Crossing the digital divide : family caregivers' acceptance of technology

The purpose of this pilot project was to collect data on how electronic technology might be used to assist family members who are caring for a relative with dementia at home. In Phase 1, we conducted five focus groups with 26 caregivers of relatives with dementia to document the specific challenges faced by caregivers and assess their access to, and familiarity with, electronic technology. In Phase 2, a technology-based solution B the Xanboo Smart House Management System B was identified. The System allows monitoring of a residence through placement and control of video cameras and other enabled devices, including sensors that detect motion, the presence of water, or noise. Sensors may be set to provide a caregiver or other interested party with immediate notification by e-mail, pager, or text messaging cell phone. In Phase 3, a household was outfitted with The System and two focus groups comprised of 8 caregivers to relatives with dementia were conducted to evaluate its utility. The report concludes with an annotated bibliography on technology and aging, with special focus on caring for a relative with dementia. Key Findings: Caregivers and the relatives for whom they provide care are in an evolving struggle to maintain continuity of roles, relationships, and lifestyles. Challenges include the safety of the individual with dementia and keeping geographically distant family members aware of their relative s condition. Caregivers used a range of technologies in their day-to-day lives, including low- tech solutions to challenges in caregiving. Caregivers felt strongly that technological solutions were neither appropriate nor useful across all situations, and were cognizant of the inherent trade-off between safety on the one hand and dignity, respect, privacy, and desires for independence and autonomy on the other hand. Caregivers do not aspire to become technology whizzes ; rather, they are interested in easily obtained, affordable, easy to use, solutions to some of the challenges they face. An affordable, easy to use, off the shelf, monitoring system (The System) was identified. Caregivers attitudes regarding The System were generally quite positive. When prompted to identify barriers to using The System, caregivers identified the need for a computer and Internet access, and cost. Conclusions: The results from this pilot project suggest that there are affordable technologies that can assist family members in their efforts to care for relatives with dementia at home, and that these caregivers were amenable to the use of these technologies. Future efforts should evaluate the installation, use, and impact of The System in the homes of family caregivers to relatives with dementia

Altered expression of mitochondrial electron transport chain proteins and improved myocardial energetic state during late ischemic preconditioning

Altered expression of mitochondrial electron transport proteins has been shown in early preconditioned myocardial tissue. We wished to determine whether these alterations persist in the Second Window of Protection (SWOP) and if so, whether a favorable energetic state is facilitated during subsequent ischemia. Fourteen pigs underwent a SWOP protocol with ten 2-minute balloon inflations in the LAD artery, each separated by 2 minutes reperfusion. Twenty-four hours later, mitochondria were isolated from SWOP and SHAM pig hearts and analyzed for uncoupling protein (UCP)-2 content by western blot analysis, proteomic changes by iTRAQ® and respiration by an oxygen electrode. In parallel in vivo studies, high-energy nucleotides were obtained by transmural biopsy from anesthetized SWOP and SHAM pigs at baseline and during sustained low-flow ischemia. Compared with SHAM mitochondria, ex vivo SWOP heart tissue demonstrated increased expression of UCP-2, Complex IV (cytochrome c oxidase) and Complex V (ATPase) proteins. In comparison with SHAM pigs during in vivo conditions, transmural energetics in SWOP hearts, as estimated by the free energy of ATP hydrolysis (ΔG 0), were similar at baseline but had decreased by the end of low-flow ischemia (-57.0 ± 2.1 versus -51.1 ± 1.4 kJ/mol; P < 0.05). In conclusion, within isolated mitochondria from preconditioned SWOP hearts, UCP-2 is increased and in concert with enhanced Complex IV and V proteins, imparts a favorable energetic state during low-flow ischemia. These data support the notion that mitochondrial adaptations that may reduce oxidant damage do not reduce the overall efficiency of energetics during sustained oxygen deprivation