We will study how well the relatively new FDA approved pneumonia vaccine can protect older renal transplant recipients against pneumococcal illness. We will specifically study the group of renal transplants in whom the cause of renal failure was either diabetes mellitus II and/or hyoertension. We will compare the findings against those we find in younger renal transplant recipients, older healthy individuals and older persons with diabetes but normal kidney function. Healthy younger individuals will serve as controls for optimal vaccine response.
The overall goal of this feasibility study is to test an individualized, nurse-led behavioral health program that leverages home telehealth technology to directly teach low and fixed income older adults residing in the community to reduce their pain and fatigue by improving mobility through strength and balance training in the context of a complementary mental health intervention to address motivation and social support. Specifically, the integrated intervention includes components to address (1) balance and fall prevention (Otago), (2) strengthening and mindfulness (Yoga), and importantly, (3) affective state and social support which are crucial to maintaining motivation (Behavioral Activation). Moreover, these 3 best practices interventions will be enhanced by integrating physical activity data tracking to complement self-report measures, the former of which will be available in real time for patient and provider review, with parameter violations (eg, non-activity during scheduled activity time; overall activity level lower for a set period of time) triggering brief telehealth sessions to address any problems. Finally, participant qualitative feedback will be captured through voice/video recorded diaries focusing on experienced pain, fatigue, sleep, personal reactions to the project and physical activity as well as technology issues they may encounter.
After stroke, it is common for individuals to experience hand impairment. This deficit can severely restrict functional ability and independence. Recovery of hand function following stroke is highly variable. In this study, we will use brain imaging to predict individual response to treatment after only one therapy session. Survivors of stroke will receive upper extremity therapy with a novel intervention using a smart watch. The device applies imperceptible vibration to the wrist and has been shown to immediately improve chronic stroke survivors' touch sensation and hand dexterity in preliminary studies.
The purpose of this study is to understand how networks in the brain change over time. Participants will have 2 study visits (about 2 years apart) where they will undergo tests to assess mental function, fill out questionnaires, and undergo a brain MRI. At the first visit only, participants will also undergo a blood draw and a PET scan.
Participants are required to have a Co-Participant accompany them. This individual must be a reliable informant that has contact with the participant at least once per week.
Older adults typically have trouble identifying the speech they hear, especially in noisy environments. Fortunately, compared to younger adults, older adults are better able to compensate for difficulties identifying the speech they hear by recruiting the visual system. However, the extent to which older adults can benefit from visual input, and how this influence relates to age-related changes in brain structure and function, have not been thoroughly investigated. The general purpose of this study is to determine how age-related changes in brain structure and function affect how well people hear and see. This study seeks participants with normal hearing to mild hearing loss, who also have normal or corrected-to-normal vision.
This study examines eye movements and the pupil's response to light in progressive supranuclear palsy (PSP), comparing to Parkinson's disease and control subjects without neurological disease. Computerized measures of eye movements and pupil changes will be used. Subjects will also receive an eye exam to rule out other eye diseases. The goal of this study is to use subtle changes in eye movements and the pupil's response to light for earlier diagnosis of PSP.
Post-stroke hand impairment is highly prevalent and severely restricts functional ability and independence. Yet, there is no assistive device to help hand function at home, every day, during activities of daily living. This study addresses this gap by providing an innovative technology. The "TheraBracelet" is a wristband applying imperceptible white-noise vibration to skin. TheraBracelet is efficacious, as it has been shown to immediately improve chronic stroke survivors' touch sensation and hand dexterity in preliminary studies. TheraBracelet is affordable by using only a low-cost vibrator. TheraBracelet is also translational, because a vibrator strategically placed at the wrist does not interfere with dexterous finger motions, and it is low-risk by involving only imperceptible vibration on skin. These practicalities assure easy adoption in home environment for large impact on sensorimotor impairment. This study is to determine the feasibility and safety of using this assistive device all day every day for a month during daily activity, and to determine if TheraBracelet's instant effects are sustained during prolonged use. This objective will be accomplished in a double-blinded, randomized, controlled, crossover design study. Feasibility (compliance of using the device everyday) and safety will be assessed for the treatment condition compared to the control condition (wearing the device without vibration) through weekly evaluations. In addition, TheraBracelet's instant benefits in improving hand function will be assessed weekly. Persistence of TheraBracelet's instant benefits across all weekly evaluations will support durability (i.e. desensitization to vibration does not occur during extended daily use over a one-month period). This project is expected to lead to an assistive wristband that increases hand function during activities of daily living, thus increasing independence and quality of life and reducing caregiver burden for a large number of stroke survivors with hand impairment.
Low vitamin d levels are common among patients undergoing orthopedic surgery. However, very little is known about how vitamin d affects outcomes in patients undergoing total joint replacement surgery. Our study will look at how common low vitamin d status is among patients undergoing total hip and total knee replacement surgery. We will also look at how vitamin d levels affect complication rates and hospital readmission rates.