scholarly journals Feasibility of salivary cortisol collection in patients and companions attending dementia diagnostic meetings in memory clinics

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
H. Pavlickova ◽  
A. E. Russell ◽  
S. Lightman ◽  
R. McCabe
Keyword(s):  
Salivary Cortisol ◽  
Elderly Population ◽  
Small Sample ◽  
Self Report ◽  
Three Samples ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
Saliva Collection ◽  
The Individual ◽  
Descriptive Level

Abstract Objectives Receiving a diagnosis of dementia is life-changing for the individual and their companion. The aim of the study was to explore the feasibility of collecting salivary cortisol from patients who are informed if they have dementia and their companions. Patients and companions collected nine saliva samples in three batches: 1–2 weeks before, immediately before, and immediately after the diagnostic meeting. Each batch consisted of three samples taken in the evening, after awaking and 30 mins post-waking. Results 22.7% (N = 10) of 44 invited patients and nine companions agreed, with 18.2% patients (N = 8) and 15.9% companions (N = 7) providing samples. Participants found that saliva collection was demanding and disrupted routines. On a purely descriptive level, some indications of an increased cortisol stress response in patients diagnosed with dementia were found in this very small sample. Researchers should expect low recruitment rates in this elderly population. Simpler collection procedures, e.g. pre-labelled packages with date/time, possible omission of morning samples and objective rather than self-report assessment of waking and saliva collection times—using actigraphy wrist-watches bleeps to prompt people at the timepoints and electronic track caps—might improve adherence and improve the accuracy of timepoints when swabs were actually collected.

scholarly journals ‘How do they want to know?’ Doctors’ perspectives on making and communicating a diagnosis of dementia

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 3004-3022 ◽  
Author(s):  
Cate Bailey ◽  
Jemima Dooley ◽  
Rose McCabe
Keyword(s):  
Cognitive Impairment ◽  
Public Awareness ◽  
Memory Clinic ◽  
Training And Supervision ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
The Individual ◽  
Limiting Condition ◽  
The Uk ◽  
First Time

Recent drives to facilitate earlier identification of dementia have led to increased memory clinic referrals and diagnoses. This study explored the perspectives of memory clinic doctors on making and delivering diagnoses. Four focus groups were conducted with 13 psychiatrists and two geriatricians in the UK. Transcripts were coded line by line using NVIVO. Thematic analysis identified 39 categories, 18 sub-themes and eight overarching themes. Inter-rater reliability on 31% of the data was 0.89. Increased public awareness of dementia was viewed positively in facilitating access to diagnosis and treatment. Doctors viewed diagnosis as a process and expressed concerns about limited pre-diagnostic counselling and post-diagnostic support. In diagnostic delivery doctors sought to develop a narrative drawing on the patient’s report of symptoms and adjust explanations to patient preferences and awareness. However, tailoring the delivery to the individual patient was challenging when meeting for the first time. These consultations often involved three participants (doctor, patient and relative), who were felt to have differing needs and expectations. Doctors emphasized that delicacy was required in deciding in what could be discussed in front of both parties, however also stressed the importance of explicitly naming ‘dementia’. Efforts were made to balance honesty and hope when discussing prognosis and medication. The work was sometimes emotionally distressing, with limited supervision. Existing communication training was felt to be inadequate for consultations involving triads or people with cognitive impairment. Delivering a dementia diagnosis is a nuanced and challenging task. Negotiating honest descriptions of a life-limiting condition whilst instilling hope is further complicated when cognitive impairment affects comprehension. Misunderstandings at the time of feedback may limit patient opportunities for informed future planning afforded by early diagnosis. Doctors in memory clinics would benefit from evidence based training and supervision to prepare them for these emotionally challenging and complex consultations.

Promoting early dementia diagnosis: a video designed by patients, for patients

2016 ◽  
Vol 29 (5) ◽  
pp. 863-867 ◽  
Author(s):  
Nina Baruch ◽  
Charlotte L. Allan ◽  
Maureen Cundell ◽  
Samuel Clark ◽  
Brian Murray
Keyword(s):  
Early Diagnosis ◽  
Small Sample Size ◽  
Small Sample ◽  
Memory Clinic ◽  
Patient Feedback ◽  
Before And After ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
Advance Decisions ◽  
Level Of Understanding

ABSTRACTEarly diagnosis of dementia allows people to access effective treatment and make advance decisions while they still have capacity. We aimed to encourage people to attend memory clinic, in order to boost rates of diagnosis. We created a patient information video about Oxford Health NHS Foundation Trust Memory Clinics, to inform and empower those awaiting assessment and to promote early diagnosis.Fourteen people (patients, carers, and staff) were approached prior to developing the video to ascertain their views on the themes the video should cover. The video consisted of unscripted interviews with patients, carers, and staff. We surveyed participants and new patients attending memory clinic to get feedback on the video and to assess patients’ level of understanding and confidence about a memory assessment before and after watching the video. The video content was refined based on this feedback and a final version was produced.Patient feedback demonstrated that confidence and understanding increased after watching the video.Although this study is limited by its small sample size and lack of access to those with undiagnosed dementia, feedback suggested that the video empowered and reassured those awaiting assessment and could be used as a tool to reduce barriers to early diagnosis. Patients and carers involved in making the video found it a therapeutic activity in itself.

Perceived Mutual Understanding (PMU)

2019 ◽  
Vol 35 (1) ◽  
pp. 98-108 ◽  
Author(s):  
Michael J. Burtscher ◽  
Jeannette Oostlander
Keyword(s):  
Mutual Understanding ◽  
Team Cognition ◽  
Internal Reliability ◽  
Confirmatory Factor Analyses ◽  
Team Processes ◽  
One Dimensional ◽  
Item Parameters ◽  
Three Samples ◽  
Confirmatory Factor ◽  
The Individual

Abstract. Team cognition plays an important role in predicting team processes and outcomes. Thus far, research has focused on structured cognition while paying little attention to perceptual cognition. The lack of research on perceptual team cognition can be attributed to the absence of an appropriate measure. To address this gap, we introduce the construct of perceived mutual understanding (PMU) as a type of perceptual team cognition and describe the development of a respective measure – the PMU-scale. Based on three samples from different team settings ( NTotal = 566), our findings show that the scale has good psychometric properties – both at the individual as well as at the team-level. Item parameters were improved during a multistage process. Exploratory as well as confirmatory factor analyses indicate that PMU is a one-dimensional construct. The scale demonstrates sufficient internal reliability. Correlational analyses provide initial proof of construct validity. Finally, common indicators for inter-rater reliability and inter-rater agreement suggest that treating PMU as a team-level construct is justified. The PMU-scale represents a convenient and versatile measure that will potentially foster empirical research on perceptual team cognition and thereby contribute to the advancement of team cognition research in general.

Salivary Cortisol And Self-Report Measures Of Post-Immigration Stress In Midlife Women

2002 ◽  
Author(s):  
Arlene Michaels Miller ◽  
Peggy J. Chandler ◽  
Dorie Schwertz ◽  
Olga Sorokin ◽  
JoEllen Wilbur
Keyword(s):  
Salivary Cortisol ◽  
Midlife Women ◽  
Self Report ◽  
Immigration Stress

Inhibition tasks are not associated with self-regulation outcomes in healthy college students

2019 ◽  
Author(s):  
Curtis David Von Gunten ◽  
Bruce D Bartholow ◽  
Jorge S. Martins
Keyword(s):  
Latent Variable ◽  
Convergent Validity ◽  
Self Regulation ◽  
Poor Performance ◽  
Self Control ◽  
Self Report ◽  
Life Outcomes ◽  
Variable Level ◽  
Cast Doubt ◽  
The Individual

Executive functioning (EF) is defined as a set of top-down processes used in reasoning, forming goals, planning, concentrating, and inhibition. It is widely believed that these processes are critical to self-regulation and, therefore, that performance on behavioral task measures of EF should be associated with individual differences in everyday life outcomes. The purpose of the present study was to test this core assumption, focusing on the EF facet of inhibition. A sample of 463 undergraduates completed five laboratory inhibition tasks, along with three self-report measures of self-control and 28 self-report measures of life outcomes. Results showed that although most of the life outcome measures were associated with self-reported self-control, none of the life outcomes were associated with inhibition task performance at the latent-variable level, and few associations were found at the individual task level. These findings challenge the criterion validity of lab-based inhibition tasks. More generally, when considered alongside the known lack of convergent validity between inhibition tasks and self-report measures of self-control, the findings cast doubt on the task’s construct validity as measures of self-control processes. Potential methodological and theoretical reasons for the poor performance of laboratory-based inhibition tasks are discussed.

Indices and Correlates of Positive Emotion in Psychopathology

2019 ◽  
pp. 95-118
Author(s):  
Sunny J. Dutra ◽  
Marianne Reddan ◽  
John R. Purcell ◽  
Hillary C. Devlin ◽  
Keith M. Welker
Keyword(s):  
Positive Emotion ◽  
Self Report ◽  
Individual Level ◽  
Advantages And Disadvantages ◽  
Innovative Methods ◽  
Behavioral Coding ◽  
Broad Array ◽  
Positive Valence ◽  
The Individual ◽  
Clinical Populations

This chapter not only draws from previous authoritative measurement overviews in the general field of emotion, but also advances these resources in several key ways. First, it provides a specific focus on positive valence systems, which have not yet received specific methodological attention. Second, the field of positive emotion (PE) has expanded in recent years with new and innovative methods, making an updated review of methodological tools timely. Third, the chapter incorporates discussion of PE disturbance in clinical populations and the methods best suited to capture PE dysfunctions. This chapter also outlines some tools that can allow researchers to capture a broad array of PE quantified by self-report, behavioral coding, and biological correlates as seen through changes in the central and peripheral nervous system (i.e., brain and body). After reviewing PE measurement methods and correlates, this chapter includes several methods for studying PE beyond the individual level (i.e., interpersonal) and traditional laboratory settings (i.e., ambulatory or experience sampling). It provides key examples of their applications to study PE in clinical populations while acknowledging several of their basic advantages and disadvantages.

scholarly journals Prevalence of disabilities and non-communicable diseases in an elderly population in the Telangana state, India: a population-based cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041755
Author(s):  
Srinivas Marmamula ◽  
Satya Brahmanandam Modepalli ◽  
Thirupathi Reddy Kumbham ◽  
Rajesh Challa ◽  
Jill E Keeffe
Keyword(s):  
Elderly Population ◽  
Self Care ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Communicable Diseases ◽  
Self Report ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Communicable Diseases

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.

An experimental approach to communal coping

2021 ◽  
pp. 026540752199246
Author(s):  
Melissa Zajdel ◽  
Vicki S. Helgeson
Keyword(s):  
Health Outcomes ◽  
Positive Relationship ◽  
Experimental Approach ◽  
Positive Mood ◽  
Self Report ◽  
Communal Coping ◽  
Observational Measures ◽  
Relationship Outcomes ◽  
The Individual

Communal coping has been linked to better psychological and physical health across a variety of stressful contexts. However, there has been no experimental work causally linking communal coping to relationship and health outcomes. In addition, research has emphasized the collaboration over the shared appraisal component of communal coping. The present study sought to isolate the role of appraisal by manipulating whether dyads viewed a stressor as shared or individual. Friend dyads (n = 64 dyads; 128 participants) were randomly assigned to view a stressor as either a shared or an individual problem, but both groups were allowed to work together. Across self-report and observational measures dyads reported more collaboration and support, better relationship outcomes, and more positive mood after the stressor in the shared than the individual appraisal group. This is the first laboratory evidence to establish causal links of communal coping—specifically shared appraisal—to positive relationship and health outcomes.

scholarly journals Differential Self-control Effects: Moral Filtering and the Subsidiary Relevance of Self-control

2021 ◽  
Author(s):  
Helmut Hirtenlehner ◽  
Heinz Leitgöb
Keyword(s):  
Action Theory ◽  
Criminal Activity ◽  
Self Control ◽  
Self Report ◽  
Moral Norms ◽  
Situational Characteristics ◽  
Report Data ◽  
Self Report Data ◽  
The Individual ◽  
Low Self Control

AbstractCriminological research has identified low self-control as major cause of criminal activity. However, astonishingly little is known about the individual and situational characteristics that affect the functioning of self-control in relation to crime. Recent theorizing, especially in the context of Situational Action Theory, suggests that the interplay of personal and contextual morality creates a morally preselected choice set whose composition determines the relevance of self-control. Guided by the ideas of differential self-control effects and a moral filtering of action alternatives, the present inquiry investigates whether the role of self-control in crime causation depends on the power of moral factors to exclude crime from the set of the considered behavioral options. We argue that the significance of an individual’s capacity for self-control increases with a growing weakness of the moral filter, reaching its maximum when both personal and setting morality encourage criminal activity. Analyses of self-report data on adolescent vandalism delinquency provide support for differential self-control effects. The general picture is that self-control ability matters most when the strength of the moral filter hits a low, which is when both an individual’s own moral rules and the moral norms of the setting facilitate offending. Further evidence suggests that crime contemplation is highest when individual morality and setting morality jointly encourage vandalism. There is also indication that trait self-control has a greater effect on vandalism delinquency at higher levels of crime contemplation. All these results accord with the notion of a subsidiary relevance of control.

scholarly journals Within-Site Variability of Liana Wood Anatomical Traits: A Case Study in Laussat, French Guiana

Forests ◽  
2020 ◽  
Vol 11 (5) ◽  
pp. 523 ◽  
Author(s):  
Félicien Meunier ◽  
Sruthi M. Krishna Moorthy ◽  
Hannes P. T. De Deurwaerder ◽  
Robin Kreus ◽  
Jan Van den Bulcke ◽  
...  
Keyword(s):  
Specific Gravity ◽  
French Guiana ◽  
Growth Form ◽  
Vessel Diameter ◽  
Small Sample ◽  
Diameter Distribution ◽  
Hydraulic Architecture ◽  
Woody Vines ◽  
Wood Trait ◽  
The Individual

Research Highlights: We investigated the variability of vessel diameter distributions within the liana growth form among liana individuals originating from a single site in Laussat, French Guiana. Background and Objectives: Lianas (woody vines) are key components of tropical forests. Lianas are believed to be strong competitors for water, thanks to their presumed efficient vascular systems. However, unlike tropical trees, lianas are overlooked in field data collection. As a result, lianas are often referred to as a homogeneous growth form while little is known about the hydraulic architecture variation among liana individuals. Materials and Methods: We measured several wood hydraulic and structural traits (e.g., basic specific gravity, vessel area, and vessel diameter distribution) of 22 liana individuals in a single sandy site in Laussat, French Guiana. We compared the liana variability of these wood traits and the correlations among them with an existing liana pantropical dataset and two published datasets of trees originating from different, but species-rich, tropical sites. Results: Liana vessel diameter distribution and density were heterogeneous among individuals: there were two orders of magnitude difference between the smallest (4 µm) and the largest (494 µm) vessel diameters, a 50-fold difference existed between extreme vessel densities ranging from 1.8 to 89.3 vessels mm−2, the mean vessel diameter varied between 26 µm and 271 µm, and the individual theoretical stem hydraulic conductivity estimates ranged between 28 and 1041 kg m−1 s−1 MPa−1. Basic specific gravity varied between 0.26 and 0.61. Consequently, liana wood trait variability, even within a small sample, was comparable in magnitude with tree surveys from other tropical sites and the pantropical liana dataset. Conclusions: This study illustrates that even controlling for site and soil type, liana traits are heterogeneous and cannot be considered as a homogeneous growth form. Our results show that the liana hydraulic architecture heterogeneity across and within sites warrants further investigation in order to categorize lianas into functional groups in the same way as trees

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