scholarly journals Louisiana Geriatric Workforce Enhancement Program: Analysis of Learning Outcomes From Dementia Training

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Katherine Kirsch ◽  
Catherine Lemieux ◽  
Laura Ainsworth ◽  
Sarah Choate ◽  
Ashleigh Borgmeyer ◽  
...  

Abstract A recent Alzheimer’s Association report noted that by year 2050, the number of Americans diagnosed with Alzheimer’s disease and related dementias (ADRD) will triple to over 15 million. The report referred to primary care as the front line for meeting this demand, yet the nation faces a severe shortage of ADRD trained, primary care professionals (PCPs). Louisiana Geriatric Workforce Enhancement Program (LA-GWEP) addresses this demand. The purpose of this study was to examine preliminary data respective to LA-GWEP effectiveness with interdisciplinary education and training seminars, primarily aimed at medical, nursing, and social work PCPs. Three seminars were conducted in south Louisiana: Seminars 1 and 2 addressed effective communication, verbal and nonverbal, among persons with ADRD and caregivers; Seminar 3 offered basic overview of dementia symptomology, stages, and behaviors. Pre- and post-training session data were collected on-site. Participants completed questionnaires that included a 10-item knowledge assessment and 20-item Dementia Attitudes Scale (DAS). These measures contained Likert response formats; higher scores indicating greater levels of ADRD knowledge, in patient and caregiver contexts. Paired sample t-tests were conducted to observe any significant pre-to-post improvement, Cohen’s d for effect size. Seminar 1 revealed no significant pre-to-post difference: t = -1.019, p = 0.320. Adjusting content from audience feedback, Seminar 2 revealed significant pre-to-post difference: t = -7.516, p < .001, Cohen’s d = 1.2. Seminar 3 yielded significant improvement on DAS scores: t = -2.96, p < .01, Cohen’s d = 0.34. Implications for seminars in future years of LA-GWEP are discussed.

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S577-S578
Author(s):  
Allison Armagan ◽  
Roderick Smith

Abstract Background Many patients are at a higher risk of influenza complications because of age and comorbidities. We sought to assess whether online education, focused on appropriate and timely use of influenza antiviral medications to patients at high risk for influenza-related complications and morbidity, could improve knowledge, competence, and confidence of clinicians. Methods Primary care physicians (PCPs) and pediatricians participated in a 30-minute video lecture with synchronized slides. Educational effect was assessed using a repeated-pairs design with pre-/post-assessment. Three multiple choice questions assessed knowledge/competence, and 1 question assessed confidence. Statistical tests to assess significance: Paired samples t-test for overall average number of correct responses and for confidence rating; McNemar’s test for individual questions (5% significance level, P < .05). Cohen’s d estimated the effect size impact on number of correct responses (< .20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 10/28/20 to 12/23/20. Results Average knowledge/competence improved from 29% to 43% (N=430, P< .001, Cohen’s d = 0.46) among primary care physicians and from 31% to 43% (N=226, P< .001, Cohen’s d = 0.38) among pediatricians. Post participation, 12% more PCPs and pediatricians answered all questions correctly. Relative improvements post-participation in specific areas were as follows (P< .001): (i) 105% improvement among PCPs and 100% improvement among pediatricians in findings associated with the efficacy of treatment with antivirals for influenza in hospitalized patients. (ii) 117% improvement among PCPs and 104% improvement among pediatricians in identifying the antiviral with the greatest activity against influenza B viral strain as reported in a phase 3 clinical trial. (iii) 34% of PCPs and 46% of pediatricians had a measurable improvement in confidence after completing the program. Conclusion This study demonstrated the success of a video lecture with synchronized slides at improving PCPs and pediatricians knowledge, competence and confidence related to appropriate and timely use of influenza antiviral medications to patients at high risk for influenza-related complications and morbidity. Disclosures All Authors: No reported disclosures


2013 ◽  
Vol 2 (4) ◽  
pp. 199-215 ◽  
Author(s):  
Maria Klatte ◽  
Claudia Steinbrink ◽  
Kirstin Bergström ◽  
Thomas Lachmann

Defizite in der phonologischen Informationsverarbeitung werden heute als Kernsymptom der Lese-Rechtschreibstörung betrachtet. In Trainingsstudien mit betroffenen Kindern erwiesen sich Phonemwahrnehmungsfähigkeiten als trainierbar, und Programme, in denen Aufgaben zur phonologischen Bewusstheit mit der systematischen Vermittlung von Phonem-Graphem-Zuordnungen kombiniert wurden, zeigten Transfereffekte auf Lese- und Rechtschreibleistungen. Ausgehend von diesen Erkenntnissen wurde ein computerbasiertes Trainingsprogramm zur Förderung der Phonemwahrnehmung, der phonologischen Bewusstheit und der Graphem-Phonem-Zuordnungen für deutschsprachige Grundschulkinder mit Lese-Rechtschreibstörung entwickelt. Aufgrund der besonderen Relevanz der Vokallänge für die deutsche Orthographie enthält das Programm neben Aufgaben, die auf Konsonanten fokussieren, auch Vokallängenaufgaben. Bei der Konzipierung des Programms wurden etablierte, ursprünglich für andere Sprachen entwickelte Aufgaben an die deutsche Phonologie angepasst und in ein computerbasiertes Format übersetzt. Im Rahmen der vorliegenden Studie sollte überprüft werden, ob die konstruierten Trainingsaufgaben die spezifischen Defizite von Kindern mit Lese-Rechtschreibstörung wie intendiert abbilden. Hierzu wurden leseschwache Dritt- und Viertklässler (n = 35) mit mindestens durchschnittlichen Lesern derselben Klassenstufen (n = 75; Kontrollgruppe) hinsichtlich ihrer Leistungen in den Aufgaben verglichen. Die leseschwachen Kinder zeigten in allen Aufgaben schlechtere Leistungen als die Kontrollgruppe. Die Effektstärken der Gruppenunterschiede (Cohen's d) lagen im mittleren bis hohen Bereich (0.50 – 2.19). Die Ergebnisse bestätigen, dass die Aufgaben des Trainingsprogramms die spezifischen Defizite leseschwacher Kinder abbilden. Ein Training mit diesen Aufgaben erscheint daher grundsätzlich sinnvoll. Die Wirkungen eines solchen Trainings auf die schriftsprachlichen Leistungen von Kindern mit Lese-Rechtschreibstörung werden in zukünftigen Studien überprüft.


2019 ◽  
Author(s):  
Jan G. Voelkel ◽  
Dongning Ren ◽  
Mark John Brandt

The political divide is characterized by liberals and conservatives who hold strong prejudice against each other. Here we introduce one possible strategy for reducing political prejudice: political inclusion. We define political inclusion as receiving a fair chance to voice one’s opinions in a discussion of political topics with political outgroup members. This strategy may reduce political prejudice by inducing perceptions of the political outgroup as fair and respectful; however, such a strategy may also highlight conflicting attitudes and worldviews, thereby further exacerbating prejudice. In three preregistered studies (total N = 799), we test if political inclusion reduces or increases prejudice toward the political outgroup. Specifically, political inclusion was manipulated with either an imagined scenario (Study 1) or a concurrent experience in an ostensible online political discussion (Studies 2 & 3). Across all studies, participants who were politically included by political outgroup members reported reduced prejudice toward their outgroup compared to participants in a neutral control condition (Cohen’s d [-0.27, -0.50]). This effect was mediated by perceptions of the political outgroup as fairer and less dissimilar in their worldviews. Our results indicate that political discussions that are politically inclusive do not cause additional prejudice via worldview conflict, but instead give others a feeling of being heard. It is a promising strategy to reduce political prejudice.


Author(s):  
Roxana Steliana Miclaus ◽  
Nadinne Roman ◽  
Ramona Henter ◽  
Silviu Caloian

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.


Author(s):  
Jieling Chen ◽  
Cho Lee Wong ◽  
Bernard Man Hin Law ◽  
Winnie Kwok Wei So ◽  
Doris Yin Ping Leung ◽  
...  

Summary Pneumoconiosis is a common occupational lung disease among construction workers. Educational interventions targeting specific ethnic groups of construction workers are of benefit for pneumoconiosis prevention. The aim of this study was to develop a multimedia educational intervention for pneumoconiosis prevention for South Asian construction workers, and to evaluate its feasibility, acceptability and effectiveness in increasing knowledge of pneumoconiosis, modifying beliefs about pneumoconiosis, and enhancing intention to implement measures for its prevention among the workers. This evaluation was performed using the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. A one-group design was adopted and intervention mapping was used to guide the process of intervention development, while the Health Belief Model guided the development of intervention content. The intervention was delivered at construction sites, ethnic minority associations and South Asian community centres. Data were collected via surveys completed at pre-intervention, post-intervention and 3 months after the intervention. A total of 1002 South Asian construction workers participated in the intervention. The participants reported a moderate-to-large increase in knowledge, perceived susceptibility, perceived severity, perceived benefits, cues to action and self-efficacy (Cohen’s d: 0.37–0.89), a small reduction in perceived barriers (Cohen’s d = 0.12) and a moderate improvement in attitudes and intention to practice (Cohen’s d: 0.45, 0.51) at post-intervention. A follow-up survey of 121 participants found that the implementation of preventive measures appeared to increase. Overall, the findings demonstrate that the implementation of a culturally adapted multimedia educational intervention could be an effective approach to improving knowledge, self-efficacy and intention regarding pneumoconiosis prevention among South Asian construction workers.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monika S. Mellem ◽  
Matt Kollada ◽  
Jane Tiller ◽  
Thomas Lauritzen

Abstract Background Heterogeneity among patients’ responses to treatment is prevalent in psychiatric disorders. Personalized medicine approaches—which involve parsing patients into subgroups better indicated for a particular treatment—could therefore improve patient outcomes and serve as a powerful tool in patient selection within clinical trials. Machine learning approaches can identify patient subgroups but are often not “explainable” due to the use of complex algorithms that do not mirror clinicians’ natural decision-making processes. Methods Here we combine two analytical approaches—Personalized Advantage Index and Bayesian Rule Lists—to identify paliperidone-indicated schizophrenia patients in a way that emphasizes model explainability. We apply these approaches retrospectively to randomized, placebo-controlled clinical trial data to identify a paliperidone-indicated subgroup of schizophrenia patients who demonstrate a larger treatment effect (outcome on treatment superior than on placebo) than that of the full randomized sample as assessed with Cohen’s d. For this study, the outcome corresponded to a reduction in the Positive and Negative Syndrome Scale (PANSS) total score which measures positive (e.g., hallucinations, delusions), negative (e.g., blunted affect, emotional withdrawal), and general psychopathological (e.g., disturbance of volition, uncooperativeness) symptoms in schizophrenia. Results Using our combined explainable AI approach to identify a subgroup more responsive to paliperidone than placebo, the treatment effect increased significantly over that of the full sample (p < 0.0001 for a one-sample t-test comparing the full sample Cohen’s d = 0.82 and a generated distribution of subgroup Cohen’s d’s with mean d = 1.22, std d = 0.09). In addition, our modeling approach produces simple logical statements (if–then-else), termed a “rule list”, to ease interpretability for clinicians. A majority of the rule lists generated from cross-validation found two general psychopathology symptoms, disturbance of volition and uncooperativeness, to predict membership in the paliperidone-indicated subgroup. Conclusions These results help to technically validate our explainable AI approach to patient selection for a clinical trial by identifying a subgroup with an improved treatment effect. With these data, the explainable rule lists also suggest that paliperidone may provide an improved therapeutic benefit for the treatment of schizophrenia patients with either of the symptoms of high disturbance of volition or high uncooperativeness. Trial Registration: clincialtrials.gov identifier: NCT 00,083,668; prospectively registered May 28, 2004


Author(s):  
Adel M. Madkhali ◽  
Shibili Nuhmani

Abstract Background Lateral ankle sprain is one of the most common injuries in competitive sports. Previous studies which investigated muscle strength and proprioception (joint position sense) focused on subjects who sustained ankle sprain with instability. It is also important to investigate strength deficits and proprioception in subjects with a history of ankle sprain without instability. Therefore the aim of the study is to investigate proprioception and muscle strength deficits in athletes with lateral ankle sprain. Methods Twenty-four male athletes with a history of lateral ankle sprain and 24 age-matched controls (mean age of 22.42±4.13 years, mean height of 173±5.73 cm, and mean weight of 71.20±7.55 Kg) participated in this cross-sectional study. Peak torque and peak torque ratio at speeds of 30 and 120°/s for concentric and eccentric ankle inversion/eversion were evaluated using an isokinetic dynamometer. The joint position sense of the ankle joint was evaluated using an active angle reproduction test. Result Peak torque produced was significantly less in subjects with history of ankle sprain in concentric inversion 30°/s(t(47)=4.11; p=0.000, Cohen’s d=1.29), concentric inversion 120°/s (t(47)=3.01; p=0.006, Cohen’s d=1.13), concentric eversion 30°/s (t(47)=3.85; p=0.001, Cohen’s d=1.24) and concentric eversion 120°/s (t(47)=3.15; p=0.005, Cohen’s d=1.09). At the same time there was no significant difference observed in eccentric eversion peak torque in both speed (eccentric eversion 30°/s p=0.079; eccentric eversion 120°/s p=0.867) between experimental and control group. No significant difference was found in the joint position sense in the maximal active inversion −5° position (p=0.312) and the 15° inversion position (P=0.386) between both group. Conclusion The study’s results reported a significantly less peak torque of invertors and evertors during concentric movements in athletes with history of ankle sprain. At the same time, no significant difference reported in the evertor/invertor peak torque ratio, and active joint position sense between the 2 groups.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Joshua R Sparks ◽  
Ryan R Porter ◽  
Shawn D Youngstedt ◽  
Kimberly P Bowyer ◽  
J Larry Durstine ◽  
...  

Abstract Study Objectives This study examined how glucose, glucose regulatory hormones, insulin sensitivity, and lipoprotein subclass particle concentrations and sizes change with sleep restriction during weight loss elicited by calorie restriction. Methods Overweight or obese adults were randomized into an 8-week calorie restriction intervention alone (CR, n = 12; 75% female; body mass index = 31.4 ± 2.9 kg/m2) or combined with sleep restriction (CR+SR, n = 16; 75% female; body mass index = 34.5 ± 3.1 kg/m2). Participants in both groups were given the same instructions to reduce calorie intake. Those in the CR+SR group were instructed to reduce their habitual time-in-bed by 30–90 minutes 5 days each week with 2 ad libitum sleep days. Fasting venous blood samples were collected at pre- and post-intervention. Results Differential changes were found between the two groups (p = 0.028 for group × time interaction) in glucagon concentration, which decreased in the CR group (p = 0.016) but did not change in CR+SR group. Although changes in mean HDL particle (HDL-P) size and visfatin concentration were not statistically different between groups (p = 0.066 and 0.066 for group×time interaction, respectively), mean HDL-P size decreased only in the CR+SR group (Cohen’s d = 0.50, p = 0.022); visfatin concentrations did not change significantly in either group but appeared to decrease in the CR group (Cohen’s d = 0.67, p = 0.170) but not in the CR+SR group (Cohen’s d = 0.43, p = 0.225). Conclusion These results suggest that moderate sleep restriction, despite the presence of periodic ad libitum sleep, influences lipoprotein subclass particles and glucose regulation in individuals undergoing calorie restriction. Clinical trial registration: ClinicalTrials.gov (NCT02413866, Weight Outlooks by Restriction of Diet and Sleep)


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 704.2-704
Author(s):  
A. Garaiman ◽  
C. Mihai ◽  
R. Dobrota ◽  
S. Jordan ◽  
B. Maurer ◽  
...  

Background:Depression, anxiety and distress affect the quality of life of patients with systemic sclerosis (SSc) [1]. The Hospital Anxiety and Depression Scale (HADS) and Sense of Coherence 13-item scale (SOC-13, measuring comprehensibility, manageability and meaningfulness) are screening tools used in patients with different medical conditions. However, their validity, reliability and sensitivity to change in SSc patients has not been evaluated yet.Objectives:To examine the psychometric properties of HADS and its subscales HADS-A and HADS-D (measuring anxiety and depression symptoms, respectively), and unidimensional SOC-13 in a large cohort of Swiss SSc patients.Methods:Consecutive patients fulfilling the ACR/EULAR 2013 classification criteria for SSc who completed the HADS, SOC-13, Short Form-36 Health Survey (SF-36) and Scleroderma Health Assessment Questionnaire (SHAQ) were included in a cross-sectional and longitudinal analysis. Cronbach’s α, split-half reliability and construct validity were measured. Sensitivity to change (Cohen’s d coefficient) was assessed in patients who worsened within 12±3 months, defined as occurrence of any of the following events: decline in forced vital capacity (FVC)≥10%, new diagnosis of interstitial lung disease (ILD) on high-resolution computed tomography (HRCT), progression of known ILD to >20% lung involvement on HRCT (ILD20), new-onset pulmonary hypertension (PH), increase in European Scleroderma Study Group activity index (EScSG-AI) >3 points, new active digital ulcers, increase in modified Rodnan skin score (mRSS) > 7 points.Results:Of 345 patients (aged 59.34±14.17, 82.9% female, 18.8% with diffuse cutaneous SSc, 47.6% anti-centromere Ab-positive, 23.5% anti-Scl-70 Ab-positive, 13% anti-U1RNP Ab-positive and 11.3% anti-RNA polymerase III Ab-positive) 85 participated with a second visit to the sensitivity to change analysis.Internal consistency was excellent for the HADS (Cronbach’s α=0.91; split-half reliability r=0.92), and very good for HADS-A, HADS-D and SOC-13 (Cronbach’s α=0.85-0.89; split-half reliability r=0.86-0.89).Regarding construct validity, all four scales showed a strong to very strong correlation to each other, as well as with the mental components of SF-36 (Spearman’s r=0.63-0.85). There was a moderate to strong correlation with the SHAQ (Spearman’s r=0.45-0.64).Regarding sensitivity to change: HADS-A showed a large to very large effect size (ES) for progression of ILD as assessed on HRCT and increase in EScSG-AI (Cohen’s d=1-1.63), and a very small to small ES for changes in FVC, DU and mRSS (Cohen’s d=0.02-0.45). HADS-D showed a large ES for changes in the ILD20, mRSS and EScSG-AI (Cohen’s d=0.82-1), and moderate ES for changes of FVC, ILD, PH, DU (Cohen’s d=0.1-0.49). SOC-13 showed generally a very small to small EF, except for change in mRSS (Cohen’s d=0.56).Conclusion:The HADS(A/D) and SOC-13 are valid and easy-to-use tools to detect depression, anxiety and distress in SSc. However, their sensitivity to change might be limited by the respective type of organ involvement and its impact on the patients’ psychological wellbeing.References:[1]Legendre C, Allanore Y, Ferrand I, Kahan A. Evaluation of depression and anxiety in patients with systemic sclerosis. Joint Bone Spine. 2005;72(5):408–411.Disclosure of Interests:Alexandru Garaiman: None declared, Carina Mihai: None declared, Rucsandra Dobrota: None declared, Suzana Jordan: None declared, Britta Maurer Grant/research support from: AbbVie, Protagen, Novartis, congress support from Pfizer, Roche, Actelion, and MSD, Speakers bureau: Novartis, Oliver Distler Grant/research support from: Grants/Research support from Actelion, Bayer, Boehringer Ingelheim, Competitive Drug Development International Ltd. and Mitsubishi Tanabe; he also holds the issued Patent on mir-29 for the treatment of systemic sclerosis (US8247389, EP2331143)., Consultant of: Consultancy fees from Actelion, Acceleron Pharma, AnaMar, Bayer, Baecon Discovery, Blade Therapeutics, Boehringer, CSL Behring, Catenion, ChemomAb, Curzion Pharmaceuticals, Ergonex, Galapagos NV, GSK, Glenmark Pharmaceuticals, Inventiva, Italfarmaco, iQvia, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Roche, Sanofi and UCB, Speakers bureau: Speaker fees from Actelion, Bayer, Boehringer Ingelheim, Medscape, Pfizer and Roche, Mike-Oliver Becker: None declared


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