).

Methods: This study consisted of a 2012 roadside survey of 1,147 weekend nighttime drivers in California.

Alcohol consumption and mortality after breast cancer diagnosis: The health and functioning in women study.

Objective: To determine the association of prediagnostic alcohol consumption with long-term mortality from breast cancer and other causes in a cohort of women with breast cancer.

Methods: We studied a Michigan-based cohort of 939 women aged 40-84 years, who provided complete information about the type, amount and intensity of prediagnostic alcohol consumption. Associations of alcohol consumption, based on weekly volume of alcohol consumption during the year prior to breast cancer diagnosis, with mortality were evaluated in Cox proportional hazards models, with adjustment for sociodemographic factors, body mass index, smoking, comorbidity, tumor characteristics, and treatment.

Fulfilling Ethical Responsibility: Moving Beyond the Minimal Standards of Protecting Human Subjects from Research Harm.

Problem: Rules for protecting human subjects, in place federally since 1974, have focused primarily on guarding against placing research subjects at social, physical, or psychological risk or violating their privacy and confidentiality. Nevertheless, high-risk communities are routinely subjected to "sins of omission," which limit access to potentially significant research opportunities and result in the absence of studies that could confer high degree of community beneficence.

Purpose Of Article: To describe "sins of omission" and provide examples from the Community Networks Program Centers (CNPC) to illustrate how community-based participatory research (CBPR) can prevent them.

Acceptance of drinking and driving and alcohol-involved driving crashes in California.

Background: Alcohol-impaired driving accounts for substantial proportion of traffic-related fatalities in the U.S. Risk perceptions for drinking and driving have been associated with various measures of drinking and driving behavior.

Walking and Walkability: Is Wayfinding a Missing Link? Implications for Public Health Practice.

Background: Research on walking and walkability has yet to focus on wayfinding, the interactive, problem-solving process by which people use environmental information to locate themselves and navigate through various settings.

Methods: We reviewed the literature on outdoor pedestrian-oriented wayfinding to examine its relationship to walking and walkability, 2 areas of importance to physical activity promotion.

Results: Our findings document that wayfinding is cognitively demanding and can compete with other functions, including walking itself.

The impact of neighborhood social and built environment factors across the cancer continuum: Current research, methodological considerations, and future directions.

Neighborhood social and built environments have been recognized as important contexts in which health is shaped. The authors reviewed the extent to which these neighborhood factors have been addressed in population-level cancer research by scanning the literature for research focused on specific social and/or built environment characteristics and their association with outcomes across the cancer continuum, including incidence, diagnosis, treatment, survivorship, and survival. The commonalities and differences in methodologies across studies, the current challenges in research methodology, and future directions in this research also were addressed.

The Impact of Health Problems on Driving Status among Older Adults.

Objective: This study assesses the impact of health problems on driving status (current driver vs. ex-driver) among older adults to identify which of those health problems have the greatest individual and population impact on driving cessation.

Methods: Data were from baseline and 5 year follow-up waves of a longitudinal survey of adults age 55 years and older (N=1,279).

Smoking and mortality after breast cancer diagnosis: the health and functioning in women study.

We examined the effect of smoking on long-term mortality from breast cancer and other causes among a cohort of women with breast cancer. A total of 975 women diagnosed with breast cancer and aged 40-84 years were followed for a median follow-up of 11 years in the U.S.

Aging, place, and technology: toward improving access and wellness in older populations.

Objective: To review the range of promising technologies (e.g., smart phones, remote monitoring devices) designed to enhance aging in place; identify challenges for implementation of those technologies; and recommend ways to improve access to technologies in older populations.

Cancer research in Asian American, Native Hawaiian, and Pacific Islander populations: accelerating cancer knowledge by acknowledging and leveraging heterogeneity.

The Asian American, Native Hawaiian, and Pacific Islander population is large, growing, and extremely heterogeneous. Not only do they bear unique burdens of incidence and outcomes for certain cancer types, they exhibit substantial variability in cancer incidence and survival patterns across the ethnic groups. By acknowledging and leveraging this heterogeneity through investing in cancer research within these populations, we have a unique opportunity to accelerate the availability of useful and impactful cancer knowledge.

Mobility Disability in Older Adults: At the Intersection of People and Places.

Purpose: Mobility disability is associated with poor lower body function among older adults. This study examines whether specific types of neighborhood characteristics moderate that association.

Design And Methods: This study is based on a cross-sectional sample of 884 people aged ≥ 65 years identified through service organizations in Alameda County, CA; Cook County, IL; Allegheny County, PA; and Wake and Durham counties, NC.

Neighborhood characteristics and depressive symptoms in an older population.

Objectives: We explored relationships between depressive symptoms and neighborhood environment measures including traffic safety, crime, social capital, and density of businesses in community-dwelling older adults from four different regions of the United States.

Method: The Healthy Aging Research Network walking study is a cross-sectional study of 884 adults aged 65+, which included a 10-item Center for Epidemiologic Studies Depression scale of depressive symptoms, demographics, self-reported neighborhood perceptions, and objective neighborhood data.

Results: After adjusting for individual covariates, reports of neighborhood crime, unsafe traffic, and unwillingness of neighbors to help each other were significantly positively associated with depressive symptoms among participants.

Developing a framework and priorities to promote mobility among older adults.

Mobility, broadly defined as movement in all of its forms from ambulation to transportation, is critical to supporting optimal aging. This article describes two projects to develop a framework and a set of priority actions designed to promote mobility among community-dwelling older adults. Project 1 involved a concept-mapping process to solicit and organize action items into domains from a broad group of stakeholders to create the framework.

Impact of neighborhood and individual socioeconomic status on survival after breast cancer varies by race/ethnicity: the Neighborhood and Breast Cancer Study.

Background: Research is limited on the independent and joint effects of individual- and neighborhood-level socioeconomic status (SES) on breast cancer survival across different racial/ethnic groups.

Methods: We studied individual-level SES, measured by self-reported education, and a composite neighborhood SES (nSES) measure in females (1,068 non-Hispanic whites, 1,670 Hispanics, 993 African-Americans, and 674 Asian-Americans), ages 18 to 79 years and diagnosed 1995 to 2008, in the San Francisco Bay Area. We evaluated all-cause and breast cancer-specific survival using stage-stratified Cox proportional hazards models with cluster adjustment for census block groups.

Long-term outcomes among African-American and white women with breast cancer: what is the impact of comorbidity?

Objectives: We examined the association between comorbidity and long-term mortality from breast cancer and other causes among African-American and white women with breast cancer.

Methods: A total of 170 African-American and 829 white women aged 40-84years were followed for up to 28years with median follow-up of 11.3years in the Health and Functioning in Women (HFW) study.

Missed or Delayed Medical Care Appointments by Older Users of Nonemergency Medical Transportation.

Purpose Of The Study: This study identified factors associated with canceling nonemergency medical transportation appointments among older adult Medicaid patients.

Design And Methods: Data from 125,913 trips for 2,913 Delaware clients were examined. Mediation analyses, as well as, multivariate logistic regressions were conducted.

Cancer prevention among adults aged 45-64 years: setting the stage.

As part of setting the stage for this supplement to the American Journal of Preventive Medicine, a life-course perspective is presented to assist in understanding the importance of cancer prevention for adults in midlife, a period roughly spanning 20 years between ages 45 and 64 years. Drawing on disciplinary perspectives from the social sciences and public health, several life-course themes are delineated in this article: how specific life transitions present unique opportunities for interventions to inform policy and practice that can improve population health outcomes; how interventions can be focused on those at particular life stages or on the entire life course; and how the onset and progression of chronic conditions such as cancer are dependent on a complex interplay of critical and sensitive periods, and trajectory and accumulation processes. A translational research framework is applied to help promote the movement of applied public health interventions for cancer prevention into practice.

Effect of physical activity, social support, and skills training on late-life emotional health: a systematic literature review and implications for public health research.

Purpose: Given that emotional health is a critical component of healthy aging, we undertook a systematic literature review to assess whether current interventions can positively affect older adults' emotional health.

Methods: A national panel of health services and mental health researchers guided the review. Eligibility criteria included community-dwelling older adult (aged ≥ 50 years) samples, reproducible interventions, and emotional health outcomes, which included multiple domains and both positive (well-being) and illness-related (anxiety) dimensions.

The impact of functional limitations on long-term outcomes among African-American and white women with breast cancer: a cohort study.

Objectives: We examined the impact of functional limitations and functional decline during the first year following breast cancer diagnosis on the risk of mortality from breast cancer and other causes among African-American and white women, respectively.

Design: The Health and Functioning in Women (HFW) cohort study.

Setting: Detroit, Michigan, USA.