Participant education, spousal education and dementia risk in a diverse cohort of members of an integrated health care delivery system in Northern California

ObjectiveThe role of spousal education on dementia risk and how it may differ by gender or race/ethnicity is unknown. This study examines the association between one’s own education separate from and in conjunction with spousal education and risk of dementia.DesignCohort.SettingKaiser Permanente Northern California (KPNC), an integrated health care delivery system.Participants8835 members of KPNC who were aged 40–55, married and reported own and spousal education in 1964–1973.Primary outcome measureDementia cases were identified through medical records from 1 January 1996 to 30 September 2017.MethodsOwn and spousal education was self-reported in 1964–1973 and each was classified as four indicator variables (≤high school, trade school/some college, college degree and postgraduate) and as ≥college degree versus <college degree. Age as timescale weighted Cox proportional hazard models adjusted for demographics and health indicators evaluated associations between participant education, spousal education and dementia risk overall and by gender and race/ethnicity.ResultsThe cohort was 37% non-white, 46% men and 30% were diagnosed with dementia during follow-up from 1996 to 2017 (mean follow-up=12.7 years). Greater participant education was associated with lower dementia risk independent of spousal education, demographics and health indicators. Greater spousal education was associated with lower dementia adjusting for demographics but became non-significant after further adjustment for participant education. The same pattern was seen for spousal education ≥college degree (not adjusting for participant education HRspousal education≥college degree=0.83 (95% CI: 0.76 to 0.90); adjusting for participant education HRspousal education≥college degree=0.92 (95% CI: 0.83 to 1.01)). These associations did not vary by gender or race/ethnicity.ConclusionIn a large diverse cohort, we found that higher levels of participant’s own education were associated with lower dementia risk regardless of spousal education. An inverse association between spousal education and dementia risk was also present, however, the effects became non-significant after adjusting for participant education.

Mental Health Literacy and Dementia

This study aimed to investigate mental health literacy (MHL) with respect to dementia. Three forms of dementia were investigated. In all, 167 participants completed an online questionnaire which consisted of five vignettes that described the three dementia conditions, as well as depression and typical ageing. The vignette characters had no age specified, or they were described as 50-years-old or 70-years-old. Participants had to firstly decide if there was a disorder present and identify it by name, then answer questions relating to treatment and help-seeking. Results showed that participants could identify Alzheimer’s Disease significantly more so than they could vascular or frontotemporal dementia. All three dementias were significantly more recognised when the vignette was described as a 70-year-old. Frontotemporal dementia was significantly misdiagnosed as depression. Participant education and mental health experience did not influence the identification of dementia. Compared to some other well-known mental illnesses like schizophrenia, lay people are relatively good at recognising Alzheimer’s disease, but much less so at other forms of dementia. Implications and limitations of the study are discussed.

Evaluating course completion, appropriateness and burden in the Understanding Multiple Sclerosis massive open online course (Preprint)

BACKGROUND Massive open online course (MOOC) research is an emerging field; to date, most research in this area has focused on participant engagement. OBJECTIVE Here, we evaluate both participant engagement and measures of satisfaction, appropriateness and burden for a MOOC entitled Understanding Multiple Sclerosis (MS) among a cohort of 3,518 international course participants. METHODS We assessed the association of key outcomes with participant education level, MS status, caregiver status, sex and age using summary statistics, t-tests and chi square tests. RESULTS Our key findings were: (1) the course was well received, with 97% of participants satisfied, with an appropriate pitch and low burden (a mean of 2.2 hours engagement per week); (2) people living with MS were less likely than those not living with MS to complete the course; (3) caregivers and participants without a university education were more likely to apply the material by course completion. CONCLUSIONS The Understanding MS MOOC is fit for purpose; it presents information in a way that is readily understood by course participants and is applicable in their lives.

Pelatihan Pengelolaan Keuangan Berbasis Komputer Dalam Peningkatan Tertib Administrasi Pada Kader Kesehatan Di Giwangan Umbulharjo Yogyakarta

PLKB health cadres in Giwangan Yogyakarta are now using conventional methods in accounting start from managing administrative data to financial processing. It requires manual documentation by writing on sheets of paper. Data loss due to paper based is vulnerable Apart from the possibility of unclear writing, tearing can cause damage on this document and cause problems that make it difficult for accountability. This paper applies the training method by giving lectures and computer demonstrations. The level of participant education requires a patient speaker in delivering the material in slowly and detail. Hence, the constraints required good, polite treatment, speech andwell ethics. The results of activity to the PLKB health cadre in Giwangan are expected to increase the understanding and give insight of computers beneficial in financial management. Besides, this activity can increase motivation in computerimplementation optimallyKeywords: PLKB cadres, financial management, training

Serious Altitude Illness at the South Pole

BACKGROUND: Gradual ascent is impractical for personnel deploying to the South Pole due to logistical challenges. Prevention of altitude illness relies on prophylactic medications such as acetazolamide and behavioral modifications including hydration and avoidance of overexertion. We present three recent cases of altitude illness that occurred in previously healthy individuals at the South Pole.CASE REPORTS: 1) A 52-yr-old woman not on prophylactics presented with headache and intractable vomiting 7 h after arriving and hiking around the station. She was treated with acetazolamide, dexamethasone, oxygen, and supportive care. Her symptoms resolved during the evacuation flight. 2) A 23-yr-old man presented with dyspnea at rest 3 d after arriving without prophylactic treatments. He had a Sao2 of 49%, wheezes and crackles on lung exam, and interstitial infiltrates on chest X-ray. His treatment included oxygen, nifedipine, acetazolamide, and dexamethasone. His symptoms resolved during the evacuation flight. 3) A 40-yr-old man presented with dyspnea after a series of strenuous workouts since his arrival 5 d prior. He had a Sao2 of 41%, and his chest X-ray was consistent with high altitude pulmonary edema. He was treated with oxygen, nifedipine, and fluids before descent to sea level, where his symptoms fully resolved 4 d later.DISCUSSION: These patients illustrate that altitude illness may develop despite medical screening, participant education, and availability of prophylactic medications based on published guidelines. These cases could be attributed to noncompliance and misinformation, bringing to light some of the challenges with managing more diverse populations that deploy to remote environments.Rose JS, Law J, Scheuring R, Ramage MH, McKeith JJ. Serious altitude illness at the South Pole. Aerosp Med Hum Perform. 2020; 91(1):46–50.

Verbal and visuospatial executive functions in healthy elderly: The impact of education and frequency of reading and writing

ABSTRACT Objective: To assess the predictive role of education and frequency of reading and writing habits (FRWH) on the cognitive flexibility, inhibition and planning abilities of healthy elderly individuals. Methods: Fifty-seven healthy adults aged between 60 and 75 years with 2 to 23 years of formal education were assessed as to the frequency with which they read and wrote different types of text, as well as their number of years of formal education. Executive functions were evaluated using the Hayling Test and the Modified Wisconsin Card Sorting Test (MWCST). Results: Weak to moderate positive correlations were found between education, FRWH and the number of categories completed in the MWCST, while negative correlations were identified between these variables and the number of perseverative and non-perseverative errors on the task. Only the FRWH was significantly correlated with the number of failures to maintain set. Speed and accuracy on the Hayling Test were only correlated with participant education. Both education and FRWH significantly predicted performance on the MWCST, and the combination of these two variables had a greater predictive impact on performance on this task than either of the two variables alone. Variability in scores on the Hayling Test was best accounted for by participant education. Conclusion: In this sample of elderly subjects, cognitive flexibility was sufficiently preserved to allow for adequate performance on verbal tasks, but may have benefitted from the additional stimulation provided by regular reading and writing habits and by formal education in the performance of more complex non-verbal tasks.