Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM)

Background Dementia has an enormous impact on the lives of individuals and families, and on health and social services, and this will increase as the population ages. The needs of people with dementia and their carers for information and support are inadequately addressed at all key points in the illness trajectory. Methods The Unit is working specifically on an evaluation of the impact of the Mental Capacity Act 2005, and will develop practice guidance to enhance concordance with the Act. Phase One of the study has involved baseline interviews with practitioners across a wide range of services to establish knowledge and expectations of the Act, and to consider change processes when new policy and legislation are implemented. Findings Phase 1, involving baseline interviews with 115 practitioners, identified variable knowledge and understanding about the principles of the Act. Phase 2 is exploring everyday decision-making by people with memory problems and their carers

Impacts of the Covid-19 pandemic on air quality in Wales: March to October 2020

The report covers the WAQF's activity in 2020 and important policy developments since the last report was published in 2020. As usual we review the latest trends in air pollution measurements and implications for policy compliance as well as maps of Air Quality for NO2, O3, PM10 and PM2.5 in 2020. The area of special interest this year looks at the Landmark Second Inquest Rules that Air Pollution Contributed to the Death in London of 9-Year Old, Ella Adoo-Kissi-Debrah. The health chapter provides a review of Air Quality and Public Health in 2020

Parasites of non-native freshwater fishes introduced into england and wales suggest enemy release and parasite acquisition

When non-native species are introduced into a new range, their parasites can also be introduced, with these potentially spilling-over into native hosts. However, in general, evidence suggests that a high proportion of their native parasites are lost during introduction and infections by some new parasites from the native range might occur, potentially resulting in parasite spill-back to native species. These processes were investigated here using parasite surveys and literature review on seven non-native freshwater fishes introduced into England and Wales. Comparison of the mean numbers of parasite species and genera per population for each fish species England andWaleswith their native ranges revealed\9 % of the native parasite fauna were present in their populations in England and Wales. There was no evidence suggesting these introduced parasites had spilled over into sympatric native fishes. The non-native fishes did acquire parasites following their introduction, providing potential for parasite spill-back to sympatric fishes, and resulted in non-significant differences in overall mean numbers of parasites per populations between the two ranges. Through this acquisition, the non-native fishes also had mean numbers of parasite species and genera per population that were not significantly different to sympatric native fishes. Thus, the non-native fishes in England and Wales showed evidence of enemy release, acquired new parasites following introduction providing potential for spill-back, but showed no evidence of parasite spill-over

The Clinical Impact and Molecular Biology of del(17p) in Multiple Myeloma Treated with Conventional or Thalidomide-Based Therapy

Hemizygous deletion of 17p (del(17p)) has been identified as a variable associated with poor prognosis in myeloma, although its impact in the context of thalidomide therapy is not well described. The clinical outcome of 85 myeloma patients with del(17p) treated in a clinical trial incorporating both conventional and thalidomide-based induction therapies was examined. The clinical impact of deletion, low expression, and mutation of TP53 was also determined. Patients with del(17p) did not have inferior response rates compared to patients without del(17p), but, despite this, del(17p) was associated with impaired overall survival (OS) (median OS 26.6 vs. 48.5 months, P < 0.001). Within the del(17p) group, thalidomide induction therapy was associated with improved response rates compared to conventional therapy, but there was no impact on OS. Thalidomide maintenance was associated with impaired OS, although our analysis suggests that this effect may have been due to confounding variables. A minimally deleted region on 17p13.1 involving 17 genes was identified, of which only TP53 and SAT2 were underexpressed. TP53 was mutated in < 1% in patients without del(17p) and in 27% of patients with del(17p). The higher TP53 mutation rate in samples with del(17p) suggests a role for TP53 in these clinical outcomes. In conclusion, del(17p) defined a patient group associated with short survival in myeloma, and although thalidomide induction therapy was associated with improved response rates, it did not impact OS, suggesting that alternative therapeutic strategies are required for this group. (C) 2011 Wiley-Liss, Inc

Neural Processing of Congruent and Incongruent Audiovisual Speech in School-Age Children and Adults

Seeing articulatory gestures enhances speech perception. Perception of auditory speech can even be changed by incongruent visual gestures, which is known as the McGurk effect (e.g., dubbing a voice saying /mi/ onto a face articulating /ni/, observers often hear /ni/). In children, the McGurk effect is weaker than in adults, but no previous knowledge exists about the neural-level correlates of the McGurk effect in school-age children. Using brain event-related potentials, we investigated change detection responses to congruent and incongruent audiovisual speech in school-age children and adults. We used an oddball paradigm with a congruent audiovisual /mi/ as the standard stimulus and a congruent audiovisual /ni/ or McGurk A/mi/V/ni/ as the deviant stimulus. In adults, a similar change detection response was elicited by both deviant stimuli. In children, change detection responses differed between the congruent and the McGurk stimulus. This reflects a maturational difference in the influence of visual stimuli on auditory processing.Peer reviewe