The effectiveness of diverse technology-based instructions in assisting people with Alzheimer’s disease with medication management

Abstract

Purpose: In patients with mild cognitive impairment and Alzheimer’s disease (AD), faculties associated with instrumental activities of daily living (IADL) decline owing to reduced cognitive function. One type of IADL is medication behaviour. Medication management is critical for patients with AD. Previous studies have reported that presentations using speech and images are effective for facilitating IADL autonomy but there are few examinations of effective presentation methods. Therefore, we examined what kind of display methods are effective in helping patients with AD with medication management.

Materials and methods: Ten healthy elderly and 9 patients with mild AD were asked to perform the task of taking out medicine bags from a case at a designated time. We gave 3 kinds of instructions and examined the differences in participants’ reaction times. Task 1 included verbal instructions alone, Task 2 included verbal instructions and pictorial and written instructions, and Task 3 used a video conference system (presenting pictorial, written, and verbal instructions) at a designated time. Task 3 could be conducted remotely over the internet. The relationship between these results and neuropsychological tests was also explored.

Results: Task 3 was an effective method for patients with mild AD. In addition, we found correlations between the methods of Tasks 1–3 and the Japanese version of the Mini-Mental State Examination (MMSE-J).

Conclusions: The method of Task 3 may lead to home support for patients with AD. The MMSE-J could be used to identify changes in the adaptive functioning of patients exposed to distinct presentation methods.

• Implications for rehabilitation

• Appropriate transmission methods will increase the IADL autonomy of patients with mild AD who have memory impairment. While still images alone are not effective for patients with mild AD, when combined with verbal instructions, they prove effective for this group.

• The results of this study are useful for providing patients with mild AD with support in their IADLs, especially when methods that use images plus speech are employed. As participants were instructed via the internet, this study shows a way to help patients with mild AD even from a remote location.

• Until now, no studies have examined the adaptation criteria for instructive methods for patients with mild AD. This study shows that the MMSE could be used to determine the applicability of these instructive methods. The identification of cut-off values in future research could lead to more effective IADL support.

     

Angiotensin receptors in Dupuytren’s disease: a target for pharmacological treatment?

Background: Attempts at the pharmacological treatment of Dupuytren’s disease have so far been unsuccessful, and the disease is not yet fully understood on a cellular level. The Renin-Angiotensin System has long been understood to play a circulating hormonal role. However, there is much evidence showing Angiotensin II to play a local role in wound healing and fibrosis, with ACE inhibitors being widely used as an anti-fibrotic agent in renal and cardiac disease.

Methods: This study was designed to investigate the presence of Angiotensin II receptors 1 (AT1) and 2 (AT2) in Dupuytren’s tissue to form a basis for further study into the pharmacological treatment of this condition. Tissue was harvested from 11 patients undergoing surgery for Dupuytren’s disease. Each specimen was processed into frozen sections and immunostaining was employed to identify AT1 and AT2 receptors.

Results: Immunostaining for AT1 receptors was mildly positive in one patient and negative in all the remaining patients. However, all specimens stained extensively for AT2 receptors. This suggests that the expression of AT2 receptors is more prominent than AT1 receptors in Dupuytren’s disease.

Conclusion: These findings have opened a new avenue for future research involving ACE inhibitors, AT2 agonists, and AT2 antagonists in Dupuytren’s disease.     

CLIL教学理念在研究生医学英语翻转课堂教学中的可行性研究

CLIL(Content and language integrated learning)教学理念中的4C’S原则即将学科知识(Content)、交际能力(Communication)、认知过程(Cognition)、文化意识(Culture)有机地融合在一起,其本质是将知识构建、思辨能力、认知参与、语言的使用和学习进行有机结合,既帮助学习者习得语言和系统知识,又培养其相应的学习能力。将CLIL教学模式中4C’S原则运用到医学专业英语翻转课堂的教学中,既能改革传统医学英语授课方式,也能促进教学效果的提升,具有良好的实践教学意义。     

中西医结合治疗帕金森病研究进展

帕金森病是一种常见的中老年疾病,严重影响病人的生活质量。通过查阅相关中西医结合治疗帕金森病的相关文献,体现中西医对帕金森病的病因、发病机制的认识,药物及外科手术的治疗等方面已取得一定的成效,展现了中西医结合治疗帕金森病的独特优势,但也存在许多不足之处。