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Background: Care partners (family and friends) for people living with Alzheimer's Disease and related dementias (ADRD) often provide care within a care network of both informal (e.g. family, friends) and formal (e.g. home aides, respite care) supports. Care networks can improve care but are often associated with increased communication and coordination demands. Technology interventions have potential to support care networks, but evidence is limited. This study explored care network use of a shared communication platform to identify care partner's perceptions of the platform's usefulness. Method: This study used data from a feasibility trial for CareVirtue, a web application designed to support care partners in storing and sharing information with members of their network. Fifty‐one care networks comprised of a primary care partner and other network members (N = 61) in California and Wisconsin used CareVirtue for 60 days and completed a post‐trial semi‐structured interview. This analysis focused on CareVirtue's journal feature, which allows users to share daily experiences through written posts published to a newsfeed that care network members can view and comment on. We exported the text of these journal entries and conducted team‐based content analysis. We performed a thematic analysis on interview transcripts to identify themes related to the journal's usefulness. Result: In total 2,535 journal entries from 51 primary care partners (75% female, mean age = 60 years old, 55% children of care recipient, 40% spouses) and their care network were analyzed. Journal entries: We identified four categories of communication and coordination activities: 1) information acquisition in which care network members sought updates; 2) information sharing including tracking behaviors, symptoms, and daily activities; 3) strategy development in which care network members used two‐way communication to co‐create care solutions; and 4) feedback including affirmation, empathy, gratitude, confirmation, and information exchange. Interviews: We identified three journal usefulness themes: individual level usefulness including tracking information and therapeutic benefits; network level usefulness including facilitating collaboration; and relational usefulness including increased situational awareness and feeling seen as a care partner. Conclusion: The CareVirtue journal facilitated communication across the care network and also enabled self‐exploration, heightened awareness, and collaborative strategy development among the care network. [ABSTRACT FROM AUTHOR]

Objectives: In the German National Cohort (GNC), 30,000 individuals are examined with whole-body MRI (wbMRI), of which about 3000 participants are expected to receive an incidental finding (IF) disclosure. In order to get feedback from participants and to evaluate the IF-management procedure of the wbMRI substudy, a follow-up questionnaire was developed. This single-center pilot trial was aimed to get a first impression on feasibility reproducibility and validity of such a survey in order to take necessary adjustments before initiating the survey among several thousand participants.Methods: The questionnaires were sent out in test-retest manner to 86 participants who received a wbMRI examination in January-February 2016 at the imaging center in Neubrandenburg. The ratio of participants with and without IF notification was 1:1. Descriptive statistics was performed.Results: A first response of 94% and completion proportion of 99% were achieved. Participants were satisfied with the examination procedure. Ninety-five percent of participants considered it very important to receive notification of IFs. Participants reported minimal stress levels while waiting for a possible IF notification letter, but high stress levels when an IF letter was received. Phrasing of the IF reports was rated in 97% as well understandable and in 55% as beneficial to health status.Conclusions: This questionnaire will serve researchers within the GNC as a fundamental instrument not only for quality management analyses but also for the investigation of still unacknowledged scientific and ethical questions contributing to evidence-based guidelines concerning the complex approach to IFs in future population-based imaging.Key Points: • Evidence-based guidelines for reporting incidental findings in population whole-body MRI are lacking. • Pilot-testing of a questionnaire for the evaluation of practical and ethical aspects of the procedure to report incidental findings in the German National Cohort shows a high level of acceptance and high return rate by participants. • Participants reported minimal stress levels while waiting for a possible incidental finding notification letter, which increased significantly, when such a letter was received. [ABSTRACT FROM AUTHOR]

Background and Objectives Facilitating older adults' successful hospital-to-home transitions remains a persistent challenge. To address this challenge, we applied a systems lens to identify and understand the performance-shaping factors (PSFs) related older adults' hospital-to-home transition success. Research Design and Methods This study was a secondary analysis of semi-structured interviews from older adults (N = 31) recently discharged from a hospital and their informal caregivers (N = 13). We used a Human Factors Engineering approach to guide qualitative thematic analysis to develop four themes concerning the system conditions shaping hospital-to-home transition success. Results The four themes concerning PSFs were: (a) the hospital-to-home transition was a complex multiphase process—the process unfolded over several months and required substantial, persistent investment/effort; (b) there were unmet needs for specialized tools—information and resources provided at hospital discharge were not aligned with requirements for transition success; (c) alignment of self-care routines with transition needs—pre-hospitalization routines could be supportive/disruptive and could deteriorate/be re-established; and (d) changing levels of work demand and capacity during the transition—demand often exceeded capacity leading to work overload. Discussion and Implications Our findings highlight that the transition is not an episodic event, but rather a longitudinal process extending beyond the days just after hospital discharge. Transition interventions to improve older adults' hospital-to-home transitions need to account for this complex multiphase process. Future interventions must be developed to support older adults and informal caregivers in navigating the establishment and re-establishment of routines and managing work demands and capacity during the transition process. [ABSTRACT FROM AUTHOR]

Background Middle-aged and older adults requiring skilled home healthcare ('home health') services following hospital discharge are at high risk of experiencing suboptimal outcomes. Information management (IM) needed to organise and communicate care plans is critical to ensure safety. Little is known about IM during this transition. Objectives (1) Describe the current IM process (activity goals, subactivities, information required, information sources/targets and modes of communication) from home health providers' perspectives and (2) Identify IMrelated process failures. Methods Multisite qualitative study. We performed semistructured interviews and direct observations with 33 home health administrative staff, 46 home health providers, 60 middle-aged and older adults, and 40 informal caregivers during the preadmission process and initial home visit. Data were analysed to generate themes and information flow diagrams. Results We identified four IM goals during the preadmission process: prepare referral document and inform agency; verify insurance; contact adult and review case to schedule visit. We identified four IM goals during the initial home visit: assess appropriateness and obtain consent; manage expectations; ensure safety and develop contingency plans. We identified IM-related process failures associated with each goal: home health providers and adults with too much information (information overload); home health providers without complete information (information underload); home health coordinators needing information from many places (information scatter); adults' and informal caregivers' mismatched expectations regarding home health services (information conflict) and home health providers encountering inaccurate information (erroneous information). Conclusions IM for hospital-to-home health transitions is complex, yet key for patient safety. Organisational infrastructure is needed to support IM. Future clinical workflows and health information technology should be designed to mitigate IM-related process failures to facilitate safer hospital-to-home health transitions. [ABSTRACT FROM AUTHOR]

Abstract A thorough understanding of the relationship between the biological and mechanical functions of articular cartilage is necessary to develop diagnostics and treatments for arthritic diseases. A key step in developing this understanding is the establishment of models which utilize large numbers of biomarkers to create comprehensive models of the interplay between cartilage biology and biomechanics, which will more accurately demonstrate the complex etiology and progression of tissue adaptation and degradation. It is the goal of this study to demonstrate the ability of artificial neural networks (ANNs) to utilize biomarkers to create predictive models of articular cartilage biomechanics, which will provide a basis for more sophisticated research in the future. Osteochondral plugs were collected from patients undergoing total knee arthroplasty, cultured, then analyzed to collect proteomic, compositional, and histologic biomarker data. Samples were subjected to stress relaxation testing as well as computational simulations using finite element analysis (FEA) modeling and optimization to determine key mechanical properties. The acquired data was fed into an ANN to generate a model which predicts the biomechanical properties of cartilage from given biomarkers. Using all significant inputs, the developed neural network predicted the ground substance modulus with a moderate degree of accuracy, but had difficulty predicting the collagen fiber modulus and cartilage permeability. Using only clinically attainable biomarkers, the best-performing model produced comparably accurate and more consistent predictions of all three mechanical properties. These models demonstrate the potential for ANNs to be included in clinical studies of articular cartilage. [ABSTRACT FROM AUTHOR]

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Women and racial/ethnic minority dementia caregivers have unique caregiving experiences and support needs. To ensure the identification of potentially important differences in outcomes within these groups, the amended National Institutes of Health (NIH) Policy on Inclusion of Women and Minorities mandates reporting by gender and race/ethnicity. The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. A focused systematic literature review of studies published from 1994 to 2015 located 48 articles meeting inclusion criteria. The majority of studies included women and racial/ethnic minorities; however, 67% did not report results by gender or racial/ethnic group. Acknowledgment of underreporting was more common for race/ethnicity than gender. Our findings suggest limited NIH guideline compliance that may reflect a lack of awareness regarding potential gender disparities in caregiving roles. Ensuring NIH guideline compliance necessitates shared investments from researchers, editors, and reviewers to ensure group differences are systematically identified and reported. [ABSTRACT FROM AUTHOR]

The objectives of this research were to (1) explore whether goal-activation models of procedurally based interrupted task performance can be applied to content production, and if not, (2) develop a new theoretical account, and (3) provide support for that theory. Experiment 1 found that interruptions during planning resulted in less developed plans, and that available theoretical models could not account for performance. Experiment 2 leveraged Verbal Protocol Analysis to explore the cognitive mechanisms underlying interrupted task performance on a content production task. We found support for a combination of processes: (1) cues and environmental context, and (2) task activation levels. These results suggested a spreading activation account of interrupted task performance. Experiment 3 provided further support for spreading activation by comparing short and long interruptions. These results have broad implications for moving our understanding of interrupted task performance forward by expanding our understanding to non-procedural task performance. [ABSTRACT FROM PUBLISHER]

Background: People living with Alzheimer's Disease or related dementias (ADRD) and their care partners (e.g. family, friends) experience legal and financial planning challenges. Technology‐based interventions have the potential to mitigate these challenges. However, care partners have reported discontinuing use of currently available technology‐based interventions because they did not align with their needs, were not relevant, or were not available when needed. This persistent need for solutions personalized to care partner needs can be met through participatory design (PD), which engages end users in collaborative design exercises. Our objectives were to conduct PD with ADRD care partners to design a web‐based financial and legal planning prototype that meets care partner needs. Method: We enrolled two groups of designers (n = 5/group). Participants were recruited nationally through community partners. We used phone screenings to confirm that participants were self‐identified current or former care partners of someone living with ADRD, had internet access, were 18 or older, and spoke English. Design teams will complete 5 co‐design sessions across 6 months, with at least 4 weeks between each design session. Sessions 1‐3 have focused on problem identification, generating solutions, and solution convergence. Sessions 4 and 5 will focus on prototyping and evaluating the final prototype. Team members individually reviewed design session recordings to extract key design requirements. Discrepancies were resolved through consensus discussion. Result: Participants (n = 10) cared for a spouse (80%) and were from Wisconsin, Texas, and California. Sessions 1‐3 generated 8 key design requirements. Participants wanted a tool that would help them 1) Learn, including learning new information; 2) Organize, including organizing existing information; 3) Act, including executing to‐do lists; and 4) Connect, including gaining access to existing resources. Participants wanted a tool characterized by 5) Privacy, including keeping their information safe; 6) Flexibility, including addressing their unique needs; 7) Peace of mind, including feeling in control of their responsibilities; and 8) Sustainability, including tool helpfulness over time. Conclusion: The results of the first three design sessions shed light on current unmet needs of ADRD caregivers, and can guide the development of financial and legal planning technologies for ADRD care partners. [ABSTRACT FROM AUTHOR]