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Objectives: To investigate whether the likelihood of hospital‐acquired complications for older people in Australia differs by whether they have dementia. Study design: Matched cohort study. Setting, participants: People aged 60 years or older with dementia who were admitted to five public hospitals in the South Western Sydney Local Health District, New South Wales, 1 January 2010 to 31 December 2020, and people without dementia admitted during the same period, matched by age, sex, number of medical conditions, and presence of selected specific medical conditions, emergency admission status, history of falls, and admission from a nursing home. Main outcome measures: Hospital‐acquired complications (falls, pressure injuries, delirium, pneumonia, venous thromboembolism, new incontinence, malnutrition, in‐hospital death), by dementia status. Results: A total of 217 459 people aged 60 years or older were admitted to the five hospitals during the study period. The mean age of the 11 393 patients with dementia (83 years; standard deviation [SD], 7.5 years) was higher than that of the 206 065 patients without dementia (73 years; SD, 8.9 years), and the proportion of women slightly larger (55% v 50%). Median hospital length of stay was longer for people with dementia (nine days; interquartile range [IQR], 4–19 days) than for people without dementia (three days; IQR, 1–9 days), and the number of in‐hospital deaths higher (768, 7% v 584, 5%). After propensity score‐based matching, the risks of falls (odds ratio [OR], 4.7; 95% confidence interval [CI], 3.8–5.7), pressure injury (OR, 1.4; 95% CI, 1.1–1.8), delirium (OR, 2.4; 95% CI, 2.0–3.0), and pneumonia (OR, 1.3; 95% CI, 1.01–1.7) were higher for people with dementia than for those without dementia; differences between the two groups in the risks of venous thromboembolism, malnutrition, and incontinence were not statistically significant. Conclusions: Given the greater risk of many hospital‐acquired complications for people with dementia, targeted models of person‐centred care are needed to ensure the best outcomes for these patients. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Here we set out to create a symptom‐led staging system for the canonical semantic and non‐fluent/agrammatic variants of primary progressive aphasia (PPA), which present unique diagnostic and management challenges not well captured by functional scales developed for Alzheimer's disease and other dementias. METHODS: An international PPA caregiver cohort was surveyed on symptom development under six provisional clinical stages and feedback was analyzed using a mixed‐methods sequential explanatory design. RESULTS: Both PPA syndromes were characterized by initial communication dysfunction and non‐verbal behavioral changes, with increasing syndromic convergence and functional dependency at later stages. Milestone symptoms were distilled to create a prototypical progression and severity scale of functional impairment: the PPA Progression Planning Aid ("PPA‐Squared"). DISCUSSION: This work introduces a symptom‐led staging scheme and functional scale for semantic and non‐fluent/agrammatic variants of PPA. Our findings have implications for diagnostic and care pathway guidelines, trial design, and personalized prognosis and treatment for PPA. Highlights: We introduce new symptom‐led perspectives on primary progressive aphasia (PPA).The focus is on non‐fluent/agrammatic (nfvPPA) and semantic (svPPA) variants.Foregrounding of early and non‐verbal features of PPA and clinical trajectories is featured.We introduce a symptom‐led staging scheme for PPA.We propose a prototype for a functional impairment scale, the PPA Progression Planning Aid. [ABSTRACT FROM AUTHOR]

Objective: Silver Chub Macrhybopsis storeriana, a predominately riverine species throughout its native range, exists within Lake Erie as the only known lake population. Its population declined in the 1950s and never fully recovered. Canada has listed Silver Chub in the Great Lakes–St. Lawrence River as endangered and has initiated a recovery plan that recognized the identification of spawning areas as a critical component to inform Silver Chub's recovery potential. Methods: We investigated potential spawning locations of Silver Chub using capture records, otolith microchemistry, and daily age analysis. Lapillus otolith Sr:Ca ratios from 27 age‐0 Silver Chub were used to identify potential spawning areas. Daily ages estimated from lapilli were used to calculate hatch dates, which then were compared with capture data of adults and river flows to further inform potential spawning areas. Result: The Detroit River (and its nearshore area) was all but ruled out as a potential spawning location. The Maumee, Portage, and Sandusky rivers or their nearshore areas were all possible spawning locations. Projected hatch dates spanned the end of May through the end of June and occurred across a wide range of flows, although some peaks in hatch dates corresponded to flow peaks, indicating recruitment is potentially enhanced by high flows. Conclusion: Silver Chub spawning period and hypothesized spawning rivers or lacustuaries overlap those of invasive Grass Carp Ctenopharyngodon idella, creating a need to jointly consider Grass Carp control efforts with conservation of Silver Chub when assessing management alternatives. Further research on spawning guild and the use of rivers themselves or nearshore areas influenced by rivers as spawning areas are required to maximize potential for conservation and recovery of Silver Chub. Impact statementConserving the Silver Chub is vital; it's an indicator of water quality, a food source for aquatic organisms, and preserves biodiversity. Identifying both locations and mode of spawning enhances the conservation of biodiversity in fish communities, ensuring ecosystem stability. [ABSTRACT FROM AUTHOR]

Background: Peer support has a key role to play in national and local health services worldwide given growing need, pressure on resources, and strategic drives towards supporting people to manage their own health. Yet evaluation of peer‐only and multi‐component peer and professional group services is held back by research methodology gaps, including the absence of direct, within‐session evaluation tools. The current study evaluates the relationship between participation and conversational characteristics using linguistic analysis of a series of online bereaved support groups. Method: Participants were bereaved family caregivers (N = 102) attending Rare Dementia Support bereaved support group meetings between March 2017 and March 2022. Attendance rates and (virtual) travel distance were compared for in person meetings (N = 9 sessions; 2017‐2019) and online meetings (N = 26 sessions; 2020‐2022). During each online session, notable phrases & contributions were recorded using a verbatim note‐making process and shared with participants post‐session as a reminder of the experiences shared by group members. These text files (660 phrases comprised of 9,600 words) were analysed using Linguistic Inquiry and Word Count (LIWC; Pennebaker et al., 2015) software, automatically classifying words into LIWC categories of analytical thinking, clout, authenticity and affect variables. Result: The switch to online sessions increased accessibility to bereaved support in terms of attendance rates (Figure 1A), geographical proximity (Figure 1B) and group consistency (Figure 1C, e.g. higher proportion of online attendees returned for further sessions [in person 42%, online 69%; McNemar χ2 = 3.84, p = 0.0001]). Linear regression analyses with robust standard errors revealed that greater session attendance (mean number of sessions attended by participants present) was associated with conversations that were more authentic and less emotional and definitive (i.e. more reflective) over time (regression coefficients: Authentic: 0.111 [0.073, 0.149]; Affect: ‐0.637 [‐1.089, ‐0.185]; Clout: ‐0.066 [‐0.112, ‐0.020]; see Figures 2A‐C). The level of analytical thinking was maintained across sessions (Analytic: ‐0.012 [‐0.086, 0.061]; see Figure 2D). Conclusion: Online peer groups offer a practical and effective medium for bereavement support. Shifting the focus of evaluation to the processes of social support – how it is delivered and received – rather than just the outcomes, offers insights into the mechanisms of peer support. [ABSTRACT FROM AUTHOR]

Background: Dementias starting with symptoms other than memory are low prevalent. Educational and training resources for caregivers of people living with these conditions are scarce and difficult to access. The aim of this trial is to test the feasibility of an online training program for carers of people with three non‐memory led dementias: Posterior Cortical Atrophy (PCA), Primary Progressive Aphasia (PPA) and behavioural variant FTD (bvFTD). The trial design is a randomised feasibility study. Method: Setting: Community. Participants were recruited from the organisation Rare Dementia Support (RDS). Participants: Carers of people with PCA, PPA and bvFTD Intervention: The experimental group was given access to an eight‐week online program consisting of 6 digital manuals addressing practical strategies to better support people living with PCA, PPA or bvFTD (depending on diagnosis of the care recipient). The control group was directed to RDS's existing website (TAU). Outcome measures: Feasibility of recruitment, measurement tools (clinical outcomes, see Table 1) and acceptability. Measures were collected at baseline, immediate post intervention (8 weeks post‐randomisation) and 3 months post‐randomisation. Randomization: Allocation ratio was 2:1 (intervention: control) stratified by diagnosis carried out by a central computer system. Participants were unblinded to intervention. All measures were self‐reported online by the participants. Result: Numbers randomized: 31 participants were recruited. 30 participants were randomized (1/31 did not complete baseline) (21 to intervention, 9 to control group). Trial status: closed. Numbers analysed: 30 participants for intention to treat analysis (3 dropped out). Outcomes: Feasibility of recruitment (see Figure 1 Flowchart) is 40% (31 people consented/78 approached). Retention rate is 87%. The proportion of eligible participants who agree to participate is 97% (30/31).Assessment of feasibility of measurement tools (proposed clinical outcomes) shows 96% response rates at 8 weeks (29/30) and 90% (27/30) at 3 months. Acceptability: 100% of participants agreed to be randomised. Intervention coherence: 28% (6/21) participants interacted with facilitator during the intervention. Follow‐up qualitative interviews were conducted to gain a better understanding of how to improve intervention coherence. Conclusion: The trialled intervention shows excellent feasibility of recruitment, retention and measurement tools. Enhancement of intervention coherence is required. [ABSTRACT FROM AUTHOR]

Restoration of wetlands in the Laurentian Great Lakes is designed to improve numerous ecosystem services including nutrient sequestration, support recreational uses, augment waterfowl habitat, and provide spawning and nursery habitat for fish. These projects often use Northern Pike Esox lucius, as a sentinel species for assessing restoration success because of their obligate use of emergent and submergent vegetation by the early life stages. However, invasive species such as Common Carp Cyprinus carpio also utilize these habitats and can have negative effects. Thus, fostering the use of these wetlands by Northern Pike and limiting access by invasive carp is a common restoration management concern. Using a dual frequency sonar system to observe fish migration in a recently connected Lake Erie coastal wetland, we were able to identify fine‐scale environmental correlates to immigration by each species during early spring. Both species overwhelmingly migrated during daylight hours and against the flow of water that was generated through seiche‐driven water oscillations. However, Northern Pike predominantly immigrated during the initial increase in water temperature immediately after ice‐out; Common Carp also began to enter the wetland at low temperatures shortly after ice‐out, but immigration exhibited a slow exponentially increasing pattern, such that the primary immigration timing differed by almost 30 d. Thus, we demonstrate common fine‐scale spawning migration patterns (i.e., water oscillation effects and time of day) for both species and reinforce the temperature‐correlated differences in spawning migration. Using these results could enable managers of connected wetlands to more precisely and dynamically manage habitat accessibility for desired species like Northern Pike while better regulating invasive Common Carp spawning migration and use of these systems. [ABSTRACT FROM AUTHOR]

Brook Trout Salvelinus fontinalis have faced significant declines throughout their native range and have been stocked in Midwestern waters since the late 1800s to offset such losses. Several studies have investigated the genetic effects of these stockings, but these efforts have been confined to relatively small spatial scales. In this study, we compiled 8,454 Brook Trout microsatellite genotypes from 188 wild Midwestern populations and 26 hatchery strains to provide novel insights of broadscale population structure, regional patterns of genetic diversity, and estimates of hatchery introgression for inland Wisconsin populations. Our results indicate high levels of differentiation among our study populations, a lack of hydrological population structuring, lower estimates of genetic diversity in the Driftless Area, and that hatchery introgression has been largely confined to regions of inland Wisconsin that have been heavily affected by anthropogenic disturbances (i.e., the Driftless Area). We also provide evidence that populations may be able to purge hatchery‐derived alleles, discuss possible mechanisms behind this phenomenon, and consider their relevance to accurate estimation of hatchery introgression. Collectively, these results summarize the genetic effects of over a century of anthropogenic disturbance on native Brook Trout populations and emphasize the importance of integrating historical data into contemporary genetic research of intensively managed species. [ABSTRACT FROM AUTHOR]

Background: Suicide is a major public health concern. However, little is known about whether dementia is associated with suicide outcomes, and if so what the risk factors for suicide are in this group. This study aimed to conduct meta‐analyses to examine pooled associations between dementia and suicide outcomes (ideation, attempts, death by suicide) as well as pooled associations between risk factors (sex, dementia subtype) and suicidality in people living with dementia (PLWD). Method: Systematic searches were conducted in Medline, Embase, Psycinfo, Cinahl Plus, and Web of Science for keywords related to dementia and suicide. Quantitative studies with a sample of PLWD and suicidality as an outcome and that were available in English were included. Experimental studies, case reports and studies with a focus on euthanasia/assisted suicide, or self‐harm without suicidal intentionality were excluded. Relevant effect sizes were extracted and inverse variance weighted meta‐analyses were run using a random‐effects model. Result: 55 studies were included. Meta analyses showed that compared to people without dementia, having dementia was significantly associated with death by suicide (OR = 2.48, 95% CI:1.82;3.38), and suicidal ideation (OR = 2.29, 95% CI:1.75‐2.99), but not suicide attempts. Men with dementia were more at risk of attempting (OR = 1.28, 95% CI:1.25;1.31) and death by suicide (OR = 2.84, 95% CI:1.51;5.37) than women with dementia, but there was no difference in suicidal ideation. Compared with Alzheimer's disease, people with vascular dementia (VaD), frontotemporal dementia (FTD), and other dementia (OD) types were significantly more likely to attempt suicide. People with Lewy body dementia (LBD) were significantly more likely to report suicidal ideation. Conclusion: PLWD are at higher risk of suicidal ideation and death by suicide than those without dementia, but not suicide attempts. This could suggest that PLWD are not more likely to attempt suicide but are more likely to be successful when an attempt is made. Key risk factors for suicide attempts amongst PLWD are being male, sub‐type of dementia diagnosis (VaD, FTD and OD), while having a diagnosis of LBD is a risk factor for suicidal ideation. These results are important for understanding and managing risk in PLWD. [ABSTRACT FROM AUTHOR]

Background: Previous research has shown that self‐efficacy is associated with a range of health outcomes. However, little is known about relationships between self‐efficacy and cognition across the life‐course. The aims of this study were to test (1) whether trajectories of self‐efficacy from age 33 to 50 are associated with midlife cognitive function (age 50); and (2) whether self‐efficacy acts as a path through which the relationship between childhood factors and adult cognition operates. Method: Data used were from the National Child Development Study, a longitudinal birth cohort of 17,415 people born during a single week of 1958. Measures of self‐efficacy were available at ages 33, 42, 46, and 50. Measures of immediate and delayed memory, verbal fluency, processing speed, and processing accuracy were available at age 50. Growth mixture models were run to identify longitudinal trajectories of self‐efficacy. Structural equation modes (SEMs) were run to test associations between different trajectories of self‐efficacy and adult cognitive function. Next, mediation models were used to test the direct, indirect and total effects of childhood factors on adult cognitive function, through accumulation of self‐efficacy. Result: According to standard indices (AIC, BIC, LRT, class proportions, etc), a 5‐class trajectory model best fitted the data (Figure 1). SEM models showed that compared with persistently high self‐efficacy, being in any other trajectory was significantly associated with poorer immediate and delayed memory, verbal fluency and processing speed. Being in the moderate and decreasing self‐efficacy trajectory was significantly associated with poorer processing accuracy, compared with the high self‐efficacy group. Greater accumulation (number of time points with high self‐efficacy) over time was significantly associated with better cognitive function in all domains. Mediation models showed significant indirect effects of childhood cognition and education on immediate memory through the accumulation of self‐efficacy score, but not for sex or childhood socioeconomic position. Conclusion: Results show that in this prospective birth cohort, persistently high self‐efficacy across early adulthood to midlife (age 33 to 50) was significantly associated with higher cognitive function in midlife. This may be one path through which associations between childhood factors (childhood cognition and education) and adult cognitive function may operate. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are well recognised as risk factors for dementia and poorer cognitive outcomes. However, considerably less is known about the relationship between quality of life and cognitive function over time. Quality of life is not simply the absence of mental health problems, but instead is a related but distinct construct. In particular, it is unclear whether poorer quality of life precedes cognitive decline, or vice versa or whether there is a bidirectional relationship. This is of import because understanding directionality allows us to start to plan interventions around dementia risk reduction. The aim of this study was to test bidirectionality between quality of life and memory in a large, nationally representative sample of people aged 50+ without cognitive impairment. Method: Data were used from the English Longitudinal Study of Ageing (ELSA), a longitudinal cohort comprising 12,099 people over the age of 50 and their partners. Repeated measures of quality of life and memory (immediate and delayed) were available nine times over a 17‐year period. Cross‐lagged models were fitted to test for bidirectionality between quality of life and memory function. Result: The fully adjusted model revealed that higher quality of life was significantly associated with higher subsequent immediate memory scores at all time‐points, and with higher subsequent delayed memory scores at all except the final time‐point. There was no consistent evidence that memory was significantly associated with subsequent quality of life. Conclusion: These results extend previous research by providing evidence for the temporal association between quality of life and memory in a population‐based sample of people aged 50+. Specifically, results suggest that quality of life is consistently associated with later memory function over nearly two decades, though the study did not provide evidence that the association operates in the opposite direction. The lack of consistent evidence for a relationship between cognitive function and subsequent quality of life may be due to the exclusion of people with cognitive impairment and adjustment for depressive symptoms. Better quality of life may act as a protective factor in retaining memory function from middle to later adulthood. [ABSTRACT FROM AUTHOR]

Background: Disease‐specific and general support is available for individuals experiencing rare [genetic and/or non‐memory‐led] dementia, broadly categorised into: professionally‐led [e.g. interacting with specialist support teams/resources] or socially‐oriented [e.g. large/small groups, buddying, online fora, and social media] offers. Membership of and engagement with different social networks may help to maintain emotional wellbeing in people living with/alongside dementia. Understanding the relationship between support service use and social connectedness, at different disease and life stages, will enable healthcare professionals to make evidence‐based individualised recommendations for support. Method: 207 participants either living with (PLWD N = 51) or alongside a rare dementia (Caregiver N = 156) provided responses via videoconference and online survey about support usage, and social connectedness. Support usage was characterised by (a) range of usage (indicated by number of different support formats accessed at least once); (b) frequency of usage rated using 4‐point Likert scales relating to 11 different types of support available. Level of social connectedness was ascertained through standardised scales: Social Network Index (SNI); De Jong Gierveld Loneliness Scale (6‐item), and Lubben Social Network Scale of social engagement (LSNS‐6). Associations between support usage and connectedness were examined separately for all/socially‐oriented support using multiple linear regressions covarying for group (PLWD/caregiver), gender, severity and age. Result: Range of support usage was significantly associated with greater social engagement (LSNS‐6: 0.071[0.003,0.139]), greater social network size (SNI:0.035[0.001,0.068]) and fewer networks (SNI: ‐0.486[‐0.947,‐0.026]). Both frequency of all‐support‐type usage and range of socially‐oriented support access was additionally associated with greater social engagement (LSNS‐6: 0.195[0.022,0.369] and 0.044[0.001,0.086] respectively). Usage across all and socially‐oriented support types was significantly associated with group (PLWD>Carers: all‐types frequency = 2.102[0.104,4.101]; social‐only frequency = 1.620[0.242,2.997]), and greater disease severity (years since diagnosis: all types frequency = 0.361[0.047,0.674]; social‐only frequency = 0.354[0.138,0.570] and social‐only range = 0.124[0.046,0.201]). Usage across all support was significantly associated with younger membership (Frequency = ‐0.125[‐0.220,‐0.030]; Range = ‐0.051[‐0.088,‐0.013]). Conclusion: Preliminary analysis indicates a relationship between range and frequency of support usage and social connectedness. The role of individual factors in and complexity of relationship between support usage and social connectedness underlines the need for co‐ordinated person‐centred provision of information‐ and socially‐based services. [ABSTRACT FROM AUTHOR]

Background: Group Cognitive Stimulation Therapy (CST) is the most widely implemented post‐diagnostic intervention for dementia in the UK (Perkins et al, 2022). This presentation describes the development and initial testing of a virtual group Cognitive Stimulation Therapy (vCST) programme for people with dementia, developed as a result of services moving online during the COVID‐19 pandemic and a general increase in teletherapies. Method: The vCST protocol was developed using the existing group CST manual, through stakeholder consultation with people living with dementia, caregivers, CST group facilitators and dementia service managers. This protocol was then field‐tested with ten groups of people living with dementia in the Brazil, China (Hong Kong), India, Ireland and the UK, and feedback on the protocol was gathered from 14 facilitators. Finally, the vCST programme was delivered to people with dementia in India (n = 15), Brazil (n = 44) and the UK (n = 24). Results: Field testing in five countries indicated acceptability to group facilitators and participants. Feedback from these groups was used to refine the developed protocol. Initial qualitative findings from the UK study and quantitative findings from India, Brazil and the UK will be presented, demonstrating the feasibility, acceptability and perceived benefits of these virtual groups. Conclusion: The final vCST protocol is proposed, including session materials for delivery of CST over video conferencing and a framework for offering CST virtually in global settings. vCST is an acceptable online intervention for many people living with dementia globally. We recommend that it is offered to those unable to access traditional in‐person CST, for example for health reasons and lack of transport or COVID‐19 restrictions. Many services have indicated plans to continue vCST long‐term, hence further research is needed to explore if participant outcomes are comparable to in‐person CST groups. Reference: Perkins, L., Fisher, E., Felstead, C., Rooney, C., Wong, G. H., Dai, R., ... & Spector, A. (2022). Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field‐Testing a New Framework. Clinical Interventions in Aging, 17, 97. [ABSTRACT FROM AUTHOR]

Background: Hope is an essential component of the human experience and can play a critical role in sustaining wellbeing and a good quality of life. It can seem somewhat at odds however with the dominant societal discourses around dementia, which, stemming from a biomedical perspective, are often (naturally) focused on deficits and decline. With recent promising developments in the field of therapeutic interventions, it is of timely importance to explore the concept of hope for those affected by rarer forms of dementia, charactersised by atypical symptoms and associated with unique challenges, for whom emerging treatments may be too late. Here, we explored the use of an innovative methodology – object elicitation – to facilitate conversations on this complex and sensitive topic with these underrepresented groups. Method: 17 people affected by dementia and primary caregivers took part in 3 facilitated discussions using object elicitation to explore the concept of hope within the context of rarer forms of dementia, including: familial Alzheimer's disease, behavioural variant frontotemporal dementia, and posterior cortical atrophy. Transcripts of the discussions were analysed thematically. Result: Findings were organised into 4 themes: (i) Reframing and reconceptualising hope in the context of dementia; (ii) Temporality: from hopes for the future to finding hope in the moment; (iii) Hope for the individual and hope for the collective; and (iv) The other side of the coin: lost hope, false hope and barriers to hope. Conclusion: The findings of this study shed light on some of the challenges to sustaining hope for people affected by lesser known forms of dementia and importantly, their resilience and resourcefulness in finding ways to continue to cultivate a sense of hope during difficult times within their everyday lives. These findings have implications for others living with these conditions and the unpaid carers and health and social care professionals supporting them, and are of particular relevance in the context of current treatment developments. This study has also demonstrated the utility and accessibility of the object elicitation method for opening up and facilitating conversations about emotionally charged topics for people living with and supporting people with different diagnoses of dementia. [ABSTRACT FROM AUTHOR]

Background: Primary care psychological therapy services can be effective in reducing symptoms of depression and anxiety in people living with dementia (PLWD) and are recommended in national guidelines (e.g., NICE, UK). However, it is currently unknown which factors are associated with better psychological therapy outcomes in PLWD. Method: National linked healthcare records (IAPT, HES, MHSD, HES‐ONS mortality data) were used to identify 1,522 PLWD who attended psychological therapy services across England. Associations between various factors (dementia‐specific and non‐dementia specific) and therapy outcomes on widely used anxiety (GAD7) and depression (PHQ9) measures (reliable improvement, recovery, deterioration, dropout) were explored. Result: People with FTD were more likely to experience a deterioration in depression or anxiety symptoms compared to people with vascular dementia (OR = 2.98, 95%CI[1.08,8.22], p =.03) and people with Alzheimer's disease (OR = 2.95, 95%CI[1.15,7.55], p =.03). Age at dementia diagnosis did not predict any therapy outcomes after controlling for sociodemographic and clinical factors. Greater depression severity (recovery: OR =.95, 95%CI[.92,.98], p<.001; deterioration: OR = 1.73, 95%CI[1.04,2.90], p =.04), lower anxiety severity (improvement: OR = 1.06, 95%CI[1.03,1.09], p<.001; deterioration: OR =.89, 95%CI[.84,.94], p<.001; dropout: OR = 1.06, 95%CI[1.02,1.11], p =.01), lower work and social functioning (improvement: OR =.98, 95%CI[.96,.99], p =.002; recovery: OR =.98, 95%CI[.96.99], p =.002; dropout: OR = 1.03, 95%CI[1.01,1.05], p =.01), psychotropic medication use (improvement: OR =.62, 95%CI[.46,.84], p =.002; recovery: OR =.67, 95%CI[.51,.90], p =.01; deterioration: OR = 1.73, 95%CI[1.04,2.90], p =.04), being working age (improvement: OR = 2.11, 95%ci[1.10, 4.04], p =.02; recovery: OR = 2.03, 95%CI[1.10,3.73], p =.02), and fewer therapy sessions (improvement: OR = 1.10, 95%CI[1.06,1.14], p<.001; recovery: OR = 1.12, 95%CI[1.09,1.16], p<.001) were all associated with worse psychological therapy outcomes in PLWD. Conclusion: Predictors of psychological therapy outcomes in PLWD were largely in line with those identified for a general population above and beyond dementia‐specific factors. Additional support and adaptations, such as more therapy sessions and regular clinical reviews, may be required to improve therapy outcomes in PLWD, particularly in those who are younger and have more severe depression. [ABSTRACT FROM AUTHOR]

Background: Family caregivers often find it difficult to access information and support in the later stages of dementia. They may have difficulties attending in‐person support groups due to caring responsibilities. If caregivers are able to attend these groups, the information and support is often targeted towards the earlier stages of dementia. Method: An eight session psychoeducational programme was developed in order to enable caregivers to access peer support and information from professionals with expertise relevant to the later stages of dementia. The programme sessions are held over Zoom and include the following topics: sensory stimulation, nutrition diet and swallowing, legal matters, care in the home and care homes, palliative care and pain management, funeral planning and brain donation. Sessions are co‐facilitated by health and social care professionals with relevant expertise, including a speech and language therapist, dietitian, solicitor and palliative care practitioner. Themes and session content have been co‐created through partnership working between facilitators and programme participants. Result: The programme has been completed by four groups of caregivers (n = 26). All participants care for someone living with a rare or young onset form of dementia, and include those caring at home as well as caregivers of people living in a care or nursing home. Participants have reported a number of positive outcomes from attending the programme, with one participant stating: 'Joining this late stage carers group – I was a bit worried about it... it's absolutely one of the best things I could have done. In some respects, I wish I could have joined this earlier'. The programme is currently being evaluated using a time and cost survey to determine ongoing feasibility. Conclusion: There is a need for accurate and timely access to information and support for family caregivers of people living with dementia in the later stages. Online psychoeducational programmes provide the opportunity for caregivers to access both peer and professional support in their own homes. The development of this programme has benefited from ongoing and iterative input from both caregivers and professionals in the dementia support field. [ABSTRACT FROM AUTHOR]

Background: There is a pressing need for interventions tailored to diverse clinical and demographic populations of dementia caregivers. The South Asian community represents the largest minority ethnic group in England and Wales. However, this community is underserved in research with many online interventions not addressing the specific care needs of South Asian carers in the UK. In this community, awareness about dementia is reported to be lower in comparison to the general population. Additionally, high levels of stigma and pressures to keep care within the family can limit help‐seeking. The World Health Organization's 'iSupport' is an online intervention that can be tailored to meet the needs of diverse populations. Method: 'iSupport' will be adapted for caregivers of UK‐based South Asian people with dementia (with translations into Bengali, Punjabi and Urdu). Stakeholder consultation and co‐design involving caregivers, healthcare professionals, researchers and charity representatives will employ a range of methods including focus groups, think‐aloud and semi‐structured interviews to support the cultural adaptation of iSupport in all three languages. Result: Adaptations for the UK South Asian population include: tailoring translations and cultural nuances that reflect the South Asian diaspora; the use of audio and videos to increase access to carers with a range of literacy levels; and addressing misconceptions about defining oneself as a caregiver. Next steps include testing the feasibility and acceptability of the adapted Bengali iSupport intervention. Conclusion: These tailored interventions will better support the knowledge and skills of South Asian caregivers. The e‐health approach enables broad reach and offers support to those unable to access interventions due to cultural and language barriers, resulting in informed communities and improved wellbeing outcomes for carers and people with dementia. [ABSTRACT FROM AUTHOR]

Background: Frontotemporal dementia is genetic in around a third of cases. Issues such as high penetrance, heterogenous symptoms and unpredictable onset may cause significant challenges for those at‐risk. Few studies have evaluated this experience and no interventions have been designed to support this group. Therefore, investigation of the at‐risk experience is required to ensure an intervention that is tailored to and appropriate for the target population, as outlined in stage 0 of the NIH stage model for Behavioural Intervention Development. Method: Participants were individuals enrolled in UK GENFI, at‐risk of MAPT, GRN and C9orf72 mutations. Participants included those with unknown genetic status, asymptomatic mutation carriers and non‐carriers. 71 participants completed questionnaires, including GAD‐7 and PHQ‐9 measures, and the Genetic Psychosocial Risk Instrument. 16 qualitative interviews were conducted, regarding feelings experienced throughout the at‐risk journey, support needs and the genetic testing experience. An inductive approach to thematic analysis was used. Themes were then utilised to form the content of the intervention and guide design. Result: There were no significant differences between genetic groups on GAD‐7, PHQ‐9 and GPRI measures, however 52% participants met the GPRI threshold for referral for psychosocial intervention. Key themes included: 1) Emotions experienced, 2) How risk influences how you live your life, 3) Coping, 4) Support wanted, 5) Barriers and facilitators, and 6) The importance of understanding the specific difficulties. Many participants expressed a desire for tailored psychological support facilitated by "someone who understands". Intervention design The intervention applies principles largely derived from the Acceptance and Commitment Therapy model and has a blended design comprising of online sessions over eight weeks, with psychoeducational videos and three face‐to‐face sessions. There are seven to ten modules depending on the individual's genetic status including: anxiety and low mood, rumination, survivor guilt, concern about symptom onset and uncertainty. A pilot study is currently underway and will be completed by April 2022. Conclusion: Living at‐risk of familial FTD is challenging, often requiring additional support therefore this work demonstrates the importance of NIH stage 0 research in intervention development. Future research should further explore the effectiveness of tailored interventions in at‐risk familial FTD. [ABSTRACT FROM AUTHOR]

Previous genetic analyses have shown that WalleyesSander vitreusin the upper Ohio River comprise two distinct genetic strains: (1) fish of Great Lakes origin that were stocked into the Ohio River basin and (2) a remnant native strain (Highlands strain). Resource agencies are developing management strategies to conserve and restore the native strain within the upper reaches of the Ohio River. Hybridization between strains has impacted the genetic integrity of the native strain. To better understand the extent and effects of hybridization on the native strain, we used mitochondrial DNA and microsatellite markers to evaluate the spatial (river sections) and temporal (pre- and poststocking) genetic diversity of Ohio River Walleyes. Contemporary Lake Erie Walleyes and archival museum specimens collected from the Ohio River basin were used for comparison to contemporary Ohio River samples. Although there was evidence of hybridization between strains, most of the genetic diversity within the Ohio River was partitioned by basin of origin (Great Lakes versus the Ohio River), with greater similarity among river sections than between strains within the same section. Results also suggested that the native strain has diverged from historical populations. Furthermore, notable decreases in measures of genetic diversity and increased relatedness among native-strain Walleyes within two sections of the Ohio River may be related to stocking aimed at restoration of the Highlands strain. Our results suggest that although the Highlands strain persists within the Ohio River, it has diverged over time, and managers should consider the potential impacts of future management practices on the genetic diversity of this native strain. Received March 17, 2017; accepted July 20, 2017Published online September 25, 2017 [ABSTRACT FROM AUTHOR]

Lake WhitefishCoregonus clupeaformisis the most commercially valuable species in Lake Huron. The fishery for this species has historically been managed based on 25 management units (17 in Canada, 8 in the USA). However, congruence between the contemporary population structure of Lake Whitefish and management units is poorly understood. We used stable isotopes of carbon (δ13C) and nitrogen (δ15N), food web markers that reflect patterns in resource use (i.e., prey, location, habitat), to assess the population structure of spawning-phase Lake Whitefish collected from 32 sites (1,474 fish) across Lake Huron. We found large isotopic variation among fish from different sites (ranges: δ13C = 10.2‰, δ15N = 5.5‰) and variable niche size and levels of overlap (standard ellipse area = 1.0–4.3‰2). Lake Huron contained spawning-phase fish from four major isotopic clusters largely defined by extensive variation in δ13C, and the isotopic composition of fish sampled was spatially structured both within and between lake basins. Based on cluster compositions, we identified six putative regional groups, some of which represented sites of high diversity (three to four clusters) and others with less (one to two clusters). Analysis of isotopic values from Lake Whitefish collected from summer feeding locations and baseline prey items showed similar isotopic variation and established spatial linkage between spawning-phase and summer fish. Our results show that summer feeding location contributes strongly to the isotopic structure we observed in spawning-phase fish. One of the regional groups we identified in northern Georgian Bay is highly distinct based on isotopic composition and possibly ecologically unique within Lake Huron. Our findings are congruent with several previous studies using different markers (genetics, mark–recapture), and we conclude that current management units are generally too small and numerous to reflect the population structure of Lake Whitefish in Lake Huron. Received June 2, 2016; accepted October 3, 2016Published online January 3, 2017 [ABSTRACT FROM AUTHOR]

Denitrifying bioreactors using woodchips or other slow-release carbon sources can be an effective method for removing nitrate (NO3-) from wastewater and tile drainage. However, the ability of these systems to remove fecal microbes from wastewater has been largely uninvestigated. In this study, reductions in fecal indicator bacteria (Escherichia coli) and viruses (F-specific RNA bacteriophage [FRNA phage]) were analyzed by monthly sampling along a longitudinal transect within a full-scale denitrifying woodchip bioreactor receiving secondary-treated septic tank effluent. Nitrogen, phosphorus, 5-d carbonaceous biochemical oxygen demand (CBOD5), and total suspended solids (TSS) reduction were also assessed. The bioreactor demonstrated consistent and substantial reduction of E. coli (2.9 log10 reduction) and FRNA phage (3.9 log10 reduction) despite receiving highly fluctuating inflow concentrations [up to 3.5 × 105 MPN (100 mL) -1 and 1.1 × 105 plaque-forming units (100 mL) -1, respectively]. Most of the removal of fecal microbial contaminants occurred within the first meter of the system (1.4 log10 reduction for E. coli; 1.8 log10 reduction for FRNA phage). The system was also efficient at removing NO3- (>99.9% reduction) and TSS (89% reduction). There was no evidence of consistent removal of ammonium, organic nitrogen, or phosphorus. Leaching of CBOD5 occurred during initial operation but decreased and stabilized at lower values (14 g O2 m-3) after 9 mo. We present strong evidence for reliable microbial contaminant removal in denitrifying bioreactors, demonstrating their broader versatility for wastewater treatment. Research on the removal mechanisms of microbial contaminants in these systems, together with the assessment of longevity of removal, is warranted. [ABSTRACT FROM AUTHOR]

The world's cities must grow to accommodate an increasing urban population, and achieving this with minimal impact on ecosystem structures and functions is a major challenge. At opposite ends of a possible development spectrum are "land sharing" - extensive sprawling urbanization where built land and natural space are interspersed - and "land sparing" - intensive and extremely compact urbanization alongside separate, large, contiguous green space. Using case studies across urbanization gradients, we demonstrate that land sparing is crucial for sustaining a majority of ecosystem services. Conversely, some land sharing may also be necessary to ensure that people benefit from urban green space. Future urban development should carefully consider green space provision, to maximize the services provided by urban ecosystems. This can be achieved by optimizing distributions of development intensity across cities by means of top-down, policy-led approaches. [ABSTRACT FROM AUTHOR]

Amultiple linear regression analysis of nine different reanalysis datasets has been performed to test the robustness of variability associated with volcanic eruptions, the El Niño Southern Oscillation, the Quasi-Biennial Oscillation and with a specific focus on the 11-year solar cycle. The analysis covers both the stratosphere and troposphere and extends over the period 1979-2009. The characteristic signals of all four sources of variability are remarkably consistent between the datasets and confirm the responses seen in previous analyses. In general, the solar signatures reported are primarily due to the assimilation of observations, rather than the underlying forecast model used in the reanalysis system. Analysis of the 11-year solar response in the lower stratosphere confirms the existence of the equatorial temperature maximum, although there is less consistency in the upper stratosphere, probably reflecting the reduced level of assimilated data there. The solar modulation of the polar jet oscillation is also evident, but only significant during February. In the troposphere, vertically banded anomalies in zonal mean zonal winds are seen in all the reanalyses, with easterly anomalies at 30°N and 30°S suggesting a weaker and possibly broader Hadley circulation under solar maximum conditions. This structure is present in the annual signal and is particularly evident in NH wintertime. As well as the 'top-down' solar contribution to Northern Annular Mode variability, we show the potential contribution from the surface conditions allowing for a 'bottom-up' pathway. Finally, the reanalyses are compared with both observed global-mean temperatures from the Stratospheric Sounding Unit (SSU) and from the latest general circulation models from CMIP-5. The SSU samples the stratosphere over three different altitudes, and the 11-year solar cycle fingerprint is identified in these observations using detection and attribution techniques. [ABSTRACT FROM AUTHOR]

ABSTRACT The aim of this study was to examine the influence of land cover changes on soil organic carbon (SOC) and soil total nitrogen (STN) in the Daqing Prefecture of China, where heavy industrialisation in the form of dense oil wells has impacted the environment. Time-series presentations for the period 1978 to 2008 of remotely sensed data and soil survey data were used to assess the extent of the changes. The study revealed soil degradation under all land cover types and in all soil types, grassland retreat (−15 per cent), swampland retreat (−45 per cent) and increases in the area of farmland (+19 per cent), sand land (+1450 per cent) and alkaline land (+52 per cent). Depletion of the SOC pool occurred in swampland (−64 per cent) both because of the decrease in the area of swampland and because of a decrease in SOC density (−34 per cent). An increase in the SOC pool occurred in alkaline land because of the increase in the area and also because of an increase in SOC density (+297 per cent), but there was little change in the SOC pool in farmland because the increase in area was largely offset by a decrease in SOC density (−14 per cent). The decrease in the STN pool was substantial (−44 per cent), with the largest contributor being the decrease in swamplands (−74 per cent), partly because of the decrease in the area of swampland and partly because of a decrease in STN density (−52 per cent). Large decreases in the STN pool also occurred in farmland (−22 per cent) and grassland (−41 per cent). The direct impacts of construction associated with the expansion of the oil industry were overshadowed by indirect impacts such as interference with water flows and water levels resulting in salinisation of soil. The study also revealed that land cover changes are much more dynamic than a simple analysis would reveal, and because of lag times in the loss of SOC, soil degradation will continue even if land cover changes cease. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the effects of substituting 1 kg of a standard lactation diet with 1 kg of a sugar-rich (15.75 DE MJ/kg) or fat-rich (23.85 DE MJ/kg) diet during late lactation on blood glucose and insulin changes in primiparous sows. During a 4-week lactation period, 21 primiparous sows were fed to appetite with a standard lactation diet (14.10 DE MJ/kg). At 9 days before weaning, sows were assigned to a control (C, n = 7), fat (F, n = 6) or sugar (S, n = 8) treatment. During the treatment period (from 8 days before weaning until weaning), 1 kg of the lactation diet was substituted with 1 kg of a sugar-rich or fat-rich diet for S and F sows. At 3 days before weaning, serial blood samples were collected for a total of 228 min around feeding to establish pre- and postprandial plasma glucose and insulin concentrations. Preprandial plasma glucose and insulin concentrations did not differ between treatments (p > 0.05); however, mean plasma glucose and insulin concentrations were higher for S compared to F (p < 0.05) and intermediate for the C sows. Postprandial plasma concentrations of glucose and insulin were higher for the S sows than for C and F sows (p < 0.05). Sow body weight loss during late lactation did not differ between treatments (p > 0.05). The results from our study suggest that a sugar-enriched diet during the last week of lactation elevates circulating glucose and insulin concentrations and may potentially improve post-weaning fertility in primiparous sows. [ABSTRACT FROM AUTHOR]

Contents The present study investigated the effects of pre-weaning energy substitutions on follicular development, endocrine characteristics and subsequent litter size in primiparous sows. Sows were fed a standard lactation diet (14.1 DE MJ/kg) and then allocated to a Control (C, n = 24), Fat (F, n = 23), Sugar (S, n = 23) or post-weaning Regumate (positive control; R, n = 22) treatment at 9 days before weaning of the C, F and S treatments. During the treatment period (8 days), 1 kg of the lactation diet was substituted with 1 kg of a fat-rich (F, 23.85 DE MJ/kg) or sugar-rich (S, 15.75 DE MJ/kg) substitution for F and S sows, respectively. For the R treatment, sows were weaned 8 days earlier than other treatments and fed a lactation diet at 3.5 kg with two doses of altrenogest as topdressing from 1 day before weaning until the day on which the other sows were weaned. The F treatment aimed to increase energy intake, and the S treatment aimed to elevate post-prandial glucose and insulin concentrations. Weaning-to-ovulation interval tended to be reduced in the S treatment compared with C (p = 0.06) and F (p = 0.08) treatments. Body weight ( BW) loss during the treatment period, post-weaning follicle development, plasma oestradiol and pre-weaning leptin did not differ among C, F and S sows, although BW loss was lower and leptin was higher in the R treatment. Post-ovulatory progesterone concentration in the S treatment was higher (p < 0.05). Sows in the S and R treatments had a greater proportion of litters with larger litter sizes (p < 0.05). The outcome suggests that increasing circulating insulin and glucose concentrations during late lactation or a week of metabolic recovery positively improves subsequent litter size in primiparous sows. [ABSTRACT FROM AUTHOR]

Ecological stability in the Laurentian Great Lakes has been altered by nonindigenous species, such as the Round GobyNeogobius melanostomusand dreissenid mussels, and by declines in native amphipodsDiporeiaspp. We evaluated whether these changes could influence diet overlap between three benthivorous fishes (Slimy SculpinCottus cognatus, Deepwater SculpinMyoxocephalus thompsonii, and Round Goby) and whether predation on eggs of native species was occurring. We examined diets of fish collected at depths of 69–128 m in Lake Michigan offshore of Frankfort and Muskegon, Michigan, and Two Rivers and Sturgeon Bay, Wisconsin, during January–May 2009 and 2010. Important prey (by dry weight proportion and by percent frequency of occurrence) for Slimy Sculpin wereMysis(0.34; 45%),Diporeia(0.16; 34%), andLimnocalanus macrurus(0.22; 68%); important prey for Deepwater Sculpin wereMysis(0.74; 92%) andDiporeia(0.16; 54%). Round Goby consumed mainly bivalves (i.e., dreissenids: 0.68; 95%) andMysis(0.15; 37%). The two sculpin species consumed the eggs of BloatersCoregonus hoyi(Slimy Sculpin: 0.04, 11%; Deepwater Sculpin: 0.02, 7%) and the eggs of Deepwater Sculpin (Slimy Sculpin: 0.03, 13%; Deepwater Sculpin: 0.05, 16%) during February–May at all sites. Round Goby also consumed eggs of these species but at lower levels (≤0.01; <1%). Diet overlap was identified between sculpin species at Frankfort and Sturgeon Bay, suggesting possible interspecific competition, but their diets did not overlap at Two Rivers; diet overlap was never observed between Round Goby and either sculpin species. Given that (1) diet overlap varied by site and (2) diet proportions varied spatially more than temporally, benthivores appear to be exhibiting localized responses to recent ecological changes. Overall, these results reveal that egg predation and interspecific competition could be important interactions to consider in future examinations of the population dynamics of these species or in ecosystem models that forecast how fisheries will respond to possible perturbations or management scenarios. Received April 24, 2012; accepted November 23, 2012 [ABSTRACT FROM AUTHOR]

The coaster Brook Trout Salvelinus fontinalis is a Lake Superior ecotype representing intraspecific variation that has been impacted by habitat loss and overfishing. Hatchery strains of Brook Trout derived from populations in Lake Superior were stocked into streams within Pictured Rocks National Lakeshore, Michigan, as part of an effort to rehabilitate adfluvial coaster Brook Trout. Wild and hatchery Brook Trout from three streams (Mosquito River, Hurricane River, and Sevenmile Creek) were examined for movement behavior, size, physiology, and reproductive success. Behavior and size of the stocked fish were similar to those of wild fish, and less than 15% of the stocked, tagged Brook Trout emigrated from the river into which they were stocked. There was little evidence of successful reproduction by stocked Brook Trout. Similar to the results of other studies, our findings suggest that the stocking of nonlocal Brook Trout strains where a local population already exists results in limited natural reproduction and should be avoided, particularly if the mechanisms governing the ecotype of interest are poorly understood. [ABSTRACT FROM AUTHOR]

There is mounting evidence that bacteria originating from pigs degrade the environment of the pig shed and adversely affect the health of the animals and the pig-shed workers. α-haemolytic cocci (AHC) occur in pig-shed environments, but are regarded as commensals. Ammonia is also a component of the pig-shed environment, and is known to damage upper respiratory tract epithelia. The aim of this study was to determine whether polluted air in pig sheds adversely affected performance indicators in pigs. Modelling revealed a direct effect of AHC on voluntary feed intake and hence AHC are not commensal. No direct effect of ammonia on the pigs was detected, but the combination of AHC and ammonia stimulated the immune system in a progressive manner, and there were direct effects of immune stimulation on food intake and growth resulting in poorer feed-conversion efficiency, even though the effects remained subclinical. The authors conclude that exposure of the respiratory epithelia of pigs to viable AHC in the presence of ammonia redirects nutrients away from production and towards the immune system, explaining the impact of poor pig-shed hygiene on production parameters. [ABSTRACT FROM AUTHOR]

Brook trout Salvelinus fontinalis from Isle Royale, Michigan, three Minnesota tributaries of Lake Superior, and Lake Nipigon in Ontario were analyzed for genetic variation at 12 microsatellite DNA loci. Analysis of molecular variance, genetic distance measures, and cluster analysis were used to examine the diversity, gene flow, and relatedness among the samples. The diversity estimates for the samples from Isle Royale were similar to those for the samples collected from Minnesota tributaries of Lake Superior, and all estimates were lower than those reported in other studies of brook trout from eastern North America. Genetic differences were detected among the brook trout at Isle Royale. Lake Nipigon, and the Minnesota tributaries of Lake Superior. Further, the population in Tobin Harbor at the eastern end of Isle Royale was distinct from the populations from tributaries at the southwestern end of the island. The Minnesota tributary population formed a group that was genetically distinct from those from Isle Royale and Lake Nipigon. The Isle Royale population should be managed to preserve the genetic and phenotypic variation that distinguishes it from the other brook trout populations analyzed to date. [ABSTRACT FROM AUTHOR]

Agriculture and livestock grazing threaten biodiversity around the world. In the grazing landscapes of eastern Australia, a common conservation strategy has been to exclude livestock from large patches of trees (typically >5 ha). This has major local benefits, but is unlikely to stem regional biodiversity loss. Using a case study from the Upper Lachlan catchment in New South Wales, we show that (1) approximately 30% of tree cover occurs as very small patches or scattered trees; (2) large patches have disappeared from 90% of the landscape; and (3) large patches are 3.5 times more likely to be in unproductive upland areas than in low-land areas of high conservation concern. Given the limitations of focusing on large patches of trees to achieve regional conservation outcomes, the next generation of conservation initiatives should consider a new suite of additional measures that could deliver biodiversity benefits across broad areas of the region. Two key measures that must be considered are new incentives for farmers to alter livestock grazing practices and reduce fertilizer use. INSET: The box-gum grassy woodland project in New South Wales, Australia. [ABSTRACT FROM AUTHOR]

Parallel efforts by several genetic research groups have tackled common themes relating to management concerns about and recent rehabilitation opportunities for coaster brook trout Salvelinus fontinalis in Lake Superior. The questions that have been addressed include the evolutionary and genetic status of coaster brook trout, the degree of relatedness among coaster populations and their relationship to riverine tributary brook trout populations, and the role and effectiveness of stocking in maintaining and restoring coasters to Lake Superior. Congruent genetic results indicate that coasters are an ecotype (life history variant) rather than an evolutionarily significant unit or genetically distinct strain. Regional structure exists among brook trout stocks, coasters being produced from local populations. Introgression of hatchery genes into wild populations appears to vary regionally and may relate to local population size, habitat integrity, and anthropogenic pressures. Tracking the genetic diversity and integrity associated with captive breeding programs is helping to ensure that the fish used for stocking are representative of their source populations and appropriate for rehabilitation efforts. Comparative analysis of shared samples among collaborating laboratories is enabling standardization of genotype scoring and interpretation as well as the development of a common toolkit for assessing genetic structure and diversity. Incorporation of genetic data into rehabilitation projects will facilitate monitoring efforts and subsequent adaptive management. Together, these multifaceted efforts provide comprehensiv4 insights into the biology of coaster brook trout and enhance restoration options. [ABSTRACT FROM AUTHOR]

Background: Frontotemporal dementia is the second most common form of dementia in those under 65 years of age and is found to be genetic in around a third of cases. Familial FTD has an autosomal dominant pattern of inheritance meaning that the offspring of a mutation carrier has a 50% chance of carrying the mutation themselves. For those at risk of FTD, there are a number of issues that can cause distress including the high penetrance of the most common FTD‐causing genes, heterogeneity of symptoms and unpredictable age of symptom onset. Despite this, there have been no studies looking at the experiences of this group, particularly those who do not pursue predictive testing. Method: Sixteen qualitative interviews were analysed using an inductive approach to thematic analysis. Participants were asked about their experience finding out about their risk, how they felt throughout different parts of their journey, their experience of genetic testing if this was performed, as well as the support they had or feel they would have benefited from. Result: Key themes identified included: 1) Depression, uncertainty and survivor guilt – the ups and downs of living at‐risk, 2) Worries about the wider family, 3) Lack of support ‐ "You need people who really understand", 4) Coping mechanisms ‐ Living like a gene carrier and 5) Seeing at risk status as a positive thing. Almost all participants expressed a need for tailored psychological support facilitated by "someone who understands" the unique issues they face. Conclusion: Living at risk of familial FTD is a psychologically challenging experience, independent of the challenges presented by predictive testing. Those who choose not to undergo predictive testing may also, at times, require specific support. Future research should explore tailored support strategies to assist people in coping with these challenges. [ABSTRACT FROM AUTHOR]

Background: The Addenbrooke's Cognitive Examination III (ACE‐III) is an effective cognitive test for detecting dementia in many countries and covers a wide range of cognitive domains. However, there has been no study about the usefulness of the ACE‐III in patients with suspected dementia in Taiwan where patients use Traditional Chinese, unlike mainland China. We therefore aimed to culturally adapt and find the sensitivity and specificity of the ACE‐III for investigating people with possible dementia presenting to hospital in Taiwan. Method: We used the guideline for cross‐cultural adaptation process to culturally adapt the simplified Chinese version (C‐ACE‐III) for Taiwanese populations (T‐ACE‐III). We recruited consenting patients who had presented to clinics with suspected dementia in Northern Taiwan and had been through the diagnostic process. We timed the interviews and conducted receiver operating characteristic (ROC) curve analysis to test the ability of the T‐ACE‐III to differentiate between dementia and non‐dementia using clinical diagnosis as the gold standard. We used linear regression to find significant predictors of ACE‐T score entering age, education, sex, language group, and dementia status as possible predictors. Result: 110 participants were invited, of whom 91 Chinese/ Hokkien‐speaking individuals aged 49 to 93 years consented to take part and ninety completed the test: 24 males and 33 females with dementia and 12 males and 21 females without. It took on average 16.3 and 24.0 minutes to administer in non‐dementia and dementia group, respectively. The T‐ACE‐III demonstrated a sensitivity of 100.0% and a specificity of 78.8%, for distinguishing dementia from non‐dementia with a cut‐off value of 86/87, a sensitivity of 89.5% and a specificity of 100.0%, with a cut‐off value of 73/74. The area under the curve (AUC) = 0.99 in T‐ACE‐III. The diagnosis of dementia, and language used were significant predictors accounting for 68.1% of the variance in T‐ACE‐III scores. Conclusion: The culturally adapted T‐ACE‐III is a brief, reliable, and acceptable tool for discriminating dementia from non‐dementia cases in a Taiwanese population in a memory clinic setting. [ABSTRACT FROM AUTHOR]

As many as 80% of breast cancer patients report significant distress during initial treatment, yet there is little in the way of systematic psychotherapeutic interventions for women coping with the stress of a recent diagnosis of breast cancer. The literature on psychotherapeutic treatment of cancer patients provides uniform evidence for an improvement in mood, coping and adjustment as a result of group therapy. The present study examined the feasibility of implementing a manualized treatment, supportive-expressive group psychotherapy, in busy oncology practices across the US. This intervention was applied to women with primary breast cancer in a manner which tests not only the efficacy of the approach but also its accessibility to group therapists not previously experienced in its use. One hundred and eleven breast cancer patients within 1 year of diagnosis were recruited from ten geographically diverse sites of the National Cancer Institute's Community Clinical Oncology Program (CCOP) and two academic medical centers. Two therapists from each site were trained in supportive-expressive group psychotherapy. Training consisted of participation in a workshop, reading a treatment manual, and viewing explanatory videotapes. Each patient participated in a supportive-expressive group that met for 12 weekly sessions lasting 90 min. Assessment of mood disturbance was made at entry, 3, 6, and 12 months. Results indicated a significant 40% decrease in the Total Mood Disturbance (TMD) scores of the Profile of Mood States (POMS) (ANOVA F [2,174]=3.98, p<0.05). The total symptom score of the Hospital Anxiety and Depression Scale (HADS) was likewise significantly reduced over the 6-month period (F [2, 174]=5.2, p<0.01). Similarly, the total score of the Impact of Event Scale (IES) was significantly reduced (F [2,174]=4.0, p<0.05). There was substantial uniformity of treatment effect across sites. Outcome was independent of stage of disease (I vs. II). We conclude that this treatment program can be effectively implemented in a community setting and results in reduced distress among breast cancer patients. [ABSTRACT FROM AUTHOR]