Progression of Alzheimer dementia (AD) is highly variable. Most estimates derive from convenience samples from dementia clinics or research centers where there is substantial potential for survival ...bias and other distortions. In a population-based sample of incident AD cases, we examined progression of impairment in cognition, function, and neuropsychiatric symptoms, and the influence of selected variables on these domains.
Longitudinal, prospective cohort study.
Cache County (Utah).
Three hundred twenty-eight persons with a diagnosis of possible/probable AD.
Mini-Mental State Exam (MMSE), Clinical Dementia Rating sum-of-boxes (CDR-sb), and Neuropsychiatric Inventory (NPI).
Over a mean follow-up of 3.80 (range: 0.07-12.90) years, the mean (SD) annual rates of change were -1.53 (2.69) scale points on the MMSE, 1.44 (1.82) on the CDR-sb, and 2.55 (5.37) on the NPI. Among surviving participants, 30% to 58% progressed less than 1 point per year on these measures, even 5 to 7 years after dementia onset. Rates of change were correlated between MMSE and CDR-sb (r = -0.62, df = 201, p < 0.001) and between the CDR-sb and NPI (r = 0.20, df = 206, p < 0.004). Female subjects (LR χ = 8.7, df = 2, p = 0.013) and those with younger onset (likelihood ratio LR χ = 5.7, df = 2, p = 0.058) declined faster on the MMSE. Although one or more apolipoprotein E ε 4 alleles and ever use of FDA-approved antidementia medications were associated with initial MMSE scores, neither was related to the rate of progression in any domain.
A significant proportion of persons with AD progresses slowly. The results underscore differences between population-based versus clinic-based samples and suggest ongoing need to identify factors that may slow the progression of AD.
While sprint interval training (SIT) is time-efficient and can elicit meaningful health benefits among adults who are insufficiently active, one major drawback is that people can find it to be ...unpleasant. Consequently, researchers have begun to investigate the use of music to enhance people’s pleasure during SIT. Presently, little is known about the application of music to SIT protocols designed for insufficiently active individuals.
To investigate the psychological (affective valence, arousal, enjoyment), psychophysical (perceived exertion), and physiological (heart rate HR, power output) effects of researcher-selected motivational music during a low-volume SIT protocol performed by insufficiently active adults.
Using a randomized, fully-counterbalanced design, 24 insufficiently active adults (12 women, 12 men; 24.08 ±4.61 years) inexperienced with SIT completed three SIT trials (3 × 20-s “all-out” sprints with 2-min recovery periods) under different conditions: motivational music, podcast control, no-audio control.
Post-exercise enjoyment was greater in the music condition (M = 89.58 ± 17.33) compared to podcast (M = 83.92 ± 19.49; p = .04, ηp2 = 0.18) and no-audio (M = 85.28 ± 17.92; p = .04, ηp2 = 0.17) controls. Over the course of the SIT trial, HR responses were elevated in the music condition in comparison to the podcast (p = .02, ηp2 = 0.23) and no-audio (p = .03, ηp2 = 0.21) controls, and peak power output was higher in the music condition when compared to the podcast (p = .02, ηp2 = 0.23) and no-audio (p = .01, ηp2 = 0.25) controls. Affective responses over the course of the SIT trial were more positive in the music condition when compared to the no-audio control (p = .03, ηp2 = 0.18), and tended to be more positive in the music condition when compared to the podcast control (p = .11, ηp2 = 0.11). Moreover, a rebound toward more positive affect was observed post-exercise in all conditions.
The application of music during SIT has the potential to enhance feelings of pleasure, improve enjoyment, and elevate performance of SIT for adults who are insufficiently active, which may ultimately lead to better adherence to this type of exercise.
•Motivational music enhanced affect and enjoyment of sprint interval training (SIT).•Heart rate and peak power output were elevated during SIT in the music condition.•Perceived exertion was similar across music, podcast, and no-audio SIT conditions.•Participants liked, and were motivated by, the researcher-selected music during SIT.
This paper presents a systematic literature review on the impact of the neighborhood physical environment on mobility and social participation among people using mobility assistive technology (MAT). ...Peer-reviewed articles from eight databases published in French or English from 1990 to 2016 were searched. Thirty studies were included in this review. Factors related to neighborhood environmental features, mobility in transit, and accessibility of homes and public buildings influenced mobility and social participation of MAT users. The majority of reviewed studies combined different types of MAT, which made the interpretation of the results challenging. Few studies included walker, cane, and crutch users. Definitions of mobility and social participation lacked consistency and were often simplistic. Future empirical research needs to examine the impact of neighborhood physical environment factors separately for different MAT users. Causality and links between mobility and social participation of different MAT users at the neighborhood level should be further explored.
Introduction
Individual attributes including disability and sex/gender have the potential to intersect and determine the likelihood of unmet workplace support needs. Our study compares unmet ...workplace support needs between workers with and without a disability, and according to disability type and sex/gender differences.
Methods
Workers with (n = 901) and without (n = 895) a disability were surveyed to examine their need and use of workplace supports including job accommodations, work modifications and health benefits. A multivariable logistic model was conducted to examine the relationship between disability status, disability type and sex/gender and unmet workplace support needs. The model included interaction terms between sex/gender × physical disability, sex/gender × nonphysical disability, and sex/gender × physical and nonphysical disability.
Results
Among participants with a disability, 24% had a physical disability, 20% had a nonphysical disability (e.g., cognitive, mental/emotional or sensory disability) and 56% had both physical and nonphysical disability. Over half of the respondents were women (56%). Results from the multivariable model showed that nondisabled women were more likely to report unmet workplace support needs when compared to nondisabled men (odds ratio OR = 1.54, 95% confidence interval CI, 1.13–2.10). Findings also showed an intersection between the number and type of disability and sex/gender; women with both a physical and nonphysical disability had the greatest likelihood of reporting unmet workplace support needs when compared to nondisabled men (OR = 2.73; 95% CI, 1.83–4.08).
Conclusions
Being a woman and having one or more disabilities can determine unmet workplace support needs. Strategies to address workplace support needs should consider the intersection between disability and sex/gender differences.
Infant cries evoke powerful responses in parents
. Whether parental animals are intrinsically sensitive to neonatal vocalizations, or instead learn about vocal cues for parenting responses is ...unclear. In mice, pup-naive virgin females do not recognize the meaning of pup distress calls, but retrieve isolated pups to the nest after having been co-housed with a mother and litter
. Distress calls are variable, and require co-caring virgin mice to generalize across calls for reliable retrieval
. Here we show that the onset of maternal behaviour in mice results from interactions between intrinsic mechanisms and experience-dependent plasticity in the auditory cortex. In maternal females, calls with inter-syllable intervals (ISIs) from 75 to 375 milliseconds elicited pup retrieval, and cortical responses were generalized across these ISIs. By contrast, naive virgins were neuronally and behaviourally sensitized to the most common ('prototypical') ISIs. Inhibitory and excitatory neural responses were initially mismatched in the cortex of naive mice, with untuned inhibition and overly narrow excitation. During co-housing experiments, excitatory responses broadened to represent a wider range of ISIs, whereas inhibitory tuning sharpened to form a perceptual boundary. We presented synthetic calls during co-housing and observed that neurobehavioural responses adjusted to match these statistics, a process that required cortical activity and the hypothalamic oxytocin system. Neuroplastic mechanisms therefore build on an intrinsic sensitivity in the mouse auditory cortex, and enable rapid plasticity for reliable parenting behaviour.
The purpose of this study was to test a partnered, self-determination theory-informed mobile health intervention called SCI Step Together, using an 8-week randomized controlled trial design. The aim ...of SCI Step Together is to increase the quantity and quality of physical activity (PA) among adults with spinal cord injury (SCI) who walk. The SCI Step Together program provides PA modules and PA self-monitoring tools and facilitates peer and health coach support. Process, resource, management, and scientific feasibility were assessed, and participants completed questionnaires at baseline, mid-, and postintervention to assess determinants and outcomes of PA. Interviews were conducted to evaluate acceptability. Results suggest that the program demonstrated good feasibility, acceptability, and engagement. The intervention group (n = 11) had greater fulfillment of basic psychological needs and knowledge (p = .05) than the control group (n = 9). There were no significant interaction effects for other outcomes. The SCI Step Together program is feasible and acceptable and efficacious for improving some psychosocial variables. Results may inform SCI mobile health programs.
Type II hybrid effectiveness-implementation trial protocol.
To (1) evaluate the implementation of coordinated physical activity (PA) coaching delivered by physiotherapists and spinal cord injury ...(SCI) peers during the transition from in-hospital care to living in a community (implementation objective) and (2) assess the effect of coaching on PA behaviour and psychosocial predictors among people with SCI (effectiveness objective).
Rehabilitation hospital and home/community settings in British Columbia, Canada.
Implementation objective: PA coaches (physiotherapists and SCI peers) receive an implementation intervention including training, monitoring, feedback, and champion support. A Theoretical Domains Framework-based questionnaire is collected at baseline, post-training, 2, and 6 months follow-up and semi-structured interviews conducted at 6 months. Effectiveness objective: Using a quasi-experimental design, 55 adults with SCI are allocated to intervention (PA coaching, n = 30) or control (usual care, n = 25) groups. Participants in the intervention group are referred by physiotherapists to receive 11 SCI peer-delivered PA coaching sessions in the community. Control participants received usual care. Questionnaires assessing PA behaviour and psychosocial predictors are administered at baseline, 2-months, 6-months, and 1-year. Semi-structured interviews are conducted to assess intervention satisfaction at 6 months. Analyses include one-way (implementation objective) and two-way (effectiveness objective) repeated measures ANCOVAs for questionnaire-reported outcomes and thematic content analysis for interview data. Data are summarised using the reach effectiveness adoption implementation maintenance (RE-AIM) framework.
The University of British Columbia Clinical Research Ethics Board approved the protocol (#H19-02694), clinicaltrials.gov registration NCT04493606. Documentation of the adoption process will inform implementation in future sites.
Vascular smooth muscle cell (VSMC) differentiation is an essential component of vascular development. These cells perform biosynthetic, proliferative, and contractile roles in the vessel wall. VSMCs ...are not terminally differentiated and are able to modulate their phenotype in response to changing local environmental cues. There is clear evidence that alterations in the differentiated state of the VSMC play a critical role in the pathogenesis of atherosclerosis and intimal hyperplasia, as well as in a variety of other major human diseases, including hypertension, asthma, and vascular aneurysms. The focus of this review is to provide an overview of the current state of knowledge of molecular mechanisms involved in controlling phenotypic switching of SMCs, with particular focus on examination of signaling pathway that regulate this process.
Purpose: To test the hypothesis among people with spinal cord injury (SCI) that greater fulfillment of peer support needs to be associated with greater participation and life satisfaction. A ...secondary objective was to identify characteristics of people in great need of SCI peer support. Method: The participants consisted of a population-based sample of 1549 adults with SCI. The participants completed a survey with questions on peer support, participation, life satisfaction and provided demographic and SCI-related information. A secondary analysis of cross-sectional survey data was conducted. A set of regression analyses tested the primary purpose and a partition analysis was conducted to examine the secondary objective. Results: In regression analyses, peer support need fulfillment was positively associated with autonomous-outdoors participation (p < 0.05), health participation (p < 0.05), and work/education participation (p < 0.05), as well as life satisfaction (p < 0.001) after controlling demographic and SCI-related variables. However, peer support need fulfillment was not related with overall participation or other subdomains of participation: autonomy indoors, social relationships and family role. The number of unmet SCI-related needs, injury characteristics and education were associated with fulfillment of SCI peer support needs. Conclusions: The results provide some evidence that SCI peer support plays an important role in promoting participation and life satisfaction. Individuals with many SCI-related unmet needs are most likely to report a need for peer support.
Implications for Rehabilitation
The receipt of peer support after a spinal cord injury (SCI) is positively related to aspects of social participation and life satisfaction.
Provision of peer support can play an important role in the SCI rehabilitation process.
Education, injury-related characteristics, and the number of other unmet needs are factors that rehabilitation professionals can use to identify those in particular need of peer support.
Rehabilitation professionals should encourage patients who have sustained an SCI, to participate in peer support programs.
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