Lu Hu

Usability of a Wearable Camera System for Dementia Family Caregivers

Health care providers typically rely on family caregivers (CG) of persons with dementia (PWD) to describe difficult behaviors manifested by their underlying disease. Although invaluable, such reports may be selective or biased during brief medical encounters. Our team explored the usability of a wearable camera system with 9 caregiving dyads (CGs: 3 males, 6 females, 67.00 ± 14.95 years; PWDs: 2 males, 7 females, 80.00 ± 3.81 years, MMSE 17.33 ± 8.86) who recorded 79 salient events over a combined total of 140 hours of data capture, from 3 to 7 days of wear per CG. Prior to using the system, CGs assessed its benefits to be worth the invasion of privacy; post-wear privacy concerns did not differ significantly. CGs rated the system easy to learn to use, although cumbersome and obtrusive. Few negative reactions by PWDs were reported or evident in resulting video. Our findings suggest that CGs can and will wear a camera system to reveal their daily caregiving challenges to health care providers.

A New Measure of Research Participant Burden: Brief Report

Effective conceptualizations of research burden should address indirect burdens related to research duration, intensity, and invasiveness. Introducing the concept of perceived research burden, we developed, tested, and validated a new instrument, the Perceived Research Burden Assessment (PeRBA). Initial psychometric evaluation of PeRBA reveals good internal consistency, evidence of face validity, and acceptable convergent and discriminant validity.

The SELF Trial: A self-efficacy based behavioral intervention trial for weight-loss maintenance

The SELF Trial examined the effect of adding individual self‐efficacy (SE) enhancement sessions to standard behavioral weight loss treatment (SBT).

Wearable Technology to Garner the Perspective of Dementia Family Caregivers

Family caregivers of individuals with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. The current article describes a prototype wearable camera system used to gather image and voice data from the caregivers perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that include salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by the research team during screening) captured in the resulting video. The current authors anticipate future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses.

Perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment:

Limited access to resources and delayed detection of subtle cognitive changes may negatively impact the long-term cognitive health of rural-dwelling adults. This study explored perceived social determinants of health among older, rural-dwelling adults with early-stage cognitive impairment. Semi-structured interviews were conducted with older, rural-dwelling adults with early-stage cognitive impairment and their care partners. Thematic content analysis was performed. Participants (n = 9) were 73.7 ± 6.0 years of age with 14.2 ± 3.1 years of education; care partners (n = 10) were 70.9 ± 7.4 years of age with 15.6 ± 2.3 years of education. Data analysis revealed six themes: Staying active, Eating well, Living with cognitive changes, Living rural, Connecting with neighbors and community, and Relying on children. Dyads’ depictions of perceived social determinants of health focused on the adoption of a healthy lifestyle, description of relationships, and advantages of living in a rural area. Emergent themes may be used to promote adoption of self-management and prevention behaviors, particularly lifestyle changes.

Qualitative Evidence in Working with Cognitively Impaired Older Adults

With the growing prevalence of dementia around the world has come a corresponding increase in the number of scientific investigations into late life cognitive disorders. In addition to fundamental inquiries about the etiology, diagnosis, and treatment of these disorders, there has been a marked increased in qualitative studies designed to understand subjective experience of cognitively impaired individuals and their family members. This objective of this chapter is to provide an overview of the current body of qualitative literature on cognitive impairment in four areas: (1) cognitive impairment and existential issues; (2) the diagnostic process and its impact; (3) functional impact; and (4) cognitive impairment and comorbid medical conditions. Synthesis of findings from 53 studies reveals that the experience and impact of living with late life cognitive impairment varies by contextual factors and stage of the illness, and may be influenced by encounters with health professionals. Implications for practice are provided with an emphasis on holistic and person-centered approaches to dementia care.

PET amyloid imaging: Implications for estimating risk of progression to Alzheimer's disease in individuals with mild cognitive impairment

criteria; differences between the best performing methods were not significant. In general, sharply-segmented GM segmentations outperformed broader ones. SPM vs Freesurfer had mixed tradeoffs. Reference regions using supratentorial WM were highly reliable but performed poorly on plausibility criteria. Cerebellar GM was outperformed by cerebellar WM, whole cerebellum, crus, and pons, which were all roughly equivalent. Methods with PVC were each better or not significantly worse than those without. Conclusions:Our results support the use of PVC, narrow GM-segmentation targets, and whole-cerebellum, cerebellum-WM, crus, or pons reference regions for SUVR calculations.