Course of Social Participation in the First 2 Years After Stroke and Its Associations With Demographic and Stroke-Related Factors

Background. Many persons with stroke experience physical, cognitive, and emotional problems that contribute to restrictions in social participation. There is, however, a lack of knowledge on the long-term course of participation over time post-stroke. Objective. To describe the time course of participation up to 2 years post-stroke and to identify which demographic and stroke-related factors are associated with this time course. Methods. This was a multicenter, prospective cohort study following 390 persons with stroke from hospital admission up to 2 years (at 2, 6, 12, and 24 months). Multilevel modeling with linear and quadratic time effects was used to examine the course of the frequency of vocational and social/leisure activities, experienced restrictions, and satisfaction with participation. Results. The frequency of vocational activities increased up to 1 year post-stroke and leveled off thereafter. Older and lower-educated persons showed less favorable courses of participation than younger and higher-educated persons, respectively. The frequency of social/leisure activities decreased post-stroke. Participation restrictions declined up to 1 year post-stroke and leveled off thereafter. Persons dependent in activities of daily living (ADL) kept experiencing more restrictions throughout time than independent persons. Satisfaction with participation increased slightly over time. Conclusions. Changes in participation occurred mostly in the first year post-stroke. Particularly older and lower-educated persons, and those dependent in ADL showed less favorable courses of participation up to 2 years post-stroke. Clinicians can apply these findings in identifying persons most at risk of long-term unfavorable participation outcome and, thus, target rehabilitation programs accordingly.

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Tracking elemental changes in an ischemic stroke model with X-ray fluorescence imaging

Scientific Reports ◽

10.1038/s41598-020-74698-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

M. J. Pushie ◽

N. J. Sylvain ◽

H. Hou ◽

S. Caine ◽

M. J. Hackett ◽

...

Keyword(s):

Cellular Response ◽

Time Course ◽

Parameter Method ◽

Stroke Severity ◽

Stroke Model ◽

Post Stroke ◽

Cellular Events ◽

Developed Nations ◽

The Brain

Abstract Stroke is a leading cause of long-term disability in adults and a leading cause of death in developed nations. The cascade of cellular events and signalling that occur after cerebral ischemia are complex, however, analyzing global element markers of metabolic state affords the means to monitor stroke severity, status of injury, and recovery. These markers provide a multi-parameter method for assessing changes through the post-stroke time course. We employ synchrotron-based elemental mapping to follow elemental changes in the brain at 1 h, 1-, 2-, and 3-days, and at 1-, 2-, 3-, and 4-weeks post-stroke in a photothrombotic stroke model in mice. Our analysis reveals a highly consistent metabolic penumbra that can be readily identified based on the level of dysregulated potassium and other key elements. Maps of elemental distributions are also useful to demarcate events in the cellular response to the inflammatory cascade, including ion dysregulation, recruitment of cells to the lesion, and glial scar formation.

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A Nutrition Behaviour Change Intervention Delivered Through Women's Self-Help Groups in India Is Protective Against Depression and Reduces Time Spent in Market Work

Current Developments in Nutrition ◽

10.1093/cdn/nzab035_035 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 127-127

Author(s):

Shivani Gupta ◽

Samuel Scott ◽

Neha Kumar ◽

Kalyani Raghunathan ◽

Giang Thai ◽

...

Keyword(s):

Mental Health ◽

Behaviour Change ◽

Time Use ◽

Leisure Activities ◽

Market Work ◽

Productive Work ◽

Self Help ◽

Social Leisure ◽

Self Help Groups ◽

Over Time

Abstract Objectives Women's self-help groups (SHGs), which operate at large scale in India, are an important platform for delivering behaviour change communication (BCC) and social support interventions to rural women. Little is known about how such group-based interventions affect women's mental health and time use. Methods The Women Improving Nutrition through Group-based Strategies (WINGS) study was a quasi-experimental impact evaluation, comparing 16 blocks (8 matched pairs) with SHG formation support; 8 blocks received a 3-year nutrition intervention (NI) with BCC topics such as nutrition, home-gardens and women's well-being, facilitated by a trained female volunteer; the other 8 received standard activities (STD) to support savings & livelihoods. We conducted repeated cross-sectional surveys of mother-child pairs in 2017–18 (n = 1609) and 2019–20 (n = 1841). We matched treatment groups over time and applied difference-in-difference (DID) regression models to estimate NI impacts. Outcomes assessed: (1) common mental disorder symptoms (CMD) (Self Reporting Questionnaire (SRQ) score, 8 or higher) and (2) time use, constructed using 24-hour recall data. Time indicators were the proportion of time spent on productive work (employed, agricultural work), reproductive work (cooking, caring for children etc.), and time spent on social-leisure activities (hobbies, socializing). Results Overall, women were 25 years old with 5 years of education and worked 10.7 hours/day. CMD were reported by 17% of women. DID estimates showed that CMD prevalence doubled over time among women in STD areas but did not change in NI areas (P < 0.01). Compared to STD areas, women in NI areas reported a larger decrease in time spent on productive work (DID: −5 percentage points (pp); P < 0.01) and larger increases in time spent on reproductive work (DID: +5 pp; P < 0.01) and on social-leisure activities (DID: +22 minutes, P < 0.01). Conclusions A BCC intervention delivered through SHGs in rural India protected against a secular trend in declining mental health and shifted women's time from market work to domestic and social-leisure activities. These findings add to a growing evidence base on the effectiveness of group-based interventions to improve women's wellbeing in developing countries. Funding Sources Bill & Melinda Gates Foundation.

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The effect of early age-related hearing loss on memory and participation in social leisure activities

10.31219/osf.io/4x3jv ◽

2017 ◽

Author(s):

Henrik Danielsson ◽

M Kathleen Pichora-Fuller ◽

Kate Dupuis ◽

Jerker Rönnberg ◽

Alison L. Chasteen ◽

...

Keyword(s):

Hearing Loss ◽

Cognitive Decline ◽

Social Participation ◽

Hearing Aids ◽

Structural Equation ◽

Leisure Activities ◽

Age Related ◽

Increased Risk ◽

Two Samples ◽

Social Leisure

Age-related declines in hearing, cognition and social participation are well recognized, as are associations between hearing loss and cognitive decline, hearing loss and increased risk for social isolation, and cognitive decline and lower participation in social leisure activities (PSLA). Nevertheless, how age and the three domains of hearing, cognition, and social participation relate to one other in the same study is unclear. Behavioural measures of hearing and memory and self-reported participation in common social leisure activities from two samples of adults with hearing loss (N=297, N=273) were analysed in the current study. Structural equation modelling on both samples yielded two models with good and similar statistical properties. The two models had the following in common: age effects on hearing and memory, an effect of hearing on memory, but no direct effect of hearing on PSLA. The models differed on the direction of the path between memory and PSLA as well as the existence of the effect of age on PSLA. The majority of participants in both samples were not candidates for hearing aids, but most of those who were candidates used them. Of note, typical pure-tone average thresholds did not contribute significantly to the models, but high-frequency hearing thresholds did, suggesting that even early stages of hearing loss can increase demands on memory that in turn may deter participation in social leisure activities.

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Abstract WMP53: Sex Differences n Long-term Mortality and Disability After Stroke: The International Stroke Outcomes Study

Stroke ◽

10.1161/str.47.suppl_1.wmp53 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Hoang T Phan ◽

Mathew J Reeves ◽

Leigh Blizzard ◽

Amanda Thrift ◽

Dominique Cadilhac ◽

...

Keyword(s):

Sex Differences ◽

Population Based ◽

Stroke Severity ◽

Related Factors ◽

Post Stroke ◽

Modifiable Factors ◽

Mortality Rate Ratio ◽

The Impact

Introduction: It is uncertain why women suffer worse long-term outcomes after stroke than men. We examined sex differences in mortality and disability 1 and 5 years after stroke and identified factors contributing to these differences. Methods: Individual patient data pooling study of incident strokes (ischemic and hemorrhagic) from 1987-2013 obtained from 12 population-based cohorts from Australasia, Europe, South America and the Caribbean. Data on socio-demographics, stroke-related factors and pre-stroke health were obtained for each patient and harmonized between studies. Poisson modelling estimated the mortality rate ratio (MRR) for women compared to men at 1 year (12 studies) and 5 years (7 studies) post-stroke. Log binomial regression estimated the relative risk (RR) of poor outcome (modified Rankin scale>2 or Barthel Index <20) for women compared to men at 1 year (9 studies) and 5 years (6 studies) after stroke. Multivariable models were adjusted for potential confounders including age, pre-stroke dependency, stroke severity and comorbidities. Results: A total of 16557 first-ever-stroke patients with follow-up data to 1 year and 12,839 with follow-up to 5 years were included. The pooled crude mortality was greater in women than men at 1-year (MRR 1.37 95% CI 1.27-1.48) and 5 years (MRR 1.25 95% CI 1.13-1.39). However, these sex differences were reversed after adjustment for confounders at both 1 year (MRR 0.94 95% CI 0.82-1.06) and 5-years post stroke (MRR 0.74 95% CI 0.66-0.84). Similarly, the pooled crude RR for disability after stroke was greater in women than men at 1-year (RR 1.28 95% CI 1.17-1.39 and 5-year (RR 1.32 95% CI 1.18-1.47), but these sex differences disappeared after adjustment at both 1 year (RR 1.08 95%CI 0.98-1.18) and 5-years post stroke (RR 1.08 95% CI 0.97-1.20). The key contributors to worse outcomes in women were greater age, pre-stroke dependency, severe strokes and atrial fibrillation (AF, mortality only) compared with men. Conclusion: Worse outcomes in women were mostly due to age and potentially modifiable factors of stroke severity and AF providing potential targets to reduce the impact of stroke in women.

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A novel suprachoroidal microinvasive glaucoma implant: in vivo biocompatibility and biointegration

BMC Biomedical Engineering ◽

10.1186/s42490-020-00045-1 ◽

2020 ◽

Vol 2 (1) ◽

Author(s):

Ian Grierson ◽

Don Minckler ◽

Marian K. Rippy ◽

Andrew J. Marshall ◽

Nathalie Collignon ◽

...

Keyword(s):

Intraocular Pressure ◽

Time Course ◽

Structural Changes ◽

Ocular Tissues ◽

Tissue Integration ◽

Drainage Channels ◽

Pressure Lowering ◽

Over Time

Abstract Background A major challenge for any glaucoma implant is their ability to provide long-term intraocular pressure lowering efficacy. The formation of a low-permeability fibrous capsule around the device often leads to obstructed drainage channels, which may impair the drainage function of devices. These foreign body-related limitations point to the need to develop biologically inert biomaterials to improve performance in reaching long-term intraocular pressure reduction. The aim of this study was to evaluate in vivo (in rabbits) the ocular biocompatibility and tissue integration of a novel suprachoroidal microinvasive glaucoma implant, MINIject™ (iSTAR Medical, Wavre, Belgium). Results In two rabbit studies, no biocompatibility issue was induced by the suprachoroidal, ab-externo implantation of the MINIject™ device. Clinical evaluation throughout the 6 post-operative months between the sham and test groups were similar, suggesting most reactions were related to the ab-externo surgical technique used for rabbits, rather than the implant material itself. Histological analysis of ocular tissues at post-operative months 1, 3 and 6 revealed that the implant was well-tolerated and induced only minimal fibroplasia and thus minimal encapsulation around the implant. The microporous structure of the device became rapidly colonized by cells, mostly by macrophages through cell migration, which do not, by their nature, impede the flow of aqueous humor through the device. Time-course analysis showed that once established, pore colonization was stable over time. No fibrosis nor dense connective tissue development were observed within any implant at any time point. The presence of pore colonization may be the process by which encapsulation around the implant is minimized, thus preserving the permeability of the surrounding tissues. No degradation nor structural changes of the implant occurred during the course of both studies. Conclusions The novel MINIject™ microinvasive glaucoma implant was well-tolerated in ocular tissues of rabbits, with observance of biointegration, and no biocompatibility issues. Minimal fibrous encapsulation and stable cellular pore colonization provided evidence of preserved drainage properties over time, suggesting that the implant may produce a long-term ability to enhance aqueous outflow.

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Habituation After Deep Brain Stimulation in Tremor Syndromes: Prevalence, Risk Factors and Long-Term Outcomes

Frontiers in Neurology ◽

10.3389/fneur.2021.696950 ◽

2021 ◽

Vol 12 ◽

Author(s):

James Peters ◽

Stephen Tisch

Keyword(s):

Deep Brain Stimulation ◽

Side Effects ◽

Brain Stimulation ◽

Time Course ◽

Electrode Placement ◽

Long Term Outcomes ◽

Parkinson's Tremor ◽

Over Time ◽

Deep Brain

Deep brain stimulation (DBS) of the thalamus is an effective treatment for medically refractory essential, dystonic and Parkinson's tremor. It may also provide benefit in less common tremor syndromes including, post-traumatic, cerebellar, Holmes, neuropathic and orthostatic tremor. The long-term benefit of DBS in essential and dystonic tremor (ET/DT) often wanes over time, a phenomena referred to as stimulation “tolerance” or “habituation”. While habituation is generally accepted to exist, it remains controversial. Attempts to quantify habituation have revealed conflicting reports. Placebo effects, loss of micro-lesional effect, disease related progression, suboptimal stimulation and stimulation related side-effects may all contribute to the loss of sustained long-term therapeutic effect. Habituation often presents as substantial loss of initial DBS benefit occurring as early as a few months after initial stimulation; a complex and feared issue when faced in the setting of optimal electrode placement. Simply increasing stimulation current tends only to propagate tremor severity and induce stimulation related side effects. The report by Paschen and colleagues of worsening tremor scores in the “On” vs. “Off” stimulation state over time, even after accounting for “rebound” tremor, supports the concept of habituation. However, these findings have not been consistent across all studies. Chronic high intensity stimulation has been hypothesized to induce detrimental plastic effects on tremor networks, with some lines of evidence that DT and ET may be more susceptible than Parkinson's tremor to habituation. However, Tsuboi and colleague's recent longitudinal follow-up in dystonic and “pure” essential tremor suggests otherwise. Alternatively, post-mortem findings support a biological adaption to stimulation. The prevalence and etiology of habituation is still not fully understood and management remains difficult. A recent study reported that alternating thalamic stimulation parameters at weekly intervals provided improved stability of tremor control consistent with reduced habituation. In this article the available evidence for habituation after DBS for tremor syndromes is reviewed; including its prevalence, time-course, possible mechanisms; along with expected long-term outcomes for tremor and factors that may assist in predicting, preventing and managing habituation.

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The effect of talker familiarity on sentence recognition accuracy over time

10.31219/osf.io/jtpc7 ◽

2020 ◽

Author(s):

Madison Buntrock ◽

Brittan Ann Barker ◽

Madison M. Guires ◽

Tyson S. Barrett

Keyword(s):

Time Course ◽

Recognition Accuracy ◽

Early Time ◽

Late Time ◽

Sentence Recognition ◽

Mixed Effects Modeling ◽

University Professor ◽

Talker Familiarity ◽

Over Time

The familiar talker advantage (FTA) reflects the robust research finding that a listener’s ability to perceive and understand a talker in noise is facilitated when the listener is familiar with the talker. However, it is unclear when the benefits of said familiarity first emerge and whether or not they strengthen over time. To better understand the time course of the FTA, we assessed the effects of long-term, implicit voice learning on 89 young adults’ sentence recognition accuracy in the presence of 4-talker babble. A university professor served as the target talker in the experiment. Half the participants were students of the professor and familiar with her voice. The professor was a stranger to the remaining participants. We manipulated the listeners’ degree of familiarity with the professor over the course of a semester. To test for the effects of the two independent variables: talker (familiar, novel) and time of testing (early: Time 1, late: Time 2), we used mixed effects modeling. Analyses revealed that an FTA emerged in the listeners after only 16 weeks (~32 hours) of exposure to the target voice in a college classroom setting. The FTA also strengthened over time. Implicit exposure to the target talker’s voice for ~12 hours over approximately 4 weeks was not enough time to yield an FTA. The present results imply that talker familiarity (outside of the confines of a long-term, familial relationship) seems to be a much quicker-to-emerge and reliable cue for bootstrapping spoken language perception than previous literature suggested.

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The role of cognitive and social leisure activities in dementia risk: assessing longitudinal associations of modifiable and on-modifiable risk factors

Epidemiology and Psychiatric Sciences ◽

10.1017/s204579602100069x ◽

2022 ◽

Vol 31 ◽

Author(s):

L. A. Duffner ◽

K. Deckers ◽

D. Cadar ◽

A. Steptoe ◽

M. de Vugt ◽

...

Keyword(s):

Risk Factors ◽

Social Participation ◽

Cox Regression ◽

Leisure Activities ◽

Modifiable Risk Factors ◽

Prevention Measures ◽

Dementia Risk ◽

Social Leisure ◽

Cognitive Activities ◽

Joint Contribution

Abstract Aims With the projected surge in global dementia cases and no curative treatment available, research is increasingly focusing on lifestyle factors as preventive measures. Social and cognitive leisure activities are promising targets, but it is unclear which types of activities are more beneficial. This study investigated the individual and joint contribution of cognitive and social leisure activities to dementia risk and whether they modify the risks associated with other potentially modifiable and non-modifiable risk factors. Methods We used data from the English Longitudinal Study of Ageing (ELSA) from 7917 participants, followed up from 2008/2009 (Wave 4) until 2018/2019 (Wave 9) for incident dementia. Self-reported baseline cognitive activities (e.g. ‘reading the newspaper’), the number of social memberships (e.g. being a member of a social club) and social participation (e.g. ‘going to the cinema’) were clustered into high and low based on a median split. Subsequently, their individual and joint contribution to dementia risk, as well as their interaction with other dementia risk factors, were assessed with Cox regression models, adjusting for age, sex, level of education, wealth and a composite score of 11 lifestyle-related dementia risk factors. Results After a median follow-up period of 9.8 years, the dementia incidence rate was 54.5 cases per 10.000 person-years (95% CI 49.0–60.8). Adjusting for demographic and other lifestyle-related risk factors, higher engagement in cognitive activities (HR = 0.58; 95% CI 0.40–0.84), a greater number of social memberships (HR = 0.65; 95% CI 0.51–0.84) and more social participation (HR = 0.71; 95% CI 0.54–0.95) were associated with lower dementia risk. In a joint model, only engagement in cognitive activities (HR = 0.60; 95% CI 0.40–0.91) and social memberships (HR = 0.75; 95% CI 0.56–0.99) independently explained dementia risk. We did not find any interaction with other modifiable and non-modifiable risk factors. Conclusions Engagement in cognitive and social leisure activities may be beneficial for overall dementia risk, independent of each other and other risk factors. Both types of activities may be potential targets for dementia prevention measures and health advice initiatives.

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Serial invasions can disrupt the time course of ecosystem recovery

10.1101/2021.10.29.466526 ◽

2021 ◽

Author(s):

Vadim A Karatayev ◽

Lars G Rudstam ◽

Alexander Y Karatayev ◽

Lyubov E Burlakova ◽

Boris V Adamovich ◽

...

Keyword(s):

Time Course ◽

Zebra Mussels ◽

Ecosystem Dynamics ◽

Ecosystem Recovery ◽

Ecosystem Impacts ◽

Quagga Mussels ◽

Species Invasions ◽

Invasion Impacts ◽

Over Time

The impacts of species invasions can subside or amplify over time as ecosystems "adapt" or additional invaders arrive. These long-term changes provide important insights into ecosystem dynamics. Yet studies of long-term dynamics are rare, system-specific, and often confound species impacts with coincident environmental change. We track post-invasion changes shared across ecosystems and multiple decades, quantifying the response of seven key features to quagga and zebra mussels congeners that re-engineer and increasingly co-invade freshwaters. Six polymictic shallow lakes with long-term data sets reveal remarkably similar trends, with the strongest ecosystem impacts occurring within 5-10 years of zebra mussel invasion. Surprisingly, plankton communities then exhibited a partial, significant recovery. This recovery was absent, and impacts of initial invasion amplified, in lakes where quagga mussels outcompeted zebra mussels and more completely depleted phytoplankton. Thus, invasion impacts subside over time but can amplify with serial introductions of competing, even closely similar, taxa.

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Barriers to Physical Activity in Adolescents

Zeitschrift für Gesundheitspsychologie ◽

10.1026/0943-8149/a000136 ◽

2015 ◽

Vol 23 (2) ◽

pp. 47-59 ◽

Cited By ~ 4

Author(s):

Nadine Langguth ◽

Tanja Könen ◽

Simone Matulis ◽

Regina Steil ◽

Caterina Gawrilow ◽

...

Keyword(s):

Physical Activity ◽

Leisure Activities ◽

Outcome Expectations ◽

Multidimensional Approach ◽

Factor Analyses ◽

Physical And Mental Health ◽

Tailored Interventions ◽

Long Term Consequences ◽

Age Range

During adolescence, physical activity (PA) decreases with potentially serious, long-term consequences for physical and mental health. Although barriers have been identified as an important PA correlate in adults, research on adolescents’ PA barriers is lacking. Thus reliable, valid scales to measure adolescents’ PA barriers are needed. We present two studies describing a broad range of PA barriers relevant to adolescents with a multidimensional approach. In Study 1, 124 adolescents (age range = 12 – 24 years) reported their most important PA barriers. Two independent coders categorized those barriers. The most frequent PA barriers were incorporated in a multidimensional questionnaire. In Study 2, 598 adolescents (age range = 13 – 21 years) completed this questionnaire and reported their current PA, intention, self-efficacy, and negative outcome expectations. Seven PA barrier dimensions (leisure activities, lack of motivation, screen-based sedentary behavior, depressed mood, physical health, school workload, and preconditions) were confirmed in factor analyses. A multidimensional approach to measuring PA barriers in adolescents is reliable and valid. The current studies provide the basis for developing individually tailored interventions to increase PA in adolescents.

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