Physical activity together for couples living with mild cognitive impairment (PAT-MCI): A feasibility study.

Mild cognitive impairment is a prodromal phase of Alzheimer's disease and related dementias. Cognitive and/or neuropsychiatric symptoms that could worsen over time cause challenges for patients and romantic partners, who often assume the role of informal caregivers. Although physical activity is beneficial, older adults with mild cognitive impairment and their romantic care partners are generally physically inactive. Our 16-week study was performed to see whether physical activity together is feasible to increase physical activity among four dyads (individuals with mild cognitive impairment and their spouses). Our dyadic intervention was feasible given more than 70 % of participants self-reported adherence to physical activity based on the guidelines for adults in the United States. In exit interviews, togetherness was highlighted as one of the biggest strengths of this study. Future studies with more representative samples are needed, as well as adopting a more tailored approach that accounts for individuals' levels of physical fitness.

Feasibility of school-based parent support groups for transition-aged youth with intellectual disabilities.

BACKGROUND: Parents experience difficulties supporting children with intellectual disabilities when they exit the school system. One promising way to mitigate this problem is to set up school-based parent support groups. This study aimed to examine the development and feasibility of school-based parent support groups in South Korea designed to connect parents of transition-aged youth with intellectual disabilities. METHODS: This qualitative study included 29 participants. Five focus groups and seven individual interviews were conducted with parents as co-researchers. Data were analysed using thematic analysis. RESULTS: Participants reported meaningful experiences after participating in the parent support groups. However, it is critical to consider the following components to promote their feasibility: clearly defined roles, small group meetings, school-based initiatives, and collaboration. CONCLUSIONS: Parent support groups could be a valuable way to promote parental empowerment. Implications for future practices are suggested.

Gait and/or balance disturbances associated with Alzheimer's dementia among older adults with amnestic mild cognitive impairment: A longitudinal observational study.

AIMS: To explore whether gait and/or balance disturbances are associated with the onset of Alzheimer's dementia (AD) among older adults with amnestic mild cognitive impairment (MCI). DESIGN: This study employed a longitudinal retrospective cohort design. METHODS: We obtained data from the National Alzheimer's Coordinating Center's Uniform Data Set collected from 35 National Institute on Aging Alzheimer's Disease Research Centers between September 2005 and December 2021. The mean age of participants (n = 2692) was 74.5 years with women making up 47.2% of the sample. Risk of incident AD according to baseline gait and/or balance disturbances as measured using the Postural Instability and Gait Disturbance Score, a subscale of the Unified Parkinson's Disease Rating Scale Motor Score, was examined by the Cox proportional hazards regression models adjusting for baseline demographics, medical conditions and study sites. The mean follow-up duration was 4.0 years. RESULTS: Among all the participants, the presence or the severity of gait and/or balance disturbances was associated with an increased risk of AD. The presence or the severity of gait and/or balance disturbances was associated with a higher risk of Alzheimer's dementia among the subgroups of female and male participants. CONCLUSION: Gait and/or balance disturbances may increase the risk of developing AD, regardless of sex. IMPACT: Gait and/or balance disturbances among community-dwelling older adults with amnestic MCI may need to be frequently assessed by nurses to identify potential risk factors for cognitive decline. NO PATIENT OR PUBLIC CONTRIBUTION: Given the secondary analysis, patients, service users, caregivers or members of the public were not directly involved in this study.

Challenges of single parents raising children with intellectual and developmental disabilities.

BACKGROUND: Single-parent families with children with disabilities need greater attention given the notable increase in their number and their additional difficulties. Single parents in East Asian countries, especially, may face greater risks than their peers elsewhere, given the region's unique cultural background. METHOD: The study used a mixed methods design; we administered a risk assessment survey to 354 families of children with intellectual and developmental disabilities and conducted in-depth interviews with eight single parents. RESULTS: Compared to two-parent families, single-parent families faced greater risks with respect to family relationships, economic status and legal rights. In the interviews, single parents reported a range of challenges, including sole parental responsibilities, poor physical and mental health, social isolation and alienation, the stress of juggling care and work, and difficulty accessing services. CONCLUSION: These findings offer implications for future policy and practices concerning single parents in South Korea.

Video-Assisted Thoracic Surgery Core Needle Biopsy for Pulmonary Nodules in Patients with Impaired Lung Function: Is It Feasible and Safe?

Background: The number of patients with incidentally identified pulmonary nodules is increasing. This study attempted to confirm the usefulness and safety of video-assisted thoracic surgery (VATS) core needle biopsy of pulmonary nodules. Methods: Data from 18 patients diagnosed with pulmonary nodules who underwent VATS core need biopsy were retrospectively reviewed. Results: Of the 18 patients, 15 had malignancies (primary lung cancer, n=14; metastatic lung cancer, n=1), and 3 had benign nodules. Mortality and pleural metastasis did not occur during the follow-up period. Conclusion: In patients with solitary pulmonary nodules that require tissue confirmation, computed tomography-guided percutaneous cutting needle biopsy or diagnostic pulmonary resection sometimes may not be feasible choices due to the location of the solitary pulmonary nodule or the patient's impaired pulmonary function, VATS core needle biopsy may be performed in these patients as an alternative method.

Caregiving and future planning perspectives of siblings of individuals with intellectual and developmental disabilities: Insights from South Korea, Japan and Taiwan.

BACKGROUND: As individuals with intellectual and developmental disabilities age, their siblings are more likely to assume caregiving responsibilities. However, little is known about experiences of East Asian siblings with respect to their caregiving and future-planning within their own country, as well as other East Asian countries. METHODS: Using a national survey, this study explored experiences of 576 siblings across South Korea, Japan and Taiwan. RESULTS: A common factor across the three countries was that siblings were less engaged in advocacy and future-planning activities and felt less competent to play the role of caregiving. Korean siblings reported more negative views about disability, while Japanese siblings reported less engagement in future-planning and Taiwanese siblings reported greater involvement in caregiving. CONCLUSION: Based on 'universalism without uniformity', it is recommended to develop culturally sensitive sibling-targeted intervention based on each country's context.

Automatic Plaque Removal Using Dual-Energy Computed Tomography Angiography: Diagnostic Accuracy and Utility in Patients with Peripheral Artery Disease.

Background and Objectives: This study aimed to evaluate the utility and accuracy of dual-energy automatic plaque removal (DE-APR) in patients with symptomatic peripheral arterial disease (PAD) using digital subtraction angiography (DSA) as the reference standard. Materials and Methods: We retrospectively analyzed 100 patients with PAD who underwent DE computed tomography angiography (DE-CTA) and DSA of the lower extremities. DE-CTA was used to generate APR subtracted images. In the three main arterial segments (aorto-iliac segment, femoro-popliteal segment, and below-the-knee segment), the presence or absence of hemodynamically significant stenosis (>50%) and calcification was assessed using the images. CTA data were analyzed using different imaging approaches (DE-standard reconstruction image (DE-SR), DE-APR maximum intensity projection image (APR), and DE-SR with APR). Results: For all segments evaluated, the sensitivity, specificity, and accuracy for detecting significant stenosis were 98.16%, 81.01%, and 89.58%, respectively, with DE-SR; 97.79%, 83.33%, and 90.56%, respectively, with APR; and 98.16%, 92.25%, and 95.20%, respectively, with DE-SR with APR. DE-SR with APR had greater accuracy than DE-SR or APR alone (p < 0.001 and p < 0.001, respectively). When analyzed based on vascular wall calcification, the accuracy of DE-SR with APR remained greater than 90% regardless of calcification severity, whereas DE-SR showed a considerable reduction in accuracy in moderate to severe calcification. In the case of APR, the degree of vascular wall calcification did not significantly influence the accuracy in the aorto-iliac and femoro-popliteal segments. DE-SR with APR achieved significantly higher diagnostic accuracy for all lower extremity segments in evaluating hemodynamically significant stenosis in patients with symptomatic PAD and transcended the impact of vascular wall calcification compared with DE-SR. Conclusions: APR demonstrated favorable diagnostic performance in the aorto-iliac and femoro-popliteal segments, exhibiting good agreement with DSA even in cases of moderate to severe vascular wall calcification.

Association of adherence to high-intensity physical activity and the Mediterranean-dietary approaches to stop hypertension intervention for neurodegenerative delay diet with cognition: A cross-sectional study.

BACKGROUND: Prevention is a priority in the absence of a cure for dementia. Physical activity and a neuroprotective diet such as the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet are healthy lifestyle behaviors that may slow the onset of dementia. However, research on the relationship between the combination of physical activity and the MIND diet and cognition is rare. OBJECTIVES: The purpose of this study was to investigate whether the combination of high-intensity physical activity and the MIND diet is associated with better cognition compared with either behavior alone or neither behavior. DESIGN: A population-based, cross-sectional study was conducted using data from the Health and Retirement Study. METHODS: Using information from a total of 3463 participants (age 68.0 ±â€¯10.0 years), multivariate linear regression models and binary logistic regression models with interaction terms between high-intensity physical activity (PA) and the MIND diet (MIND) were used to assess associations of PA and MIND with global cognition and odds of cognitive decline. Group comparisons were conducted among four groups: PA-/MIND-, PA+/MIND-, PA-/MIND+, and PA+/MIND+. RESULTS: PA+/MIND- did not predict cognitive outcomes (versus PA-/MIND-). PA-/MIND+ was associated with better global cognition (mean difference [d] = 0.81; 95% confidence interval [CI] = 0.50-1.11; p < 0.001) and lower odds of cognitive decline (odds ratio [OR] = 0.68; 95% CI = 0.54-0.86; p = 0.001) (versus PA-/MIND-). PA+/MIND+ predicted better global cognition (d = 0.98; 95% CI = 0.59-1.36; p < 0.001) and lower odds of cognitive decline (OR = 0.69; 95% CI = 0.50-0.94; p = 0.004) (versus PA-/MIND-). PA+/MIND+ was associated with better global cognition (d = 0.60; 95% CI = 0.08-1.12; p < 0.001), but did not predict lower odds of cognitive decline (versus PA+/MIND-). PA+/MIND+ did not predict cognitive outcomes (versus PA-/MIND+). CONCLUSIONS: Combining high-intensity physical activity and the MIND diet was associated with better cognitive health than high-intensity physical activity alone or non-adherence to both behaviors. To potentially exert additive effects, it will be important to encourage these two healthy habits. More research on the role of combined physical activity and dietary change is necessary to further inform policy and clinical guidance.

Compound Caregiving: Toward a Research Agenda.

Aging family caregivers of adults with intellectual and developmental disabilities (IDD) have unique circumstances setting them apart from the general caregiving population. Such differences include the extensive duration of the caregiving, and health concerns that manifest in the caregiver and individuals with IDD over time. Because of increasing longevity, family caregivers are likely to become compound caregivers (i.e., individuals caregiving for multiple people). Almost 70% of family caregivers of individuals with IDD experience compound caregiving, yet we know very little about compound caregiving. In this article, we highlight the importance of supporting compound caregivers by identifying research issues that address current challenges and future directions. Implications for research are noted, including the need for multidimensional outcome measures and longitudinal studies.

Development, Feasibility, and Acceptability of a Nationally Relevant Parent Training to Improve Service Access During the Transition to Adulthood for Youth with ASD.

Many youth with autism spectrum disorder (ASD) face challenges accessing needed services as they transition to adulthood. The present study describes the development, feasibility and acceptability of a new intervention designed to teach parents of transition-aged youth with ASD about the adult service system and the most effective ways to access services and supports. As part of a randomized-controlled trial, the intervention-named ASSIST-was delivered to 91 participants in three states in the U.S. Results suggested that ASSIST is feasible and acceptable to participants. Though intended to be an in-person group-based program, due to COVID-19 restrictions ASSIST was primarily delivered online. Results and discussion explore the trade-offs and implications of these different treatment delivery modalities in relation to ASSIST.

Goal attainment scaling-community-based: A method to incorporate personalized outcomes into intervention research with youth and adults on the autism spectrum.

LAY ABSTRACT: Among people with autism-all who have the same diagnosis-there are major differences on a nearly limitless number of areas, such as language, daily living skills, intellectual ability, sensory difficulties, and physical and mental health diagnoses. Despite these many differences, the targeted outcomes of intervention studies are often measured the same way across autistic adults, including outcomes such as getting a job, achieving greater independence, or getting more services. People have different goals and abilities, and it is important to have a way for intervention studies to measure outcomes in a way that is more personal to each individual. To address this issue, we developed a new approach-called "Goal Attainment Scaling-Community-based" or GAS-CB-to measure individualized outcomes across different research settings. In this article, we describe the need for individualized outcomes in autism intervention research and current approaches to gathering these outcomes, with our discussion focused on a method called goal attainment scaling. We then describe reasons why current goal attainment scaling approaches might not be useful in intervention research that takes place in the community. Finally, we discuss a new goal attainment scaling approach (GAS-CB) that can be flexibly used for research participants with very different characteristics.

The role of parental advocacy in addressing service disparities for transition-aged youth on the autism spectrum.

LAY ABSTRACT: It can be difficult for youth on the autism spectrum to get the services they need after they leave high school. Because of this, many studies have examined the different factors that are related to service access. These studies have shown that youth on the autism spectrum who belong to an underrepresented racial or ethnic group or whose families have lower incomes are less likely to receive the services that they need. However, it is difficult or impossible to change things like race/ethnicity or family income. It is important to also identify factors that might improve service access that we can change. One potential factor that fits into this category is parental advocacy activities. Using data collected from 185 parents of youth on the autism spectrum, we found that more parental advocacy activities were related to youth receiving more services, even after accounting for variables related to the functioning of the youth (e.g. whether they have an intellectual disability, their autism symptom severity) and demographic information about the family (e.g. state in which they live, parental race/ethnicity, and family income). Our findings suggest that building parental advocacy skills may be one important way to increase the number of services that youth on the autism spectrum receive as they transition to adulthood.

Factors associated with caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy: A cross-sectional study.

BACKGROUND: The number of patients on home mechanical ventilation (HMV) worldwide has been steadily rising as medical technological advanced. To ensure the safety and quality care of the patients receiving HMV with tracheostomy, caring behavior of family caregivers is critical. However, studies on caring behavior of family caregivers and its associated factors were remained unexplored. This study aimed to describe the caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy and to identify factors associated with their caring behaviors. METHODS: This was a cross-sectional study for 95 family caregivers for patients with invasive home mechanical ventilation in South Korea. Caring behaviors were assessed by the Caring Behavior Scale with 74 items with 5-point Likert scale. Data were analyzed using multiple regression analysis. RESULTS: Caring behaviors score of caregivers was 304.68±31.05 out of 370. They were significantly associated with knowledge on emergency care (ß = 0.22, p = .011), number of required instruments for care (ß = 0.21, p = .010), frequency of home visit care (ß = 0.19, p = .017), experience of emergency situation for the last six months (ß = 0.19, p = .009) and activities of daily living of patient (ß = 0.27, p = .002). CONCLUSION: Development of standardized multidisciplinary discharge education for improving the caring capacity of caregivers is required for successful and healthy application of home mechanical ventilation.

The serial connection of two extracorporeal membrane oxygenators for patient with refractory hypoxemia.

A 34-year-old man developed severe hypoxemia and hypercapnia due to acute respiratory distress during ventilator care after surgery with acute intracranial hemorrhage. Severe hypoxemia had not been corrected even with maximum extracorporeal membrane oxygenation (ECMO) flow and full ventilator settings. We applied a novel technique for the serial connection of two veno-venous ECMO circuits for optimal oxygen delivery and CO2 removal and could wean VV ECMO. The use of serial connection of two VV ECMO circuits may be considered worthwhile when severe hypoxemia or hypercapnia are not improved and the use of protective ventilators is not permitted.

Who Is Leading the Field in 2020?: AAIDD Students and Early Career Professionals.

The American Association on Intellectual and Developmental Disabilities (AAIDD) has been a leader in the field of intellectual and developmental disabilities since its founding in 1876. Today, student and early career professionals make up approximately 8.5% of the organization, with their engagement supported by the Student and Early Career Professional Interest Network (SECP). An article by Havercamp et al. (2003), "Who Will Lead the Field Beyond 2020?", recommended organizational changes that have been largely addressed in the years following by SECP. The present research replicates Havercamp et al.'s (2003) original survey of the organization's student and early career professionals, and results support the effectiveness of SECP as a welcoming platform from which students and early career professionals can establish themselves in the organization.

A scoping review of cross-cultural experiences of siblings of individuals with intellectual and developmental disabilities in the United States.

BACKGROUND: Siblings undergo unique experiences in growing up with brothers and sisters with intellectual and developmental disabilities (IDD). Although sibling relationships or adjustments among individuals with IDD have received greater attention from the disability field, there has been still less attention to how cultural identities (e.g., race, ethnicity) may influence experiences of siblings of individuals with IDD. AIM: This study used scoping review methodology to understand cross-cultural experiences of siblings of individuals with IDD in the United States. METHOD: Eight articles met inclusion criteria, using the PubMed, Web of Knowledge, PsycINFO, and ERIC databases. RESULTS: Studies reported the impact of cultural identities on sibling emotional and behavioral functioning, school functioning, and caregiving responsibilities. CONCLUSIONS: The need for culturally responsive sibling interventions and implications for international contexts is discussed.

Examining Growth Among College Students With Intellectual and Developmental Disability: A Longitudinal Study.

Inclusive postsecondary education programs for adults with intellectual and developmental disabilities (IDD) are proliferating across the United States. Although college can be a formative time for any student, there has been limited research on the growth that college students with IDD may experience during their time on campus. We address this gap by using a longitudinal design to examine the adaptive behavior, self-determination, executive functioning, and social skills of college students with IDD across three points in time-upon initial entry into the program, at the end of their first year, and at the end of their second year. Analyses suggested significant improvements in adaptive behavior and self-determination across the first year of the program. We offer recommendations for research and practice aimed at documenting and promoting growth for students with IDD throughout their collegiate experience.

Internet use among adults with intellectual and developmental disabilities in South Korea.

BACKGROUND: It is evident that people with disabilities worldwide face digital divide; although this divide has been mitigated owing to greater access to technologies, a gap remains in terms of Internet use. Given that South Korea has one of the highest Internet access rates, it is necessary to examine how adults with intellectual and developmental disabilities (IDD) access the Internet, and what correlates with Internet usage. METHOD: A total of 298 adults with IDD in South Korea participated in the survey. RESULTS: The participants reported benefits from the Internet including increased opportunities for leisure and entertainment, updated news and networking with friends. Internet access was found to be pervasive among people of younger ages and less severe disabilities. Further, Internet usage corresponded to material access, digital literacy and a positive attitude towards digital applications. CONCLUSIONS: Targeted digital literacy programmes can be developed for adults with IDD.

Future planning for individuals with intellectual and developmental disabilities: Perspectives of siblings in South Korea.

BACKGROUND: Future planning has emerged as a global issue for families of individuals with intellectual and developmental disabilities due to the longer lives and limited long-term services and supports in the adult disability system. While it has received greater attention, most future planning studies only included parents of individuals with intellectual and developmental disabilities within the context of European or American countries. The purpose of this study was to examine future planning among siblings of individuals with intellectual and developmental disabilities in South Korea. METHOD: In this study, 185 Korean siblings of individuals with intellectual and developmental disabilities responded to a survey. RESULTS: Few siblings engaged in future planning activities and reported a range of barriers to conduct future planning. Further, greater future planning involvement was associated with older siblings, greater advocacy level and greater sibling caregiving. CONCLUSION: For future research, culturally relevant measures and intervention should be addressed.

Chemical pleurodesis with Viscum album L. extract for secondary spontaneous pneumothorax in elderly patients.

BACKGROUND: Secondary spontaneous pneumothorax is generally managed by surgery, if pneumothorax was not improved following chest tube insertion or in the event of persistent air leakage lasting more than 5 days. However, if surgery is not an option, chemical pleurodesis with sclerosants can be performed. Several sclerosants have been used in the chemical pleurodesis of secondary spontaneous pneumothorax, However, there is still controversy for what is the ideal sclerosant for Secondary spontaneous pneumothorax. The use of Viscum album L. for chemical pleurodesis in patients with secondary spontaneous pneumothorax aged >65 years has not been described to date, despite its extensive use. The authors tried to find out the effect of Viscum album L. for sclerosant for Secondary spontaneous pneumothorax in elder. METHODS: This retrospective analysis examined 25 patients (aged >65 years) with secondary spontaneous pneumothorax with persistent air leakage who underwent chemical pleurodesis with Abnova Viscum-F® (V. album L.). RESULTS: The duration of chest tube drainage was 5.08 days after chemical pleurodesis. Adverse effects related to chemical pleurodesis with Abnova Viscum-F® were fever (7/25), pain (4/25), leukocytosis (10/25), and dyspnea with desaturation (7/25); however all the patients recovered without sequela and were subsequently discharged. CONCLUSIONS: The present study demonstrated the successful use of chemical pleurodesis with V. album L. in the management of elderly patients with secondary spontaneous pneumothorax. Because of the high probability of dyspnea with desaturation in the elderly, caution must be exercised.