Development of an instrument to assess social functioning in dementia: The Social Functioning in Dementia scale (SF-DEM)

INTRODUCTION: Social functioning is a core domain in the life of people with dementia, but there is no accepted instrument to measure it. We aimed to develop the Social Functioning in Dementia (SF-DEM) scale and test its psychometric properties for assessing social function in people with dementia. METHODS: We interviewed people with mild dementia and family caregivers to develop patient and caregiver-rated SF-DEM versions and refined them through interviews with health care professionals. We tested its psychometric properties in 30 dyads of people with dementia and family caregivers. RESULTS: Both SF-DEM versions had content validity and demonstrated concurrent validity against a single item rating overall social functioning (patient rated r = 0.42, 95% CI [0.07–0.68]; caregiver rated r = 0.59, 95% CI [0.29–0.78]). All participants found it acceptable. Analyses showed reliability (test–retest, inter-rater, internal consistency) and indications of responsiveness to change. DISCUSSION: SF-DEM shows promise as a valid, reliable, acceptable measure of social functioning in dementia

Potential for carbon dioxide reduction from cement industry through increased use of industrial pozzolans

Concrete is the most widely used material on earth, eclipsing the combined volumes of all other man made materials by a factor of ten. In terms of its embedded carbon, it is a benign product, being associated with relatively little CO2 per unit mass when compared with metals, glasses and polymers. Conversely, it is made in such vast quantities, that it is responsible for over five percent of anthropogenic CO2. Despite recent advances in kiln design and alternative, low energy clinkers, it seems likely that the greatest carbon savings from the industry are likely to be made by the inclusion of supplementary cementing materials. This article reviews some of the options currently under investigation, especially from the UK perspective, and highlights that some of the research needs to be satisfied before such materials are more widely adopted

The prevalence and incidence of mental ill-health in adults with autism and intellectual disabilities

The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem behaviours compared with the whole adult population with intellectual disabilities, compared with individually matched controls there was no difference in prevalence, or incidence of either problem behaviours or other mental ill-health. Adults with autism who had problem behaviours were less likely to recover over a two-year period than were their matched controls. Apparent differences in rates of mental ill-health are accounted for by factors other than autism, including Down syndrome and ability level

Nightly treatment of primary insomnia with prolonged release melatonin for 6 months: a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety

<p>Background: Melatonin is extensively used in the USA in a non-regulated manner for sleep disorders. Prolonged release melatonin (PRM) is licensed in Europe and other countries for the short term treatment of primary insomnia in patients aged 55 years and over. However, a clear definition of the target patient population and well-controlled studies of long-term efficacy and safety are lacking. It is known that melatonin production declines with age. Some young insomnia patients also may have low melatonin levels. The study investigated whether older age or low melatonin excretion is a better predictor of response to PRM, whether the efficacy observed in short-term studies is sustained during continued treatment and the long term safety of such treatment.</p> <p>Methods: Adult outpatients (791, aged 18-80 years) with primary insomnia, were treated with placebo (2 weeks) and then randomized, double-blind to 3 weeks with PRM or placebo nightly. PRM patients continued whereas placebo completers were re-randomized 1:1 to PRM or placebo for 26 weeks with 2 weeks of single-blind placebo run-out. Main outcome measures were sleep latency derived from a sleep diary, Pittsburgh Sleep Quality Index (PSQI), Quality of Life (World Health Organzaton-5) Clinical Global Impression of Improvement (CGI-I) and adverse effects and vital signs recorded at each visit.</p> <p>Results: On the primary efficacy variable, sleep latency, the effects of PRM (3 weeks) in patients with low endogenous melatonin (6-sulphatoxymelatonin [6-SMT] ≤8 μg/night) regardless of age did not differ from the placebo, whereas PRM significantly reduced sleep latency compared to the placebo in elderly patients regardless of melatonin levels (-19.1 versus -1.7 min; P = 0.002). The effects on sleep latency and additional sleep and daytime parameters that improved with PRM were maintained or enhanced over the 6-month period with no signs of tolerance. Most adverse events were mild in severity with no clinically relevant differences between PRM and placebo for any safety outcome.</p> <p>Conclusions: The results demonstrate short- and long-term efficacy and safety of PRM in elderly insomnia patients. Low melatonin production regardless of age is not useful in predicting responses to melatonin therapy in insomnia. The age cut-off for response warrants further investigation.</p&gt

Parent-of-origin-specific allelic associations among 106 genomic loci for age at menarche.

Age at menarche is a marker of timing of puberty in females. It varies widely between individuals, is a heritable trait and is associated with risks for obesity, type 2 diabetes, cardiovascular disease, breast cancer and all-cause mortality. Studies of rare human disorders of puberty and animal models point to a complex hypothalamic-pituitary-hormonal regulation, but the mechanisms that determine pubertal timing and underlie its links to disease risk remain unclear. Here, using genome-wide and custom-genotyping arrays in up to 182,416 women of European descent from 57 studies, we found robust evidence (P < 5 × 10(-8)) for 123 signals at 106 genomic loci associated with age at menarche. Many loci were associated with other pubertal traits in both sexes, and there was substantial overlap with genes implicated in body mass index and various diseases, including rare disorders of puberty. Menarche signals were enriched in imprinted regions, with three loci (DLK1-WDR25, MKRN3-MAGEL2 and KCNK9) demonstrating parent-of-origin-specific associations concordant with known parental expression patterns. Pathway analyses implicated nuclear hormone receptors, particularly retinoic acid and γ-aminobutyric acid-B2 receptor signalling, among novel mechanisms that regulate pubertal timing in humans. Our findings suggest a genetic architecture involving at least hundreds of common variants in the coordinated timing of the pubertal transition

MTDATA and the prediction of phase equilibria in oxide systems : 30 years of industrial collaboration

This paper gives an introduction to MTDATA, Phase Equilibrium Software from the National Physical Laboratory (NPL), and describes the latest advances in the development of a comprehensive database of thermodynamic parameters to underpin calculations of phase equilibria in large oxide, sulfide, and fluoride systems of industrial interest. The database, MTOX, has been developed over a period of thirty years based upon modeling work at NPL and funded by industrial partners in a project co-ordinated by Mineral Industry Research Organisation. Applications drawn from the fields of modern copper scrap smelting, high-temperature behavior of basic oxygen steelmaking slags, flash smelting of nickel, electric furnace smelting of ilmenite, and production of pure TiO2via a low-temperature molten salt route are discussed along with calculations to assess the impact of impurities on the uncertainty of fixed points used to realize the SI unit of temperature, the kelvin

Institutionalised Islamophobia in British universities

This thesis is a conceptual study of institutionalised Islamophobia in British universities. Myanalysis is illustrated, although not driven, by exemplars drawn from fieldwork undertaken infour case study universities.The thesis is situated in the paradoxical context of increasing provisions for Muslim studentsthat occurred throughout the 1990s while simultaneously fears of Muslim student'fundamentalism' on campus were also on the increase and resulted in targeted action by theNational Union of Students, the Committee for Vice-Chancellors and Principals, and a numberof individual universities concerned about the possible threat to campus harmony posed byMuslim students.Employing a conceptual vocabulary influenced by anti-foundationalism and psychoanlysis, Iexplore the ways in which racialised governmentality is exercised over Muslim students. Thisanalysis includes consideration of the functions of formal multiculturalist practices asstrategies for the governance of bodies, and through which racialised exercise of disciplinarypower over Muslim students can be exercised. The thesis begins with a generalconsideration of the reasons why perceived distinct changes to the ways in which Muslimsarticulate their identities should so often be seen as potentially transgressive or disruptive, Itthen proceeds to an analysis of the ways in which Muslim students are constructed throughinstitutional practices, paying particular attention to strategies for stabilising representations ofMuslims, whiteness and the west which range from lslamophobic hoaxing to lslamophobicviolence