Connecting Cohorts to Diminish Alzheimer’s Disease (CONCORD-AD): A Report of an International Research Collaboration Network

Longitudinal observational cohort studies are being conducted worldwide to understand cognition, biomarkers, and the health of the aging population better. Cross-cohort comparisons and networks of registries in Alzheimer’s disease (AD) foster scientific exchange, generate insights, and contribute to the evolving clinical science in AD. A scientific working group was convened with invited investigators from established cohort studies in AD, in order to form a research collaboration network as a resource to address important research questions. The Connecting Cohorts to Diminish Alzheimer’s Disease (CONCORD-AD) collaboration network was created to bring together global resources and expertise, to generate insights and improve understanding of the natural history of AD, to inform design of clinical trials in all disease stages, and to plan for optimal patient access to disease-modifying therapies once they become available. The network brings together expertise and data insights from 7 cohorts across Australia, Europe, and North America. Notably, the network includes populations recruited through memory clinics as well as population-based cohorts, representing observations from individuals across the AD spectrum. This report aims to introduce the CONCORD-AD network, providing an overview of the cohorts involved, reporting the common assessments used, and describing the key characteristics of the cohort populations. Cohort study designs and baseline population characteristics are compared, and available cognitive, functional, and neuropsychiatric symptom data, as well as the frequency of biomarker assessments, are summarized. Finally, the challenges and opportunities of cross-cohort studies in AD are discussed.

Educational Assessment Experiences of College Students during COVID-19

To better understand the impact of coronavirus disease 2019 (COVID-19) on today's college students and tomorrow's workforce, a survey was administered to 992 U.S. college students (Meanage=22.36 years, SDage=5.24; %female=53.3) between February and June 2021 on academic assessment practices they experienced before and after COVID-19. Females reported greater test anxiety and lower computer self-efficacy; neither varied based on race/ethnicity nor parental education. Most reported a transition to an online modality during the COVID-19 outbreak with a decrease in classroom assessments. Though classroom assessment formats appeared to change minimally, assessment administration changed markedly during the pandemic-affected period. Untimed and open-book assessments became more common. Assessments administered in-class and in-person proctored became less frequent. Interestingly, during spring 2021, as many colleges returned to in-person instruction, open-book, outside of class, and exams proctored online or unproctored remained common, suggesting a persistent shift in assessment administration practices. Students generally did not feel that exams covered any less content, however cheating was a concern. Most indicated it was difficult to concentrate and reported the idea of taking an exam was stressful during the pandemic, though many still believed that it is important to have assessments to demonstrate learning. Some noted they no longer planned to take certain standardized exams (e.g., GRE) given changes in admission requirements of post-baccalaureate academic programs. Some felt deterred from pursuing further education, yet others felt more inclined given perceptions of a highly competitive job market. Implications of these findings are discussed.

Picky Eating in Children: A Scoping Review to Examine Its Intrinsic and Extrinsic Features and How They Relate to Identification

The health benefits and importance of family mealtimes have been extensively documented. Picky eating can impact this complex activity and has numerous extrinsic (or external) and intrinsic (or internal) features. Occupational therapists work with children and their families by looking at both intrinsic and extrinsic influences and are therefore well-placed to work within this context. This scoping review comprises a comprehensive search of key health industry databases using pre-determined search terms. A robust screening process took place using the authors pre-agreed inclusion and exclusion criteria. There were 80 studies that met the inclusion criteria, which were then mapped using content analysis. The most common assessments used to identify picky eating relied on parental reports and recall. Often additional assessments were included in studies to identify both the intrinsic and extrinsic features and presentation. The most common reported intrinsic features of the child who is a picky eater included increased sensitivity particularly to taste and smell and the child’s personality. Extrinsic features which appear to increase the likelihood of picky eating are authoritarian parenting, rewards for eating, and pressuring the child to eat. Most commonly reported extrinsic features that decrease the likelihood of picky eating are family meals, responsive parents, and involving the child in the preparation of food. In conclusion, there is a lack of published papers addressing the role of occupational therapists in the assessment and identification of picky eating in children. There appears to be a complex interplay between intrinsic and extrinsic features which impact caregiver responses and therefore on the picky eater.

Pediatric Stroke and Current Practice Trends of OT Practitioners

Date Presented 04/23/21 The mixed-methods study of 122 OT practitioners in the continental United States revealed current practice trends for the use of common assessments, interventions, outcome measures, and referral sources for children diagnosed with pediatric stroke. The study provided relevant information based on practice setting, type of stroke, and time of stroke that informed the selection of resources included in a Pediatric Stroke Resource Guide for OT Practitioners. Primary Author and Speaker: Aarone M. Cefalo Additional Authors and Speakers: Lisa Jaegers Contributing Authors: Lisa Jaegers

Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis

A better understanding of motor recovery after stroke requires large-scale, longitudinal trials applying suitable assessments. Currently, there is an abundance of upper limb assessments used to quantify recovery. How well various assessments can describe upper limb function change over 1 year remains uncertain. A uniform and feasible standard would be beneficial to increase future studies' comparability on stroke recovery. This review describes which assessments are common in large-scale, longitudinal stroke trials and how these quantify the change in upper limb function from stroke onset up to 1 year. A systematic search for well-powered stroke studies identified upper limb assessments classifying motor recovery during the initial year after a stroke. A metaregression investigated the association between assessments and motor recovery within 1 year after stroke. Scores from nine common assessments and 4,433 patients were combined and transformed into a standardized recovery score. A mixed-effects model on recovery scores over time confirmed significant differences between assessments (P < 0.001), with improvement following the weeks after stroke present when measuring recovery using the Action Research Arm Test (β = 0.013), Box and Block test (β = 0.011), Fugl–Meyer Assessment (β = 0.007), or grip force test (β = 0.023). A last-observation-carried-forward analysis also highlighted the peg test (β = 0.017) and Rivermead Assessment (β = 0.011) as additional, valuable long-term outcome measures. Recovery patterns and, thus, trial outcomes are dependent on the assessment implemented. Future research should include multiple common assessments and continue data collection for a full year after stroke to facilitate the consensus process on assessments measuring upper limb recovery.

Lipopolysaccharide endotoxin injections elevated salivary TNFα and corneal temperatures and induced dynamic changes in circulating leukocytes, inflammatory cytokines, and metabolic indicators in wether lambs

Pathogenic infections increase morbidity and reduce performance in livestock, and thus understanding the comprehensive physiological changes associated with infections can benefit production sustainability. In this study, we sought to investigate such physiological responses to an acute immune challenge in lambs. Polypay wethers received single IV injections of 1.5 µg/kg lipopolysaccharide endotoxin (LPS-injected; n = 6) or saline (controls; n = 6). Corneal temperatures (via infrared thermography), rectal temperatures, blood, plasma, and saliva were assessed every 2 h for 10 h after injections. Blood was also assessed at 24 h. LPS-injected lambs exhibited elevated (P < 0.05) corneal and rectal temperatures that peaked at 4 h but were still slightly greater (P < 0.05) than controls at 10 h. Circulating total white blood cells, monocytes, and granulocytes were reduced (P < 0.05) in LPS-injected lambs within the first 4 h but were subsequently greater (P < 0.05) than in controls. Lymphocytes were reduced (P < 0.05) in LPS-injected lambs over the first 8 h and did not differ from controls thereafter. Red blood cells, hematocrit, and hemoglobin were increased (P < 0.05) in LPS-injected lambs over the first 6 h, indicating mild dehydration. Blood glucose briefly increased (P < 0.05) in LPS-injected lambs at 2 h but was less (P < 0.05) than in controls thereafter. Blood lactate was greater (P < 0.05) in LPS-injected lambs between 6 and 10 h after injections, which together with reduced (P < 0.05) CO2 partial pressure indicated a metabolic shift toward glycolysis. LPS-injected lambs exhibited a transient increase (P < 0.05) in plasma TNFα at 2 and 4 h only and sustained increases (P < 0.05) in CXCL9 and CXCL10 beginning at 6 and 4 h, respectively. They also exhibited a mild, paradoxical increase (P < 0.05) in the anti-inflammatory sFRP3. Salivary TNFα was increased (P < 0.05) in LPS-injected lambs at 2 h only. Regression analyses indicated that rectal temperatures were a generally poor predictor of the other inflammatory components in this study, with the exception of circulating leukocyte populations. Likewise, correlations among the 10 cytokines measured in this study were generally weak, with notable exceptions between CXCL9 and CXCL10 and between IL-21 and IFNγ. These findings demonstrate that physiological changes to even short-lived immune challenges are dynamic in nature and persist beyond the time frame of febrile responses and other common assessments.

Health and Fall Risk Monitoring Within Common Assessments

This chapter presents an exploratory review on the evaluation, assessment, and monitoring in health and fall risk by common and the most used assessment tools. The main discussion of this chapter of evaluation in health and fall risk is divided into six categories—global health assessment, specific physical (and fitness) assessment, cognitive and psychological assessment, pharmacological assessment, fall risk specific assessment, and some complementary assessment—which show information and how to access. Whereas health evaluative experiences and practices are essential to drive a better and specific intervention, revealing its importance and necessity was also highlighted.