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Perceived Stigma Negatively Affects Social Participation and Satisfaction Among Individuals With Huntington Disease
e88 cognitive impairments. As a first step in developing TBI-specific nursing education, we asked nurses about their concerns in caring for patients with TBI. The purpose of this study was to investigate nurses’ primary concerns about caring for patients with TBI. Design: We conducted a survey of 692 nurses across hospital departments and used conventional qualitative content analysis to analyze responses. Setting: See above. Participants: See above. Interventions: N/A. Main Outcome Measure(s): N/A. Results: Nurses had multiple concerns about caring for patients in the acute stage after TBI, but few concerns about caring for patients in the chronic stage. Concerns identified included: 1) preventing physical harm; 2) missing changes in condition; and 3) providing support. Barriers to providing adequate care included: 1) lack of knowledge; 2) limited staffing; and 3) inadequate resources. Conclusions: Findings have implications for education of nurses and development of guidelines for management of patients with TBI. Key Words: Brain injuries, nursing, perceptions, health knowledge, attitudes, and practice Disclosures: None disclosed. Research Poster 586 Work Performance and Residual Limb Volume in Men With Transtibial Amputation Over A 12-Month Timeframe Carol Dionne (University of Oklahoma Health Sciences Center), William Ertl, Jonathan Day Research Objectives: To examine work-related activity performance and residuum volume changes 2 visits, 12 months apart. Design: Prospective, cross-sectional study. Setting: Clinical research lab, comprehensive health sciences center campus. Participants: Consecutively selected and formally consented (IRB #4884), 21 otherwise healthy and active working-age men (18-64 yrs) with transtibial amputation due to a traumatic event; 20 similar controls without amputation underwent the study protocol: resdiuum girths and length measures; self-paced and brisk-paced 2-minute walk tests, floor-to-knuckle lift, and 25ft carry tests at 2 visits, 12 months apart. Interventions: None. Main Outcome Measure(s): Dependent variables were:differences in step length, stride length, cadence & residuum volumetrics (standardized length, girths); report of perceived exertion (RPE). Results: Little difference noted between visits in residuum volume measures or in distances walked (p>.05). Reported greater exertion at visit 2 during the brisk 2MWT (.9 RPE difference; pZ0.034). Lifted 40.4lbs more at visit 2 than at the initial visit (pZ0.034). Progressively larger cadence difference from visit 1 to visit 2 (increased asymmetry) during the timed self-paced walk test (pZ0.026). Conclusions: Regardless of improved lift capacity or residuum volumetric stability, healthy men with TTA demonstrated progressively worsened cadence asymmetry during self-paced gait. Otherwise healthy working-age men with TTA may require continual, more advanced gait training to minimize cadence asymmetry, potentially reducing residuum injury risk. Key Words: Transtibial amputation, work related activity, work performance Disclosures: None disclosed. Research Poster 587 Perceived Stigma Negatively Affects Social Participation and Satisfaction Among Individuals With Huntington Disease Ketlyne Sol (University of Michigan Health System), Anna L. Kratz, Stacey Barton, Elizabeth A. Hahn, Jin-Shei Lai, Jennifer Miner, Jane S. Paulsen, Noelle E. Carlozzi, Rebecca E. Ready, Siera Goodnight
Research Posters Research Objectives: Huntington disease (HD) is a fatal autosomal dominant neurodegenerative disease characterized by progressive physical, cognitive, and behavioral changes with profound functional decline, including social functioning. Negative perceptions, interactions, and rejection may contribute to perceived stigma in HD. We examined whether perceived stigma predicts satisfaction and participation in social activities in individuals with HD. Design: Observational study. Setting: Established HD clinics at large academic medical centers. Participants: 486 individuals with prodromal (40%) or manifest (60%) HD with an average age of 48.3 years (SDZ13.21); individuals were primarily white (96%), female (59%), and married (62%), with an average of 15.05 (SDZ2.88) years of education. Interventions: Not Applicable. Main Outcome Measure(s): Neuro-QoL: Ability to Participate in Social Roles and Activities, Satisfaction with Social Roles and Activities, Stigma. Results: Two hierarchical regressions examined associations between perceived stigma and social participation and satisfaction, controlling for HD symptom manifestation (prodromal vs manifest). Results indicated that stigma was significantly predictive of both ability to participate in (F[2,483]Z 86.07), p<.001; RsquareZ.26) and satisfaction with (F[2,481] Z104.59), p<.001; Rsquare Z.30) social role and activities. Conclusions: This study demonstrated a link between perceived stigma on community and social interactions for people with HD, above and beyond the contribution of HD stage. Several factors might contribute to perceived stigma, such as visibility, public stigma, social distance, and previous experience with stigma and discrimination. Future research on these factors may identify ways to mitigate perceived stigma in persons with HD. Key Words: Huntington disease, Social Adjustment, Community Integration, Stigma, Social Disclosures: None disclosed. Research Poster 588 Time-Frequency Analysis of Cortical Sensorimotor Integration In Response to Orofacial Palpation Janey Prodoehl (Midwestern University), Kyle Henderson, Megan E. Cuellar Research Objectives: To map the spatio-temporal dynamics of sensorimotor activity in response to orofacial muscle and joint palpation. Design: Quasi-experimental, within subjects repeated measures design. Setting: University research setting. Participants: Ten right handed individuals without any history of orofacial pain. Interventions: Using 64 channel electroencephalography, cortical activity was measured while pressure was applied to the masseter muscle and the lateral pole of the temporomandibular joint, as well as to a control location at the radial styloid process using a digital algometer. Main Outcome Measure(s): Alpha (8-13 Hz) and beta (15-25 Hz) event related desynchronization (ERD) was measured to obtain cortical sensory and motor activity in response to palpation. Results: Independent component analysis revealed bilateral frontal and parietal sensorimotor components in response to palpation at each site of stimulation. Robust alpha ERD was observed prior to and immediately following the onset of palpation, continuing throughout the epoched timeline. Beta ERD began w500 ms after the onset of palpation and continued for the duration of the timeline. Conclusions: Muscle and joint orofacial palpation elicits robust cortical sensorimotor activity that can be spatially and temporally indexed using independent component analysis and event related spectral perturbations. Time-sensitive changes in activity were observed relative to palpation, thereby supporting further study regarding the use of this novel approach to quantitatively analyze central sensitization phenomena in patients with orofacial pain and headache. Key Words: Electroencephalograph, Somatosensory Cortex, Pain Perception Disclosures: None disclosed.
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Research Posters Research Objectives: Huntington disease (HD) is a fatal autosomal dominant neurodegenerative disease characterized by progressive physical, cognitive, and behavioral changes with profound functional decline, including social functioning. Negative perceptions, interactions, and rejection may contribute to perceived stigma in HD. We examined whether perceived stigma predicts satisfaction and participation in social activities in individuals with HD. Design: Observational study. Setting: Established HD clinics at large academic medical centers. Participants: 486 individuals with prodromal (40%) or manifest (60%) HD with an average age of 48.3 years (SDZ13.21); individuals were primarily white (96%), female (59%), and married (62%), with an average of 15.05 (SDZ2.88) years of education. Interventions: Not Applicable. Main Outcome Measure(s): Neuro-QoL: Ability to Participate in Social Roles and Activities, Satisfaction with Social Roles and Activities, Stigma. Results: Two hierarchical regressions examined associations between perceived stigma and social participation and satisfaction, controlling for HD symptom manifestation (prodromal vs manifest). Results indicated that stigma was significantly predictive of both ability to participate in (F[2,483]Z 86.07), p<.001; RsquareZ.26) and satisfaction with (F[2,481] Z104.59), p<.001; Rsquare Z.30) social role and activities. Conclusions: This study demonstrated a link between perceived stigma on community and social interactions for people with HD, above and beyond the contribution of HD stage. Several factors might contribute to perceived stigma, such as visibility, public stigma, social distance, and previous experience with stigma and discrimination. Future research on these factors may identify ways to mitigate perceived stigma in persons with HD. Key Words: Huntington disease, Social Adjustment, Community Integration, Stigma, Social Disclosures: None disclosed. Research Poster 588 Time-Frequency Analysis of Cortical Sensorimotor Integration In Response to Orofacial Palpation Janey Prodoehl (Midwestern University), Kyle Henderson, Megan E. Cuellar Research Objectives: To map the spatio-temporal dynamics of sensorimotor activity in response to orofacial muscle and joint palpation. Design: Quasi-experimental, within subjects repeated measures design. Setting: University research setting. Participants: Ten right handed individuals without any history of orofacial pain. Interventions: Using 64 channel electroencephalography, cortical activity was measured while pressure was applied to the masseter muscle and the lateral pole of the temporomandibular joint, as well as to a control location at the radial styloid process using a digital algometer. Main Outcome Measure(s): Alpha (8-13 Hz) and beta (15-25 Hz) event related desynchronization (ERD) was measured to obtain cortical sensory and motor activity in response to palpation. Results: Independent component analysis revealed bilateral frontal and parietal sensorimotor components in response to palpation at each site of stimulation. Robust alpha ERD was observed prior to and immediately following the onset of palpation, continuing throughout the epoched timeline. Beta ERD began w500 ms after the onset of palpation and continued for the duration of the timeline. Conclusions: Muscle and joint orofacial palpation elicits robust cortical sensorimotor activity that can be spatially and temporally indexed using independent component analysis and event related spectral perturbations. Time-sensitive changes in activity were observed relative to palpation, thereby supporting further study regarding the use of this novel approach to quantitatively analyze central sensitization phenomena in patients with orofacial pain and headache. Key Words: Electroencephalograph, Somatosensory Cortex, Pain Perception Disclosures: None disclosed.
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