Systematic Multi-Domain Alzheimer's Risk Reduction Trial (SMARRT): Study Protocol.

This article describes the protocol for the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT), a single-blind randomized pilot trial to test a personalized, pragmatic, multi-domain Alzheimer's disease (AD) risk reduction intervention in a US integrated healthcare delivery system. Study participants will be 200 higher-risk older adults (age 70-89 years with subjective cognitive complaints, low normal performance on cognitive screen, and ≥ two modifiable risk factors targeted by our intervention) who will be recruited from selected primary care clinics of Kaiser Permanente Washington, oversampling people with non-white race or Hispanic ethnicity. Study participants will be randomly assigned to a two-year Alzheimer's risk reduction intervention (SMARRT) or a Health Education (HE) control. Randomization will be stratified by clinic, race/ethnicity (non-Hispanic white versus non-white or Hispanic), and age (70-79, 80-89). Participants randomized to the SMARRT group will work with a behavioral coach and nurse to develop a personalized plan related to their risk factors (poorly controlled hypertension, diabetes with evidence of hyper or hypoglycemia, depressive symptoms, poor sleep quality, contraindicated medications, physical inactivity, low cognitive stimulation, social isolation, poor diet, smoking). Participants in the HE control group will be mailed general health education information about these risk factors for AD. The primary outcome is two-year cognitive change on a cognitive test composite score. Secondary outcomes include: 1) improvement in targeted risk factors, 2) individual cognitive domain composite scores, 3) physical performance, 4) functional ability, 5) quality of life, and 6) incidence of mild cognitive impairment, AD, and dementia. Primary and secondary outcomes will be assessed in both groups at baseline and 6, 12, 18, and 24 months

Sowing in the autumn season : exploring benefits of green care farms for dementia patients

In the Netherlands an increasing number of farms combine agricultural production with care services for people with care needs. It is generally believed that these green care farms (GCFs) have beneficial effects on the health status of a diversity of target groups. At present, empirical studies testing this hypothesis are scarce. The main objective of the studies described in this thesis was to gain insight into the potential benefits of day care at GCFs for community‐dwelling older dementia patients. Day care at GCFs was therefore compared with day care at regular day care facilities (RDCFs). In view of the differences between both day care types regarding the day care setting and day care program it was hypothesized that they would differ in their effects on the health status of dementia patients. In two cross‐sectional studies it was tested to what extent the day program of dementia patients at GCFs differed from those at RDCFs. It appeared that at GCFs, dementia patients were (physically) more active, participated in more diverse activities, were more outdoors, and had more opportunities to perform activities in smaller groups than those at RDCFs. It was tested whether these differences resulted into different effects for five domains of health: dietary intake, cognition, emotional well‐being, behaviour, and functional performance. In a comparative cross‐sectional study dietary intake of dementia patients attending day care at GCFs or RDCFs was recorded both at home and during their time at the day care facility. The study showed that dementia patients attending day care at GCFs had significantly higher intakes of energy, carbohydrate, and fluid than their counterparts attending day care at RDCFs. In a cohort study, rates of change during 1 year in cognitive functioning, emotional well‐being, behavioural symptoms, and functional performance were compared between dementia patients attending day care at GCFs and RDCFs. Functioning in these domains remained rather stable and no differences were observed between subjects from GCFs and RDCFs. In the cohort study, also caregiver burden of family caregivers of these dementia patients was assessed. Caregivers’ quality of life, emotional distress, and feelings of competence remained rather stable in family caregivers of dementia patients from both day care settings. In conclusion, the present work has shown that GCFs exceeded RDCFs in offering older dementia patients a diverse day program and in stimulating their dietary intake. The latter may result into a better preserved nutritional status in dementia patients attending day care at GCFs than in those attending day care at RDCFs. GCFs and RDCFs were equally effective in preventing significant decrease of cognitive functioning, emotional well‐being, and functional performance and in preventing significant increase of the number of behavioural symptoms. Both day care types further prevented significant increase of caregiver burden. Day care at GCFs is a new and valuable addition to the present care modalities for community‐dwelling older dementia patients and their caregiver

Gen X and Digital Games: Looking back to look forward

Despite there being increased attention in recent years to older adults who actively play digital games, it seems that there has been comparatively minimal scholarly focus on the next generation of older adult gamers – Generation X gamers. Although there have been few, current audience studies that examine this population within a gaming context, a temporal perspective reveals another story. Older members of this generation were the first age cohort to be exposed to and engage in video gameplay at an early age (i.e., childhood). With the emerging popularity of video games in the 1980s, this did not escape the attention of scholars. This study provides an overview of those early studies that assessed video game use and its potential (for better or worse) among the older members Gen X. The study themes identified include: health, education, and behavior. In addition, the first studies that identified gaming characteristics of this generation in their formative years emerged in the latter half of that decade. By identifying themes in these early studies, scholars have the potential to track an entire generation’s gaming history and characteristics from childhood to present day. Ultimately, this may glean richer insight into those qualities when they become the next older generation of digital game players

Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions.

Fall prediction is a multifaceted problem that involves complex interactions between physiological, behavioral, and environmental factors. Existing fall detection and prediction systems mainly focus on physiological factors such as gait, vision, and cognition, and do not address the multifactorial nature of falls. In addition, these systems lack efficient user interfaces and feedback for preventing future falls. Recent advances in internet of things (IoT) and mobile technologies offer ample opportunities for integrating contextual information about patient behavior and environment along with physiological health data for predicting falls. This article reviews the state-of-the-art in fall detection and prediction systems. It also describes the challenges, limitations, and future directions in the design and implementation of effective fall prediction and prevention systems

Psychology in Education and Health- Proceedings of the II Leipzig-Évora Scientific Meeting in Psychology

This ebook contains several papers on the application applied psychology in education, health and well-being, personality,family interactions and emotional and epistemological development.The aim of this volume is to inform the scientific community on the research on Psychology mainly made at Évora and Leipzig Universities, but also in other contexts like Mexico or Brazil.FC

Towards validation of a new computerised test of goal neglect: preliminary evidence from clinical and neuroimaging pilot studies

Objective: Goal neglect is a significant problem following brain injury, and is a target for rehabilitation. It is not yet known how neural activation might change to reflect rehabilitation gains. We developed a computerised multiple elements test (CMET), suitable for use in neuroimaging paradigms. Design: Pilot correlational study and event-related fMRI study. Methods: In Study 1, 18 adults with acquired brain injury were assessed using the CMET, other tests of goal neglect (Hotel Test; Modified Six Elements Test) and tests of reasoning. In Study 2, 12 healthy adults underwent fMRI, during which the CMET was administered under two conditions: self-generated switching and experimenter-prompted switching. Results: Among the clinical sample, CMET performance was positively correlated with both the Hotel Test (r = 0.675, p = 0.003) and the Modified Six Elements Test (r = 0.568, p = 0.014), but not with other clinical or demographic measures. In the healthy sample, fMRI demonstrated significant activation in rostro-lateral prefrontal cortex in the self-generated condition compared with the prompted condition (peak 40, 44, 4; ZE = 4.25, p(FWEcorr) = 0.026). Conclusions: These pilot studies provide preliminary evidence towards the validation of the CMET as a measure of goal neglect. Future studies will aim to further establish its psychometric properties, and determine optimum pre- and post-rehabilitation fMRI paradigms

GPS analysis of a team competing at a national Under 18 field hockey tournament

The purpose of this study was to utilise global-positioning system (GPS) technology to quantify the running demands of national Under 18 field hockey players competing in a regional field hockey tournament. Ten male players (mean ± SD; age 17.2 ± 0.4 years; stature 178.1 ± 5.2 cm; body mass 78.8 ± 8.8 kg) wore GPS units while competing in six matches over seven days at the 2018 New Zealand national under 18 field hockey tournament. GPS enabled the measurement of total distance (TD), low-speed activity (LSA; 0 -14.9 km/hr), and high-speed running (HSR; ≥ 15 km/hr) distances. Differences in running demands (TD, LSA, HSR) between positions were assessed using effect size and percent difference ± 90% confidence intervals. Midfielders covered the most TD and LSA per game and strikers the most HSR during the 6 matches. There were “very large” differences between strikers and midfielders for TD and LSA, strikers and defenders for LSA and HSR, and defenders and midfielders for LSA. These results suggest that these playing positions are sufficiently different to warrant specialised position-specific conditioning training leading into a field hockey tournament

The effects of morning preconditioning protocols on testosterone, cortisol and afternoon sprint cycling performance [conference presentation]

Opportunities exist for athletes to undertake morning exercise protocols in an attempt to potentate afternoon performance. Four sub elite track sprint cyclists completed a morning cycling (Cyc) or weights-based protocol (WP) prior to an afternoon cycling time trial (500m) in a repeated measures, counterbalance crossover design. Measured variables included heart rate, blood lactate, cycling peak power, salivary testosterone (T) and cortisol levels along with time trial performance. Standardised differences in means via magnitude-based inferences were calculated using paired samples T-tests in SPSS version 24 with statistical significance set at p < 0.05. The WP produced significantly faster times in the final 250m in comparison to CycP. The anticipated circadian decline of T was observed after the CycP but was however mitigated following the WP. While slight decreases in 500m times were experienced during the WP, they were not significant and were considered within the normal variations experienced between performances by elite athletes. The effect of the WP on the circadian rhythm of T could be linked to a greater recruitment of muscle fibres. Results suggest a morning resistance protocol can positively affect testosterone levels for afternoon performance. Possible gender and individual responses from conducting a W over Cyc protocol were observed and require further investigation

Human experience in the natural and built environment : implications for research policy and practice

22nd IAPS conference. Edited book of abstracts. 427 pp. University of Strathclyde, Sheffield and West of Scotland Publication. ISBN: 978-0-94-764988-3