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Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS)

The Healthy Aging in Neighborhoods of Diversity across the Life Span study (HANDLS) is a multidisciplinary, community-based, prospective longitudinal epidemiologic study examining the influences of race and socioeconomic status (SES) on the development of age-related health disparities among socioeconomically diverse African Americans and whites in Baltimore. This study investigates whether health disparities develop or persist due to differences in SES, differences in race, or their interaction. This study is unique because it will assess over a 20-year period physical parameters as well as evaluate genetic, biologic, demographic, and psychosocial parameters of African American and white participants in higher and lower SES. It also employs novel research tools, mobile medical research vehicles, in hopes of improving participation rates and retention among non-traditional research participants. The domains of the HANDLS study include: nutrition, cognition, biologic biomarkers, body composition and bone quality, physical function and performance, sociodemographics, psychosocial, neighborhood environment and cardiovascular disease. Utilizing data from these study domains will facilitate understand the driving factors behind persistent black-white health disparities in overall longevity, cardiovascular disease, and cognitive decline. HANDLS recruited a fixed cohort as an area probability sample of Baltimore City from August 2004 through November 2009 as Wave 1. HANDLS Wave 2 entitled The Association of Personality and Socioeconomic status with Health Status - An Interim Follow-up Study began in June 2006 under a separate protocol. It was designed as a follow-up telephone interview approximately 18 months after the initial examination (Wave 1) was complete. Wave 2 provided interim contact with study participants, and important interim information regarding their health. Now completed, waves 3 and 4 were the first and second follow-up examinations and participants second and third visit to our mobile Medical Research Vehicles (MRVs). The current protocol outlines Wave 5, the third follow-up examination and participants fourth visit to our mobile Medical Research Vehicles (MRVs). Planned as a follow-up after 3-4 years, Wave 5 consists of health examinations, questionnaires, a telephone dietary-recall interview, sensory assessments (visual, olfactory), health literacy assessment, skin color analysis, renal function assessments, environmental assessments and structural MRIs.

Start: July 2009
Developing the Family Map: Looking at Communal Coping

Background: - Knowing one s family medical history is a part of staying healthy. Some health risks run in families, and knowing these risks can promote more healthy behavior. Different social and cultural factors may affect how family members share this information. Genetic risk information that is shared in one family may not be shared in the same way in another. This information may also be shared differently between spouses, siblings, or parents and children. It may even be shared with more distant relatives. Knowing the information that family members share and how they share it may help researchers improve genetic disease treatment and support plans. Family surveys of people who have genetic health risks may help provide this information. Objectives: - To study how family members affected by genetic-related diseases share health information with each other. Eligibility: Individuals at least 18 years of age who can read English or Spanish. Participants affected by a genetic disease or be related or married to someone who has the disease. Design: Participants will be screened with an initial questionnaire. They will identify their genetic disease and provide a basic health history. Participants who have the disease will complete an online survey or participate in a personal interview. The questions will take about 45 minutes to 1 hour to answer. The survey will ask about family health history and family support. Participants will also provide referrals to a spouse or relatives who will participate in the study. The spouse or relative will answer a similar survey. The survey will ask about health history and support for the spouse/relative with the disease. A gift card will be given as thanks for participating in the study.

Start: July 2012
Compassionate Use of Metreleptin in Previously Treated People With Partial Lipodystrophy

Background: - Partial lipodystrophy can cause high blood fat levels and resistance to insulin. This can lead to health problems including diabetes. Researchers have found that the drug metreleptin improves health in people with this disease. Objective: - To test the safety and effectiveness of metreleptin. Eligibility: People age 6 months and older with partial lipodystrophy who have received metreleptin through NIH studies and shown improvement AND cannot get metreleptin other ways. Design: Participants will come to NIH approximately every 6 months during year one, then every 1 2 years. Financial assistance may be available for travel within the U.S. At visits, participants will get a supply of metreleptin to take home for daily injections, or it can be shipped to them inside the U.S. They will have: plastic catheter placed in an arm vein. blood tests, urine collection, and physical exam. oral glucose tolerance test, drinking a sweet liquid. ultrasound of the heart, liver, uterus, and ovaries. A gel and a probe are placed on the skin and pictures are taken of the organs. echocardiogram, which takes pictures of the heart with sound waves. Resting Metabolic Rate taken. A plastic hood is worn over the head while the oxygen they breathe is measured. Participants will have up to 3 DEXA scan x-rays per year. Participants may have: annual bone x-rays. liver biopsies every few years. A needle will be inserted into the liver to obtain a small piece. Participants will sign a separate consent for this. Participants must be seen regularly by their local doctors and have blood tests at least every 3-6 months at home.

Start: October 2014