Mnemoscape: Supporting Older Adults' Event Memory Using Wearable Camera Photographs on an Immersive Interface.

BACKGROUND: Wearable camera photographs have been shown to be an effective memory aid in people with and without memory impairment. Most studies using wearable cameras as a memory aid have presented photographs on a computer monitor and used a written diary or no review as a comparison. In this pioneering study, we took a new and innovative approach to wearable camera photograph review that embeds the photographs within a virtual landscape. This approach may enhance these benefits by reinstating the original environmental context to increase participants' sense of re-experiencing the event. OBJECTIVE: We compare the traditional computer monitor presentation of wearable camera photographs and actively taken digital photographs with the presentation of wearable camera photographs in a new immersive interface that reinstates the spatiotemporal context. METHODS: Healthy older adults wore wearable or took digital photographs during a staged event. The next day and 2 weeks later, they viewed wearable camera photographs on a computer monitor or in context on an immersive interface, or digital photographs. RESULTS: Participants who viewed wearable camera photographs in either format recalled more details during photo viewing and subsequent free recall than participants who viewed digital photographs they had taken themselves. CONCLUSION: Wearable camera photographs are an effective support for event memory, regardless of whether they are presented in context in an experience-near format.

GATA4 and GATA6 Knockdown During Luteinization Inhibits Progesterone Production and Gonadotropin Responsiveness in the Corpus Luteum of Female Mice.

The surge of luteinizing hormone triggers the genomic reprogramming, cell differentiation, and tissue remodeling of the ovulated follicle, leading to the formation of the corpus luteum. During this process, called luteinization, follicular granulosa cells begin expressing a new set of genes that allow the resulting luteal cells to survive in a vastly different hormonal environment and to produce the extremely high amounts of progesterone (P4) needed to sustain pregnancy. To better understand the molecular mechanisms involved in the regulation of luteal P4 production in vivo, the transcription factors GATA4 and GATA6 were knocked down in the corpus luteum by crossing mice carrying Gata4 and Gata6 floxed genes with mice carrying Cre recombinase fused to the progesterone receptor. This receptor is expressed exclusively in granulosa cells after the luteinizing hormone surge, leading to recombination of floxed genes during follicle luteinization. The findings demonstrated that GATA4 and GATA6 are essential for female fertility, whereas targeting either factor alone causes subfertility. When compared to control mice, serum P4 levels and luteal expression of key steroidogenic genes were significantly lower in conditional knockdown mice. The results also showed that GATA4 and GATA6 are required for the expression of the receptors for prolactin and luteinizing hormone, the main luteotropic hormones in mice. The findings demonstrate that GATA4 and GATA6 are crucial regulators of luteal steroidogenesis and are required for the normal response of luteal cells to luteotropins.

Incongruent perceptions of pain and physical function among families living with lung cancer.

PURPOSE: The purpose of the study was to examine the roles of concealment and communication in incongruence in perceptions of the lung cancer patient's physical function and pain severity. METHODS: Lung cancer patients and their family members (N = 108 family care dyads) rated the patient's physical function and pain severity. RESULTS: Multilevel modeling revealed that family members, on average, rated patient physical function significantly worse than patients; incongruence did not significantly differ from 0, on average, for pain severity. However, there was significant variability across family care dyads in how much incongruence existed within dyads. Controlling for depressive symptoms, family member role overload, family member physical function, the patients' cognitive impairment, relationship type, and stage of lung cancer, the patients' level of concealment was significantly associated with incongruence for both physical function and pain severity. Additionally, the family members' perceptions of communication problems in the dyad were significantly associated with incongruence for pain severity. Models accounted for 23 and 30 % of the incongruence in physical function and pain severity, respectively. CONCLUSIONS: Open communication and disclosure play important roles in the appraisal of symptoms within the lung cancer patient-family member dyad. These interpersonal factors may be promising targets for interventions to maximize patient and family member outcomes.

Resistance training reduces disability in prostate cancer survivors on androgen deprivation therapy: evidence from a randomized controlled trial.

OBJECTIVES: To investigate whether functionally based resistance exercise could improve strength, physical function, and disability among prostate cancer survivors (PCS) on androgen deprivation therapy (ADT); and to explore potential mediators of changes in outcomes from exercise. DESIGN: Randomized controlled trial. SETTING: Academic medical center. PARTICIPANTS: PCS (N=51; mean age, 70.2y) on ADT. INTERVENTION: PCS were randomized to moderate to vigorous intensity resistance training or stretching (placebo control) for 1 year. MAIN OUTCOME MEASURES: Maximal leg press and bench press strength, objective and self-reported physical function, and self-reported disability. Hierarchical linear modeling was used to test for significant group × time differences adjusting for covariates. RESULTS: Retention in the study was 84%, and median attendance to supervised classes was 84% in the resistance group. No study-related injuries occurred. Maximal leg strength (P=.032) and bench press strength (P=.027) were improved after 1 year of resistance training, whereas little change occurred from stretching. Self-reported physical function improved with resistance training, whereas decreases occurred from stretching (P=.016). Disability lessened more with resistance training than stretching (P=.018). One-year change in leg press strength mediated the relation between groups (resistance or stretching) and 1-year change in self-reported disability (P<.05). CONCLUSIONS: One year of resistance training improved muscle strength in androgen-deprived PCS. Strengthening muscles using functional movement patterns may be an important feature of exercise programs designed to improve perceptions of physical function and disability. Findings from this study contribute to the mounting evidence that exercise should become a routine part of clinical care in older men with advanced prostate cancer.

Patterns and predictors of symptom incongruence in older couples coping with prostate cancer.

PURPOSE: Prostate cancer survivors (PCSs) may experience persistent symptoms following treatment. If PCSs and spouses differ in their perceptions of symptoms, that incongruence may cause mismanagement of symptoms and reduced relationship quality. The purpose of this study was to examine symptom incongruence and identify the PCS and spouse characteristics associated with symptom incongruence in older couples coping with prostate cancer. METHODS: Participants in the study were older PCSs (>60 years) and their spouses (N=59 couples). Symptom incongruence was determined by comparing patient and spouse independent ratings of the severity of his cancer-related symptoms. Predictor variables included PCS age, time since diagnosis, PCS comorbidity, PCS and spouse depressive symptoms, and spouse caregiving strain. RESULTS: PCS and spouse ratings of his symptom severity and the amount of incongruence over his symptoms varied significantly across couples. Overall, couples rated a moderate level of PCS symptom severity, but PCSs and their spouses significantly differed in their perceptions of PCS symptom severity with spouses rating severity higher (t=-2.66, df=51, p<0.01). PCS younger age and high spouse caregiver strain accounted for 29 % of incongruence in perceptions of PCS symptom severity. CONCLUSIONS: This study is among the first to show that PCSs and spouses may perceive cancer-related persistent symptoms differently. Among this older sample, younger PCS age and spouse caregiver strain were associated with incongruence in symptoms perceptions in couples. These and other factors may inform future interventions aimed at preserving relationship quality in older couples who have experienced prostate cancer.

Measuring activity levels associated with rehabilitative care in hospitalized older adults.

Older adults often experience functional losses during hospitalization. Clinical care activities have been increasingly promoted as a way to help older hospitalized patients offset these losses and recover from acute illness. Little research exists to objectively measure clinical care activities. This study evaluated the utility and feasibility of using the Actiheart, a combined heart rate monitor and accelerometer, to measure heart rate and motion (activity counts) during five clinical care activities. Fifty-four adults, aged 65 and older, scheduled for surgery, participated in a simulation of activities. The Actiheart successfully measured motion and heart rate during each of the five activities. One-way repeated measures analyses of variance showed that the Actiheart discriminated significant differences within and across the five activities. This study supports the use of an activity monitor to quantify clinical care activities in research studies that can be translated into clinical care. However, the complexity associated with data collection and analysis using the Actiheart could limit its direct use in clinical research.

Experimenting with arts-based methods and affective provocations to understand complex lived experience of a diagnosis of borderline personality disorder.

This article draws on arts-based psycho-social research to explore embodied and visceral knowing and feeling in the context of people living with a diagnosis of borderline personality disorder (BPD). It presents a discussion of creative artworks solicited through a nation-wide online survey conducted in Australia in 2021 that generated intimate and affective understanding about living with a diagnosis of BPD. To investigate what lived experiences of distress associated with a BPD diagnosis communicate through sensation, emotion, image and affective capacity, the authors put to work Blackman's (2015) concept of "productive possibilities of negative states of being" and the broader theoretical framework of new materialism. This approach allows a more transformative feeling-with that exceeds the normative affective repertoires and scripts associated with a diagnosis of BPD. The authors recognise the often unspoken and invisible affects of complex mental distress and trauma, and purposefully open the space for affective and symbolic aspects of creative artworks to communicate what is less known or has less presence in dominant biomedical frameworks about living with a BPD diagnosis. The article foregrounds the lived and living experience of participants to generate experiential rather than clinical understandings of the diagnosis.

Comparison of tai chi vs. strength training for fall prevention among female cancer survivors: study protocol for the GET FIT trial.

BACKGROUND: Women with cancer are significantly more likely to fall than women without cancer placing them at higher risk of fall-related fractures, other injuries and disability. Currently, no evidence-based fall prevention strategies exist that specifically target female cancer survivors. The purpose of the GET FIT (Group Exercise Training for Functional Improvement after Treatment) trial is to compare the efficacy of two distinct types of exercise, tai chi versus strength training, to prevent falls in women who have completed treatment for cancer. The specific aims of this study are to: 1) Determine and compare the efficacy of both tai chi training and strength training to reduce falls in older female cancer survivors, 2) Determine the mechanism(s) by which tai chi and strength training each reduces falls and, 3) Determine whether or not the benefits of each intervention last after structured training stops. METHODS/DESIGN: We will conduct a three-group, single-blind, parallel design, randomized controlled trial in women, aged 50-75 years old, who have completed chemotherapy for cancer comparing 1) tai chi 2) strength training and 3) a placebo control group of seated stretching exercise. Women will participate in supervised study programs twice per week for six months and will be followed for an additional six months after formal training stops. The primary outcome in this study is falls, which will be prospectively tracked by monthly self-report. Secondary outcomes are maximal leg strength measured by isokinetic dynamometry, postural stability measured by computerized dynamic posturography and physical function measured by the Physical Performance Battery, all measured at baseline, 3, 6 and 12 months. The sample for this trial (N=429, assuming 25% attrition) will provide adequate statistical power to detect at least a 47% reduction in the fall rate over 1 year by being in either of the 2 exercise groups versus the control group. DISCUSSION: The GET FIT trial will provide important new knowledge about preventing falls using accessible and implementable exercise interventions for women following chemotherapy for cancer. ClinicalTrials.gov NCT01635413.

Theory-based predictors of follow-up exercise behavior after a supervised exercise intervention in older breast cancer survivors.

PURPOSE: Supervised exercise interventions can elicit numerous positive health outcomes in older breast cancer survivors. However, to maintain these benefits, regular exercise needs to be maintained long after the supervised program. This may be difficult, as in this transitional period (i.e., time period immediately following a supervised exercise program), breast cancer survivors are in the absence of on-site direct supervision from a trained exercise specialist. The purpose of the present study was to identify key determinants of regular exercise participation during a 6-month follow-up period after a 12-month supervised exercise program among women aged 65+ years who had completed adjuvant treatment for breast cancer. METHODS: At the conclusion of a supervised exercise program and 6 months later, 69 breast cancer survivors completed surveys examining their exercise behavior and key constructs from the Transtheoretical Model. RESULTS: After adjusting for weight status and physical activity at the transition point, breast cancer survivors with higher self-efficacy at the point of transition were more likely to be active 6 months after leaving the supervised exercise program (odds ratio [95% confidence interval, 1.10 [1.01-1.18]). Similarly, breast cancer survivors with higher behavioral processes of change use at the point of transition were more likely to be active (odds ratio [95% confidence interval], 1.13 [1.02-1.26]). CONCLUSION: These findings suggest that self-efficacy and the behavioral processes of change, in particular, play an important role in exercise participation during the transition from a supervised to a home-based program among older breast cancer survivors.

Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors: a randomized, controlled trial.

Targeted exercise training could reduce risk factors for fracture and obesity-related diseases that increase from breast cancer treatment, but has not been sufficiently tested. We hypothesized that progressive, moderate-intensity resistance + impact training would increase or maintain hip and spine bone mass, lean mass and fat mass and reduce bone turnover compared to controls who participated in a low-intensity, non-weight bearing stretching program. We conducted a randomized, controlled trial in 106 women with early stage breast cancer who were >1 year post-radiation and/or chemotherapy, ≥ 50 years of age at diagnosis and postmenopausal, free from osteoporosis and medications for bone loss, resistance and impact exercise naïve, and cleared to exercise by a physician. Women were randomly assigned to participate in 1 year of thrice-weekly progressive, moderate-intensity resistance + impact (jump) exercise or in a similar frequency and length control program of progressive, low-intensity stretching. Primary endpoints were bone mineral density (BMD; g/cm²) of the hip and spine and whole body bone-free lean and fat mass (kg) determined by DXA and biomarkers of bone turnover-serum osteocalcin (ng/ml) and urinary deoxypyrodiniline cross-links (nmol/mmolCr). Women in the resistance + impact training program preserved BMD at the lumbar spine (0.47 vs. -2.13%; P = 0.001) compared to controls. The resistance + impact group had a smaller increase in osteocalcin (7.0 vs. 27%, P = 0.03) and a larger decrease in deoxypyrodinoline (-49.9 vs. -32.6%, P = 0.06) than controls. Increases in lean mass from resistance + impact training were greatest among women currently taking aromatase inhibitors compared to controls not on this therapy (P = 0.01). Our combined program of resistance + impact exercise reduced risk factors for fracture among postmenopausal breast cancer survivors (BCS) and may be particularly relevant for BCS on aromatase inhibitors (AIs) because of the additional benefit of exercise on muscle mass that could reduce falls.

A visit with Viv: Empathising with a digital human character embodying the lived experiences of dementia.

The Visit, an immersive participatory artwork (viewed on a screen or virtual reality headset), was produced as part of a research programme investigating the subjective experience of dementia and the relational dynamic between people with dementia and others. It invites viewers to engage with a digital human character, 'Viv', as she shares her experiences of living with dementia. The experiences that Viv recounts are based on verbatim accounts from in-depth interviews with four women living with dementia. The artwork was designed with the combined aim of generating insights into the lived experience of dementia and establishing conditions under which viewers might cultivate empathy for the character portrayed. Viewers engaging with Viv were invited to complete pre- and post-engagement measures of state empathy alongside an assessment of emotional distance. State empathy was significantly greater after engaging with The Visit, and correspondingly, there was a significant decrease in emotional distance (aversion), suggesting that the aims were met.

Scientific and statistical reviews of manuscripts submitted to Nursing Research: Comparison of completeness, quality, and usefulness.

Sound statistical analysis is fundamental to high-quality reporting of quantitative studies. Peer review are also important in determining whether statistical procedures in submitted manuscripts are appropriate and effectively reported. However, the quality of statistical reviews of manuscripts submitted to nursing journals has not been previously evaluated. The purpose of this project was to compare the content and quality of statistical and scientific (general) reviews of manuscripts submitted to Nursing Research. The General Assessment of Reviews of Nursing Research (GARNR) and the Statistical Assessment of Reviews of Nursing Research (SARNR) were used to evaluate 105 reviews of 35 manuscripts assigned to both scientific and statistical review between August 2007 and February 2009. Scientific reviews were rated as more comprehensive, but most did not evaluate statistical aspects of a manuscript. Statistical reviews were more likely to identify fatal flaws, were generally rated higher in overall usefulness to the editor in making a decision on whether to publish, and were rated as more useful to authors for improving a manuscript. Statistical and scientific reviews are complementary and both are necessary. More thorough integration of substantive and methodological content in reviews of quantitative studies has potential for even greater leverage of effort and improved quality of nursing research reports.

Edge of the Present: A Virtual Reality Tool to Cultivate Future Thinking, Positive Mood and Wellbeing.

Depression and suicidality are characterized by negative imagery as well as impoverished positive imagery. Although some evidence exists supporting the link between positive imagery and enhanced mood, much work needs to be done. This study explored the impact of an immersive virtual reality experience (Edge of the Present-EOTP) on an individual's mood, state of well-being, and future thinking. Using a 10-min mixed reality experience, 79 individuals explored virtual landscapes within a purposefully built, physical room. A pre and post survey containing mental health measures were administered to each participant. An optional interview following the virtual work was also conducted. The results indicated that positive mood and well-being increased significantly post-intervention. Hopelessness scores and negative mood decreased, whilst sense of presence was very high. This pilot study is among the first to assess the feasibility of a mixed reality experience as a potential platform for depression and suicide prevention by increasing well-being and mood as well as decreasing hopelessness symptoms.

Women and Stigma: A Protocol for Understanding Intersections of Experience through Body Mapping.

This paper outlines a research and dissemination protocol to be undertaken with specific groups of marginalised women in Australia. Women impacted by significant mental distress, disability, or refugee status are among society's most vulnerable and disenfranchised groups. They can experience significant social exclusion, marginalisation and stigma, associated with reduced help seeking, deprivation of dignity and human rights, and threats to health, well-being and quality of life. Previous research has assessed the experiences of discrete groups of women but has to date failed to consider mental health-refugee-disability intersections and overlaps in experience. Using body mapping, this research applies an intersectional approach to identify how women impacted by significant mental distress, disability, and refugee status negotiate stigma and marginalisation. Findings on strategies to cope with, negotiate and resist stigmatised identities will inform health policy and yield targeted interventions informed by much-needed insights on women's embodied experience of stigma. The women's body maps will be exhibited publicly as part of an integrated knowledge translation strategy. The aim is to promote and increase sensitivity and empathy among practitioners and policy makers, strengthening the basis for social policy deliberation.

Differences between older and younger cancer survivors in seeking cancer information and using complementary/alternative medicine.

OBJECTIVE: The purpose of this study was to describe the differences between younger and older cancer survivors in seeking cancer information, using complementary and alternative medical (CAM) services, and using conventional support services. DESIGN AND METHODS: Participants were 836 survivors of adult cancers (6 months-43 years since completion of primary cancer treatment) in New Zealand who answered a mailed questionnaire between April 2007 and January 2008. RESULTS: Younger survivors (aged <60 years at diagnosis) were more likely to seek information from sources beyond their physicians and used different sources for that information, compared to older survivors. Older and younger survivors used similar conventional support services, but different CAM services. In logistic regression analyses, information-seekers were 5.9 times more likely to use CAM than those who did not seek cancer information (p = 0.02), but the association between information-seeking and CAM use depended on age (p = 0.02). Older cancer survivors who did not seek information from sources beyond that provided by physicians were less likely to use CAM. IMPLICATIONS: Physicians should consider talking to older cancer survivors about their use of information sources or CAM therapies. A conversation between physician and patient may uncover inaccurate information or CAM use that has potential for adverse effects, while allowing the physician to encourage CAM that is potentially useful. Even a brief conversation may be sufficient to encourage older cancer survivors to take action themselves to find services that support their recovery from cancer and cancer treatment.

Changes in employment and household income during the 24 months following a cancer diagnosis.

GOALS OF WORK: The purpose of the study was to describe the changes in employment and household income following a cancer diagnosis. MATERIALS AND METHODS: Participants were 68 recent cancer survivors (6-24 months since diagnosis) aged 18 years or older who were employed full- or part-time prior to receiving a cancer diagnosis. Data were both quantitative and qualitative. Participants completed a mailed questionnaire about various issues faced by cancer survivors, including 36 questions about work, finances, and income. In addition, space was provided for participants to write optional narrative details about work experiences. MAIN RESULTS: Before cancer, all 68 participants were employed, 45 full-time and 23 part-time. After completion of primary cancer treatment, 49 (72%) were employed (29 full-time and 20 part-time). A decrease in household income after cancer diagnosis was reported by 37% of participants. Of those who were the main income earners in their households prior to cancer, 26% were no longer the main earners after cancer. The qualitative data about work difficulties fell broadly into two areas: physical difficulties and attitudes of employers. CONCLUSIONS: Though limited by a comparatively small sample size, this study is the first to focus on employment in the very early survivorship period, using both questionnaire and qualitative data. The findings show that many individuals continue to work during and after treatment, though reduction of work hours or quitting work is not uncommon. The complex factors associated with work decisions are not easily assessed with questionnaires, and in-depth qualitative studies of recent cancer survivors are warranted.

A telephone-only motivational intervention to increase physical activity in rural adults: a randomized controlled trial.

BACKGROUND: Both urban and rural adults are likely to be inactive, but rural adults have less access to exercise classes or facilities to increase physical activity. OBJECTIVES: To evaluate whether a telephone-only motivational interviewing (MI) intervention would increase daily physical activity of rural adults. METHODS: This randomized controlled trial enrolled 86 physically inactive adults living in rural communities (mean age = 58 years, range = 30-81 years) who stated that they were ready to increase physical activity during the next 6 months. Participants were assigned randomly to MI intervention (n = 43) or control (n = 43) groups. The MI group participants received a pedometer and monthly MI telephone calls over 6 months from a counselor. Control group participants received an equal number of telephone calls without MI content. Physical activity was measured by self-report using the Community Healthy Activities Model Program For Seniors Physical Activity Questionnaire for Older Adults. Data were collected by mailed surveys and analyzed using analysis of variance. RESULTS: Seventy-two participants completed the study (35 in the intervention group and 37 in the control group). The telephone-only MI intervention increased self-efficacy for exercise (p = .019) but did not increase levels of physical activity (p = .572) compared with controls. DISCUSSION: The intervention increased self-efficacy for exercise but did not increase physical activity, possibly due to seasonal effects, the control condition, or the length of the MI intervention. Even so, future studies are warranted because telephone-only MI has potential as a practical, relatively inexpensive method to provide health counseling to rural adults in a broad geographic area. This study produced an effect size on physical activity that will be useful to guide future studies.

Heart-to-Heart: promoting walking in rural women through motivational interviewing and group support.

BACKGROUND: Walking can significantly increase cardiorespiratory fitness and thereby reduce the incidence of heart disease in women. However, there is a paucity of research aimed at increasing walking in rural women, a high-risk group for heart disease and one for which exercise strategies may pose particular challenges. PURPOSE: This study tested Heart-to-Heart (HTH), a 12-week walking program, designed to increase fitness through walking in rural women. Heart-to-Heart integrated individual-oriented strategies, including motivational interviewing, and group-based strategies, including team building. METHODS: Forty-six rural women were randomized to either HTH or a comparison group. The primary outcome of cardiorespiratory fitness and secondary outcomes of self-efficacy and social support were measured preintervention and post-intervention. Group differences were analyzed with repeated-measures analysis of variance. RESULTS: Women in HTH group had a greater improvement in cardiorespiratory fitness (P =.057) and in social support (P =.004) compared with women in the comparison group. Neither group of women experienced a change in exercise self-efficacy (P =.814). CONCLUSIONS: HTH was effective in improving cardiorespiratory fitness in a sample of rural women. Further research is needed to refine HTH and determine the optimal approach in rural women to increase their walking.

New Zealand women living with HIV/AIDS: a feminist perspective.

This paper draws on current and earlier literature, together with observational and anecdotal data to reveal the situation of HIV positive women in New Zealand. The present picture is examined in relation to data from a previously unpublished qualitative study undertaken by the author in 2001 using a feminist perspective. It would seem that dominant concerns of the women today are much the same as those surfacing in the earlier study. These include stigma and the associated problem of whether to conceal or reveal. Additionally these women are concerned that health professionals do not always take their problems seriously. Their distress is aggravated by fact of them being women suffering from what is generally seen as a male disease. The feminist perspective highlights the relative powerlessness of many women in the context of sexual relations whereby much of the prophylactic advice--such as insistence on condom use--becomes irrelevant. New women oriented education programmes are needed. It is argued that nurses are well placed to make a positive contribution in this area of care, and in fact are obligated to do so if their practice is to be consistent with the profession's declared aims with respect to cultural safety. However it is noted that there is still a degree of prejudice and ignorance to be overcome before the desired results will be achieved.