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Clark DO, Xu H, Moser L, Adeoye P, Lin AW, Tangney CC, Risacher SL, Saykin AJ, Considine RV, Unverzagt FW. MIND food and speed of processing training in older adults with low education, the MINDSpeed Alzheimer's disease prevention pilot trial. Contemp Clin Trials 2019; 84:105814. [PMID: 31326523 PMCID: PMC6721976 DOI: 10.1016/j.cct.2019.105814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 01/22/2019] [Revised: 07/11/2019] [Accepted: 07/16/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple national organizations and leaders have called for increased attention to dementia prevention in those most vulnerable, for example persons with limited formal education. Prevention recommendations have included calls for multicomponent interventions that have the potential to improve both underlying neurobiological health and the ability to function despite neurobiological pathology, or what has been termed cognitive reserve. OBJECTIVES Test feasibility, treatment modifier, mechanism, and cognitive function effects of a multicomponent intervention consisting of foods high in polyphenols (i.e., MIND foods) to target neurobiological health, and speed of processing training to enhance cognitive reserve. We refer to this multicomponent intervention as MINDSpeed. DESIGN MINDSpeed is being evaluated in a 2 × 2 randomized factorial design with 180 participants residing independently in a large Midwestern city. Qualifying participants are 60 years of age or older with no evidence of dementia, and who have completed 12 years or less of education. All participants receive a study-issued iPad to access the custom study application that enables participants, depending on randomization, to select either control or MIND food, and to play online cognitive games, either speed of processing or control games. METHODS All participants complete informed consent and baseline assessment, including urine and blood samples. Additionally, up to 90 participants will complete neuroimaging. Assessments are repeated immediately following 12 weeks of active intervention, and at 24 weeks post-randomization. The primary outcome is an executive cognitive composite score. Secondary outcomes include oxidative stress, pro-inflammatory cytokines, and neuroimaging-captured structural and functional metrics of the hippocampus and cortical brain regions. SUMMARY MINDSpeed is the first study to evaluate the multicomponent intervention of high polyphenol intake and speed of processing training. It is also one of the first dementia prevention trials to target older adults with low education. The results of the study will guide future dementia prevention efforts and trials in high risk populations.
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Affiliation(s)
- Daniel O Clark
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America; Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, United States of America.
| | - Huiping Xu
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America; Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, United States of America
| | - Lyndsi Moser
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Philip Adeoye
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America
| | - Annie W Lin
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States of America
| | - Christy C Tangney
- Department of Clinical Nutrition, Rush University Medical Center, Chicago, IL, United States of America
| | - Shannon L Risacher
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Robert V Considine
- Department of Medicine, Division of Endocrinology, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Frederick W Unverzagt
- Indiana University Center for Aging Research, Indianapolis, IN, United States of America; Regenstrief Institute, Inc., Indianapolis, IN, United States of America; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States of America
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Wain T, Sim M, Bessarab D, Mak D, Hayward C, Rudd C. Engaging Australian Aboriginal narratives to challenge attitudes and create empathy in health care: a methodological perspective. BMC Med Educ 2016; 16:156. [PMID: 27255769 PMCID: PMC4890246 DOI: 10.1186/s12909-016-0677-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 08/28/2015] [Accepted: 05/26/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND Unconscious bias and negative attitudes towards minority groups have detrimental effects on the way health care is, or is not, provided to these groups. Recognition of racist attitudes and behaviours as well as understanding clients' experiences of health and health care are pivotal to developing better health care strategies to positively impact on the quality and safety of care provided to Indigenous people. Indigenous research demands inclusive research processes and the use of culturally appropriate methodologies. This paper presents a methodological account of collecting narratives which accurately and respectfully reflect Aboriginal Australians' experiences with health care in Western Australia. The purpose of these narratives is to provide health students and professionals with an opportunity to 'walk-in the shoes' of Aboriginal people where face-to-face interaction is not feasible. METHODS With the incorporation of Indigenous peoples' voices being an important link in cultural safety, the project was led by an Indigenous Reference group, who encouraged active participation of Aboriginal people in all areas of the project. Using a phenomenological approach and guided by the Indigenous Reference group, yarning data collection was implemented to collect stories focusing on Aboriginal people's experiences with health care services. An open-access, on-line website was established to host education resources developed from these "yarns". RESULTS Yarning provided a rich source of information on personal experiences and encouraged the story provider to recognise their facilitative role in the research process. While the methodology used in this project was lengthy and labour-intensive it afforded a respectful manner for story collection and highlighted several innate flaws when Western methods are applied to an Indigenous context. CONCLUSION Engagement of an Indigenous Reference Group was pivotal to designing an appropriate methodology that incorporated the voices of Aboriginal people in a multimedia resource of Aboriginal narratives. However further research is warranted to understand how the resources are being used and integrated into curricula, and their impact on students and health care outcomes.
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Affiliation(s)
- Toni Wain
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Moira Sim
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Dawn Bessarab
- University of Western Australia, Centre for Aboriginal Medical and Dental Health, 35 Stirling Hwy, Crawley, WA, 6009, Australia
| | - Donna Mak
- The University of Notre Dame Australia, 32 Mouat St, Fremantle, WA, 6959, Australia
| | - Colleen Hayward
- Edith Cowan University, Kurongkurl Katitjin, 2 Bradford St, Mount Lawley, WA, 6050, Australia
| | - Cobie Rudd
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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Dekkers OM, Cevallos M, Bührer J, Poncet A, Ackermann Rau S, Perneger TV, Egger M. Comparison of noninferiority margins reported in protocols and publications showed incomplete and inconsistent reporting. J Clin Epidemiol 2014; 68:510-7. [PMID: 25450451 DOI: 10.1016/j.jclinepi.2014.09.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/19/2014] [Accepted: 09/12/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To compare noninferiority margins defined in study protocols and trial registry records with margins reported in subsequent publications. STUDY DESIGN AND SETTING Comparison of protocols of noninferiority trials submitted 2001 to 2005 to ethics committees in Switzerland and The Netherlands with corresponding publications and registry records. We searched MEDLINE via PubMed, the Cochrane Controlled Trials Register (Cochrane Library issue 01/2012), and Google Scholar in September 2013 to identify published reports, and the International Clinical Trials Registry Platform of the World Health Organization in March 2013 to identify registry records. Two readers recorded the noninferiority margin and other data using a standardized data-abstraction form. RESULTS The margin was identical in study protocol and publication in 43 (80%) of 54 pairs of study protocols and articles. In the remaining pairs, reporting was inconsistent (five pairs, 9%), or the noninferiority margin was either not reported in the publication (five pairs, 9%) or not defined in the study protocol (one pair). The confidence interval or the exact P-value required to judge whether the result was compatible with noninferior, inferior, or superior efficacy was reported in 43 (80%) publications. Complete and consistent reporting of both noninferiority margin and confidence interval (or exact P-value) was present in 39 (72%) protocol-publication pairs. Twenty-nine trials (54%) were registered in trial registries, but only one registry record included the noninferiority margin. CONCLUSION The reporting of noninferiority margins was incomplete and inconsistent with study protocols in a substantial proportion of published trials, and margins were rarely reported in trial registries.
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Affiliation(s)
- Olaf M Dekkers
- Department of Clinical Epidemiology, Leiden University Medical Center, The Netherlands
| | - Myriam Cevallos
- Institute of Social & Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH-3012, Switzerland; CTU Bern, Department of Clinical Research, University of Bern, 3012 Bern, Switzerland
| | - Jonas Bührer
- Institute of Social & Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH-3012, Switzerland
| | - Antoine Poncet
- Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Sabine Ackermann Rau
- Institute of Social & Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH-3012, Switzerland
| | - Thomas V Perneger
- Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Matthias Egger
- Institute of Social & Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH-3012, Switzerland; Centre for Infectious Disease Epidemiology and Research (CIDER), University of Cape Town, South Africa.
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Ateba Ngoa U, Zinsou JF, Kassa RFK, Ngoune Feugap E, Honkpehedji YJ, Massinga-Loembe M, Kenguele Moundounga H, Nkoma Mouima AM, Mbenkep LH, Wammes LJ, Mbow M, Kruize Y, Mombo-Ngoma G, Bouyoukou Hounkpatin AL, Dejon Agobe JC, Saadou I, Lell B, Smits H, Kremsner PG, Yazdanbakhsh M, Adegnika AA. Assessment of the effect of Schistosoma haematobium co infection on malaria parasites and immune responses in rural populations in Gabon: study protocol. Springerplus 2014; 3:388. [PMID: 25120947 PMCID: PMC4128953 DOI: 10.1186/2193-1801-3-388] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/15/2014] [Indexed: 02/05/2023]
Abstract
Background Malaria and helminth co infection are common in tropical and subtropical areas where they affect the life of millions of people. While both helminth and malaria parasites have immunomodulatory activities, little is known about the consequence of co-infections on malaria antigen specific immune responses. Method/Design This study will be conducted in two rural areas of the Moyen Ogooué province in Gabon, endemic for both Plasmodium falciparum and Schistosoma haematobium infections. Participants, 5 to 50 years old, will be enrolled and grouped according to their infection status. S. haematobium and malaria parasites will be detected, demographic and clinical data will be recorded and blood will be collected for hematological as well as for immunological assays. The level of antibody specific to Plasmodium falciparum blood stage and gametocyte antigens will be measured using ELISA. PBMC will be isolated for phenotyping of different T cell subsets ex vivo by flow cytometry and for culture and cytokine response assessment. Discussion We will provide a comprehensive picture of the interaction between schistosomes and malaria parasites which co-localize in peripheral blood. We will test the hypothesis that schistosome infection has an impact on specific humoral as well as on cellular immune responses to malaria antigens.
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Affiliation(s)
- Ulysse Ateba Ngoa
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Roland Fabrice Kassa Kassa
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Eliane Ngoune Feugap
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Marguerite Massinga-Loembe
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Faculté de Médecine, Université des Sciences de la Santé de Libreville, BP: 4009, Libreville, Gabon
| | - Hilaire Kenguele Moundounga
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Anne Marie Nkoma Mouima
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Lima Honorine Mbenkep
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Linda Judith Wammes
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Moustapha Mbow
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Immunology Unit of the Laboratory of Bacteriology and Virology of Aristide Le Dantec Teaching Hospital, 30 Avenue Pasteur, BP 7325, Dakar, Senegal ; Institute of Tropical Medicine of Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Yvonne Kruize
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands ; Faculté de Médecine, Université des Sciences de la Santé de Libreville, BP: 4009, Libreville, Gabon
| | - Aurore Larissa Bouyoukou Hounkpatin
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Jean Claude Dejon Agobe
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Issifou Saadou
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Hermelijn Smits
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Peter Gottfried Kremsner
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, BP: 118, Lambaréné, Gabon ; Institut für Tropenmedizin, Universität Tübingen, Wilhelmstraβe 27, D-72074 Tübingen, Germany ; Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
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