Coleman, E. A., Smith, J. D., Frank, J. C., Min, S. J., Parry, C., & Kramer, A. M. (2004). Preparing patients and caregivers to participate in care delivered across settings: the Care Transitions Intervention. Journal of the American Geriatrics Society , 52 (11), 1817-1825.
Coleman et al. (2004) embark on a test on preparing patients and caregivers. The study aims at asserting more active roles among the participants to identify proper transitions of disease intervention process. The study is aimed at enhancing the prowess of patients and caregivers who play a vital role in disease recovery and counteracting the subsequent likelihoods of hospitalizations after the recovery process. Additionally, the authors indicate that health care delivery is subject to the ostensible division of care. This implies how different loci of care operate independent of each other and the vitality of smoothening transition from one setting to another thus lessening the quality of health care, especially, where older adults are involved. The study was conducted within a large integrated delivery system in Colorado. It is a quasi-experimental design, which adopted 158 subjects who were compared with 1,235 control subjects derived from the administrative data. Notably, the participants of the experiment comprised the county community-dwelling adults aged 65 years and above who happened to have been hospitalized within the system due to conditions within the selected range. The study adopted a process of the intervention by providing tools that promoted cross-site communication and encouraged subjects to play an active role in the delivery of the care process. Subjects were also urged to assert their preferences through the medical care process while ensuring continuity across different settings. Measurements posited through the study were based on 30, 60 and 90 days rates of post-discharge. The intervened patients reported higher levels of confidence compared to the control subjects. Confidence was directed to the mannerisms which intervention patients managed their condition, communication with the healthcare teams, and the understanding of the patient’s medical treatment. This study demonstrated that the support accorded to patients and caregivers in exemplifying a more active role in the health care delivery process ensures reduced risk of subsequent hospitalizations and the entire reliability of care transition processes.
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Dahm, R. (2006). Alzheimer's discovery. Current Biology , 16 (21), R906-R910.
This resource provides insights on the development of Alzheimer’s discovery as traced back in the 19 th century. Ralf Dalm indicates that Alois Alzheimer, a German psychiatrist and neuropathologist, delivered a talk on November 3, 1906, of a disease condition that described psychiatric symptomatic and disrupted brain histology. Alzheimer’s contentions were based on an evaluation of his late patient; Auguste D. The study indicates that this was the first publication of a predicament that later fostered infamous afflictions in the medical practice. Consequentially, the disease bore the doctor’s name Alzheimer, which exists until today and still triggers extensible research curiosity within the medical realms. The study majors on Auguste D as the sole participant of the evaluation. Dahm indicates that Auguste possessed spatial and temporal disorientation, confusion, and anxiety, which were causative of the patient’s reluctance to cooperating with the hospital personnel. The study indicates that Dr. Alzheimer had hardships communicating with his patient, as she stopped mid-sentence while talking as if she were indecisive about what she said. Also, Auguste would spell letter by letter when reading out a name, and when writing, she would repeatedly omit or duplicate letters and syllables. Due to the abnormal depictions of Auguste’s condition, Dr. Alzheimer interviewed Auguste to evaluate her situation further and recorded her responses in detailed protocols. Resultantly, Alzheimer indicated specific conditions attributed to Auguste diseases. Among Alzheimer depictions, clinical symptoms associated with AD included increased failing memory, failure in remembering memories of past and recent events, impaired comprehension, behavior unpredictability, and psychosocial inaptitude, disorientation and progressively developing aphasia. Also, illustrations of the AD to show neurofibrillary tangles and amyloid plaques are included in the essay to substantiate the validity of Alzheimer’s diagnosis on Auguste D. Notably, Dahm denotes that these symptoms have continually been expounded in Alzheimer disease pathogenesis in the present-day. The study summarizes with a primer on the evolution of the neocortex as envisaged by Jon H. Kaas.
Han, X., Rozen, S., Boyle, S. H., Hellegers, C., Cheng, H., Burke, J. R., ... & Kaddurah-Daouk, R. (2011). Metabolomics in early Alzheimer's disease: identification of altered plasma sphingolipidome using shotgun lipidomics. PloS one , 6 (7), e21643.
This study focuses on identifying sphingolipidome in Alzheimer’s disease (AD) plasma, which is influential in monitoring the progression of the disease. The authors of this article develop an interest in evaluating plasma biomarkers, which aid in facilitating the early detection of AD thus enabling the assessment of the risk entailed, and subsequently generating a monitoring process for the disease. The study notes that the alterations made within ceramides and sphingomyelins result in a significant effect on amyloidogenesis and inflammatory stress of the neuronal apoptosis. The study examined plasma from 26 AD patients who had a Mini-Mental State Examination of 21 on the prevalent cognitive impairment. There were 26 cognitively normal control subjects expressed in a non-targeted approach. The study adopted a multi-dimensional mass spectrometry-based shotgun lipidomics to govern the levels of lipid species. The data collected was then correlated with the diagnosis, the apolipoprotein E4 genotype, and the cognitive performance of the subjects. Resultantly, there was great altering of the plasma levels of sphingolipids species. Eight molecular species out of the 33 sphingomyelin species tested exhibited a lower presence in AD patients compared to the control subject. Particularly, the study indicated that these molecular species contained long aliphatic chains of 22 and 24 carbon atoms. Additionally, the levels of N16:0 and N21:0 ceramide species projected higher significance in AD patients, and showed similar results on five other species. The ratio of ceramide to sphingomyelin species that contained matching fatty acyls chains varied significantly. In addition, there were notable specific differences in the genotypes of the AD subjects. The prospective study provided insights on indulging in AD sphingolipidome and metabolomics signatures as outlying biomarkers given the established disruption pattern on the sphingomyelin and ceramide mass levels within AD plasma.
Hebert, L. E., Weuve, J., Scherr, P. A., & Evans, D. A. (2013). Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology , 80 (19), 1778-1783.
The authors of this study aimed at providing updated estimates on Alzheimer disease (AD) dementia prevalence in the United States from 2010 to 2050. The study was inspired by notable detrimental effects associated with the disease, especially, among the aging “baby boomers “generation. The study found that a considerable burden is placed on the affected persons, their caregivers, and the society at large. As indicated in the National Plan formulated during the Obama administration to address AD, there was an intense appreciation of the disease’s challenges anticipated in the future, which was the reason the authors were urged to evaluate the current and projected AD statistics in the American population. The study adopted a methodology for calculating the probabilities of AD dementia from a longitudinal population-based study. The study encompassed numbers from both white and black participants. Additionally, the study computed incidence probabilities for age, race, and the level of education among the subjects. These probabilities were measured using the weighted logistic regression. 2,577 clinical evaluations of 1913 people were obtained from a stratified random sampling of 10,800 people. The study combined the aforementioned variables with the US mortality statistics, education, and the United States Census Bureau estimates of the current and the future population in the United States. The study estimated that in 2010, 4.7 million persons aged above 65 years had dementia on a 95% confidence interval. Particularly, 0.7 million of these victims were aged between 65 and 74 years, 2.3 million ranged from 75 to 84 years, and 1.8 million were 85 years or older. Additionally, the number of persons predicted to ail from AD dementia by 2050 was 13.8 million, among which 7.0 million will be 85 years or older. Conclusively, the study noted that there would be an anticipated increase in the number of AD dementia patients in the following 40 years of the research unless appropriate preventative measures are instituted.
Kalaria, R. N., Maestre, G. E., Arizaga, R., Friedland, R. P., Galasko, D., Hall, K., ... & Prince, M. (2008). Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors. The Lancet Neurology , 7 (9), 812-826.
The authors of this study sought to investigate the prevalence, management, and risk factors for Alzheimer’s disease and vascular dementia in developing countries owing to the increase in dementia cases within the developing countries. Additionally, due to the insufficient funding for Alzheimer’s management and research, the authors intended to identify the significance of traditional medicine and diets in the health management and prevention of Alzheimer’s and vascular dementia in these countries. Notably, the authors based their study on secondary information relating to Alzheimer’s prevalence estimates. The classification of developing countries was in line with the United Nation’s categorization of the same. The study hypothesized that there were phenotypic variations in dementia in populations from different cultures and environments. Also, dietary and lifestyle illnesses such as hypertension, diabetes type 2 and obesity increase the risk of dementia. The article is mainly founded on secondary information and partly on primary information. The primary data was collected from The World Federation of Neurology Dementia Research Group member and co-authors on cognitive screening. Consecutively, most of the secondary information was extracted from medical journals such as PubMed and Medline which included keyword searches related to the objectives of the report. The developing countries analyzed were inclusive of those from Africa, Asia, and Latin America. The authors found that there was an increasing predominance of the AD in developing countries particularly in Asia and Latin America and subsequent low prevalence in Sub-Saharan Africa and India. Illiteracy and depressive illness were also found to be significant risk factors as far as AD and Dementia are concerned. The cost of treating dementia was also found to have a bigger impact among people living in developing countries compared to developed countries. The content and findings of the study are relevant to this study as they provide information about the prevalence of AD and dementia in developing countries. Moreover, it also shows the impact of certain aspects such as age, depressive diseases, and diet as possible causes of AD and dementia. The study also expounds on the need for governments to prioritize on creating awareness for AD dementia-related diseases as well as setting aside funds for the care and management of Alzheimer’s patients.
Maccioni, R. B., Muñoz, J. P., & Barbeito, L. (2001). The molecular bases of Alzheimer's disease and other neurodegenerative disorders. Archives of medical research , 32 (5), 367-381.
The authors of this study focused on creating an understanding of the molecular bases of Alzheimer’s disease and selective neurodegenerative disorders. The research indicates that AD is a prevalent malady affecting the brain, especially of the elderly, and is characterized by the formation of the senile plaques and neurofibrillary tangles protein aggregates. These protein aggregates are influential in accelerating neuronal degeneration, which consequentially leads to death. The study indicates that neurodegeneration in the AD is as a result of pathologic conditioning of cells. Multiple experiments of the molecular bases of the disease were done, and the deductions stipulated that senile plaques are generated by the deposition of fibrils of the beta-amyloid peptide in the human brain. Tau proteins form a major component of the helical filaments (PHFs). Experiments conducted on hippocampal cells demonstrated substantial relationships between fibrillary amyloid and the molecular signals that activate tau hyperphosphorylations. The study noted that two protein kinases are involved in atypical tau phosphorylation. These protein kinases are the Cyclin-dependent kinase Cdk5 and glycogen synthase kinase. The cyclin-dependent kinase is vital in brain development as well as the neurogenesis process. Notably, the review is mainly focused on the main protein aggregates responsible for Neuronal death for both sporadic and familial AD. Additionally, the analysis extended the focus on neuroprotective factors that were inclusive of selective inhibitors of tau phosphorylating protein kinases. Other inhibiting factors considered in the study were estrogens, antioxidants, and other relevant molecules that inhibit the neuronal degeneration. Ultimately, the study creates relevance in understanding the molecular bases, which are integral in the pathogenesis process of Alzheimer disease. The revelations are instrumental in crippling the rate at which elderly persons contract AD, as well as understanding neuronal degeneration aids in the suppression of the senile plaques and neurofibrillary tangles.
Mega, M. S., Cummings, J. L., Fiorello, T., & Gornbein, J. (1996). The spectrum of behavioral changes in Alzheimer's disease. Neurology , 46 (1), 130-135.
The behavioral abnormality is one of the most distinct signs of Alzheimer’s disease. The authors of this study, therefore, focused on investigating the range or extent of behavioral abnormalities among these patients. The research is grounded in the theoretical framework that behavior change in patients with Alzheimer’s is inevitable and depends on the different stages of Alzheimer. The study suggests that there is a positive correlation between agitation, dysphoria, apathy, aberrant motor behavior and cognitive impairment. In addition, the extent of delusions, hallucinations, agitation, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability, and aberrant motor behavior was greater in patients with Alzheimer’s more than in the control population. This study employed a quantitative research approach. The data was collected by interviewing 50 outpatients with mild, moderate, and severe cases of Alzheimer, and 40 aged-matched normal patients. The study used the test and control approach where 50 outpatients with Alzheimer’s were the test population while normal patients offered a control population. Ten behaviors (delusions, hallucinations, agitation, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability, and aberrant motor behavior were investigated for the study. The authors of this article employed a horizontal analysis of data to check the correlation between the ten behavioral abnormalities and the cognitive impairment intrinsic in Alzheimer patients. Concurrently, the authors investigated the extent of behavioral impairment between the test and control population. Information decoded from the research showed that among the ten behavioral abnormalities, apathy was the most common behavior while hallucination was the least common. Moreover, the study found that there existed a positive correlation between agitation, aberrant motor behavior, dysphonia and apathy, and cognitive impairment. Similarly, the ten behaviorisms were more in Alzheimer diseases patients’ compared to the normal subjects. The information available from this research is vital in building proof that behavioral abnormality is a common sign of Alzheimer’s disease. Most importantly, the research provides awareness on the possible signs caretakers of patients with Alzheimer’s disease should expect as a patient’s condition deteriorates.
Reinhard, S. C., Given, B., Petlick, N. H., & Bemis, A. (2008). Supporting family caregivers in providing care.
This study emanates from an evidence-based handbook for nurses and focuses on patient safety and quality as practiced in various healthcare facilities. Also, research employed in this study develops numerous claims on the subject associated with care recipients and their caregivers. Authors of this chapter draw concerns to expound on patient’s safety and quality due to the need for establishing better relationships between caregivers and care recipients within healthcare facilities. The study hypothesizes that most patients receive significant care and support from their families or guardians. Particularly, where patients are elderly or suffering from severe chronic maladies, the care and support can be substantial in the scope of the healthcare structuring, intensity, and duration. Therefore, the care stemming from family can compromise safety issues. The methodology adopted by the study encompasses a comprehensive but not exhaustive review of caregiving literature. Databases searched were MEDLINE, PsycINFO, and CINAHIL. The key search terms implemented varied from “caregiver,” “long-term care” and “home care services.” Other terms used in the search strategy and relatable to patient safety and quality in nursing practice were “case management,” medication,” “education training,” and “risk management.” The study focuses on caregivers as subjects to harm or abuse while conducting their services. Also, it highlights family caregivers as intensely affiliated to care recipients who often need help to learn to provide more competent and safe care. The study concluded that family caregivers were critical partners of delivering better health care giving. Similarly, family caregivers are complementary to the efforts put in place by the hospital caregiving personnel. To lessen sabotage on patients’ safety and quality of care, communication was perceived as an important tool for administering healthcare improvement. Additionally, the vitality of teaching family caregivers on the techniques of handling patients is substantial. Particularly, evidence-based research indicates that where nurses are involved in teaching family caregivers on competency and skill, there is better coordination on healthcare delivery, which is instrumental in improving patients’ safety and quality.
Schulz, R., & Martire, L. M. (2004). Family caregiving of persons with dementia: prevalence, health effects, and support strategies. The American journal of geriatric psychiatry , 12 (3), 240-249.
The authors of this study provide supportive caregiving literature on how to handle persons with dementia in relation to the prevalence of caregiving, health effects associated with dementia caregiving, and informed support strategies on monitoring dementia cases. The study is directed to family caregiving with reported concerns in the United States on how family caregiving on older patients with disabilities is influential in increasing their life expectancy. The authors are motivated to counteract the adversities characterized by the increase in the prevalence of chronic diseases and related disabilities in the United States. Also, the increases in healthcare restrictions on reimbursement results to family caregivers performing substantial portions of tasks that a paid health worker would do. This study summarizes the literature on key issues and findings on the definition and the prevalence of caregiving and describes the psychiatrist and physical effects associated with caregiving.
Additionally, the study advances a review of various intervention approaches applied in the processes of improving caregivers burden, depression, and the quality of life within healthcare facilities. Ultimately, the authors provide a review of the practice guidelines and recommendations aimed at enhancing patient safety and quality based on the insights derived from the developed empirical literature on family caregiving. This study is relevant as it focuses on family caregiving, which is inherently instrumental in the care delivery process. Indisputably, family caregivers and guardians are pivotal in accelerating patients’ recovery from ailments, and studies directed towards bettering such relationships within healthcare facilities are essential in providing adequate patient care. Notably, the increment on chronic diseases in the United States suggests the need to tighten safety measures within medical facilities to ensure proper flow of services within all hospital loci, devoid of any caregiving distractions and subjectivities.
References
Coleman, E. A., Smith, J. D., Frank, J. C., Min, S. J., Parry, C., & Kramer, A. M. (2004). Preparing patients and caregivers to participate in care delivered across settings: the Care Transitions Intervention. Journal of the American Geriatrics Society, 52(11), 1817-1825.
Dahm, R. (2006). Alzheimer's discovery. Current Biology, 16(21), R906-R910.
Han, X., Rozen, S., Boyle, S. H., Hellegers, C., Cheng, H., Burke, J. R., ... & Kaddurah-Daouk, R. (2011). Metabolomics in early Alzheimer's disease: identification of altered plasma sphingolipidome using shotgun lipidomics. PloS one, 6(7), e21643.
Hebert, L. E., Weuve, J., Scherr, P. A., & Evans, D. A. (2013). Alzheimer disease in the United States (2010–2050) estimated using the 2010 census. Neurology, 80(19), 1778-1783.
Kalaria, R. N., Maestre, G. E., Arizaga, R., Friedland, R. P., Galasko, D., Hall, K., ... & Prince, M. (2008). Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors. The Lancet Neurology, 7(9), 812-826.
Maccioni, R. B., Muñoz, J. P., & Barbeito, L. (2001). The molecular bases of Alzheimer's disease and other neurodegenerative disorders. Archives of medical research, 32(5), 367-381.
Mega, M. S., Cummings, J. L., Fiorello, T., & Gornbein, J. (1996). The spectrum of behavioral changes in Alzheimer's disease. Neurology, 46(1), 130-135.
Reinhard, S. C., Given, B., Petlick, N. H., & Bemis, A. (2008). Supporting family caregivers in providing care.
Schulz, R., & Martire, L. M. (2004). Family caregiving of persons with dementia: prevalence, health effects, and support strategies. The American journal of geriatric psychiatry, 12(3), 240-249.
