Exploring the healthcare experiences and quality of life of people with mild cognitive impairment and their caregivers

Mild cognitive impairment (MCI) is a common condition which lies between normal cognition and dementia. Relatively little is known about the experiences of people with MCI (PWMCI) and their caregivers (‘advocates’), particularly regarding healthcare services. No measures developed specifically to evaluate health related quality of life in PWMCI or their advocates exist. Therefore the aim of this work was to gather information about these groups’ experiences of living with MCI, with particular reference to their contact with healthcare services, to use this information to develop a patient reported outcome measure (PROM) for PWMCI and equivalent measure for advocates and to suggest improvements to healthcare services in light of the findings. Initial, in-depth information was gathered during semi-structured interviews with 23 PWMCI and 20 linked advocates, the resulting data was analysed using grounded theory methods. Commonly recurring and salient themes from analysis of the interview data were used as a basis for initial drafts of the outcome measures and patient and advocate surveys regarding healthcare experiences. The outcome measures and healthcare surveys were combined into two questionnaires (one for PWMCI and one for advocates). These initial drafts were discussed with a focus group and refined in light of their feedback, the resulting questionnaires were administered (by post) to 280 PWMCI (recruited from research databases and memory clinics) and their linked advocates. The response rate was 54% for PWMCI and 36% for advocates. Data from the outcome measure section of the questionnaire was analysed using factor analysis producing a measure for PWMCI (the MCQ) and one for advocates (the MCQ-Carer); both had good psychometric properties. Descriptive analysis of the healthcare experiences survey data revealed that both the PWMCI and advocates reported a range of unmet needs for help, support and information related to MCI; appropriate suggested improvements to healthcare services are made

Health benefits from nature experiences depend on dose

Nature within cities will have a central role in helping address key global public health 3 challenges associated with urbanization. However, there is almost no guidance on how much 4 or how frequently people need to engage with nature, and what types or characteristics of 5 nature need to be incorporated in cities for the best health outcomes. Here we use a nature 6 dose framework to examine the associations between the duration, frequency and intensity of 7 exposure to nature and health in an urban population. We show that people who made long 8 visits to green spaces had lower rates of depression and high blood pressure, and those who 9 visited more frequently had greater social cohesion. Higher levels of physical activity were 10 linked to both duration and frequency of green space visits. A dose-response analysis for 11 depression and high blood pressure suggest that visits to outdoor green spaces of 30 minutes 12 or more during the course of a week could reduce the population prevalence of these illnesses 13 by up to 7% and 9% respectively. Given that the societal costs of depression alone in 14 Australia are estimated at AUD$12.6 billion per annum, savings to public health budgets 15 across all health outcomes could be immense.D.F.S. is supported through ARC Discovery Grant DP120102857 and the Centre of Excellence for Environmental Decisions (CEED, Australia); R.A.F. holds an ARC Future Fellowship; B.B.L. is supported through the CSIRO Land and Water Flagship; and K.J.G. is supported by NERC grant NE/J015237/1. J. Rhodes, K. Johansen and S. Wu contributed to the development of the vegetation data. Authors would like to thank the Brisbane City Council for providing GIS data layers, the Department of Science, Information Technology and Innovation and the Department of Natural Resources and Mines, QLD for providing access to the airborne LiDAR

Less-healthy eating behaviors have a greater association with a high level of sugar-sweetened beverage consumption among rural adults than among urban adults

Background: Sugar-sweetened beverage (SSB) consumption is associated with the increasing prevalence of overweight and obesity in the United States; however, little is known about how less-healthy eating behaviors influence high levels of SSB consumption among rural adults. Objective: We assessed the frequency of SSB consumption among rural and urban adults, examined the correlates of frequent SSB consumption, and determined difference in correlates between rural and urban adults in a large region of Texas. Design: A cross-sectional study using data on 1,878 adult participants (urban = 734 and rural = 1,144), who were recruited by random digit dialing to participate in the seven-county 2006 Brazos Valley Community Health Assessment. Data included demographic characteristics, eating behaviors (SSB consumption, frequency of fast-food meals, frequency of breakfast meals, and daily fruit and vegetable intake), and household food insecurity. Results: The prevalence of any consumption of SSB and the prevalence of high consumption of SSB were significantly higher among rural adults compared with urban counterparts. The multivariable logistic regression models indicated that a high level of SSB consumption (≥3 cans or glasses SSB/day) was associated with demographic characteristics (poverty-level income and children in the home), frequent consumption of fast-food meals, infrequent breakfast meals, low fruit and vegetable intake, and household food insecurity especially among rural adults. Conclusions: This study provides impetus for understanding associations among multiple eating behaviors, especially among economically and geographically disadvantaged adults. New strategies are needed for educating consumers, not only about how to moderate their SSB intake, but also how to simultaneously disrupt the co-occurrence of undesirable eating and promote healthful eating

Revisiting the symptom iceberg in today's primary care: results from a UK population survey

Peer reviewedPublisher PD

Electron quantum metamaterials in van der Waals heterostructures

In recent decades, scientists have developed the means to engineer synthetic periodic arrays with feature sizes below the wavelength of light. When such features are appropriately structured, electromagnetic radiation can be manipulated in unusual ways, resulting in optical metamaterials whose function is directly controlled through nanoscale structure. Nature, too, has adopted such techniques -- for example in the unique coloring of butterfly wings -- to manipulate photons as they propagate through nanoscale periodic assemblies. In this Perspective, we highlight the intriguing potential of designer sub-electron wavelength (as well as wavelength-scale) structuring of electronic matter, which affords a new range of synthetic quantum metamaterials with unconventional responses. Driven by experimental developments in stacking atomically layered heterostructures -- e.g., mechanical pick-up/transfer assembly -- atomic scale registrations and structures can be readily tuned over distances smaller than characteristic electronic length-scales (such as electron wavelength, screening length, and electron mean free path). Yet electronic metamaterials promise far richer categories of behavior than those found in conventional optical metamaterial technologies. This is because unlike photons that scarcely interact with each other, electrons in subwavelength structured metamaterials are charged, and strongly interact. As a result, an enormous variety of emergent phenomena can be expected, and radically new classes of interacting quantum metamaterials designed

False negative results from using common PCR reagents

Background\ud The sensitivity of the PCR reaction makes it ideal for use when identifying potentially novel viral infections in human disease. Unfortunately, this same sensitivity also leaves this popular technique open to potential contamination with previously amplified PCR products, or "carry-over" contamination. PCR product carry-over contamination can be prevented with uracil-DNA-glycosylase (UNG), and it is for this reason that it is commonly included in many commercial PCR master-mixes. While testing the sensitivity of PCR assays to detect murine DNA contamination in human tissue samples, we inadvertently discovered that the use of this common PCR reagent may lead to the production of false-negative PCR results.\ud \ud Findings\ud We show here that contamination with minute quantities of UNG-digested PCR product or any negative control PCR reactions containing primer-dimers regardless of UNG presence can completely block amplification from as much as 60 ng of legitimate target DNA.\ud \ud Conclusions\ud These findings could potentially explain discrepant results from laboratories attempting to amplify MLV-related viruses including XMRV from human samples, as none of the published reports used internal-tube controls for amplification. The potential for false negative results needs to be considered and carefully controlled in PCR experiments, especially when the target copy number may be low - just as the potential for false positive results already is

Structural Alterations from Multiple Displacement Amplification of a Human Genome Revealed by Mate-Pair Sequencing

Comprehensive identification of the acquired mutations that cause common cancers will require genomic analyses of large sets of tumor samples. Typically, the tissue material available from tumor specimens is limited, which creates a demand for accurate template amplification. We therefore evaluated whether phi29-mediated whole genome amplification introduces false positive structural mutations by massive mate-pair sequencing of a normal human genome before and after such amplification. Multiple displacement amplification led to a decrease in clone coverage and an increase by two orders of magnitude in the prevalence of inversions, but did not increase the prevalence of translocations. While multiple strand displacement amplification may find uses in translocation analyses, it is likely that alternative amplification strategies need to be developed to meet the demands of cancer genomics

Rac1 Is Required for Pathogenicity and Chm1-Dependent Conidiogenesis in Rice Fungal Pathogen Magnaporthe grisea

Rac1 is a small GTPase involved in actin cytoskeleton organization and polarized cell growth in many organisms. In this study, we investigate the biological function of MgRac1, a Rac1 homolog in Magnaporthe grisea. The Mgrac1 deletion mutants are defective in conidial production. Among the few conidia generated, they are malformed and defective in appressorial formation and consequently lose pathogenicity. Genetic complementation with native MgRac1 fully recovers all these defective phenotypes. Consistently, expression of a dominant negative allele of MgRac1 exhibits the same defect as the deletion mutants, while expression of a constitutively active allele of MgRac1 can induce abnormally large conidia with defects in infection-related growth. Furthermore, we show the interactions between MgRac1 and its effectors, including the PAK kinase Chm1 and NADPH oxidases (Nox1 and Nox2), by the yeast two-hybrid assay. While the Nox proteins are important for pathogenicity, the MgRac1-Chm1 interaction is responsible for conidiogenesis. A constitutively active chm1 mutant, in which the Rac1-binding PBD domain is removed, fully restores conidiation of the Mgrac1 deletion mutants, but these conidia do not develop appressoria normally and are not pathogenic to rice plants. Our data suggest that the MgRac1-Chm1 pathway is responsible for conidiogenesis, but additional pathways, including the Nox pathway, are necessary for appressorial formation and pathogenicity