The Nature and Perceived Influence of Lifestyle Discussions with Older Adults in Primary Care

The Nature and Perceived Influence of Lifestyle Discussions with Older Adults in Primary Care Rationale: A healthy diet and physical activity help with disease prevention and disease management and can promote quality of life regardless of the age at which an individual begins engaging in these behaviors. Despite the value of these health behaviors, many older adults do not follow lifestyle recommendations. Given that older adults frequently interact with the healthcare system, primary care providers are well situated to counsel older adults to improve their health behaviors. Unfortunately, we do not know how to most effectively engage in this counseling. The purpose of this dissertation is to better understand whether and how providers discuss diet and physical activity with their older patients and how patients perceive their providers’ communication regarding diet and physical activity. Method: One hundred and four older adults, ranging in age from 65 to 95, consented to have their routine primary care visits recorded and immediately following their visits engaged in semi-structured interviews regarding current health behaviors and perceptions of their providers’ diet and physical activity recommendations. Clinical visits were selectively transcribed and analyzed using qualitative description. Interviews were transcribed verbatim, coded, and analyzed through a process of constant comparison. Findings: Discussions of diet and physical activity occurred in over two thirds of visits; recommendations for diet and physical activity occurred in less than half of these discussions. The majority of patients correctly recalled whether or not discussions of diet or physical activity had taken place. Patients reported that the likelihood of engaging in healthy diet and physical activity related to personal motivation and perceived confidence in the ability to make effective changes, both of which could be influenced by providers’ recommendations. When providers did not discuss diet or physical activity, or mentioned these topics only briefly, patients often perceived the message that they should continue with their current behaviors. Implications: These findings support an integrated theoretical framework, highlighting the role of autonomy and confidence, for understanding how providers can promote patients’ health behaviors. Implications for providers’ training and the healthcare system are discussed

Perspectives of Healthcare Practitioners: An Exploration of Interprofessional Communication Using Electronic Medical Records

Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners’ experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one’s notes. Limitations in technology—including limited computer availability, documentation complexity, and sluggish sign-in processes—also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care

ORIENTATION BY BULK MESSENGER SENSORS IN AQUATIC VERTEBRATES

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72353/1/j.1749-6632.1969.tb13050.x.pd

Motivators for Alzheimer\u27s Disease Clinical Trial Participation

Background Alzheimer’s disease (AD) research progress is impeded due to participant recruitment challenges. This study seeks to better understand, from the perspective of individuals engaged in clinical trials (CTs), research motivations. Methods Participants, or their caregivers, from AD treatment and prevention CTs were surveyed about research motivators. Results The 87 respondents had a mean age of 72.2, were predominantly Caucasian, 55.2% were male, and 56.3% had cognitive impairment. An overwhelming majority rated the potential to help themselves or a loved one and the potential to help others in the future as important motivators. Relatively few respondents were motivated by free healthcare, monetary rewards, or to make others happy. Conclusions Recruitment efforts should focus on the potential benefit for the individual, their loved ones, and others in the future rather than free healthcare or monetary rewards

Rural Caregivers: Identification of Informational Needs through Telemedicine Questions

OBJECTIVES: The prevalence of Alzheimer\u27s disease and associated disorders is increasing. Rural residents in the United States have less access to memory care specialists and educational and community resources than in other areas of the country. Over a decade ago, we initiated an interdisciplinary rural caregiving telemedicine program to reach Kentucky residents in areas of the state where resources for supporting individuals with dementia are limited. Telemedicine programs involve a short informational presentation followed by a question and answer session; programs are offered 4 times a year. The purpose of this study was to explore questions asked over 1 year of the rural caregiving telemedicine program-encompassing 5 programs-to identify the scope of dementia-related knowledge gaps among attendees. METHODS: Questions from the 5 programs were recorded and content analyzed to identify areas of frequent informational requests. RESULTS: There were a total of 69 questions over the 5 sessions. For each program, questions ended due to time constraints rather than exhausting all inquiries. The most common topical areas of questions related to risk factors, behavioral management, diagnosis, and medications. DISCUSSION AND IMPLICATIONS: This study highlights that rural caregivers in Kentucky have diverse dementia educational needs. Rural communities may benefit from additional, targeted resources addressing these common areas of unmet informational needs

Will Social Distancing Lead to Future Research Distancing : A Reflection on COVID-19 Impacts on Alzheimer\u27s Disease Research

Coronavirus disease 19 (COVID-19) has dramatically altered everyday life, including the field of Alzheimer\u27s disease (AD) research. This perspective article explores some of the ways in which COVID-19 has already impacted the field, anticipates some of the long-lasting effects, and explores strategies for addressing current and future needs. Areas of impact include study integrity, regulatory and industry issues, and participant engagement. Proposed strategies for addressing these challenges include analytic methods to deal with large degrees of missing data and development of patient-centered, user-friendly, remote data collection tools and assessments. We also highlight the importance of maintaining participant well-being as a first and constant priority

Sensory Processing Abnormalities in Community-Dwelling Older Adults with Cognitive Impairment: A Mixed Methods Study

Mild cognitive impairment (MCI) or dementia often leads to behavioral and psychiatric symptoms of dementia (BPSD). Sensory processing abnormalities may be associated with BPSD. The purpose of this study was to explore relationships among sensory processing, behavior, and environmental features within the homes of people with MCI or dementia. This project used mixed methods to assess participants’ sensory processing, care partner perspectives on behaviors, and in situ observations of the home environment. Nine participants with cognitive impairment (MCI n = 8, early dementia = 1) and their care partners were included. Seven participants with cognitive impairment were reported to have abnormal sensory processing. Findings suggest that unique environmental adaptations, tailored to personal and sensory preferences for each participant, were associated with a decreased level of behavioral disruption during the observation periods. Implementing sensory-based approaches to maximize environment adaptation may be beneficial in reducing disruptive behaviors for adults with cognitive impairment

Pediatric COVID-19 in Argentina: a comprehensive analysis of disease and economic burden through official data and a systematic literature review

BackgroundLimited data are available on the clinical impact and economic burden of COVID-19 in the pediatric population in Argentina. We aimed to estimate the disease and economic burden of COVID-19 on children and adolescents.MethodsWe analyzed official national databases and conducted a supplemental systematic review of the published literature with meta-analysis in children aged 0–18. The period of interest was from March 2020 to August 2021, before the introduction of vaccination in this age group as a national strategic plan. In addition, we used a cost of illness analysis to estimate the direct medical costs associated with COVID-19. All costs are reported in US dollars 2023.ResultsA total of 450,503 confirmed COVID-19 cases and 180 multisystem inflammatory syndrome (MIS-C) were reported in Argentina in the study period. Fourteen observational clinical studies were identified. The meta-analyses of severity level from hospital patients showed that according to different studies 15%–28% of cases were asymptomatic, 68%–88% were mild or moderate, and 3%–10% were severe or critical. About 28% of children had an underlying disease. In addition, the estimated economic burden associated with COVID-19 was 80 million dollars and 4 million dollars corresponded to MISC.ConclusionSignificant impact of COVID-19 on the healthcare system and substantial economic implications for the pediatric population in Argentina were identified. The findings should help policymakers to make informed decisions and allocate resources effectively

Community Mental Health Centers as Human Service Organizations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67333/2/10.1177_000276428502800506.pd

Cutaneous Larva Migrans among Devotees of the Nallur Temple in Jaffna, Sri Lanka

Background: Many cases of Cutaneous Larva Migrans (CLM) have been observed among devotees, during and immediately after the annual festival at the Nallur Hindu temple in Jaffna. Objective: To ascertain the risk factors associated with infestation and devotees ’ knowledge and practices regarding the condition. Methodology/Principal Findings: A cross-sectional study using an interviewer-administered questionnaire and observation was conducted in August 2010. Out of 200 selected devotees 194(97%) responded. Soil and dog faecal samples were collected from the temple premises and examined for the presence of nematode larva and egg respectively. Among 194 male respondents, 58.2%(95 % CI: 51.2%–65.0%) had lesions of CLM. One hundred and thirty (67%) respondents performed the ritual everyday; whereas 33 % did so on special days. One hundred and twelve (57.7%) participants performed the ritual before 5.00am and remaining 42.3 % performed after 5.00am. Among the participants, 77(36.7%) had the similar condition in previous years. One hundred and fifty seven (80.9%) were aware about this disease and 52(27%) devotees adopted some kind of precautionary measures. Bivariate analysis showed significant association between occurrence of CLM lesions and frequency of performing the ritual (p,0.001, OR-15.1; 95 % CI:7.2-32.0), the timing of ritual performance (p = 0.022, OR-1.96; 95 % CI:1.10–3.52), similar condition in previous year (p,0.001, OR-6.83; 95 % CI: 3.39–13.76) and previous awareness of th