scholarly journals AN INTERVENTION TO SUPPORT PERSONS WITH EARLY-STAGE DEMENTIA AND THEIR FAMILY CARE PARTNERS: ADAPTED VERSIONS TARGETED FOR INDIVIDUAL DYADS, DYAD GROUPS, HEART FAILURE DYADS, AND DUTCH FAMILIES IN THE NETHERLANDS

2015 ◽  
Vol 55 (Suppl_2) ◽  
pp. 140-141
2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 625-626
Author(s):  
Carol Whitlatch ◽  
Steven Zarit ◽  
Steven Zarit

Abstract Persons living with a recent diagnosis of dementia experience great uncertainty and stress as they and their families try to adjust to the new reality of their lives and futures. One fruitful strategy for intervening with these families is to include both the person living with dementia and their family care partner in the program. Although dyadic approaches are rare among early-stage programs, promising examples exist. The SHARE Program (Support, Health, Activities, Resources, and Education) is one exception where dyadic materials address: 1) current and long- term needs of care partners, and 2) how the family can develop a realistic plan of care based on their care values and preferences. This symposium describes the development and positive outcomes of the original SHARE intervention and the promising adaptations that expand how and to whom the intervention is delivered. Presentations explore: 1) the original SHARE for Dementia program and strategies for expanding its reach into chronic conditions populations (Orsulic-Jeras & Whitlatch), 2) a group version translated into Spanish (“EPIC: Early-stage Partners in Care,” Dr. Coon), and 3) the development of a remote needs assessment and unobtrusive in-home monitoring technology platform that guides care planning and helps to maintain independence (“SHARE-sense,” Dr. Miller). Discussion will focus on the challenges, unique solutions, and positive outcomes when adapting SHARE to different settings and populations (Dr. Zarit).


2014 ◽  
Vol 19 (2) ◽  
pp. 50-56 ◽  
Author(s):  
Kerry Mills ◽  
Jennifer Brush

Speech-language pathologists can play a critical role in providing education and intervention to prevent social withdrawal, prevent premature disability, and maximize cognitive functioning in persons with MCI. The purpose of this article is to describe positive, solution-focused educational program that speech-language pathologists can implement with family care partners to improve relationships and provide quality care for someone living with MCI.


Author(s):  
Katherine P. Supiano ◽  
Troy Andersen ◽  
Marilyn Luptak ◽  
Cynthia Beynon ◽  
Eli Iacob ◽  
...  

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 626-626
Author(s):  
Silvia Orsulic-Jeras ◽  
Carol Whitlatch

Abstract Advances in diagnostic procedures have helped to make diagnosing Alzheimer’s disease and other dementias more accurate and to occur earlier in the disease progression. For persons living with dementia and their family care partners, finding programs that meet their needs for support post diagnosis can be challenging. Likewise, for persons with chronic conditions, few programs exist which help care dyads to create a manageable plan of care that addresses each person’s concerns and fears. SHARE, (Support, Health, Activities, Resources, and Education), originally designed for dementia care partners, has shown positive outcomes for both members of the care partnership. This presentation describes the development of the six-session SHARE intervention, its implementation in community settings, and its current standing as an evidence-based program and product that has been commercialized. Discussion will also focus on adapting SHARE for use with chronic illness families, highlighting revisions to program procedures, materials, recruitment, and evaluation.


Proceedings ◽  
2021 ◽  
Vol 77 (1) ◽  
pp. 12
Author(s):  
Annemarie van de Weert

In recent years, the fight against terrorism and political violence has focused more on anticipating the threats that they pose. Therefore, early detection of ideas by local professionals has become an important part of the preventive approach in countering radicalization. Frontline workers who operate in the arteries of society are encouraged to identify processes towards violent behavior at an early stage. To date, however, little is known about how these professionals take on this screening task at their own discretion. Research from the Netherlands suggests that subjective assessment appears to exist. This is due to the absence of a clear norm for preliminary judgments. However, such an approach affects prejudice or administrative arbitrariness, which may cause side effects due to unjustified profiling. The publications about the Dutch case are inspired by the concept of “performativity”, (de Graaf, B., & de Graaff, B. G. J. (2010). Bringing politics back in: The introduction of the ‘performative power’ of counterterrorism. Critical Studies on Terrorism, 3(2), pp. 261–275.) which points to a distinct relationship between the performative power of counterterrorism instruments and the effectiveness of the local approach. Performativity contends that the overall effect of the policy in question is not necessarily determined by the policy measures and their intended results, as such, but more by the way in which they are presented and perceived. This means that, in order to create an equitable approach, governments, whether local or national, should focus more on the actual practice performed by frontline practitioners. The focus on practices is part of a larger project, entitled ‘Gatekeepers of Justice’ (See: https://www.internationalhu.com/research/access-to-justice), by the Research Group Access2Justice (Research Centre of Social Innovation at Utrecht University of Applied Science), led by professor Quirine Eijkman, Deputy President of the Netherlands Institute for Human Rights.


2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Tsung-Hsien Chen ◽  
Shan-Wen Liu ◽  
Mei-Ru Chen ◽  
Kurt M Lin

Whereas aggregation of intracellular proteins was linked to the initiation of cardiac myopathy, the sequence of participating events, including myocyte apoptosis, autophagy, necrosis and fibrosis as the underlying mechanisms leading to heart failure, was not clear. Green fluorescent protein (GFP) and its derivatives induced cardiac dysfunction in mice when expressed in high quantity; however, the mechanism underlying the aggregation of fluorescent protein leading to heart failure remains unexplored.We created a transgenic mouse with switchable expression of the GFP monomer or the expression of DsRed, a red fluorescent protein (RFP) tetramer that tends to aggregate into a large protein complex. GFP mice were free of cardiac symptoms; in contrast, RFP mice with homozygous DsRed alleles developed myocyte necrosis, carditis, ventricular hypertrophy and fibrosis, left atrium thrombosis, dilated heart failure and death at the age of approximately five months. The hemizygote mice displayed similar symptoms at a later age. The expression of the microtubule-associated protein 1 light chain 3 cleaved isoform II (LC3 II) and transglutaminase 2, and the expression of many myopathy- and fibrosis-related genes were significantly induced in the hearts of two-month-old RFP mice. Together with the findings of increased autophagosomes, lysosomes and dysfunctional mitochondria, these results suggest a marked induction of myocyte autophagy and fibrosis as the main underlying mechanism of heart failure in RFP mice. Interestingly, apoptosis was not elevated in RFP hearts. One of the most up-regulated genes in the early stage RFP heart was the tissue inhibitor of matrix metalloproteinases type 1 (TIMP-1), corroborating the role of TIMP-1 in cardiac remodeling and anti-apoptotic activity. The heart-origin of the morbidity in RFP mice was confirmed by expressing DsRed tetramers specifically in cardiac tissues, and the same phenotypes as in RFP mice were observed. In summary, in cardiac myocytes under the stress of protein aggregation, strong induction of TIMP-1 and down-regulation of MMP activity may play a significant role in enhancing the synthesis of extracellular matrix, resulting in fibrosis and heart failure.


2016 ◽  
Vol 15 (2) ◽  
pp. 86-93
Author(s):  
M.L. Mamalyga ◽  
◽  
L.M. Mamalyga ◽  

On the early stage of cardiac decompensation, the blood flow in common carotid and basilar arteries does not change, however the seizure readiness (SR) of animals increases. The preserved reaction on hypercapnic and compression tests allows us to stipulate that the increased SR is not related to the circulatory brain disorders. Progressive aggravation of cardiac failure (CF) leads to the severe stage of decompensation accompanied by decreased blood flow in common carotid and basilar arteries, as well as increases SR. At the same time the metabolic cascade of autoregulation is areactive and myogenic is significantly decreased. Ineffective operation of heart in different stages of heart failure shows not the same effect or backup possibilities for cerebral hemodynamic autoregulation affecting the formation and aggravation of SR. The increased SR in cardiac failure is not always caused by brain ischemia.


2018 ◽  
Author(s):  
Jorien Maria Margaretha van der Burg ◽  
Nasir Ahmad Aziz ◽  
Maurits C. Kaptein ◽  
Martine J.M. Breteler ◽  
Joris H. Jansen ◽  
...  

UNSTRUCTURED Objective The aim of this study was to evaluate the effectiveness of home telemonitoring in reducing healthcare usage and costs in patients with heart failure or chronic obstructive pulmonary disease (COPD). Design The study was a retrospective observational study with a pre-post research design and a follow-up duration of up to 3 years, based on hospital data collected in the period 2012-2016. Setting Data was collected at the Slingeland Hospital in Doetinchem, The Netherlands. Participants In 2012 the Slingeland Hospital in The Netherlands started a telemonitoring program for patients with COPD or heart failure as part of their usual care. Patients were eligible for the telemonitoring program if they were in an advanced disease stage (New York Heart Association (NYHA) functional class 3 or 4; COPD gold stage 3 or 4), received treatment for their condition by a cardiologist or pulmonary specialist at the Slingeland Hospital, were proficient in Dutch and capable of providing informed consent. Exclusion criteria were absence of the cognitive, physical or logistical ability required to fully participate in the program. Hundred seventy-seven patients with heart failure and 83 patients with COPD enrolled the program between 2012 and 2016. Intervention Using a touchscreen, participants with heart failure recorded their weight (daily), blood pressure and heart rate (once a week) through connected instruments, and completed a questionnaire about their symptoms (once a week). Symptoms in patients with COPD were monitored via the Clinical COPD Questionnaire (CCQ), which participants were asked to complete twice per week. All home registrations were sent via a telemonitoring application (cVitals, FocusCura, Driebergen-Rijssenburg) on the iPad to a medical service center were a trained nurse monitored the data and contacted the patient by video chat or a specialised nurse in the hospital in case of abnormal results, such as deviations from a preset threshold or alterations in symptom score. Outcome measures The primary outcome was the number of hospitalisations; the secondary outcomes were total number of hospitalisation days and healthcare costs during the follow-up period. Generalised Estimating Equations were applied to account for repeated measurements, adjusting for sex, age and length of follow-up. Results In heart failure patients (N=177), after initiation of home telemonitoring both the number of hospitalisations and the total number of hospitalisation days significantly decreased (incidence rate ratio of 0.35 (95% CI: 0.26-0.48) and 0.35 (95% CI: 0.24-0.51), respectively), as did the total healthcare costs (exp(B) = 0.11 (95% CI: 0.08-0.17)), all p < 0.001. In COPD patients (N=83) neither the number of hospitalisations nor the number of hospitalisation days changed compared to the pre-intervention period. However, the average healthcare costs were about 54% lower in COPD patients after the start of the home telemonitoring intervention (exp(B) = 0.46, 95% CI 0.25-0.84, p = 0.011). Conclusion Integrated telemonitoring significantly reduced the number of hospital admissions and days spent in hospital in patients with heart failure, but not in patients with COPD. Importantly, in both patients with heart failure and COPD the intervention substantially reduced the total healthcare costs.


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