Befriending Older Adults in Nursing Homes: Volunteer Perceptions of Switching to Remote Befriending in the COVID-19 Era.

Objectives: Residents in nursing homes are being isolated to prevent exposure to COVID-19. Many are prone to depression, anxiety and loneliness, and extra isolation leaves them vulnerable to compromised mental health. In this study, trained volunteers providing befriending for residents with symptoms of depression, anxiety and loneliness switched to remote befriending during COVID-19. The purpose of this study was to gauge volunteer perceptions of the switch.Methods: A qualitative phenomenological approach was used to understand how switching to remote befriending impacted on volunteers and residents. A convenience sample of 18 participants responded to questions either in individual or group interviews.Results: Volunteers adapted their befriending visits, switching from face to face visits to remote options. The format was decided collaboratively. Hearing impairments hindered phone calls. Residents sometimes felt uncomfortable with digital technology but on the whole, the change to remote "visiting" was accepted.Conclusions: Further research is being conducted to gauge mental health outcomes for residents. Most volunteers and residents accepted the switch to remote befriending as better than no contact.Clinical implications: Volunteers can provide valuable support for residents living with social isolation during COVID-19. The format for social support needs to be decided collaboratively between volunteer and resident.

RATE OF POSTERIOR CAPSULAR RENT AS A COMPLICATION OF RESIDENT PERFORMED CATARACT EXTRACTION PROCEDURES.

BACKGROUND: Cataract extraction is the most commonly offered treatment for cataract. This is done surgically by a number of methods which include extracapsular cataract extraction and phacoemulsification. This study was done to assess the rate of posterior capsule rupture as a complication of resident performed cataract extraction procedures. METHODS: It is a descriptive case series conducted from 1st March to 1st April 2014 at Al Shifa Trust Eye Hospital, a tertiary care hospital. Cataract extraction procedures were done by first to fourth year residents. The surgical procedures done were extracapsular cataract extraction, phacoemulsification and lens matter aspiration. RESULTS: A total of 577 cases were operated, 307 males and 270 females. Out of which 336 were right eyes and 241 left eyes. The patients were in the age range 17-80 years. Only 61 out of 577 cases had posterior capsular rent. In phacoemulsification rate of posterior capsular rent was 29% and in extracapsular cataract extraction 69%. According to the year of residency cases done by first year were 24, second year 131, third year 231 and fourth year 191 with posterior capsular rents in 3, 23, 5 and 30 cases respectively. A total of 11 cases were left aphakic, 10 after extracapsular cataract extraction and 1 after phacoemulsification. CONCLUSION: There is a relatively high rate of posterior capsular rupture in cataract extraction procedures performed by residents. This rate is directly related to the procedure, being low for phacoemulsification and high for extracapsular cataract extraction. Rate of posterior capsular rupture is also directly related to the skill and expertise of the surgeon, being high for second year residents as compared to third and fourth year residents.

MAPT allele and haplotype frequencies in Nigerian Africans: Population distribution and association with Parkinson's disease risk and age at onset.

INTRODUCTION: The association between MAPT and PD risk may be subject to ethnic variability even within populations of similar geographical origin. Data on MAPT haplotype frequencies, and its association with PD risk in black Africans are lacking. We aimed to determine the frequencies of MAPT haplotypes and their role as risk factors for PD and age at onset in Nigerians. METHODS: The haplotype and genotype frequencies of MAPT rs1052553 were analysed in 907 individuals with PD and 1022 age-matched healthy controls from the Nigeria Parkinson's Disease Research network cohort. Clinical data related to PD included age at study, age at onset (AAO), and disease duration. RESULTS: The frequency of the H1 haplotype was 98.7% in PD, and 99.1% in controls (p = 0.19). The H2 haplotype was present in - 1.3% of PD and 0.9% of controls (p = 0.24). The most frequent MAPT genotype was H1H1 (PD - 97.5%, controls - 98.2%). The H1 haplotype was not associated with PD risk after accounting for gender and AAO (Odds ratio for H1/H1 vs H1/H2 and H2/H2: 0.68 (95% CI:0.39-1.28); p = 0.23). CONCLUSIONS: Our findings support previous studies that report a low frequency of the MAPT H2 haplotype in black ancestry Africans but document its occurrence in Nigerians. The MAPT H1 haplotype was not associated with an increased risk or age at onset of PD in this cohort.

MAPT allele and haplotype frequencies in Nigerian Africans: population distribution and association with Parkinson's disease risk and age at onset.

Background: The microtubule-associated protein tau ( MAPT ) gene is critical because of its putative role in the causal pathway of neurodegenerative diseases including Parkinson's disease (PD). However, there is a lack of clarity regarding the link between the main H1 haplotype and risk of PD. Inconsistencies in reported association may be driven by genetic variability in the populations studied to date. Data on MAPT haplotype frequencies in the general population and association studies exploring the role of MAPT haplotypes in conferring PD risk in black Africans are lacking. Objectives: To determine the frequencies of MAPT haplotypes and explore the role of the H1 haplotype as a risk factor for PD risk and age at onset in Nigerian Africans. Methods: The haplotype and genotype frequencies of MAPT rs1052553 were analysed using PCR-based KASP™ in 907 individuals with PD and 1,022 age-matched neurologically normal controls from the Nigeria Parkinson's Disease Research (NPDR) network cohort. Clinical data related to PD included age at study, age at onset, and disease duration. Results: The frequency of the main MAPT H1 haplotype in this cohort was 98.7% in individuals with PD, and 99.1% in healthy controls (p=0.19). The H2 haplotype was present in 41/1929 (2.1%) of the cohort (PD - 1.3%; Controls - 0.9%; p=0.24). The most frequent MAPT genotype was H1H1 (PD - 97.5%, controls - 98.2%). The H1 haplotype was not associated with PD risk after accounting for gender and age at onset (Odds ratio for H1/H1 vs H1/H2 and H2/H2: 0.68 (95% CI:0.39-1.28); p=0.23). Conclusions: Our findings support previous studies that report a low frequency of the MAPT H2 haplotype in black ancestry Africans, but document its occurrence in the Nigerian population (2.1%). In this cohort of black Africans with PD, the MAPT H1 haplotype was not associated with an increased risk or age at onset of PD.

Holistic system of care: evidence of effectiveness.

The Native American Health Center provides substance use and mental health services for urban American Indians and Alaska Natives (AIs/ANs) utilizing a culturally based holistic system of care (HSOC). Substance use prevention, treatment, and recovery services emphasize traditional AI/AN healing practices alongside evidence-based practices. This article describes the HSOC approach and provides preliminary findings from an outcome evaluation. Participants in outpatient and residential treatment were interviewed at baseline and 6-month follow-up with a standardized assessment tool (n = 490). The sample we composed of 86% AI/AN, 70% females, 30% males, and was entirely urban. Decreases in substance use and its related consequences were evident in both modalities but were most pronounced in residential treatment. Study's limitations and implications are included.

A Dene First Nation's community readiness assessment to take action against HIV/AIDS: a pilot project.

BACKGROUND: Among Indigenous people in Canada the incidence of HIV is 3.5 times higher than other ethnicities. In Manitoba First Nations, Metis and Inuit people are disproportionately represented (40%) among people who are new to HIV care. Northlands Denesuline First Nation (NDFN) identified the need to revisit their level of knowledge and preparedness for responding to the increasing rates of HIV. NDFN piloted a community readiness assessment (CRA) tool to assess its appropriateness for use in northern Manitoba. METHODS: A First Nation and non-First Nation research team trained to administer the CRA tool at NDFN in Manitoba. Five informants were interviewed using the CRA tool and the responses were scored, analysed and reviewed at community workshops and with stakeholders to develop a 1-year action plan. RESULTS: CRA training was best conducted in the community. Using the readiness score of 2.4 along with feedback from two workshops, community members, the research team and stakeholders, we identified priorities for adult education and youth involvement in programmes and planning. CONCLUSIONS: In response to the increasing incidence of HIV, a northern First Nation community successfully modified and implemented a CRA tool to develop an action plan for culturally appropriate interventions and programmes.