Living With Ambiguity: A Metasynthesis of Qualitative Research on Mild Cognitive Impairment

Purpose of the study: Mild Cognitive Impairment (MCI) is a diagnosis proposed to describe an intermediate state between normal cognitive aging and dementia. MCI has been criticised for its conceptual fuzziness, its ambiguous relationship to dementia, and the tension it creates between medical and sociological understandings of “normal aging”. Design and Methods: We examined the published qualitative literature on experiences of being diagnosed and living with MCI using metasynthesis as the methodological framework. Results: Two overarching conceptual themes were developed. The first, MCI and myself-in-time, showed that a diagnosis of MCI could profoundly affect a person’s understanding of their place in the world. This impact appears to be mediated by multiple factors including a person’s social support networks, which daily activities are affected, and subjective interpretations of the meaning of MCI. The second theme, Living with Ambiguity, describes the difficulties people experienced in making sense of their diagnosis. Uncertainty arose, in part, from lack of clarity and consistency in the information received by people with MCI, including whether they are even told MCI is the diagnosis. Implications: We conclude by suggesting an ethical tension is always at play when a MCI diagnosis is made. Specifically, earlier support and services afforded by a diagnosis may come at the expense of a person’s anxiety about the future, with continued uncertainty about how his or her concerns and needs can be addressed

Prevalence of infraocclusion of primary molars determined using a new 2D image analysis methodology

The reported prevalence of infraocclusion varies widely, reflecting differences in definitions and measurement/scoring approaches.This study aimed to quantify the prevalence and extent of infraocclusion in singletons and twins during the late mixed dentition stage of dental development using a new diagnostic imaging method and objective criteria. The study also aimed to determine any associations between infraocclusion and sex, arch type, arch side and tooth type.Two samples were analysed; 1,454 panoramic radiographs of singletons and 270 dental models of twins. Both samples ranged in age from 8-11 years. Adobe Photoshop CS5 was used to measure the extent of infraocclusion. Repeatability tests showed systematic and random errors were small.The prevalence in the maxilla was low (<1%), whereas the prevalence in the mandible was 22% in the singleton sample and 32% in the twin sample. The primary mandibular first molar was affected more often than the second molar. There was no significant difference in the expression between sexes or sides.A new technique for measuring infraocclusion has been developed with high intra- and inter-operator reproducibility. This method should enhance early diagnosis of tooth developmental abnormalities and treatment planning during late mixed dentition stage of development.Ruba Odeh, Suzanna Mihailidis, Grant Townsend, Raija Lähdesmäki, Toby Hughes, and Alan Broo

Technology and dementia: the future is now

Background: Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. Objectives: To summarise key areas of technology development in dementia and identify future directions and implications. Method: Members of the US Alzheimer’s Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. Results: The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. Conclusions: The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and pre- vention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia

Search for High-Spin Stretched States in 206-Pb

This research was sponsored by the National Science Foundation Grant NSF PHY-931478

High Spin States in the (p,t) Reaction

This research was sponsored by the National Science Foundation Grant NSF PHY-931478

Hand Extension Robot Orthosis (HERO) Grip Glove: enabling independence amongst persons with severe hand impairments after stroke

Background The Hand Extension Robot Orthosis (HERO) Grip Glove was iteratively designed to meet requests from therapists and persons after a stroke who have severe hand impairment to create a device that extends all five fingers, enhances grip strength and is portable, lightweight, easy to put on, comfortable and affordable. Methods Eleven persons who have minimal or no active finger extension (Chedoke McMaster Stage of Hand 1–4) post-stroke were recruited to evaluate how well they could perform activities of daily living and finger function assessments with and without wearing the HERO Grip Glove. Results The 11 participants showed statistically significant improvements (p < 0.01), while wearing the HERO Grip Glove, in the water bottle grasp and manipulation task (increase of 2.3 points, SD 1.2, scored using the Chedoke Hand and Arm Inventory scale from 1 to 7) and in index finger extension (increase of 147o, SD 44) and range of motion (increase of 145o, SD 36). The HERO Grip Glove provided 12.7 N (SD 8.9 N) of grip force and 11.0 N (SD 4.8) of pinch force to their affected hands, which enabled those without grip strength to grasp and manipulate blocks, a fork and a water bottle, as well as write with a pen. The participants were ‘more or less satisfied’ with the HERO Grip Glove as an assistive device (average of 3.3 out of 5 on the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 Scale). The highest satisfaction scores were given for safety and security (4.6) and ease of use (3.8) and the lowest satisfaction scores were given for ease of donning (2.3), which required under 5 min with assistance. The most common requests were for greater grip strength and a smaller glove size for small hands. Conclusions The HERO Grip Glove is a safe and effective tool for enabling persons with a stroke that have severe hand impairment to incorporate their affected hand into activities of daily living, which may motivate greater use of the affected upper extremity in daily life to stimulate neuromuscular recovery

Calculation of the kinematics of hypoid gears towards developing a method for an equivalent crossed helical gear pair selection for use in tribological experimental evaluations

To experimentally verify power loss and friction for hypoid gears, measurements in a closed power-loop test rig are necessary. However, these are costly and mechanically complex, since they require additional spur gear reducers in the loop. ISO directives document the use of crossed helical gear pairs as virtual gears for hypoids to calculate the sliding velocity since, the flank geometry at the mean point can be precisely represented. The use of such pairs can be a cost effective and simpler alternative for testing purposes. However, the validity of this analogy regarding contact mechanics and tribology for the full mesh cycle has not been investigated hitherto. In the current study a new method for calculating the sliding and rolling speed along the full path of contact of a hypoid gear pair is presented. Cutter kinematics are considered, for the accurate definition of the contact bodies. Using TCA, the load distribution on the tooth under quasi-static conditions and the sliding velocity are calculated for comparison purposes. By applying a selection algorithm, a single experimental crossed helical gear pair is chosen aiming to simulate the contact conditions of hypoid gears. Two test scenarios are studied using EHL film thickness equations and friction models for evaluating the power loss. The contact is an elongated ellipse with varying directions of the sliding and sum velocities, which are considered in the model. The kinematic equivalence shows good agreement while the tribological equivalence is achievable using a reduced input torque

Engaging older adults with dementia in creative occupations using artificially intelligent assistive technology

Engagement in creative occupations has been shown to promote well-being for older adults with dementia. Providing access to such occupations is often difficult as successful participation requires face-time with a person who is knowledgeable in facilitating engagement as well as access to any required resources, such as an arts studio. In response, a computer-based device, the Engaging Platform for Art Development (ePAD), was created to with the aim of enabling more independent access to art creation. ePAD is a an artificially intelligent touch-screen device that estimates a client’s level of engagement and provides prompts to encourage engagement if the client becomes disengaged. ePAD is customizable such that an art therapist can choose themes and tools that they feel reflect their client’s needs and preferences. This paper presents a mixed-methods study that evaluated ePAD’s usability by six older adult (with mild-to-moderate dementia) and art therapist dyads. Usability measures suggest that all participants found ePAD engaging but did not find prompts effective. Future development of ePAD includes improving the prompts, implementing the recommendations made by participants in this research, and long- term testing in more naturalistic art therapy contexts

Beam energy metrics for the acceptance and quality assurance of Halcyon linear accelerator

PURPOSE: Establish and compare two metrics for monitoring beam energy changes in the Halcyon platform and evaluate the accuracy of these metrics across multiple Halcyon linacs. METHOD: The first energy metric is derived from the diagonal normalized flatness (F RESULTS: Five Halcyon linacs from five institutions were used to evaluate the accuracy of the D CONCLUSION: The

Tolerance limits and methodologies for IMRT measurement‐based verification QA: Recommendations of AAPM Task Group No. 218

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143649/1/mp12810_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143649/2/mp12810.pd