End-of-life care is paramount in maintaining the quality of life of the terminally ill, protecting them from unnecessary treatment, and controlling costs incurred in their care. Training doctors to be effective end-of-life caregivers begins in medical school. A survey design was used to collect data from 166 first-year medical students before and after exposure to hospice or palliative care through an early clinical exposure program. Data demonstrated that students had a significant change in attitude scores after the observational experience (P < .05). Providing students with the opportunity to observe and participate in end-of-life care has a positive effect on attitudes toward the care of dying persons. We recommend that direct exposure to end-of-life care practices be incorporated early in the medical school curriculum.
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http://dx.doi.org/10.1177/1049909113505760 | DOI Listing |
Background: The autophagy lysosomal pathway (ALP) and the ubiquitin-proteasome system (UPS) are key proteostasis mechanisms in cells, which are dysfunctional in AD and linked to protein aggregation and neuronal death. Autophagy is over activated in Alzheimer's disease brain whereas UPS is severely impaired. Activating autophagy has received most attention, however recent evidence suggests that UPS can clear aggregate proteins and a potential therapeutic target for AD and protein misfolding diseases.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, U.S.A., Philadelphia, PA, USA.
Background: This study investigates the therapeutic versus side effects of intranasal lithium chloride (LiCl) in Ryanodex formulation vehicle (RFV) to inhibit inflammation and pyroptosis and to ameliorate on cognitive dysfunction and depressive behavior in 5XFAD mice.
Method: 5XFAD and wild type (WT) B6SJLF1/J mice were treated with intranasal or oral LiCl (3 mM/kg) dissolved in RFV starting at 2 or 9 months old and the continuous treatment lasted for 12 weeks. Behavior was examined for depression, cognition, olfaction, and motor function at the ages of 5 or 12 months.
Alzheimers Dement
December 2024
ivision of Cognitive Neuroscience, John's Hopkins University School of Medicine, Baltimore, MD, USA.
Background: People living with dementia (PwD) experience progressive functional decline with increasing dependence on their caregivers. Advanced care planning (ACP) has the potential to promote quality of life, reduce iatrogenic harm, and minimize overutilization of healthcare resources, yet planning ahead in the context of dementia is challenging and requires consideration of numerous factors over an extended period of time. We examined caregivers' perceptions of current and end-stage medical care preferences in PwD and the impact of ACP-related discussions between caregivers and PwD.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of New Hampshire, Durham, NH, USA.
Background: Resource-constrained rural areas face significant challenges in providing access to healthcare resources, especially for older adults, including those living with Alzheimer's disease and related dementia (ADRD). We seek to address these gaps by equipping six rural community sites in New Hampshire and Maine with tele-rehabilitative equipment. Libraries and community centers that serves youth and older adults, vital in rural communities, are identified as key partners to advance digital health literacy, equity, and telemedicine services for older adults including those living with ADRD, with the University of [blind for review] Center for Digital Health Innovation (CDHI).
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Pennsylvania, Philadelphia, PA, USA.
Background: Within the dementia space, many caregivers lack understanding of hospice care and may not be well prepared for transition to hospice. Nonetheless, few studies have explored hospice transition specifically from the perspective of caregivers for persons with dementia and how it impacts their mental health. In this study, we aimed to examine caregivers' mental health indicators and their correlation structure based on the timing of hospice transition.
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