Sleep disturbances in people with dementia living in care homes: measurement, prevalence, manifestation, causes, impact, and persistence

Background :Sleep disturbances are common in people living with dementia and maybe the reason they move into a care home. A third of people with dementia in the UK live in care homes. However, there is little research into the prevalence, causes and impacts of sleep disturbances in this population, and this has practical implications on if and how these disturbances should be treated. / Aim: I aimed to investigate measurement, prevalence, manifestation, causes, impact, and persistence of sleep disturbances in people with dementia living in care homes. / Methods: I conducted a meta-analysis on the measurement and prevalence of sleep disturbances and qualitatively interviewed care home staff about their experiences of sleep disturbances in residents with dementia. Lastly, I investigated the manifestation, persistence and impact of sleep disturbances using the MARQUE (Managing Agitation and Raising QUality of lifE) cohort study; data collected from 1483 residents with dementia for 16 months. / Results: In my meta-analyses, the prevalence of sleep disturbances on validated questionnaires was 38% for symptoms and 20% for clinically significant cases. On actigraphy, 70% had sleep disturbance and staff described how sleep disturbances negatively impacted residents with dementia, staff and other residents. In MARQUE, half of the residents had symptoms of sleep disturbance at one-time point of the study, often getting up at night-time and daytime sleepiness. Of those who had symptoms of sleep disturbance at baseline, the disturbance mostly fluctuated (47%) or persisted (25%) across the study. Having sleep disturbances longitudinally negatively impacted residents’ quality of life (regression coefficient -3.94, 95% confident intervals -4.82 to -3.06), and those with clinically significant cases were more likely to have hospital admissions. There was no correlation between sleep disturbances and mortality. / Conclusion: Sleep disturbances in residents with dementia are common, often fluctuate or persist, and negatively impact their quality of life and are therefore a priority for treatment

Early parenting and attachment experiences : the association with adult affective symptoms

This portfolio has three parts:-Part one is a systematic literature review, in which the empirical literature relating to factors mediating the relationship between experiences of parenting and offspring adult depression is reviewed. A prior review demonstrated consistent results showing a predicting relationship between recalled adverse parenting experiences and adult depressive symptomology (Rappe, 1997). As the previous review did not consider factors that may be mediating this relationship,studies examining various potential mediating factors were reviewed in the present article. This systematic literature review identifies mediating variables within themes of cognition, standard setting and evaluation, personality, dissociation and current relationships. The nature of the relationship between experiences of early parenting and offspring adult depressive vulnerability is discussed with reference to the background research area. Clinical and research implications are also addressed.Part two is an empirical paper, which examines the relationships between attachment style and forms and functions of self-criticism and social risk taking. The literature base suggests there may be interactions between these concepts, as well as in their potential association with symptoms of depression and anxiety, therefore the present study also examines the relative contribution of the aforementioned factors to depression and anxiety symptoms in a normal population sample. Finally, the relationship between childhood experiences of care and abuse and adult attachment style is also examined. Results indicate some supporting evidence for the links between attachment style and forms/functions of self-criticism, as well as the predicting relationship between adverse childhood experiences and insecure attachment style. Further results suggest that variables are generally more associated with anxiety,early parenting and attachment experiences symptoms rather than depressive symptoms. Limitations of the present study are discussed, with recommendations for future research within the field.Part three comprises the appendixes, which include a personal reflective statement regarding the research process

Identification and characterisation of 17 polymorphic candidate genes for response to parasitic nematode (Trichostrongylus tenuis) infection in red grouse (Lagopus lagopus scotica)

Acknowledgements This study was funded by a BBSRC studentship (MA Wenzel) and NERC Grants NE/H00775X/1 and NE/D000602/1 (SB Piertney). We are grateful to Jacob Hoglund for providing willow grouse samples, Mario Roder, Keliya Bai, Marianne James, Matt Oliver, Gill Murray-Dickson, Francois Mougeot and Jesus Martınez-Padilla for help with fieldwork, and all grouse estate factors, owners and keepers, most particularly Alistair Mitchell, Shaila Rao, Christopher Murphy, Richard Cooke and Fred Taylor, for providing access to estate game larders.Peer reviewedPostprin

Letter from Lucy Webster, R. Squire, W.F. Webster, and Alice M. Squire to John Muir, 1864 Jan 25

[2] Dear friend Muir I am now seated to write you a few lines to let you know that I am well and hope these few lines will find you the same There have been a great many men enlisting and there is a great many more to go to war. I wish this war would soon end but I fear it will be a long time before [illegible] rebellion is Crushed. Mr Muir I thank you a thousand times for [thoes?] images alltho they never entered our house. W. F. Webster[3] Dear Mr Muir I will write a few lines to you now the rest got through. I thank you very much for those presents. Those imagyes got broke the boys was playing ball and [they?] threw it through the window and hit them and broke them all to pieces but we got the bell Eddys Gilberts folks have moved down to Green County so he does not come to school this winter. A lady from Bellvile teaches our school. We have [99?] scholars. Weston and Charley came here to school this winter their Father has enlisted. I got that picture from Mrs. Heebys but it does not look much as it did for it was clean then but it is dirty now and looks real bad. They are having a singing school down to Storytown this winter Alice M SquireMr John Muir, 00347 [4]I shall have to explain the reason for delaying to send this letter or you will think we were very negligent, I have a Niece attending school at the University, and she said she would see the janitor and get him to bring those things you left, to her room, And she took your letter, lest she might forget, And if we could not remember your address, and did not get your letter again, until yesterday. Mr Squire has gone back to his Reg\u27t. and we feel very sad about it. I went up Saturday, expecting to see him but they had sent him away two days before, His Regiment are at Natehes. R Squire[1] January 11th 1864Dear friend Muir We received your kind letter and was very glad to hear from you and to know that you was enjoying yourself among your friends. we are all well at present we are going to school but do not have a very good one this winter we have a female teacher. Gilbert McKeeby is teaching up to the white school house this winter [Nett?] goes up there to school, Mr [illegible] people are as well as usual Willie as mischievous as ever. Sophia Mc Keeby is teaching down to Story town. Mr Smoles people I believe are all well Henerette and Jacob come here to school they had the great affliction to loose a son who came home sick from the army, Mrs Harper has returned from the east they are all well. I think of no more to write at present. write soon good by. [Long?] Webster64

Evaluating the bones of adaptive learning: Do the initial promises really increase student engagement and flexible learning within first year anatomy subjects?

[EN] Knowledge of human anatomy is essential in first-year undergraduate allied health courses. Traditionally this discipline has used time and resource intensive laboratory classes, however recent changes in resourcing and student learning preferences have led to a combination of pedagogical approaches being used. The aim of this study was to examine whether the use of Smart Sparrow adaptive and interactive online resources provided real flexibility in learning and influenced both student engagement and motivation to learn for allied health students studying first year anatomy. Twenty adaptive online anatomy lessons were created. These adaptive lessons were evaluated with (i) a student survey amd (ii) inbuilt learning analytics (n = 157). Our results showed that a total of 96% of students agreed or strongly agreed that the resources enhanced overall engagement in the subject and 96% found the resource easy to access. Overall our findings revealed that students overwhelmingly engaged with the lessons, and self-reported improvements in their learning through repeated use of flexible and adaptive learning resources.Linden, K.; Pemberton, L.; Webster, L. (2019). Evaluating the bones of adaptive learning: Do the initial promises really increase student engagement and flexible learning within first year anatomy subjects?. En HEAD'19. 5th International Conference on Higher Education Advances. Editorial Universitat Politècnica de València. 331-339. https://doi.org/10.4995/HEAD19.2019.9346OCS33133

A transcriptomic investigation of handicap models in sexual selection

We are grateful to D. Calder and T. Helps for access to study sites, and G. Murray-Dickson and M. Oliver for help with fieldwork and comments on manuscript drafts. This work was funded by NERC grant NE/D000602/1 (SBP), a NERC advanced fellowship (FM) and a BBSRC studentship (MAW)Peer reviewedPostprin

Community health workers and stand-alone or integrated case management of malaria: a systematic literature review.

A systematic literature review was conducted to assess the effectiveness of strategies to improve community case management (CCM) of malaria. Forty-three studies were included; most (38) reported indicators of community health worker (CHW) performance, 14 reported on malaria CCM integrated with other child health interventions, 16 reported on health system capacity, and 13 reported on referral. The CHWs are able to provide good quality malaria care, including performing procedures such as rapid diagnostic tests. Appropriate training, clear guidelines, and regular supportive supervision are important facilitating factors. Crucial to sustainable success of CHW programs is strengthening health system capacity to support commodity supply, supervision, and appropriate treatment of referred cases. The little evidence available on referral from community to health facility level suggests that this is an area that needs priority attention. The studies of integrated CCM suggest that additional tasks do not reduce the quality of malaria CCM provided sufficient training and supervision is maintained

Pronounced genetic structure and low genetic diversity in European red-billed chough (Pyrrhocorax pyrrhocorax) populations

Conservation Genetics August 2015, Volume 16, Issue 4, pp 1011–1012 Erratum to: Pronounced genetic structure and low genetic diversity in European red-billed chough (Pyrrhocorax pyrrhocorax) populations Erratum to: Conserv Genet (2012) 13:1213–1230 DOI 10.1007/s10592-012-0366-6 In the original publication, Tables 3 and 6 were published with incorrect estimates of population heterozygosities. All other diversity statistics were correct as originally presented. Updated versions of Tables 3 and 6 with corrected heterozygosity estimates confirmed using Arlequin 3.5 (Excoffier and Lischer 2010) as in Dávila et al. (2014) are provided in this erratum. Discrepancies were minor for populations on the British Isles. The correct estimates for Spain are slightly larger than those reported for La Palma by Dávila et al. (2014), but this does not necessarily affect their interpretation that choughs on La Palma may have originated from multiple migration events. The original conclusion that chough populations on the British Isles have low genetic diversity compared to continental European populations remains and is now, in fact, strengthened.Peer reviewedPostprin

The minimum clinically important difference on the sleep disorders inventory for people dementia

Objectives: Sleep disturbances in dementia causes distress to people with dementia and their family carers and are associated with care home admission. The Sleep Disorders Inventory (SDI) is a validated questionnaire of sleep disturbances in dementia often used to measure treatment effectiveness, but the minimum clinically important difference (MCID) is unknown. Methods: We triangulated three investigative methods to determine the MCID of the SDI. Using data on SDI from a randomised controlled trial (RCT) with 62 participants in an intervention for sleep disorders in dementia, we (1) calculated distribution-based values where MCID = 0.33 of a SD (SD) (2) an anchor based approach using quality of life (measured using DEMQOL-Proxy) as an anchor. We also employed a Delphi consensus process asking 12 clinicians, sleep researchers and family carers to rate which changes on vignettes were equivalent to a MCID. Results: We found that 0.33 SD in the SDI = 4.86. Reduction in SDI total score was not significantly correlated with improvement in DEMQOL-Proxy (Pearson's correlation = −0.01; P = 0.96) score. The Delphi consensus required two rounds to reach a consensus and concluded that changes equivalent to three points on the SDI equated to the MCID. Conclusions: Taking into account both the distribution-based values and the Delphi process we used a whole number at the midpoint and judged the minimum clinically important difference MCID to be equal to four points. We note the clinicians and carers opinions from the Delphi process determined the MCID to be lower at three points