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Background: The National Institute for Health and Care Excellence guidelines state that psychosocial interventions should be the first line of treatment for people with dementia who are experiencing distress behaviours, such as agitation and depression. However, little is known about the characteristics and outcomes of psychosocial interventions or the facilitators and barriers to implementation on inpatient mental health dementia wards which provide care for people with dementia who are often experiencing high levels of distress. Methods: A systematic search was conducted on MEDLINE, CINAHL, PsycINFO, Psychology and Behavioural Sciences Collection, and Scopus in May 2023, following PRISMA guidelines. Reference and citation searches were conducted on included articles. Peer-reviewed literature of any study design, relating to psychosocial interventions in inpatient mental health dementia wards, was included. One author reviewed all articles, with a third of results reviewed independently by a second author. Data were extracted to a bespoke form and synthesised using a narrative review. The quality of included studies was appraised using the Mixed Methods Appraisal Tool. Results: Sixteen studies were included in the synthesis, which together included a total of 538 people with dementia. Study methods and quality varied. Psychosocial interventions delivered on wards included music therapy (five studies), multisensory interventions (four studies), multicomponent interventions (two studies), technology-based interventions (two studies), massage interventions (two studies) and physical exercise (one study). Reduction in distress and improvement in wellbeing was demonstrated inconsistently across studies. Delivering interventions in a caring and individualised way responding to patient need facilitated implementation. Lack of staff time and understanding of interventions, as well as high levels of staff turnover, were barriers to implementation. Conclusion: This review highlights a striking lack of research and therefore evidence base for the use of psychosocial interventions to reduce distress in this vulnerable population, despite current healthcare guidelines. More research is needed to understand which psychosocial interventions can reduce distress and improve wellbeing on inpatient mental health dementia wards, and how interventions should be delivered, to establish clinical and cost effectiveness and minimise staff burden. [ABSTRACT FROM AUTHOR]

The behavioral and psychological symptoms of dementia (BPSD) can be challenging for family caregivers to cope with, leading to distress and fatigue. It is therefore important to offer effective strategies to reduce the impact of BPSD. The HOMESIDE randomized controlled trial (RCT) was testing purposefully developed interventions to improve the quality of life and wellbeing of dyads of people with dementia and family caregivers as a result of reduction of BPSD. HOMESIDE RCT was conducted in Australia, Germany, Norway, Poland and the United Kingdom between 2019 and 2022. The study design was a three-arm parallel-group single-blinded, pragmatic RCT with a sample size of 432 dyads. Dyads were randomly allocated to one of three treatment conditions: Music Intervention plus Standard Care; or Reading Intervention plus Standard Care; or Standard Care only. The Reading Intervention (RI) within the HOMESIDE RCT aimed to evoke shared discussion, reminiscence, meaningful shared experiences and consequently enrich everyday life, interaction and the emotional connection between the caregiver (CG) and carereceiver (CR); as well as to enhance activities of daily living and to promote relaxation or stimulation as appropriate. This paper describes the underlying conceptual framework, the content, and delivery of the Reading Intervention within the HOMESIDE RCT. [ABSTRACT FROM AUTHOR]

We use newly linked tax records to show that the large responses of UK company owner-managers to personal taxes are due to intertemporal income shifting and not to reductions in real business activity. Around half of this shifting is short-term and helps prevent volatile incomes being taxed more heavily under progressive personal taxes. The remainder reflects systemic profit retention over long periods to take advantage of lower tax rates, including preferential treatment of capital gains. We find no evidence that this tax-induced retention increases business investment. It does, however, substantially reduce the tax revenue raised from high income business owners. [ABSTRACT FROM AUTHOR]

Christian theological training institutions broadly agree that they provide holistic education which fosters students' spiritual formation. The integration of spiritual formation and academic study is augmented through experiential learning facilitated in community-based settings. Bringing together biblical, ethical and pedagogical insights, this paper examines the complexities of formally assessing students' spiritual formation in confessional theological education within UK Higher Education contexts. It asks questions as to what extent, and how, meaningful character assessment is possible, especially when students might engage with community-based practice settings that may not occupy a Christian worldview. Finally, it makes recommendations to move the conversation forward. [ABSTRACT FROM AUTHOR]

Objective: Real-life research into the underlying neural dynamics of improvisational music therapy, used with various clinical populations, is largely lacking. This single case study explored within-session differences in musical features and in within- and between-brain coupling between a Person with Dementia (PwD) and a music therapist during a music therapy session. Methods: Dual-EEG from a music therapist and a PwD (male, 31 years) was recorded. Note density, pulse clarity and synchronicity were extracted from audio-visual data. Three music therapists identified moments of interest and no interest (MOI/MONI) in two drum improvisations. The Integrative Coupling Index, reflecting time-lagged neural synchronization, and musical features were compared between the MOI and MONI. Results: Between-brain coupling of 2 Hz activity was increased during the MOI, showing anteriority of the therapist's neural activity. Within-brain coupling for the PwD was stronger from frontal and central areas during the MOI, but within-brain coupling for the therapist was stronger during MONI. Differences in musical features indicated that both acted musically more similar to one another during the MOI. Conclusion: Within-session differences in neural synchronization and musical features highlight the dynamic nature of music therapy. Significance: The findings contribute to a better understanding of social and affective processes in the brain and (interactive) musical behaviors during specific moments in a real-life music therapy session. This may provide insights into the role of such moments for relational-therapeutic processes. [ABSTRACT FROM AUTHOR]

Background: There is a global need for interventions that support the wellbeing of people living with dementia and their family care partners. Studies show that shared musical activities may achieve this. Our systematic review aimed to synthesise existing research exploring dyads' experiences of shared musical activities across a range of contexts. Method: From 31 October 2020 we searched PubMed, PsycInfo, CINAHL Complete, EMBASE, RILM, Web of Science Core Collection, Google Scholar and ProQuest Dissertations & Theses for studies published up to 14 April 2021, and hand searched five music therapy journals plus citation lists. Thirteen qualitative studies reporting on dyads' experiences and perspectives of shared musical activities across a range of settings were included. Studies with mixed populations or mixed modality interventions were excluded. We analysed the final studies using thematic synthesis, engaging in reflective discussions and reflexivity throughout. The quality of included studies was assessed using the CASP qualitative checklist. This study is registered on PROSPERO: CRD42020169360. Results: Six themes were identified from 13 studies: 1) shared musical activities support wellbeing for people living with dementia, 2) music groups become ecological systems, 3) shared musical activities are experienced differently over time, 4) shared musical activities are experienced by me and as we, 5) music is a supportive structure, and 6) the thread of connection (an overarching theme). A GRADE-CERQual assessment found moderate to high confidence in these findings. Findings informed the development of the Contextual Connection Model of Health Musicking. Conclusion: Shared musical activities foster experiences of connection for people living with dementia and their family care partners. Experiences of connection are supported through professional facilitation and the structural aspects of music, and are influenced by the setting and changes over time. These experiences of connection play a central role in supporting dyadic and individual wellbeing. These findings are largely relevant to a western cultural context; future research should seek to include more diverse cultural experiences. [ABSTRACT FROM AUTHOR]

Simple Summary: Weaning causes gut microbiota disruption that results in dysbiosis and post-weaning diarrhea. The recent ban on pharmacological doses of in-feed zinc oxide in the weaned pig diet has made exploration of alternative dietary supplements to improve the post-weaning condition of pigs imperative. Plants (e.g., red beetroot) containing bioactive compounds have shown great potential in this regard, favorably abating gut microbiota dysbiosis and promoting gut metabolite production and health. Red beetroot is a well-recognized and established source of bioactive compounds (e.g., betalains and polyphenols) with anti-inflammatory and antimicrobial properties. It is proposed as a potential alternative to zinc oxide with a focus on gut microbiota modulation and metabolite production. In this study, weaned pigs aged 28 days were fed either a control diet, a diet supplemented with zinc oxide (3000 mg/kg), or 2% and 4% pulverized whole red beetroot (CON, ZNO, RB2, and RB4; respectively) for 14 days. After pigs were euthanized, blood and digesta samples were collected for microbial composition and metabolite analyses. The results showed that the diet supplemented with red beetroot at 2% improved the gut microbial richness relative to other diets but marginally influenced the cecal microbial diversity compared to a zinc-oxide-supplemented diet. A further increase in red beetroot levels (4%—RB4) led to loss in cecal diversity and decreased short chain fatty acids and secondary bile acid concentrations. Also, an increased Proteobacteria abundance, presumably due to increased lactate/lactic-acid-producing bacteria was observed. In summary, red beetroot contains several components conceived to improve the gut microbiota and metabolite output of weaned pigs. Future studies investigating individual components of red beetroot will better elucidate their contributions to gut microbiota modulation and pig health. [ABSTRACT FROM AUTHOR]

Nopalea cochenillifera (L.) Salm-Dyck is a cactus species native to Mexico, now widely distributed in the West Indies and tropical America. It is a species not usually consumed as food, but due to its composition of bioactive compounds, it could be used to treat diabetes. The present study aimed to evaluate the effect of N. cochenillifera cladode flour on glucose levels in streptozotocin-induced diabetic CD-1 mice. The flour obtained from cladodes absorbed glucose proportionally to the glucose concentration, and it was observed that the administration of flour (10.5 mg/kg body) decreased glucose levels in diabetic mice compared to the control group. This preclinical study demonstrates that N. cochenillifera flour could be used to improve glucose homeostasis in type 2 diabetes. [ABSTRACT FROM AUTHOR]

Understanding immune mechanisms that mediate malaria protection is critical for improving vaccine development. Vaccination with radiation-attenuated Plasmodium falciparum sporozoites (PfRAS) induces high level of sterilizing immunity against malaria and serves as a valuable tool for the study of protective mechanisms. To identify vaccine-induced and protection-associated responses during malarial infection, we performed transcriptome profiling of whole blood and in-depth cellular profiling of PBMCs from volunteers who received either PfRAS or noninfectious mosquito bites, followed by controlled human malaria infection (CHMI) challenge. In-depth single-cell profiling of cell subsets that respond to CHMI in mock-vaccinated individuals showed a predominantly inflammatory transcriptome response. Whole blood transcriptome analysis revealed that gene sets associated with type I and II interferon and NK cell responses were increased in prior to CHMI while T and B cell signatures were decreased as early as one day following CHMI in protected vaccinees. In contrast, non-protected vaccinees and mock-vaccinated individuals exhibited shared transcriptome changes after CHMI characterized by decreased innate cell signatures and inflammatory responses. Additionally, immunophenotyping data showed different induction profiles of vδ2+ γδ T cells, CD56+ CD8+ T effector memory (Tem) cells, and non-classical monocytes between protected vaccinees and individuals developing blood-stage parasitemia, following treatment and resolution of infection. Our data provide key insights in understanding immune mechanistic pathways of PfRAS-induced protection and infective CHMI. We demonstrate that vaccine-induced immune response is heterogenous between protected and non-protected vaccinees and that inducted-malaria protection by PfRAS is associated with early and rapid changes in interferon, NK cell and adaptive immune responses. Trial Registration: ClinicalTrials.gov NCT01994525. Author summary: Malaria poses a significant global health threat, causing over half a million deaths annually. Effective vaccines are critically needed to prevent malaria disease. Our incomplete understanding of immune mechanisms that mediate malaria protection is hampering the development of effective vaccines. Irradiated sporozoite vaccines can induce highly sterilizing protection against malaria and are a valuable tool for the analysis of immune protection. Here, we aimed to characterize correlates of immune protection in individuals vaccinated with a suboptimal dose of irradiated sporozoite and subsequently challenged with live malaria parasite. Blood samples were taken before and after malaria challenge, and gene expression and cell type profiles were measured. We observed that the trajectories of immune response after malaria challenge is highly distinct between protected and non-protected vaccinees. We observed early perturbations in interferon, NK cell, and adaptive immune responses in protected vaccinees whereas inflammatory and innate cell response were unique to non-protected vaccinees. We also observed that the immune profile after malaria challenge was distinctly similar between non-protected vaccinees and mock-vaccinated individuals. Our study sheds light on the dynamics of vaccine-induced immune responses that are associated with protection from malaria after CHMI. [ABSTRACT FROM AUTHOR]

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Selective mutism (SM) is an anxiety disorder that affects some children when they begin school. If left untreated the long-term impact can include complex, debilitating mental health conditions. The usual presentation is lack of speech in the education setting, contrasting with confident speech at home. Prevalence is estimated at 0.7% but can be three times higher for children who are immigrant second language learners. There is some evidence to suggest that music therapy is helpful but a deeper understanding is needed. This study aims to develop a new theoretical framework for the use of music therapy for young children with SM. The paper reports on multiple case study research of music therapy for six children with SM aged 3–5. Template analysis combining inductive and deductive enquiry is used to revise and develop the framework. The six case studies describe contrasting paths into speech. Four key domains – Approach; Therapeutic Process; Interconnected Elements of Music Therapy; Context – were necessary to clinical practice across cases, and are presented in detail in the final theoretical framework. Music therapists bring many useful skills, with musical communication established as an empowering tool for alleviating SM. The framework provides the theoretical basis for comprehensive guidance for music therapy with young children with SM. An open, flexible, multi-modal approach, integrating teamwork and considering transdisciplinary practice, is indicated. The need for SM training for music therapists and the potential role of music therapy on the care pathway for SM is demonstrated. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review is to identify factors that influence relationship quality in couples living with dementia. Previous research has shown how maintaining a positive spousal relationship quality is important for quality of life and coping for both the caregiver and the person with dementia. Knowledge of influential factors could contribute to a deeper understanding of the value of a couple-centred clinical practice and research, within the field of dementia. Research design and methods: Systematic procedures to database search, screening, data extraction and synthesis were followed. Qualitative, quantitative and mixed methods studies were included. A narrative synthesis was conducted through narrative summaries of included studies, thematic analysis and narrative descriptions of factors influencing relationship quality. Results: 39 studies were included in the study: 28 qualitative, 8 quantitative and 3 mixed methods. Through the narrative synthesis, 20 factors were identified. The factors were grouped into two overarching themes: The world of us and The world outside of us, and further to six influencing factor categories: (1) Attitudes and strategies, (2) Behaviour and activities, (3) Emotional connectedness, (4) Activities and experiences outside of the home, (5) Social behaviour and roles, and (6) Belonging and safety. Discussion and conclusion: The identified factors influence relationship quality in couples living with dementia on various levels. The findings of this review study should inform clinical, couple-centred dementia care practise and intervention studies, and further research should seek to gain deeper understandings of the individual factors and broader understandings of the correlations between factors. [ABSTRACT FROM AUTHOR]

Background: The number of people living with dementia (PwD) worldwide is expected to double every 20 years. Many continue living at home, receiving support from family caregivers who may experience significant stress, simultaneously to that of the PwD. Meaningful and effective home-based interventions to support PwD and their caregivers are needed. The development of a theory- and practice-driven online home-based music intervention (MI) is delivered by credentialed music therapists, nested within the HOMESIDE RCT trial. Methods: Dyads including the PwD and their family carer are randomised to MI, reading (RI) or standard care (SC). MI aims to support health wellbeing and quality of life by training caregivers to intentionally use music (singing, instrument playing, movement/dancing, and music listening) with their family member (PwD) in daily routines. MI is underpinned by cognitive, relational, social, and psychological theories of mechanisms of change. Results: Preliminary sub-cohort results analyses show MI can be delivered and is accepted well by participants and music-therapist interventionists across five countries. Conclusions: The specialist skills of a music therapist through MI enable carers to access music when music therapists are not present, to meet carer and PwD needs. Music therapists embrace this changing professional role, observing therapeutic change for members of the dyads. [ABSTRACT FROM AUTHOR]

Species‐specific responses to landscape configuration and landscape composition have been studied extensively. However, little work has been done to compare intraspecific differences in habitat preferences. Bats have potential as good bioindicator taxa in woodland habitats. Therefore, studying sex differences in responses to woodland and the wider landscape can allow us to gain insight into the relative importance of these habitats for both bats and other taxa. In this study, we aimed to test the predictions that (i) habitat type and connectivity will influence the probability of recording female bats in woodlands and (ii) sex differences in response to habitat type and connectivity will be species‐specific. Bat capture data was collected in 206 woodlands over 3 years in England. The probability of detecting females relative to males was modeled in response to a range of woodland characteristics and landscape metrics for six bat species. We recorded sex differences in responses to landscape features in three species. We found a higher probability of capturing female Myotis nattereri in woodlands that were surrounded by a higher proportion of improved grasslands, whereas female Myotis mystacinus were less likely to be recorded in woodlands surrounded by semi‐natural vegetation. Female Plecotus auritus were more likely to be recorded in isolated woodlands with less connectivity to other woodlands and where agriculture dominated the surrounding landscape. Our findings indicate that sexual segregation occurs across several UK bat species in response to landscape connectivity and composition. Sexual segregation in response to landscape characteristics in bats should therefore be an important consideration in the management of fragmented agricultural landscapes. [ABSTRACT FROM AUTHOR]

Qualitative systematic reviews, or qualitative evidence syntheses (QES), are increasingly used in health settings to guide the development of practice and policy. Thematic synthesis is one of the most well-developed approaches used for QES, however there are limited worked examples describing how to apply the steps of analysis in the literature. This paper describes the processes and decisions undertaken in a qualitative systematic review and thematic synthesis from the perspective of a novice researcher. The described review aimed to explore the shared musical experiences of people living with dementia and their family care partners across a range of settings. We found that shared musical activities fostered experiences of connection and wellbeing for people living with dementia and their family care partners. This was demonstrated with moderate-high confidence through six themes, and our findings informed the development of the Contextual Connection Model of Health Musicking. In presenting a worked example of our review, this paper introduces a systematic approach to coding and discusses the complexities of developing and reporting on analytical themes. We identify the need for a specific thematic synthesis reporting tool, and the need to embed reflexive practices into QES tools more broadly. [ABSTRACT FROM AUTHOR]

Carbon taxes or similar pricing instruments could play a crucial role in helping countries decarbonise their economies. No country has a single carbon price that applies to all greenhouse gas emissions. The UK is typical in having adopted a complex patchwork of policies that raise the cost of different polluting activities to different degrees, resulting in implied carbon taxes that vary greatly across sources of emissions. We document and quantify these inconsistencies in the case of the UK, and assess the case for greater uniformity after accounting for considerations of efficiency, distribution, carbon leakage and the use of alternative policy instruments. We argue for greater rationalisation of environmental taxes in the UK and other developed economies. [ABSTRACT FROM AUTHOR]

Gaining a better understanding of the immune cell subsets and molecular factors associated with protective or pathological immunity against severe acute respiratory syndrome coronavirus (SARS-CoV)-2 could aid the development of vaccines and therapeutics for coronavirus disease 2019 (COVID-19). Single-cell technologies, such as flow cytometry, mass cytometry, single-cell transcriptomics and single-cell multi-omic profiling, offer considerable promise in dissecting the heterogeneity of immune responses among individual cells and uncovering the molecular mechanisms of COVID-19 pathogenesis. Single-cell immune-profiling studies reported to date have identified innate and adaptive immune cell subsets that correlate with COVID-19 disease severity, as well as immunological factors and pathways of potential relevance to the development of vaccines and treatments for COVID-19. For facilitation of integrative studies and meta-analyses into the immunology of SARS-CoV-2 infection, we provide standardized, download-ready versions of 21 published single-cell sequencing datasets (over 3.2 million cells in total) as well as an interactive visualization portal for data exploration. This Review provides an overview of existing studies using single-cell technologies to provide insights over the immune responses and molecular mechanisms at work in COVID-19. [ABSTRACT FROM AUTHOR]

Positive effects of music therapy for people with dementia and their family carers are reported in a growing number of studies. However, small sample sizes or low recruitment rates often limit the success of these research studies. More adequately powered evidence-based studies are needed to impact policy and funding in dementia care. This systematic review examined recruitment strategies in music therapy clinical trials involving people living with dementia and/or their family carers. Eligible studies described enrolment, consent, accrual, or recruitment methods as well as recruitment or consent rates. Thirty studies with a total of 1,192 participants were included. Recruitment and conversion rates in residential aged care facilities (RACFs) (14 studies) were substantially higher than in community-based studies (16 studies). Whereas studies in RACFs most commonly recruited participants through staff approaching residents face-to-face or conversing with residents' legal guardians, community-based studies utilized a vast array of strategies, including staff referral, demonstrations/information sessions by researchers, advertisements, and direct contact with residents. Recruitment rates are likely to be higher when recruiters have an existing relationship with potential participants and when an independent third-party dementia organization is involved. Randomized controlled trials led to equally or greater recruitment conversion rates than other designs. Findings suggest that recruitment in dementia trials is complex, challenging, and needs thorough planning and consideration to be time- and cost-effective. Future studies should include reporting of recruitment strategies, enrolment rates, and related aspects so that researchers can better design recruitment strategies and estimate resources needed to reach the target sample size. [ABSTRACT FROM AUTHOR]

Summary: Most of the work on pomegranate antioxidant and antibacterial activity has been carried out with solvent extracts of different plant or fruit parts. Biosensitive compounds in juice may be subject to oxidation, reducing their biological activities. Microencapsulation can be used to protect compounds, allowing its incorporation into functional foods. This study aimed at investigating antioxidant activity after in vitro digestion of microencapsulated juice. Pomegranate juice was encapsulated by spray drying its maltodextrin and gum arabic. The average diameter of the microcapsules was 10–50 µm. We evaluated the bioaccessibility of microencapsulated phenolic compounds by using an in vitro enzymatic digestion. The total phenolic content in digested microencapsulated juice was three times greater than in undigested, indicating that the compounds were made bioaccessible. Digestion also increased antioxidant activity, as measured by ABTS●+ or by DPPH●. Additionally, microencapsulated pomegranate juice showed antibacterial activity against the nine bacteria species tested. [ABSTRACT FROM AUTHOR]

Pomegranate is a polyphenol-rich fruit. Studies have shown that extracts prepared from its juice or from different parts of the pomegranate plant have various biological activities including antioxidant, antimicrobial, anti-inflammatory, anticarcinogenic, cardioprotective, and antidiabetic. The therapeutic potential has been attributed to various phytochemicals, including ellagic acid, punicic acid, flavonoids, anthocyanidins, anthocyanins, flavonols, and flavones. This review focuses on the scientific evidence of pomegranate juice as hypoglycemic, emphasizing the chemical composition and the possible mechanisms of action associated with this effect. Studies were identified using the PubMed, Scopus, and ISI Web of Science databases to identify relevant articles focused on the hypoglycemic effect of pomegranate juice. The physiological responses to pomegranate juice are reported here, including a decrease of oxidative stress damage, an increase of insulin-dependent glucose uptake, maintenance of β-cell integrity, inhibition of nonenzymatic protein glycation, an increase of insulin sensitivity, modulation of peroxisome proliferator-activated receptor-gamma, inhibition of α-amylase, inhibition of α-glucosidase and dipeptidyl peptidase-4, and decreases in inflammation. Overall, we found a significant hypoglycemic effect of pomegranate in in vitro and in vivo studies and we summarize the potential mechanisms of action. [ABSTRACT FROM AUTHOR]

Background: Pharmacological interventions to address behavioural and psychological symptoms of dementia (BPSD) can have undesirable side effects, therefore non‐pharmacological approaches to managing symptoms may be preferable. Past studies show that music therapy can reduce BPSD, and other studies have explored how formal caregivers use music in their caring roles. However, no studies have examined the effects on BPSD of music interventions delivered by informal caregivers (CGs) in the home setting. Our project addresses the need for improved informal care by training cohabiting family CGs to implement music interventions that target BPSD, and the quality of life (QoL) and well‐being of people with dementia and CGs. Methods: An international three‐arm parallel‐group randomised controlled trial has so far randomised 130 of the target 495 dyads from Australia, Germany, UK, Poland and Norway. Dyads are randomised equally to standard care (SC), a home‐based music programme plus SC, or a home‐based reading programme plus SC for 12 weeks. The primary outcome is BPSD of people with dementia (measured using the Neuropsychiatric Inventory‐Questionnaire). Secondary outcomes examine relationship quality between CG and people with dementia, depression, resilience, competence, QoL for CG and QoL for people with dementia. Outcomes are collected at baseline, at the end of the 12‐week intervention and at 6 months post randomisation. Resource Utilisation in Dementia captures economic data across the life of the intervention and at 6‐month follow‐up. Our presentation will briefly outline the study protocol and describe the caregiver training protocol and interventions in detail with video footage illustrating how the intervention looks in practice. [ABSTRACT FROM AUTHOR]