Interdisciplinary Community-Based Support for Caregivers of Individuals Living with Dementia

Evidence indicates family caregivers of individuals living with dementia (ILwD) are at risk for diminished physical and mental health; which may decrease their quality of life and directly impact their ability to provide care. An interdisciplinary approach to self-care and skill-building for caregivers is provided in a virtual support group offered by Council on Aging in Sonoma County, CA. As part of the nonprofit’s Adult Day Program, the group is offered to client caregivers and has two goals: First, creating a communitybased, long-term support system for ILwD who are agingin-place; second, fostering a safe and supportive community for family caregivers, by providing opportunities to collaborate with peers and an interdisciplinary team that includes a Marriage and Family Therapist (MFT), an Occupational Therapist (OT), and a Recreation Therapist (the day program manager). The closed group model established through eight weekly sessions builds trusting relationships in a frame that combines: the OT client-centered and collaborative approach to problem-solving everyday challenges of caregiving, the MFT skills of creating a safe space for discussion and deeper exploration, and program staff insights regarding the ILwD’s current interests and abilities exhibited during Day Program activities. Sessions include an emotional check-in by group members; a brief overview of best-practices and common caregiving concerns related to a weekly topic; and an opportunity for caregivers to explore the integration of best-practices into daily routines, while also attending to their well-being as caregivers. Program evaluation and results related to the program’s effectiveness and implications for scalability will be discussed

Bites by spiders of the family Theraphosidae in humans and canines

Spiders of the family Theraphosidae occur throughout most tropical regions of the world. There have only been three case reports of bites by these spiders in Australia. The aim of this study was to describe the clinical effects of bites by Australian theraphosid spiders in both humans and canines. Cases of spider bite were collected by the authors over the period January 1978–April 2002, either prospectively in a large study of Australian spider bites, or retrospectively from cases reported to the authors. Subjects were included if they had a definite bite and had collected the spider. The spiders were identified by an expert arachnologist to genus and species level where possible. There were nine confirmed bites by spiders of the family Theraphosidae in humans and seven in canines. These included bites by two Selenocosmia spp. and by two Phlogiellus spp. The nine spider bites in humans did not cause major effects. Local pain was the commonest effect, with severe pain in four of seven cases where severity of pain was recorded. Puncture marks or bleeding were the next most common effect. In one case the spider had bitten through the patient's fingernail. Mild systemic effects occurred in one of nine cases. There were seven bites in dogs (Phlogellius spp. and Selenocosmia spp.), and in two of these the owner was bitten after the dog. In all seven cases the dog died, and as rapidly as 0.5–2 h after the bite. This small series of bites by Australian theraphosid spiders gives an indication of the spectrum of toxicity of these spiders in humans. Bites by these spiders are unlikely to cause major problems in humans. The study also demonstrates that the venom is far more toxic to canines.\ud \u

Initial segment Kv2.2 channels mediate a slow delayed rectifier and maintain high frequency action potential firing in medial nucleus of the trapezoid body neurons

The medial nucleus of the trapezoid body (MNTB) is specialized for high frequency firing by expression of Kv3 channels, which minimize action potential (AP) duration, and Kv1 channels, which suppress multiple AP firing, during each calyceal giant EPSC. However, the outward K+ current in MNTB neurons is dominated by another unidentified delayed rectifier. It has slow kinetics and a peak conductance of ∼37 nS; it is half-activated at −9.2 ± 2.1 mV and half-inactivated at −35.9 ± 1.5 mV. It is blocked by several non-specific potassium channel antagonists including quinine (100 μm) and high concentrations of extracellular tetraethylammonium (TEA; IC50 = 11.8 mm), but no specific antagonists were found. These characteristics are similar to recombinant Kv2-mediated currents. Quantitative RT-PCR showed that Kv2.2 mRNA was much more prevalent than Kv2.1 in the MNTB. A Kv2.2 antibody showed specific staining and Western blots confirmed that it recognized a protein ∼110 kDa which was absent in brainstem tissue from a Kv2.2 knockout mouse. Confocal imaging showed that Kv2.2 was highly expressed in axon initial segments of MNTB neurons. In the absence of a specific antagonist, Hodgkin–Huxley modelling of voltage-gated conductances showed that Kv2.2 has a minor role during single APs (due to its slow activation) but assists recovery of voltage-gated sodium channels (Nav) from inactivation by hyperpolarizing interspike potentials during repetitive AP firing. Current-clamp recordings during high frequency firing and characterization of Nav inactivation confirmed this hypothesis. We conclude that Kv2.2-containing channels have a distinctive initial segment location and crucial function in maintaining AP amplitude by regulating the interspike potential during high frequency firing