The project “understAID”, a platform that helps informal caregivers to understand and aid their demented relatives

[Abstract] “UnderstAID” is a platform that helps informal caregivers to understand and aid their demented relatives. It is an international project initiated by Denmark, Poland and Spain. The aim of the project is to design, and implement the multimedia platform “understAID” to support informal caregivers of dementia patients. The project was launched in April 2013 and is expected to end 36 months later. The project is divided into five tasks concerning the final aim. The aim of task 1 is the management of the project, as well as the exploitation and dissemination of gathered information. Task 2 is meant to define the contents and solutions of the CarePlatform based on the knowledge gained from real-case studies. Demented elderlies from each country (n = 40) suffering from different degrees of dementia were evaluated by formal caregivers and dementia professionals. The aim of task 3 is the development of the social learning interface. Task 4 focuses on the CarePlatform development and system integration. Finally, task 5 assumes testing and validation of the platform. The platform is devised to be available in two versions, namely the light one for mobile appliance and the premium version. Also different activities leading to the popularization of the platform are planned

What causes grief in dementia caregivers?

[Abstract] Alzheimer’s disease (AD) is the most prevalent neurodegenerative disease in the world. Most AD patients become dependent on their relatives, i.e. family caregivers. Providing care to a person with AD influences caregiver’s life and leads to feelings of grief, which often precede caregiver depression. The purpose of the article was to evaluate the Meuser and Marwit Caregiver Grief Inventory (MM-CGI-50) for use in Polish family caregivers and to find out determinants of grief of family caregivers of AD individuals living in Poland. A sample of 151 spouse and adult child caregivers of community-dwelling AD patients (95 females and 56 males) was interviewed to determine the influence of such factors as caregiver’s age, gender, family relation to the care recipient (CR) and caregiving-related changes in caregiver’s working time, leisure time and material status to find out the impact of caregiving role on intensity of caregiver grief. Caregiver grief was measured by means of MM-CGI-50. Additionally, carers were administered a questionnaire including patient’s and caregiver’s demographics. Also, CR’s dementia assessment was informant-based and determined with investigator-administered clinical dementia rating (CDR) scale. Of all analyzed factors, only caregiver’s informant dementia rating significantly influenced caregiver grief. To conclude, the effect of caregiver’s age, gender, family relation to the CR and caregiving-related changes in caregiver’s working time; leisure time and material status could not be found. To add, MM- CGI-50 can be effectively used to assess grief in Polish family caregivers of AD patients

RECOMMENDATIONS OF THE ALZHEIMER'S DISEASE INTERNATIONAL CONCERNING THE CARE OF PATIENTS WITH DEMENTIAAND THE SITUATION IN POLAND

According to data of WHO research, there are an estimated 36,5 million people with dementia worldwide. They need long-term care. The nature of this care depends on economic situation of the country - the higher developed it is, the bigger participation of institutions specialized in long-term care and smaller participation of home care. In high income countries around one-third to one-half of people with dementia are cared for in care homes. Alzheimer's Disease International (ADI) predicts that by 2030 number of patients with dementia will double and triple by 2050. This prognosis requires advanced planning, monitoring and coordination actions to improve system of long-term care. To achieve this goal, ADI recommends: promoting broad public awareness of dementia and combating stigma, identifying dementia capable support services at all stages of the disease, assessing and improving the quality of health care, social care and long-term care support and services, assessing availability and access to diagnostic services, promotion of brain health. Caregivers should be valued by society for they demanding and difficult work. Also patients should keep their autonomy and choice. 92% of suffering from dementia patents in Poland are cared at home since beginning of disease until their death. Other 8% stays at different types of home cares. There are also short-term care, daily care and ambulatory care available. The reasons of small participation of those institutions are: maladjusted to growing number of patients with dementia system of care, complicated administrative procedures, lack of money to cover up costs of care and lack of knowledge about dementia in society

UnderstAID, an ICT platform to help informal caregivers of people with dementia: a pilot randomized controlled study

[Abstract] Information and communications technology (ICT) could support ambient assisted living (AAL) based interventions to provide support to informal caregivers of people with dementia, especially when they need to cope with their feelings of overburden or isolation. An e-learning platform (understAID application) was tested by informal caregivers from Denmark, Poland, and Spain to explore the technical and the pedagogical specifications, as well as evaluating the impact of its use on the psychological status of the participants. 61 informal caregivers completed the study taking part in the experimental (n=30) or control (n=31) groups. 33.3% of the caregivers were satisfied with the application and around 50% of the participants assessed it as technically and pedagogically acceptable. After using understAID the caregivers in the experimental group significantly decreased their depressive symptomatology according to the Center for Epidemiologic Studies Depression scale, but a possible benefit on their feelings of competence and satisfaction with the caring experience was also observed. The low scores obtained for satisfaction were highlighting issues that need to be modified to meet the informal caregivers’ needs in national, social, and cultural context. Some possible biases are also considered and discussed to be taken into account in future improvements of understAID application.European Commission; AAL-2012-5-10

Immunoglobulin G structure and rheumatoid factor epitopes

Antibodies are important for immunity and exist in several classes (IgM, IgD, IgA, IgG, IgE). They are composed of symmetric dimeric molecules with two antigen binding regions (Fab) and a constant part (Fc), usually depicted as Y-shaped molecules. Rheumatoid factors found in patients with rheumatoid arthritis are autoantibodies binding to IgG and paradoxically appear to circulate in blood alongside with their antigen (IgG) without reacting with it. Here, it is shown that rheumatoid factors do not react with native IgG in solution, and that their epitopes only become accessible upon certain physico-chemical treatments (e.g. heat treatment at 57 °C), by physical adsorption on a hydrophobic surface or by antigen binding. Moreover, chemical cross-linking in combination with mass spectrometry showed that the native state of IgG is a compact (closed) form and that the Fab parts of IgG shield the Fc region and thereby control access of rheumatoid factors and presumably also some effector functions. It can be inferred that antibody binding to pathogen surfaces induces a conformational change, which exposes the Fc part with its effector sites and rheumatoid factor epitopes. This has strong implications for understanding antibody structure and physiology and necessitates a conceptual reformulation of IgG models