Responses of Persons Living With Dementia to Caregiver Validating Communication: A Secondary Analysis.

Background and Purpose: Good communication between persons living with dementia and their caregivers is one important consideration when fostering a positive relationship and improving the effectiveness of care. Care can be a challenge if the person living with dementia does not feel understood or fails to cooperate with care. The individual may feel disrespected and may resist assistance. Validation therapy is a person-centered method for communicating with persons living with dementia that involves validating the experiences, feelings, and reality of an individual to encourage cooperation or provide for safety. The purpose of this study was to identify frequencies of four behavioral responses (cooperation, apathy, resistiveness, and distress) from persons living with dementia when validation communication strategies were used during care activities. Methods: This was a secondary analysis of homecare videos (n = 41) of family caregivers interacting with a person living with dementia during daily care. Behavioral coding was used to examine the relationships between validating communication and the response of a person living with dementia. Caregiver use of specific validation techniques in their communication (affirmation, acknowledging emotions, and verbalizing understanding) was coded along with subsequent responses of the person living with dementia (resistiveness, distress, apathy, or cooperation). Results: Affirmations produced an 11% probability of a cooperative response by the person living with dementia. Caregiver verbalization of understanding resulted in a 6% probability of cooperation, and silence was associated with an 8% probability of cooperation. Nonvalidating communication behaviors were associated with negative reactions. Implications for Practice: Effective person-centered communication between caregivers and persons living with dementia improved cooperation with care and decreased distress. Affirmations and verbalizing understanding were two types of validating communication more likely to elicit a cooperative response and can improve care quality, decrease caregiver burnout, and mitigate challenging behavioral responses in persons living with dementia.

Predictors of testosterone in zoo-managed male African elephants (Loxodonta Africana).

Reproductive complications for both male and female zoo-managed African elephants (Loxodonta africana) contribute to the rapidly declining population. In zoo-managed bull elephants, few studies have explored the potential physiological, physical, social, and environmental factors that influence bull fertility, particularly, androgen production. Testosterone is the essential steroid hormone for male sexual maturation and inadequate concentrations can be detrimental for spermatogenesis. Testosterone, fecal glucocorticoid metabolites, leptin, glucose, insulin, and triglycerides were analyzed from weekly fecal and blood serum samples taken over 6 months from six zoo-managed African elephant bulls (10-19 years of age). Testosterone levels were compared to endocrine factors, weekly social and environmental variables, daily musth signs, and body condition scores (BCS). The glucose-to-insulin ratio (G:I) was the only physiological biomarker found to be positively associated with testosterone. Predictive physical variables included Musth Score (+) and Moderate Exercise (+). Bulls with BCS signifying overweight (BCS 4) had lower testosterone (36.6 ± 1.6 ng/g fecal extraction [FE]) than bulls with healthy BCS 3; 51.2 ± 4.9 ng/g FE). Numerous social variables influenced testosterone concentrations, including Total Contact Day (+), Female Interaction Day (+), Indirect Contact Day (+), Indirect Contact Night (+) and Total No Contact (-). Both percentage of Time Outdoor and Time Mixed positively influenced testosterone, whereas testosterone decreased for percentage of Time Indoors. Each additional daily browse opportunity increased testosterone by approximately 7 ng/g FE. In managed care, the emphasis should be placed on optimizing these predictors of testosterone production to promote bull reproductive health.

Loss of TDP-43 in male germ cells causes meiotic failure and impairs fertility in mice.

Meiotic arrest is a common cause of human male infertility, but the causes of this arrest are poorly understood. Transactive response DNA-binding protein of 43 kDa (TDP-43) is highly expressed in spermatocytes in the preleptotene and pachytene stages of meiosis. TDP-43 is linked to several human neurodegenerative disorders wherein its nuclear clearance accompanied by cytoplasmic aggregates underlies neurodegeneration. Exploring the functional requirement for TDP-43 for spermatogenesis for the first time, we show here that conditional KO (cKO) of the Tardbp gene (encoding TDP-43) in male germ cells of mice leads to reduced testis size, depletion of germ cells, vacuole formation within the seminiferous epithelium, and reduced sperm production. Fertility trials also indicated severe subfertility. Spermatocytes of cKO mice showed failure to complete prophase I of meiosis with arrest at the midpachytene stage. Staining of synaptonemal complex protein 3 and γH2AX, markers of the meiotic synaptonemal complex and DNA damage, respectively, and super illumination microscopy revealed nonhomologous pairing and synapsis defects. Quantitative RT-PCR showed reduction in the expression of genes critical for prophase I of meiosis, including Spo11 (initiator of meiotic double-stranded breaks), Rec8 (meiotic recombination protein), and Rad21L (RAD21-like, cohesin complex component), as well as those involved in the retinoic acid pathway critical for entry into meiosis. RNA-Seq showed 1036 upregulated and 1638 downregulated genes (false discovery rate <0.05) in the Tardbp cKO testis, impacting meiosis pathways. Our work reveals a crucial role for TDP-43 in male meiosis and suggests that some forms of meiotic arrest seen in infertile men may result from the loss of function of TDP-43.