Significant Mean Group Differences Research Articles

THE EFFECT OF THE JIGSAWDIO PROGRAM ON COGNITION AMONG OLDER ADULTS WITH DEMENTIA

Abstract Puzzle activities in dementia patients have been associated with improvements in mood and cognition across a number of studies. Our research team designed and developed Jigsawdio, a digital technology that provides an innovative and interactive multisensory solution which supports memory recall in patients with dementia through the completion of personalized, audio-visual jigsaw puzzles. This device builds on the benefits derived from traditional puzzles by integrating salient audiovisual stimuli aimed at evoking nostalgia and encouraging reminiscence. The purpose of this study was to assess pre- and post-intervention effects of Jigsawdio use after six weeks among older adults with mild to moderate cognitive impairment. Using a single arm, twice weekly intervention, nine persons participated in the Jigsawdio program study. The Montreal Cognitive Assessment (MoCA) was used to measure changes in cognitive function and recall on the first and last days of the intervention. A paired t-test was used to investigate the group mean differences in cognition before and after participation in the intervention program. We found a significant group mean difference between the post-assessment and the baseline assessment MoCA scores of participants. This study presents suggestive evidence of cognitive benefits and feasibility of the technology in older adults with dementia.

Frequency Following Responses to Tone Glides: Effects of Age and Hearing Loss.

Speech is characterized by dynamic acoustic cues that must be encoded by the auditory periphery, auditory nerve, and brainstem before they can be represented in the auditory cortex. The fidelity of these cues in the brainstem can be assessed with the frequency-following response (FFR). Data obtained from older adults-with normal or impaired hearing-were compared with previous results obtained from normal-hearing younger adults to evaluate the effects of age and hearing loss on the fidelity of FFRs to tone glides. A signal detection approach was used to model a threshold criterion to distinguish the FFR from baseline neural activity. The response strength and temporal coherence of the FFR to tone glides varying in direction (rising or falling) and extent ([Formula: see text], [Formula: see text], or 1 octave) were assessed by signal-to-noise ratio (SNR) and stimulus-response correlation coefficient (SRCC) in older adults with normal hearing and with hearing loss. Significant group mean differences in both SNR and SRCC were noted-with poorer responses more frequently observed with increased age and hearing loss-but with considerable response variability among individuals within each group and substantial overlap among group distributions. The overall distribution of FFRs across listeners and stimulus conditions suggests that observed group differences associated with age and hearing loss are influenced by a decreased likelihood of older and hearing-impaired individuals having a detectable FFR response and by lower average FFR fidelity among those older and hearing-impaired individuals who do have a detectable response.

Automated Adaptive Wideband Acoustic Stapedius Reflex Thresholds in Adults With Normal Hearing and Sensorineural Hearing Loss.

This study compared the measurement of the acoustic stapedius reflex threshold (ART) obtained using a traditional method with that obtained using an automated adaptive wideband (AAW) method. Participants included three groups of adults with normal hearing (NH), mild sensorineural hearing loss (SNHL), or moderate SNHL. The purpose of the study was to compare ARTs for the three groups and to determine which method had the best performance in detecting SNHL. Ipsilateral and contralateral ARTs were obtained using 0.5, 1, and 2 kHz tonal activators, and broadband noise (BBN) activators on a traditional admittance system (Clinical) at tympanometric peak pressures (TPP) and on an experimental wideband system using an AAW method at both ambient pressure and TPP. ART data previously reported for 39 NH adults with a mean age of 47.7 years were compared with data for 25 participants with mild SNHL with a mean age of 63.8 years, and 20 participants with moderate SNHL with a mean age of 65.7 years. Differences in ARTs between the normal-hearing and SNHL groups for the three methods were examined using a General Linear Model Repeated-Measures test. A receiver operating characteristic curve (ROC) analysis was also used to determine the ability of an ART test to detect SNHL. For the 0.5 kHz activator condition, there were no significant group mean differences in ART between NH and SNHL groups for either ipsilateral or contralateral activator presentation modes for the Clinical or AAW methods. There were significant group mean differences for the 1 and 2 kHz tonal activators and BBN activator for both ipsilateral and contralateral modes with greater differences in ART between groups for the AAW method than the Clinical method. In these conditions, the mean ART was lower for the AAW tests relative to the Clinical test. The greatest difference between groups was for the ipsilateral AAW tests for the comparison of NH with moderate SNHL for the BBN activator. This difference was approximately 20 dB for the AAW tests and 8 dB for the Clinical test. The ROC analysis showed that the area under the ROC curve (AUC) increased with the frequency of the activator stimulus and with the degree of hearing loss and was maximal for the BBN activator for both the AAW and Clinical methods for both ipsilateral and contralateral presentations. For ipsilateral and contralateral ART tests for activator frequencies above 0.5 kHz and BBN, listeners with SNHL generally had elevated ARTs compared with those with NH. The AAW method resulted in greater differences between SNHL groups and NH than the Clinical method. The AUC for detecting SNHL also increased with activator frequency and degree of hearing loss and was greatest for the BBN activator for the AAW method in both the ambient and TPP conditions. The results are encouraging for the use of an AAW ART method for the assessment of individuals with SNHL.

DIFFERENT LEVELS OF LEISURE-TIME PHYSICAL ACTIVITY AND MENTAL HEALTH FOR OLDER ADULTS WITH DIABETES IN THE PANDEMIC

Abstract This study is an initial investigation of the association of different levels of LTPA engagement with mental health (e.g., loneliness, happiness, and positive and negative affect) among older adults with diabetes during the COVID-19 pandemic. The COVID-19 has led public health researchers to improve mental health among older adults with diabetes. Leisure-time physical activity (LTPA) has been emerged to cope with mental health difficulties in the pandemic. Total 301 respondents were extracted from the Health and Retirement Study (HRS) based on the following two criteria: over 50 years old and the onset of diabetes. Multiple questionnaire items were used to assess mental health (i.e., loneliness, happiness, and positive and negative affect) for older adults with diabetes. Multivariate Analysis of Variance was utilized to investigate the relationships between the fixed variable (i.e., LTPA) and outcome variables (i.e., mental health). We categorized LTPA participation into three groups (i.e., low, mid, high) and examined mental health following a different level of LTPA participation. LTPA participation showed a significant group mean differences for loneliness, happiness, and positive affect, but not for negative affect. High-LTPA respondents presented lower loneliness) and higher happiness than Low-LTPA respondents. High-LTPA and Mid-LTPA respondents indicated higher positive affect than Low-LTPA respondents. This study provides evidence of the benefits of LTPA on mental health for older adults with diabetes. Our study supports the evidence that high-LPTA involvement can be effective in promoting mental health among older adults with diabetes in the COVID-19 era.

Facial expression recognition is linked to clinical and neurofunctional differences in autism

BackgroundDifficulties in social communication are a defining clinical feature of autism. However, the underlying neurobiological heterogeneity has impeded targeted therapies and requires new approaches to identifying clinically relevant bio-behavioural subgroups. In the largest autism cohort to date, we comprehensively examined difficulties in facial expression recognition, a key process in social communication, as a bio-behavioural stratification biomarker, and validated them against clinical features and neurofunctional responses.MethodsBetween 255 and 488 participants aged 6–30 years with autism, typical development and/or mild intellectual disability completed the Karolinska Directed Emotional Faces task, the Reading the Mind in the Eyes Task and/or the Films Expression Task. We first examined mean-group differences on each test. Then, we used a novel intersection approach that compares two centroid and connectivity-based clustering methods to derive subgroups based on the combined performance across the three tasks. Measures and subgroups were then related to clinical features and neurofunctional differences measured using fMRI during a fearful face-matching task.ResultsWe found significant mean-group differences on each expression recognition test. However, cluster analyses showed that these were driven by a low-performing autistic subgroup (~ 30% of autistic individuals who performed below 2SDs of the neurotypical mean on at least one test), while a larger subgroup (~ 70%) performed within 1SD on at least 2 tests. The low-performing subgroup also had on average significantly more social communication difficulties and lower activation in the amygdala and fusiform gyrus than the high-performing subgroup.LimitationsFindings of autism expression recognition subgroups and their characteristics require independent replication. This is currently not possible, as there is no other existing dataset that includes all relevant measures. However, we demonstrated high internal robustness (91.6%) of findings between two clustering methods with fundamentally different assumptions, which is a critical pre-condition for independent replication.ConclusionsWe identified a subgroup of autistic individuals with expression recognition difficulties and showed that this related to clinical and neurobiological characteristics. If replicated, expression recognition may serve as bio-behavioural stratification biomarker and aid in the development of targeted interventions for a subgroup of autistic individuals.

GABAergic interneurons' feedback inhibition of dorsal raphe-projecting pyramidal neurons of the medial prefrontal cortex suppresses feeding of adolescent female mice undergoing activity-based anorexia.

Anorexia Nervosa (AN) is characterized by voluntary food restriction, excessive exercise and extreme body weight loss. AN is particularly prevalent among adolescent females experiencing stress-induced anxiety. We used the animal model, activity-based anorexia (ABA), which captures these characteristics of AN, to reveal the neurobiology underlying individual differences in AN vulnerability. Dorsal raphe (DR) regulates feeding and is recruited when coping inescapable stress. Through chemogenetic activation, we investigated the role of mPFC pyramidal neurons projecting to DR (mPFC→DR) in adolescent female mice's decision to eat or exercise following ABA induction. Although the DREADD ligand C21 could activate 44% of the mPFC→DR neurons, this did not generate significant group mean difference in the amount of food intake, compared to control ABA mice without chemogenetic activation. However, analysis of individuals' responses to C21 revealed a significant, positive correlation between food intake and mPFC→DR neurons that co-express cFos, a marker for neuronal activity. cFos expression by GABAergic interneurons (GABA-IN) in mPFC was significantly greater than that for the control ABA mice, indicating recruitment of GABA-IN by mPFC→DR neurons. Electron microscopic immunohistochemistry revealed that GABAergic innervation is 60% greater for the PFC→DR neurons than adjacent Layer 5 pyramidal neurons without projections to DR. Moreover, individual differences in this innervation correlated negatively with food intake specifically on the day of C21 administration. We propose that C21 activates two antagonistic pathways: (1) PFC→DR pyramidal neurons that promote food intake; and (2) GABA-IN in the mPFC that dampen food intake through feedback inhibition of mPFC→DR neurons.

Quantifying virtual reality pain modulation in healthy volunteers: A randomized, crossover study

Study ObjectiveVirtual reality (VR) is an emerging tool to reduce pain and anxiety during procedures. Although VR's clinical benefits are reported, biometric data quantifying VR's effect on pain tolerance is lacking. We used time-lapse, subjective, and biometric data to evaluate VR's effect on modulating pain. DesignRandomized, controlled crossover within-subject clinical trial. SettingThis study was conducted in the Chariot Lab at Lucile Packard Children's Hospital and outdoors at Stanford University School of Medicine. Patients156 healthy volunteers were included. InterventionsParticipants underwent pain-inducing ice immersions while connected to biometric sensors. Participants were randomized to immerse their dominant or non-dominant hand with VR or control (no VR) for one immersion, and then crossed-over to the other hand for the second immersion. We instructed participants to submerge their hand until they reached their pain tolerance or until four minutes elapsed. MeasurementsOutcomes included ice immersion duration, perceived pain scores, and skin conductance response density (SCRD), a marker of sympathetic arousal. We used survival analysis and mixed effects models to compare measurements with and without VR. Main Results153 participants were included in the analysis. Participants with VR were 64% less likely to remove their hands from the ice bath throughout the immersion's duration compared to control (P < 0.001). Participants with VR reported significantly lower pain scores after controlling for dominant hand treatment assignment, VR vs. no VR treatment order, and gender (P < 0.001). SCRD increased as time progressed for both VR and control groups (P = 0.047 combined), with no significant mean group differences. ConclusionsParticipants with VR were more likely to survive the 4-min ice bath challenge longer and with lower levels of pain perception, supporting VR's effectiveness as a distraction tool during painful procedures. We observed no differences in sympathetic response when comparing VR to no VR.

Different Levels of Leisure-time Physical Activity, Coping, and Mental Health among Older Adults with Diabetes during the COVID-19 Pandemic

Background: The COVID-19 has led public health researchers to try to improve mental health among older adults with diabetes. Leisure-time physical activity (LTPA) has emerged as a means of coping with mental health difficulties in the pandemic. Methods: We extracted 301 respondents from the Health and Retirement Study (HRS) based on the following criteria: over 50 years old and the onset of diabetes. We used multiple questionnaire items to assess mental health (ie, loneliness, happiness, and positive and negative affect) for older adults with diabetes. We used multivariate analysis of variance to investigate the relationships between the fixed variable (ie, LTPA) and outcome variables (ie, mental health). We categorized LTPA participation into 3 groups (ie, low, mid, and high) and examined mental health following various levels of LTPA participation. Results: LTPA participation showed a significant group mean differences for loneliness, happiness, and positive affect, but not for negative affect. High-LTPA respondents presented lower loneliness and higher happiness than low-LTPA respondents. High-LTPA and mid-LTPA respondents indicated higher positive affect than low-LTPA respondents. Conclusions: This study provides evidence of the benefits of LTPA on mental health for older adults with diabetes and suggests that high-LPTA involvement can be effective in promoting mental health among older adults with diabetes in the COVID-19 era.

Health-Related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care Plus Chiropractic Care vs Usual Care Alone: Secondary Outcomes of a Pragmatic Clinical Trial

ObjectiveThis study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to: 1) worst pain intensity from a numerical pain rating 0–10 scale, 2) 24-item Roland-Morris Disability Questionnaire (RMDQ); and 3) global improvement (modified visual analog scale).DesignA pragmatic, prospective, multisite, parallel-group comparative effectiveness clinical trial comparing usual medical care (UMC) with UMC plus chiropractic care (UMC+CC).SettingThree military treatment facilitiesSubjects750 active-duty military personnel with low back painMethodsLinear mixed effects regression models estimated the treatment group differences. Coefficient of repeatability to estimate significant individual change.ResultsWe found statistically significant mean group differences favoring UMC+CC for all PROMIS®-29 scales and the RMDQ score. Area under the curve estimates for global improvement for the PROMIS®-29 scales and the RMDQ, ranged from 0.79 to 0.83.ConclusionsFindings from this pre-planned secondary analysis demonstrate that chiropractic care impacts health-related quality of life beyond pain and pain-related disability. Further, comparable findings were found between the 24-item RMDQ and the PROMIS®-29 v1.0 briefer scales.

Application of a SWAT Model for Supporting a Ridge-to-Reef Framework in the Pago Watershed in Guam

This study implemented experimental and numerical approaches for supporting the Pago Bay ridge-to-reef management program. Water quality tests for turbidity and inorganic dissolved nitrogen (IDN) were performed using water samples collected from four sites within the Pago Watershed. After conducting a one-way ANOVA test, the result shows significant differences in group means in turbidity levels (F value = 20.4 and p-value 3.29 × 10−7). Application of Tukey’s HSD test identifies one of the sites, the Pago River section, yields more sediment and IDN to the river system and Pago coral reef area. Observation of heavy rainfall, which causes much of the erosion and sediment transport, over the area should be taken into account in order to create best management practices. In addition, this study proposes a SWAT model for the watershed to identify locations of concern. The SWAT model was calibrated using historical streamflow data for the period of 2012–2018 and validated with data for the period of 2019–2020. The NSE and R2 values for the calibration are 0.864 and 0.938, respectively. For the validation period, the NSE value is 0.857, and the value of R2 is 0.937. In terms of sediments and nutrients, sub-basins connected to Pago River comprise the major source areas. Estimation of more sediment loads during the wet-monsoon season implies that heavy rainfall induces more erosion over the region.

The meaning of significant mean group differences for biomarker discovery.

Over the past decade, biomarker discovery has become a key goal in psychiatry to aid in the more reliable diagnosis and prognosis of heterogeneous psychiatric conditions and the development of tailored therapies. Nevertheless, the prevailing statistical approach is still the mean group comparison between “cases” and “controls,” which tends to ignore within-group variability. In this educational article, we used empirical data simulations to investigate how effect size, sample size, and the shape of distributions impact the interpretation of mean group differences for biomarker discovery. We then applied these statistical criteria to evaluate biomarker discovery in one area of psychiatric research—autism research. Across the most influential areas of autism research, effect size estimates ranged from small (d = 0.21, anatomical structure) to medium (d = 0.36 electrophysiology, d = 0.5, eye-tracking) to large (d = 1.1 theory of mind). We show that in normal distributions, this translates to approximately 45% to 63% of cases performing within 1 standard deviation (SD) of the typical range, i.e., they do not have a deficit/atypicality in a statistical sense. For a measure to have diagnostic utility as defined by 80% sensitivity and 80% specificity, Cohen’s d of 1.66 is required, with still 40% of cases falling within 1 SD. However, in both normal and nonnormal distributions, 1 (skewness) or 2 (platykurtic, bimodal) biologically plausible subgroups may exist despite small or even nonsignificant mean group differences. This conclusion drastically contrasts the way mean group differences are frequently reported. Over 95% of studies omitted the “on average” when summarising their findings in their abstracts (“autistic people have deficits in X”), which can be misleading as it implies that the group-level difference applies to all individuals in that group. We outline practical approaches and steps for researchers to explore mean group comparisons for the discovery of stratification biomarkers.

Feasibility of administering the WAIS-IV using a home-based telehealth videoconferencing model

Objective: Use of telehealth to deliver neuropsychological services has proven to be a feasible approach, however, there is limited research which has examined the reliability of home-based assessment models using a comprehensive intelligence test. The aim of this study was to examine the reliability and feasibility of a home-based videoconferencing administration of the Wechsler Adult Intelligence Scales-4th Edition (WAIS-IV). Method: Thirty healthy participants (aged 18–40 years) completed the WAIS-IV both in-person and via home-based videoconferencing utilizing a randomized counter-balanced methodology to attempt to control for an order effect. Paper record forms for Coding/Symbol Search and Blocks were sent and returned via tamper proof courier packs. Participants completed an online survey of their experiences of TNP following completion of their assessments. Group mean comparisons, intra class correlation coefficients (ICCs) and Bland-Altman measures of bias were calculated. Results: Findings from both modalities were highly concordant across all WAIS-IV subtests and indices, with all ICCs rated as “excellent,” (≥0.9). There were no significant mean group differences and no evidence of proportional bias. The majority of participants were very satisfied with the use of videoconferencing as an application for cognitive assessment and high levels of participant compliance were observed. Conclusions: In this non-clinical cohort home-based videoconference administration of the WAIS-IV was feasible, reliable and acceptable. TNP may offer an alternative for those consumers where there are challenges in accessing a face-to-face service delivery model, thereby improving equity, and enabling continuation of service delivery. Future research is needed with a larger and more ethnically diverse clinical population.

Communication attitude of Kannada-speaking adults who do and do not stutter

The Communication Attitude Test for Adults who stutter (BigCAT) is an established measure of cognitive traits in adults who stutter (AWS). The primary purpose of the present study was to adapt and validate the BigCAT to the Kannada language. The secondary purpose was to compare AWS’ and adults who do not stutter (AWNS) BigCAT-K scores and compare AWS’ score in sub-populations in terms of severity and age. The study included a purposive sample of 100 AWS and 317 AWNS. There was high test-retest reliability and solid construct validity, as made evident by the results of the discriminant analysis and cross-validation. Further, as in other investigations with the BigCAT (Vanryckeghem & Brutten, 2019), this self-report test revealed a statistically significant group mean difference between AWS and AWNS, suggesting the presence of a negative attitude towards communication in Kannada-speaking AWS. Further, individuals with severe stuttering had a significantly higher level of speech-associated negative attitude compared to those with mild stuttering. Age does not seem to influence the AWS’ speech-associated belief system. Both of these findings augment the existing scant literature on exploring the association between stuttering severity and age on the cognitive dimension of stuttering. The outcomes establish the BigCAT-K as an effective tool in the assessment and subsequent management of stuttering.

DEMOGRAPHIC PREDICTION TOWARDS LEADERSHIP AND TEACHERS’ COMMITMENT AND MOTIVATION IN THE EDUCATIONAL SECTOR

Purpose of the study: The existing research study aimed to investigate the predictive effect of demographic traits, leadership styles on teachers’ job commitment and motivation at the college level, in Punjab, Pakistan.&#x0D; Methodology: The population of the study consisted of 576 male and female lecturers (PE). The total number of lecturers (PE) working in all Government colleges is 576, male lecturer (PE) is 366, and female lecturers (PE) are 210. Three self cum closed-ended questionnaires were designed for the data collection. Mean, standard deviation, Independent Samples Test, and One-way ANOVA were applied to test the formulated hypotheses.&#x0D; Main Findings: It was found that there no positive impact of leadership styles of the head of institutions upon professional commitment and motivation of the lecturers based on demographics. It was also found that the study respondents regarding demographic attributes have significant group mean differences in opinion about the research variables under study.&#x0D; Implications of the study: It was recommended that the most motivated and committed worker is the one who is senior, married, educated, and female, has a sound salary package, has served the institution for a long time- period and has a chance of professional development. It was also found that s/he performs his/her duty under an HOI who has more of a transformational leadership style than the rest and should be more transformational. Therefore HOI of the institutions should adopt a transformational leadership style to get maximum output from the employees.

Chemotherapy-related cognitive impairment (CRCI) among early-stage breast cancer survivors in Malaysia

ABSTRACT Introduction: Breast cancer survivors frequently develop cognitive impairment following chemotherapy which can significantly hamper their well-being, ability to function independently, and overall quality of life. Evidence of cognitive functioning in breast cancer survivors from lower and middle-income countries remains scarce. We examined the prevalence of cognitive impairment among Malaysian multiethnic early-stage breast cancer survivors one to three years post-chemotherapy. Methods: This cross-sectional study included 160 breast cancer survivors from the University Malaya Medical Center (UMMC). The cognitive assessments used included the Montreal Cognitive Assessment (MoCA-BM), the Rey Auditory and Verbal Learning Test (RAVLT-BM), and the digit span and arithmetic of the Working Memory Index (WMI) of Wechsler Adult Intelligence Scale-IV (WAIS-IV). Data were analyzed using independent sample t-tests and Pearson’s correlation. Results: Our breast cancer survivors demonstrated poor performances in MoCA-BM (31.9%) RAVLT-BM, recall (53.8%), and WMI of WAIS-IV (51.3%) with 30.6% of them performed poorly in all three cognitive tests administered. There were no significant mean group differences in cognitive performances between <24 months after chemotherapy and ≥24 months after chemotherapy. Conclusions: A high proportion of breast cancer survivors exhibited poor performances in the cognitive assessments. Cognitive rehabilitation programmes tailored to the needs of these survivors should be incorporated into cancer care management.

Orbital volume, ophthalmic sequelae and severity in unilateral coronal synostosis

PurposeUnilateral coronal synostosis (UCS) results in an asymmetrical skull, including shallow and asymmetrical orbits, associated with reduced orbital volume and high prevalences of ophthalmic sequelae. Aim is to link orbital volumes in patients with UCS to severity according to UCSQ (Utrecht Cranial Shape Quantifier) and presence of ophthalmic sequelae.MethodsWe included preoperative patients with UCS (≤ 18 months). Orbital volume was measured on CT scans by manual segmentation (Mimics software (Materialise, Leuven, Belgium)), and severity of UCS was determined by UCSQ. Orbital volume of affected side was compared to unaffected side using Wilcoxon signed rank test. Orbital volume ratio was calculated (affected/unaffected volume) and compared to the category of UCSQ by Kruskal-Wallis test. Opthalmic sequelae were noted.ResultsWe included 19 patients (mean age 7 months). Orbital volume on affected side was significantly lower (p = 0.001), mean orbital volume ratio was 0.93 (SD 0.03). No significant differences in group means of orbital volume ratio between different levels of severity of UCSQ were found (Kruskal-Wallis H (2) = 0.873; p > 0.05). Ophthalmic sequelae were found in 3 patients; one had adduction impairment and strabismus (mild UCS), one had astigmatism (moderate UCS), and one had abduction impairment (on both ipsi- and contralateral side) and vertical strabismus (severe UCS).ConclusionNo association between orbital volume ratio and severity of UCS was found. Side-to-side asymmetry in orbital volume was noted. No association between either preoperative orbital volume ratio or severity of UCS and the presence of preoperative ophthalmic sequelae was found.

Promoting sustainable dementia education in African American communities

AbstractBackgroundAfrican Americans are at higher risk of developing Alzheimer’s disease (AD) and AD‐related dementia. They are also more likely to live in communities with fewer dementia resources. The 2011 National Alzheimer’s Project Act calls for special attention to dementia‐related health disparities in high risk groups. Ensuring access to dementia‐specific information is one tactic for addressing disparities; however, the method by which information is delivered may play a role in how effectively that information is understood and retained over time.MethodWe delivered the same dementia education presentation to two comparable, predominantly African American neighborhoods in Jacksonville, FL. In one (intervention) community, the presentation was followed by an hour‐long focus group on what makes a community “dementia friendly”, using modified materials from the Dementia Friendly America (DFA) toolbox. In the other (control) community, the presentation was followed by a social hour allowing participants to interact with presenters and ask questions informally. Our primary objective was to assess the impact of the different conditions on AD knowledge.ResultsA 7‐item scale assessing AD knowledge was administered to immediately before and after the educational presentation (pre‐test, immediate post), and again two months later (Intervention group n=40; Control n=37). Additional, one‐year follow‐up was completed on the intervention community (n=21). Groups did not differ in AD knowledge at pre‐test (M=4.5 vs. 4.2, p=NS). At immediate post‐test, both groups improved their scores, but there was again no difference between groups (M=5.8 vs. 5.4, p=NS). At two‐month post‐testing, both groups declined in their knowledge score, but the control group declined more precipitously, yielding a significant group mean difference (M= 5.4 vs. 4.7, p=0.02). At one year follow‐up, a subsample of the intervention group (n=21) was re‐examined and demonstrated no significant decline in knowledge scores as compared to 2‐month follow‐up (M=5.7 vs. 5.4, p=0.36).ConclusionResults suggest that focus group discussion following dementia education as per the DFA model may contribute to greater retention of information and exert a sustainable impact on AD knowledge over time in an African American community setting.

Examining posttraumatic stress disorder as a key postinjury risk factor in OIF/OEF veterans with blast-induced mild traumatic brain injury.

To explore the neuropsychological sequelae of blast-induced mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD), several neuropsychological tests and self-reported measures of cognitive and emotional functioning were administered to 138 Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) veterans. We hypothesized that veterans affected by mTBI and PTSD would manifest differences in neuropsychological testing and self-report measures compared to a group of healthy veteran controls and to veterans with only PTSD. Participants included 3 groups of veterans: (a) healthy controls (n = 43); (b) PTSD only (n = 48); and (c) comorbid blast-induced mTBI and PTSD (n = 47). An exploratory factor analysis (EFA) was used to extract a smaller number of latent dimensions for group comparison. The EFA supported an 8-factor model. A multivariate analysis of variance on the 8 factor scores demonstrated 3 significant factor mean differences: (a) perceived cognitive complications (PCC), (b) perceived emotional distress (PED), and (c) processing speed (PS). Post hoc analyses showed significant group mean difference in PS between the comorbid and the control groups. In addition, the comorbid group presented with the highest levels of PCC and PED. Results suggest that among OIF/OEF veterans with blast-induced mTBI, PTSD with its accompanying emotional distress may be a significant determinant of subjective sense of well-being both cognitively and emotionally. The objective discrepancy in PS between the comorbid group and the healthy controls also appears largely due to PTSD more so than the remote blast-induced mTBI, as the group mean difference in PS became negligible after controlling for PTSD levels. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Vestibular function after cochlear implantation: A test battery and case-by-case approach.

ObjectivesThe purpose of this study was to assess the effects of cochlear implantation on the functional integrity of the horizontal semicircular canal using multiple methodologies, and to discuss and highlight the limitations of using isolated vestibular tests to assess vestibular function in surgical ears.MethodsTen cochlear implant patients were consented to undergo a preoperative and 3‐month postoperative vestibular assessment. The horizontal semicircular canal (SCC) was assessed using three different vestibular test measures that assess function using different stimuli and at different frequencies ranges: caloric testing, sinusoidal harmonic acceleration testing in the rotary chair, and video head impulse testing in the plane of the horizontal SCC. Data was analyzed using different methods: descriptive, statistical, and by an examination of individual case studies.ResultsEach analysis method yielded a different interpretation. Statistical analysis showed no significant group mean differences between baseline pre‐op vestibular test results and 3‐month post‐op vestibular test results. Descriptive analysis showed 30% of individuals presented with postoperative abnormal vestibular testing findings. A case study examination showed that only one patient presented with a post‐op decrease in vestibular function in the implanted ear.ConclusionsThere are several limitations of conventional vestibular testing in postsurgical cochlear implant patients. A test‐battery approach, including case history, and test interpretation made on a case‐by‐case basis is needed to determine whether the patient has undergone vestibular damage, is at risk for falling, or in need of further management.Level of Evidence2b individual cohort study.

Effects of Terbutaline Sulfate on Physiological and Biomechanical as Well as Perceived Exertion in Healthy Active Athletes: A Pilot Study.

This study aimed to investigate the effects of beta2‐agonist terbutaline sulfate (TER) at a supra‐therapeutic dose (8 mg) on aerobic exercise performance. Twelve (6 females and 6 males) amateur athletes familiarized with all experimental procedures had their anthropometric data obtained on day 1. On days 2 and 3 either 8 mg of TER or a placebo (PLA) was administered orally (double‐blind manner) to participants who had rested for 3 h prior to aerobic exercise performance 20 m multistage fitness test (MSFT)]. This test was used to predict maximal oxygen uptake (VO2max) and velocity at which VO2max occurs (vVO2max). The Borg rating of perceived exertion (RPE), cardiovascular variables [heart rate (HR) and blood pressure (BP)] and blood glucose concentration [BGC] were obtained 15 min pre‐ and immediately post‐MSFT. Significant mean group differences were reported between PLA and TER groups (p < 0.05), respectively, in the RPE (15.6 ± 1.2 vs. 17.3 ± 1.5 a.u.), maximum heart rate (HRmax: 191.2 ± 7.1 vs. 197.2 ± 8.6 bpm) and BGC (118.4 ± 18.3 vs. 141.2 ± 15.8 mg/dL) post‐MSFT. The main effect of gender (male vs. female) in TER and PLA groups (p< 0.05) was observed, with higher estimated VO2max, vVO2max, HRmax and a lower mean HR pre‐test in male than female athletes. For these reasons, the inclusion of TER in the Prohibited List should be re‐discussed because of the lack of ergogenic effects.