Jeff Radel

Perspectives of People with Dementia About Meaningful Activities: A Synthesis.

Qualitative studies were synthesized to describe perspectives of people with dementia regarding meaningful activities. Themes of connectedness were identified using a meta-ethnography approach. The theme of being connected with self encompasses engagement for continuity, health promotion, and personal time. The theme of being connected with others includes being with others not to feel alone, doing an activity with others, and meaningful relationships. The theme of being connected with the environment encompasses being connected to one’s familiar environment, community, and nature. This synthesis suggests that connectedness is an important motivation for engagement in daily activities. Findings indicate that identifying the underlying motivation for an individual with dementia to engage in different activities is important for matching a person with activities that will be satisfying. This review may inform the development of interventions for engaging people with dementia in meaningful, daily activities and creating connectedness to self, others, and the environment.

Honokiol inhibits pathological retinal neovascularization in oxygen-induced retinopathy mouse model

Aberrant activation of the hypoxia inducible factor (HIF) pathway is the underlying cause of retinal neovascularization, one of the most common causes of blindness worldwide. The HIF pathway also plays critical roles during tumor angiogenesis and cancer stem cell transformation. We have recently shown that honokiol is a potent inhibitor of the HIF pathway in a number of cancer and retinal pigment epithelial cell lines. Here we evaluate the safety and efficacy of honokiol, digoxin, and doxorubicin, three recently identified HIF inhibitors from natural sources. Our studies show that honokiol has a better safety to efficacy profile as a HIF inhibitor than digoxin and doxorubicin. Further, we show for the first time that daily intraperitoneal injection of honokiol starting at postnatal day (P) 12 in an oxygen-induced retinopathy (OIR) mouse model significantly reduced retinal neovascularization at P17. Administration of honokiol also prevents the oxygen-induced central retinal vaso-obliteration, characteristic feature of the OIR model. Additionally, honokiol enhanced physiological revascularization of the retinal vascular plexuses. Since honokiol suppresses multiple pathways activated by HIF, in addition to the VEGF signaling, it may provide advantages over current treatments utilizing specific VEGF antagonists for ocular neovascular diseases and cancers.

Inpatient Rehabilitation Outcomes of Patients With Apraxia After Stroke

Abstract Background: Stroke-induced paresis commands much attention during rehabilitation; other stroke-related consequences receive less consideration. Apraxia is a stroke disorder that may have important implications for rehabilitation and recovery. Objective: To investigate association of apraxia with stroke rehabilitation outcomes during inpatient rehabilitation. Methods: This cohort study compared patients with and without apraxia after a first left hemispheric stroke. All study patients received standard of care. Clinical measures were the Functional Independence Measure (FIM) and the upper extremity section of the Fugl-Meyer Assessment (FMA) administered upon admission and at discharge. Length of stay was also documented. Florida Apraxia Battery subtests were used to classify patients with apraxia. Results: Fifteen patients were included in this study, 10 of whom had apraxia. Data analysis revealed that patients with apraxia exhibited improvement from admission to discharge in clinical measures; however, admission FIM score was significantly lower compared to patients without apraxia. There was no statistically significant difference between groups on FMA score, length of stay, or amount of change on clinical measures. Conclusions: This study of acute patients found those with apraxia to be significantly less independent upon admission to inpatient rehabilitation compared to patients without apraxia. Although both groups improved a similar amount during rehabilitation, patients with apraxia discharged at a level of independence comparable to patients without apraxia upon admission. Such disparity in independence is of concern, and apraxia as a factor in stroke rehabilitation and recovery deserves further attention.

The Benefits of Individualized Leisure and Social Activity Interventions for People with Dementia: A Systematic Review

This systematic review describes the benefits of individualized leisure and social activity interventions for people with dementia (aim 1), how these interventions were individually tailored (aim 2), and what recommendations or suggestions can be made for these interventions and further studies (aim 3). Thirty-two included studies were organized into four categories based on how the intervention was individually tailored. These categories include: (1) performance factors; (2) self-identity; (3) music preference; and (4) life experiences and past memories. The authors discuss suggestions and benefits by synthesizing the finding of the included studies in each category.

Spousal Caregiver Perspectives on a Person-Centered Social Program for Partners With Dementia

This qualitative study explored spousal caregiver perspectives on the experience and impact of a person-centered social program for partners with dementia. Interviews with 5 caregivers and the spouses with dementia were conducted 7 to 8 months after the program ended to explore the sustained impact of the program. Interpretative phenomenological analysis was used to support in-depth exploration of interviews. Three themes emerged including benefits of the program for caregivers, initial expectations and later perspectives of caregivers about the program, and conflicting values and perspectives between caregivers and the spouses. These findings suggest participation in a person-centered social program by people with dementia benefits their caregivers, by meeting the caregivers’ desire for their spouses to increase social participation and engagement in meaningful activities. Participation in the program provided a sustained benefit to one couple in particular, by encouraging the caregiver to resume arranging activities the couple once enjoyed but now had difficulty pursuing.

The Benefits of a Person-Centered Social Program for Community-Dwelling People with Dementia: Interpretative Phenomenological Analysis

ABSTRACT This qualitative study aimed to explore the experience and impact of a person-centered social program for community-dwelling people in earlier stages of dementia. Semi-structured interviews with five people with dementia and their spouses were conducted seven to eight months after the program ended to assess persistence of the program’s impact on people with dementia. An interview with each person with dementia went deeper and further, based on each person’s salient experiences, having personally significant meaning and emotion. The present study used interpretative phenomenological analysis to support in-depth analysis of a small number of cases. Three main themes emerged for persons with dementia: (1) Participation in activities supporting self-identity; (2) The value of newly established intergenerational relationships; and (3) Empowerment (choice and control) and the student partner’s attitude. These findings fill a gap in the literature, by demonstrating how a person-centered social program was experienced by and benefited community-dwelling people with dementia.

Reliability and validity of a motion-based reaction time assessment using a mobile device

Abstract Information processing speed is often altered following a concussion. Few portable assessments exist to evaluate simple reaction time (SRT) in hospitals and clinics. We evaluated the use of a SRT application for mobile device measurement. 27 healthy adults (age = 30.7 ± 11.5 years) completed SRT tests using a mobile device with Sway, an application for SRT testing. Participants completed computerized SRT tests using the Computerized Test of Information Processing (CTIP). Test–retest reliability was assessed using intraclass correlation coefficients (ICC) between Sway trials. Pearson correlations and Bland-Altman analyses were used to assess criterion validity between Sway and CTIP means. ICC comparisons between Sway tests were all statistically significant. ICCs ranged from 0.84–0.90, with p-values <.001. A one-way analysis of variance (ANOVA) revealed no significant differences between trials (F3,104 =  1.35, p = .26. Pearson correlation between Sway and CTIP outcomes yielded a significant correlation (r = 0.59, p = .001). The mean difference between measurement methods was 43.7 ms, with limits of agreement between −140.8–53.4 ms. High ICC indicates Sway is a reliable method to assess SRT. A strong correlation and clinically acceptable agreement between Sway and the computer-based test indicates that Sway is suited for rapid administration of SRT testing in healthy individuals. Future research using Sway to assess altered information processing in a population of individuals after concussion is warranted.