Medicine and Health Sciences Commons^™

Finding A Good Fit: Tips On Hiring Rural Personal Assistants, Rayna A. Sage, Krys Standley

Health and Wellness

Living in rural areas means being part of close communities. For people with disabilities in these areas, Personal Assistance Services (PAS) help them live on their own. But finding good PAS workers in rural places can be hard. To help you pick the right PAS worker, we explored what traits make them a good fit.

Project Dig Summary Report, Tracy Boehm Barrett, University Of Montana Rural Institute

Health and Wellness

People with intellectual and developmental disabilities (IDD) are commonly overlooked in society because of a combination of social, economic, political, and cultural barriers. Due to such constraints, they also experience a wide range of health and community disparities that result in negative impact on their quality of life and well-being (Mpofu et al., 2020; Akyurek & Bumin, 2017). While many community-based organizations provide a variety of supports for people with disabilities, far less common are those providing therapeutic horticulture (TH) programs within the scope of their services. This report provides information about and recommendations for TH as an increased practice …

Creating Rural Community Outreach Materials Related To Covid-19 And Disability, University Of Montana Rural Institute

Health and Wellness

RTC:Rural researchers led by Andrew Myers present best practices in rural COVID-19 outreach based on feedback from regional rural disability leaders.

Research Report: Social Isolation And Loneliness Experiences Among People With Disabilities Before And During Covid-19, University Of Montana Rural Institute

Health and Wellness

Increased risk and fear of exposure to COVID-19 may impact social isolation and loneliness among vulnerable populations who are disproportionately at risk of COVID-19 complications, like people with disabilities. In a previous report, research findings showed people with disabilities experienced more than double the rates of social isolation and loneliness compared to those without disabilities before the COVID-19 pandemic. While recent data indicates rates of social isolation and loneliness have increased for the general population with the onset of the COVID-19 pandemic, less is known how rates of social isolation and loneliness have shifted for people with disabilities. Data in …

Social Isolation And Loneliness Among Rural And Urban People With Disabilities, University Of Montana Rural Institute

Health and Wellness

Social connection is the experience of interacting with and feeling connected to other people. A lack of social connections can lead to social isolation and loneliness. Social isolation is an objective measure based on a limited number of social connections. Loneliness is the perception of being isolated or feeling alone. Both social isolation and loneliness are associated with adverse physical and mental health outcomes. Researchers used data from two national surveys to understand the experiences of social isolation and loneliness among people with disabilities. Findings indicate people with disabilities report higher rates of social isolation and loneliness than people without …

People With Disabilities Still At Risk In Congregate Care Settings, University Of Montana Rural Institute

Health and Wellness

This report provides an analysis of data to better understand where cases and deaths are rising in nursing homes as of August 8 2021. We hope this analysis can help support local community planning and networking among rural partners to improve outcomes.

• COVID-19 cases among residents and staff are on the rise in nursing homes with the steepest increases in urban areas and in the South and Midwest.
• Disabled people are disproportionately overrepresented in the resident populations of unsafe congregate settings, such as nursing homes.
• Vaccination rates across both residents and staff in nursing homes have stagnated.
• Policy priorities should …

America At A Glance: Covid-19 Vaccination Among People With Disabilities, University Of Montana Rural Institute

Health and Wellness

There is a lack of foucs on how people with disabilities are experiencing COVID-19 vaccination efforts. Addressing this knowledge gap is critical to ensuring that people with disabilities are considered as vaccination efforts progress during the ongoing pandemic and future health crises. Overall, 19% of our sample of people with disabilities reported already being vaccinated, 56% wanted to get vaccinated, 10% were unsure, and 15% did not want to be vaccinated. Rural residents with disabilities reported higher rates of current vaccination, but higher rates of overall hesitancy, and more barriers to vaccination than urban residents with disabilities. Political party affiliation …

Leucine Carboxyl Methyltransferase 1 Overexpression Protects Against Cognitive And Electrophysiological Impairments In Tg2576 App Transgenic Mice, Madhumathi Gnanaprakash, Agnieszka Staniszewski, Hong Zhang, Rose Pitstick, Michael P. Kavanaugh, Ottavio Arancio, Russell E. Nicholls

Biomedical and Pharmaceutical Sciences Faculty Publications

Background: The serine/threonine protein phosphatase, PP2A, is thought to play a central role in the molecular pathogenesis of Alzheimer’s disease (AD), and the activity and substrate specificity of PP2A is regulated, in part, through methylation and demethylation of its catalytic subunit. Previously, we found that transgenic overexpression of the PP2A methyltransferase, LCMT-1, or the PP2A methylesterase, PME-1, altered the sensitivity of mice to impairments caused by acute exposure to synthetic oligomeric amyloid-β (Aβ).

Objective: Here we sought to test the possibility that these molecules also controlled sensitivity to impairments caused by chronically elevated levels of Aβ produced in vivo. …

Supplemental Ascorbate Diminishes Dna Damage Yet Depletes Glutathione And Increases Acute Liver Failure In A Mouse Model Of Hepatic Antioxidant System Disruption, Colin G. Miller, Jean A. Kundert, Justin R. Prigge, Julie A. Amato, Allison E. Perez, Lucia Coppo, Gabrielle N. Rizzo, Michael P. Kavanaugh, David J. Orlicky, Colin T. Shearn, Edward E. Schmidt

Biomedical and Pharmaceutical Sciences Faculty Publications

Cellular oxidants are primarily managed by the thioredoxin reductase-1 (TrxR1)- and glutathione reductase (Gsr)-driven antioxidant systems. In mice having hepatocyte-specific codisruption of TrxR1 and Gsr (TrxR1/Gsr-null livers), methionine catabolism sustains hepatic levels of reduced glutathione (GSH). Although most mice with TrxR1/Gsr-null livers exhibit long-term survival, ~25% die from spontaneous liver failure between 4- and 7-weeks of age. Here we tested whether liver failure was ameliorated by ascorbate supplementation. Following ascorbate, dehydroascorbate, or mock treatment, we assessed survival, liver histology, or hepatic redox markers including GSH and GSSG, redox enzyme activities, and oxidative damage markers. Unexpectedly, rather than providing protection, ascorbate …

Creating Educational Opportunities For Independent Living Through Participatory Curriculum Development: A Toolkit For Centers For Independent Living, University Of Montana Rural Institute

Health and Wellness

This toolkit is an introduction for staff at centers for independent living (CILs) and their community partners who are interested in developing curriculums or trainings that meet the unique needs and goals of Independent Living. It provides instructions and guidance on how to use Participatory Curriculum Development (PCD) to create new ways of supporting Independent Living skills education and development.

This toolkit is for those who can commit to working collaboratively with consumers and other stakeholders to address an Independent Living service gap or training need.

Healthy Community Living: An Update On Outcomes, Craig Ravesloot Ph.D., Tracy Boehm Barrett, Tannis Mardece Hargrove, Justice Ender, Mary Willard, University Of Montana Rural Institute

Health and Wellness

The Healthy Community Living (HCL) program combines independent living skills training with health promotion to support self-determination and health status of adults with disabilities. It includes two workshop curricula, Community Living Skills and Living Well in the Community. Each of these provides a framework for workshop participants to increase peer support while building their individual capacity to live independently and maintain their health. The HCL Program weaves consumer choice and control throughout all of the workshop sessions by guiding consumers to identify their own goals, intentions, and process for reaching them. These workshops can be conducted in face-to-face groups or …

Engaging Stakeholders To Address Changing Service Delivery Conditions Due To Covid-19, University Of Montana Rural Institute

Health and Wellness

The COVID-19 pandemic forced organizations working in the field of disability research and program development to adapt when in-person services were suspended at Centers for Independent Living (CILs). One way this adaption occurred was by embracing collaborative problem-solving using a participatory curriculum development (PCD) approach. PCD requires consistent and continued stakeholder engagement. These practices align with Knowledge translation (KT) in that KT requires continued investment to adapt to the ever-changing contexts for which interventions are originally designed.

Prion Protein Lowering Is A Disease-Modifying Therapy Across Prion Disease Stages, Strains And Endpoints, Eric Vallabh Minikel, Hien T. Zhao, Jason Le, Jill O'Moore, Rose Pitstick, Samantha Graffam, George A. Carlson, Michael P. Kavanaugh

Biomedical and Pharmaceutical Sciences Faculty Publications

Lowering of prion protein (PrP) expression in the brain is a genetically validated therapeutic hypothesis in prion disease. We recently showed that antisense oligonucleotide (ASO)-mediated PrP suppression extends survival and delays disease onset in intracerebrally prion-infected mice in both prophylactic and delayed dosing paradigms. Here, we examine the efficacy of this therapeutic approach across diverse paradigms, varying the dose and dosing regimen, prion strain, treatment timepoint, and examining symptomatic, survival, and biomarker readouts. We recapitulate our previous findings with additional PrP-targeting ASOs, and demonstrate therapeutic benefit against four additional prion strains. We demonstrate that <25% PrP suppression is sufficient to extend survival and delay symptoms in a prophylactic paradigm. Rise in both neuroinflammation and neuronal injury markers can be reversed by a single dose of PrP-lowering ASO administered after the detection of pathological change. Chronic ASO-mediated suppression of PrP beginning at any time up to early signs of neuropathology confers benefit similar to constitutive heterozygous PrP knockout. Remarkably, even after emergence of frank symptoms including weight loss, a single treatment prolongs survival by months in a subset of animals. These results support ASO-mediated PrP lowering, and PrP-lowering therapeutics in general, as a promising path forward against prion disease.

America At A Glance: Social Isolation And Loneliness During The First Wave Of Covid-19, University Of Montana Rural Institute

Health and Wellness

Social isolation and loneliness are a public health concern because they are associated with poor mental and physical health outcomes and mortality. To learn more about how COVID-19 and related responses (i.e. stay-at-home orders) may contribute to feelings of social isolation and loneliness among people with disabilities, we compared data from two cross-sectional samples collected before and after the first wave of “stay-at-home” orders. Post-COVID rural and urban samples reported significantly more interactions with family and close friends. Post-COVID urban respondents reported significantly lower rates of feeling left out, while the post-COVID rural respondents reported similar rates.

America At A Glance: Covid-19 And Disability In Rural Areas, Rtc: Rural, University Of Montana Rural Institute

Health and Wellness

To learn more about COVID-19 impacts on rural people with disabilities, we conducted a survey in late April/early May to explore rural and urban differences in COVID-19 health risks, adherence to public health recommendations, and trust in different information sources. We focused on people with disabilities because they often experience higher rates of secondary health conditions that place them at heightened risk of COVID-19 complications. Summary findings: Rural respondents reported higher rates of COVID-19 health risk factors, but less adherence to public health recommendations. Overall, individuals with health risk factors reported adopting fewer public health recommendations than individuals without health …

Reduced Expression Of The Pp2a Methylesterase, Pme-1, Or The Pp2a Methyltransferase, Lcmt-1, Alters Sensitivity To Beta-Amyloid-Induced Cognitive And Electrophysiological Impairments In Mice, Agnieszka Staniszewski, Hong Zhang, Kesava Asam, Rose Pitstick, Michael P. Kavanaugh, Ottavio Arancio, Russell E. Nicholls

Biomedical and Pharmaceutical Sciences Faculty Publications

Beta-amyloid (Ab) is thought to play a critical role in Alzheimer’s disease (AD), and application of soluble oligomeric forms of Ab produces AD-like impairments in cognition and synaptic plasticity in experimental systems. We found previously that transgenic overexpression of the PP2A methylesterase, PME-1, or the PP2A methyltransferase, LCMT-1, altered the sensitivity of mice to Ab-induced impairments, suggesting that PME-1 inhibition may be an effective approach for preventing or treating these impairments. To explore this possibility, we examined the behavioral and electrophysiological effects of acutely applied synthetic Ab oligomers in male and female mice heterozygous for either a PME-1 KO or …

Aca And Medicaid Expansion Associated With Increased Insurance Coverage For Rural Americans With Disabilities, Rtc: Rural, University Of Montana Rural Institute

Health and Wellness

This fact sheet explores insurance rate changes associated with the Affordable Care Act (ACA) and Medicaid expansion on insurance coverage for rural and urban people with and without disabilities. Following the implementation of the ACA, rural people with disabilities had the greatest gains in insurance coverage. Rural people with disabilities in Medicaid expansion states saw a 10.7% increase in insurance coverage, compared to a 5.3% increase for those in non-expansion states. The loss of the ACA and Medicaid expansion could hurt rural people with disabilities more than their urban counterparts, or those without disabilities.

Cocreating With Stakeholders Through Participatory Curriculum Development, University Of Montana Rural Institute

Health and Wellness

Participatory curriculum development (PCD) is an approach to forming a working relationship between researchers and decisionmakers. The purpose of this relationship is to work together to create products that benefit the people who use them. During the PCD process, the researchers receive feedback from the decisionmakers, or stakeholders, about how the products work and any changes that could be made to improve them. This approach is called integrated knowledge translation.

Modeling Of Excitatory Amino Acid Transporters And Clearance Of Synaptic Cleft On Millisecond Time Scale, Denis M. Shchepakin, Leonid Kalachev, Michael Kavanaugh

Biomedical and Pharmaceutical Sciences Faculty Publications

Excitatory Amino Acid Transporters (EAATs) operate over wide time scales in the brain. They maintain low ambient concentrations of the primary excitatory amino acid neurotransmitter glutamate, but they also seem to play a significant role in clearing glutamate from the synaptic cleft in the millisecond time-scale process of chemical communication that occurs between neurons. The detailed kinetic mechanisms underlying glutamate uptake and clearance remain incompletely understood. In this work we used a combination of methods to model EAAT kinetics and gain insight into the impact of transport on glutamate dynamics in a general sense. We derive reliable estimates of the …

Epigenetic Biomarkers For Alzheimer’S Disease Using A Transgenic Porcine Model, Yoon Hee Cho

University Grant Program Reports

Alzheimer’s disease (AD) is the most common cause of dementia, accounting for approximately 60~70% of dementia cases. AD afflicts more than 35.6 million individuals worldwide and is expected to increase to 65.7 million by 2030 and 115.4 million by 2050 ¹; AD is a serious public health problem that is causing increased health care costs worldwide. Typically, AD is a relentlessly progressive disorder that initially manifests as severe loss of memory, particularly episodic memory.² The disorder is not curable at present, and the mechanisms driving development of AD are not fully understood. Therefore, there is an urgent need …

Epigenetic Biomarkers For Mwcnt Exposure And Lung Disease, Yoon Hee Cho

University Grant Program Reports

Multi-walled carbon nanotubes (MWCNT) are engineered nano-materials being developed and used in a wide variety of medical, engineering, and personal products with many potential benefits [1]. However, MWCNT have been shown to cause significant pathological changes in animal models, particularly in the airways, raising the concern that adverse human health effects will emerge with increasing use and exposure to these materials [2-4]. Potential bioactivity of MWCNT, including in vitro and in vivo toxicity and increased inflammation and pathology, has been attributed to their unique physical and chemical characteristics such as length, diameter, contaminants and rigidity [5]. However, MWNCT toxicity and/or …

Survey Of Prescription Medication Disposal Practices In Older Patients, Kimberly A. Madson

University Grant Program Reports

The purpose of the proposed study was to survey participants on current medication disposal practices, and to gather preliminary data on the types of medications found in the home environment.

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Verifying Discharge Orders During Rural Transitions, Tom Seekins

Health and Wellness

Patients typically leave a hospital with numerous tasks that need to be performed in order to complete their treatment successfully. The discharge process is designed, in part, to describe the services a patient needs to secure or the tasks they need to perform in order to complete treatment and promote recovery once he or she gets home. Many of the orders or services planned should be implemented immediately or soon after discharge to be useful. Some involve additional medical treatment. Others may involve starting long-term services that address chronic conditions.

In this delicate transition, hospital staff may not convey the …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Developing A Local Health And Human Services Resource Bank For Rural Communities, Tom Seekins

Health and Wellness

Patients may have a wide range of needs when they are discharged from a regional hospital back home to a small town or rural community. Discharge planners and other staff at the regional referral hospital are seldom aware of the range of services and resources that a patient could use to facilitate their recovery close to home. Indeed, in our research, regional providers acknowledged that they lacked information about the many small towns they served in their catchment area. Patients, regional referral hospital staff, and small town providers all reported that this frequently led regional providers to refer patients to …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Building A Rural Transitions Network Between Regional Referral And Critical Access Hospitals, Tom Seekins, University Of Montana Rural Institute

Health and Wellness

Residents of rural and frontier counties experience significant disparities in healthcare access and outcomes when compared to their urban counterparts. The organization of health care delivery contributes significantly to these disparities. Simply put, rural residents can face many challenges when they have to go to a hospital in a distant city for treatment and then return home to recover. The transition back home is also problematic because discharge planning generally does not adequately account for limited access to care in rural areas. The specific aim of this research project was to ascertain rural patients’ actual experience of the discharge planning …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Conducting A Rural Transition Needs Assessment, Tom Seekins

Health and Wellness

Researchers have suggested that readmissions following hospital discharge might be reduced by providing additional resources to patients most likely to be re-hospitalized. They have suggested three broad approaches to assessing the likelihood of readmission and prioritizing patients for extra support. These approaches include: (1) medical risk, (2) personal capacity, and (3) environmental. While work on assessing medical risk and personal capacity has been reported, few researchers have explored the role of environmental factors.

We used the third approach, an environmental perspective, to develop and test a Rural Transition Needs Assessment. This process involved patients in assessing their practical needs for …

Validation Of Evidence-Based Fall Prevention Programs For Adults With Intellectual And/Or Developmental Disorders: A Modified Otago Exercise Program, Mindy Oxman Renfro, Donna B. Bainbridge, Matthew Lee Smith

Health and Wellness

Introduction: Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer’s disease and related dementias, cerebral vascular accident, or traumatic brain injury.

Background: Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to …

Secondary Data Analysis Of Informal Caregiving In A Medicare Population, Jean T. Carter

University Grant Program Reports

The purpose of the study is to describe the status of informal caregiving within a subset of the Medicare population that is receiving some of its health care in the home and patient outcomes associated with informal caregiving. Rural settings and medication issues will be a particular focus.

D-Serine Is A Substrate For Neutral Amino Acid Transporters Asct1/Slc1a4 And Asct2/Slc1a5, And Is Transported By Both Subtypes In Rat Hippocampal Astrocyte Cultures, Alan C. Foster, Jill Farnsworth, Genevieve Lind, Yong-Xin Lin, Jia-Ying Yang, Van Dang, Mahmud Penjwini, Veena Viswanath, Ursula Staubli, Michael Kavanaugh

Biomedical and Pharmaceutical Sciences Faculty Publications

N-methyl-D-aspartate (NMDA) receptors play critical roles in synaptic transmission and plasticity. Activation of NMDA receptors by synaptically released L-glutamate also requires occupancy of co-agonist binding sites in the tetrameric receptor by either glycine or D-serine. Although D-serine appears to be the predominant co-agonist at synaptic NMDA receptors, the transport mechanisms involved in D-serine homeostasis in brain are poorly understood. In this work we show that the SLC1 amino acid transporter family members SLC1A4 (ASCT1) and SLC1A5 (ASCT2) mediate homo- and hetero-exchange of D-serine with physiologically relevant kinetic parameters. In addition, the selectivity profile of D-serine uptake in cultured rat hippocampal …

Modeling Of Ambient Glutamate Concentration Measurement In The Mammalian Nervous System, Denis M. Shchepakin, Michael Kavanaugh, Leonid Kalachev

Biomedical and Pharmaceutical Sciences Faculty Publications

A neuron is an electrically excitable cell that processes and transmits information through electrical and chemical signals. Neurons connect and pass signals to other cells through the structure called synapse. We focus on synapses through which the signals are transferred by signaling molecules called neurotransmitters. One of the predominant excitatory neurotransmitters in the central nervous system of the mammals, including humans, is glutamate. It is directly or indirectly involved in most brain functions. However, the excessive stimulation of the glutamate receptors is toxic to neurons, therefore it is important to rapidly clear the glutamate from the extra-cellular space and keep …