Behavioural activation written self-help to improve mood, wellbeing and quality of life in people with dementia supported by informal carers (PROMOTE): study protocol for a single-arm feasibility study.

Background: Increases in life expectancy have resulted in a global rise in dementia prevalence. Dementia is associated with poor wellbeing, low quality of life and increased incidence of mental health difficulties such as, low mood or depression. However, currently there is limited access to evidence-based psychological interventions for people with dementia experiencing low mood and poor wellbeing. Behavioural activation-based self-help, supported by informal carers and guided by mental health professionals, may represent an effective and acceptable solution. Methods/design: The present study is a Phase II (feasibility) single-arm trial informed by the MRC Complex Interventions Research Methods Framework. Up to fifty dementia participant/informal carer dyads will be recruited from a variety of settings including primary care, dementia-specific health settings, and community outreach. People living with dementia will receive behavioural activation based self-help and be supported by their informal carer who has received training in the skills required to support the self-help approach. In turn, during the use of the intervention the informal carer will be guided by mental health professionals to help them work through the materials and problem solve any difficulties. Consistent with the objectives of feasibility studies, outcomes relating to recruitment from different settings, employment of different recruitment methods, attrition, data collection procedures, clinical delivery and acceptability of the intervention will be examined. Clinical outcomes for people with dementia (symptoms of depression and quality of life) and informal carers (symptoms of depression and anxiety, carer burden and quality of life) will be measured pretreatment and at 3 months post-treatment allocation. Discussion: This study will examine the feasibility and acceptability of a novel behavioural activation-based self-help intervention designed to promote wellbeing and improve low mood in people living with dementia, alongside methodological and procedural uncertainties associated with research-related procedures. As determined by pre-specified progression criteria, if research procedures and the new intervention demonstrate feasibility and acceptability, results will then be used to inform the design of a pilot randomised controlled trial (RCT) to specifically examine remaining methodological uncertainties associated with recruitment into a randomised controlled design.This study is collaboratively funded by Cornwall Foundation Partnership Trust, South West Peninsula Academic Health Sciences Network and the University of Exeter

Solitons of the Resonant Nonlinear Schrodinger Equation with Nontrivial Boundary Conditions and Hirota Bilinear Method

Physically relevant soliton solutions of the resonant nonlinear Schrodinger (RNLS) equation with nontrivial boundary conditions, recently proposed for description of uniaxial waves in a cold collisionless plasma, are considered in the Hirota bilinear approach. By the Madelung representation, the model is transformed to the reaction-diffusion analog of the NLS equation for which the bilinear representation, soliton solutions and their mutual interactions are studied.Comment: 15 pages, 1 figure, talk presented in Workshop `Nonlinear Physics IV: Theory and Experiment`, 22-30 June 2006, Gallipoli, Ital

The validation of a computer-based food record for older adults: the Novel Assessment of Nutrition and Ageing (NANA) method

Dietary assessment in older adults can be challenging. The Novel Assessment of Nutrition and Ageing (NANA) method is a touch-screen computer-based food record that enables older adults to record their dietary intakes. The objective of the present study was to assess the relative validity of the NANA method for dietary assessment in older adults. For this purpose, three studies were conducted in which a total of ninety-four older adults (aged 65–89 years) used the NANA method of dietary assessment. On a separate occasion, participants completed a 4 d estimated food diary. Blood and 24 h urine samples were also collected from seventy-six of the volunteers for the analysis of biomarkers of nutrient intake. The results from all the three studies were combined, and nutrient intake data collected using the NANA method were compared against the 4 d estimated food diary and biomarkers of nutrient intake. Bland–Altman analysis showed a reasonable agreement between the dietary assessment methods for energy and macronutrient intake; however, there were small, but significant, differences for energy and protein intake, reflecting the tendency for the NANA method to record marginally lower energy intakes. Significant positive correlations were observed between urinary urea and dietary protein intake using both the NANA and the 4 d estimated food diary methods, and between plasma ascorbic acid and dietary vitamin C intake using the NANA method. The results demonstrate the feasibility of computer-based dietary assessment in older adults, and suggest that the NANA method is comparable to the 4 d estimated food diary, and could be used as an alternative to the food diary for the short-term assessment of an individual’s dietary intake

Bench-to-bedside review : targeting antioxidants to mitochondria in sepsis

Peer reviewedPublisher PD

The clinical use of Cogmed Working Memory Training (CWMT): a clinician survey

This is the author accepted manuscript. The final version is available from the British Psychological SocietyDespite controversy surrounding the effectiveness of working memory training, Cogmed Working Memory Training (CWMT, Pearson) remains a popular choice of intervention. We surveyed 100 CWMT practitioners from Australia, U.S.A., the Netherlands, and the U.K. to find out how CWMT is used, who with, and what outcomes are measured. Practitioners reported that CWMT was easy-to-use and a valuable use of clinical resources. Findings are discussed in relation to current research and recommendations for practice are made.This project was supported by generous grants from the Henry Smith Charity and Action Medical Research

Anisotropic pH-Responsive Hydrogels Containing Soft or Hard Rod-Like Particles Assembled Using Low Shear

A simple and versatile low-shear approach for assembling hydrogels containing aligned rod-like particles (RLPs) that are birefringent and exhibit pH-triggered anisotropic swelling is developed. Anisotropic composite hydrogels are prepared by applying low shear (0.1 s–1) to mixtures of pH-responsive nanogels (NGs) and RLPs. The NGs, which contained high methacrylic acid contents, acted as both shear transfer vehicles and macro-cross-linkers for anisotropic gel formation. Three model RLP systems are investigated: (i) soft triblock copolymer worms, (ii) stiff self-assembled β-sheet peptide fibers, and (iii) ultrahigh modulus nanocrystalline cellulose fibers. RLP alignment was confirmed using polarized light imaging, atomic force microscopy, and small-angle X-ray scattering as well as modulus and anisotropic swelling experiments. Unexpectedly, the composite gel containing the soft copolymer worms showed the most pronounced anisotropy swelling. The copolymer worms enabled higher RLP loadings than was possible for the stiffer RLPs. For fixed RLP loading, the extent of anisotropic swelling increased with intra-RLP bonding strength. The facile and versatile approach to anisotropic gel construction demonstrated herein is expected to enable new applications for strain sensing or biomaterials for soft tissue repair

Classic and recent advances in understanding amnesia

Neurological amnesia has been and remains the focus of intense study, motivated by the drive to understand typical and atypical memory function and the underlying brain basis that is involved. There is now a consensus that amnesia associated with hippocampal (and, in many cases, broader medial temporal lobe) damage results in deficits in episodic memory, delayed recall, and recollective experience. However, debate continues regarding the patterns of preservation and impairment across a range of abilities, including semantic memory and learning, delayed recognition, working memory, and imagination. This brief review highlights some of the influential and recent advances in these debates and what they may tell us about the amnesic condition and hippocampal function

How child‐centred education favours some learners more than others

Debates on how best to educate young children have been raging over the last 100 years—more often fuelled by ideological preferences rather than empirical evidence. To some extent this is hardly surprising given the difficulty of examining pupil progress in a systematic and comparative way. However, the introduction of a new child‐centred curriculum in Wales provides the opportunity to undertake just such an examination. The Foundation Phase curriculum, introduced in 2008, is designed to provide all 3‐ to 7‐year‐olds with a developmental, experiential, play‐based approach to learning. Evidence from a major 3‐year evaluation of this intervention finds that, overall, pupil progress and well‐being is fostered in those settings where the principles of the Foundation Phase have been most closely followed. However, the evidence also suggests that even within these contexts, progress is uneven and that some kinds of children seem to gain more from this approach than others. The ‘losers’ appear to be boys and those living in poverty. Drawing on the theories of Basil Bernstein, the paper explores why this may be the case and examines the relative significance of teacher dispositions, teacher–learner dynamics and the availability of resources. The paper concludes by arguing that these issues will need to be addressed if the benefits of child‐centred approaches are to benefit all

Prevalence of Cardiovascular Disease in Patients With Potentially Curable Malignancies: A National Registry Dataset Analysis

Background: Although a common challenge for patients and clinicians, there is little population-level evidence on the prevalence of cardiovascular disease (CVD) in individuals diagnosed with potentially curable cancer. Objectives: We investigated CVD rates in patients with common potentially curable malignancies and evaluated the associations between patient and disease characteristics and CVD prevalence. Methods: The study included cancer registry patients diagnosed in England with stage I to III breast cancer, stage I to III colon or rectal cancer, stage I to III prostate cancer, stage I to IIIA non-small-cell lung cancer, stage I to IV diffuse large B-cell lymphoma, and stage I to IV Hodgkin lymphoma from 2013 to 2018. Linked hospital records and national CVD databases were used to identify CVD. The rates of CVD were investigated according to tumor type, and associations between patient and disease characteristics and CVD prevalence were determined. Results: Among the 634,240 patients included, 102,834 (16.2%) had prior CVD. Men, older patients, and those living in deprived areas had higher CVD rates. Prevalence was highest for non-small-cell lung cancer (36.1%) and lowest for breast cancer (7.7%). After adjustment for age, sex, the income domain of the Index of Multiple Deprivation, and Charlson comorbidity index, CVD remained higher in other tumor types compared to breast cancer patients. Conclusions: There is a significant overlap between cancer and CVD burden. It is essential to consider CVD when evaluating national and international treatment patterns and cancer outcomes