Dementia in Malta : new prevalence estimates and projected trends

Previous estimates have indicated that in 2005, there were 4,072 individuals with dementia (IWD) in the Maltese islands and that this number would almost double by the year 2050. These figures were based on the EURODEM project that analysed the results of a population-based systematic review of published studies on the global prevalence of dementia from 1980 to 2004. Since then, further dementia prevalence studies have been carried out in Europe. These were reviewed in another European funded project, the EUROCODE project, with the aim of developing consensual European age and gender specific prevalence rates that would be acceptable for all countries. Using these revised rates, the estimated number of IWD over 60 years of age in the Maltese islands in 2010 was found to be 5,198; a significant increase on previous projected data. Likewise, the number of IWD in Malta over 60 years in 2030 is projected to be close to 10,000 persons or 2.3% of the total Maltese population. Using these revised estimates, the 2% prevalence rate of dementia among the local population is expected to be reached by 2025; twenty-five years prior to what was previously reported. The data presented here include current updated estimates and projections for the number of IWD in the Maltese islands.peer-reviewe

Reframing dementia care in Maltese Hospitals

This commentary addresses the urgent need to improve the care of patients with dementia and cognitive impairment in Maltese hospitals by proposing a number of dementia-friendly hospital-based initiatives. The authors discuss the rationale for developing these interventions in view of the increase in prevalence of persons with dementia in the Maltese Islands, some of whom may require hospital care at any time. Lessons learned from initiatives abroad are reviewed and an overview of the key objectives set out in the National Strategy for Dementia in the Maltese Islands is given. Finally, this article proposes a number of dementia-friendly initiatives that can be introduced in Maltese hospitals so as to induce the required change.peer-reviewe

Alzheimer's disease research group (ADRG)

In these last few years, there has been a growing consensus in Europe and beyond on the need of increasing research on neurodegenerative diseases including Alzheimer's disease and other related dementias. The societal impact and financial consequences of these diseases are already being felt and will continue to grow with the projected rise in the elderly population. Currently, there are over 35 million individuals with dementia worldwide, a figure that will treble by the year 2050. It has been estimated that formal and informal dementia care costs a total of €445 billion (2009 data),' equivalent to 1 % of the global gross domestic product. It is therefore not surprising that the European Union supports various funding programmes in the hope of enhancing diagnosis, provide better treatment and improve care pathways and support for individuals with dementia, their caregivers and relatives.peer-reviewe

Caring for older persons with dementia : the principles of person-centred care

Dementia is not a single disease or condition but a syndrome of multiple causes. It is usually used as an ‘umbrella’ term (Moore, 2009) for more than 200 different conditions and disorders characterised by a progressive deterioration in cognitive function, some of which are considerably rare. Knopman et al. (2003) proposed different diagnostic criteria for differentiating between the most common types of dementia, namely Alzheimer’s disease (AD), Vascular Dementia, Dementia with Lewy Body and Fronto-temporal dementia. Such cognitive decline includes loss of memory and impairment in executive functions such as planning and organisational skills, accompanied by personality changes and deterioration in cognitive function sufficient to limit social activities.peer-reviewe

Using appreciative inquiry to implement person-centred dementia care in hospital wards

The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an Appreciative Inquiry (AI) approach to implement person-centred dementia care in two hospital wards. Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using AI approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in AI workshops, during which they are listened to and appreciated for what they can contribute

A common variant associated with dyslexia reduces expression of the KIAA0319 gene

This work was supported by the Wellcome Trust (MYD, SP, TSS, JCK, RWM, PC, SB, and APM), the Intramural Research Programs of the National Human Genome Research Institute (MYD and EDG) and National Cancer Institute (MPO), and the NIH/Ox-Cam Graduate Partnership Program (MYD).Numerous genetic association studies have implicated the KIAA0319 gene on human chromosome 6p22 in dyslexia susceptibility. The causative variant(s) remains unknown but may modulate gene expression, given that (1) a dyslexia-associated haplotype has been implicated in the reduced expression of KIAA0319, and (2) the strongest association has been found for the region spanning exon 1 of KIAA0319. Here, we test the hypothesis that variant(s) responsible for reduced KIAA0319 expression resides on the risk haplotype close to the gene's transcription start site. We identified seven single-nucleotide polymorphisms on the risk haplotype immediately upstream of KIAA0319 and determined that three of these are strongly associated with multiple reading-related traits. Using luciferase-expressing constructs containing the KIAA0319 upstream region, we characterized the minimal promoter and additional putative transcriptional regulator regions. This revealed that the minor allele of rs9461045, which shows the strongest association with dyslexia in our sample (max p-value = 0.0001), confers reduced luciferase expression in both neuronal and non-neuronal cell lines. Additionally, we found that the presence of this rs9461045 dyslexia-associated allele creates a nuclear protein-binding site, likely for the transcriptional silencer OCT-1. Knocking down OCT-1 expression in the neuronal cell line SHSY5Y using an siRNA restores KIAA0319 expression from the risk haplotype to nearly that seen from the non-risk haplotype. Our study thus pinpoints a common variant as altering the function of a dyslexia candidate gene and provides an illustrative example of the strategic approach needed to dissect the molecular basis of complex genetic traits.PostprintPeer reviewe

Systemic inflammation in COPD is not influenced by pulmonary rehabilitation

Purpose: Pulmonary rehabilitation is known to lead to improvements in exercise tolerance, health-related quality of life and help reduce symptoms. Exercise, one of the largest components of such an intervention, although of great benefit, can increase the inflammatory response related to chronic obstructive pulmonary disease, depending on intensity and duration. Through this study, the effects of a 12week, high-intensity PR programme on COPD inflammatory-related markers were investigated. Materials and methods: This study is a longitudinal, observational type of study. Sixty COPD patients were enrolled, 49 of which completed the programme. A 2-h high-intensity PR programme was delivered, twice weekly for 12 weeks. The following markers were assessed at baseline, 4, 8 and 12 weeks through rehabilitation – C-reactive protein, erythrocyte sedimentation rate, neutrophil, eosinophil counts, complete blood count, six-minute walk test and St. George’s Respiratory Questionnaire. Serum amyloid A levels were assessed at baseline, week 8 and 12 and exhaled NO at baseline and upon completion of the programme. Results: This 12-week PR programme resulted in no changes in the inflammatory markers but resulted in significant improvements in both the 6MW distance and health quality of life. Conclusions: Beneficial effects on functional and HRQoL measures resulted, which, however, appear unrelated to changes in the systemic inflammatory markers.peer-reviewe

Taking social networks to the next level

Since the boom of social networking lead to people using multiple account on many platforms in order to keep in touch with hundreds of contacts, managing one's contacts risks becoming a burden for many users. Following and finding information about friends and family has become an issue too. Guided by these observations and by careful research of existing adaptive web technologies, our team worked on the development of SNAP - an adaptive social network integrator which aimed to amalgamate various social networks (Facebook, Twitter and Flickr) in one adaptive environment, which unobtrusively sorts the users' feed according to his/her preference. To achieve data transfer and authorisation, SNAP uses the newest version of the OAuth protocol. Adaptivity was achieved through statistical filtering. The initial field tests show that the system works, however there is definitely room for improvement in terms of Social Network Integration, and testers generally expressed an interest in the idea of using an adaptive social integrator such as SNAP. On top of this, we will be suggesting a number of improvements which will change the way we use social networks forever.peer-reviewe

Genome-wide screening for DNA variants associated with reading and language traits

This research was funded by: Max Planck Society, the University of St Andrews - Grant Number: 018696, US National Institutes of Health - Grant Number: P50 HD027802, Wellcome Trust - Grant Number: 090532/Z/09/Z, and Medical Research Council Hub Grant Grant Number: G0900747 91070Reading and language abilities are heritable traits that are likely to share some genetic influences with each other. To identify pleiotropic genetic variants affecting these traits, we first performed a genome‐wide association scan (GWAS) meta‐analysis using three richly characterized datasets comprising individuals with histories of reading or language problems, and their siblings. GWAS was performed in a total of 1862 participants using the first principal component computed from several quantitative measures of reading‐ and language‐related abilities, both before and after adjustment for performance IQ. We identified novel suggestive associations at the SNPs rs59197085 and rs5995177 (uncorrected P ≈ 10–7 for each SNP), located respectively at the CCDC136/FLNC and RBFOX2 genes. Each of these SNPs then showed evidence for effects across multiple reading and language traits in univariate association testing against the individual traits. FLNC encodes a structural protein involved in cytoskeleton remodelling, while RBFOX2 is an important regulator of alternative splicing in neurons. The CCDC136/FLNC locus showed association with a comparable reading/language measure in an independent sample of 6434 participants from the general population, although involving distinct alleles of the associated SNP. Our datasets will form an important part of on‐going international efforts to identify genes contributing to reading and language skills.Publisher PDFPeer reviewe

SNAP : the social network adaptive portal

Since the boom of social networking lead to people using multiple account on many platforms in order to keep in touch with hundreds of contacts, managing one's contacts risks becoming a burden for many users. Following and finding information about friends and family has become an issue too. Guided by these observations and by careful research of existing adaptive web technologies, our team worked on the development of SNAP - an adaptive social network integrator which aimed to amalgamate four social networks (Facebook, Twitter, Flickr and Buzz) in one adaptive environment, which to unobtrusively sort the users' feed according to his/her preference. To achieve data transfer and authorisation, SNAP used APIs and the newest version of the OAuth protocol. Adaptivity was achieved through statistical filtering. Despite efforts, the initial field tests show that the system is not as yet ready to be launched for wider use. However, there is room for improvement in terms of Social Network Integration, and tester users expressed an interest in the idea of using an adaptive social integrator such as SNAP.peer-reviewe