Role of dicentric analysis in an overarching biodosimetry strategy for use following a nuclear detonation in an urban environment.

In the moments immediately following a nuclear detonation, casualties with a variety of injuries including trauma, burns, radiation exposure, and combined injuries would require immediate assistance. Accurate and timely radiation dose assessments, based on patient history and laboratory testing, are absolutely critical to support adequately the triage and treatment of those affected. This capability is also essential for ensuring the proper allocation of scarce resources and will support longitudinal evaluation of radiation-exposed individuals and populations.

An overview of the LASER-AD study: a longitudinal epidemiological study of people with Alzheimer's disease.

Research into the epidemiological, clinical characteristics and economic impact of dementia is critical to increase understanding and better inform care and policy, and empower people with Alzheimer's disease (AD) and their families to make preparations and timely decisions about accommodation, care and treatment. The LASER-AD longitudinal study of people with AD and their carers has contributed to our understanding of the progression, characteristics and costs of the disease, and to developing tools that help detect dementia earlier, and screen and identify problems experienced by carers. Our work on quality of life shows that even those with severe dementia can report this meaningfully, although family proxy ratings of quality of life do not necessarily mirror the views of the individual.

Diagnostic rates and treatment of dementia before and after launch of a national dementia policy: an observational study using English national databases.

Objectives: To assess the 2009 National Dementia Strategy's (NDS) impact on dementia diagnosis and treatment.

Setting And Participants: Primary care data for England before and after launch of the NDS.

Primary Outcome Measures: We used nationally available data to estimate the trends over time in rates of dementia diagnoses recorded on the Quality Outcomes Framework (QOF) in Primary Care Trusts (PCT) and antidementia medication prescriptions from 2006/2007 (the first available figures) and the associated increase in cost relative to all other prescriptions.

Relationship of coping style to mood and anxiety disorders in dementia carers.

Purpose Of Review: Mood and anxiety disorders are common in family carers of people with dementia, and are associated with poor carer and care recipient outcomes. Caring for someone with dementia is stressful, but how carers cope may be an important determinant of carer psychological morbidity. This review summarizes and integrates the literature on the effect of coping style and its role in effective carer interventions.

Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial.

Objective: To assess whether the START (STrAtegies for RelatTives) intervention added to treatment as usual is cost effective compared with usual treatment alone.

Design: Cost effectiveness analysis nested within a pragmatic randomised controlled trial.

Setting: Three mental health and one neurological outpatient dementia service in London and Essex, UK.

Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial.

Objective: To assess whether a manual based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia.

Design: Randomised, parallel group, superiority trial.

Setting: Three mental health community services and one neurological outpatient dementia service in London and Essex, UK.

Conservation value and permeability of neotropical oil palm landscapes for orchid bees.

The proliferation of oil palm plantations has led to dramatic changes in tropical landscapes across the globe. However, relatively little is known about the effects of oil palm expansion on biodiversity, especially in key ecosystem-service providing organisms like pollinators. Rapid land use change is exacerbated by limited knowledge of the mechanisms causing biodiversity decline in the tropics, particularly those involving landscape features.

Treatment for mild cognitive impairment: systematic review.

Background: More people are presenting with mild cognitive impairment (MCI), frequently a precursor to dementia, but we do not know how to reduce deterioration.

Aims: To systematically review randomised controlled trials (RCTs) evaluating the effects of any intervention for MCI on cognitive, neuropsychiatric, functional, global outcomes, life quality or incident dementia.

Method: We reviewed 41 studies fitting predetermined criteria, assessed validity using a checklist, calculated standardised outcomes and prioritised primary outcome findings in placebo-controlled studies.

Improving the end-of-life for people with dementia living in a care home: an intervention study.

Background: One in three adults, most of whom are living in a care home at the time, dies with dementia. Their end-of-life is often in hospital, where they may experience uncomfortable interventions without known benefit and die rapidly with uncontrolled pain and comfort needs. This study aimed to improve end-of-life care for people with dementia in a care home by increasing the number and implementation of advanced care wishes.

Incidence of dementia in older adults with intellectual disabilities.

Dementia may be more common in older adults with intellectual disability (ID) than in the general population. The increased risk for Alzheimer's disease in people with Down syndrome (DS) is well established, but much less is known about dementia in adults with ID who do not have DS. We estimated incidence rates from a longitudinal study of dementia in older adults with ID without DS and compared them to general population rates.

Health professionals' and students' perceptions of elder abuse.

Aim: This study aimed to compare perceptions about elder abuse among health professionals and students in the same health disciplines.

Methods: The Caregiving Scenario Questionnaire (CSQ) was disseminated to Australian health professionals from two metropolitan health services and to university health care students.

Results: One hundred and twenty health professionals and 127 students returned surveys.

Improving access to dementia services for people from minority ethnic groups.

Purpose Of Review: Only a minority of people with dementia receive a formal diagnosis despite a growing body of evidence highlighting the benefits of early diagnosis and intervention. People from minority ethnic groups are even more disadvantaged, as they tend to access dementia services later in the illness. Studies exploring the reasons behind underuse of dementia services by minority ethnic groups have highlighted the barriers to help-seeking that seem specific to the cultural groups studied.

Study of the use of antidepressants for depression in dementia: the HTA-SADD trial--a multicentre, randomised, double-blind, placebo-controlled trial of the clinical effectiveness and cost-effectiveness of sertraline and mirtazapine.

Objective: Depression is common in dementia, causing considerable distress and other negative impacts. Treating it is a clinical priority, but the evidence base is sparse and equivocal. This trial aimed to determine clinical effectiveness of sertraline and mirtazapine in reducing depression 13 weeks post randomisation compared with placebo.

Validity of criteria for dementia in older people with intellectual disability.

Objective: Valid definitions of dementia should discriminate dementia from other forms of cognitive impairment such as intellectual disability (ID). We aimed to evaluate the usefulness of criteria for dementia and mild cognitive impairment (MCI) in ID, including predictive validity, and inter-rater reliability.

Method: We assessed 222 participants in a survey of older adults with ID without Down syndrome at two time points for dementia (T1 and T2).

Systematic review of the effectiveness of pharmacologic interventions to improve quality of life and well-being in people with dementia.

Objective: To review systematically, for the first time, the effectiveness of all pharmacologic interventions to improve quality of life and well-being in people with dementia.

Design: Systematic review and meta-analysis.

Methods: We systematically reviewed the 15 randomized controlled trials and one review that fitted predetermined criteria.

Cost-effectiveness analyses for mirtazapine and sertraline in dementia: randomised controlled trial.

Background: Depression is a common and costly comorbidity in dementia. There are very few data on the cost-effectiveness of antidepressants for depression in dementia and their effects on carer outcomes.

Aims: To evaluate the cost-effectiveness of sertraline and mirtazapine compared with placebo for depression in dementia.

Competition-colonization dynamics in experimental bacterial metacommunities.

One of the simplest hypotheses used to explain species coexistence is the competition-colonization trade-off, that is, species can stably coexist in a landscape if they show a trade-off between competitive and colonization abilities. Despite extensive theory, the dynamics predicted to result from competition-colonization trade-offs are largely untested. Landscape change, such as habitat destruction, is thought to greatly influence coexistence under competition-colonization dynamics, although there is no formal test of this prediction.

Do changes in coping style explain the effectiveness of interventions for psychological morbidity in family carers of people with dementia? A systematic review and meta-analysis.

Background: Observational studies find that family carers of people with dementia who use more emotional support and acceptance-based coping, and less dysfunctional coping, are less depressed and anxious. We hypothesized that interventions effective in reducing psychological symptoms would increase emotional support and acceptance-based coping, or decrease dysfunctional coping.

Methods: We systematically reviewed randomized controlled trials published up to July 2011, of interventions for carers of people with dementia measuring coping and psychological morbidity.

Ethnic inequalities in the use of health services for common mental disorders in England.

Purpose: The purpose of this study is to investigate whether minority ethnic people were less likely to receive treatment for mental health problems than the white population were, controlling for symptom severity.

Method: We analysed data from 23,917 participants in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. Survey response rates were 79, 69 and 57 %, respectively.

Efficacy of memantine for agitation in Alzheimer's dementia: a randomised double-blind placebo controlled trial.

Background: Agitation in Alzheimer's disease (AD) is common and associated with poor patient life-quality and carer distress. The best evidence-based pharmacological treatments are antipsychotics which have limited benefits with increased morbidity and mortality. There are no memantine trials in clinically significant agitation but post-hoc analyses in other populations found reduced agitation.

A modified system for analyzing ionizing radiation-induced chromosome abnormalities.

The analysis of dicentric chromosomes in human peripheral blood lymphocytes (PBLs) by Giemsa staining is the most established method for biological dosimetry. However, this method requires a well-trained person because of the difficulty in detecting aberrations rapidly and accurately. Here, we applied a fluorescence in situ hybridization (FISH) technique, using telomere and centromere peptide nucleic acid (PNA) probes, to solve the problem of biological dosimetry in radiation emergency medicine.

The effect of an educational intervention on junior doctors' knowledge and practice in detecting and managing elder abuse.

Background: Elder abuse is often unreported, undetected, and underestimated by professionals. For the first time, we report the effectiveness of an educational elder abuse intervention over three months and its impact on professionals' practice.

Methods: Forty trainee psychiatrists in two London National Health Service trusts completed the KAMA (Knowledge and Management of Elder Abuse) and CSQ (Caregiver Scenario Questionnaire) measuring knowledge about managing and detecting elder abuse, before and immediately after a brief group education session.

Grief reactions in dementia carers: a systematic review.

Objective: Supporting dementia carers is an identified target of the UK government, yet we know little about such family carers' grief before and after the death of the person with dementia for whom they care. We systematically review the existing literature on characteristics, prevalence, predictors and associations of grief in dementia carers before and after death.

Methods: We searched electronic databases and found 31 publications meeting predetermined criteria.

The potential of case management for people with dementia: a commentary.

Background: A recent review of studies of case management in dementia argues that lack of evidence of cost-effectiveness should discourage the use of this approach to care. We argue that that this is too conservative a stance, given the urgent need throughout the world to improve the quality of care for people with dementia and their caregivers. We propose a research agenda on case management for people with dementia.