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Manera V, Agüera-Ortiz L, Askenazy F, Dubois B, Corveleyn X, Cross L, Febvre-Richards E, Fabre R, Fernandez N, Foulon P, Gros A, Gueyraud C, Lebourhis M, Malléa P, Martinez L, Pancrazi MP, Payne M, Robert V, Tamagno L, Thümmler S, Robert P. In-Person and Remote Workshops for People With Neurocognitive Disorders: Recommendations From a Delphi Panel. Front Aging Neurosci 2022; 13:747804. [PMID: 35126087 PMCID: PMC8814601 DOI: 10.3389/fnagi.2021.747804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/07/2021] [Indexed: 12/01/2022] Open
Abstract
Workshops using arts and board games are forms of non-pharmacological intervention widely employed in seniors with neurocognitive disorders. However, clear guidelines on how to conduct these workshops are missing. The objective of the Art and Game project (AGAP) was to draft recommendations on the structure and content of workshops for elderly people with neurocognitive disorders and healthy seniors, with a particular focus on remote/hybrid workshops, in which at least a part of the participants is connected remotely. Recommendations were gathered using a Delphi methodology. The expert panel (N = 18) included experts in the health, art and/or board games domains. They answered questions via two rounds of web-surveys, and then discussed the results in a plenary meeting. Some of the questions were also shared with the general public (N = 101). Both the experts and the general public suggested that organizing workshops in a hybrid format (some face-to-face sessions, some virtual session) is feasible and interesting for people with neurocognitive disorders. We reported guidelines on the overall structure of workshops, practical tips on how to organize remote workshops, and a SWOT analysis of the use of remote/hybrid workshops. The guidelines may be employed by clinicians to decide, based on their needs and constraints, what interventions and what kind of workshop format to employ, as well as by researcher to standardize procedures to assess the effectiveness of non-pharmacological treatments for people with neurocognitive disorders.
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Affiliation(s)
- Valeria Manera
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- *Correspondence: Valeria Manera,
| | - Luis Agüera-Ortiz
- Servicio de Psiquiatría, Instituto de Investigación (i + 12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Florence Askenazy
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- University Department of Child and Adolescent Psychiatry, Children’s Hospitals of Nice CHU-Lenval, Nice, France
| | - Bruno Dubois
- Institut de la mémoire et de la Maladie d’Alzheimer (IM2A), INSERM, U1127, AP-HP, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France
- Institut du Cerveau et de la Moelle Épinière (ICM), INSERM, U1127, AP-HP, Sorbonne Université, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Xavier Corveleyn
- Laboratoire d’Anthropologie et de Psychologie Cliniques, Cognitives et Sociales (LAPCOS), Université Côte d’Azur, Nice, France
- Maison des Sciences de l’Homme et de la Société Sud-Est (MSHS Sud-Est), Nice, France
| | - Liam Cross
- Department of Psychology, Edge Hill University, Liverpool, United Kingdom
| | - Emma Febvre-Richards
- Whiti o Rehua School of Art, College of Creative Arts, Massey University, Wellington, New Zealand
| | - Roxane Fabre
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- Public Health Department, Nice University Hospital, Côte d’Azur University, Nice, France
| | | | - Pierre Foulon
- GENIOUS Healthcare–Mindmaze Group Co., Lausanne, Switzerland
| | - Auriane Gros
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
| | - Cedric Gueyraud
- Centre National de Formation aux Métiers du Jeu et du Jouet (FM2J), Caluire-et-Cuire, France
| | | | | | - Léa Martinez
- Asmodee Research, Asmodee, Guyancourt, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Université de Poitiers, Poitiers, France
| | | | - Magali Payne
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d’Azur, Nice, France
- Centre Mémoire de Ressources et de Recherche, Université Côte d’Azur, Nice, France
| | | | | | - Susanne Thümmler
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- University Department of Child and Adolescent Psychiatry, Children’s Hospitals of Nice CHU-Lenval, Nice, France
| | - Philippe Robert
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d’Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côte d’Azur, Nice, France
- Centre Mémoire de Ressources et de Recherche, Université Côte d’Azur, Nice, France
- Association Innovation Alzheimer, Nice, France
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Chen SP, Azad AD, Pershing S. Bidirectional Association between Visual Impairment and Dementia Among Older Adults in the United States Over Time. Ophthalmology 2021; 128:1276-1283. [PMID: 33647283 PMCID: PMC10728499 DOI: 10.1016/j.ophtha.2021.02.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 01/26/2023] Open
Abstract
PURPOSE Although visual impairment (VI) has been associated with worse cognitive performance among older adults, the temporal relationship between the 2 remains subject to debate. Our objective was to investigate the longitudinal impact of VI on cognitive function and vice versa. DESIGN Retrospective, time-to-event study. PARTICIPANTS National Health and Aging Trends Study (NHATS) participants from 2011 to 2018 cycles. METHODS A total of 10 676 participants aged 65 years and older were included. Cox proportional hazards regression models evaluated the impact of baseline VI on subsequent dementia and impact of baseline dementia on subsequent VI. Models were adjusted for potential confounding variables, including demographics, clinical comorbidities, and hearing and physical function limitations. MAIN OUTCOME MEASURES Hazard ratio (HR) for incident dementia among participants with baseline self-reported VI and HR for incident VI among participants with baseline dementia. RESULTS Of the 10 676 participants included in the analysis, approximately 40% were aged 65-74 years, 40% were aged 75-84 years, and the remaining 20% were aged 85 years and older. The majority were female (59%), and 68% self-identified as non-Hispanic White. Among participants with normal cognitive status at baseline, subsequent dementia was observed in 1753 (16%), and among participants with normal self-reported vision at baseline, subsequent VI was reported in 2371 (22%). In adjusted regression models, participants with baseline VI had higher likelihood of developing dementia over subsequent follow-up (HR, 2.3; 95% confidence interval [CI], 2.0-2.6; P < 0.001). Likewise, participants with baseline dementia had a higher likelihood of developing self-reported VI over time (HR, 2.5; 95% CI, 2.2-2.8; P < 0.001). CONCLUSIONS Self-reported VI in the US Medicare population is associated with greater dementia likelihood over time, and dementia is similarly associated with greater VI likelihood over time. Associations are likely multifactorial and bidirectional and could be explained by intervening variables in the path from VI to dementia, or vice versa, or by common risk factors for pathological processes in both eyes and brain. These findings suggest the need for early identification of older adults with visual compromise and consideration of visual disability in the cognitively impaired.
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Affiliation(s)
- Stephanie P Chen
- University of California San Francisco, Department of Ophthalmology, San Francisco, California; Stanford University School of Medicine, Stanford, California
| | - Amee D Azad
- Stanford University School of Medicine, Stanford, California
| | - Suzann Pershing
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California; Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
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Leroi I, Vaitheswaran S, Sheikh S, Chaudhry N, Goswami SP, Miah J, Sakel M, Tofique S, Husain N. Capacity & capability building for applied dementia research in low- & middle-income countries: Two exemplars from South Asia. Indian J Med Res 2021; 152:614-625. [PMID: 34145101 PMCID: PMC8224155 DOI: 10.4103/ijmr.ijmr_2095_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background & objectives: Cognitive and other neurodegenerative conditions related to ageing have become public health priorities in low- and middle-income countries. However, contextually based, applied research to support the development of awareness, diagnosis and care pathways for people with dementia in South Asia is still largely undeveloped. This study was aimed to use applied research studies for dementia in South Asia as exemplars of how individual-level capacity and capability building for dementia research can be achieved. Methods: Using Theory of Change as a framework, we embedded capacity and capability building into the studies through six domains: people (human resources), research integrity and governance, study delivery skills, international collaborative working, patient and public involvement (PPI) (awareness raising, stigma and health literacy) and development of ‘pathways’. For each aspect, development goals were defined and how they would be achieved. Results: New principal investigators, research assistants (including outcome raters), study coordinators and intervention practitioners were trained across eight study sites in India, Pakistan, and Bangladesh, for dementia research. Training was delivered at study start, and through booster sessions, using workshops, face-to-face sessions, online training and video-link sessions. International collaborations were fostered, leading to a proposal for international funding. Each study site co-created PPI events to raise awareness and to inform the research. The recruitment pathways and study logistics fostered the development dementia diagnosis and care pathways. Interpretation & conclusions: Embedding capacity and capability building in applied dementia research in South Asia fosters the sustainability of dementia research, which is essential in developing diagnostic and care pathways.
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Affiliation(s)
- Iracema Leroi
- Department of Psychiatry, Global Brain Health Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sridhar Vaitheswaran
- Department of Dementia Care, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India
| | - Saima Sheikh
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Nasim Chaudhry
- Department of Psychiatry, Dow University of Health Sciences; Pakistan Institute of Living & Learning, Karachi, Pakistan
| | - S P Goswami
- Department of Speech-Language Pathology, Telecentre for Persons Communication Disorder, All India Institute of Speech & Hearing, Mysuru, Karnataka, India
| | - Jahanara Miah
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Mohamed Sakel
- Department of Neuro-rehabilitation, East Kent University NHS FT Hospitals, Global Ambassador; Department of Health and Social Care, Sir William Beveridge Foundation, Dhaka, Bangladesh
| | - Sehrish Tofique
- Department of Psychiatry, Pakistan Institute of Living & Learning, Karachi, Pakistan
| | - Nusrat Husain
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
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Sheikh S, Tofique S, Zehra N, Amjad R, Rasheed M, Usman M, Lal S, Hooper E, Miah J, Husain N, Jafri H, Chaudhry N, Leroi I. SENSE-Cog Asia: A Feasibility Study of a Hearing Intervention to Improve Outcomes in People With Dementia. Front Neurol 2021; 12:654143. [PMID: 34194381 PMCID: PMC8236518 DOI: 10.3389/fneur.2021.654143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022] Open
Abstract
Background: There are few evidence-based non-pharmacological interventions adapted for people with dementia (PwD) in lower- and middle-income countries (LMIC). Thus, there is value in culturally adapting existing interventions from other settings. One such intervention for PwD involves hearing rehabilitation, which may improve dementia-related outcomes. Objective: To culturally adapt and evaluate the feasibility and acceptability of a multi-faceted hearing support intervention to enhance quality of life in PwD for a LMIC setting, Pakistan. Design: This was a study in three phases: (1) training and capacity building to deliver the study, including Patient and Public Involvement (PPI); (2) cultural adaptation of the intervention; and (3) delivery of a single-group feasibility study with a pre-test post-test design. Setting: Home-based intervention, in two cities of Pakistan. Participants: Adults aged ≥ 60 with mild-moderate dementia and uncorrected or partially corrected hearing impairment, and their study partners (n = 14). Intervention: An adapted hearing support intervention (HSI) comprising a full assessment of hearing function, fitting of hearing aids, and home-based support from a “hearing support practitioner.” Outcomes: Ratings of the feasibility of the study procedures, and acceptability/tolerability of the adapted intervention were ascertained through questionnaires, participant diaries, therapist logbooks and semi-structured interviews. A signal of effectiveness of the intervention was also explored using a battery of dementia-related outcome measures. Results: Following cultural adaptation and capacity building for study conduct and delivery, we successfully implemented all intervention components in most participants, which were well-received and enacted by participant dyads. Acceptability (i.e., understanding, motivation, sense of achievement) and tolerability (i.e., effort, fatigue) ratings and safety of the intervention were within a priori target ranges. Recruitment and retention targets required improvement, due to the COVID-19 pandemic outbreak, as well as the lack of a clear clinical diagnostic pathway for dementia in both sites. Areas for future modification were clearly identified, including: the assessment/delivery logistics circuit; procedures for arranging visits; communication among referring clinicians and the study team. Conclusion: This is the first study in a LMIC of sensory enhancement to improve dementia outcomes. Positive feasibility, acceptability and tolerability findings suggest that a full-scale effectiveness trial, with certain modifications is warranted.
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Affiliation(s)
- Saima Sheikh
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Sehrish Tofique
- Department of Psychiatry, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Nosheen Zehra
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Rabia Amjad
- Department of Psychiatry, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Maham Rasheed
- Department of Psychiatry, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Maria Usman
- Department of Psychiatry, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Shanker Lal
- Department of Psychiatry, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Emma Hooper
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom.,Department of Health, Institute of Health, University of Cumbria, Lancaster, United Kingdom
| | - Jahanara Miah
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Nusrat Husain
- Division of Global Mental Health, University of Manchester, Manchester, United Kingdom
| | - Hussain Jafri
- Department of Health, Alzheimer Pakistan, Lahore, Pakistan.,Department of Health, Fatima Jinnah Medical University, Lahore, Pakistan
| | - Nasim Chaudhry
- Department of Psychiatry, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Iracema Leroi
- Department of Psychiatry, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Leroi I, Wolski L, Charalambous AP, Constantinidou F, Renaud D, Dawes P, Hann M, Himmelsbach I, Miah J, Payne M, Simkin Z, Thodi C, Yeung WK, Yohannes AM. Support care needs of people with hearing and vision impairment in dementia: a European cross-national perspective. Disabil Rehabil 2021; 44:5069-5081. [PMID: 34027751 DOI: 10.1080/09638288.2021.1923071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Aging-related sensory impairments are among the most common and disabling comorbidities in people with dementia (PwD). This study explored the unmet support care needs (SCNs) from the perspectives of people with hearing and/or vision impairment in dementia (PwD), and their care partners in Europe. METHODS This was a two-phase mixed methods study. We administered standardized questionnaires of SCNs and quality of life (QoL) to PwD with hearing and/or vision impairment (n = 97), and their care partners (n = 97) in the UK, France, and Cyprus. Next, a purposive sub-sample of 34 participants (PwD and care partners) participated as focus groups (FGs) or semi-structured interviews to explore their SCNs in depth. RESULTS Over 94% of the participants reported unmet SCNs (median, 13 (range 5-23)). Nearly three-quarters reported SCNs in the moderate to high range, with the most prevalent unmet SCNs for PwD being in the psychological (>60%) and physical domains (>56%), followed by the need for health information (>46%). Emergent qualitative themes were: (1) the need for tailored support care interventions; (2) care burden, social isolation, and loneliness arising from the combined problems; (3) the need for adequate support from professionals from the different fields, including education around the use of sensory aids. Both study phases revealed that SCNs were highly individualized. CONCLUSIONS This cross-national study revealed that PwD with sensory impairment and their care partners experience a wide range of unmet SCNs, the interactions between sensory impairments, SCNs and QoL are also complex. A tailored intervention could address these unmet SCNs, including additional support with sensory aids, psychological support, more information about concurrent impairments, and joined up health systems providing care.Implications for rehabilitationA majority of participants with combined age-related hearing, vision, and cognitive impairment had unmet SCNs.The needs of care partners including the risk of loneliness and social isolation, need to be considered.Individually tailored, specific interventions for hearing, vision, and cognitive impairment should incorporate physical and psychological support, as well as education.
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Affiliation(s)
- Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Lucas Wolski
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | | | - Fofi Constantinidou
- Centre for Applied Neurosciences & Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - David Renaud
- CMRR Memory Center, Claude Pompidou Institute, University of Nice Sophia Antipolis, Nice, France
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK
| | - Mark Hann
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Ines Himmelsbach
- Catholic University of Applied Sciences Freiburg, Freiburg, Germany
| | - Jahanarah Miah
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Magali Payne
- CMRR Memory Center, Claude Pompidou Institute, University of Nice Sophia Antipolis, Nice, France
| | - Zoe Simkin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Chryssoula Thodi
- Department of Health Sciences, European University Cyprus, Engomi, Cyprus
| | - Wai Kent Yeung
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
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Leroi I, Chauhan N, Hann M, Jones L, Prew S, Russell G, Sturrock RA, Taylor J, Worthington M, Dawes P. Sensory Health for Residents with Dementia in Care Homes in England: A Knowledge, Attitudes, and Practice Survey. J Am Med Dir Assoc 2021; 22:1518-1524.e12. [PMID: 33932354 DOI: 10.1016/j.jamda.2021.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/12/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Most residents with dementia (RwD) in long-term care (LTC) facilities experience hearing and vision problems, yet these sensory deficits, which are associated with poor outcomes, are frequently under-recognized or incompletely managed. OBJECTIVE We investigated the knowledge, attitudes, and practice (KAP) of LTC facility staff in England regarding sensory-cognitive health of RwD. DESIGN A cross-sectional survey using self-administered online or mail-in questionnaires. SETTING AND PARTICIPANTS The study included 117 LTC facilities throughout England, involving 887 staff of different grades (managers, n=79; nurses/allied health professionals, n=160; care workers, n=648). METHODS Using a sampling frame of all LTC facilities nationwide, we included a stratified random selection of facilities, surveying staff regarding KAP of sensory-cognitive health. Analysis was descriptive, followed by a regression model for predictors of overall KAP capacity of staff, based on a Rasch analysis of survey items. RESULTS Staff of all grades reported high knowledge and awareness of sensory-health concerns amongst RwD, but training opportunities were infrequent and most front-line staff felt they lacked the skills necessary to support the use of hearing and vision aids. The most reported reason for poor use of hearing aids/glasses related to lack of maintenance and care procedures (ie, broken and lost devices), and poor adherence support (ie, not tolerating the devices). Staff willingness to receive training was high. Most managers reported that training in communication skills and "sensory-friendly" environments was not provided. Finally, higher overall KAP capacity of staff was predicted by smaller facility size and public, rather than private, facility type. CONCLUSIONS AND IMPLICATIONS Training and practice of sensory health care in RwD in LTC in England is lacking. To improve sensory-cognitive care for LTC RwD, there is a clear need for (1) practice recommendations and (2) multifaceted interventions that include staff training, tailored sensory support, and environmental modification.
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Affiliation(s)
- Iracema Leroi
- Global Brain Health Institute, Department of Psychiatry, School of Medicine, Trinity College Dublin, Ireland.
| | - Nisha Chauhan
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Mark Hann
- University of Manchester, Manchester, United Kingdom
| | - Louise Jones
- Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom
| | - Sandra Prew
- ENRICH Lead West Midlands NIHR Clinical Research Network (CRN), Birmingham, United Kingdom
| | - Gregor Russell
- Bradford District Care NHS Foundation Trust, Bradford, United Kingdom
| | | | | | - Mark Worthington
- Lancashire & South Cumbria NHS Foundation Trust, Preston, United Kingdom
| | - Piers Dawes
- Department of Linguistics, Macquarie University, Sydney, Australia; Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, United Kingdom
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7
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Miah J, Sheikh S, Francis RC, Nagarajan G, Antony S, Tahir M, Sattar R, Naz A, Tofique S, Billah M, Saha S, Leroi I. Patient and Public Involvement for Dementia Research in Low- and Middle-Income Countries: Developing Capacity and Capability in South Asia. Front Neurol 2021; 12:637000. [PMID: 33833728 PMCID: PMC8021770 DOI: 10.3389/fneur.2021.637000] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Patient and public involvement (PPI) is an active partnership between the public and researchers in the research process. In dementia research, PPI ensures that the perspectives of the person with "lived experience" of dementia are considered. To date, in many lower- and middle-income countries (LMIC), where dementia research is still developing, PPI is not well-known nor regularly undertaken. Thus, here, we describe PPI activities undertaken in seven research sites across South Asia as exemplars of introducing PPI into dementia research for the first time. Objective: Through a range of PPI exemplar activities, our objectives were to: (1) inform the feasibility of a dementia-related study; and (2) develop capacity and capability for PPI for dementia research in South Asia. Methods: Our approach had two parts. Part 1 involved co-developing new PPI groups at seven clinical research sites in India, Pakistan and Bangladesh to undertake different PPI activities. Mapping onto different "rings" of the Wellcome Trust's "Public Engagement Onion" model. The PPI activities included planning for public engagement events, consultation on the study protocol and conduct, the adaptation of a study screening checklist, development and delivery of dementia training for professionals, and a dementia training programme for public contributors. Part 2 involved an online survey with local researchers to gain insight on their experience of applying PPI in dementia research. Results: Overall, capacity and capability to include PPI in dementia research was significantly enhanced across the sites. Researchers reported that engaging in PPI activities had enhanced their understanding of dementia research and increased the meaningfulness of the work. Moreover, each site reported their own PPI activity-related outcomes, including: (1) changes in attitudes and behavior to dementia and research involvement; (2) best methods to inform participants about the dementia study; (3) increased opportunities to share knowledge and study outcomes; and (4) adaptations to the study protocol through co-production. Conclusions: Introducing PPI for dementia research in LMIC settings, using a range of activity types is important for meaningful and impactful dementia research. To our knowledge, this is the first example of PPI for dementia research in South Asia.
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Affiliation(s)
- Jahanara Miah
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Saima Sheikh
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Rachel C. Francis
- Department of Speech Language Pathology, All India Institute of Speech & Hearing, Mysuru, India
| | | | - Sojan Antony
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengluru, India
| | - Maryam Tahir
- Division for Neurocognitive Disorder, Pakistan Institute of Living & Learning, Karachi, Pakistan
| | - Rabia Sattar
- Division for Neurocognitive Disorder, Pakistan Institute of Living & Learning, Karachi, Pakistan
| | - Anum Naz
- Division for Neurocognitive Disorder, Pakistan Institute of Living & Learning, Karachi, Pakistan
| | - Sehrish Tofique
- Division for Neurocognitive Disorder, Pakistan Institute of Living & Learning, Karachi, Pakistan
| | - Mostazir Billah
- Hearing Care Center Ltd., Renaissance Hospital & Research Institute, Dhaka, Bangladesh
| | - Sajib Saha
- Hearing Care Center Ltd., Renaissance Hospital & Research Institute, Dhaka, Bangladesh
| | - Iracema Leroi
- School of Medicine, Global Brain Health Institute, Trinity College, Dublin, Ireland
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Höbler F, McGilton KS, Wittich W, Dupuis K, Reed M, Dumassais S, Mick P, Pichora-Fuller MK. Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review. J Alzheimers Dis 2021; 84:1115-1138. [PMID: 34633326 PMCID: PMC8673512 DOI: 10.3233/jad-215087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. OBJECTIVE To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. METHODS Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O'Malley's scoping review and appraisal process was followed. RESULTS There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. CONCLUSION Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.
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Affiliation(s)
- Fiona Höbler
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katherine S. McGilton
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Kate Dupuis
- Sheridan Centre for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Marilyn Reed
- Audiology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Shirley Dumassais
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
| | - Paul Mick
- Department of Surgery, Faculty of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Miah J, Parsons S, Lovell K, Starling B, Leroi I, Dawes P. Impact of involving people with dementia and their care partners in research: a qualitative study. BMJ Open 2020; 10:e039321. [PMID: 33109666 PMCID: PMC7592301 DOI: 10.1136/bmjopen-2020-039321] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the impact of patient and public involvement (PPI) at each stage of the research cycle in a dementia research programme. DESIGN We used monitoring forms to record the impact of the research programme's PPI at different stages of research and qualitative interviews with all participants to evaluate the impact of PPI. SETTING We evaluated Research User Groups (RUGs-older people with dementia and care partners) which were established to provide PPI support for the research programme in multiple European sites. PARTICIPANTS We purposively sampled RUG members (n=34) and researchers (n=13) who had participated in PPI activities. Inclusion criteria for the study were: (a) RUG members who had participated in the research awareness training and in PPI activities and had the capacity to consent; (b) researchers who involved RUGs in their work. RESULTS Impact on the research: changes to the study conduct were made as a result of the feedback from RUGs. These included prioritisation of clinical recommendations, the wording of study information and recruitment materials, the content and layout of the user interface for a computerised memory test, interpretation of intervention results and advice on dissemination avenues. Impact on RUG members: they reported that involvement had given them a sense of purpose and satisfaction. Their perception of health research changed from being an exclusive activity to one, which lay people, could have meaningful involvement. Impact on researchers: PPI was a new way of working and interacting with PPI members had given them insight into the impact of their work on people living with dementia. CONCLUSIONS PPI can have a substantial impact on dementia research and the people involved in the research. To justify the time and expense of PPI, the advantageous practical impacts of PPI should be systematically recorded and consistently reported.
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Affiliation(s)
- Jahanara Miah
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
- Public Programmes Team, Manchester University NHS Foundation Trust, Manchester, UK
| | - Suzanne Parsons
- Public Programmes Team, Manchester University NHS Foundation Trust, Manchester, UK
| | - Karina Lovell
- The School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Bella Starling
- Public Programmes Team, Manchester University NHS Foundation Trust, Manchester, UK
| | - Iracema Leroi
- School of Medicine, Global Brain Health Institute, Dublin, Ireland
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester, UK
- Department of Linguistics, Australian Hearing Hub, Macquarie University, Sydney, New South Wales, Australia
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10
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Leroi I, Constantinidou F, Langenbahn D, Heyn P, Yeung WK, Dawes P. Hearing and Vision Impairment in People With Dementia: A Guide for Clinicians. Arch Phys Med Rehabil 2020; 101:1667-1670. [DOI: 10.1016/j.apmr.2020.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 11/26/2022]
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Time for dinner: the communal dining room in care homes and its impact on nutritional outcomes. Int Psychogeriatr 2020; 32:803-805. [PMID: 32744489 DOI: 10.1017/s1041610220000101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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12
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Gao J, Armstrong NM, Deal JA, Lin FR, He P. Hearing loss and cognitive function among Chinese older adults: the role of participation in leisure activities. BMC Geriatr 2020; 20:215. [PMID: 32560691 PMCID: PMC7305626 DOI: 10.1186/s12877-020-01615-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/15/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess the association between self-reported hearing loss and cognitive decline, and whether engagement in leisure activities moderated this association among older adults in China. METHODS Data were obtained from two waves of the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011/12-2014. Eight thousand eight hundred forty-four individuals aged 65 years old or above with a dichotomized measure of self-reported hearing status were included. Modified Mini-Mental Examination (MMSE) was used to measure global cognition. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and sex subsamples. RESULTS Self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference in the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive decline, with 8% increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognitive decline for the whole and male samples. CONCLUSION Hearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.
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Affiliation(s)
- Jiamin Gao
- Guanghua School of Management, Institute of Strategy Research, Peking University, Beijing, 100871 China
| | - Nicole M. Armstrong
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD USA
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA
- Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Frank R. Lin
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA
- Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA
| | - Ping He
- China Center for Health Development Studies, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191 People’s Republic of China
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Leroi I. "Losing my glasses…losing my mind": Perspectives on sensory impairment, loneliness, social isolation and dementia. Int J Geriatr Psychiatry 2020; 35:335-337. [PMID: 31943355 DOI: 10.1002/gps.5265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Iracema Leroi
- Global Brain Health Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
- University of Manchester, Manchester, UK
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14
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Leroi I, Simkin Z, Hooper E, Wolski L, Abrams H, Armitage CJ, Camacho E, Charalambous AP, Collin F, Constantinidou F, Dawes P, Elliott R, Falkingham S, Frison E, Hann M, Helmer C, Himmelsbach I, Hussain H, Marié S, Montecelo S, Thodi C, Yeung WK. Impact of an intervention to support hearing and vision in dementia: The SENSE-Cog Field Trial. Int J Geriatr Psychiatry 2020; 35:348-357. [PMID: 31713262 PMCID: PMC7079053 DOI: 10.1002/gps.5231] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/07/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Hearing, vision, and cognitive impairment commonly co-occur in older adults. Improving sensory function may positively impact outcomes in people with dementia (PwD). We developed a "sensory intervention" (SI) to support hearing and vision in PwD. Here, we report the findings of an international open-label field trial, and nested case series, to explore the impact of the SI on dementia-related outcomes. METHODS This was a home-based trial conducted in France, England, and Cyprus. Participants were people with mild-to-moderate dementia and hearing and/or vision impairment (n = 19) and their study partners (unpaid carers; n = 19). The "basic" SI included a hearing and vision assessment and provision of glasses and/or hearing aids. A subsample received the "extended" SI with additional weekly visits from a sensory support therapist (SST). Exploratory analyses of dementia-related, health utility and resource utilisation outcomes were performed. RESULTS Quality of life (QoL) and sensory functional ability improved. Change in QoL exceeded the threshold for a minimum clinically important difference. There was a modest improvement (in absolute terms) post intervention in behavioural disturbance, self-efficacy, and relationship satisfaction. Study partner time assisting instrumental activities of daily living (iADL) and supervision decreased by about 22 and 38 hours per month, respectively, although time for personal ADL support increased. Qualitative data supported effectiveness of the intervention: PwD were more socially engaged, less isolated, less dependent on study partners, and had improved functional ability and communication. CONCLUSIONS These findings support the need for a definitive randomised controlled trial (RCT) to evaluate the effectiveness of the intervention.
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Affiliation(s)
- Iracema Leroi
- Global Brain Health InstituteTrinity College DublinDublinIreland
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
| | - Zoe Simkin
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
| | - Emma Hooper
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
| | - Lucas Wolski
- Institute of Applied Research, Development and Further EducationCatholic University of Applied Sciences FreiburgFreiburgGermany
| | - Harvey Abrams
- Department of Communication Sciences and DisordersUniversity of South FloridaTampaFL
| | | | - Elizabeth Camacho
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | | | - Fideline Collin
- INSERM, EUCLID/F‐CRIN Clinical Trials PlatformUniversity of BordeauxTalenceAquitaineFrance
| | | | - Piers Dawes
- Manchester Centre for Audiology and DeafnessUniversity of ManchesterManchesterUK
| | - Rachel Elliott
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | - Sue Falkingham
- Department of AudiologyStarkey Hearing TechnologiesStockportUK
| | - Eric Frison
- INSERM, EUCLID/F‐CRIN Clinical Trials PlatformUniversity of BordeauxTalenceAquitaineFrance
| | - Mark Hann
- Centre for BiostatisticsUniversity of ManchesterManchesterUK
| | - Catherine Helmer
- INSERM, Bordeaux Population Health Research Center, Team LEHAUniversity of BordeauxTalenceAquitaineFrance
| | - Ines Himmelsbach
- Institute of Applied Research, Development and Further EducationCatholic University of Applied Sciences FreiburgFreiburgGermany
| | - Hannah Hussain
- Manchester Centre for Health EconomicsUniversity of ManchesterManchesterUK
| | - Sarah Marié
- Research and DevelopmentEssilor InternationalParisFrance
| | | | - Chryssoula Thodi
- Department of Health SciencesEuropean University CyprusNicosiaCyprus
| | - Wai Kent Yeung
- Division of Neuroscience and Experimental PsychologyUniversity of ManchesterManchesterUK
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15
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Leroi I, Armitage CJ, Collin F, Frison E, Hann M, Hooper E, Reeves D, Simkin Z, Wolski L. A randomised controlled trial of hearing and vision support in dementia: Protocol for a process evaluation in the SENSE-Cog trial. Trials 2020; 21:223. [PMID: 32093757 PMCID: PMC7041097 DOI: 10.1186/s13063-020-4135-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Optimising hearing and vision function may be important in improving a range of outcomes for people living with dementia (PwD) and their companions. The SENSE-Cog cross-national randomised controlled trial (RCT) is evaluating the effectiveness of a sensory intervention (SI) to improve quality of life for PwD with concurrent hearing and/or vision impairment, in five European countries. To ascertain how or why the intervention will, or will not, achieve its outcomes, we have designed a process evaluation to explore potential discrepancies between expected and observed outcomes. This will also help us to understand how context may influence the outcomes. Here we describe the protocol for this process evaluation, which is embedded within the RCT. METHODS/DESIGN We will use a mixed methods approach with a theoretical framework derived from the UK Medical Research Council's' guidance on process evaluations. It will include the following: (1) evaluating how key aspects of the intervention will be delivered, which will be important to scale the intervention in real world populations; (2) characterising the contextual issues, which may shape the delivery and the impact of the intervention in different countries; and (3) investigating possible causal mechanisms through analyses of potential moderators and mediators. To avoid bias, we will analyse the process data before the analysis of the main effectiveness outcomes. DISCUSSION This evaluation will provide insight into how the complex SENSE-Cog SI will be tailored, enacted and received across the different European contexts, all of which have unique health and social care economies. The findings will provide insight into the causal mechanisms effecting change, and will determine whether we should implement the intervention, if effective, on a wider scale for PwD and concurrent sensory impairment. TRIAL REGISTRATION ISRCTN, ISRCTN17056211. Registered on 19 February 2018.
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Affiliation(s)
- Iracema Leroi
- Global Brain Health Institute, School of Medicine, Trinity College Dublin, Trinity College Institute of Neurosciences, Room 0.60, Lloyd Building, Dublin 2, Ireland
- Division of Neuroscience and Experimental Psychology, University of Manchester and the Manchester Academic Health Sciences Centre, Manchester, UK
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Fidéline Collin
- Bordeaux Population Health Center, Univ. Bordeaux, INSERM, EUCLID/F-CRIN Clinical Trials Platform, CHU Bordeaux, F-33000 Bordeaux, France
| | - Eric Frison
- Bordeaux Population Health Center, Univ. Bordeaux, INSERM, EUCLID/F-CRIN Clinical Trials Platform, CHU Bordeaux, F-33000 Bordeaux, France
| | - Mark Hann
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Emma Hooper
- Division of Neuroscience and Experimental Psychology, University of Manchester and the Manchester Academic Health Sciences Centre, Manchester, UK
| | - David Reeves
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Zoe Simkin
- Division of Neuroscience and Experimental Psychology, University of Manchester and the Manchester Academic Health Sciences Centre, Manchester, UK
| | - Lucas Wolski
- Institute of Applied Research, Development and Continuing Education, Catholic University of Applied Sciences, Freiburg, Germany
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