A systematic literature review of group-based training interventions for informal carers: impact on the behavioural and psychological symptoms of dementia (BPSD)

Objectives: Caring for a relative with dementia can be extremely challenging especially when someone presents with behavioural and psychological symptoms of dementia (BPSD). The training provided to informal carers is varied and inconsistent. Group-based training programmes are often prescribed but their impact on care-recipient wellbeing and symptomology is yet to be well established. This review synthesises the literature on consensus, themes and effectiveness of informal-carer, group-based educational training programmes on BPSD symptoms. Methods: Ten papers were included of which very few considered BPSD outcomes as their primary aim of investigation. Results: Methodological and theoretical approaches across the empirical papers varied considerably. Generally, studies of higher quality and with some positive results on BPSD outcomes tended to incorporate teaching on structured problem-solving skills. Studies measuring for longer term changes also tended to conclude more beneficial outcomes. The length and duration of groups and the group-sizes appeared inconsequential to BPSD outcomes. Conclusion: The empirical evidence is weak for carer group interventions in the management of BPSD. Practice reasons for this are discussed. Future studies designed to measure BPSD as a primary outcome would be a welcome addition to the literature

Draft Genome Sequences of Three Cellulolytic Bacillus licheniformis Strains Isolated from Imperial Geyser, Amphitheater Springs, and Whiterock Springs inside Yellowstone National Park

Novel cellulolytic microorganisms are becoming more important for rapidly growing biofuel industries. This paper reports the draft genome sequences of Bacillus licheniformis strains YNP2-TSU, YNP3-TSU, and YNP5-TSU. These cellulolytic isolates were collected from several hydrothermal features inside Yellowstone National Park

Draft Genome Sequence of Bacillus altitudinis YNP4-TSU, Isolated from Yellowstone National Park

Undisturbed hot springs inside Yellowstone National Park remain a dynamic biome for novel cellulolytic thermophiles. We report here the draft genome sequence of one of these isolates, Bacillus altitudinis YNP4-TSU

Draft Genome Sequence of Bacillus licheniformis Strain YNP1-TSU Isolated from Whiterock Springs in Yellowstone National Park

Novel cellulolytic microorganisms can potentially influence second-generation biofuel production. This paper reports the draft genome sequence of Bacillus licheniformis strain YNP1-TSU, isolated from hydrothermal-vegetative microbiomes inside Yellowstone National Park. The assembled sequence contigs predicted 4,230 coding genes, 66 tRNAs, and 10 rRNAs through automated annotation

Interaction between cognitive impairment and discharge destination and its effect on rehospitalization

OBJECTIVES: To evaluate the effect of cognitive impairment on rehospitalization in older adults. DESIGN: One-year longitudinal study. SETTING: Medical service of an urban, 340-bed public hospital in Indianapolis between July 2006 and March 2008. PARTICIPANTS: Individuals aged 65 and older admitted to the medical service (N = 976). MEASUREMENTS: Rehospitalization was defined as any hospital admission after the index admission. Participant demographics, discharge destination, Charlson Comorbidity Index, Acute Physiology Score, and prior hospitalizations were measured as the confounders. Participants were considered to have cognitive impairment if they had two or more errors on the Short Portable Mental Status Questionnaire. RESULTS: After adjusting for confounders, a significant interaction between cognitive impairment and discharge location was found to predict rehospitalization rate (P = .008) and time to 1-year rehospitalization (P = .03). Participants with cognitive impairment discharged to a facility had a longer time to rehospitalization (median 142 days) than participants with no cognitive impairment (median 98 days) (hazard ratio (HR) = 0.77, 95% confidence interval (CI) = 0.58-1.02, P = .07), whereas participants with cognitive impairment discharged to home had a slightly shorter time to rehospitalization (median 182 days) than those without cognitive impairment (median 224 days) (HR = 1.15, 95% CI = 0.92-1.43, P = .23). These two nonsignificant HRs in opposite directions were significantly different from each other (P = .03). CONCLUSION: Discharge destination modifies the association between cognitive impairment and rehospitalization. Of participants discharged to a facility, those without cognitive impairment had higher rehospitalization rates, whereas the rates were similar between cognitively impaired and intact participants discharged to the community

Using Total Fluorescence Increase (Signal Mass) to Determine the Ca2+ Current Underlying Localized Ca2+ Events

The feasibility of determining localized Ca2+ influx using only wide-field fluorescence images was explored by imaging (using fluo-3) single channel Ca2+ fluorescence transients (SCCaFTs), due to Ca2+ entry through single openings of Ca2+-permeable ion channels, while recording unitary channel currents. Since the image obtained with wide-field optics is an integration of both in-focus and out-of-focus light, the total fluorescence increase (ΔFtotal or “signal mass”) associated with a SCCaFT can be measured directly from the image by adding together the fluorescence increase due to Ca2+ influx in all of the pixels. The assumptions necessary for obtaining the signal mass from confocal linescan images are not required. Two- and three-dimensional imaging was used to show that ΔFtotal is essentially independent of the position of the channel with respect to the focal plane of the microscope. The relationship between Ca2+ influx and ΔFtotal was obtained using SCCaFTs from plasma membrane caffeine-activated cation channels when Ca2+ was the only charge carrier of the inward current. This relationship was found to be linear, with the value of the slope (or converting factor) affected by the particular imaging system set-up, the experimental conditions, and the properties of the fluorescent indicator, including its binding capacity with respect to other cellular buffers. The converting factor was used to estimate the Ca2+ current passing through caffeine-activated channels in near physiological saline and to estimate the endogenous buffer binding capacity. In addition, it allowed a more accurate estimate of the Ca2+ current underlying Ca2+ sparks resulting from Ca2+ release from intracellular stores via ryanodine receptors in the same preparation

R Functions for Sample Size and Probability Calculations for Assessing Consistency of Treatment Effects in Multi-Regional Clinical Trials

Multi-regional clinical trials have been widely used for efficient global new drug developments. Due to potential heterogeneity of patient populations, it is critical to evaluate consistency of treatment effects across different regions in a multi-regional trial in order to determine the applicability of the overall treatment effect to the patients in individual regions. Quan et al. (2010) proposed definitions for the assessments of consistency of treatment effects in multi-regional trials. To facilitate the application of their ideas to design multi-regional trials, in this paper, we provide the corresponding R functions for calculating the unconditional and conditional probabilities for demonstrating consistency in relationship with the overall/regional sample sizes and the anticipated treatment effects. Detailed step by step instructions and trial examples are also provided to illustrate the applications of these R functions