How people with dementia and carers understand and react to social functioning changes in mild dementia: a UK-based qualitative study

OBJECTIVES: To analyse people with dementia and their family carers' attribution of social changes in dementia and the consequences of these attributions. DESIGN: Qualitative study, using a semi-structured interview guide. Individual interviews continued to theoretical saturation. Two researchers independently analysed interview transcripts. SETTING AND PARTICIPANTS: People with mild dementia and family carers purposively selected from London-based memory services for diverse demographic characteristics to encompass a range of experiences. PRIMARY AND SECONDARY OUTCOMES: Attribution of social changes experienced by the person with dementia and the consequences of these attributions. RESULTS: We interviewed nine people with dementia and nine carers, encompassing a range of age, ethnicity and educational backgrounds.Both groups reported that the person with dementia had changed socially. People with dementia tended to give one or two explanations for social change, but carers usually suggested several. People with dementia were often socially embarrassed or less interested in going out, and they or their relatives' physical illness or fear of falls led to reduced social activity. Carers often attributed not going out to a choice or premorbid personality. Carers found that their relative needed more support to go out than they could give and carers needed time to themselves because of carer stress or other problems from which they shielded the person with dementia. Additionally, there was decreased opportunity to socialise, as people were bereaved of friends and family. Participants acknowledged the direct impact of dementia symptoms on their ability to socially engage but sometimes decided to give up socialising when they knew they had dementia. There were negative consequences from social changes being attributed to factors such as choice, rather than dementia. CONCLUSION: Clinicians should ask about social changes in people with dementia. Explaining that these may be due to dementia and considering strategies to overcome them may be beneficial

Revisiting Brown Versus Board of Education: Differences in School Context and the influence of Racial Attitudes on Academic Attainment and Civic Engagement among Black Americans across the Lifespan

Since Brown versus the Board of Education 60 years ago, educators and social and behavioral scientists have tried to identify factors related to better achievement for Black Americans. Since the desegregation of schools in the U.S., Black American students have reported lower grade point averages, standardized test scores, and graduation rates (Allen, 1992). Previous research has investigated school context and climate as well as the influence of racial attitudes on academic achievement. Findings suggest that positive student perceptions of school climate and context (e.g., pride, social support, relationships with a teacher, access to resources) were related to better academic outcomes (Hurley & Lustbader, 1997). However, the research on the influence of racial attitudes have been inconclusive (Chavous et al., 2003; Fordham & Ogbu 1986). Thus, the purpose of this study is two-fold. First, to explore whether racial attitudes were related to academic attainment and civic engagement, and second, to examine whether there are differences in perceptions in school pride and school climate for students in historically black high schools and historically white high schools. To assess the aforementioned research questions, thirty-three Black American high school graduates from a historically white high school and eighty-two Black Americans from historically black high schools were sampled. Spearman Rho correlations and Independent sample T-tests were run to assess the relationship between the following. 1) Racial attitudes, educational attainment, and civic engagement. 2) Differences in perceptions of school climate for Blacks at historically White and Black high schools. Findings reveal statistically significant associations between racial attitudes and educational attainment as well as civic engagement. Moreover, differences were also found in perceptions of climate across school types. Given these results, further research is needed to explore the influence of students’ perception of their school experience and racial attitudes upon educational and life outcomes

The relationship of bilingualism to cognitive decline: The Australian Longitudinal Study of Ageing

OBJECTIVES: We wished to clarify the link between bilingualism and cognitive decline, and examine whether improved executive function due to bilingualism may be a factor in preventing cognitive decline. METHODS: We used the Australian Longitudinal Study of Ageing which collected data on 2087 participants aged over 65 over 20 years. We compared baseline demographics, health, and social characteristics between bilingual and non-bilingual participants. We used linear mixed models analysis to explore the effect of bilingualism on MMSE score over time and linear regression to explore the effect of bilingualism on baseline MMSE scores, controlling for pre-specified potential confounders. RESULTS: Bilingual participants had lower baseline MMSE scores than the non-bilingual population (mean difference = -2.3 points; 95% confidence intervals = 1.56-2.90). This was fully explained by education and National Adult Reading Test scores (17.4; standard deviation [SD] =7.7 versus 28.1; SD = 8.2) which also partly explained baseline executive function test scores differences. Bilingual and non-bilingual participants did not differ in MMSE decline over time (-0.33 points, P = 0.31) nor on baseline tests of executive function (-0.26, P = 0.051). CONCLUSIONS: In this cohort, education rather than bilingualism was a predictor of MMSE score, and being bilingual did not protect from cognitive decline. We conclude that bilingualism is complex, and when it is not the result of greater educational attainment, it does not always protect from cognitive decline. Neuroprotective effects of bilingualism over time may be attributable to the precise patterns of language use but not to bilingualism per se

Helping education undergraduates to use appropriate criteria for evaluating accounts of motivation

The aim of the study was to compare students in a control group with those in a treatment group with respect to evaluative comments on psychological accounts of motivation. The treatment group systematically scrutinized the nature and interpretation of evidence that supported different accounts, and the assumptions, logic, coherence and clarity of accounts. Content analysis of 74 scripts (using three categories) showed that the control group students made more assertions than either evidential or evaluative points, whereas the treatment group used evaluative statements as often as they used assertion. The findings provide support for privileging activities that develop understanding of how knowledge might be contested, and suggest a need for further research on pedagogies to serve this end. The idea is considered that such understanding has a pivotal role in the development of critical thinking

Initial multicenter experience with double nucleoside therapy for human immunodeficiency virus infection during pregnancy.

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications. METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV infection status. RESULTS: For all 39 women, zidovudine (ZDV) therapy was instituted at 13.4 +/- 8.2 weeks, with a second agent (lamivudine [3TC] in 85% of cases) being added at a mean gestational age of 17.6 weeks. Duration of therapy with two agents was 20.6 +/- 10.4 weeks overall, with no women stopping medications because of side effects or toxicity. No significant changes in maternal laboratory values were seen, except for an increase in mean corpuscular volume, over the course of pregnancy. No clinically significant adverse neonatal outcomes were noted, with all but the three preterm newborns leaving hospital with their mothers. Neonatal anemia (hematocrit < 50%) was seen in 62% of newborns, with no children needing transfusion; mild elevations of liver function tests, primarily aspartate aminotransferase, were noted in 58% of newborns tested, though none were clinically jaundiced. Overall rate of neonatal HIV infection was 2.5% (95% confidence interval: 0.1-13.2%). CONCLUSION: Combination antiretroviral therapy during pregnancy with two nucleoside analogs was well-tolerated by mothers and newborns, with no significant short-term toxicities or side effects noted. Surveillance of exposed newborns' hematologic and liver function appears warranted

A Young Planet Search in Visible and IR Light: DN Tau, V836 Tau, and V827 Tau

In searches for low-mass companions to late-type stars, correlation between radial velocity variations and line bisector slope changes indicates contamination by large starspots. Two young stars demonstrate that this test is not sufficient to rule out starspots as a cause of radial velocity variations. As part of our survey for substellar companions to T Tauri stars, we identified the ~2 Myr old planet host candidates DN Tau and V836 Tau. In both cases, visible light radial velocity modulation appears periodic and is uncorrelated with line bisector span variations, suggesting close companions of several M_Jup in these systems. However, high-resolution, infrared spectroscopy shows that starspots cause the radial velocity variations. We also report unambiguous results for V827 Tau, identified as a spotted star on the basis of both visible light and infrared spectroscopy. Our results suggest that infrared follow up observations are critical for determining the source of radial velocity modulation in young, spotted stars.Comment: Accepted for publication in the Astrophysical Journal Letter

Promoting well-being: Crisis, loss and alcohol

Well-being is a concept which can connect together a number of important ideas that have a strong resonance for professional education and practice across the human services. This can critically include considerations of illness, crisis, and loss. Such acute moments in individuals’ lives can be examined through their precipitating events, coping mechanisms, and responses. This article explores some of the dimensions of well-being and how they facilitate a greater understanding of illness, crisis, and loss. These deliberations are then exemplified through a focus on alcohol and other drug use