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Research shows that cognitive rehabilitation (CR) has the potential to improve goal performance and enhance well-being for people with early stage Alzheimer’s disease (AD). This single subject, multiple baseline design (MBD) research investigated the clinical efficacy of an 8-week individualised CR intervention for individuals with early stage AD.
Three participants with early stage AD were recruited to take part in the study. The intervention consisted of eight sessions of 60–90 minutes of CR. Outcomes included goal performance and satisfaction, quality of life, cognitive and everyday functioning, mood, and memory self-efficacy for participants with AD; and carer burden, general mental health, quality of life, and mood of carers.
Visual analysis of MBD data demonstrated a functional relationship between CR and improvements in participants’ goal performance. Subjective ratings of goal performance and satisfaction increased from baseline to post-test for three participants and were maintained at follow-up for two. Baseline to post-test quality of life scores improved for three participants, whereas cognitive function and memory self-efficacy scores improved for two.
Our findings demonstrate that CR can improve goal performance, and is a socially acceptable intervention that can be implemented by practitioners with assistance from carers between sessions. This study represents one of the promising first step towards filling a practice gap in this area. Further research and randomised-controlled trials are required.
A substantial literature has reported that stress negatively impacts on cognitive processes. As dementia caregiving can be stressful, it has been hypothesized that the challenges of dementia care may increase caregivers’ own vulnerability to cognitive decline. Prefrontal processes are thought to be most vulnerable to stress; however, few studies have examined whether greater caregiver stress predicts poorer executive dysfunction, and no previous research has considered potential moderators of this relationship. We examined (1) whether greater psychological stress mediated a relationship between caregiver stress exposure and executive functioning and (2) whether greater self-efficacy and cognitive reserve (CR) moderated this relationship.
Spousal dementia caregivers (n = 253) completed the Neuropsychiatric Inventory Questionnaire (stress exposure), the Perceived Stress Scale, the National Adult Reading Test (CR), the Fortinsky dementia-specific caregiver self-efficacy scale, and the Color Trails Test (executive functioning). Moderated mediation was tested using the PROCESS macro. Age, gender, and dementia risk factors were included as covariates.
Greater stress exposure indirectly predicted executive functioning through psychological stress. Stronger relationships between greater psychological stress and poorer executive functioning were observed among caregivers with lower CR; there was no evidence that self-efficacy moderated the relationship between stress exposure and psychological stress.
Our findings are in line with the idea that greater psychological stress in response to challenges associated with dementia care predicts poorer caregiver executive functioning, particularly among caregivers with low CR. However, these findings are cross sectional; it is also possible that poorer executive functioning contributes to greater caregiver stress.
Universal screening for postpartum depression is recommended in many countries. Knowledge of whether the disclosure of depressive symptoms in the postpartum period differs across cultures could improve detection and provide new insights into the pathogenesis. Moreover, it is a necessary step to evaluate the universal use of screening instruments in research and clinical practice. In the current study we sought to assess whether the Edinburgh Postnatal Depression Scale (EPDS), the most widely used screening tool for postpartum depression, measures the same underlying construct across cultural groups in a large international dataset.
Ordinal regression and measurement invariance were used to explore the association between culture, operationalized as education, ethnicity/race and continent, and endorsement of depressive symptoms using the EPDS on 8209 new mothers from Europe and the USA.
Education, but not ethnicity/race, influenced the reporting of postpartum depression [difference between robust comparative fit indexes (∆*CFI) < 0.01]. The structure of EPDS responses significantly differed between Europe and the USA (∆*CFI > 0.01), but not between European countries (∆*CFI < 0.01).
Investigators and clinicians should be aware of the potential differences in expression of phenotype of postpartum depression that women of different educational backgrounds may manifest. The increasing cultural heterogeneity of societies together with the tendency towards globalization requires a culturally sensitive approach to patients, research and policies, that takes into account, beyond rhetoric, the context of a person's experiences and the context in which the research is conducted.
This study aimed to monitor the microbiological effect of cleaning near-patient sites over a 48-hour period with a novel disinfectant, electrolyzed water.
One ward dedicated to acute care of the elderly population in a district general hospital in Scotland.
Lockers, left and right cotsides, and overbed tables in 30 bed spaces were screened for aerobic colony count (ACC), methicillin-susceptible Staphylococcus aureus (MSSA), and methicillin-resistant S. aureus (MRSA) before cleaning with electrolyzed water. Sites were rescreened at varying intervals from 1 to 48 hours after cleaning. Microbial growth was quantified as colony-forming units (CFUs) per square centimeter and presence or absence of MSSA and MRSA at each site. The study was repeated 3 times at monthly intervals.
There was an early and significant reduction in average ACC (360 sampled sites) from a before-cleaning level of 4.3 to 1.65 CFU/cm2 at 1 hour after disinfectant cleaning (P <.0001). Average counts then increased to 3.53 CFU/cm2 at 24 hours and 3.68 CFU/cm2 at 48 hours. Total MSSA/MRSA (34 isolates) decreased by 71% at 4 hours after cleaning but then increased to 155% (53 isolates) of precleaning levels at 24 hours.
Cleaning with electrolyzed water reduced ACC and staphylococci on surfaces beside patients. ACC remained below precleaning levels at 48 hours, but MSSA/MRSA counts exceeded original levels at 24 hours after cleaning. Although disinfectant cleaning quickly reduces bioburden, additional investigation is required to clarify the reasons for rebound contamination of pathogens at near-patient sites.
Infect Control Hosp Epidemiol 2014;35(12):1505–1510
The Australian Imaging, Biomarkers and Lifestyle (AIBL) Flagship Study of Ageing is a prospective study of 1,112 individuals (211 with Alzheimer's disease (AD), 133 with mild cognitive impairment (MCI), and 768 healthy controls (HCs)). Here we report diagnostic and cognitive findings at the first (18-month) follow-up of the cohort. The first aim was to compute rates of transition from HC to MCI, and MCI to AD. The second aim was to characterize the cognitive profiles of individuals who transitioned to a more severe disease stage compared with those who did not.
Eighteen months after baseline, participants underwent comprehensive cognitive testing and diagnostic review, provided an 80 ml blood sample, and completed health and lifestyle questionnaires. A subgroup also underwent amyloid PET and MRI neuroimaging.
The diagnostic status of 89.9% of the cohorts was determined (972 were reassessed, 28 had died, and 112 did not return for reassessment). The 18-month cohort comprised 692 HCs, 82 MCI cases, 197 AD patients, and one Parkinson's disease dementia case. The transition rate from HC to MCI was 2.5%, and cognitive decline in HCs who transitioned to MCI was greatest in memory and naming domains compared to HCs who remained stable. The transition rate from MCI to AD was 30.5%.
There was a high retention rate after 18 months. Rates of transition from healthy aging to MCI, and MCI to AD, were consistent with established estimates. Follow-up of this cohort over longer periods will elucidate robust predictors of future cognitive decline.
The subaqueous margins of calving glaciers have the potential to make significant contributions to glacier mass loss. However, to date, very little is known about the morphology and development of subaqueous margins. A unique combination of sub-bottom profile and bathymetric data collected between 2008 and 2010 in proglacial lakes at Mueller, Hooker and Tasman glaciers in New Zealand’s Southern Alps reveal subaqueous ice ramps extending up to 510 m from the terminus of each glacier. Ice ramp surfaces are undulating and covered with a thick layer (up to 10 m) of unsorted sediment derived from supraglacial and englacial debris, lateral moraines and deltaic deposits. A cyclic calving pattern, relatively stable lake level and the debris cover appear to control the development and maintenance of these ice ramps. High subaerial retreat rates generally correspond to high subaqueous calving rates, although the highest subaerial retreat rates are not associated with the largest ice ramp. Debris mantling the subaqueous ice ramp surfaces insulates the ice from melting and also reduces buoyant forces acting on the terminus. Comparisons with previous studies show that the ice ramps evolve over time with changes in glacier dynamics and water-body properties.
Size-based analyses of marine animals are increasingly used to improve understanding of community structure and function. However, the resources required to record individual body weights for benthic animals, where the number of individuals can reach several thousand in a square metre, are often prohibitive. Here we present morphometric (length–weight) relationships for 216 benthic species from the North Sea to permit weight estimation from length measurements. These relationships were calculated using data collected over two years from 283 stations. For ten abundant and widely dispersed species we tested for significant spatial and temporal differences in morphometric relationships. Some were found, but the magnitude of differences was small in relation to the size-ranges of animals that are usually present and we recommend that the regression relationships given here, based on pooled data, are appropriate for most types of population and community analyses. Our hope is that the availability of these morphometric relationships will encourage the more frequent application of size-based analyses to benthic survey data, and so enhance understanding of the ecology of the benthic/demersal component of marine ecosystems and food webs.
Thin-film transistors (TFT) of poly and nano crystalline silicon have been made at temperature as low as 170°C on flexible PET (polyethylene terephthalate) substrates.The crystallization of the silicon film has been achieved using external mechanical stress assisted by a plasma hydrogenation technique. The formation of TFT is possible by means of a lateral crystallization of amorphous silicon under the channel region. High mobility TFTs with an electron mobility of 25cm2/Vs and an on/off ratio of 2000 have been obtained. Scanning electron microscopy, X-ray diffraction analysis and optical microscopy have been used to examine the crystallinity of the layer. In addition we report the deposition of high quality low-temperature silicon-oxide layers on PET substrates using an RF-plasma enhanced chemical vapor deposition unit with direct introduction of oxygen gas into the chamber and its reaction with Silane. Infrared spectroscopy was used to examine the quality of the oxide layer.
It is hardly achieved to prepare highly pure MgH2 by the conventional method of solid-gas reaction between solid magnesium and hydrogen; therefore, we proposed and succeeded to synthesize MgH2 by Hydriding Chemical Vapor Deposition (HCVD). Very interestingly, the HCVDed MgH2 was made of single crystals with fibrous figures; however, further detail of the HCVDed product had not been studied. Therefore the aim of this study was to examine the HCVDed MgH2 in hydrogen storage and to observe the microstructure of the HCVDed MgH2 after the hydrogen desorption and absorption.
As the results of Pressure-Composition-Isotherm (PCT) measurement, the HCVDed MgH2 reversibly absorbed and desorbed 7.6 mass% hydrogen, as much as the theoretical maximum hydrogen capacity of magnesium, without any activation treatment. The equilibrium pressure was slightly lower than the reported value. Before and after the PCT measurement, the HCVDed MgH2 did not showed noticeable difference in figure; however, MgHx, which was prepared dehydriding the HCVDed MgH2 in the PCT, showed significant difference in figure: It had zebra stripes in the SEM observation. This observation showed that the hydrogen storage and release went in the radious direction and the hydrogen diffusion was no more rate-limiting. The phase boundaries of Mg and MgH2 involving strain should affected on the plateau pressure in PCT.
In order to investigate the reason for the higher capacity of the interpenetrating isoreticular metal-organic frameworks (IRMOFs) at lower temperatures, we performed grand canonical Monte Carlo (GCMC) simulations and molecular dynamics simulations at 77 K for a set of the interpenetrating IRMOF-11 and the non-interpenetrating counterpart IRMOF-12. From the GCMC simulations, we found universal force field (UFF) is better for describing the hydrogen adsorption behavior than DREIDING force field. The results from the molecular dynamics simulations showed the density of adsorbed hydrogen molecules was increased in the various pores created by the catenation of IRMOF comparing to that of the pores in IRMOF-12. Moreover, the adsorbed hydrogen molecules in IRMOF-11 have the smaller diffusion coefficients. It means that their dynamic behavior is more restricted because of the complexity of the interpenetrating network of IRMOF-11. These results of molecular simulations show the small pores created by the catenation are important for the increase of hydrogen adsorption on IRMOF-11 at lower temperatures.
The pressure-temperature phase diagrams of alkali metal alanates and borohydrides are of large current interest, and we have recently studied phase transformations under pressure in several of these materials. We here report Raman studies of KBH4 under pressure at room temperature, showing a phase transition near 6 GPa. Although no structural information is yet available, the similarity between KBH4 and NaBH4 suggests the new structure is orthorhombic. We also report studies on LiBH4 showing that the high pressure phase of this material is metastable to zero pressure below 200 K.
Recent investigations on thermodynamical stabilities of metal borohydrides were reviewed. The first-principles calculations indicated that the heat of formation normalized by the number of BH4 complexs, ΔHboro, show a good correlation with the Pauling electronegativitiese of M, χp, which is represented by the liner relation, ΔHboro = 252.8χp − 396.4 in the unit of kJ/mol BH4. In order to clarify the correlation between the stability of borohydrides and the electronegativity χp of M, M(BH4)n (M = Mg, Ca, Sc, Ti, V, Cr, Mn, Zn, Zr and Al; n = 2-4) were systematically synthesized by mechanical milling. The thermal desorption analyses indicated that Td correlate with χ p of M; Td decrease with increasing the values of χp, in M(BH4)n. Furthermore, the correlation can be reasonably extended to double cation ones, (ZrLin-4)(BH4)n. For single cation, M(BH4)n (M = Mn, Zn and Al; χp ≥ 1.5) desorb borane besides hydrogen, and M(BH4)n (M = Ti, V and Cr; χp ≥ 1.5) desorbe small amount of hydrogen provably due to desorption reaction during milling. Therefore χp is an indicator to approximately estimate the stability of M(BH4)n, and appropriateχp in M(BH4)n is expected to be smaller than 1.5. The enthalpy change for the desorption reaction, ΔHdes, is estimated using our predicted ΔHboro and the reported data for decomposition product, ΔHhyd/borideboro, which shows a good correlation with the observed Td. These results are useful for exploring M(BH4)n with appropriate stability for hydrogen storage applications
The microstructure and hydrogen sorption behaviour of MgH2 based nano-hydrides with different additives prepared by ball milling and inert gas condensation has been investigated by XRD, Differential Scanning Calorimetry and Mechanical Spectroscopy. Preliminary results on materials with similar composition and different nanostructures show that suitable mechanical processing and additive additions induce in the nanostructured composites tailored channels for improved ab/de-sorption kinetics at reduced temperatures.
Hydrogen desorption reactions of the mixtures of (i) lithium amide and lithium hydride (LiNH2/LiH), and (ii) magnesium amide and lithium hydride (Mg(NH2)2/4LiH) were studied. Titanium compounds and nano-particles including fullerene (C60), were doped to those hydrogen storage mixtures respectively. The hydrogen desorption reactions were monitored by means of temperature programmed desorption (TPD) technique under an Ar atmosphere. The reaction of LiNH2/LiH was accelerated by adding either 1 mol% of Ti species or 0.2 mol% of fullerene (C60), while those additives did not show significant acceleration effects on the reaction of Mg(NH2)2/4LiH. Kinetic studies revealed the enhanced hydrogen desorption reaction rate constant for TiCl3 doped LiNH2/LiH, k = 3.1 × 10−4 s−1 at 493 K, and the prolonged ball-milling further improved reaction rate, k = 1.1 × 10−3 s−1 at the same temperature. For the dehydrogenation reaction of TiCl3 doped LiNH2/LiH, the activation energies estimated by Kissinger plot (95 kJ mol−1) and Arrhenius plot (110 kJ mol−1) were in reasonable agreement each other. The LiNH2/LiH mixture without additive exhibited slower hydrogen desorption process and the kinetic traces deviated from single exponential behavior. The results indicated the Ti(III) additives change the hydrogen desorption reaction mechanism of LiNH2/LiH.