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These results elucidate predictors of eHealth literacy and inform strategies to improve eHealth literacy among young and older adults. [Journal of Gerontological Nursing, 46(8), 46-56.].The objective of the current retrospective cohort study was to identify vascular and/or neuropsychiatric risk factors predicting clinical progression in persons with subjective cognitive decline (SCD). Information on 1,525 persons with SCD (mean age = 73.8 [SD = 8.1] years) was obtained from the National Alzheimer's Coordinating Center. Clinical progression occurred from SCD to either amnestic mild cognitive impairment or Alzheimer's dementia over an average of 4.7 (SD = 2.9) years. Stepwise Cox regression was used. Compared to obesity (hazard ratio [HR] = 0.59) in the univariate unadjusted model, obesity (HR = 0.64), current smoking (HR = 2.02), and depressive symptoms (HR = 1.35) were significant after adjusting for covariates in the univariate model. In the multivariate adjusted model, obesity (HR = 0.64), current smoking (HR = 2.04), and depressive symptoms (HR = 1.36) remained significant predictors. Interventions should be designed to minimize transition by managing smoking and depressive symptoms. Further research is required for associations between obesity and clinical progression to test the hypothesis of obesity paradox. [Journal of Gerontological Nursing, 46(8), 28-36.].The majority of older adult nursing home residents have dementia and are at risk of not having their care needs met, largely due to communication deficits. Promoting comfort and minimizing distress for these residents is important. Direct care workers (DCW) and clinical staff completed a 6-day training on a person-directed care (PDC) model-a model guided by the needs of the individual that focuses on empowering DCW to understand and support resident preferences and remaining abilities supported by relationship development and consistent staffing. A retrospective comparison was conducted of residents in two PDC communities with matched residents (n = 72) and three traditional communities (n = 72) on functional and clinical outcomes over a 6-month period. A two-way analysis of variance showed a significant interaction between group and time, where only those in the PDC group had a decreased number of clinical symptoms (e.g., pain, depression, agitation) over time. This study found support for the benefit of PDC on clinical outcomes of interest over time. PDC training for DCW and clinical staff promotes quality care and the reduction of clinical symptoms, leading to improved quality of life. [Journal of Gerontological Nursing, 46(8), 7-11.].
Children with spastic cerebral palsy (CP) have gait impairments resulting from decreased selective motor control, an inability to move the leg joints independently of one another, relying on excessive flexion or extension coupling across the 3 joints. MK-4827 Infants with white matter injury are at high risk of CP and have decreased selective motor control as early as 1month corrected age. An in-home kicking-activated mobile task was developed to motivate more selective hip-knee control of infants at high risk of CP. The purposes of this study were to determine the feasibility of the in-home mobile task and to determine whether infants at high risk of CP and infants with typical development (TD) learn the association between their leg movements and mobile activation.
Ten infants at high risk of CP based on neuroimaging and 11 infants with TD participated in this cohort study at 3.5 to 4.5months corrected age. Each infant participated in the in-home kicking-activated mobile task for 8 to 10min/d, 5 d/wk, for 6weekto motivate certain types of age-appropriate leg movements of infants who are at high risk of CP, the task could help improve walking outcomes, which eventually could contribute to improving children's ability to participate in daily life. This study showed that infants at high risk of CP did learn the infant kicking-activated mobile task but at a much reduced amount compared with infants who are developing typically; so, this is a first step in determining whether the task has potential to motivate more age-appropriate leg movements in infants at high risk of cerebral palsy.
Obesity reduces voluntary recruitment of quadriceps during single-joint exercises, but the effects of obesity on quadriceps femoris muscle activation during dynamic daily living tasks, such as sit-to-stand (STS), are largely unknown. The purpose of this study was to determine how obesity affects quadriceps muscle recruitment during STS.
In this cross-sectional study, 10 women who were lean and 17 women who were obese completed STS from a chair with arms crossed over the chest. Three-dimensional motion analysis was used to define 3 distinct phases (I-III) of the STS cycle. The electromyographic (EMG) activity of the vastus medialis, vastus lateralis, and semitendinosus was measured.
STS duration was greater (3.02 [SD=0.75] seconds vs 1.67 [SD=0.28] seconds) and peak trunk flexion angle was lower (28.9 degrees [SD=10.4 degrees] vs 35.8 degrees [SD=10.1 degrees]) in the women who were obese than in the women who were lean. The mean EMG activity of the knee extensors increased from phase I to phase II in boobility during daily activities. This study shows that women who are obese have lower voluntary recruitment of quadriceps when rising from a chair than women who are lean do, which could increase workload on hip or ankle muscles during this important daily task. Quadriceps strengthening exercises might improve the ability to rise from sitting to standing.
People with obesity often have low quadriceps muscle strength and impaired mobility during daily activities. This study shows that women who are obese have lower voluntary recruitment of quadriceps when rising from a chair than women who are lean do, which could increase workload on hip or ankle muscles during this important daily task. Quadriceps strengthening exercises might improve the ability to rise from sitting to standing.
Integrase strand transfer inhibitor (INSTI)-based combination antiretroviral therapy (cART) is associated with greater weight gain among persons with HIV, though the metabolic consequences, such as diabetes mellitus (DM), are unclear. We examined the impact of initial cART regimen and weight on incident DM in a large North American HIV cohort (NA-ACCORD).
cART-naïve adults (≥18 years) initiating INSTI-, PI-, or NNRTI-based regimens from 01/2007-12/2017 who had weight measured 12 (±6) months after treatment initiation contributed time until clinical DM (HbA1c ≥6.5%, initiation of DM-specific medication, or new DM diagnosis plus DM-related medication), virologic failure, cART regimen switch, administrative close, death, or loss to follow-up. Multivariable Cox regression yielded adjusted hazard ratios (HR) and 95% confidence intervals ([-]) for incident DM by cART class. Mediation analyses, with 12-month weight as mediator, adjusted for all covariates from the primary analysis.
Among 22,884 eligible individuals, 47% started NNRTI-, 30% PI-, and 23% INSTI-based cART with median follow-up of 3.
Website: https://www.selleckchem.com/products/mk-4827.html
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