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Shaw AR, Perales-Puchalt J, Valdivieso-Mora E, McGee JL, Vaduvathiriyan P, Vidoni ED. Effectiveness of non-pharmaceutical interventions on cognitive function among non-demented African American and Latino older adults in the USA: a scoping review. Ethn Health 2022; 27:929-945. [PMID: 33021816 PMCID: PMC8021606 DOI: 10.1080/13557858.2020.1828292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE African Americans and Latinos/Hispanics have a higher prevalence of dementia compared to non-Latino Whites. This scoping review aims to synthesize non-pharmaceutical interventions to delay or slow age-related cognitive decline among cognitively healthy African American and Latino older adults. DESIGN A literature search for articles published between January 2000 and May 2019 was performed using the databases PubMed, CINAHL, PsycINFO and Web of Science. Relevant cited references and grey literature were also reviewed. Four independent reviewers evaluated 1,181 abstracts, and full-article screening was subsequently performed for 145 articles. The scoping review consisted of eight studies, which were evaluated according to the peer-reviewed original manuscript, non-pharmaceutical intervention, cognitive function as an outcome, separate reporting of results for African American and Latinos, minimum age of 40, and conducted in the US. A total of 8 studies were considered eligible and were analyzed in the present scoping review. RESULTS Eight studies were identified. Four studies focused on African Americans and four focused on Latinos. Through the analysis, results indicated cognitive training-focused interventions were effective in improving memory, executive function, reasoning, visuospatial, psychological function, and speed among African Americans. Exercise interventions were effective in improving cognition among Latinos. CONCLUSION This scoping review identified effective non-pharmaceutical interventions among African American and Latinos. Effective interventions focused on cognitive training alone for African Americans and exercise combined with group educational sessions for Latinos. Future research should explore developing culturally appropriate non-pharmaceutical interventions to reduce disparities and to enhance cognition among older African American and Latinos.
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Affiliation(s)
- Ashley R. Shaw
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, United States
| | - Jaime Perales-Puchalt
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, United States
| | | | - Jerrihlyn L. McGee
- School of Nursing, University of Kansas Medical Center, Kansas City, United States
| | | | - Eric D. Vidoni
- University of Kansas Alzheimer’s Disease Center, University of Kansas Medical Center, Kansas City, United States
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Perales-Puchalt J, Townley R, Niedens M, Vidoni ED, Greiner KA, Zufer T, Schwasinger-Schmidt T, McGee JL, Arreaza H, Burns JM. Acceptability and Preliminary Effectiveness of a Remote Dementia Educational Training Among Primary Care Providers and Health Navigators. J Alzheimers Dis 2022; 89:1375-1384. [PMID: 36031891 PMCID: PMC9703617 DOI: 10.3233/jad-220235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Optimal care can improve lives of families with dementia but remains under-implemented. Most healthcare professional training is in person, time-intensive, and does not focus on key aspects such as early detection, and cultural competency. OBJECTIVE We explored the acceptability and preliminary effectiveness of a training, The Dementia Update Course, which addressed these issues. We hypothesized that the training would lead to increased levels of perceived dementia care competency among key healthcare workers, namely primary care providers (PCPs) and health navigators (HNs). METHODS We conducted pre-post training assessments among 22 PCPs and 32 HNs. The 6.5-h training was remote, and included didactic lectures, case discussion techniques, and materials on dementia detection and care. Outcomes included two 5-point Likert scales on acceptability, eleven on perceived dementia care competency, and the three subscales of the General Practitioners Confidence and Attitude Scale for Dementia. We used paired samples t-tests to assess the mean differences in all preliminary effectiveness outcomes. RESULTS The training included 28.6% of PCPs and 15.6% of HNs that self-identified as non-White or Latino and 45.5% of PCPs and 21.9% of HNs who served in rural areas. PCPs (84.2%) and HNs (91.7%) reported a high likelihood to recommend the training and high satisfaction. Most preliminary effectiveness outcomes analyzed among PCPs (11/14) and all among HNs (8/8) experienced an improvement from pre- to post-training (p < 0.05). CONCLUSION A relatively brief, remote, and inclusive dementia training was associated with high levels of acceptability and improvements in perceived dementia care competency among PCPs and HNs.
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Affiliation(s)
- Jaime Perales-Puchalt
- University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Ryan Townley
- University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
- University of Kansas Medical Center, Kansas City, KS, USA
- Universityof Kansas Health System, Kansas City, KS, USA
| | - Michelle Niedens
- University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
- University of Kansas Medical Center, Kansas City, KS, USA
- Universityof Kansas Health System, Kansas City, KS, USA
| | - Eric D Vidoni
- University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
- University of Kansas Medical Center, Kansas City, KS, USA
| | - K Allen Greiner
- University of Kansas Medical Center, Kansas City, KS, USA
- Universityof Kansas Health System, Kansas City, KS, USA
| | - Tahira Zufer
- University of Kansas Medical Center, Kansas City, KS, USA
- Universityof Kansas Health System, Kansas City, KS, USA
| | | | | | - Hector Arreaza
- Clínica Sierra Vista, Bakersfield, CA, USA
- Rio Bravo Family Medicine Residency Program, Bakersfield, CA, USA
| | - Jeffrey M Burns
- University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA
- University of Kansas Medical Center, Kansas City, KS, USA
- Universityof Kansas Health System, Kansas City, KS, USA
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Perales-Puchalt J, Gauthreaux K, Shaw A, McGee JL, Teylan MA, Chan KCG, Rascovsky K, Kukull WA, Vidoni ED. Risk of mild cognitive impairment among older adults in the United States by ethnoracial group. Int Psychogeriatr 2021; 33:51-62. [PMID: 31948505 PMCID: PMC7365740 DOI: 10.1017/s1041610219002175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To compare the risk of mild cognitive impairment (MCI) among a wide range of ethnoracial groups in the US. DESIGN Non-probabilistic longitudinal clinical research. SETTING Participants enrolling into the National Alzheimer's Coordinating Center Unified Data Set recruited via multiple approaches including clinician referral, self-referral by patients or family members, or active recruitment through community organizations. PARTICIPANTS Cognitively normal individuals 55 and older at the initial visit, who reported race and ethnicity information, with at least two visits between September 2005 and November 2018. MEASUREMENTS Ethnoracial information was self-reported and grouped into non-Latino Whites, Asian Americans, Native Americans, African Americans (AAs), and individuals simultaneously identifying as AAs and another minority race (AA+), as well as Latinos of Caribbean, Mexican, and Central/South American origin. MCI was evaluated clinically following standard criteria. Four competing risk analysis models were used to calculate MCI risk adjusting for risk of death, including an unadjusted model, and models adjusting for non-modifiable and modifiable risk factors. RESULTS After controlling for sex and age at initial visit, subhazard ratios of MCI were statistically higher than non-Latino Whites among Native Americans (1.73), Caribbean Latinos (1.80), and Central/South American Latinos (1.55). Subhazard ratios were higher among AA+ compared to non-Latino Whites only in the model controlling for all risk factors (1.40). CONCLUSION Compared to non-Latino Whites, MCI risk was higher among Caribbean and South/Central American Latinos as well as Native Americans and AA+. The factors explaining the differential MCI risk among ethnoracial groups are not clear and warrant future research.
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Affiliation(s)
| | - Kathryn Gauthreaux
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Ashley Shaw
- Alzheimer's Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA
| | - Jerrihlyn L McGee
- School of Nursing, University of Kansas, MS 4043, Kansas City, KS66160, USA
| | - Merilee A Teylan
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Kwun C G Chan
- Department of Biostatistics, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Katya Rascovsky
- Department of Neurology, Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Walter A Kukull
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, WA98195, USA
| | - Eric D Vidoni
- Alzheimer's Disease Center, University of Kansas, MS6002, Fairway, KS66205, USA
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Perales-Puchalt J, Shaw A, McGee JL, Moore WT, Hinton L, Resendez J, Monroe S, Dwyer J, Vidoni ED. Preliminary Efficacy of a Recruitment Educational Strategy on Alzheimer's Disease Knowledge, Research Participation Attitudes, and Enrollment Among Hispanics. Hisp Health Care Int 2020; 18:144-149. [PMID: 31840539 PMCID: PMC7293919 DOI: 10.1177/1540415319893238] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Hispanics remain underrepresented in dementia clinical research. This one-arm trial aimed to assess the preliminary efficacy of a culturally tailored recruitment educational strategy among Hispanic older adults on dementia knowledge, research participation attitudes, and enrollment. METHOD The recruitment strategy included 6 one-session culturally tailored dementia education events at trusted community senior centers. Participants received a pre-post survey including a 5-point Likert-type scale and the Epidemiology/Etiology Disease Scale to assess dementia knowledge, and a 4-point Likert-type scale assessing research participation attitudes. We gave participants contact information slips to complete if interested in dementia research. We also tracked participants' enrollment into the National Alzheimer's Coordinating Center Cohort. RESULTS Dementia knowledge increased 0.9 points (5-point Likert-type scale) and 2.2 points (epidemiology/etiology disease scale, p < .001). Interest in participating in dementia research increased from 61.7% to 80.9% (p = .039), 64.0% returned their contact information slips, and 41.1% successfully enrolled into the National Alzheimer's Coordinating Center Cohort. CONCLUSION A recruitment strategy including culturally tailored dementia education improves dementia knowledge, research participation attitudes, and enrollment among Hispanic older adults.
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Affiliation(s)
| | | | | | - W Todd Moore
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Ladson Hinton
- University of California, Davis, Sacramento, CA, USA
| | | | | | - John Dwyer
- Global Alzheimer's Platform Foundation, Washington, DC, USA
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Abstract
OBJECTIVE The Robert Wood Johnson Foundation's culture of health initiative advocates for making health a shared value. Health cannot be a shared value without an understanding of how health is defined and perceived. The purpose of this qualitative descriptive study was to examine community members' perceptions of health and influencing factors, including health care services. DESIGN AND SAMPLE Data were collected through a purposive sample of nine focus groups with 52 participants who were primarily Black (94%) and female (65%). The mean age was 50 years. The average education was 14 years. Data were analyzed using inductive content analysis. RESULTS Four themes were developed: health is resilience to deal with life's challenges describes health as necessary to deal with daily challenges; external perceptions affect community identity represents perceptions that other metropolitan counties are flourishing while this county remains depressed, negatively impacting individual and community identity; structural barriers negatively impact health describes a lack of adequate resources to achieve or maintain health, as defined by the participants; and mistrust influences health-seeking behaviors reflects perceptions of differential treatment. CONCLUSIONS This study provides unique information to nurses and other health care providers about urban-residing community members' perceptions of health and health care services. Providing a voice to residents regarding personal, family, and community health is imperative in making health a shared value to achieve the goals of population health, well-being, and equity.
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Affiliation(s)
| | - Jill N Peltzer
- School of Nursing, University of Kansas, Kansas City, KS, USA
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Abstract
Purpose. To present a case study involving the use of fast neutron
therapy to treat an extensive unresectable osteogenic sarcoma arising from
the left maxilla. Patient. A 14-year-old male presented with a massive tumor producing
severe distortion of his facial structures. He had already received six courses of
chemotherapy, which had reduced his pain, but had not measurably reduced the tumor. Methods. The patient was treated with 66 MeV fast neutrons to a dose
of 20.4 Gy in 13 fractions over 35 days. Results. CT assessments indicate gradually increasing calcification
and noticeable reduction of soft-tissue disease in the frontal sinus, orbit and maxillary
antrum.There has been some recontouring of the facial structures.The boy conducts an
active life, has no pain, and feels well. He was 17 years old at the last follow-up. Discussion. Fast neutrons have a greater biological effectiveness
than conventional photon beams. Their use has been associated with improved chance
for local control of unresectable disease.This case illustrates their effectiveness in
controlling an unusual and aggressive osteogenic sarcoma of the facial bone and sinuses.
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Affiliation(s)
- G L Smoron
- Midwest Institute for Neutron Therapy at Fermilab P.O. Box 500 MS301 Batavia Illinois Provena Saint Joseph Hospital Elgin Illinois 60510 USA
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McGee JL, Alexander B, Perry PJ. Lithium citrate syrup and trifluoperazine hydrochloride concentrate incompatibility: effect on serum lithium levels. Am J Hosp Pharm 1980; 37:1052. [PMID: 7405933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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McGee JL. A MEDLINE feasibility study. Bull Med Libr Assoc 1980; 68:278-87. [PMID: 6998531 PMCID: PMC226508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A MEDLINE feasibility study was conducted with the Northeastern Consortium for Health Information (NECHI) and sponsored by the New England Regional Medical Library Service. It is based on the theory that most potential users and supporters of MEDLINE within hospitals are unaware of its usefulness and applications, and that there exists a need for expanding MEDLINE services to more hospital libraries. The purpose of the study was to provide NECHI with an evaluation of MEDLINE as a feasible service by ascertaining the need and by evaluating the usefulness, satisfaction, and costs of the system. The study demonstrated sufficient use of MEDLINE to justify implementation within NECHI and it provided useful data to determine the future of MEDLINE in each institution. It documented that utilization improved rapidly with publicity and the presence of the system within an institution, that MEDLINE can be an effective and economical complement to the traditional reference services used to support information needs in hospitals, and that more hospital libraries should be able to implement MEDLINE to their advantage once potential users and supporters have been exposed to the system.
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McGee JL, Alexander MR. Phenothiazine analgesia--fact or fantasy? Am J Hosp Pharm 1979; 36:633-40. [PMID: 36754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Double-blind clinical trials involving the use of phenothiazines as analgesics or potentiators of analgesics (aspirin, meperidine, morphine sulfate) and adverse effects of phenothiazines are reviewed and evaluated. Promethazine, promazine and propiomazine were not found to possess analgesic or potentiating properties. One chlorpromazine study contained important design and reporting deficiencies which precluded a recommendation for use of chlorpromazine in the treatment of pain. Methotrimeprazine was determined by numerous authors to have analgesic properties; however, most of the studies also were deficient in design or data presented, or both. Adverse reactions to phenothiazines, including hypotension, sedation, drowsiness, extrapyramidal symptoms, tardive dyskinesia, cardiac toxicity and agranulocytosis, are often more common and severe than those attributed to narcotic analgesics. Because of the lack of data supportive of analgesic activity and the adverse reactions associated with phenothiazines, use of these agents in the management of pain should be discouraged. The prophylactic use of phenothiazine for narcotic analgesic-induced emesis also is, in most cases, a questionable practice.
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