Nevin Manimala

Alzheimers Dement. 2021 Dec;17 Suppl 11:e051128. doi: 10.1002/alz.051128.

ABSTRACT

BACKGROUND: COVID-19 has placed an extraordinary and disproportionate level of responsibility and risk on certified nursing assistants (CNAs) caring for persons with dementia (PWD) relative to their training, resources, and compensation levels. Nearly one-quarter of COVID-19 deaths in the United States have been nursing home residents and staff. Despite providing the majority of direct care, CNAs are amongst the most under-resourced and under-trained frontline workers. Given their essentiality, it is critical to support CNAs during the COVID-19 pandemic. The purpose of this work is to provide CNAs with a space to strengthen their knowledge and confidence in caring for PWD. This pilot study applies a virtual reality (VR) curriculum to train CNAs regarding the lived experiences of PWD and their loved ones. The VR vignette portrays a Latinx woman, Beatriz, through progressive stages of Alzheimer’s disease.

METHOD: Chicago Methodist Senior Services (CMSS) CNAs were recruited (N=7; 86% female, 86% Black) for a seven-week online training program consisting of 1.5 hours per week. Each class included a didactic lecture and an Embodied Labs VR module depicting a first-person experience of dementia through a distributive model approach. The program concluded with two recorded focus groups. Participants completed the UCLA Geriatric Attitudes Scale, a dementia knowledge assessment, the Interpersonal Reactivity Index surveys, and a COVID-19 Impact questionnaire. Current analyses include qualitative content analysis for focus group data and descriptive, quantitative statistics for pre-and post-VR intervention surveys.

RESULT: Preliminary results demonstrate that CNAs endorsed a positive change in attitudes toward older adults (p=0.069), a deepened understanding of dementia, and increased confidence in caregiving skills. Focus groups allowed CNAs to discuss changes in resident behavior and support one another through a virtual platform during a global pandemic.

CONCLUSION: Combining traditional didactic lectures with VR-based curricula provided CNAs with foundational knowledge and first-hand experience of dementia pathology. Participants reported greater levels of insight and empathy for PWD. Future aims include expansion of training content to include end-of-life conversations, LGBTQIA aging, and Lewy body dementia.

PMID:34971052 | DOI:10.1002/alz.051128

Alzheimers Dement. 2021 Dec;17 Suppl 11:e052585. doi: 10.1002/alz.052585.

ABSTRACT

BACKGROUND: An estimated 44 million people worldwide live with Alzheimer’s disease and related dementias (ADRD). There is increasing interest in using emerging technologies such as robotics and artificial intelligence to provide assistance to people living with ADRD and their caregivers.

METHOD: We conducted an anonymous, online survey to study the public’s attitude and acceptance of using a human-like robot to assist people with ADRD. The survey was distributed via social media (e.g., Facebook, Twitter, LinkedIn), emails, and Listservs. Participants above age 18 were recruited to complete the survey. After informed consent, participants watched a brief (3 minute) video, which provided examples of how humanoid robots could be used to help people with ADRD. This was followed by questions, which took approximately 10 minutes to complete and assessed perceptions of the robot’s appearance and functions (e.g., companion, communication, providing entertainment, medication, emergence call). The participant could skip any questions that they do not wish to answer.

RESULT: Inputs to the survey were collected between November 13, 2020 and January 15, 2021. During that time, 1,004 people viewed the survey. The survey was started by 249 people from 16 different countries and districts (7 in Asia, 5 in Europe, 2 in North America, 1 in Oceania, and 1 in Africa). Ninety-seven people dropped out before finishing all the questions and 152 people completed the survey. Among the complete responses, 11 persons reported to have dementia and 79 people had experience in providing care to ADRD patients. Among a list of robot’s functions, reminding to take medicine, making emergency call, and helping to contact medical services were rated as the most important by participants with dementia. Monitoring medication and making emergency communication/alert were rated as the most important by participants with experience in dementia caregiving.

CONCLUSION: The study presents statistical results from an anonymous online survey that collect international inputs on the use of social robots in Alzheimer’s care. Results of the survey show an overall positive attitude towards using humanoid robots for people with ADRD. Results may shed insight for design and development of assistive technology in robotics and AI for ADRD.

PMID:34971041 | DOI:10.1002/alz.052585

Alzheimers Dement. 2021 Dec;17 Suppl 11:e052988. doi: 10.1002/alz.052988.

ABSTRACT

BACKGROUND: Conventional means for dementia diagnosis rely on qualitative tests usually administered after significant pathogenesis. Past studies suggest the utility of more quantitative analytical approaches such as handwriting/drawing tasks (Impedevo et al., 2018). Such tools would provide low-cost, portable, and instantaneous quantitative diagnostics for more efficient patient screening. However, efforts to realize these methods have faced challenges such as low sample size, incomplete feature extraction, and lack of task diversity. We attempted to create a tablet application that uses pen-tracking technology to surmount these challenges.

METHOD: As fine motor control provides fundamental markers of neurological health (Bisio et al., 2017; Thomas et al., 2017), rigorous statistical analysis of simple drawing tasks on a tablet permitted differentiation between neuronormative patients and dementia patients with high fidelity. We have started testing our data analysis pipeline with open access datasets: PaHaW (Drotár et al., 2016), Isuniba (Impedovo et al, 2013), ParkinsonHW (Isenkul et al., 2014). These datasets contain drawing data for healthy individuals and those with both dementia and other neurodegenerative diseases. They contain similar raw data that the in-house iPad app collects. From that raw data, we extracted predictive features, including velocity, acceleration, jerk, curvature, and measures of variation.

RESULT: We have successfully created an iPad app that is able to record the dynamic handwriting process with an Apple Pencil. Our platform has the potential to generate more standardized datasets with improved documentation compared to existing archives. Patients trace complex figures such as spirals and infinity symbols at varying speeds over multiple trials. Additionally, the subjects are asked to remember and draw a shape that was presented to them at the beginning of the test. The app collects key data such as the position of the pen tip, velocity of pen movement, pen angle relative to the surface, and pressure exerted on the surface.

CONCLUSION: We plan to deploy our in-house iPad app in clinical trials to collect pen-tracking data with which to facilitate differential diagnoses for neurodegenerative diseases afflicting Alzheimer’s and Parkinson’s patients. The validation of such a platform would improve upon existing diagnostic datasets and lower major barriers to dementia screening.

PMID:34971031 | DOI:10.1002/alz.052988

Alzheimers Dement. 2021 Dec;17 Suppl 11:e050149. doi: 10.1002/alz.050149.

ABSTRACT

BACKGROUND: People with dementia (PwD) often become lost, which is commonly attributed to spatial disorientation, one of the earliest symptoms of dementia, particularly of the Alzheimer’s disease type. Spatial disorientation can limit a person’s ability to navigate in an outdoor environment. As a result, PwD experience outdoor mobility decline, which, in turn, can have a negative impact on their cognitive functions. Thus, enabling safe outdoor mobility is important for dementia research. Artificial Intelligence (AI) methods in conjunction with Global Positioning System (GPS) data show great potential for supporting the outdoor mobility needs of PwD. The objective of this work is to evaluate the extent to which we can predict future destinations of PwD by learning from their past mobility habits.

METHOD: Eight cognitively-intact older adults (CTL) and seven older adults with dementia completed four weeks of GPS recording. Each participant’s stops and trips were extracted from their trajectories. We determined the predictability of each participant’s mobility patterns using three approaches. First, we assumed each stop is visited with equal probability, thus, disregarding temporal aspects of travel. Next, we built on the previous approach by including stop visitation probability, thus, capturing the heterogeneity of visitations. Finally, to capture the full spatiotemporal characteristics of mobility, we added in-depth temporal characteristics including the visitation frequency, the order in which the stops were visited, and the time spent at each stop.

RESULT: Relying solely on the spatial dimension of mobility yielded no predictive power across the two groups. Adding the heterogeneity of visitation patterns, we observed an increase in the predictability power; PwD displayed a trend toward higher predictability compared to the CTLs, but the student’s t-test did not reach statistical significance (0.833±0.085vs.0.768±0.029, t(13)=-2.06, p=0.06; d=-1.07). Finally, relying on full spatiotemporal characteristics, a 4-week record of mobility patterns displayed 95% (SD=2%) and 92% (SD=1%) predictability among PwD and CTLs, respectively. This value was significantly higher among PwD, t(13) = -3.39, p<.01; d=-1.75.

CONCLUSION: Our findings offer new perspectives on the predictive mobility models based on GPS data and AI that can be used to provide personalized assistance for outdoor navigation of people with dementia.

PMID:34971030 | DOI:10.1002/alz.050149

Neuro Endocrinol Lett. 2021 Nov 30;42(7). Online ahead of print.

ABSTRACT

OBJECTIVES: The main aim of this study was to analyse selected biomechanical aspects of the asymmetrical loading of the human postural system when riding the C1 speed canoe and their influence on the development of muscular imbalances.

METHODS: 3D kinematic analysis of a simulated forward stroke of the canoeist in a pool with a counter-current (N = 9) and analysis of MRI data with selected individuals (N = 5), videoanalysis of actual paddling top athletes (N = 12), the kinesiological analysis of movement.

RESULTS: Can be stated that when riding a C1 speed canoe the postural system is exposed to two types of asymmetric loading. In the first place, there is lateral asymmetry, which stems from the very nature of the one-sided paddling on this type of vessel. The canoeist has to compensate for the consequent instability by shifting the body’s centre of gravity higher above the kneeling lower limb. This effect is achieved by the so-called pelvic lateralisation from the paddling side and by this side’s skewing to the kneeling lower limb. Another asymmetry is connected to the forward-backward body movement and its time-dependent deviation from the neutral posture. A significant disproportion between generally fixation movements of the lower part of the body and phasic movements of the upper part of the body has been confirmed. These asymmetrical positions result in a significant unilateral overloading of the quadratus lumborum on the side of the supporting lower limb (side without the paddle), as well as an overloading of the spine straighteners in the lumbar area, in particular on the part of a supporting lower limb, and bilateral yet asymmetric overloading of m. iliopsoas, which in addition takes place in different isometries. The analysis of MRI data indicates that, during longitudinal training, lateral disproportion in the volume and intensity of postural system loading is the cause of different cross sections of the iliopsoas muscle and quadratus lumborum muscle on the side of the kneeling and supporting lower limbs. With both muscles, larger cross sections with a statistical significance level α = 0.05 and thus also strength on the side of the supporting lower limb can be expected.

CONCLUSION: When canoeing on the C1, a significant unilateral overloading occurs with m. quadratus lumborum on the part of the supporting lower limb (side without paddle). Furthermore, spine straighteners in the lumbar area are overloaded, in particular in the part of the supporting lower limb. Last but not least however, the bilateral asymmetric overloading of m. iliopsoas occurs.

PMID:34969187

Int J Dev Neurosci. 2021 Dec 30. doi: 10.1002/jdn.10167. Online ahead of print.

ABSTRACT

Moyamoya disease (MMD) is a rare, progressive cerebrovascular disorder, with an unknown etiology and pathogenesis. It is characterized by steno-occlusive changes at the terminal portion of the internal carotid artery (ICA), which is accompanied by variable development of the basal collaterals called moyamoya vessels. In this study, we investigate the potential for structural T1 magnetic resonance imaging (MRI) to help characterize MMD clinically, with the help of regionally distributed relative signal intensities (RRSIs) and volumes (RRVs). These RRSIs and RRVs provide the ability to characterize aspects of regional brain development and represent an extension to existing automated biomarker extraction technologies. This study included 269 MRI examinations from MMD patients and 993 MRI examinations from neurotypical controls, with regional biomarkers compared between groups with the area under the receiver operating characteristic curve (AUC). Results demonstrate abnormal presentation of RRSIs and RRVs in the insula (15-20 year old cohort, left AUC: 0.74, right AUC: 0.71), and the lateral orbitofrontal region (5-10 year old cohort, left AUC: 0.67; 15-20 year cohort, left AUC: 0.62, right AUC: 0.65). Results indicate that RRSIs and RRVs may help in characterizing brain development, assist in the assessment of the presentation of the brains of children with MMD, and may help overcome standardization challenges in multi-protocol clinical MRI. Further investigation of the potential for RRSIs and RRVs in clinical imaging is warranted and supported through the release of open source software.

PMID:34969179 | DOI:10.1002/jdn.10167

Psych J. 2021 Dec 30. doi: 10.1002/pchj.509. Online ahead of print.

ABSTRACT

There is a limited number of studies on the impact of mindfulness-based interventions on university students and their positive effect on collective experiences of shared flow. The aim of the present study was to explore the effectiveness of mindfulness training in terms of reducing stress and enhancing well-being, experiences of shared flow and classroom climate (engagement and affiliation). The intervention and control groups were matched by age and sex (n = 125; M = 20.71, SD = 4.60, 68% women). The intervention group comprised mindfulness exercises performed in the classroom over the course of 7 weeks. The principal variables were measured at pretest and posttest, and shared flow was also measured in the intervention group. In comparison with the control group, statistically significant differences were observed in the intervention group in relation to mindfulness, perceived stress, and classroom climate (affiliation). Furthermore, the perception of shared flow among students increased from the beginning to the end of the program. Mindfulness skills were found to mediate improvements in perceived well-being and stress. It is concluded that mindfulness practice can turn learning into a challenging and shared task. The study highlights the importance of fostering programs that enhance the development of competencies related to mindfulness among university students.

PMID:34969176 | DOI:10.1002/pchj.509

J Community Psychol. 2021 Dec 30. doi: 10.1002/jcop.22782. Online ahead of print.

ABSTRACT

The relative homogeneity in ethnicity and language of native Koreans and their highly competitive lifestyle, especially among adolescents preparing for college, have limited their solidarity with heterogeneous ethnic groups, which may cause problems in this global era. This study uses the Korean Children and Youth Panel Survey to explore the relationships among multicultural receptivity, sense of community, and self-esteem for Korean adolescents over three time points. For this purpose this study conducted an autoregressive cross-lagged path analysis, controlling for covariates such as gender, parenting style, peer attachment, and satisfaction with academic achievement. The cross-lagged effects on each other of self-esteem and sense of community were positive over time. The cross-lagged effects on each other of multicultural receptivity and self-esteem were not statistically significant. The results were less symmetrical for the third pairing: the effects of multicultural receptivity on sense of community were consistently positive, but the effects of sense of community on multicultural receptivity were not statistically significant. To enhance the sense of community, promoting multicultural receptivity and self-esteem would therefore show good results.

PMID:34969149 | DOI:10.1002/jcop.22782

Neurourol Urodyn. 2021 Dec 30. doi: 10.1002/nau.24856. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess changes in voiding phase, especially urethral resistance after post-prostatectomy urinary incontinence (PPI) treatment with the Adjustable TransObturator Male System (ATOMS).

MATERIAL AND METHODS: A longitudinal prospective study was performed on 45 men treated with ATOMS for PPI, with the intention to evaluate the changes produced by the implant on the voiding phase. Patients with preoperative urodynamic study were offered postoperative urodynamic evaluation, and both studies were compared. The following urodynamic date were evaluated: maximum voiding detrusor pressure, detrusor pressure at maximum flow rate, maximum flow rate (Qmax), voiding volume, post-void residue, bladder outlet obstruction index (BOOI), urethral resistance factor (URA), and bladder contractility index (BCI). The statistical analysis used were the mean comparison test for dependent groups (Student’s t test) for parametric variables and the Wilcoxon test for non-parametric variables. The signification level was set at 95% bilateral.

RESULTS: A total of 37 patients (82.2%) used zero pads/day at the time of urodynamic postoperative evaluation and pad-test evolved from 592 ± 289 ml baseline to 25 ± 40 ml (p = 0.0001). Significant differences were observed in Qmax (15 ± 8.3 before and 11 ± 8.3 after surgery; p = 0.008), voiding volume (282 ± 130.7 before and 184 ± 99.92 after surgery). BOOI (-12 ± 23.9 before and -2 ± 21.4 after surgery; p = 0.025) and BCI (93 ± 46.4 before and 76 ± 46.0 after surgery; p = 0.044). In no case did we observe postoperative bladder outlet obstruction, according to URA parameter below 29 cm H₂ O in all cases. There was not a significant variation either in post-void urinary residual volume (15 ± 47.4 before and 14 ± 24.2 after surgery, p = 0.867).

CONCLUSIONS: The ATOMS implant induces a decrease of Qmax, voided volume, and bladder contractility and an increase of BOOI. However, our findings suggest that ATOMS device does not cause bladder outlet obstruction.

PMID:34969148 | DOI:10.1002/nau.24856

Int J Pharm Pract. 2021 Dec 30:riab076. doi: 10.1093/ijpp/riab076. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess antibiotic dispensing knowledge and practice among dispensing staff who may or may not have a formal pharmacy qualification working in pharmacies near teaching hospitals in Kathmandu Valley, Nepal.

METHODS: A face-to-face cross-sectional study was conducted among 220 dispensing staff. The data were analysed using SPSS 20 to measure descriptive statistics and logistic regressions.

KEY FINDINGS: Among 220 participants, half of them (50.0%) had inadequate knowledge and slightly less than half of the participants (46.4%) had poor antibiotics dispensing practices.

CONCLUSIONS: The government authority should develop and implement a plan for continuous professional education programmes and frequent monitoring of pharmacies to address inadequate antibiotic dispensing knowledge and poor practice.

PMID:34969084 | DOI:10.1093/ijpp/riab076