Awareness of memory functioning and quality of life for people with dementia and their caregivers

Background: Unawareness of memory functioning is a key symptom of Alzheimer’s disease and dementia that has been demonstrated to be related to a number of important factors for the person with dementia (PwD) and their family caregivers including quality of life and depression. Understanding more about how awareness relates to these factors will help inform how PwD and their caregivers are best supported. Objective: A meta-analysis was conducted in order to examine the relationship between Awareness and depression in dementia. An empirical study was conducted to examine the contribution awareness provides to explaining PWDs’ Quality of Life (QoL). PwD have been found to be aware of factors that affect their caregiver and so caregiver wellbeing and quality of life and the quality of the caregiving relationship were also investigated as well as more established predictors of quality of life for PwD. Both PwD self-ratings and caregiver ratings of the PwD they care for of QoL were examined as they have been shown to be affected by different factors. Method: Meta-analysis: A search of electronic databases Psycinfo, Embase and Medline was conducted. A meta-analysis of correlations was undertaken examining the relationship between awareness and depression in dementia. Empirical study: 27 PwD and their caregivers were recruited. In order to assess the research aims the PwD completed measures of: Quality of life (Quality Of Life-Alzheimer’s Disease scale), awareness of memory functioning (Memory Awareness Rating Scale-Adjusted), cognitive functioning (Addenbrooke’s Cognitive Exam-R), depression and anxiety (Hospital Anxiety and Depression Scale). The caregiver completed measures of: PwD Quality of life (Quality Of Life-Alzheimer’s Disease scale proxy), Memory Functioning Scale (from MARSA), self-ratings of depression and anxiety (Hospital Anxiety and Depression Scale), activities of daily living (Disability Assessment in Dementia), Neuropsychiatric symptoms (Neuropsychiatric symptoms inventory-Questionnaire), caregiver burden (Zarit Burden Inventory), and rating of relationship quality with PwD (Burns Relationship Satisfaction Scale). Results: Meta-analysis: Thirty-one studies were identified. A small association was found between awareness and depression with substantial amount of heterogeneity (- 0.23). Analysing the studies that excluded major depression demonstrated that mild depression had a moderate negative relationship with awareness (-0.42). Subgroup analysis showed that the different measures of awareness used seemed to suggest different effects with depression for different measures. Empirical study: Awareness was not found to predict PwD rated or caregiver rated QoL. No caregiver variables predicted PwD QoL. Depression and neuropsychiatric symptoms predicted PwD QoL. Caregiver rated QoL was predicted by activities of daily living and caregiver rated quality of caregiving relationship. Conclusions: Meta-analysis: The effect between mild depression and lack of awareness but not major depression supports the assertion that unawareness is a psychological response to decline in memory functioning in dementia. Neither depression nor awareness appear to be unitary constructs in PwD. Empirical study: Awareness not related to PwD QoL. The quality of caregiving relationship is important to QoL in a dementia context. PwD and their caregivers rate the QoL of PwD differently

Further development and feasibility randomised controlled trial of a digital programme for adolescent depression, MoodHwb: study protocol

Introduction: A digital programme, MoodHwb, was codesigned with young people experiencing or at high risk of depression, parents/carers and professionals, to provide support for young people with their mood and well-being. A preliminary evaluation study provided support for the programme theory and found that MoodHwb was acceptable to use. This study aims to refine the programme based on user feedback, and to assess the acceptability and feasibility of the updated version and study methods. Methods and analysis: Initially, this study will refine MoodHwb with the involvement of young people, including in a pretrial acceptability phase. This will be followed by a multicentre feasibility randomised controlled trial comparing MoodHwb plus usual care with a digital information pack plus usual care. Up to 120 young people aged 13–19 years with symptoms of depression and their parents/carers will be recruited through schools, mental health services, youth services, charities and voluntary self-referral in Wales and Scotland. The primary outcomes are the feasibility and acceptability of the MoodHwb programme (including usage, design and content) and of trial methods (including recruitment and retention rates), assessed 2 months postrandomisation. Secondary outcomes include potential impact on domains including depression knowledge and stigma, help-seeking, well-being and depression and anxiety symptoms measured at 2 months postrandomisation. Ethics and dissemination: The pretrial acceptability phase was approved by the Cardiff University School of Medicine Research Ethics Committee (REC) and the University of Glasgow College of Medicine, Veterinary and Life Sciences REC. The trial was approved by Wales NHS REC 3 (21/WA/0205), the Health Research Authority(HRA), Health and Care Research Wales (HCRW), university health board Research and Development (R&D) departments in Wales, and schools in Wales and Scotland. Findings will be disseminated in peer-reviewed open-access journals, at conferences and meetings, and online to academic, clinical, and educational audiences and the wider public. Trial registration number ISRCTN12437531

Novel chemotaxonomic markers of the Alternaria infectoria species-group

We demonstrate cascade manipulation between magic number gold–fullerene hybrid clusters by channelling thermal energy into a specific reaction pathway with a trigger from the tip of a scanning tunnelling microscope (STM). The (C₆₀)_<i>m</i>–Au_<i>n</i> clusters, formed via self-assembly on the Au(111) surface, consist of <i>n</i> Au atoms and <i>m</i> C₆₀ molecules; the three smallest stable clusters are (C₆₀)₇–Au₁₉, (C₆₀)₁₀–Au₃₅, and (C₆₀)₁₂–Au₄₉. The manipulation cascade was initiated by driving the STM tip into the cluster followed by tip retraction. Temporary, partial fragmentation of the cluster was followed by reorganization. Self-selection of the correct numbers of Au atoms and C₆₀ molecules led to the formation of the next magic number cluster. This cascade manipulation is efficient and facile with an extremely high selectivity. It offers a way to perform on-surface tailoring of atomic and molecular clusters by harnessing thermal energy, which is known as the principal enemy of the quest to achieve ultimate structural control with the STM

B0 Concomitant Field Compensation for MRI Systems Employing Asymmetric Transverse Gradient Coils

Purpose: Imaging gradients result in the generation of concomitant fields, or Maxwell fields, which are of increasing importance at higher gradient amplitudes. These time‐varying fields cause additional phase accumulation, which must be compensated for to avoid image artifacts. In the case of gradient systems employing symmetric design, the concomitant fields are well described with second‐order spatial variation. Gradient systems employing asymmetric design additionally generate concomitant fields with global (zeroth‐order or B0) and linear (first‐order) spatial dependence. (c) 2017 International Society for Magnetic Resonance in Medicine.2