Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementia

Objective: The authors systematically reviewed the literature on psychological approaches to treating the neuropsychiatric symptoms of dementia.Method: Reports of studies that examined effects of any therapy derived from a psychological approach that satisfied prespecified criteria were reviewed. Data were extracted, the quality of each study was rated, and an overall rating was given to each study by using the Oxford Centre for Evidence-Based Medicine criteria.Results: A total of 1,632 studies were identified, and 162 satisfied the inclusion criteria for the review. Specific types of psychoeducation for caregivers about managing neuropsychiatric symptoms were effective treatments whose benefits lasted for months, but other caregiver interventions were not. Behavioral management techniques that are centered on individual patients' behavior or on caregiver behavior had similar benefits, as did cognitive stimulation. Music therapy and Snoezelen, and possibly sensory stimulation, were useful during the treatment session but had no longer-term effects; interventions that changed the visual environment looked promising, but more research is needed.Conclusions: Only behavior management therapies, specific types of caregiver and residential care staff education, and possibly cognitive stimulation appear to have lasting effectiveness for the management of dementia-associated neuropsychiatric symptoms. Lack of evidence regarding other therapies is not evidence of lack of efficacy. Conclusions are limited because of the paucity of high-quality research ( only nine level-1 studies were identified). More high-quality investigation is needed

Levels of procoagulant microvesicles are elevated after traumatic injury and platelet microvesicles are negatively correlated with mortality

Background: Microvesicles (MV) have been implicated in the development of thrombotic disease, such as acute respiratory distress syndrome (ARDS) and multiple organ failure (MOF). Trauma patients are at increased risk of late thrombotic events, particularly those who receive a major transfusion. The aims of this study were: (a) to determine whether there were increased numbers of pro-coagulant MV following injury; (b) to determine their cellular origin; and (c) to explore the effects of MV with clinical outcomes; in particular red cell transfusion requirements and death. Methods: Trauma patients were recruited at a Level 1 trauma centre. The presence of MV procoagulant phospholipid (PPL) was assessed using 2 activity assays (PPL and thrombin generation). Enumeration and MV cellular origin was assessed using 2 colour flow cytometry. Results: Fifty consecutive patients were recruited; median age 38 (IQR: 24–55), median ISS 18 (IQR: 9–27). Circulating procoagulant MV, rich in phospholipid, were significantly elevated following traumatic injury relative to controls and remained elevated at 72 h post-injury. Red cell/AnnV+ and platelet/AnnV+ MV numbers were 6-fold and 2-fold higher than controls, respectively. Patients who died (n=9, 18%) had significantly fewer CD41/AnnV+ MV and lower endogenous thrombin potential relative to patients who survived. Conclusions: MV are elevated following traumatic injury and may be implicated in the increased risk of trauma patients to pro-thrombotic states such as MOF and ARDS. Lower levels of procoagulant MV are associated with mortality and further investigation of this association is warranted

Systems Level Approach Reveals the Correlation of Endoderm Differentiation of Mouse Embryonic Stem Cells with Specific Microstructural Cues of Fibrin Gels.

Stem cells receive numerous cues from their associated substrate that help to govern their behaviour. However, identification of influential substrate characteristics poses difficulties because of their complex nature. In this study, we developed an integrated experimental and systems level modelling approach to investigate and identify specific substrate features influencing differentiation of mouse embryonic stem cells (mESCs) on a model fibrous substrate, fibrin. We synthesized a range of fibrin gels by varying fibrinogen and thrombin concentrations, which led to a range of substrate stiffness and microstructure. mESCs were cultured on each of these gels, and characterization of the differentiated cells revealed a strong influence of substrate modulation on gene expression patterning. To identify specific substrate features influencing differentiation, the substrate microstructure was quantified by image analysis and correlated with stem cell gene expression patterns using a statistical model. Significant correlations were observed between differentiation and microstructure features, specifically fibre alignment. Furthermore, this relationship occurred in a lineage-specific manner towards endoderm. This systems level approach allows for identification of specific substrate features from a complex material which are influential to cellular behaviour. Such analysis may be effective in guiding the design of scaffolds with specific properties for tissue engineering applications

Searching for Galactic White Dwarf Binaries in Mock LISA Data using an F-Statistic Template Bank

We describe an F-statistic search for continuous gravitational waves from galactic white-dwarf binaries in simulated LISA Data. Our search method employs a hierarchical template-grid based exploration of the parameter space. In the first stage, candidate sources are identified in searches using different simulated laser signal combinations (known as TDI variables). Since each source generates a primary maximum near its true "Doppler parameters" (intrinsic frequency and sky position) as well as numerous secondary maxima of the F-statistic in Doppler parameter space, a search for multiple sources needs to distinguish between true signals and secondary maxima associated with other, "louder" signals. Our method does this by applying a coincidence test to reject candidates which are not found at nearby parameter space positions in searches using each of the three TDI variables. For signals surviving the coincidence test, we perform a fully coherent search over a refined parameter grid to provide an accurate parameter estimation for the final candidates. Suitably tuned, the pipeline is able to extract 1989 true signals with only 5 false alarms. The use of the rigid adiabatic approximation allows recovery of signal parameters with errors comparable to statistical expectations, although there is still some systematic excess with respect to statistical errors expected from Gaussian noise. An experimental iterative pipeline with seven rounds of signal subtraction and re-analysis of the residuals allows us to increase the number of signals recovered to a total of 3419 with 29 false alarms.Comment: 29 pages, 11 figures; submitted to Classical and Quantum Gravit

A Three-Stage Search for Supermassive Black Hole Binaries in LISA Data

Gravitational waves from the inspiral and coalescence of supermassive black-hole (SMBH) binaries with masses ~10^6 Msun are likely to be among the strongest sources for the Laser Interferometer Space Antenna (LISA). We describe a three-stage data-analysis pipeline designed to search for and measure the parameters of SMBH binaries in LISA data. The first stage uses a time-frequency track-search method to search for inspiral signals and provide a coarse estimate of the black-hole masses m_1, m_2 and of the coalescence time of the binary t_c. The second stage uses a sequence of matched-filter template banks, seeded by the first stage, to improve the measurement accuracy of the masses and coalescence time. Finally, a Markov Chain Monte Carlo search is used to estimate all nine physical parameters of the binary. Using results from the second stage substantially shortens the Markov Chain burn-in time and allows us to determine the number of SMBH-binary signals in the data before starting parameter estimation. We demonstrate our analysis pipeline using simulated data from the first LISA Mock Data Challenge. We discuss our plan for improving this pipeline and the challenges that will be faced in real LISA data analysis.Comment: 12 pages, 3 figures, submitted to Proceedings of GWDAW-11 (Berlin, Dec. '06

How children eat may contribute to rising levels of obesity children's eating behaviours: An intergenerational study of family influences

The term ‘obesogenic environment’ is rapidly becoming part of common phraseology. However, the influence of the family and the home environment on children's eating behaviours is little understood. Research that explores the impact of this micro environment and intergenerational influences affecting children's eating behaviours is long overdue. A qualitative, grounded theory approach, incorporating focus groups and semi-structured interviews, was used to investigate the family environment and specifically, the food culture of different generations within families. What emerged was a substantive theory based on ‘ordering of eating’ that explains differences in eating behaviours within and between families. Whereas at one time family eating was highly ordered and structured, typified by the grandparent generation, nowadays family eating behaviours are more haphazard and less ordered, evidenced by the way the current generation of children eat. Most importantly, in families with an obese child eating is less ordered compared with those families with a normal weight child. Ordering of eating' is a unique concept to emerge. It shows that an understanding of the eating process is crucial to the development and improvement of interventions targeted at addressing childhood obesity within the family context

Labour supply and skills demands in fashion retailing

If, as Adam Smith once famously suggested, Britain was a nation of shopkeepers then it is now a nation of shopworkers. Retail is now a significant part of the UK economy, accounting for £256 billion in sales and one-third of all consumer spending (Skillsmart, 2007). It is the largest private sector employer in the UK, employing 3m workers, or 1 in 10 of the working population. For future job creation in the UK economy retail is also similarly prominent and the sector is expected to create a further 250,000 jobs to 2014 (Skillsmart, 2007). The centrality of retail to economic success and job creation is apparent in other advanced economies. For example, within the US, retail sales is the occupation with the largest projected job growth in the period 2004-2014 (Gatta et al., 2009) and in Australia retail accounts for 1 in 6 workers (Buchanan et al., 2003). Within the UK these workers are employed in approximately 290,000 businesses, encompassing large and small organizations and also a number of sub-sectors. This variance suggests that retail should not be regarded as homogenous in its labour demands. Hart et al. (2007) note how skill requirements and the types of workers employed may differ across the sector. This chapter further opens up this point, providing an analysis of the labour supply and skills demands for the sub-sectors of clothing, footwear and leather goods, which are described by Skillsmart (2007: 48) as being 'significant categories in UK retailing'

The Mock LISA Data Challenges: from Challenge 3 to Challenge 4

The Mock LISA Data Challenges are a program to demonstrate LISA data-analysis capabilities and to encourage their development. Each round of challenges consists of one or more datasets containing simulated instrument noise and gravitational waves from sources of undisclosed parameters. Participants analyze the datasets and report best-fit solutions for the source parameters. Here we present the results of the third challenge, issued in Apr 2008, which demonstrated the positive recovery of signals from chirping Galactic binaries, from spinning supermassive--black-hole binaries (with optimal SNRs between ~ 10 and 2000), from simultaneous extreme-mass-ratio inspirals (SNRs of 10-50), from cosmic-string-cusp bursts (SNRs of 10-100), and from a relatively loud isotropic background with Omega_gw(f) ~ 10^-11, slightly below the LISA instrument noise.Comment: 12 pages, 2 figures, proceedings of the 8th Edoardo Amaldi Conference on Gravitational Waves, New York, June 21-26, 200

A Global Hypothesis for Women in Journalism and Mass Communications: The Ratio of Recurrent and Reinforced Residuum

This paper examines the status of women in communications industries and on university faculties. It specifically tests the Ratio of Recurrent and Reinforced Residuum or R3 hypothesis, as developed by Rush in the early 1980s [Rush, Buck & Ogan,1982]. The R3 hypothesis predicts that the percentage of women in the communications industries and on university faculties will follow the ratio residing around 1/4:3/4 or 1/3:2/3 proportion females to males. This paper presents data from a nationwide U.S. survey and compares them to data from global surveys and United Nations reports. The evidence is overwhelming and shows the relevance and validity of the R3 hypothesis across different socio-economic and cultural contexts. The paper argues that the ratio is the outcome of systemic discrimination that operates at multiple levels. The obstacles to achieving equality in the academy as well as media industries are discussed and suggestions for breaking out of the R3 ratio are included.