SB-258585 reduces food motivation while blocking 5-HT6 receptors in the non-human primate striatum.

The interest in new 5-HT6 agents stems from their ability to modulate cognition processing, food motivation and anxiety-like behaviors. While these findings come primarily from rodent studies, no studies on primates have been published. Furthermore, our understanding of where and how they act in the brain remains limited. Although the striatum is involved in all of these processes and expresses the highest levels of 5-HT6 receptors, few studies have focused on it. We thus hypothesized that 5-HT6 receptor blockade would influence food motivation and modulate behavioral expression in non-human primates through striatal 5-HT6 receptors. This study thus aimed to determine the effects of acute administration of the SB-258585 selective 5-HT6 receptor antagonist on the feeding motivation and behaviors of six male macaques. Additionally, we investigated potential 5-HT6 targets using PET imaging to measure 5-HT6 receptor occupancy throughout the brain and striatal subregions. We used a food-choice task paired with spontaneous behavioral observations, checking 5-HT6 receptor occupancy with the specific PET imaging [18F]2FNQ1P radioligand. We demonstrated, for the first time in non-human primates, that modulation of 5-HT6 transmission, most likely through the striatum (the putamen and caudate nucleus), significantly reduces food motivation while exhibiting variable, weaker effects on behavior. While these results are consistent with the literature showing a decrease in food intake in rodents and proposing that 5-HT6 receptor antagonists can be used in obesity treatment, they question the antagonists' anxiolytic potential.

Potential assistive technology preferences of informal caregivers of people with disability.

Background: Preferences of informal caregivers of people with neurocognitive disorders for technological solutions are important in user- centered design approaches. It is crucial to take into consideration the needs and preferences of users when developing new technology to facilitate their uptake. Objectives: The objective of this study was to determine caregiver preferences for potential technological solutions to help address their needs and compare technology preferences of caregivers who provide care to those with and without neurocognitive disorders (NCD). Methods: This was a quantitative descriptive study. We surveyed informal caregivers of older adults with disability in Canada. Participants were asked to answer questions about their preferences for 10 potential technological solutions that could be developed to make caregiving easier. Results: Data from 125 respondents (72 caregivers of people with NCD and 53 caregivers of people with non-NCD-related disabilities) were analyzed. Generally, caregivers preferred web-based solutions as these were among the first five choices for both groups combined. However, there were some differences in the order of preference of potential solutions in both groups. Conclusion: Informal caregivers of people with NCD preferred web-based solutions to help address their needs.

Influence of Roulez avec confiance, a peer-led community-based wheelchair skills training program, on manual wheelchair users.

PURPOSE: Few studies have demonstrated that peer-led manual wheelchair (MWC) skills training can increase MWC skills, MWC use self-efficacy and satisfaction with participation of MWC users. Limited information is available on MWC skills training in the community. The primary objective was to measure the influence of Roulez avec confiance (RAC, which translated to "Wheeling with confidence"), a peer-led community-based wheelchair skills training program, on satisfaction with participation. The secondary objectives were to explore the: (1) influence of RAC on MWC use self-efficacy, MWC skills, and quality of life; (2) experiences of the participants who completed RAC and (3) three-month retention of outcomes. METHODS: A parallel mixed design was used with validated questionnaires on satisfaction with participation (WhOM), MWC use self-efficacy (WheelCon-M), MWC skills (WST-Q), quality of life (SWLS) and a semi-structured interview on participants' experiences. Non-parametric longitudinal analyses of the questionnaires and thematic content analysis of the interviews were completed. RESULTS: Nineteen community-dwelling MWC users participated. There was a statistically significant increase (p < 0.0001) in all outcomes except quality of life (p = 0.16). Improvements were retained after three months. Participants mentioned their background influenced their experiences in RAC. Positive elements about RAC and areas for improvement were discussed. Participants reported overall positive social experiences and stated that the physical environment influenced RAC. Finally, participants spoke about what they learned and emotions they felt during RAC. CONCLUSIONS: Peer-led community-based MWC training influenced satisfaction with participation, MWC skills, and MWC use self-efficacy. This study was a first step in demonstrating the efficiency of RAC.IMPLICATIONS FOR REHABILITATIONLimited information is available on manual wheelchair skills training in the community.Peer-led community-based manual wheelchair training influenced satisfaction with participation, manual wheelchair skills and use self-efficacy.This study was a first step in demonstrating the efficiency of Roulez Avec Confiance.

Technical quality of online resources for mobility device training.

PURPOSE: Training is recommended to improve safe and effective use of mobility aids. The internet offers a large amount of information and it can be difficult to identify resources with good quality. This project aimed to create a catalogue of online educational resources for mobility device training. The objective of this study was to identify and assess the quality of existing online educational resources for mobility device training for individuals with physical disabilities and caregivers. METHODS: A Google search was conducted in October 2016 and replicated in January 2018. Resources were included if they were educational, were available in English or French, provided instruction or training in mobility aid use, were free of charge, and were targeted towards mobility device users or their caregivers. Resources were assessed using a modified version of the Journal of the American Medical Association (JAMA) benchmarks for the evaluation of technical quality. RESULTS: Two hundred and seventy-one resources were included in the final analysis. Two resources were added by the research team for a total of 273 resources. The average JAMA quality score per mobility device varied between 3 (for crutches) and 5 (for knee scooters) out of 6, and weighted average was 3.6. The two resources added by the research team obtained a JAMA quality score of 6. 58 resources were retained for the catalogue. CONCLUSIONS: The results suggest that the technical quality of online educational resources for mobility device training could be improved. A need for higher quality resources for device users and caregivers was identified.Implications for rehabilitationThe overall technical quality of online educational resources for mobility device training for users and caregivers is low.A Mobility Device Training Catalogue is freely available and summarizes the highest quality online resources found on mobility device training.The Mobility Device Training Catalogue is intended for use by users and caregivers, but it may also provide clinicians with a tool that may be shared with their clients.

Usability of the Participation and Quality of Life (PAR-QoL) Outcomes Toolkit Website for Spinal Cord Injury.

Background: Quality of life (QoL) is an important parameter to monitor during rehabilitation; however, accurate assessment is challenging. Among individuals with spinal cord injury (SCI), assessing QoL is further challenged due to complex sequelae, such as secondary health conditions and factors related to community integration. A Participation and Quality of Life (PAR-QoL) toolkit was created to aid clinicians and researchers in the selection of QoL outcomes tools specific to SCI. Objectives: The aim of this study was to evaluate the use and usability of the PAR-QoL toolkit. Methods: A cross-sectional study was conducted using an online survey from December 2013 to November 2016. Google Analytics were collected from April 2012 to April 2018. Survey sections addressed "use" (behavioral practices and actual use) and "usability" (perceived ease of use and perceived usefulness). Any person who visited the PAR-QoL website was invited to complete the survey. Summary statistics and percent concordances were calculated to describe results from the survey and Google Analytics. Results: The PAR-QoL website had 188,577 users. The five most visited webpages were outcome tools, with bounce rates ranging from 77% to 90%. Of the 46 survey respondents, 67% were not current users of the PAR-QoL website, and 87% intended to use the resources in the future. Conclusion: Uptake of the PAR-QoL website is currently limited. Usability of the PAR-QoL website may be improved by modifying navigation, removing the "less useful" components, ensuring regular updates of content and resources, and promoting the website.

Influence of peer-based rehabilitation interventions for improving mobility and participation among adults with mobility disabilities: a systematic review.

Purpose: The prevalence of mobility disability reaches up to 20.5% among older adults. Mobility is a key factor of participation, thus rehabilitation interventions often aim to improve mobility and participation. Peer-based approaches to intervention delivery have become increasingly common. This study aims to identify peer-based rehabilitation interventions and summarize their influence on mobility and participation among individuals with mobility disabilities.Method: A systematic review was conducted using CINALH, EMBASE, MEDLINE, and PsycINFO. Articles that evaluated peer-based rehabilitation interventions for individuals with a mobility disability and assessed mobility or participation, as defined in the International Classification of Functioning, Disability and Health framework, were included. Study quality was assessed using the Physical Therapy Evidence Database and the Quality Assessment Tool for Before-After Studies With No Control Group.Results: Thirteen peer-based studies were identified. Six peer-led studies evaluated participation and two evaluated mobility. Seven professional-led studies evaluated participation and six evaluated mobility. Randomized controlled trials had fair to high quality. The quality of pre-post studies ranged from poor to good.Conclusion: Peer-based interventions should not be overlooked as a potential intervention strategy, but further research is needed to establish their influence on mobility and participation.Implications for rehabilitationPeers offer a unique model of intervention that could support clinicians in their effort to improve mobility and participation outcomes for individuals with disabilities.There are currently two main models of peer-based interventions in rehabilitation: professional-led (peers assist professionals to facilitate the intervention) and peer-led interventions (peers facilitate the intervention).Both professional-led and peer-led models of intervention could be helpful in facilitating participation and in increasing mobility.

Psychometric properties of the Community Integration Questionnaire: a systematic review of five populations.

OBJECTIVES: This systematic review documents the content and the quality of the psychometric evidence concerning the utilization of the Community Integration Questionnaire for individuals living with a disability other than a traumatic brain injury. DATA SOURCES: Medline, Embase, CINAHL, OTseeker and PsycINFO (searched from inception to June 2019). REVIEW METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for conducting and reporting this review. Studies that investigated at least one psychometric property of the Community Integration Questionnaire for individuals living with a disability other than traumatic brain injury were included. Data extraction and critical methodological appraisal of the articles (MacDermid checklist, COnsensus-based Standards for the selection of health Measurement INstruments checklist) were independently performed and validated by the first two authors. RESULTS: Ten studies representing 3000 individuals met the inclusion criteria. Five populations were documented. There are positive and trustable data regarding internal consistency for adults living with multiple sclerosis, spinal cord injury or burns and in mixed samples (α = 0.71-0.84). Construct validity is fairly documented for adults living with multiple sclerosis or aphasia and in mixed samples. Test-retest reliably is acceptable for adults living with multiple sclerosis (intraclass correlation coefficient = 0.91-0.97) as well as responsiveness (area under the receiver operating characteristic curve = 0.81). Other psychometric properties could not be demonstrated sufficiently solid. CONCLUSION: Many psychometric properties of the Community Integration Questionnaire are still poorly evaluated for adults living with a disability other than a traumatic brain injury. However, promising data have been documented in each population included in this review.

Long-term use of the JACO robotic arm: a case series.

PURPOSE: Past research with JACO has principally focused on the short-term impacts on new users. Therefore, this study aims to document the long-term impacts of this assistive device on users and their family caregivers following prolonged use. METHODS: Users' characteristics, caregivers' characteristics and expenses related to JACO were documented with questionnaires designed for this study. Upper extremity performance was measured with an adaptation of an upper extremity performance test, the TEMPA, and accomplishment of life habits was documented in an interview based on the LIFE-H questionnaire. Satisfaction with JACO and psychosocial impacts of its use were measured with validated questionnaires, namely the QUEST and the PIADS-10. Impacts of JACO on family caregivers were documented with a validated questionnaire, the CATOM. Descriptive statistics were used to report the results. RESULTS: Seven users and five caregivers were recruited. One user had expenses related to JACO in the past two months. Users had a better upper extremity performance with JACO than without it and they used their robotic arm to accomplish certain life habits. Most users were satisfied with JACO and the psychosocial impacts were positive. Impacts on family caregivers were slight. CONCLUSIONS: JACO increased performance in manipulation and facilitated the accomplishment of certain life habits. Users' increased participation in their life habits may slightly decrease the amount of caregiver assistance required. Future studies are needed to clarify its economic potential, its impact on caregivers' burden, including paid caregivers, and the variability in the tasks performed using JACO. Implications for Rehabilitation The use of JACO may have positive impacts on its users in terms of upper extremity performance, accomplishment of life habits, satisfaction with the device and psychosocial impacts. More research is needed to quantify more accurately the economic potential of the long-term use of JACO, to explore the factors related to the variability in the tasks performed using JACO, and to clarify the impact of JACO on caregivers' burden, including paid caregivers.

Impacts of robotic arm use on individuals with upper extremity disabilities: A scoping review.

BACKGROUND.: Robotic arms may help users perform various activities. Even though robotic arms are commercially available, their impacts are still poorly understood. PURPOSE.: This scoping review aimed to identify the potential impacts of using robotic arms for individuals with upper-extremity disabilities and appraise the scientific quality of the selected studies. METHOD.: A search for studies published between 1970 and 2016 was conducted in PubMed, Embase, Compendex, and Scopus. The Canadian Model of Occupational Performance and Engagement was used to classify activities in which impacts were evaluated. The quality of each study was rated using McMaster University's critical review form for quantitative studies. FINDINGS.: Thirty-six studies were reviewed, which evaluated self-care (21), productivity (33), and leisure (8). The short-term impacts were more commonly documented than long-term impacts. The impacts identified were mostly positive. The studies' mean quality score was 8.8/15. IMPLICATIONS.: Additional studies with more rigorous conditions are needed to produce higher-quality scientific evidence of the long-term impacts of robotic arm use.