21 results
Intervention for sleep problems in nursing home residents with dementia: a cluster-randomized study
- Martin Nikolaus Dichter, Jonas Dörner, Denise Wilfling, Almuth Berg, Thomas Klatt, Ralph Möhler, Burkhard Haastert, Gabriele Meyer, Margareta Halek, Sascha Köpke
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- International Psychogeriatrics , First View
- Published online by Cambridge University Press:
- 08 January 2024, pp. 1-14
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Objective:
To reduce sleep problems in people living with dementia using a multi-component intervention.
Design:Cluster-randomized controlled study with two parallel groups and a follow-up of 16 weeks.
Setting:Using external concealed randomization, 24 nursing homes (NH) were allocated either to the intervention group (IG, 12 clusters, 126 participants) or the control group (12 clusters, 116 participants).
Participants:Participants were eligible if they had dementia or severe cognitive impairment, at least two sleep problems, and residence of at least two weeks in a NH.
Intervention:The 16-week intervention consists of six components: (1) assessment of sleep-promoting activities and environmental factors in NHs, (2) implementation of two “sleep nurses,” (3) basic education, (4) advanced education for staff, (5) workshops to develop sleep-promoting concepts, and (6) written information and education materials. The control group (CG) received standard care.
Measurements:Primary outcome was ≥ two sleep problems after 16 weeks assessed with the Sleep Disorders Inventory (SDI).
Results:Twenty-two clusters (IG = 10, CG = 12) with 191 participants completed the study. At baseline, 90% of people living with dementia in the IG and 93% in the CG had at least two sleep problems. After 16 weeks, rates were 59.3% (IG) vs 83.8% (CG), respectively, a difference of −24.5% (95% CI, −46.3% – −2.7%; cluster-adjusted odds ratio 0.281; 95% CI 0.087–0.909). Secondary outcomes showed a significant difference only for SDI scores after eight and 16 weeks.
Conclusions:The MoNoPol-Sleep intervention reduced sleep problems of people living with dementia in NH compared to standard care.
45698 Molecular Signatures of Cocaine Neurotoxicity in Human Brain Models
- Emily Mendez, Laura Stertz, Gabriel Fries, Ruifeng Hu, Thomas Meyer, Zhongming Zhao, Consuelo Walss-Bass
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- Journal of Clinical and Translational Science / Volume 5 / Issue s1 / March 2021
- Published online by Cambridge University Press:
- 30 March 2021, p. 115
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ABSTRACT IMPACT: This project will use human neuron models and bioinformatics techniques to elucidate mechanisms of cocaine neurotoxicity, which will allow treatments to be developed for minimizing or preventing neurological damage caused by cocaine abuse and overdose. OBJECTIVES/GOALS: The goals of this project are to identify genes and gene networks altered by cocaine exposure in neurons (short term), and to use these pathways to understand mechanisms of cocaine neurotoxicity for the establishment of therapeutic targets (long term). METHODS/STUDY POPULATION: To study the molecular effects of cocaine, we generated preliminary proteomics and next-generation RNA sequencing (RNAseq) data from human postmortem prefrontal cortex (Broadmann area 9 or BA9) of 12 cocaine overdose subjects and 17 controls. Future directions for this project include RNAseq analysis of neuronal nuclei sorted from human postmortem BA9 and a human induced pluripotent stem cell-derived neuron (hiPSN) model of cocaine exposure from the same postmortem subjects from whom we have brain samples. RESULTS/ANTICIPATED RESULTS: We found alterations in neuronal synaptic protein levels and gene expression, including the serotonin transporter SLC6A4, and synaptic proteins SNAP25, SYN2, SYNGR3. Pathway analysis of our results revealed alterations in specific pathways involved with neuronal function including voltage-gated calcium channels, and GABA receptor signaling. In the future, we expect to see an enhancement in neuron-specific gene expression signatures in our sorted neuronal nuclei and our hiPSN model of cocaine exposure. The hiPSN model will help elucidate which effects are due to acute versus chronic exposure of cocaine. DISCUSSION/SIGNIFICANCE OF FINDINGS: Transcriptomic signatures found with this analysis can help us understand mechanisms of cocaine neurotoxicity in human neurons. With this work and future proposed studies, we can discover targetable molecular pathways to develop drugs that can reduce or reverse cocaine-related impairment.
Septic Shock: A Genomewide Association Study and Polygenic Risk Score Analysis
- Shannon D’Urso, Dorrilyn Rajbhandari, Elizabeth Peach, Erika de Guzman, Qiang Li, Sarah E. Medland, Scott D. Gordon, Nicholas G. Martin, CHARGE Inflammation Working Group, Symen Ligthart, Matthew A. Brown, Joseph Powell, Colin McArthur, Andrew Rhodes, Jason Meyer, Simon Finfer, John Myburgh, Antje Blumenthal, Jeremy Cohen, Balasubramanian Venkatesh, Gabriel Cuellar-Partida, David M. Evans
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- Twin Research and Human Genetics / Volume 23 / Issue 4 / August 2020
- Published online by Cambridge University Press:
- 05 August 2020, pp. 204-213
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Previous genetic association studies have failed to identify loci robustly associated with sepsis, and there have been no published genetic association studies or polygenic risk score analyses of patients with septic shock, despite evidence suggesting genetic factors may be involved. We systematically collected genotype and clinical outcome data in the context of a randomized controlled trial from patients with septic shock to enrich the presence of disease-associated genetic variants. We performed genomewide association studies of susceptibility and mortality in septic shock using 493 patients with septic shock and 2442 population controls, and polygenic risk score analysis to assess genetic overlap between septic shock risk/mortality with clinically relevant traits. One variant, rs9489328, located in AL589740.1 noncoding RNA, was significantly associated with septic shock (p = 1.05 × 10–10); however, it is likely a false-positive. We were unable to replicate variants previously reported to be associated (p < 1.00 × 10–6 in previous scans) with susceptibility to and mortality from sepsis. Polygenic risk scores for hematocrit and granulocyte count were negatively associated with 28-day mortality (p = 3.04 × 10–3; p = 2.29 × 10–3), and scores for C-reactive protein levels were positively associated with susceptibility to septic shock (p = 1.44 × 10–3). Results suggest that common variants of large effect do not influence septic shock susceptibility, mortality and resolution; however, genetic predispositions to clinically relevant traits are significantly associated with increased susceptibility and mortality in septic individuals.
Multi-scale Characterization Study Enabling Deactivation Mechanism in Formed Zeolite Catalyst
- Qianying Guo, Harry M. Meyer III, Anton Ievlev, Anne Starace, Calvin Mukarakate, Susan E. Habas, Gabriel M. Veith, Kinga A. Unocic
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- Microscopy and Microanalysis / Volume 26 / Issue S2 / August 2020
- Published online by Cambridge University Press:
- 30 July 2020, pp. 1270-1271
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- August 2020
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4141 Molecular Signatures of Cocaine Toxicity in Postmortem Human Brain and Neurons
- Emily Frances Mendez, Laura Stertz, Gabriel Fries, Ruifeng Hu, Thomas Meyer, Zhongming Zhao, Consuelo Walss-Bass
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- Journal of Clinical and Translational Science / Volume 4 / Issue s1 / June 2020
- Published online by Cambridge University Press:
- 29 July 2020, p. 140
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OBJECTIVES/GOALS: The goal of this project is to identify new therapeutic targets and biomarkers to treat or prevent cocaine toxicity by investigating proteomic, transcriptomic and epigenetic signatures of cocaine exposure in human subjects. METHODS/STUDY POPULATION: Cocaine is a highly addictive neurotoxic substance, and it is estimated that 1.9 million Americans are current users of cocaine. To study the molecular effects of cocaine, we generated preliminary proteomics and next-generation RNA sequencing (RNAseq) data from human postmortem dorsolateral prefrontal cortex (Broadmann area 9 or BA9) of 12 cocaine-exposed subjects and 17 controls. Future directions for this project include RNAseq and DNA methylation analysis of neuronal nuclei sorted from human postmortem BA9 and a human induced pluripotent stem cell-derived neuron (hiPSN) model of cocaine exposure from the same postmortem subjects from whom we have brain samples. RESULTS/ANTICIPATED RESULTS: We found alterations in neuronal synaptic protein levels and gene expression, including the serotonin transporter SLC6A4, and synaptic proteins SNAP25, SYN2, SYNGR3. Pathway analysis of our results revealed alterations in specific pathways involved with neuronal function including voltage-gated calcium channels, and GABA receptor signaling. In the future, we expect to see an enhancement in neuron-specific gene expression signatures in our sorted neuronal nuclei and our hiPSN model of cocaine exposure. The hiPSN model will help elucidate which effects are due to acute versus chronic exposure of cocaine. DISCUSSION/SIGNIFICANCE OF IMPACT: Neuronal signatures found with this analysis can help us understand mechanisms of cognitive decline in long-term cocaine users as well as the acute effects on the brain of cocaine taken in overdose. With this work and future proposed studies, we can discover novel clinical biomarkers for cocaine neurotoxicity in patients with cocaine use disorder and determine readouts for future therapeutic development on cocaine addiction and overdose.
Characteristics of multicomponent, nonpharmacological interventions to reduce or avoid sleep disturbances in nursing home residents: a systematic review
- Denise Wilfling, Jonas Hylla, Almuth Berg, Gabriele Meyer, Sascha Köpke, Margareta Halek, Ralph Möhler, Martin N. Dichter
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- International Psychogeriatrics / Volume 33 / Issue 3 / March 2021
- Published online by Cambridge University Press:
- 05 June 2020, pp. 245-273
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Background:
Dementia guidelines propose the use of nonpharmacological interventions for sleep disturbances for older people. Based on available reviews, it seems most likely that multicomponent interventions have the strongest potential to be effective in improving sleep. However, a detailed description of multicomponent interventions is missing. This systematic review aims to identify, describe, and summarize multicomponent, nonpharmacological interventions to reduce or avoid sleep disturbances in nursing home residents.
Methods:This review followed established methodological frameworks for systematic evidence syntheses. A computerized search was conducted in December 2018, using the databases PubMed, CINAHL, Scopus, and Cochrane Library. Two independent reviewers assessed all search results to identify eligible studies and assessed studies’ methodological quality following the Cochrane Risk of Bias methodology for randomized controlled trials and the CASP Appraisal Checklist for controlled trials.
Evaluation studies of any design investigating multicomponent interventions were included, except case studies. Components of included intervention programs were analyzed applying the TIDieR and CReDECI 2 criteria.
Results:A total of 2056 studies were identified through the database search; ten publications about nine interventions met the inclusion criteria and were included in the review. The identified interventions can be summarized assigned to the categories “daytime activities,” “nighttime activities,” “staff training,” and “light exposure.” The approaches showed similarities and differences in procedures, materials, modes of delivery, intervention provider, and intervention period. None of the studies described any intended interactions between components or considered context characteristics in intervention modeling as well as internal and external facilitators or barriers influencing delivery of intervention. We identified positive or mixed positive effects for sleep-related outcomes for the mentioned categories.
Conclusions:The analysis of included interventions demonstrates somehow promising results, although findings are difficult to interpret as interventions were not well described, and the challenges of developing and evaluating complex interventions were not sufficiently acknowledged.
Carers’ experiences of timely access to and use of dementia care services in eight European countries
- Hannah Jelley, Liselot Kerpershoek, Frans Verhey, Claire Wolfs, Marjolein de Vugt, Anja Bieber, Astrid Stephan, Gabriele Meyer, Mona Michelet, Geir Selbaek, Britt-Marie Sjölund, Anders Sköldunger, Louise Hopper, Kate Irving, Maria Marques, Maria Conceição Balsinha, Manuel Gonçalves-Pereira, Daniel Michael Portolani, Orazio Zanetti, Bob Woods, the Actifcare Consortium
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- Journal:
- Ageing & Society / Volume 41 / Issue 2 / February 2021
- Published online by Cambridge University Press:
- 16 September 2019, pp. 403-420
- Print publication:
- February 2021
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Timely access to care services is crucial to support people with dementia and their family carers to live well. Carers of people with dementia (N = 390), recruited from eight countries, completed semi-structured interviews about their experiences of either accessing or not using formal care services over a 12-month period in the Access to Timely Formal Care (Actifcare) study. Participant responses were summarised using content analysis, categorised into clusters and frequencies were calculated. Less than half of the participants (42.3%) reported service use. Of those using services, 72.8 per cent reported timely access and of those not using services 67.2 per cent were satisfied with this situation. However, substantial minorities either reported access at the wrong time (27.2%), or feeling dissatisfied or mixed feelings about not accessing services (32.8%). Reasons for not using services included use not necessary yet, the carer provided support or refusal. Reasons given for using services included changes in the condition of the person with dementia, the service's ability to meet individual needs, not coping or the opportunity to access services arose. Facilitators and barriers to service use included whether participants experienced supportive professionals, the speed of the process, whether the general practitioner was helpful, participant's own proactive attitude and the quality of information received. To achieve timely support, simplified pathways to use of formal care services are needed.
Parenting style moderates the effects of exposure to natural disaster-related stress on the neural development of reactivity to threat and reward in children
- Ellen M. Kessel, Brady D. Nelson, Megan Finsaas, Autumn Kujawa, Alexandria Meyer, Evelyn Bromet, Gabrielle A. Carlson, Greg Hajcak, Roman Kotov, Daniel N. Klein
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- Development and Psychopathology / Volume 31 / Issue 4 / October 2019
- Published online by Cambridge University Press:
- 06 February 2019, pp. 1589-1598
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Little is known about the effect of natural disasters on children's neural development. Additionally, despite evidence that stress and parenting may both influence the development of neural systems underlying reward and threat processing, few studies have brought together these areas of research. The current investigation examined the effect of parenting styles and hurricane-related stress on the development of neural reactivity to reward and threat in children. Approximately 8 months before and 9 months after Hurricane Sandy, 74 children experiencing high and low levels of hurricane-related stress completed tasks that elicited the reward positivity and error-related negativity, event-related potentials indexing sensitivity to reward and threat, respectively. At the post-Hurricane assessment, children completed a self-report questionnaire to measure promotion- and prevention-focused parenting styles. Among children exposed to high levels of hurricane-related stress, lower levels of promotion-focused, but not prevention-focused, parenting were associated with a reduced post-Sandy reward positivity. In addition, in children with high stress exposure, greater prevention-focused, but not promotion-focused, parenting was associated with a larger error-related negativity after Hurricane Sandy. These findings highlight the need to consider contextual variables such as parenting when examining how exposure to stress alters the development of neural reactivity to reward and threat in children.
Safety of tracheal intubation in the presence of cardiac disease in paediatric ICUs
- Eleanor A. Gradidge, Adnan Bakar, David Tellez, Michael Ruppe, Sarah Tallent, Geoffrey Bird, Natasha Lavin, Anthony Lee, Vinay Nadkarni, Michelle Adu-Darko, Jesse Bain, Katherine Biagas, Aline Branca, Ryan K. Breuer, Calvin Brown III, Kris Bysani, Guillaume Emeriaud, Sandeep Gangadharan, John S. Giuliano, Jr, Joy D. Howell, Conrad Krawiec, Jan Hau Lee, Simon Li, Keith Meyer, Michael Miksa, Natalie Napolitano, Sholeen Nett, Gabrielle Nuthall, Alberto Orioles, Erin B. Owen, Margaret M. Parker, Simon Parsons, Lee A. Polikoff, Kyle Rehder, Osamu Saito, Ron C. Sanders, Jr, Asha Shenoi, Dennis W. Simon, Peter W. Skippen, Keiko Tarquinio, Anne Thompson, Iris Toedt-Pingel, Karen Walson, Akira Nishisaki, For National Emergency Airway Registry for Children (NEARKIDS) Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)
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- Cardiology in the Young / Volume 28 / Issue 7 / July 2018
- Published online by Cambridge University Press:
- 25 April 2018, pp. 928-937
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Introduction
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methodsWe sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
ResultsA total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
ConclusionsThe overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.
Transdiagnostic factors and pathways to multifinality: The error-related negativity predicts whether preschool irritability is associated with internalizing versus externalizing symptoms at age 9
- Ellen M. Kessel, Alexandria Meyer, Greg Hajcak, Lea R. Dougherty, Dana C. Torpey-Newman, Gabrielle A. Carlson, Daniel N. Klein
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- Development and Psychopathology / Volume 28 / Issue 4pt1 / November 2016
- Published online by Cambridge University Press:
- 14 October 2016, pp. 913-926
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There is increasing interest among developmental psychopathologists in broad transdiagnostic factors that give rise to a wide array of clinical presentations (multifinality), but little is known about how these processes lead to particular psychopathological manifestations over the course of development. We examined whether individual differences in the error-related negativity (ΔERN), a neural indicator of error monitoring, predicts whether early persistent irritability, a prototypical transdiagnostic construct, is associated with later internalizing versus externalizing outcomes. When children were 3 years old, mothers were interviewed about children's persistent irritability and completed questionnaires about their children's psychopathology. Three years later, EEG was recorded while children performed a go/no-go task to measure the ΔERN. When children were approximately 9 years old, mothers again completed questionnaires about their children's psychopathology. The results indicated that among children who were persistently irritable at age 3, an enhanced or more negative ΔERN at age 6 predicted the development of internalizing symptoms at age 9, whereas a blunted or smaller ΔERN at age 6 predicted the development of externalizing symptoms. Our results suggest that variation in error monitoring predicts, and may even shape, the expression of persistent irritability and differentiates developmental trajectories from preschool persistent irritability to internalizing versus externalizing outcomes in middle to late childhood.
Cross-cultural adaptation of the German version of the Quality of Life in Alzheimer's Disease scale - Nursing Home version (QoL-AD NH)
- Martin Nikolaus Dichter, Eva-Maria Wolschon, Gabriele Meyer, Sascha Köpke
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- International Psychogeriatrics / Volume 28 / Issue 8 / August 2016
- Published online by Cambridge University Press:
- 10 February 2016, pp. 1399-1400
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Dementia is a chronic and currently incurable syndrome. Therefore, quality of life (QoL) is a major goal when caring for people with dementia (Gibson et al., 2010) and a major outcome in dementia research (Moniz-Cook et al., 2008). The measurement of QoL, especially proxy-rating, is challenging because of the proxy-perspective (Pickard and Knight, 2005), reliability (Dichter et al., 2016), validity (O'Rourke et al., 2015), and responsiveness (Perales et al., 2013). Probably due to these challenges, it has not been possible to show positive effects for QoL in almost all non-pharmacological interventions for people with dementia (Cooper et al., 2012). One recommended (Moniz-Cook et al., 2008) and frequently used instrument is the Quality of Life in Alzheimer's Disease scale (QoL-AD), which was originally developed in the US for community-dwelling people with dementia. The QoL-AD consists of 13 items based on a 4-point Likert scale ranging from “1”=poor to “4”=excellent (Logsdon et al., 1999). The original instrument has been adapted for people living in nursing homes (NH) by Edelmann et al. (2005).
Notes on Contributors
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- By Genevieve Abravanel, André Benhaïm, Michelle Clayton, Jonathan P. Eburne, Gregg Lambert, Marc Manganaro, Gabrielle McIntire, Tracy McNulty, Steven Meyer, Elizabeth A. Mosimann, Paul North, Christine Poggi, Jean-Michel Rabaté, Alastair Renfrew, Judith Ryan, Matt Wilson Smith, Angeliki Spiropoulou, Adam Takács
- Edited by Jean-Michel Rabaté, University of Pennsylvania
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- 1922
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- 05 March 2015
- Print publication:
- 09 March 2015, pp vii-x
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Measuring the quality of life in mild to very severe dementia: Testing the inter-rater and intra-rater reliability of the German version of the QUALIDEM
- Martin Nikolaus Dichter, Christian G. G. Schwab, Gabriele Meyer, Sabine Bartholomeyczik, Olga Dortmann, Margareta Halek
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- International Psychogeriatrics / Volume 26 / Issue 5 / May 2014
- Published online by Cambridge University Press:
- 10 February 2014, pp. 825-836
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Background:
Quality of life (Qol) is an increasingly used outcome measure in dementia research. The QUALIDEM is a dementia-specific and proxy-rated Qol instrument. We aimed to determine the inter-rater and intra-rater reliability in residents with dementia in German nursing homes.
Methods:The QUALIDEM consists of nine subscales that were applied to a sample of 108 people with mild to severe dementia and six consecutive subscales that were applied to a sample of 53 people with very severe dementia. The proxy raters were 49 registered nurses and nursing assistants. Inter-rater and intra-rater reliability scores were calculated on the subscale and item level.
Results:None of the QUALIDEM subscales showed strong inter-rater reliability based on the single-measure Intra-Class Correlation Coefficient (ICC) for absolute agreement ≥ 0.70. Based on the average-measure ICC for four raters, eight subscales for people with mild to severe dementia (care relationship, positive affect, negative affect, restless tense behavior, social relations, social isolation, feeling at home and having something to do) and five subscales for very severe dementia (care relationship, negative affect, restless tense behavior, social relations and social isolation) yielded a strong inter-rater agreement (ICC: 0.72–0.86). All of the QUALIDEM subscales, regardless of dementia severity, showed strong intra-rater agreement. The ICC values ranged between 0.70 and 0.79 for people with mild to severe dementia and between 0.75 and 0.87 for people with very severe dementia.
Conclusions:This study demonstrated insufficient inter-rater reliability and sufficient intra-rater reliability for all subscales of both versions of the German QUALIDEM. The degree of inter-rater reliability can be improved by collaborative Qol rating by more than one nurse. The development of a measurement manual with accurate item definitions and a standardized education program for proxy raters is recommended.
Validity, reliability, and feasibility of the German version of the Caregiver Reaction Assessment scale (G-CRA): a validation study
- Astrid Stephan, Herbert Mayer, Anna Renom Guiteras, Gabriele Meyer
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- International Psychogeriatrics / Volume 25 / Issue 10 / October 2013
- Published online by Cambridge University Press:
- 25 July 2013, pp. 1621-1628
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Background:
Instruments measuring caregiver reactions usually disregard positive aspects, and focus predominately on home care. The Caregiver Reaction Assessment (CRA) scale is an exception. Until now, no German version has been available. We translated the instrument to German (G-CRA) and evaluated its psychometric properties and feasibility.
Methods:Face-to-face interviews with 234 informal caregivers of persons with dementia were performed. Half of the persons with dementia (n = 118) had been recently admitted to institutional long-term care (iLTC); the remainder (n = 116) lived at home. Exploratory factor analysis (EFA) was performed. Subscales were inter-correlated and further correlated with the Zarit Burden Interview (ZBI), the General Health Questionnaire (GHQ-12), and the EuroQuol (EQ-5D). Internal consistency was measured (Cronbach's α), and interviewers (n = 9) appraised feasibility. The time needed to apply the scale was measured in 20 interviews.
Results:The EFA yielded six factors (Kaiser criterion), but a scree plot supported the five dimensions of the original version that explained 56.2% of variance. Low-to-moderate subscales’ inter-correlation was revealed. Highest correlation (r = 0.5) was found between impact on health and impact on daily schedule, indicating slight overlap. Criterion validity was supported by reasonable correlations between subscales and ZBI and GHQ-12 (r = −0.21–0.71). Subscale impact on health was negatively correlated with the EQ-5D. The internal consistency was sufficient (α = 0.67 − 0.78). Interviewers judged the G-CRA to be appropriate. Completion took 6.50 min (median value).
Conclusions:Our results suggest that the G-CRA is sufficiently valid and internally reliable. The instrument is applicable in home care and iLTC as well as in the transitional phase.
Shape effects on turbulent modulation by large nearly neutrally buoyant particles
- Gabriele Bellani, Margaret L. Byron, Audric G. Collignon, Colin R. Meyer, Evan A. Variano
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- Journal of Fluid Mechanics / Volume 712 / 10 December 2012
- Published online by Cambridge University Press:
- 27 September 2012, pp. 41-60
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We investigate dilute suspensions of Taylor-microscale-sized particles in homogeneous isotropic turbulence. In particular, we focus on the effect of particle shape on particle–fluid interaction. We conduct laboratory experiments using a novel experimental technique to simultaneously measure the kinematics of fluid and particle phases. This uses transparent particles having the same refractive index as water, whose motion we track via embedded optical tracers. We compare the turbulent statistics of a single-phase flow to the turbulent statistics of the fluid phase in a particle–laden suspension. Two suspensions are compared, one in which the particles are spheres and the other in which they are prolate ellipsoids with aspect ratio 2. We find that spherical particles at volume fraction ${\phi }_{v} = 0. 14\hspace{0.167em} \% $ reduce the turbulent kinetic energy (TKE) by 15 % relative to the single-phase flow. At the same volume fraction (and slightly smaller total surface area), ellipsoidal particles have a much smaller effect: they reduce the TKE by 3 % relative to the single-phase flow. Spectral analysis shows the details of TKE reduction and redistribution across spatial scales: spherical particles remove energy from large scales and reinsert it at small scales, while ellipsoids remove relatively less TKE from large scales and reinsert relatively more at small scales. Shape effects are far less evident in the statistics of particle rotation, which are very similar for ellipsoids and spheres. Comparing these with fluid enstrophy statistics, we find that particle rotation is dominated by velocity gradients on scales much larger than the particle characteristic length scales.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. 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Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. 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Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Phenomenology and diagnosis of bipolar disorder in children, adolescents, and adults: Complexities and developmental issues
- GABRIELLE A. CARLSON, STEPHANIE E. MEYER
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- Journal:
- Development and Psychopathology / Volume 18 / Issue 4 / December 2006
- Published online by Cambridge University Press:
- 25 October 2006, pp. 939-969
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This review addresses the phenomenology of mania/bipolar disorder from a developmental psychopathology perspective and uses cases with longitudinal information to illustrate major points. Beginning with a summary of the phenomenology of bipolar illness as it occurs in adults, the authors identify diagnostic complexities unique to children and adolescents. These include the challenges of characterizing elation and grandiosity; differentiating mania from comorbid symptoms, rages, sequelae of maltreatment, and typical developmental phenomena; and the unique manifestations of psychosis. We conclude with the observation that a significant difference between early and later onset bipolar disorder is that, in the former, there appears to be a global delay or arrest in the development of appropriate affect regulation; whereas in adult-onset bipolar illness, emotion dysregulation generally presents as an intermittent phenomenon. At this juncture, the study of childhood bipolar illness would benefit from a developmental psychopathology perspective to move beyond the level of cross-sectional symptom description to begin to study individuals over time, focusing on developmental, environmental, genetic, and neurobiological influences on manifest behavior.
This review was supported in part by funding from NIMH Grant 44801 and grants from Janssen Pharmaceutica and Abbott Laboratories.
A prospective high-risk study of the association among maternal negativity, apparent frontal lobe dysfunction, and the development of bipolar disorder
- STEPHANIE E. MEYER, GABRIELLE A. CARLSON, EDYTHE A. WIGGS, DONNA S. RONSAVILLE, PEDRO E. MARTINEZ, BONNIE KLIMES-DOUGAN, PHILIP W. GOLD, MARIAN RADKE-YARROW
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- Journal:
- Development and Psychopathology / Volume 18 / Issue 2 / June 2006
- Published online by Cambridge University Press:
- 28 March 2006, pp. 573-589
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In a previous paper, the authors found that impairment on the Wisconsin Card Sorting Test (WCST) in adolescence was predictive of bipolar disorder in young adulthood among offspring of mothers with bipolar illness. In the present study, the authors explore the contribution of maternal characteristics, beyond maternal mood disorder, to the prediction of offspring dysfunction on the WCST. Results showed that maternal bipolar disorder and maternal negativity were both predictive of impaired performance on the WCST during adolescence. The contribution of maternal negativity to offspring WCST impairment was not better explained by maternal personality disorder, mother's functional impairment, family loading for bipolar disorder, or offspring disruptive behavioral disturbance. Findings did not support a moderator model. However, support was found for a mediation model in which maternal negativity contributed to risk for offspring bipolar disorder through its negative association with apparent frontal lobe functioning, as measured by the WCST. Findings are discussed from the perspective of a vulnerability–stress model. In addition, the authors consider the possibility that maternal negativity and offspring impairment on the WCST may be reflective of a common heritable trait.
The findings presented in this paper come from the doctoral dissertation of the first author, which was funded by an NIMH Intramural Research Training Award. The authors are enormously grateful to Anne Mayfield, without whom this project would not have been possible. We are deeply indebted to Ann S. Masten, W. Andrew Collins, L. Alan Sroufe, Monica Luciana, and Carrie Borchardt, who provided support and guidance throughout all stages of this project. We are also thankful to Robert Asarnow for his advice and encouragement, and to Roger E. Meyer and Daniel N. Klein for their comments on earlier drafts of this paper. In addition, we acknowledge the contributions of Gail Inoff-Germain, who administered diagnostic interviews and neuropsychological measures at adolescent follow-up; Rula B. Garside, who undertook the painstaking job of establishing interrater reliability; Erika Sundstrom, who devoted many hours to data organization and quality assurance; and Sara Avery Torvik and Patricia Kasdan, whose combined gifts of organization and warmth created a comfortable atmosphere for study participants. Finally, we thank the extraordinary research participants of the NIMH Childrearing Study, who have shown enormous bravery and dedication by sharing with us 23 years of their lives.
5 - The globalization of business education
- from Part I - Leading the global organization
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- By Arnoud De Meyer, Insead, Patrick T. Harker, Wharton School, Gabriel Hawawini, Insead
- Edited by Hubert Gatignon, INSEAD, Fontainebleau, France, John R. Kimberly, Wharton School, University of Pennsylvania
- With Robert E. Gunther
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- The INSEAD-Wharton Alliance on Globalizing
- Published online:
- 14 January 2010
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- 20 September 2004, pp 104-128
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Summary
What does it mean to be a global business school? As business has become increasingly international, the demands of preparing business leaders for success in a global environment have forced leading business schools to reexamine their programs and structure. Schools have used a variety of strategies to raise the bar on internationalization. They have established programs and campuses around the world, brought in international students and faculty, and reshaped their organizations through alliances and joint ventures. The authors review four different models business schools have used to “internationalize” their programs: the import model, the export model, the partnership model, and the network model. They examine some of the key challenges of the process and strategies for success for each model. Finally, they explore some of the key leadership challenges for global business schools. While the focus is on education and research, the solutions of business schools to their global challenges offer insights for corporate managers on the development of global learning communities and managing international networks of knowledge workers.
Business schools are becoming more global. Our students and faculty are drawn increasingly from around the world. The content of what we offer to participants in our courses, be they full-time graduate students or executives, is gradually adapted to the needs of operating in an international environment. As shown in Table 5.1, of the top twenty schools listed in a recent Financial Times ranking, all drew at least a quarter of their students from outside their domestic markets, and with one exception, at least a tenth of their faculty members from abroad.
A prospective study of the association among impaired executive functioning, childhood attentional problems, and the development of bipolar disorder
- STEPHANIE E. MEYER, GABRIELLE A. CARLSON, EDYTHE A. WIGGS, PEDRO E. MARTINEZ, DONNA S. RONSAVILLE, BONNIE KLIMES–DOUGAN, PHILIP W. GOLD, MARIAN RADKE–YARROW
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- Journal:
- Development and Psychopathology / Volume 16 / Issue 2 / June 2004
- Published online by Cambridge University Press:
- 01 June 2004, pp. 461-476
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Studies of adults who have been diagnosed with, and treated for, bipolar disorder have shown that these patients exhibit impairment on measures of executive functioning. However, it is unclear whether executive dysfunction precedes the diagnosis of bipolar illness, or develops subsequent to its onset. Moreover, investigators have failed to control for the effects of premorbid attentional problems on cognitive performance in these patients. The present authors explored these questions using data from a longitudinal prospective study of individuals at risk for major mood disorder. Results revealed that 67% of participants who met criteria for bipolar disorder in young adulthood showed impairment on the Wisconsin Card Sorting Test (WCST) when they were assessed during adolescence, as compared with 17% of individuals with no major mood diagnosis, and 19% with unipolar depression. This association between performance on the WCST and bipolar illness was not accounted for by high rates of premorbid attentional disturbance. In fact, among participants with early attentional problems, only those who ultimately developed bipolar disorder exhibited impairment on the WCST. Early attentional problems that preceded unipolar depression or no mood disorder were not associated with executive dysfunction.
The findings presented in this paper come from the doctoral dissertation of the first author, which was funded by an NIMH Intramural Research Training Award. The authors are enormously grateful to Roger E. Meyer for his comments on earlier drafts of this paper and to Anne Mayfield, without whom this project would not have been possible. We are deeply indebted to Ann S. Masten, W. Andrew Collins, L. Alan Sroufe, Monica Luciana, and Carrie Borchardt, who provided invaluable guidance throughout all stages of this project, as well as Robert Asarnow, who was an important mentor during the review process. In addition, we acknowledge the contributions of Gail Inoff–Germain, who administered diagnostic interviews and neuropsychological measures at adolescent follow-up; Rula B. Garside, who undertook the painstaking job of establishing interrater reliability; Erika Sundstrom, who devoted many hours to data organization and quality assurance; and Sara Avery Torvik and Patricia Kasdan, whose combined gifts of organization and warmth created a comfortable atmosphere for study participants. Finally, we thank the extraordinary research participants of the NIMH Childrearing Study, who have shown enormous bravery and dedication by sharing with us 23 years of their lives.