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Objective: Caregivers play an essential role in supporting people with Alzheimer's disease globally. User‐informed research is vital to developing trans‐cultural guidelines for dementia support organisations. While coping strategies of caregivers are well researched, the 'coping‐effectiveness' framework falls short of representing all caregiver needs. Our aim was to develop a robust and inclusive, globally applicable framework of caregiver‐informed support needs. Methods: In partnership with Alzheimer's Disease International and Roche, we conducted qualitative online semi‐structured interviews with 34 family caregivers from the Global North (UK, US) and Global South (Brazil, South Africa) in the COVID‐19 context. Participant‐generated photographs helped encourage discussions of hidden contextual issues. Iterative inductive narrative analysis of interviews and photographs was carried out with input from global and national charity and industry sectors. Results: We identified a framework of four cross‐cultural caring approaches with implications for support: (1) Empathising, using emotion‐focused strategies to develop strong expertise and coping skills, with time specific information, psychosocial and peer support needs. (2) Organising, using problem‐focused strategies, with strong narratives of expertise and advocacy which benefited from early structured information and professional confirmation. (3) Non‐identifying caregiving, where daily aspects of caring occurred without specialist knowledge and expertise, and caregivers sought assistance in managing disease‐related support. (4) Reluctance, where struggling with unwanted caring responsibilities meant caregivers looked to professionals to carry out daily care. Conclusion: Our findings move beyond the 'coping‐effectiveness' framework of support to suggest a novel 'role‐needs' framework. Our approach supports inclusive ways of tailoring support to fit individual caregiver circumstances globally. [ABSTRACT FROM AUTHOR]

Background: Attachment style has been linked with basal cortisol secretion in healthy adult women. We investigated whether dysregulation in basal cortisol secretion may be evident in younger healthy females. Methods: Sixty healthy females aged 9-18 years (mean 14.16, SD [plus or minus] 2.63 years) participated in the Attachment Style Interview (ASI). Eight saliva samples, synchronised to awakening, were collected per day on two consecutive weekdays to examine the cortisol awakening response (CAR) and the subsequent diurnal decline. Results: Participants exhibiting an anxious attachment style had higher cortisol levels on awakening, in contrast to those who were securely attached. The anxious insecure group also showed an attenuated CAR compared to all other participants. Attachment style groups did not differ in cortisol secretion over the remainder of the day. Conclusions: These findings indicate that the same pattern of cortisol dysregulation associated with disorder in adulthood manifests as a function of anxious (but not avoidant) insecure attachment style in females during healthy childhood and adolescence.

People working in the music industry report significantly higher levels of anxiety and depression than the general population, but to date, studies have not explored the differences between professional musicians and those who perform music primarily for recreation. In this study, 254 musicians from 13 countries completed measures of anxiety, depression, and wellbeing as well as answering questions about their professional status, level of success, and income. Across the whole sample, we found that over half had high levels of anxiety, and a third were experiencing depression. We showed that musicians who viewed music as their main career were more likely to have poor mental wellbeing and had significantly higher levels of clinical depression. Status as a solo or lead artist and perceived level of success also significantly predicted higher levels of anxiety and depression, and lower levels of positive wellbeing. We conclude that low mental wellbeing in musicians is the result of working as a professional musician, as opposed to being an inherent trait. Future work should explore underlying beliefs and perceptions of career musicians alongside other key factors, such as health behaviors and social support, with the aim of making specific recommendations to the music industries and educators. [ABSTRACT FROM AUTHOR]

Objective To compare the incidence of silent cerebral infarction and impact on cognitive function following transcatheter aortic valve implantation (TAVI) with the firstgeneration CoreValve (Medtronic, Minneapolis, Minnesota, USA) and second-generation Lotus valve (Boston Scientific, Natick Massachusetts, USA). Design A prospective observational study comprising a 1.5 T cerebral MRI scan, performed preoperatively and immediately following TAVI, and neurocognitive assessments performed at baseline, 30 days and 1 year follow-up. Setting University hospitals of Leeds and Leicester, UK. Patients 66 (80.6±8.0 years, 47% male) patients with high-risk severe symptomatic aortic stenosis recruited between April 2012 and May 2015. Main outcome measures Incidence of new cerebral microinfarction and objective decline in neurocognitive performance. Results All underwent cerebral MRI at baseline and immediately following TAVI, and 49 (25 Lotus, 24 CoreValve) completed neurocognitive assessments at baseline, 30 days and 1 year. There was a significantly greater incidence of new cerebral microinfarction observed following the Lotus TAVI (23 (79%) vs 22 (59%), p=0.025) with a greater number of new infarcts per patient (median 3.5 (IQR 7.0) vs 2.0 (IQR 3.0), p=0.002). The mean volume of infarcted cerebral tissue per patient was equivalent following the two prostheses (p=0.166). More patients suffered new anterior (14 (48%) vs 2 (5%), p=0.001) and vertebrobasilar (15 (52%) vs 7 (19%), p=0.005) lesions following Lotus. Lotus was associated with a decline in verbal memory and psychomotor speed at 30 days. However, performance longitudinally at 1 year was preserved in all neurocognitive domains. Conclusions There was a higher incidence of silent cerebral microinfarction and a greater number of lesions per patient following Lotus compared with CoreValve. However, there was no objective decline in neurocognitive function discernible at 1 year following TAVI with either prosthesis. [ABSTRACT FROM AUTHOR]