Health

Tool to support long-distance caregivers gets NIH funding boost

Eri Furukawa — Sat, 18 Feb 2023 01:13:24 +0000

Tool to support long-distance caregivers gets NIH funding boost

Interactive platform offers real-time, bird’s-eye view of older adults living with cognitive decline

Eri Furukawa February 17, 2023 Rebecca Badeaux

February 17 is National Caregivers Day

The day honors individuals who selflessly provide personal care, and physical and emotional support to those who need it most.

(SACRAMENTO) More than four million Americans provide care for a relative who lives an average of 450 miles away. According to the National Alliance for Caregiving, that equates to 15% of the approximately 44 million caregivers. That number is expected to grow in the coming years.

UC Davis Health neuropsychologist Alyssa Weakley knows the challenges all too well. In 2019, her grandmother developed Alzheimer’s disease while living in Southern California. Weakley and the rest of her family lived in Northern California and Washington state, a reality that proved to be guilt and anxiety-producing.

“Beyond issues of safety, I was concerned about her ability to remember to go to doctor appointments or connect with friends, activities that would result in a decline in her independence and quality of life,” Weakley explained. “I was also very worried that we would not know when it was time to get her the help she needed.”

Increasing need sparks innovative solution

The pandemic showed us that connection was possible through technology. But Zoom, Skype and Facetime are no substitute for in-person contact when assessing and managing a loved one’s mental and physical state.

“The population of older adults with cognitive impairment is rapidly expanding,” Weakley explained. “There is a need for enabling technologies to provide remote care and reduce the burden on family caregivers and the health system in general.”

The I-Care platform connects older adults with cognitive impairment to their long-distance caregivers.

To address this need, Weakley has developed Interactive Care, or I-Care. The unique web-based platform connects caregivers who live apart from care recipients with mild cognitive impairment and early-stage Alzheimer’s disease. The goal is to help long-distance caregivers monitor, support and engage in their loved one’s everyday activities. This includes remotely setting medication reminders and motivating them to set and track brain health goals such as exercising.

“The ability to follow and communicate between caregiver and the person struggling with cognitive impairment is critical to sustaining independence,” said Charles DeCarli, director of the Alzheimer's Disease Research Center. “Making it possible to both monitor and support someone with cognitive impairment, particularly in the early stages of the disease, can make a huge difference to their health, safety and quality of life.”

After field testing and refining the computer-based program based on users’ experiences, Weakley now moves into the next phase of her project: unobtrusive sensors to monitor the in-home behavior of care recipients.

Weakley's related research recently got a funding boost from the National Institutes of Health/National Institute on Aging. Weakley was awarded a five-year $900,000 Mentored Patient-Oriented Research Career Development Award, known as a K23, to develop an accessible and innovative intervention to enhance I-Care use and the caregiver-care receiver relationship. In her application, Weakley noted that to her knowledge, no research has utilized a co-design approach for technology training that encapsulates remote caregiver and care receiver needs.

Weakly also was recently awarded a one-year, $60,000 pilot grant from the Center for Information Technology Research in the Interest of Society and the Banatao Institute (CITRIS) at the University of California to move this research forward.

There is a need for enabling technologies to provide remote care and reduce the burden on family caregivers and the health system in general.

—Alyssa Weakley, neuropsychologist and researcher

“Our team is going to develop markers for a variety of important everyday activities, so we can detect whether there is deviation in normal patterns,” Weakley explained. “Those changes may suggest a change in cognition or that the care recipient is becoming ill, which could require more attention from their caregiver.”

Innovation can increase communication and ease isolation

Weakley leads a multicampus, interdisciplinary team. Shijia Pan, an electronic and computer engineer from UC Merced, has developed brick-sized vibration sensors that will be placed throughout the home. They’ll be located in areas such as kitchen and bathroom counters or bedroom and hallway floors. Hao-Chuan Wang, a computer scientist from UC Davis, uses machine-learning to create an interactive visualization tool.

The technology gives caregivers a birds-eye view of what’s going on inside the home without intrusion. While older adults are typically accepting of unobtrusive monitoring, they are less accepting of invasive monitoring such as microphones or cameras, especially in the bedroom and shower, which these new sensors can access.

A sensor can precisely quantify the type and quality of an activity. For example, it can determine if a person is washing their hands and forgot to use soap. It can tell if the water temperature of a shower is too hot, a common problem in the dementia population, given reduced sensitivity to temperature. The research team hopes to extend this work to detect other important daily activities such as medication taking, including whether they took the correct dosage.

I-Care helps long-distance caregivers monitor loved ones’ everyday activities through a web-based platform and in-home monitors.

“One of the big goals of I-Care is to help build a relationship that is harder to obtain when people live in two separate locations. We believe this addition of behavioral monitoring will help foster further communication, reduce the sense of isolation and loneliness and lead to improved care,” Weakley said.

By detecting deviations that may signal a change in cognition, it also has the potential to prompt an intervention before the need for care reaches a crisis, which can be debilitating and expensive.

Weakley plans to pilot I-Care with the vibration sensors this spring and summer. She hopes additional grant funding and donor support to the Healthy Aging in a Digital World initiative ultimately bring the solution to market. It’s a tool Weakley says would have helped when long-distance caring for her grandmother, who has since moved to Sacramento.

“I believe that I-Care would have allowed my grandma to stay in her home longer, enriched our connection, guided our decisions about care needs and reduced family tension,” Weakley added.

Media Resources

Rebecca Badeaux
rrbadeaux@ucdavis.edu
Phone: 916-751-0443
Fax: 916-452-2112

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California’s ‘red flag’ law utilized for 58 threatened mass shootings

Anonymous — Tue, 07 Jun 2022 16:37:18 +0000

California’s ‘red flag’ law utilized for 58 threatened mass shootings

Researchers looked at case details for the first three years of California’s Gun Violence Restraining Order law

(not verified) June 07, 2022

(SACRAMENTO) In the wake of the shooting in Uvalde, Texas, that left 19 children and two teachers dead, legislators in Washington, D.C., and across the country are debating “red flag” laws or extreme risk protection orders (ERPOs).

Known as gun violence restraining orders (GVROs) in California, extreme risk protection orders exist in 19 states and the District of Columbia.

A new study from the Violence Prevention Research Program at UC Davis examines case details and mortality records from the first three years of California’s GVRO law, which went into effect on Jan. 1, 2016.

The “red flag” law allows law enforcement, family and household members, some co-workers, employers and teachers to work with a judge to temporarily remove access to firearms and ammunition from people at significant risk of self-harm or harming others.

The research, published June 2 in Injury Prevention, shows that GVROs were used most often by law enforcement officers to prevent firearm assault and homicide. About 80% of GVROs were used in cases of threatened interpersonal violence.

The findings suggest GVROs are being used as intended — to remove firearms from individuals threatening to harm themselves, their intimate partners, co-workers, classmates, or the general public. —Veronica Pear

Mass shooting threats — a threat to shoot an unspecified number of people or more than three people — occurred in almost 30% (58 cases) of all GVROS during this period. Six of the cases involved minors, all of whom targeted schools.

Among the individuals who had firearms temporarily removed with a restraining order, almost 30% had an assault-type weapon such as an AR or AK-style rifle.

GVROs were also shown to potentially be effective in preventing self-harm, which was threatened in about 40% of the cases. No suicides occurred among individuals who were subject to the restraining orders.

“Extreme risk protection orders, or GVROs, offer a common sense, popular, and promising tool for firearm violence prevention,” said Veronica Pear, lead author of the study and an assistant professor in the Department of Emergency Medicine at UC Davis Health. “The findings suggest GVROs are being used as intended — to remove firearms from individuals threatening to harm themselves, their intimate partners, co-workers, classmates or the general public.”

Some other key findings:

Law enforcement officers filed 96.5% of the GVROs. Filings by family and household members made up 3.5% of the cases.
Of the cases that involved a threat to others, almost 30% were directed at intimate partners, 23% at random people, 20% at family members, and about 9% at someone at school.
Individuals served with a GVRO had a median age of 39 and were predominantly male (93.5%).

Methods

The researchers took information from 201 available court case files for GVROs issued during the first three years of implementation in California. They characterized the recipients of the orders, the case circumstances and GVRO process details. They also linked the subjects of the restraining orders to mortality records to evaluate post-ERPO outcomes.

The researchers noted one limitation of the study. They could not obtain court files for all GVROs issued during the first three years (2016-2018). Of the 413 restraining orders issued during that period, they obtained records for 218. Of those, 17 were dropped because the provided case file did not include a GVRO form.

GVROs stopped shootings

Firearms are the most common means of homicide and suicide in the U.S. Many acts of firearm violence are preceded by implicit or explicit threats, including two-thirds of public mass violence.

Despite these warning signs, law enforcement officers in most states cannot remove firearms from individuals at risk of violence who are not already prohibited from possessing firearms. California’s Gun Violence Restraining Order law was created to fill this legal gap.

“Based on the evidence available to date, we believe that ERPOs are effective and enjoy broad public support, including among firearm owners,” said Garen Wintemute, senior author of the study, director of the VPRP and professor of emergency medicine at UC Davis Health.

The other authors of the study are Rocco Pallin, Julia Schleimer, Elizabeth Tomsich, Nicole Kravitz-Wirtz, and Aaron Shev from VPRP, and Christopher E. Knoepke from the University of Colorado School of Medicine.

This work was supported by the Fund for a Safer Future (NVF FFSF UC Davis GA004701) and the California Firearm Violence Research Center.

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AUDIO: Do red flag laws work?

Anonymous — Sun, 29 May 2022 16:27:40 +0000

AUDIO: Do red flag laws work? (not verified) May 29, 2022

Red flag laws are one potential solution for high rates of gun violence in the U.S. Nineteen states now allow the removal of firearms from gun owners when there is a risk of violence. As NPR's Martin Kaste reports, researchers, including UC Davis Director of the Violence Prevention Research Program Garen Wintemute, are tracking the effectiveness of those laws.

Via NPR

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If there’s any glimmer of hope for gun reforms, it’s coming from California

Anonymous — Sun, 29 May 2022 16:19:48 +0000

If there’s any glimmer of hope for gun reforms, it’s coming from California (not verified) May 29, 2022

Amid 3,449 flower vases in Sue Bierman Park, former Rep. Gabby Giffords hosts a candlelight vigil to honor the lives lost to gun violence in San Francisco. (Scott Strazzante/The Chronicle)

It is hard not to feel hopeless about the political system after 19 elementary school students and two teachers were slaughtered last week in a Texas school, 10 days after 10 people were killed in Buffalo, N.Y.

Despite being immersed daily in that horror, Garen Wintemute, director of the Violence Prevention Research Program at UC Davis and a leading national researcher on the impact of gun violence, remains hopeful, both in the power of humanity and in California’s ability to lead.

“Me, the hopeful person, says we can’t give up,” Wintemute said. “We cannot let go of the belief in the possibility of the species to change for the better.”

Via San Francisco Chronicle

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Armed and Prohibited: Why a California program to get guns out of the hands of criminals is facing significant challenges

Anonymous — Tue, 24 May 2022 17:52:03 +0000

Armed and Prohibited: Why a California program to get guns out of the hands of criminals is facing significant challenges (not verified) May 24, 2022

After a violent few months in the Sacramento area, many are wondering what leaders are doing to keep our community safe. Garen Wintemute is studying the impacts of the prohibited persons list for UC Davis Health Violence Prevention Research. He said currently, courts report new prohibitions to the state daily. Overnight, computers run that list against a list of gun owners. Officials have to confirm the matches by hand. If the suspects don’t turn in the guns like they’re supposed to, that launches an investigation process that could lead to seizures.

“The ideal solution, quite frankly, would be not to have a need for law enforcement to go out and recover the weapons from a person at home. For example, it would be to make it part of the transaction,” Wintemute said. “Here’s your restraining order and give us the guns at the same time.”

Via KCRA

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Why surge in US gun sales? Job loss, COVID social disruptions

Anonymous — Mon, 16 May 2022 18:05:46 +0000

Why surge in US gun sales? Job loss, COVID social disruptions (not verified) May 16, 2022

The Geneva Presbyterian Church is pictured after a deadly shooting where one person was killed and five were wounded in Laguna Woods, California, U.S. May 15, 2022. (REUTERS/David Swanson)

On Saturday, 13 people were shot, and 10 died in a mass shooting at a Tops grocery store in a predominantly Black neighborhood in Buffalo, New York. It’s one of six mass shootings that happened over the weekend, including one locally in Laguna Woods at a Presbytarian church.

“The year-to-year increase we saw from 2019 to 2020 in homicide was the greatest we've ever seen historically, in 100 years of record keeping. … Homicide rates in 2021 were [on average] 45% higher than they were just two years earlier in 2019. And 2022 is on pace to exceed 2021,” says Dr. Garen Wintemute, an emergency medicine physician and the director of the Violence Prevention Research Program at UC Davis.

Via KCRW

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Gun deaths surged during the pandemic’s first year, the C.D.C. reports.

Anonymous — Tue, 10 May 2022 16:33:28 +0000

Gun deaths surged during the pandemic’s first year, the C.D.C. reports. (not verified) May 10, 2022

The rate of gun-related homicides in the United States reached its highest level in over 25 years in 2020, but experts are still not certain why. (Bryan Anselm for The New York Times)

Gun deaths reached the highest number ever recorded in the United States in 2020, the first year of the pandemic, as gun-related homicides surged by 35 percent, the Centers for Disease Control and Prevention reported on Tuesday.

Today, gun buying has largely returned to prepandemic levels, but there remain roughly 15 million more guns in circulation than there would be without the pandemic, according to Garen J. Wintemute, a gun violence researcher at the University of California, Davis.

Via New York Times

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VIDEO ADDED: ‘UC Davis LIVE’ on Gun Violence Research

Anonymous — Tue, 19 Apr 2022 19:27:27 +0000

VIDEO ADDED: ‘UC Davis LIVE’ on Gun Violence Research (not verified) April 19, 2022 Andy Fell

April 19, 10:45 a.m. — Six people died in the April 3 shooting in Sacramento, and the spring holiday weekend saw at least four mass shootings across the country. Gun sales surged during the pandemic, while the White House recently announced a crackdown on untraceable “ghost guns.” What are the trends in gun violence, and what are we learning about its causes, consequences and prevention? Joining us Tuesday to discuss these and other questions are two experts from the UC Davis Violence Prevention Research Program.

Garen Wintemute is a practicing emergency medicine physician and a pioneer in the field of injury epidemiology and the prevention of firearm violence. His work helped create the public health approach to violence prevention. Dr. Wintemute is director of the UC Davis Violence Prevention Research Program and also directs the California Firearm Violence Research Center.
Amy Barnhorst is the vice chair for community mental health at the UC Davis Department of Psychiatry, associate professor in the Department of Emergency Medicine and director of the BulletPoints Project, a state-funded effort to develop a firearm violence prevention curriculum for health care providers. She is a nationally recognized expert on firearms law and mental illness.

The conversation, hosted by Soterios Johnson, will be streamed live on Facebook and YouTube beginning at 10:45 a.m. on Tuesday, April 19. Questions can be submitted via Facebook and Twitter either in advance or during the show.

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‘We Can’t Endure This’: Surge in U.S. Shootings Shows No Sign of Easing

Anonymous — Thu, 31 Mar 2022 19:03:08 +0000

‘We Can’t Endure This’: Surge in U.S. Shootings Shows No Sign of Easing (not verified) March 31, 2022

Around the country, gun purchases, which surged in 2020, have begun to level off, at least when measured by the number of federal background checks, a proximate measure of Americans’ gun-buying habits. Garen J. Wintemute, who researches gun violence at the University of California, Davis, said that while he was pleased to see the apparent reversal in the surge of gun purchases, “we have no choice but to live through the aftermath, whatever it is going to be. We’re doing that now.”

Via New York Times

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Unemployment associated with increase in violence early in COVID-19 pandemic

Anonymous — Sat, 29 Jan 2022 00:40:14 +0000

Unemployment associated with increase in violence early in COVID-19 pandemic

Study of 16 U.S. cities shows historic level of job losses associated with an increase in firearm violence and homicide

(not verified) January 28, 2022

The sharp rise in unemployment during the five months of the pandemic was associated with an increase in firearm violence and homicide in 16 American cities. That’s the finding of a new study from researchers at the Violence Prevention Research Program (VPRP) at UC Davis.

The study was published in the Journal of Urban Health.

The researchers did not find a corresponding increase in other crimes, such as aggravated assault, burglary, larceny-theft, motor vehicle theft and robbery.

“Economic disadvantage and income inequality have long been associated with increased risk of violence,” said Julia Schleimer, the lead author of the study and a research data analyst at VPRP. “Our results indicate that the acute worsening of economic conditions, as we saw at the beginning of the COVID-19 pandemic, may also increase violence risk.”

Historic unemployment at the beginning of the pandemic

In March 2020, the number of Americans who abruptly lost their jobs surged to 17.7 million. By April 2020, the unemployment rate in the United States reached 14.7%, the highest since data collection began in 1948. Low-income households in the United States were disproportionately harmed, with low-wage workers losing jobs at five times the rate of middle-wage workers.

The historic events gave the researchers an opportunity to examine the relationship between increased unemployment and violence separated from systemic or ongoing factors.

The researchers obtained unemployment data from the Bureau of Labor Statistics Local Area Unemployment Statistics for each of the 16 cities. They used unemployment data going back to 2015 to estimate what would likely have been the expected unemployment numbers had the pandemic not occurred.

Data on firearm violence was obtained from the Gun Violence Archive (GVA), a real-time repository for gun violence incidents. Data for other crimes were obtained from city open data portals.

Our findings may help us understand why violence occurs and how to prevent it. Policies that reduce unemployment or provide support to the unemployed might reduce violence and improve public health.”—Julia Schleimer

The researchers estimate an average increase of 3.3 firearm violence incidents and 2 homicides per city each month from March to July 2020. That assumes peak unemployment levels in all cities were sustained for the entire 5-month period.

Excess unemployment and violent crime March-July 2020

Adjusted association between excess unemployment and violent crime, March-July 2020 in 16 US cities: Baltimore, MD; Boston, MA; Chicago, IL; Cincinnati, OH; Dallas, TX; Denver, CO; District of Columbia; Kansas City, MO; Los Angeles, CA; Milwaukee; WI; Philadelphia, PA; Phoenix, AZ; Riverside, CA; Sacramento, CA; San Francisco, CA; and Seattle, WA.

“Our findings may help us understand why violence occurs and how to prevent it. Policies that reduce unemployment or provide support to the unemployed might reduce violence and improve public health,” said Schleimer.

One area for future research is looking at the underlying mechanisms associating an increase in unemployment with some types of violent crime. Another is whether unemployment benefits or other financial protections buffer against the adverse consequences of unemployment.

“Social factors are important determinants of rates of violence, and interventions on those factors are essential to a comprehensive violence prevention effort,” said Garen Wintemute, an emergency department physician and director of VPRP.

Additional authors on the study include Veronica A. Pear, Christopher D. McCort, Aaron B. Shev, Alaina De Biasi, Elizabeth Tomsich, Shani Buggs, Hannah S. Laqueur and Garen J. Wintemute from the Violence Prevention Research Program.

This research was supported by grants from The Joyce Foundation, the Heising-Simons Foundation and the California Firearm Violence Research Center.

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