Creating 'Partnership in iSupport program' to optimise family carers' impact on dementia care: a randomised controlled trial protocol

Background: The majority of people with dementia are cared for by their family members. However, family carers are often unprepared for their caring roles, receiving less education and support compared with professional carers. The consequences are their reduced mental and physical health and wellbeing, and that of care recipients. This study protocol introduces the ‘Partnership in iSupport program’ that includes five interventional components: managing transitions, managing dementia progression, psychoeducation, carer support group and feedback on services. This health services research is built on family carer and dementia care service provider partnerships. The aims of the study are to evaluate the effectiveness, cost-effectiveness and family carers’ experiences in the program. Methods: A multicentre randomised controlled trial will be conducted with family carers of people living with dementia from two tertiary hospitals and two community aged care providers across three Australian states. The estimated sample size is 185 family carers. They will be randomly assigned to either the intervention group or the usual care group. Outcomes are measurable improvements in quality of life for carers and people with dementia, caregiving self-efficacy, social support, dementia related symptoms, and health service use for carers and their care recipients. Data will be collected at three time points: baseline, 6 months and 12 months post-initiation of the intervention. Discussion: This is the first large randomised controlled trial of a complex intervention on health and social care services with carers of people living with dementia in real-world practice across hospital and community aged care settings in three Australian states to ascertain the effectiveness, cost-effectiveness and carers’ experiences of the innovative program. We expect that this study will address gaps in supporting dementia carers in health and social care systems while generating new knowledge of the mechanisms of change in the systems. Findings will strengthen proactive health management for both people living with dementia and their carers by embedding, scaling up and sustaining the ‘Partnership in iSupport program’ in the health and social care systems.Lily Xiao, Ying Yu, Julie Ratcliffe, Rachel Milte, Claudia Meyer, Michael Chapman, Langduo Chen, Shahid Ullah, Alison Kitson, Andre Queiroz De Andrade, Elizabeth Beattie, Henry Brodaty, Sue McKechnie, Lee, Fay Low, Tuan Anh Nguyen, Craig Whitehead, Bianca Brijnath, Ronald Sinclair, and Diana Vos

Crescimento de pimentão em diferentes arranjos espaciais

The objective of this work was to evaluate the growth of green pepper cv. Atlantis under different spatial arrangements. Three spacing arrangements between double and simple planting rows (1.5x0.5 m, 1.6x0.4 m and 1.7x0.3 m) and four spacing distances between plants in the rows (0.2, 0.3, 0.4 and 0.5 m) combined in factorial scheme were evaluated. A randomized block design in split-plots divided in time with three replicates was used. The growth assessment was done in nine occasions, 14 days apart, and the first one was performed 14 days after transplanting (DAT). Leaf area (LA), leaf area index (LAI), dry masses of leaves (LDM), stem (SDM), fruit (FrDM) and total shoot (TDM); absolute growth rate (AGR), rates of net assimilation (NAR) and relative growth (RGR); and leaf area (LAR) and leaf mass (LWR) ratios were evaluated until 126 DAT. The changes in LA, RGR, LWR and LAR did not depend on row spacing, but spacing influenced LDM, SDM, FrDM and TDM, LAI and AGR. The increase in spacing reduces LAI and LAR, and increases LA, LDM, SDM, FrDM, TDM, AGR and NAR, but does not influence RGR and LWR.O objetivo deste trabalho foi avaliar o crescimento do pimentão cv. Atlantis sob diferentes arranjos espaciais. Foram avaliados três arranjos de espaçamentos entre fileiras duplas e fileiras simples de plantio (1,5x0,5, 1,6x0,4 e 1,7x0,3 m), e quatro espaçamentos entre plantas nas fileiras (0,2, 0,3, 0,4 e 0,5 m), combinados em esquema fatorial. Utilizou-se o delineamento de blocos ao acaso, com três repetições e parcelas subdivididas no tempo. A avaliação de crescimento foi realizada em nove épocas espaçadas em 14 dias, com a primeira avaliação realizada 14 dias após o transplantio (DAT). Até os 126 DAT, foram avaliados: área foliar (AF); índice de área foliar (IAF); massas secas de folhas (MSF), do caule (MSC), de frutos (MSFr) e do total da parte aérea (MST); taxa de crescimento absoluto (TCA), assimilatória líquida (TAL) e de crescimento relativo (TCR); e as razões de área foliar (RAF) e de massa foliar (RMF). As alterações em AF, TCR, RMF e RAF foram independentes do espaçamento entre fileiras que, no entanto, influenciou MSF, MSC, MSFr e MST, IAF e TCA. O aumento do espaçamento entre plantas reduz o IAF e a RAF e aumenta a AF, MSF, MSC, MSFr, MST, TCA e TAL, mas não influencia a TCR e RMF

Human T-cell lymphotropic virus types I and II infections in a cohort of patients with neurological disorders in Belém, Pará, Brazil Infecção pelos vírus linfotrópicos humanos de células T tipos I e II entre pacientes com doença neurológica em Belém, Pará, Brasil

Serum- and/or- cerebrospinal fluid (CSF) samples obtained from 190 patients suffering from chronic, progressive neurological disease were screened for the presence of human T-cell lymphotropic viruses type I (HTLV-I) and type II (HTLV-II) antibodies over a six-year period (1996 to 2001) in Belém, Pará, Brazil. Patients were of both sexes (male subjects, 52%) with ages ranging from 2 to 79 years (mean, 35.9). Overall, 15 (7.9%) subjects - of whom 12 (80%) were female adults - reacted HTLV-I/II-seropositive when screened by enzyme-linked immunosorbent assay (ELISA). Serum samples from 14 of these patients were also analyzed using a recombinant Western blot (WB) assay that yielded HTLV-I-, HTLV-II-, and HTLV-I/II- reactivities for 10 (71.4%), 3 (21.4%) and 1 (7.2%) of them, respectively. The yearly rates of HTLV-I/II antibodies ranged from 2.6% (2001) to 21.7% (2000), with progressively increasing seropositivities from 1998 to 2000. Altogether, walking difficulty (n = 5 subjects), spasticity (n = 4) and leg weakness (n = 3) accounted for 80% of symptoms recorded among the 15 patients whose sera had antibodies to HTLV-I/II as detected by ELISA. These findings provide evidence that both HTLV-I and HTLV-II play a role in the development of chronic myelopathy in Belém, Pará, Northern Brazil.<br>Amostras de soro e/ou líquido céfalo-raquidiano (LCR) foram obtidas de 190 pacientes com quadro de doença neurológica crônica e progressiva, com vistas à detecção de anticorpos para os vírus linfotrópicos humanos de células T dos tipos I (HTLV-I) e II (HTLV-II), durante um período de seis anos (1996 a 2001) em Belém, Pará, Brasil. O grupo compreendia ambos os sexos (homens, 52%), com idades variando de 2 a 79 anos (média, 35,9 anos). Tomando-se os resultados como um todo, 15 (7,9%) indivíduos, incluindo 12 (80%) mulheres adultas, apresentaram anticorpos para HTLV-I/II a partir da triagem pelo procedimento imunoenzimático (ELISA). Soros de 14 desses pacientes também foram testados utilizando-se procedimento de Western blot (WB), alcançando-se freqüências de anticorpos para HTLV-I, HTLV-II e dupla reação (HTLV-I e HTLV-II) em 10 (71,4%), 3 (21,4%) e 1 (7,2%) indivíduos, respectivamente. As freqüências anuais de positividade para HTLV-I/II variaram de 2,6% (2001) a 21,7% (2000), em escala crescente no período de 1998 a 2000. Em conjunto, dificuldade na deambulação (n = 5 pacientes), espasticidade (n = 4) e hipotonia crural compreenderam 80% das manifestações clínicas registradas entre os 15 pacientes cujas amostras de soro continham anticorpos para HTLV-I/II, com base em ELISA. Tais resultados oferecem indicadores quanto a uma possível associação do HTLV-I e do HTLV-II à gênese das mielopatias crônicas em Belém, norte do Brasil