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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.

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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Alzheimer's

New Breakthrough in Parkinson’s Diagnosis: A Reliable Biomarker Discovered in Body Fluids

Researchers have discovered a new biomarker for Parkinson’s disease. A misfolded protein facilitates reliable diagnosis even in the early stages of Parkinson’s disease in body fluids.

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Parkinson’s disease is a neurodegenerative disorder that affects millions worldwide. Traditionally, it was diagnosed in its late stage based on motor symptoms, by which time the brain had already suffered significant damage. However, researchers from the PRODI Center for Protein Diagnostics at Ruhr University Bochum, Germany, and betaSENSE have made a groundbreaking discovery – a reliable biomarker in the spinal fluid that enables early diagnosis of Parkinson’s disease.

The misfolding of alpha-synuclein (αSyn) protein plays a crucial role in the development of Parkinson’s. When αSyn transforms from its normal α-helical structure to a β-sheet-rich structure, it becomes “sticky” and forms larger complexes called oligomers. These oligomers eventually produce long fibrillar filaments that aggregate into macroscopically large Lewy bodies in the brain.

A team led by Professor Klaus Gerwert has successfully detected this misfolding of αSyn in body fluids with a sensitivity and specificity of over 90 percent, using cerebrospinal fluid samples from patients at two Parkinson’s centers. The measurements were carried out using betaSENSE’s patented iRS (immuno-infrared sensor) technology.

This breakthrough is not only significant for diagnosing Parkinson’s but also has the potential to revolutionize the development of new treatments. By identifying early-stage disease, researchers can explore more effective therapeutic options and potentially slow down or halt the progression of the disease.

The successful implementation of iRS technology in Alzheimer’s diagnosis has shown that it can accurately predict the risk of dementia up to 17 years before clinical diagnosis. Similarly, this approach for αSyn misfolding in Parkinson’s can shed light on the progression of the disease and the efficacy of treatments.

This discovery brings hope to millions worldwide, offering a new window into early diagnosis and treatment of this debilitating condition.

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