Emotion regulation and decision-making in persons with dementia: a scoping review

Background and Objectives Emotion is integral to decision-making, and emotion regulation is associated with improved well-being in older age. Persons with dementia are likely to experience impairments in emotion regulation processes that can potentially contribute to differential decision-making and well-being outcomes. To promote the development of theoretical models of well-being in dementia, we review the quantitative evidence concerning the associations between emotion regulation and decision-making in dementia. Methods Scoping review. Results Seven studies of persons with dementia met our criteria. In persons with frontotemporal lobar degeneration, emotion regulation processes that precede the emotional experience were associated with decision-making in a moral (but not uncertainty) context. Independent of type of dementia, evidence concerning the associations between emotion regulation processes that occur after emotion is experienced and decision-making was mixed and drew on different methodologies. No studies relating to the associations between decision-making in dementia and several emotion regulation processes and strategies were found. Conclusions In this review, we sought to clarify the concept of everyday decision-making in dementia and map the current state of evidence concerning its associations with emotion regulation. Our findings show that emotion regulation processes are associated with decision-making in dementia, depending on type of decision-making assessment and emotional experience. We outline the gaps in the literature to set a research agenda for promoting our understanding of how emotion regulation processes can shape the various decisions that are made by persons with dementia on a daily basis

Predictors of loneliness during the Covid-19 pandemic in people with dementia and their carers in England: findings from the DETERMIND-C19 study

Objectives To identify factors that predict the risk of loneliness for people with dementia and carers during a pandemic. Methods People with dementia and their carers completed assessments before (July 2019–March 2020; 206 dyads) and after (July–October 2020) the first Covid-19 ‘lockdown’ in England. At follow-up, the analytic sample comprised 67 people with dementia and 108 carers. We built a longitudinal path model with loneliness as an observed outcome. Carer type and social contacts at both measurements were considered. Other social resources (quality of relationship, formal day activities), wellbeing (anxiety, psychological wellbeing) and cognitive impairment were measured with initial level and change using latent growth curves. We adjusted for socio-demographic factors and health at baseline. Results In carers, higher levels of loneliness were directly associated with non-spouse coresident carer type, level and increase of anxiety in carer, more formal day activities, and higher cognitive impairment in the person with dementia. In people with dementia, non-spouse coresident carer type, and higher initial levels of social resources, wellbeing, and cognitive impairment predicted the changes in these factors; this produced indirect effects on social contacts and loneliness. Conclusion Loneliness in the Covid-19 pandemic appears to be shaped by different mechanisms for people with dementia and their carers. The results suggest that carers of those with dementia may prioritize providing care that protects the person with dementia from loneliness at the cost of experiencing loneliness themselves. Directions for the promotion of adaptive social care during the Covid-19 pandemic and beyond are discussed

B-cell dysregulation in Crohn's disease is partially restored with infliximab therapy

Background: B-cell depletion can improve a variety of chronic inflammatory diseases, but does not appear beneficial for patients with Crohn's disease. Objective: To elucidate the involvement of B cells in Crohn's disease, we here performed an 'in depth' analysis of intestinal and blood B-cells in this chronic inflammatory disease. Methods: Patients with Crohn's disease were recruited to study B-cell infiltrates in intestinal biopsies (n = 5), serum immunoglobulin levels and the phenotype and molecular characteristics of blood B-cell subsets (n = 21). The effects of infliximab treatment were studied in 9 patients. Results: Granulomatous tissue showed infiltrates of B lymphocytes rather than Ig-secreting plasma cells. Circulating transitional B cells and CD21low B cells were elevated. IgM memory B cells were reduced and natural effector cells showed decreased replication histories and somatic hypermutation (SHM) levels. In contrast, IgG and IgA memory B cells were normally present and their Ig gene transcripts carried increased SHM levels. The numbers of transitional and natural effector cells were normal in patients who responded clinically well to infliximab. Conclusions: B cells in patients with Crohn's disease showed signs of chronic stimulation with localization to granulomatous tissue and increased molecular maturation of IgA and IgG. Therapy with TNFα-blockers restored the defect in IgM memory B-cell generation and normalized transitional B-cell levels, making these subsets candidate markers for treatment monitoring. Together, these results suggest a chronic, aberrant B-cell response in patients with Crohn's disease, which could be targeted with new therapeutics that specifically regulate B-cell function

A cohort study of the impact of COVID-19 on the quality of life of people newly diagnosed with dementia and their family carers

Introduction COVID-19 has impacted people with dementia and their family carers, yet little is known about effects on overall quality of life. Methods In a UK cohort study, pre- and post-pandemic data were collected from 114 carers and 93 recently diagnosed people with dementia. Latent growth curve modeling examined change in quality of life. Results Carers reported significant decline in quality of life, although no change was demonstrated by people with dementia. In multivariable analyses, higher levels of cognitive impairment, deprivation, study site, and lower number of memory clinic contacts were associated with greater decline in carer quality of life. Discussion Maintaining life quality for people with dementia during the pandemic appears to have come at the expense of their family carers. This inequity has fallen hardest on those caring for people with more severe dementia, in deprived areas, and with least support from memory services. These effects may be prevented or reversed by post-diagnostic care

Anthropogenic Space Weather

Anthropogenic effects on the space environment started in the late 19th century and reached their peak in the 1960s when high-altitude nuclear explosions were carried out by the USA and the Soviet Union. These explosions created artificial radiation belts near Earth that resulted in major damages to several satellites. Another, unexpected impact of the high-altitude nuclear tests was the electromagnetic pulse (EMP) that can have devastating effects over a large geographic area (as large as the continental United States). Other anthropogenic impacts on the space environment include chemical release ex- periments, high-frequency wave heating of the ionosphere and the interaction of VLF waves with the radiation belts. This paper reviews the fundamental physical process behind these phenomena and discusses the observations of their impacts.Comment: 71 pages, 35 figure

DETERMinants of quality of life, care and costs, and consequences of INequalities in people with dementia and their carers (DETERMIND): a protocol paper

Objectives: DETERMIND (DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers) is designed to address fundamental, and, as yet unanswered, questions about inequalities, outcomes and costs following diagnosis with dementia. These answers are needed to improve the quality of care and equity of access to care, and therefore the quality of life, of people with dementia and their carers. Method: DETERMIND is a programme of research consisting of seven complementary workstreams (WS) exploring various components that may result in unequal dementia care: WS1: Recruitment and follow-up of the DETERMIND cohort - 900 people with dementia and their carers from three geographically and socially diverse sites within six months following diagnosis, and follow them up for three years. WS2: Investigation of the extent of inequalities in access to dementia care WS3: Relationship between use and costs of services and outcomes WS4: Experiences of self-funders of care WS5: Decision-making processes for people with dementia and carers WS6: Effect of diagnostic stage and services on outcomes WS7: Theory of Change informed strategy and actions for applying the research findings Outcomes: During the life of the programme, analysing baseline results and then follow-up of the DETERMIND cohort over 3 years, we will establish evidence on current services and practice. DETERMIND will deliver novel, detailed data on inequalities in dementia care and what drives positive and negative outcomes and costs for people with dementia and carers, and identify factors that help or hinder living well with dementia

Chronology of Dune Development in the White River Badlands, Northern Great Plains, USA

Aeolian dune field chronologies provide important information on drought history on the Great Plains. The White River Badlands (WRB) dunes are located approximately 60 km north of the Nebraska Sand Hills (NSH), in the western section of the northern Great Plains. Clifftop dunes, sand sheets, and stabilized northwest-southeast trending parabolic dunes are found on upland mesas and buttes, locally called tables. The result of this study is a dune stabilization history determined from samples collected from stratigraphic exposures and dune crests. Thirty-seven OSL ages, from this and previous investigations, show three periods of dune activity: 1) ∼21,000 years ago to 12,000 years ago (a), 2) ∼9 to 6 ka, and 3) post-700 a. Stratigraphic exposures and low-relief dune forms preserve evidence of late Pleistocene and middle Holocene dune development, while high-relief dune crests preserve evidence of late Holocene dune development. Results of 12 OSL ages from the most recent dune activation event indicate that Medieval Climate Anomaly (MCA) droughts and Little Ice Age (LIA) droughts caused dune reactivation on the tables. Dune reactivation was accompanied by other drought-driven geomorphological responses in the WRB, including fluvial incision of the prairie and formation of sod tables. Regional significance of the MCA and LIA droughts is supported by similarities in the aeolian chronologies of the NSH at 700–600 a and some western Great Plains dune fields at 420–210 a. Aerial photographs of the WRB show little activity during the Dust Bowl droughts of the 1930s

Propagation of leaky MHD waves at discontinuities with tilted magnetic field

We investigate the characteristics of magneto-acoustic surface waves propagating at a single density interface, in the presence of an inclined magnetic field. For linear wave propagation, the dispersion relation is obtained and analytical solutions are derived for small inclination angle. The inclination of the field renders the frequency of the waves complex, where the imaginary part describes wave attenuation, due to lateral energy leakage