RESUMO
Most people with dementia live at home and depend on informal caregivers for care. Both caregivers and persons with dementia can experience negative psychological and behavioural effects as the disease progresses. Non-pharmacological interventions can alleviate these effects and dyadic interventions, involving both caregiver and person with dementia, may be particularly effective. In this systematic review, the effect of dyadic interventions involving community-dwelling persons with dementia and their informal caregivers was researched. This article is an update of a review of dyadic interventions up to 2012 (Van't Leven et al., 2013). Twenty-two randomized controlled trials published between January 2012 and March 2023 met eligibility criteria, representing 3857 dyads. Results of a meta-analysis showed no overall intervention effect. Thirteen studies reported positive intervention effects, 9 studies reported no intervention effects. Intervention content and participant characteristics and knowledge of the disease varied widely between the studies reviewed. Effective interventions were those that matched activities for the person with dementia to their interests and abilities and educating the caregiver about dementia and communication. Interventions of moderate length (3-4 months) tended to be more effective than longer or shorter interventions. Future studies should further explore the factors contributing to the effects of dyadic interventions.
Assuntos
Cuidadores , Demência , Vida Independente , Humanos , Cuidadores/psicologia , Demência/psicologia , Demência/terapia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Low energy availability (LEA) has been associated with several physiological consequences, but its impact on sleep has not been sufficiently investigated, especially in the context of young athletes. This study examined the potential association between energy availability (EA) status and objective sleep quality in 42 male rugby players (mean age: 16.2 ± 0.8 years) during a 7-day follow-up with fixed sleep schedules in the midst of an intensive training phase. Participants' energy intake was weighed and recorded. Exercise expenditure was estimated using accelerometry. Portable polysomnography devices captured sleep on the last night of the follow-up. Mean EA was 29.3 ± 9.14 kcal·kg FFM-1·day-1, with 47.6% of athletes presenting LEA, 35.7% Reduced Energy Availability (REA), and 16.7% Optimal Energy Availability (OEA). Lower sleep efficiency (SE) and N3 stage proportion, along with higher wake after sleep onset (WASO), were found in participants with LEA compared to those with OEA (p = 0.04, p = 0.03 and p = 0.005, respectively, with large effect sizes). Segmented regression models of the EA-sleep outcomes (SE, sleep onset latency [SOL]), WASO and N3) relationships displayed two separate linear regions and produced a best fit with a breakpoint between 21-33 kcal·kg FFM-1·day-1. Below these thresholds, sleep quality declines considerably. It is imperative for athletic administrators, nutritionists, and coaches to conscientiously consider the potential impact of LEA on young athletes' sleep, especially during periods of heavy training.
Assuntos
Qualidade do Sono , Esportes , Humanos , Masculino , Adolescente , Rugby , Ingestão de Energia , Atletas , Metabolismo EnergéticoRESUMO
Sleep is bi-directionally linked to energy balance. This crossover study design will evaluate the acute effect of a moderate energy deficit (500 kcal) induced by diet, exercise, or mixed (-250 kcal by diet and 250 kcal by exercise) on sleep and the next morning's appetitive responses. The study sample comprises 24 healthy young adults. The experimental measurements will be conducted in a naturalistic, momentary manner and partly assessed by the participants. The participants will undergo a run-in period in order to stabilize their sleep schedules and provide them with training on the study protocol and measurements. Indirect calorimetry will be used to determine their resting metabolic rate and peak oxygen consumption (VO2 peak). Then, they will take part in a control session (CTL), followed by three energy deficit sessions in random order: a diet-induced energy deficit session (DED), an exercise-induced energy deficit session (EED), and a mixed energy deficit session (MED). All experimental sessions will be separated by a one-week washout. The participants' sleep will be monitored by ambulatory polysomnography, and the next morning's appetitive response will be evaluated via ad libitum food intake, appetite sensations, and food reward, measured by a food liking and wanting computerized test.
Assuntos
Apetite , Ingestão de Energia , Humanos , Adulto Jovem , Apetite/fisiologia , Estudos Cross-Over , Dieta , Ingestão de Energia/fisiologia , Metabolismo Energético/fisiologia , Sono/fisiologiaRESUMO
A state-dependent learning paradigm was studied in which healthy adult volunteers studied/encoded and recalled information from short passages, neutral in their content, in one of the following conditions: (1) Pain during study-Pain during both recall sessions; (2) Pain during study-No Pain during both recall sessions; (3) No Pain during study-Pain during both recall sessions; and (4) No Pain during study-No Pain during both recall sessions. Pain was experimentally induced using the cold pressor technique. In this study, we looked at evidence for state-dependent learning when the context of learning is not emotionally driven, but neutral. The memory task consisted of encoding detailed information about short stories, then recalling as many details as possible 20 min and 48 hr later. The results indicated no occurrence of a state-dependent learning and retrieval effect in this sample: Participants in the pain-no pain and no pain-pain conditions did not significantly perform differently than participants in the pain-pain and no pain-no pain conditions. However, a main effect of the state during study/encoding was significant, suggesting that being in pain during study had a detrimental effect on performance on the memory tests regardless of the state at retrieval. These results oppose previous studies' findings and shed new light on possible implications in various research areas.