Differences in the Experience of Caregiving Between Spouse and Adult Child Caregivers in Dementia With Lewy Bodies.

Background and objectivesDementia caregiving has been associated with increased burden, depression, grief, a decreased sense of well-being and quality of life, and a weakening of social support. Little is known about the experience of caregiving in Dementia with Lewy Bodies (DLB). The present study examines differences in the caregiving experience of spouse versus adult child caregivers of individuals with DLB.Research design and methodsIn this cross-sectional analytic study of spouses (n = 255) and adult children (n = 160) caregivers of individuals with DLB, participants completed an online survey of burden, grief, depression, well-being, quality of life, and social support.ResultsAdult child caregivers were more likely to care for women (p < .001) and see the care recipient less often (p < .001) than spouses. Adult child caregivers reported lower quality of life (p < .001) and more caregiver burden (p < .009), but also greater social support (p < .001) than spouses. Between group analyses of caregiver type by disease severity demonstrated that spousal caregivers experience greater grief with advancing disease (p = .005), while adult child caregivers increase social support with advancing disease (p < .001).Discussion and implicationsSpouses and adult children experience DLB caregiving differently. This was explained by the younger age of the adult child caregiver, frequency of contact with the care recipient, and differences in the care recipient's characteristics, frequency of neuropsychiatric symptoms, and disease severity. DLB caregiver support for this population should target psychoeducation for complicated neuropsychiatric symptoms in the care recipient. Screening all DLB caregivers for burden, grief, and depression is suggested to identify those that may benefit most from intervention. Spouses specifically may benefit from interventions that target increasing social support, while adult child caregivers may benefit from interventions aimed at mitigating burden and improving quality of life

Multi-Spacecraft Observations of the Evolution of Interplanetary Coronal Mass Ejections Between 0.3 and 2.2 AU: Conjunctions with the Juno Spacecraft

We present a catalogue of 35 interplanetary coronal mass ejections (ICMEs) observed by the Juno spacecraft and at least one other spacecraft during its cruise phase to Jupiter. We identify events observed by MESSENGER, Venus Express, Wind, and STEREO with magnetic features that can be matched unambiguously with those observed by Juno. A multi-spacecraft study of ICME properties between 0.3 and 2.2 AU is conducted: we firstly investigate the global expansion by tracking the variation in magnetic field strength with increasing heliocentric distance of individual ICME events, finding significant variability in magnetic field relationships for individual events in comparison with statistical trends. With the availability of plasma data at 1 AU, the local expansion at 1 AU can be compared with global expansion rates between 1 AU and Juno. Despite following expected trends, the local and global expansion rates are only weakly correlated. Finally, for those events with clearly identifiable magnetic flux ropes, we investigate the orientation of the flux rope axis as they propagate; we find that 64% of events displayed a decrease in inclination with increasing heliocentric distance, and 40% of events undergo a significant change in orientation as they propagate towards Juno. The multi-spacecraft catalogue produced in this study provides a valuable link between ICME observations in the inner heliosphere and beyond 1 AU, thereby improving our understanding of ICME evolution

Conceptual Design of the Coronagraphic High Angular Resolution Imaging Spectrograph (CHARIS) for the Subaru Telescope

Recent developments in high-contrast imaging techniques now make possible both imaging and spectroscopy of planets around nearby stars. We present the conceptual design of the Coronagraphic High Angular Resolution Imaging Spectrograph (CHARIS), a lenslet-based, cryogenic integral field spectrograph (IFS) for imaging exoplanets on the Subaru telescope. The IFS will provide spectral information for 140x140 spatial elements over a 1.75 arcsecs x 1.75 arcsecs field of view (FOV). CHARIS will operate in the near infrared (lambda = 0.9 - 2.5 microns) and provide a spectral resolution of R = 14, 33, and 65 in three separate observing modes. Taking advantage of the adaptive optics systems and advanced coronagraphs (AO188 and SCExAO) on the Subaru telescope, CHARIS will provide sufficient contrast to obtain spectra of young self-luminous Jupiter-mass exoplanets. CHARIS is in the early design phases and is projected to have first light by the end of 2015. We report here on the current conceptual design of CHARIS and the design challenges

Early Stages of Alzheimer\u27s Disease: Evolving the Care Team for Optimal Patient Management.

Alzheimer\u27s disease (AD) is a progressive, neurodegenerative disease that creates complex challenges and a significant burden for patients and caregivers. Although underlying pathological changes due to AD may be detected in research studies decades prior to symptom onset, many patients in the early stages of AD remain undiagnosed in clinical practice. Increasing evidence points to the importance of an early and accurate AD diagnosis to optimize outcomes for patients and their families, yet many barriers remain along the diagnostic journey. Through a series of international working group meetings, a diverse group of experts contributed their perspectives to create a blueprint for a patient-centered diagnostic journey for individuals in the early stages of AD and an evolving, transdisciplinary care team. Here, we discuss key learnings, implications, and recommendations

HIV-1 Enhancing Effect of Prostatic Acid Phosphatase Peptides Is Reduced in Human Seminal Plasma

We recently reported that HIV-1 infection can be inhibited by innate antimicrobial components of human seminal plasma (SP). Conversely, naturally occurring peptidic fragments from the SP-derived prostatic acid phosphatase (PAP) have been reported to form amyloid fibrils called “SEVI” and enhance HIV-1 infection in vitro. In order to understand the biological consequence of this proviral effect, we extended these studies in the presence of human SP. PAP-derived peptides were agitated to form SEVI and incubated in the presence or absence of SP. While PAP-derived peptides and SEVI alone were proviral, the presence of 1% SP ablated their proviral activity in several different anti-HIV-1 assays. The anti-HIV-1 activity of SP was concentration dependent and was reduced following filtration. Supraphysiological concentrations of PAP peptides and SEVI incubated with diluted SP were degraded within hours, with SP exhibiting proteolytic activity at dilutions as high as 1∶200. Sub-physiological concentrations of two prominent proteases of SP, prostate-specific antigen (PSA) and matriptase, could degrade physiological and supraphysiological concentrations of PAP peptides and SEVI. While human SP is a complex biological fluid, containing both antiviral and proviral factors, our results suggest that PAP peptides and SEVI may be subject to naturally occurring proteolytic components capable of reducing their proviral activity

Alzheimer's “Prevention” vs. “Risk Reduction”: Transcending Semantics for Clinical Practice

The terms “prevention” and “risk reduction” are often used interchangeably in medicine. There is considerable debate, however, over the use of these terms in describing interventions that aim to preserve cognitive health and/or delay disease progression of Alzheimer's disease (AD) for patients seeking clinical care. Furthermore, it is important to distinguish between Alzheimer's disease prevention and Alzheimer's dementia prevention when using these terms. While prior studies have codified research-based criteria for the progressive stages of AD, there are no clear clinical consensus criteria to guide the use of these terms for physicians in practice. A clear understanding of the implications of each term will help guide clinical practice and clinical research. The authors explore the semantics and appropriate use of the terms “prevention” and “risk reduction” as they relate to AD in clinical practice