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BackgroundVisual impairment is a common comorbidity in people living with dementia. Addressing sources of visual difficulties can have a significant impact on the quality of life for people living with dementia and their caregivers. Depth perception problems are purportedly common in dementia and also contribute to falls, visuomotor task difficulties, and poorer psychosocial well-being. However, depth perception and binocular vision are rarely assessed in dementia research. Sleep fragmentation is also common for people living with dementia, and binocular cooperation for depth perception can be affected by fatigue. Pupillary responses under cognitive load also have the potential to be a risk marker for cognitive decline in people living with dementia and can be combined with the above measures for a comprehensive evaluation of clinical visual changes in people living with dementia and their relation to changes in cognitive status, sleep quality, and cortical structure or function. ObjectiveThis study aims to characterize the nature of clinical visual changes and altered task-evoked pupillary responses that may occur in people living with dementia and evaluate whether these responses relate to changes in cognitive status (standardized Mini Mental State Examination [MMSE] score), Pittsburgh sleep quality index, and cortical structure or function. MethodsThis proposed exploratory observational study will enroll ≤210 people with recently diagnosed dementia (within the last 24 months). The following parameters will be assessed on 3 occasions, 4 months apart (plus or minus 2 weeks): visual function (visual acuity and contrast sensitivity), binocular function (motor fusion and stereopsis), task-evoked pupillary responses (minimum and maximum pupil size, time to maximum dilation, and dilation velocity), cognitive status (MMSE score), and sleep quality (Pittsburgh Sleep Quality Index). A subset of patients (n=30) with Alzheimer disease will undergo structural and functional magnetic resonance imaging at first and third visits, completing a 10-day consensus sleep diary to monitor sleep quality, verified by sleep actimetry. ResultsThis research was funded in February 2018 and received National Health Service Research Ethics Committee approval in September 2018. The data collection period was from October 1, 2018, to November 30, 2019. A total of 24 participants were recruited for the study. The data analysis is complete, with results expected to be published before the end of 2020. ConclusionsFindings will demonstrate how often people with dementia experience binocular vision problems. If frequent, diagnosing and treating them could improve quality of life by reducing the risk of falls and fine visuomotor task impairment and by relieving psychosocial anxiety. This research will also demonstrate whether changes in depth perception, pupillary responses, and quality of vision relate to changes in memory or sleep quality and brain structure or function. If related, these quick and noninvasive eye tests help monitor dementia. This would help justify whether binocular vision and pupillary response testing should be included in dementia-friendly eye-testing guidelines. International Registered Report Identifier (IRRID)RR1-10.2196/16089

Post-acute sequelae of COVID-19 (PASC) represent an emerging global crisis. However, quantifiable risk factors for PASC and their biological associations are poorly resolved. We executed a deep multi-omic, longitudinal investigation of 309 COVID-19 patients from initial diagnosis to convalescence (2-3 months later), integrated with clinical data and patient-reported symptoms. We resolved four PASC-anticipating risk factors at the time of initial COVID-19 diagnosis: type 2 diabetes, SARS-CoV-2 RNAemia, Epstein-Barr virus viremia, and specific auto-antibodies. In patients with gastrointestinal PASC, SARS-CoV-2-specific and CMV-specific CD8+ T cells exhibited unique dynamics during recovery from COVID-19. Analysis of symptom-associated immunological signatures revealed coordinated immunity polarization into four endotypes, exhibiting divergent acute severity and PASC. We find that immunological associations between PASC factors diminish over time, leading to distinct convalescent immune states. Detectability of most PASC factors at COVID-19 diagnosis emphasizes the importance of early disease measurements for understanding emergent chronic conditions and suggests PASC treatment strategies.

Purpose: There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively supportive environmental assessment tool to improve the design of health centres, where the majority of National Health Service consultations take place, for all users, including people living with dementia and those who are neurodiverse. Design/methodology/approach: A three-stage process was used: a literature review; the development of a matrix of key design features for people living with dementia, autism and other neurodiverse conditions; and the development of an environmental assessment tool and guide for users, which included easy-to-read versions to maximise service user involvement. Findings: The overarching concepts of dementia-friendly design can be adapted to create designs for everyone, including those who are neurodiverse. Research limitations/implications: There is a paucity of research in environmental design for primary care from the patient's perspective, and, more generally, further research on design for adults with learning disabilities and autism is needed. Practical implications: The tools are free to download. With adaptation, they have potential applicability across health and care settings. Originality/value: This project has confirmed that the principles of dementia-friendly design are applicable, with modifications, to a wider group of neurodiverse people. Critically, each person's response to sensory stimuli is individual rather than determined by their condition. [ABSTRACT FROM AUTHOR]

In the Australian university context, Academic Language and Learning (ALL) entails advisors working with academics and students to enhance learning. It is a relatively new area, beginning around the mid-1980s, and ALL units developed within their respective institutions. Since early 2000s, there has been an increasing amount of literature discussing the work of these centres. Significantly though, academic support services remain on the periphery of higher education. This article seeks to define the dynamic role of academic skills advisors. In late 2016, we distributed a questionnaire to ALL unit managers at each of the 39 Australian universities, receiving 29 responses. Combining multiple-choice and open-ended questions, the survey investigated the location of the unit, the role of ALL advisors, the qualifications and experience asked for at recruitment, the training required, and pedagogy when working one-to-one with students. A consistent picture emerged in the responses. One key point is a growing demand for advisors with eLearning and eTeaching skills, indicative of broader changes in Australian universities. This article describes the unique set of professional and personal attributes that ALL advisors bring to the role. The survey results found that ALL advisors are responsive to change; broadly use constructivist approaches; have an extensive range of skills, experience and competencies; and are knowledgeable across a range of disciplines. Further investigation comparing the scope of work done in countries such as the UK, New Zealand and Canada could shape and define the changing role of ALL advisors in Australia.