Effect of Variable Activities on the Engagement of Memory Care Patients

Background and Objectives: Studies demonstrate that social activities (e.g., church attendance, recreation, and group activities), productive activities (e.g., gardening, preparing meals, and shopping), and fitness activities (e.g., sports, walking, and exercise) are independently associated with survival of elderly persons even after functional disability. The Heritage Community of Kalamazoo focuses on activities such as bible study, music, pet therapy, and modified volleyball exercises to provide and maintain residents’ spiritual appreciation, cognitive abilities, and quality of life. The purpose of the project is to identify any strengths and weaknesses in activity programming for memory care residents at Heritage Community through observation and reflection of resident engagement. Furthermore, ongoing student interaction with the residents provides the organization with the opportunity to reflect upon their experiences on how to better communicate with geriatric and dementia populations. Methods: Five medical students investigated the engagement of Heritage Community memory care residents in various activities from July 2016 to December 2016. Students attended organized activities at Amber Place twice per month for two hours per session. Activities include devotions, dog visits, and modified volleyball games involving hitting a balloon. During each session, students observed residents as they participated in the day’s activities and recorded their observations. Student reflections were compiled to identify common themes between activities and attitudes. Results: Analysis of reflection notes demonstrate that most activities were effective in engaging residents with varying success. Activity effectiveness tended to vary by activity and day. It was not uncommon for residents to join and subsequently leave activities. Sometimes residents were not eager to engage initially, but with some persuasion and discussion, sat quietly and eventually participated. Activities involving music, singing, and devotions evoked general engagement. Residents enjoyed repetitive activities, such as dog visits and balloon games. However, residents most commonly lost interest in the balloon games during the activity. Conclusions: Overall, Heritage Community utilizes effective activities to maintain a stimulating environment for memory care residents. Residents appreciated activity consistency and commonly recognized when activities would occur. Study limitations included the inability to measure activity effectiveness across differing days of the week, as well as limited sample size. There are numerous opportunities for further research into resident engagement and activity programming at Heritage Community. Activity impact on resident engagement and emotional health is a particularly important area to direct further research with quantitative measures

Reconstructing the Deep Population History of Central and South America

We report genome-wide ancient DNA from 49 individuals forming four parallel time transects in Belize, Brazil, the Central Andes, and the Southern Cone, each dating to at least 9,000 years ago. The common ancestral population radiated rapidly from just one of the two early branches that contributed to Native Americans today. We document two previously unappreciated streams of gene flow between North and South America. One affected the Central Andes by 4,200 years ago, while the other explains an affinity between the oldest North American genome associated with the Clovis culture and the oldest Central and South Americans from Chile, Brazil, and Belize. However, this was not the primary source for later South Americans, as the other ancient individuals derive from lineages without specific affinity to the Clovis-associated genome, suggesting a population replacement that began at least 9,000 years ago and was followed by substantial population continuity in multiple regions

A Year in Review: Clarifying the State of Chronic Traumatic Encephalopathy Research in 2016

Introduction: Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease associated with repeated mild traumatic brain injury. In the past decade, CTE has raised concern regarding safety in athletics and has been subject to intense media coverage. The medical and lay community continue to debate its impact as it pertains to athletics, military trauma, and domestic abuse. Despite newfound focus in recent years, fundamental knowledge gaps persist in understanding CTE. Purpose: To better understand the state of current CTE research, we performed a systematized review of publications from 2016. The study clarifies the manner in which CTE research has evolved over time, distinguishes the various areas of research as of 2016, and identifies knowledge gaps requiring further investigation. Methods: We completed a PubMed search with MeSH terms Chronic Traumatic Encephalopathy and CTE on publications released after January 1st, 2016. The search places priority on articles considered to have had the most impact in the past year based on their number of times cited and impact factor. The various papers are organized into categories based on their primary focus: Cellular and Molecular Mechanisms, Pathology and Pathophysiology, Antemortem Diagnosis, Suicide, Risk and Protective Factors, Review articles, and Controversy and Challenges in the diagnosis of CTE. Results: After applying inclusion criteria, 136 articles were identified and categorized. Efforts to identify impact articles from the overall search cohort are ongoing as of abstract submission in order to avoid study exclusion. Search results demonstrate the breadth of ongoing research and the areas in which researchers made particularly notable achievements in 2016. Of greatest note, a NINDS/NIBIB consensus panel (McKee et al. 2016) published a series of studies to standardize neuropathological criteria for post-mortem diagnosis of CTE and to distinguish CTE from other neurodegenerative tauopathies. Furthermore, significant research was published in the above categories including the development of biomarkers for antemortem diagnosis of CTE and the impact of cognitive reserve on the progression of symptomatic disease. Discussion: Despite increased awareness of CTE in the medical community, debate continues over the underlying pathogenic mechanism and its status as its own entity rather than as a subset of another neurodegenerative disease. A knowledge gap exists in the ability to make a definitive antemortem diagnosis of CTE and requires further research. Overall, this review accomplishes its primary aims of clarifying the state of current CTE research and identifying areas for future direction

Whole-genome sequencing reveals host factors underlying critical COVID-19

Altres ajuts: Department of Health and Social Care (DHSC); Illumina; LifeArc; Medical Research Council (MRC); UKRI; Sepsis Research (the Fiona Elizabeth Agnew Trust); the Intensive Care Society, Wellcome Trust Senior Research Fellowship (223164/Z/21/Z); BBSRC Institute Program Support Grant to the Roslin Institute (BBS/E/D/20002172, BBS/E/D/10002070, BBS/E/D/30002275); UKRI grants (MC_PC_20004, MC_PC_19025, MC_PC_1905, MRNO2995X/1); UK Research and Innovation (MC_PC_20029); the Wellcome PhD training fellowship for clinicians (204979/Z/16/Z); the Edinburgh Clinical Academic Track (ECAT) programme; the National Institute for Health Research, the Wellcome Trust; the MRC; Cancer Research UK; the DHSC; NHS England; the Smilow family; the National Center for Advancing Translational Sciences of the National Institutes of Health (CTSA award number UL1TR001878); the Perelman School of Medicine at the University of Pennsylvania; National Institute on Aging (NIA U01AG009740); the National Institute on Aging (RC2 AG036495, RC4 AG039029); the Common Fund of the Office of the Director of the National Institutes of Health; NCI; NHGRI; NHLBI; NIDA; NIMH; NINDS.Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care or hospitalization after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes-including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)-in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease