scholarly journals A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia

Dementia ◽  
2018 ◽  
Vol 19 (4) ◽  
pp. 1086-1130 ◽  
Author(s):  
Garuth Chalfont ◽  
Christine Milligan ◽  
Jane Simpson
Keyword(s):  
Case Studies ◽  
Stress Reduction ◽  
Grey Literature ◽  
Individual Case ◽  
Primary Diagnosis ◽  
Cognitive Outcome ◽  
Patient Treatment ◽  
Gut Health ◽  
Pharmacological Interventions ◽  
People With Dementia

Objective Multimodal non-pharmacological interventions have been argued to have the potential to complement current pharmacological approaches to improving quality of life for people living with dementia. The aim of this review was to identify, synthesise and appraise the evidence for the effectiveness of multimodal non-pharmacological interventions for improving cognitive function specifically. Method After a comprehensive search strategy including grey literature, 26 studies were reviewed. The inclusion criteria concerned adults with a primary diagnosis of dementia. Studies used two or more different modes of intervention, and measured a cognitive outcome. Due to differences in the conceptualisations of the term ‘multimodal’, a typology of modes and methods was developed to facilitate classification of candidate studies. Results Twenty-one group studies and five case studies were found. Group studies used two or three modes of intervention and multiple methods to implement them. Interventions utilised were cognitive, physical, psychological and psychosocial, nutrition, fasting, gut health, sleep hygiene, stress reduction, detoxification, hormonal health and oxygen therapy. Five individual case studies were found in two separate papers. Each personalised patient treatment utilised in-depth assessments and prescribed up to nine different modes. In 19 (90%) of the 21 group comparisons, participants were reported to have cognitive improvements, stability with their dementia or a delay in their decline. The extent of these improvements in terms of meaningful clinical change was variable. Conclusion Multimodal non-pharmacological interventions have the potential to complement singular therapeutic approaches by addressing multiple modifiable risk factors currently understood to contribute towards cognitive decline.

scholarly journals Assessing Environmental Factors within the One Health Approach

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 240
Author(s):  
Sarah Humboldt-Dachroeden ◽  
Alberto Mantovani
Keyword(s):  
Case Studies ◽  
One Health ◽  
Animal Health ◽  
Grey Literature ◽  
Aflatoxin M1 ◽  
First Case ◽  
Italian Regions ◽  
Environmental Component ◽  
Environmental Considerations ◽  
The One

Background: One Health is a comprehensive and multisectoral approach to assess and examine the health of animals, humans and the environment. However, while the One Health approach gains increasing momentum, its practical application meets hindrances. This paper investigates the environmental pillar of the One Health approach, using two case studies to highlight the integration of environmental considerations. The first case study pertains to the Danish monitoring and surveillance programme for antimicrobial resistance, DANMAP. The second case illustrates the occurrence of aflatoxin M1 (AFM1) in milk in dairy-producing ruminants in Italian regions. Method: A scientific literature search was conducted in PubMed and Web of Science to locate articles informing the two cases. Grey literature was gathered to describe the cases as well as their contexts. Results: 19 articles and 10 reports were reviewed and informed the two cases. The cases show how the environmental component influences the apparent impacts for human and animal health. The DANMAP highlights the two approaches One Health and farm to fork. The literature provides information on the comprehensiveness of the DANMAP, but highlights some shortcomings in terms of environmental considerations. The AFM1 case, the milk metabolite of the carcinogenic mycotoxin aflatoxin B1, shows that dairy products are heavily impacted by changes of the climate as well as by economic drivers. Conclusions: The two cases show that environmental conditions directly influence the onset and diffusion of hazardous factors. Climate change, treatment of soils, water and standards in slaughterhouses as well as farms can have a great impact on the health of animals, humans and the environment. Hence, it is important to include environmental considerations, for example, via engaging environmental experts and sharing data. Further case studies will help to better define the roles of environment in One Health scenarios.

scholarly journals Dementia Care under COVID-19 and Infectious Disease Pandemic Restrictions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 941-942
Author(s):  
Kelly Bradbury ◽  
Elaine Moody ◽  
Katie Aubrecht ◽  
Meaghan Sim ◽  
Melissa Rothfus
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Assessment Tool ◽  
Grey Literature ◽  
Limited Information ◽  
Public Health Emergencies ◽  
People With Dementia ◽  
English Articles ◽  
Emergency Measures ◽  
Dementia Services

Abstract Emergency measures including social distancing and program restrictions during COVID-19 has reduced supports for people living with dementia and family/friend caregivers in the community. Consequently, these reductions in dementia services and resources have added to existing challenges and (in)equities for this stigmatized population. The objectives of this study were to identify how community-based resources and services for people with dementia and their caregivers are impacted by public health emergency measures enacted during COVID-19 and other infectious pandemics and secondly, use an intersectional health equity perspective to explore how supports for people and families living with dementia are affected by social determinants of health. A scoping review using JBI methodology was conducted. Academic databases searched included Embase, Medline, CINAHL and PAIS. Grey literature was searched using the CADTH tool. English articles published after 2000 in high-income countries were included. Data was extracted by two reviewers using an adaptation of the Health Equity Impact Assessment tool to explore factors related to health equity. Findings included articles discussing the COVID-19 pandemic (N=15). Most alterations to dementia services included switching to telehealth platforms with some advantages/disadvantages of this method discussed. Limited information on how different populations experienced service changes was identified and more research is needed to address issues of (in)equities for people living with dementia and their caregivers during public health emergencies. Information on how health emergency responses affects dementia services and their users will provide important information on resources for current and future efforts to analyze and assess their impacts.

Skin and soft tissue infection management failure in the emergency department observation unit: a systematic review

2016 ◽  
Vol 35 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Jeremy W Abetz ◽  
Nicholas G Adams ◽  
Biswadev Mitra
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Soft Tissue ◽  
Failure Rate ◽  
Grey Literature ◽  
Clinical Decision ◽  
Primary Diagnosis ◽  
Inpatient Admission ◽  
Decision Tools ◽  
Observation Units

IntroductionSkin and soft tissue infections (SSTIs) are commonly treated in ED observation units (EDOUs). The management failure rate in this setting is high, as evidenced by a large proportion of patients requiring inpatient admission. This systematic review sought to quantify the management failure rate and identify risk factors associated with management failure.MethodsSearches of six databases and grey literature were conducted with no limits on publication year or language. Manuscripts describing patients admitted to an EDOU setting (≤24 hours planned admission to EDOU) with a primary diagnosis of cellulitis or other SSTIs were included. Variables associated with failure of management, defined as inpatient admission, stay >28 hours (4 hours in ED, 24 hours in EDOU) or death, were extracted. A narrative description of variables associated with failure of EDOU admission was conducted.ResultsThere were 1119 unique articles identified through the literature search. Following assessment, 10 studies were included in the final systematic review, 9 of which reported the management failure rate (range 15%–38%). The presence of fever, a high total white blood cell count and known methicillin-resistant Staphylococcus aureus exposure were the most commonly reported variables associated with management failure.ConclusionA higher rate of EDOU management failure in SSTIs than the generally accepted rate of 15% was observed in most studies identified by this review. Risk factors identified were varied, but presence of a fever and elevated inflammatory markers were commonly associated with failure of EDOU admission by multiple studies. Recognition of risk factors and the increased application of clinical decision tools may help to improve disposition of patients at high risk for clinical deterioration or management failure.

Transatlantic Radicalism

2021 ◽  
Keyword(s):  
South America ◽  
Atlantic Ocean ◽  
Case Studies ◽  
Individual Case ◽  
History Of ◽  
Late Nineteenth ◽  
Organizational Ties ◽  
North And South America ◽  
North And South ◽  
Political Radicalism

The Atlantic Ocean not only connected North and South America with Europe through trade but also provided the means for an exchange of knowledge and ideas, including political radicalism. Socialists and anarchists would use this “radical ocean” to escape state prosecution in their home countries and establish radical milieus abroad. However, this was often a rather unorganized development and therefore the connections that existed were quite diverse. The movement of individuals led to the establishment of organizational ties and the import and exchange of political publications between Europe and the Americas. The main aim of this book is to show how the transatlantic networks of political radicalism evolved with regard to socialist and anarchist milieus and in particular to look at the actors within the relevant processes—topics that have so far been neglected in the major histories of transnational political radicalism of the late nineteenth and early twentieth centuries. Individual case studies are examined within a wider context to show how networks were actually created, how they functioned and their impact on the broader history of the radical Atlantic.

Seksueel onaangepast gedrag bij een patiënt met dementie: literatuurreview en casusrapport

2021 ◽  
Author(s):  
C. SEAUX ◽  
K. GOEDSEELS ◽  
J. DE LEPELEIRE
Keyword(s):  
Case Studies ◽  
Randomised Controlled Trials ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Pharmacological Interventions ◽  
Drug Of Choice ◽  
Cochrane Database ◽  
History Of ◽  
Randomised Controlled

Sexually inappropriate behaviour in a patient with dementia: literature review and case report In this paper, the medical history of a 75-year-old man with dementia and sexually inappropriate behaviour (SIB) is described. An overview of the literature regarding the approach and treatment of SIB in persons with dementia was performed. PubMed, Web of Science and the Cochrane database were consulted, and thirteen articles selected. There are no randomised controlled trials available. The literature is limited to case studies and reviews of case studies. Non-pharmacological treatments are perceived to be the first step, although they are rarely studied. There is no consensus regarding a pharmacological approach. However, all studies suggest the paradigm of “start low and go slow”. A variety of drugs have been described. When starting a pharmacological treatment, it is recommended to keep in mind comorbidities and possible side-effects. Selective serotonin reuptake inhibitors (SSRIs) seem to be the preferred first line treatment if the behaviour is not too harmful. If the behaviour is intrusive, anti-androgens seem to be the drug of choice. Further research is needed: a consensus regarding the definition and the development of a screening tool could support randomised controlled trials concerning pharmacological and non-pharmacological interventions. Research concerning ethical dilemmas should, however, not be neglected.

Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia

2012 ◽  
Vol 24 (6) ◽  
pp. 856-870 ◽  
Author(s):  
Claudia Cooper ◽  
Naaheed Mukadam ◽  
Cornelius Katona ◽  
Constantine G. Lyketsos ◽  
David Ames ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coping Strategy ◽  
Cognitive Stimulation ◽  
Care Homes ◽  
Improve Quality ◽  
Family Carer ◽  
Pharmacological Interventions ◽  
People With Dementia ◽  
At Home

ABSTRACTBackground: People with dementia report lower quality of life, but we know little about what interventions might improve it.Methods: We systematically reviewed 20 randomized controlled trials reporting the effectiveness of non-pharmacological interventions in improving quality of life or well-being of people with dementia meeting predetermined criteria. We rated study validity with a checklist. We contacted authors for additional data. We calculated standardized mean differences (SMD) and, for studies reporting similar interventions, pooled standardized effect sizes (SES).Results: Pooled analyses found that family carer coping strategy-based interventions (four studies, which did not individually achieve significance; n = 420; SES 0.24 (range 0.03–0.45)) and combined patient activity and family carer coping interventions (two studies, not individually significant; n = 191; SES 0.84 (range 0.54–1.14)) might improve quality of life. In one high-quality study, a care management system improved quality of life of people with dementia living at home. Group Cognitive Stimulation Therapy (GCST) improved quality of life of people with dementia in care homes.Conclusion: Preliminary evidence indicated that coping strategy-based family carer therapy with or without a patient activity intervention improved quality of life of people with dementia living at home. GCST was the only effective intervention in a higher quality trial for those in care homes, but we did not find such evidence in the community. Few studies explored whether effects continued after the intervention stopped. Future research should explore the longer-term impact of interventions on, and devise strategies to increase, life quality of people with dementia living in care homes or at home without a family carer.

scholarly journals Investigating deaf children’s plural and diverse use of sign and spoken languages in a super diverse context

2016 ◽  
Vol 7 (2) ◽  
pp. 117-147 ◽  
Author(s):  
Ruth Swanwick ◽  
Sue Wright ◽  
Jackie Salter
Keyword(s):  
Case Studies ◽  
Deaf Education ◽  
Individual Case ◽  
Deaf Children ◽  
Small Scale ◽  
Unique Type ◽  
The North ◽  
Context Data ◽  
Language Exposure ◽  
Diverse Context

AbstractThis paper examines the meaning of plurality and diversity with respect to deaf children’s sign and spoken language exposure and repertoire within a super diverse context. Data is drawn from a small-scale project that took place in the North of England in a Local Authority (LA) site for deaf education. The project documented the language landscape of this site and gathered five individual case studies of deaf children to examine their plural and diverse language practices at home and at school. Analysis of the language landscape and case studies from this context is undertaken in order to define and exemplify deaf children’s language plurality and diversity in terms of context and individual experience. Concepts of repertoire are explored with particular reference to the unique type of translanguaging that the plural use of sign and spoken languages affords. Implications of these preliminary insights are discussed in terms of the development of methodologies that are sensitive to the particular translanguaging practices of deaf children, and approaches to pedagogy that are appropriately nuanced and responsive to deaf children’s language plurality and diversity.

The Overtraining Syndrome: A Multicontextual Assessment

2004 ◽  
Vol 18 (2) ◽  
pp. 154-171 ◽  
Author(s):  
Heidi L. Meehan ◽  
Stephen J. Bull ◽  
Dan M. Wood ◽  
David V.B. James
Keyword(s):  
Case Studies ◽  
Case Analysis ◽  
Individual Case ◽  
Medical Examination ◽  
Endurance Athletes ◽  
Semistructured Interview ◽  
Coping Response ◽  
Daily Hassle ◽  
Overtraining Syndrome ◽  
Cross Case Analysis

The present study explored the experiences of five competitive endurance athletes (1 female, 4 male) diagnosed with the overtraining syndrome (OTS). A multicontextual method of inquiry was used, which first involved a medical examination whereby OTS was diagnosed according to established criteria. In addition, 2 questionnaires were administered: the Athlete Daily Hassle Scale (Albinson & Pearce, 1998) and the Coping Response Inventory (Moos, 1992), and a semistructured interview was conducted. Individual case studies were then developed and cross-case analysis carried out. Findings from the present study illustrate that together with sport stress, nonsport stress appears to make an important contribution to the experience of those athletes diagnosed with the OTS. This finding provides evidence to support anecdotes in previous reports.

scholarly journals Investigating the humor of gelotophobes: Does feeling ridiculous equal being humorless?

2009 ◽  
Vol 22 (1-2) ◽  
Author(s):  
Willibald Ruch ◽  
Ursula Beermann ◽  
René T. Proyer
Keyword(s):  
Case Studies ◽  
Individual Case ◽  
Future Studies ◽  
Frequent Use ◽  
Humor Style ◽  
Humor Appreciation ◽  
Three Samples ◽  
Health Journal

AbstractTitze (Humor and Health Journal 5:1–11, 1996) concluded from individual case studies that gelotophobes do not experience humor and laughter as a shared enjoyment but rather as a threat. Two studies examined whether gelotophobes are less humorous in general or whether this is true only for certain components of humor. In study I, three samples (N = 120 and 70 students; N = 169 adults) filled in the GELOPH〈46〉 along with several humor instruments (i.e., 3 WD, CHS, HBQD, HSQ, HUWO, STCI-T〈60〉). Results showed that gelotophobes are less cheerful and characterize their humor style as inept, socially cold, and mean-spirited. They report less frequent use of humor as a means for coping and indulge less often in self-enhancing and social humor. Appreciation of incongruity-resolution humor and nonsense humor (but not sexual humor) was lower than for non-gelotophobes. Study II (N = 131 adults) focused on the relation between gelotophobia, gelotophilia, and katagelasticism and the ability to create humor (i.e., the CPPT). The ability to create humor is unrelated to gelotophobia, and tends to be positively correlated with gelotophilia and katagelasticism. Future studies should investigate why gelotophobes see their humor style as inept despite not lacking wit, and how their beliefs can be made more consistent with their abilities.

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