Effects of nonpharmacological interventions on disruptive vocalisation in nursing home patients with dementia-A systematic review

Background: Vocally disruptive behaviour is a common and difficult to treat condition in older residents with dementia. The aim of this systematic review is to evaluate the efficacy of nonpharmacological interventions in its management in persons with dementia residing in a nursing home.Methodology: A systematic search was conducted using Ovid MEDLINE, CINAHL, and Cochrane databases and reference lists from relevant publications on various nonpharmacological approaches to manage vocally disruptive behaviour in nursing home residents. The method of appraisal was through the National Institutes of Health scoring for the Quality Assessment of controlled intervention studies. Inclusion criteria included residents of nursing homes over the age of 65 with dementia and disruptive vocalisation. Only randomised controlled trials published in English were included.Results: A total of 5,606 articles were identified, which cover 501 trials, of which 23 were selected. There were fourteen studies observed to have an impact of clinical and statistical significance with interventions including (i) a multidimensional approach with different nonpharmacological interventions, (ii) multisensory stimulation, (iii) staff education and training, (iv) personalised bathing, and (v) pain recognition and appropriate management. Seven studies demonstrated no observable effect whereas two showed worsening in vocally disruptive behaviour.Conclusions: Many aspects of vocally disruptive behaviour management are poorly understood. Limited empirical evidence supports the use of several nonpharmacological interventions to reduce it. There is more robust evidence to support the use of a tailored approach to management over the universal approach

Free l-glutamate-induced modulation in oxidative and neurochemical profile contributes to enhancement in locomotor and memory performance in male rats

Glutamate (Glu), the key excitatory neurotransmitter in the central nervous system, is considered essential for brain functioning and has a vital role in learning and memory formation. Earlier it was considered as a harmful agent but later found to be useful for many body functions. However, studies regarding the effects of free L-Glu administration on CNS function are limited. Therefore, current experiment is aimed to monitor the neurobiological effects of free L-Glu in male rats. L-Glu was orally administered to rats for 5-weeks and changes in behavioral performance were monitored. Thereafter, brain and hippocampus were collected for oxidative and neurochemical analysis. Results showed that chronic supplementation of free L-Glu enhanced locomotor performance and cognitive function of animals which may be attributed to the improved antioxidant status and cholinergic, monoaminergic and glutamatergic neurotransmission in brain and hippocampus. Current results showed that chronic supplementation of L-Glu affects the animal behaviour and brain functioning via improving the neurochemical and redox system of brain. Free L-Glu could be a useful therapeutic agent to combat neurological disturbances however this requires further targeted studies

Administration of 5-HT-1B agonist ameliorates pseudodementia induced by depression in rats

Major depressive disorder (MDD) is the leading cause of memory impairment in general population. The serotonin hypothesis provides a target model for the treatment of depression and depression-associated memory loss. 5-HT-1B receptor is suggested as a potential candidate in the pathophysiology of depressive illness. Dysfunction of 5-HT-1B receptors has been observed previously in depressive patients. Zolmitriptan, 5-HT-1B agonist is clinically recommended for the treatment of migraine. However, in present study this drug was tested as a potential treatment for depression and associated memory loss by altering the serotonergic function at receptor level. Rats (n=24) were equally divided into unstressed and stressed groups. Depression was induced by 19 days of restraint stress for 4 h which was followed by forced swim test and pattern separation test to assess depressive symptoms and memory impairment, respectively. The initial sign of depression-associated memory loss involves impaired pattern separation which is regarded as pseudodementia. In this study stressed ratsshowed depression- and pseudodementia-like symptoms. After the induction of depression, rats were treated with zolmitriptan at a dose of 0.3 mg/kg which resulted in a significant attenuation of depression and depression-associated memory impairment. Results are discussed with reference to the modulation of function of 5-HT-1B receptor following the administration of exogenous agonist

Clonal dissemination of successful emerging clone mecA-MRSA t304/ST6 among humans and hedgehogs in the Helsinki metropolitan area in Finland

Methicillin-resistant Staphylococcus aureus (MRSA) carrying mecC gene (mecC-MRSA) is frequently reported among European hedgehogs (Europeaus erineaus) due to co-evolutionary adaptation to dermatophyte infection in European hedgehogs. The occurrence of MRSA in European hedgehogs in Finland is unknown. Consequently, we investigated the occurrence of MRSA in wild hedgehogs from urban Helsinki metropolitan area in 2020–2021 and applied whole genome sequencing (WGS) to further characterize the studied isolates and compared them with human clinical MRSA isolates. Altogether 115 dead hedgehogs were screened for MRSA using selective cultivation methods. Presumptive MRSA isolates were tested for antimicrobial susceptibility and confirmed MRSA isolates were further characterized by spa-typing and WGS. Hedgehog derived MRSA isolates were compared with clinical human MRSA isolates using core genome multilocus sequence typing (cgMLST). In total MRSA was recovered from 11 out of 115 (10%) hedgehogs. Among these four different spa types (t304; n = 4, t8835; n = 4, t5133; n = 2 and t622; n = 1) and three different sequence types (STs) (ST6; n = 6, ST7663; n = 4 and ST2840; n = 1) were identified. From the studied MRSA isolates seven harboured the mecA gene (mecA-MRSA) and four were identified as mecC-MRSA. All mecA-MRSA isolates carried immune evasion cluster genes, and one isolate was positive for Panton-Valentine leukocidin. cgMLST comparison revealed close genetic relatedness among three hedgehog and two human mecA-MRSA isolates all belonging to t304/ST6. Our results suggest a clonal dissemination of a successful MRSA clone among humans and hedgehogs. Further studies are warranted to investigate the sources and dissemination of such clone in urban environments. We observed a relatively low occurrence of mecC-MRSA in Finnish hedgehogs.Methicillin-resistant Staphylococcus aureus (MRSA) carrying mecC gene (mecC-MRSA) is frequently reported among European hedgehogs (Europeaus erineaus) due to co-evolutionary adaptation to dermatophyte infection in European hedgehogs. The occurrence of MRSA in European hedgehogs in Finland is unknown. Consequently, we investigated the occurrence of MRSA in wild hedgehogs from urban Helsinki metropolitan area in 2020–2021 and applied whole genome sequencing (WGS) to further characterize the studied isolates and compared them with human clinical MRSA isolates. Altogether 115 dead hedgehogs were screened for MRSA using selective cultivation methods. Presumptive MRSA isolates were tested for antimicrobial susceptibility and confirmed MRSA isolates were further characterized by spa-typing and WGS. Hedgehog derived MRSA isolates were compared with clinical human MRSA isolates using core genome multilocus sequence typing (cgMLST). In total MRSA was recovered from 11 out of 115 (10%) hedgehogs. Among these four different spa types (t304; n = 4, t8835; n = 4, t5133; n = 2 and t622; n = 1) and three different sequence types (STs) (ST6; n = 6, ST7663; n = 4 and ST2840; n = 1) were identified. From the studied MRSA isolates seven harboured the mecA gene (mecA-MRSA) and four were identified as mecC-MRSA. All mecA-MRSA isolates carried immune evasion cluster genes, and one isolate was positive for Panton-Valentine leukocidin. cgMLST comparison revealed close genetic relatedness among three hedgehog and two human mecA-MRSA isolates all belonging to t304/ST6. Our results suggest a clonal dissemination of a successful MRSA clone among humans and hedgehogs. Further studies are warranted to investigate the sources and dissemination of such clone in urban environments. We observed a relatively low occurrence of mecC-MRSA in Finnish hedgehogs.Peer reviewe

Effects of Nonpharmacological Interventions on Disruptive Vocalisation in Nursing Home Patients With Dementia—A Systematic Review

BackgroundVocally disruptive behaviour is a common and difficult to treat condition in older residents with dementia. The aim of this systematic review is to evaluate the efficacy of nonpharmacological interventions in its management in persons with dementia residing in a nursing home.MethodologyA systematic search was conducted using Ovid MEDLINE, CINAHL, and Cochrane databases and reference lists from relevant publications on various nonpharmacological approaches to manage vocally disruptive behaviour in nursing home residents. The method of appraisal was through the National Institutes of Health scoring for the Quality Assessment of controlled intervention studies. Inclusion criteria included residents of nursing homes over the age of 65 with dementia and disruptive vocalisation. Only randomised controlled trials published in English were included.ResultsA total of 5,606 articles were identified, which cover 501 trials, of which 23 were selected. There were fourteen studies observed to have an impact of clinical and statistical significance with interventions including (i) a multidimensional approach with different nonpharmacological interventions, (ii) multisensory stimulation, (iii) staff education and training, (iv) personalised bathing, and (v) pain recognition and appropriate management. Seven studies demonstrated no observable effect whereas two showed worsening in vocally disruptive behaviour.ConclusionsMany aspects of vocally disruptive behaviour management are poorly understood. Limited empirical evidence supports the use of several nonpharmacological interventions to reduce it. There is more robust evidence to support the use of a tailored approach to management over the universal approach