Severity of Neuropsychiatric Symptoms in Nursing Home Residents

We aimed at assessing time shift in the severity of neuropsychiatric symptoms (NPS) in nursing home residents between 2004/2005 and 2010/2011 and associations between NPS and socio-demographic variables, physical health status, dementia severity, and the use of psychotropic drugs. The Neuropsychiatric Inventory Nursing Home Version was used in 2004/2005 (n = 1,163) and 2010/2011 (n = 1,858). Linear mixed model analysis was applied. There was no time shift in the severity of apathy, psychosis, and affective symptoms, but agitation did exhibit a time shift. Agitation was less severe in 2010/2011 than in 2004/2005 in residents with a Clinical Dementia Rating (CDR) sum of boxes score ≤4, and more severe in residents with a CDR sum of boxes score >16. Higher CDR sum of boxes scores and use of psychotropic medication were associated with more severe apathy, agitation, psychosis, and affective symptoms. Poor physical health was associated with more severe apathy, psychosis, and affective symptoms. Women had more severe agitation and less severe affective symptoms than men. A longer stay in a nursing home was associated with more severe agitation and less severe affective symptoms. In conclusion, agitation was less severe in 2010/2011 than in 2004/2005 among nursing home residents with a milder degree of dementia, and more severe in residents with severe dementia.

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The course of neuropsychiatric symptoms in nursing-home patients with dementia over a 53-month follow-up period

International Psychogeriatrics ◽

10.1017/s1041610213001609 ◽

2013 ◽

Vol 26 (1) ◽

pp. 81-91 ◽

Cited By ~ 76

Author(s):

Geir Selbæk ◽

Knut Engedal ◽

Jūratė Šaltytė Benth ◽

Sverre Bergh

Keyword(s):

Nursing Home ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Clinical Dementia Rating ◽

Severe Dementia ◽

Persistent Symptoms ◽

Nursing Home Patients ◽

Affective Symptoms ◽

Clinically Significant

ABSTRACTBackground:Neuropsychiatric symptoms (NPS) are prevalent in nursing-home (NH) patients with dementia, but little is known about the long-term course of these symptoms.Methods:In this study, 931 NH patients with dementia took part in a prospective cohort study with four assessments over a 53-month follow-up period. NPS and level of dementia were assessed with the Neuropsychiatric Inventory scale and the Clinical Dementia Rating scale, respectively.Results:Mild, moderate, and severe dementia was present in 25%, 33%, and 42%, respectively. There was an increase in the severity of the dementia from the first to the fourth assessment. Agitation, irritability, disinhibition, and apathy were the most prevalent and persistent symptoms during the study period. The affective subsyndrome (depression and anxiety) became less severe, whereas the agitation subsyndrome (agitation/aggression, disinhibition, and irritability) and apathy increased in severity during the follow-up period. More severe dementia was associated with more severe agitation, psychosis, and apathy, but not more severe affective symptoms. Mild dementia was associated with an increase in the severity of psychosis, whereas moderate or severe dementia was associated with decreasing severity of psychosis over the follow-up period.Conclusion:Nearly all the patients experienced clinically significant NPS, but individual symptoms fluctuated. Affective symptoms became less severe, while agitation and apathy increased in severity. An increase in dementia severity was associated with an increase in the severity of agitation, psychosis, and apathy, but not affective symptoms. The results may have implications when planning evaluation, treatment, and the prevention of NPS in NH patients.

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The relationship between guilt feelings, conflicts with staff and satisfaction with care in relatives of nursing home residents with dementia: A longitudinal analysis

Dementia ◽

10.1177/14713012211024015 ◽

2021 ◽

pp. 147130122110240

Author(s):

Laura Gallego-Alberto ◽

Hanneke JA Smaling ◽

Anneke L Francke ◽

Tim van de Brug ◽

Jenny T van der Steen ◽

...

Keyword(s):

Nursing Home ◽

Family Caregivers ◽

Mixed Model ◽

Linear Mixed Model ◽

Nursing Home Residents ◽

Satisfaction With Care ◽

People With Dementia ◽

Person With Dementia ◽

The Impact ◽

Over Time

Introduction Family caregivers often experience guilt after nursing home placement. The aim of the present study was to describe family caregivers’ guilt over time and assess the impact of conflicts with staff and satisfaction with care on guilt. Method Data of 222 family caregivers at three assessments during one-year follow-up were used. In addition to caregivers’ guilt and the variables conflicts with staff and satisfaction with the care, potential confounders were measured: sociodemographic data, clinical characteristics of the person with dementia, and caregiver burden. Linear mixed model analyses were performed to examine the longitudinal relationships between variables. Results Guilt remained stable over time. Unadjusted models showed that conflicts with staff were positively associated with guilt ( β = 0.11; p < 0.001; 95% CI: 0.06 to 0.16) and satisfaction with care showed a negative association with guilt ( β = −0.10; p< 0.05; 95% CI: −0.18 to −0.01). After adjusting for the confounders, only the positive association of guilt with conflicts with staff was similar as in the unadjusted analysis ( β = 0.11; p < 0.001; 95% CI: 0.05 to 0.16), whereas satisfaction with care was not significantly associated with guilt in the adjusted analyses ( β = −0.07; p = 0.10; 95% CI: −0.16 to 0.01). Discussion More conflicts with staff are associated with stronger guilt feelings. Guilt feelings are experienced by caregivers even after the admission of the person with dementia, and they remain stable over time. Further studies should focus on how to address guilt in family caregivers of people with dementia living in nursing homes.

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Neuropsychiatric Burden Is a Predictor of Early Freezing and Motor Progression in Drug-Naïve Parkinson’s Disease

Journal of Parkinson s Disease ◽

10.3233/jpd-212660 ◽

2021 ◽

pp. 1-10

Author(s):

Seong Ho Jeong ◽

Han Soo Yoo ◽

Seok Jong Chung ◽

Jin Ho Jung ◽

Yang Hyun Lee ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Mixed Model ◽

Linear Mixed Model ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Model Analysis ◽

Mixed Model Analysis ◽

Linear Mixed Model Analysis ◽

Drug Naïve

Background: Neuropsychiatric symptoms (NPS) are the most common non-motor symptom in Parkinson’s disease (PD). Objective: To investigate the association between the burden of NPS and motor prognosis in patients with PD. Methods: We enrolled 329 drug-naïve patients with PD, who was non-demented and followed-up≥2 years after their first visit to the clinic with baseline dopamine transporter (DAT) imaging and neuropsychiatric inventory (NPI) scores. We performed a survival analysis and a linear mixed model analysis to assess longitudinal motor outcomes according to the NPI total score. Results: The Kaplan-Meier analysis showed no difference in the development of levodopa-induced dyskinesia and wearing-off according to the NPI total score. However, higher burden of NPI total score was associated with earlier freezing of gait (FOG) development in the time-dependent Cox regression models after adjusting for age at symptom onset, sex, disease duration, Unified PD Rating Scale motor score, baseline Mini-Mental State Examination score, DAT activity in the posterior putamen and levodopa-equivalent daily dose (LEDD) (Hazard ratio 1.047, p = 0.002). A linear mixed model analysis revealed that patients with a higher NPI total score had a more rapid LEDD increment (NPI×time, p = 0.003). Among 52 patients with PD who eventually developed FOG during the follow-up period, there was a significant correlation between the NPI total score and time with FOG development (γ= –0.472; p = 0.001) after adjusting for confounding factors. Conclusion: The present study demonstrated that the severity of NPS is a predictor of early freezing and motor progression in patients with PD.

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Association between housing and health of refugees and asylum seekers in Germany: explorative cluster and mixed model analysis

BMC Public Health ◽

10.1186/s12889-021-12458-1 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Verena Dudek ◽

Oliver Razum ◽

Odile Sauzet

Keyword(s):

Mental Health ◽

Regression Analysis ◽

Health Disparities ◽

Physical Health ◽

Asylum Seekers ◽

Mixed Model ◽

Linear Mixed Model ◽

Bivariate Analysis ◽

Cross Sectional ◽

Mixed Model Analysis

Abstract Background Accommodation for asylum seekers and refugees (ASR) in Germany differs in many ways depending on a range of political, structural, social, and environmental factors. These contextual differences present a challenge for assessing health impacts of refugee accommodation. We aimed to devise a broad typology of refugee accommodation that allows to assess associations between housing and health of ASR. Methods We performed a cluster analysis of population-based, cross-sectional secondary data in Germany to identify clusters of refugee accommodation. We then assessed health disparities across clusters by performing bivariate analysis and linear mixed model regression analysis. Results We identified four clusters, three of them reflected different types of private accommodation and one pointed to collective accommodation. The collective accommodation cluster clearly differed from the private accommodation clusters in terms of space, area, level of restrictions, social connections and respondent satisfaction. Across private accommodation clusters we also found differences in space, area, and level of restrictions. In regression analysis, belonging to one of the private accommodation cluster was significantly associated with better mental health compared to belonging to the collective accommodation cluster. Physical health was significantly lower in one private accommodation cluster characterized by poor access to public transport and a higher level of restrictions compared to a private accommodation cluster showing better connections and a lower level of restrictions. Conclusion We demonstrate that unfavourable conditions cluster in collective accommodation with negative outcomes for mental health but not for physical health. We also found health disparities across types of private accommodation. We conclude that housing plays a role in the production of health inequalities in ASR but needs to be assessed in a differentiated, multidimensional way.

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Reducing Aggression by Developing Emotional and Inhibitory Control

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105263 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5263

Author(s):

Miriam Romero-López ◽

María Carmen Pichardo ◽

Ana Justicia-Arráez ◽

Judit Bembibre-Serrano

Keyword(s):

Psychosocial Development ◽

Mixed Model ◽

Linear Mixed Model ◽

Generalized Linear Mixed Model ◽

Emotional Control ◽

Control Group ◽

Post Intervention ◽

Mixed Model Analysis ◽

Intervention Measures ◽

Experimental Group

The objective of this study is to measure the effectiveness of a program on improving inhibitory and emotional control among children. In addition, it is assessed whether the improvement of these skills has an effect on the reduction of aggressive behavior in pre-school children. The participants were 100 children, 50 belonging to the control group and 50 to the experimental group, aged between 5 and 6 years. Pre-intervention and post-intervention measures of inhibitory and emotional control (BRIEF-P) and aggression (BASC) were taken. A Generalized Linear Mixed Model analysis (GLMM) was performed and found that children in the experimental group scored higher on inhibitory and emotional control compared to their peers in the control group. In addition, these improvements have an effect on the decrease in aggressiveness. In conclusion, preventive research should have among its priorities the design of such program given their implications for psychosocial development.

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Methods to Assess Fat Mass in Infants and Young Children: A Comparative Study Using Skinfold Thickness and Air-Displacement Plethysmography

Life ◽

10.3390/life11020075 ◽

2021 ◽

Vol 11 (2) ◽

pp. 75

Author(s):

Stefanie M. P. Kouwenhoven ◽

Nadja Antl ◽

Jos W. R. Twisk ◽

Berthold V. Koletzko ◽

Martijn J. J. Finken ◽

...

Keyword(s):

Young Children ◽

Fat Mass ◽

Mixed Model ◽

Linear Mixed Model ◽

Correlation Coefficients ◽

Skinfold Thickness ◽

Limited Information ◽

Air Displacement Plethysmography ◽

Mixed Model Analysis ◽

Infants And Young Children

Background: Traditionally, fat mass is estimated using anthropometric models. Air-displacement plethysmography (ADP) is a relatively new technique for determining fat mass. There is limited information on the agreement between these methods in infants and young children. Therefore we aimed to longitudinally compare fat mass percentage values predicted from skinfold thicknesses (SFTs) and ADP in healthy infants and young children. Methods: Anthropometry and body composition were determined at the ages of 1, 4, and 6 months and 2 years. We quantified the agreement between the two methods using the Bland–Altman procedure, linear mixed-model analysis, and intra-class correlation coefficients (ICC). Results: During the first 6 months of life, fat mass% predicted with SFT was significantly different from that measured with ADP in healthy, term-born infants (n = 245). ICCs ranged from 0.33 (at 2 years of age) and 0.47 (at 4 months of age). Although the mean difference (bias) between the methods was low, the Bland–Altman plots showed proportional differences at all ages with wide limits of agreement. Conclusions: There is poor agreement between ADP and SFTs for estimating fat mass in infancy or early childhood. The amount of body fat was found to influence the agreement between the methods.

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Factors influencing the occurrence of high ultimate pH in three muscles of lamb carcasses in Australia

Animal Production Science ◽

10.1071/an14315 ◽

2014 ◽

Vol 54 (10) ◽

pp. 1853 ◽

Cited By ~ 8

Author(s):

N. G. McPhail ◽

J. L. Stark ◽

A. J. Ball ◽

R. D. Warner

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Rectus Femoris ◽

Carcass Weight ◽

Mixed Model Analysis ◽

Factors Influencing ◽

South Wales ◽

Generalised Linear Mixed Model ◽

Processing Plants ◽

Few Data

Chilled lamb meat exported from Australia has, on occasions, been rejected by importing countries due to greening, after only 6 weeks of storage time. Greening is known to be more prevalent in high ultimate pH (pHu) beef meat (>5.9). There are few data available for lamb carcasses in Australia on the occurrence of high pHu meat, which may have an impact on the understanding and control of quality and greening during storage. The aim of this project was to determine the prevalence of, and influencing factors for, high pHu meat in a range of muscle types in lamb carcasses in Australia. Muscle pHu data were collected from a total of 1614 carcasses from 78 lots at four lamb processing plants in Victoria and New South Wales in autumn and spring of 2013. The pHu of the knuckle (rectus femoris), rack (longissimus) and blade (infraspinatus) was measured and data on carcass and lot characteristics were recorded. Data were subjected to restricted maximum likelihood and generalised linear mixed model analysis. The mean pHu of the knuckle, rack and shoulder were 6.06, 5.79 and 6.12 respectively, and the main factors influencing muscle pHu and occurrence of dark-cutting were breed, season, electrical stimulation and carcass weight. Merino lambs had a higher pHu in the blade and knuckle than did other breeds (P < 0.05, P < 0.01 respectively). Lambs processed in autumn had a higher predicted pHu in the blade and knuckle and a higher percentage dark-cutting (DC; pHu >6.0) for those muscles, than did those processed in spring (P < 0.05). Carcasses that had been electrically stimulated had a higher %DC and a higher pHu in all three muscles (P < 0.05). Carcass weight had a significant effect on the pHu of all three muscles (P < 0.001), with heavier carcasses having a lower pHu and lower %DC. The pHu of the rack was not a reliable predictor for the pHu in other muscles of the lamb carcass. In conclusion, the high occurrence of DC in the muscles, particularly the blade and knuckle, suggests that these muscles may be at risk for producing greening in the vacuum bag during storage.

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Size-related boldness is not altered by stomach flushing in a terrestrial salamander

Amphibia-Reptilia ◽

10.1163/15685381-bja10054 ◽

2021 ◽

pp. 1-6

Author(s):

Sebastiano Salvidio ◽

Andrea Costa ◽

Fabrizio Oneto

Keyword(s):

Body Condition ◽

Mixed Model ◽

Linear Mixed Model ◽

Animal Personality ◽

Model Analysis ◽

Mixed Model Analysis ◽

Linear Mixed Model Analysis ◽

Before And After ◽

Trophic Strategy ◽

The Relationship

Abstract Animal personality is a relatively neglected field in amphibian research. In this study we assessed the influence of stomach flushing, a non-lethal technique used in amphibian dietary studies, on the boldness behaviour of the cave salamander Speleomantes strinatii. The time of emergence from a shelter located in an unfamiliar environment (a proxy for individual boldness) was measured in 26 cave salamanders before and after stomach flushing, while 14 non-flushed salamanders were tested as controls. Boldness was a repeatable behaviour for salamanders and larger individuals emerged from their shelter more rapidly than smaller ones. Linear mixed model analysis showed that flushing, sex and body condition had no effect on this behaviour. These findings are promising in the framework of the study of salamander personality. In particular, our results will be useful when exploring the relationship between individual trophic strategy and boldness, aggression or exploration behaviours in terrestrial salamanders.

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Maximin Efficiencies under Treatment-Dependent Costs and Outcome Variances for Parallel, AA/BB, and AB/BA Designs

Computational and Mathematical Methods in Medicine ◽

10.1155/2018/8025827 ◽

2018 ◽

Vol 2018 ◽

pp. 1-15

Author(s):

Math J. J. M. Candel

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Optimal Allocation ◽

Power Level ◽

Equal Treatment ◽

Small Samples ◽

Asymptotic Results ◽

Crossover Designs ◽

Mixed Model Analysis ◽

Intraclass Correlations

If there are no carryover effects, AB/BA crossover designs are more efficient than parallel (A/B) and extended parallel (AA/BB) group designs. This study extends these results in that (a) optimal instead of equal treatment allocation is examined, (b) allowance for treatment-dependent outcome variances is made, and (c) next to treatment effects, also treatment by period interaction effects are examined. Starting from a linear mixed model analysis, the optimal allocation requires knowledge on intraclass correlations in A and B, which typically is rather vague. To solve this, maximin versions of the designs are derived, which guarantee a power level across plausible ranges of the intraclass correlations at the lowest research costs. For the treatment effect, an extensive numerical evaluation shows that if the treatment costs of A and B are equal, or if the sum of the costs of one treatment and measurement per person is less than the remaining subject-specific costs (e.g., recruitment costs), the maximin crossover design is most efficient for ranges of intraclass correlations starting at 0.15 or higher. For other cost scenarios, the maximin parallel or extended parallel design can also become most efficient. For the treatment by period interaction, the maximin AA/BB design can be proven to be the most efficient. A simulation study supports these asymptotic results for small samples.

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Which Test of Divergent Thinking Is Best?

Creativity Theories – Research – Applications ◽

10.1515/ctra-2016-0001 ◽

2016 ◽

Vol 3 (1) ◽

pp. 4-18 ◽

Cited By ~ 19

Author(s):

Mark A. Runco ◽

Ahmed M. Abdulla ◽

Sue Hyeon Paek ◽

Fatima A. Al-Jasim ◽

Hanadi N. Alsuwaidi

Keyword(s):

Divergent Thinking ◽

Mixed Model ◽

Linear Mixed Model ◽

Mixed Model Analysis ◽

Demographic Questionnaire ◽

Problem Generation ◽

Behavior Scale ◽

Realistic Problem ◽

Post Hoc ◽

Better Than

AbstractDivergent thinking (DT) tests are probably the most commonly used measures of creative potential. Several extensive batteries are available but most research relies on one or two specific tests rather than a complete battery. This may limit generalizations because tests of DT are not equivalent. They are not always highly inter-correlated. Additionally, some DT tests appear to be better than others at eliciting originality. This is critical because originality is vital for creativity. The primary purpose of the present study was to determine which test of DT elicits the most originality. Seven measures of DTwere administered on a sample of 611 participants in eight Arabic countries. The tests were Figural, Titles, Realistic Presented Problems, Realistic Problem Generation, Instances, Uses, and Similarities. The Quick Test of Convergent Thinking, Runco’s Ideational Behavior Scale, and a demographic questionnaire were also administered. A linear mixed model analysis confirmed that the originality scores in the DT tests differed by test. Post-hoc tests indicated that the Titles and Realistic Problem Generation tests produced the highest mean originality scores, whereas the Realistic Presented Problems test produced the lowest mean originality scores. These differences confirm that research using only one DT test will not provide generalizable results.

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