Improving health-promoting self-care in family carers of people with dementia: a review of interventions

Background: Providing care for a family member with dementia can leave little time for carers to look after their own health needs, which makes them more susceptible to mental and physical health problems. This scoping review aimed to explore potential health benefits of interventions aimed at improving health-promoting self-care in family carers of people with dementia.Methods: A scoping review was carried out using Arksey and O’Malley’s methodological framework. EMBASE, MEDLINE, PsycINFO, Google Scholar databases. Original and peer-reviewed research published in English up to April 2017 were included. Publications were selected by two reviewers independently. Eight experts from several countries provided extra relevant information, which was triangulated with the review results. A narrative approach was used to describe and discuss the review findings.Results: Seven interventions were identified. These were highly heterogeneous in content, method of delivery and outcome measures. None was specifically focused on improving and evaluating health-promoting self-care, instead they often focused on health promotion and healthy lifestyle (e.g. physical activity). Some of the multi-component interventions included ‘self-care’ as a domain, but as none used a specific measure of health-promoting self-care, so we are unable to affirm that the improvements found in the interventions were due to an improvement in this area. Interventions helped reduce carer depression and burden and increased quality of life, positive affect and physical activity. The expert panel recommended to consider carers’ preparedness and capacity to adhere to self-care practices, as well as carers’ age and culture. Future interventions should be context specific, flexible and person-centered.Conclusions: Psychosocial interventions may improve health-promoting self-care behavior, but more research is needed to establish efficacy. Interventions should be flexible, use a person-centered approach, be implemented with fidelity and use the right dosage

Carbohydrate‐Functionalized Triazolylidene Iridium Complexes: Hydrogenation Catalysis in Water with Asymmetric Induction

Two sets of carbohydrate‐NHC hybrid iridium complexes were synthesised in order to combine properties of carbohydrates and triazolylidene (trz) ligands in organometallic catalysis. One set features a direct trz linkage to the anomeric carbohydrate carbon, while the second set is comprised of an ethyl linker between the two functional units. Deprotection of the carbohydrate afforded hybrid complexes that efficiently catalyse the direct hydrogenation of ketones in water. The catalytic activity of the hybrid complexes was influenced by the pH of the aqueous medium and surpassed the activity of carbohydrate‐free or acetyl‐protected analogues (>90 % vs 13 % yield). While no enantiomeric induction was observed for the ethyl‐linked hybrids, a moderate enantiomeric excess (ee) was induced by the directly linked systems. Moreover, these carbohydrate‐trz hybrid complexes displayed mixed inhibitory activity towards a glycosidase from H. orenii that contain a glucose binding site

Synaptic Activity Regulated mRNA-Silencing Foci for the Fine Tuning of Local Protein Synthesis at the Synapse

The regulated synthesis of specific proteins at the synapse is important for neuron plasticity, and several localized mRNAs are translated upon specific stimulus. Repression of mRNA translation is linked to the formation of mRNA-silencing foci, including Processing Bodies (PBs) and Stress Granules (SGs), which are macromolecular aggregates that harbor silenced messengers and associated proteins. In a recent work, we identified a kind of mRNA-silencing foci unique to neurons, termed S-foci, that contain the post-transcriptional regulator Smaug1/SAMD4. Upon specific synaptic stimulation, the S-foci dissolve and release mRNAs to allow their translation, paralleling the cycling of mRNAs between PBs and polysomes in other cellular contexts. Smaug 1 and other proteins involved in mRNA regulation in neurons contain aggregation domains distinct from their RNA binding motifs, and we speculate that self-aggregation helps silencing and transport. In addition to S-foci and PBs, other foci formed by distinct RNA binding proteins, such as TDP-43 and FMRP among others, respond dynamically to specific synaptic stimuli. We propose the collective name of synaptic activity-regulated mRNA silencing (SyAS) foci for these RNP aggregates that selectively respond to distinct stimulation patterns and contribute to the fine-tuning of local protein synthesis at the synapse.Fil: Pascual, Malena Lucía. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquimicas de Buenos Aires; Argentina. Fundación Instituto Leloir; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Luchelli, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquimicas de Buenos Aires; Argentina. Fundación Instituto Leloir; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Habif, Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquimicas de Buenos Aires; Argentina. Fundación Instituto Leloir; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Boccaccio, Graciela Lidia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquimicas de Buenos Aires; Argentina. Fundación Instituto Leloir; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentin

Dyadic construction of dementia: meta-ethnography and behaviour-process synthesis

Objectives: Positive identity in people with dementia is maintained when there is good interaction with family caregivers. However, research on the experiences of dyadic interaction in dementia care is still limited. For this reason, we aimed to systematically review the dyadic experience of dementia caring. Method: Studies were identified through searching five databases: MedLine, EMBASE, PsycInfo, ASSIA, and CINAHL. Eligible studies employed qualitative or mixed method design, reported the experience of dyads of dementia with no comorbid organic or psychiatric disorders. No restrictions were made on language or year of publication, nor on sex or age of participants. The quality appraisal of studies was conducted by two researchers independently. We used meta-ethnography to synthesise data and developed a behavioural model to explain dyadic interaction. Results: A total of 17 studies were included in the review. The meta-ethnography generated two third-order constructs: Personal orientation and noises. When both people with dementia and their carers opt for dyadic oriented goals, their behavioural responses are likely to promote positive interaction. When only one partner opts for dyadic goals, the stress posed by the context may affect the interaction because of no perceived shared understanding of the situation. Conclusion: Our findings suggest that unequal power distribution within dementia dyads, can cause significant stress especially when coping strategies are impaired. Implications are found for family carers, people with dementia, and health professionals as the model we derived enhances the understanding of dyadic dynamics to care

Shock metamorphism in plagioclase and selective amorphization

Plagioclase feldspar is one of the most common rock‐forming minerals on the surfaces of the Earth and other terrestrial planetary bodies, where it has been exposed to the ubiquitous process of hypervelocity impact. However, the response of plagioclase to shock metamorphism remains poorly understood. In particular, constraining the initiation and progression of shock‐induced amorphization in plagioclase (i.e., conversion to diaplectic glass) would improve our knowledge of how shock progressively deforms plagioclase. In turn, this information would enable plagioclase to be used to evaluate the shock stage of meteorites and terrestrial impactites, whenever they lack traditionally used shock indicator minerals, such as olivine and quartz. Here, we report on an electron backscatter diffraction (EBSD) study of shocked plagioclase grains in a metagranite shatter cone from the central uplift of the Manicouagan impact structure, Canada. Our study suggests that, in plagioclase, shock amorphization is initially localized either within pre‐existing twins or along lamellae, with similar characteristics to planar deformation features (PDFs) but that resemble twins in their periodicity. These lamellae likely represent specific crystallographic planes that undergo preferential structural failure under shock conditions. The orientation of preexisting twin sets that are preferentially amorphized and that of amorphous lamellae is likely favorable with respect to scattering of the local shock wave and corresponds to the “weakest” orientation for a specific shock pressure value. This observation supports a universal formation mechanism for PDFs in silicate minerals

Riego por goteo en nogal

El mercado mundial de las nueces ha experimentado un aumento sostenido en los últimos años, sustentado en el creciente interés por los frutos secos, que se perciben como alimentos naturales y saludables. En Mendoza, el área cultivada con nogales ha tenido un gran crecimiento, lo que queda plasmado en el último Relevamiento Nacional de frutos secos (2016/2017) donde se registró una superficie de 5.299 ha, área que continúa en aumento y con incorporación de importantes mejoras tecnológicas, principalmente el cambio del riego tradicional por gravedad a riego localizado (goteo)

Simultaneous bilateral dual mobility total hip arthroplasty dislocation in a patient with hepatic encephalopathy: A case report

Luxació; Mobilitat dual; Encefalopatia hepàticaDislocación; Movilidad dual; Encefalopatía hepáticaDislocation; Dual mobility; Hepatic encephalopathyIntroduction and importance Dislocation is a severe complication after total hip arthroplasty (THA). It is one of the most common reasons for failure and revision surgery. This is the first case of a documented simultaneous bilateral dual mobility (DM) THA dislocation. Case presentation A forty-nine-year-old man presented with bilateral hip pain, immobility and deformity. X-ray images demonstrated simultaneous bilateral posterior THA dislocation. Previously, the patient had presented atraumatic dislocations recurrently. When he was thoroughly re-interrogated, he complained of uncontrolled and generalized muscle contractions, which were compatible with myoclonus due to hepatic encephalopathy (HE). Multidisciplinary treatment was performed satisfactorily to control myoclonus symptomatology and to prevent dislocation. Clinical discussion Patient’s most important risk factor was a neuromuscular disorder, which we initially gave little notice and undervalued. HE is a serious but reversible syndrome, observed in patients with liver dysfunction. It leads to a wide spectrum of neuropsychiatric abnormalities. Management is based on prevention of episodes, avoiding the underlying triggers. Due to the high risk for dislocation of our patient, we decided to use DM cups bilaterally. This system has demonstrated lower rates of dislocation. Conclusion This case report reminds us that a careful evaluation through meticulous history and physical examination are mandatory when faced with recurrent instability. Furthermore, prevention of dislocation is vastly preferable to treating this challenging complication. High-risk patients should be identified, and appropriate surgical approach, technique and implants have to be collectively used to reach a strategy that mitigates and ideally prevents dislocation

Miocene semidiurnal tidal rhythmites in Madre de Dios, Peru: Reply

Hoorn et al. commented on the following aspects of our 2005 Geology article: 1) the age of the sediments, 2) the interpreted brackish water affi nity of the studied deposits, and 3) the possible connection between Paraná and western Amazonia depositional systems during the late Miocene

Serum neurofilament light chains in progressive multiple sclerosis patients treated with repeated cycles of high-dose intravenous steroids

Background and objectives: In progressive multiple sclerosis (MS) patients, CNS inflammation trapped behind a closed blood brain barrier drives continuous neuroaxonal degeneration, thus leading to deterioration of neurological function. Therapeutics in progressive MS are limited. High-dose intravenous glucocorticosteroids (HDCS) can cross the blood-brain barrier and may reduce inflammation within the CNS. However, the treatment efficacy of HDCS in progressive MS remains controversial. Serum neurofilament light chains (sNfL) are an established biomarker of neuroaxonal degeneration and are used to monitor treatment responses. We aimed to investigate whether repeated cycles of intravenous HDCS reduce the level of sNfL in progressive MS patients. Methods: We performed a monocentric observational study of 25 patients recruited during ongoing clinical routine care who were treated with repeated cycles of intravenous HDCS as long-term therapy for their progressive MS. sNfL were measured in 103 repeated blood samples (median time interval from baseline 28 weeks, range 2-55 weeks) with the Single Molecular Array (SiMoA) technology. The Expanded Disability Status Score (EDSS) was documented at baseline and follow-up. Results: The median age of patients was 55 years (range 46-77 years) with a median disease duration of 26 years (range 11-42 years). sNfL baseline levels at study inclusion were significantly higher in progressive MS patients compared to age-matched healthy controls (median 16.7 pg/ml vs 11.5 pg/ml, p=0.002). sNfL levels showed a positive correlation with patient age (r=0.2, p=0.003). The majority of patients (72%, 16/23) showed reduced sNfL levels ≥20 weeks after HDCS compared to baseline (median 13.3 pg/ml, p=0.03). sNfL levels correlated negatively with the time interval from baseline HDCS therapy (r=-0.2, p=0.03). This association was also evident after correction for treatment with disease-modifying drugs (adjusted R2=0.10, p=0.001). The EDSS remained stable (median 6.5) within a median treatment duration of 26 weeks (range 13-51 weeks). Conclusion: Although larger studies are needed to confirm our findings, we were able to demonstrate that HDCS treatment reduces sNfL levels and therefore may slow down neuroaxonal damage in a subgroup of patients with progressive MS. Moreover, a stable EDSS was observed during therapy. Findings suggest that HDCS may be beneficial for the treatment of progressive MS

Les coopérations scientifiques entre les laboratoires français et polonais

Il s'agit d'une tentative de description et d'identification des éléments constitutifs des coopérations entre la France (FRA) et la Pologne (POL). Dans la première partie, nous présentons quelques tableaux qui montrent la position de la Pologne sur la scène mondiale, dans la coopération scientifique internationale, en fonction des champs scientifiques. Il s'agit de l'application à la Pologne du système d'indicateurs d'internationalisation de la science mis au point par le LEPI. Les données présentées dans ces tableaux feront ultérieurement l'objet d'une analyse approfondie en coopération avec le LEPI. Les chiffres utilisés pour la première partie de cette étude sont extraits de la base de données MEV-MAC qui est constituée des cosignatures de 72 pays avec pour chacun d'eux, une période de six ans (1981-1986) et huit champs scientifiques à partir de la base de données bibliographique Science Citation Index (ISI). Les journaux scientifiques (plus de 3000 titres) retenus par ISI sont, pour la plupart, sélectionnés à partir de critères solides qui ont fait l'objet de nombreuses analyses critiques. La classification et abréviations de chaque champs scientifique sont les suivantes : Mathématiques (MAT) Physique (PHY) Ingénierie et Technologie (ENT) Terre et Espace (EAS) Biologie fondamentale, animale et végétale (BIO) Clinique (CLI) Chimie (CHM) Dans la deuxième partie nous présentons une approche MEV-micro qui offre une vision de ce qui se passe entre la France et la Pologne au niveau des universités et des laboratoires de recherche à partir de l'extraction des cosignatures d'articles publiés en 1984. Cette extraction (France-Monde) a été faite par la société Computer Horizons Inc.(CHI) à la demande du Laboratoire d'Evaluation et de Prospective Internationales du CNRS (LEPI) à partir de la base originale SCI (ISI) pour l'année 1984. CHI a compté le nombre d'articles, les notes à l'éditeur et les revues, tandis que les éditoriaux, les séminaires ou les congrès sont exclus. La méthodologie utilisée en deuxième partie (MEV-micro), brièvement décrite en conclusion, est une analyse documentaire qui aboutit à la détermination de la structure de la coopération telle qu'elle a été définie par le LEPI dans les bases de données BADIN et ME