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A New Model for Home Care: How Cooperatives Can Address the Growing Shortage of Caregivers

Home care cooperatives may be the key to alleviating the shortage of paid caregivers for older Americans. Participants in cooperatives experienced more respect, control, job support, and compensation than their counterparts in traditional care services.

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The article highlights the potential solution to addressing the critical shortage of paid caregivers for older Americans: home care cooperatives. These innovative models allow caregivers to own and operate their services, leading to improved job quality, retention, and satisfaction. A recent study published in JAMA Network Open found that participants in cooperatives experienced more respect, control, job support, and compensation compared to traditional care services.

The research, led by Dr. Geoffrey Gusoff, assistant professor of family medicine at the David Geffen School of Medicine at UCLA, involved interviewing 23 home care workers and nine staff members from five cooperatives. The caregivers identified four key factors contributing to better job quality and lower turnover rates: respect, control, job support, and compensation.

Unlike traditional home care services, which are plagued by high turnover rates and employee dissatisfaction, cooperatives offer a more collaborative experience and sense of ownership for the participants. Home care cooperatives provide the same daily living assistance to the elderly as traditional services, including bathing, medication management, and meal preparation.

To address the growing demand for caregivers, Dr. Gusoff emphasizes the need for new strategies and policies that retain and recruit caregivers. He suggests that other home care businesses can learn from cooperatives’ practices to improve caregiver jobs and ultimately meet the growing demand.

The study’s limitations include potential recall or selection bias when participants compared their experiences at cooperatives with traditional services, the inclusion of only English-speaking home care workers, and potential factors such as agency size that may influence workers’ perceptions of the cooperatives.

More work is needed to further identify the qualities influencing home care workers’ job satisfaction. Dr. Gusoff suggests testing the factors identified in the study through a national caregiver survey to better quantify their role in caregiver retention, satisfaction, and care quality.

The study’s co-authors include Miguel Cuevas and Dr. Catherine Sarkisian of UCLA, Dr. Madeline Sterling of Weill Cornell Medicine, Ariel Avgar of Cornell University, and Gery Ryan of Kaiser Permanente. The research was funded by Career Development Awards from the National Institute on Aging, the National Heart Lung and Blood Institute, the National Institutes of Health, the Cornell University Industrial and Labor Relations Center for Applied Research on Work, and a Clinical Scientist Development Award from the Doris Duke Charitable Foundation.

Agriculture and Food

“Processed with Caution: Ultra-Processed Foods May Accelerate Early Signs of Parkinson’s Disease”

People who eat more ultra processed foods like cold breakfast cereal, cookies and hot dogs are more likely to have early signs of Parkinson’s disease when compared to those who eat very few ultra processed foods, according to a new study. The study does not prove that eating more ultra processed foods causes early signs of Parkinson’s disease; it only shows an association.

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Eating ultra-processed foods like cold breakfast cereal, cookies, and hot dogs may speed up early signs of Parkinson’s disease, according to a recent study published in Neurology. The research found that people who consumed more of these processed foods were more likely to experience early symptoms of the disease compared to those who ate very few.

The study analyzed data from over 42,000 participants with an average age of 48, who did not have Parkinson’s disease at the start of the study. They were followed up to 26 years and completed regular medical exams and health questionnaires. Researchers also reviewed food diaries that listed what participants ate and how often.

The team looked at several types of ultra-processed foods, including sauces, spreads, or condiments; packaged sweets; snacks or desserts; artificially or sugar-sweetened beverages; animal-based products; yogurt or dairy-based desserts; and packaged savory snacks. One serving was equivalent to a single can of soda, one ounce of potato chips, one slice of packaged cake, a single hot dog, or one tablespoon of ketchup.

Researchers divided participants into five groups based on how many ultra-processed foods they ate per day on average. The highest group consumed 11 or more servings daily, while the lowest group averaged fewer than three servings daily.

After adjusting for factors like age, physical activity, and smoking, researchers found that participants who ate 11 or more servings of ultra-processed food per day had a 2.5-fold higher likelihood of having three or more early signs of Parkinson’s disease compared to those consuming fewer than three servings per day.

When looking at individual symptoms, eating more ultra-processed foods was tied to an increased risk for nearly all symptoms except constipation. The study’s author, Xiang Gao, emphasized the importance of choosing whole, nutritious foods over processed ones to maintain brain health.

While the study suggests a link between ultra-processed food consumption and early signs of Parkinson’s disease, it does not prove causation. More research is needed to confirm these findings and understand the complex relationships between diet, lifestyle, and neurodegenerative diseases.

In the meantime, individuals can take steps to reduce their exposure to ultra-processed foods by:

* Reading labels carefully
* Choosing whole grains over refined ones
* Limiting sugary drinks and snacks
* Opting for fresh fruits and vegetables instead of packaged options
* Cooking meals from scratch using fresh ingredients

By making informed food choices, individuals can contribute to a healthier brain and potentially reduce their risk of developing neurodegenerative diseases like Parkinson’s.

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Behavior

Shingles Vaccine Shows Surprising Heart Disease Benefits Lasting Up To Eight Years

People who are given a vaccine for shingles have a 23% lower risk of cardiovascular events, including stroke, heart failure, and coronary heart disease, according to a recent study of more than a million people. The protective effect of the vaccine lasts for up to eight years and is particularly pronounced for men, people under the age of 60 and those with unhealthy lifestyles.

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The shingles vaccine has been found to lower the risk of heart disease for up to eight years, according to a recent study published in the European Heart Journal. The study, which included over 1.2 million people aged 50 or older living in South Korea, revealed that those who received the vaccine had a 23% lower risk of cardiovascular events, including stroke, heart failure, and coronary heart disease.

The protective effect of the vaccine was particularly pronounced for men, younger individuals (under 60), and those with unhealthy lifestyles such as smoking, drinking alcohol, and being inactive. The study’s findings suggest that vaccination could offer health benefits beyond preventing shingles, a painful rash caused by the varicella zoster virus.

Led by Professor Dong Keon Yon from the Kyung Hee University College of Medicine in Seoul, South Korea, the research team aimed to investigate whether getting vaccinated against shingles could lower the risk of heart problems associated with the condition. Their study involved gathering data on cardiovascular health and other factors that can influence health, such as age, sex, wealth, and lifestyle, for individuals who received the live zoster vaccine between 2012 and 2020.

The researchers found that among people who received the vaccine, there was a 23% lower risk of cardiovascular events overall, with a 26% lower risk of major cardiovascular events (a stroke, heart attack or death from heart disease), a 26% lower risk of heart failure, and a 22% lower risk of coronary heart disease. The protective effect was strongest in the two to three years after the shingles vaccine was given, but researchers found that the protection lasted for up to eight years.

The study’s findings have significant implications for public health policy and could lead to changes in vaccination recommendations to include cardiovascular benefits. However, as Professor Yon noted, more research is needed on the recombinant vaccine, which is now being used in many countries, to confirm its effectiveness in reducing heart disease risk.

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Alzheimer's

AI Helps Unravel Alzheimer’s Mystery and Identify a Therapeutic Candidate

A new study found that a gene recently recognized as a biomarker for Alzheimer’s disease is actually a cause of it, due to its previously unknown secondary function that triggers a pathway that disrupts how cells in the brain turn genes on and off.

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The latest study published in Cell has revealed that phosphoglycerate dehydrogenase (PHGDH), previously known as a biomarker for early detection of Alzheimer’s disease, is actually a causal gene for spontaneous Alzheimer’s. Using artificial intelligence to visualize the three-dimensional structure of PHGDH, researchers at the University of California San Diego discovered a previously unknown regulatory role played by the protein.

The study found that altering PHGDH expression levels had consequential effects on Alzheimer’s disease progression in mice and human brain organoids. Lower levels corresponded to less disease progression, whereas increasing the levels led to more disease advancement. This established that PHGDH is indeed a causal gene for spontaneous Alzheimer’s disease.

In further support of this finding, the researchers determined that PHGDH triggers a pathway that disrupts how cells in the brain turn genes on and off, leading to issues such as the development of Alzheimer’s disease.

The research team used AI again to identify NCT-503, a small molecule with the potential to inhibit PHGDH’s regulatory role. They tested NCT-503 in two mouse models of Alzheimer’s disease and observed that it significantly alleviated Alzheimer’s progression, demonstrating substantial improvement in memory and anxiety tests.

While there are limitations to their study, the results are promising, according to lead author Sheng Zhong. “Now there is a therapeutic candidate with demonstrated efficacy that has the potential of being further developed into clinical tests,” he said.

“The next steps will be to optimize the compound and subject it to FDA IND-enabling studies.” An advantage of small molecules is that they could even be administered orally, unlike current treatments that require infusions.

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