The Mobile City of Accra : Urban Families, Housing and Residential Practices = Accra, Capitale en mouvement : Familles citadines, logement et pratiques résidentielles

This book, with contributions in both English and French, is a product of collaborative research between the Institut de recherche pour le développement (IRD, France), the University of Ghana, Legon and CODESRIA. It examines various economic, social and environmental challenges of urbanization that critically affect the capital of Ghana, which has experienced high demographic growth and territorial expansion. The study analyses the Greater Accra city dwellers residential practices, and focuses on two main factors influencing land and rental markets. On the one hand, it interrogates the constraints and dynamics of urban families, their needs and gender characteristics in terms of accommodation. On the other hand, it explores the opportunities and interests in investment on the part of land owners and real estate developers. At these two levels of describing the social and spatial discriminations, the book attempts to explain the difficult choices that this fragmented city faces. It emphasizes the role of mobility in structuring the metropolitan area, and the negative impact of lack of mobility which results in some households and communities suffering more than others. Light is thrown on diagnostics and prospects in the matter of urban planning

Using Clinical Scales and Digital Measures to Explore Falls in Patients with Lewy Body Dementia

Introduction: PRESENCE was a phase 2 clinical trial assessing the efficacy of mevidalen, a D1 receptor positive allosteric modulator, for symptomatic treatment of Lewy body dementia (LBD). Mevidalen demonstrated improvements in motor and non-motor features of LBD, global functioning, and actigraphy-measured activity and daytime sleep. Adverse events (AEs) of fall were numerically increased in mevidalen-treated participants. Methods: A subset of PRESENCE participants wore a wrist actigraphy device for 2-week periods pre-, during, and posttreatment. Actigraphy sleep and activity measures were derived per period and analyzed to assess for their association with participants’ reports of an AE of fall. Prespecified baseline and treatment-emergent clinical characteristics were also included in the retrospective analysis of falls. Independent-samples t test and χ2 test were performed to compare the means and proportions between individuals with/without falls. Results: A trend toward more falls was observed with mevidalen treatment (31/258 mevidalen-treated vs. 4/86 in placebo-treated participants: p = 0.12). Higher body mass index (BMI) (p < 0.05), more severe disease measured by baseline Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part II (p < 0.05), and a trend toward improved Alzheimer’s Disease Assessment Scale-Cognitive Subscale 13 (ADAS-Cog13) (p = 0.06) were associated with individuals with falls. No statistically significant associations with falls and treatment-emergent changes were observed. Conclusion: The association of falls with worse baseline disease severity and higher BMI and overall trend toward improvements on cognitive and motor scales suggest that falls in PRESENCE may be related to increased activity in mevidalen-treated participants at greater risk for falling. Future studies to confirm this hypothesis using fall diaries and digital assessments are necessary