Cognitive complaint and test performance in elderly patients suffering depression or dementia

Ten depressed elderly patients were compared with 20 age-matched normal controls on measures of memory, perceptual organization, and speed of letter cancellation. Only on the letter cancellation task were there significant differences between groups. In contrast, 10 elderly patients with primary degenerative dementia (Alzheimer's type) performed more poorly than 10 age-matched normal controls on all the cognitive tests employed. Depressed patients rated their level of dysfunction in performing everyday tasks as more severe than the controls; however, the demented patients rated their degree of deficit as significantly less severe than the normal controls. The relationship between patient's subjective ratings of their cognitive difficulties and their results on neuropsychological tests is discussed. The present data suggest that determining subjective complaint may be important when assessing geriatric patients.     

Supporting family carers in the UK: overview of issues and challenges

Support for family carers is currently a policy priority in both health and social care. However, despite the launch of the Carers' National Strategy there is a need for further innovation if services are to be optimally effective. This article identifies a number of issues and challenges for the future if family carers are to receive the type and level of support they need. It highlights the need to think more clearly about the intended outcomes of services supporting carers and about the range and type of interventions that should be provided if such outcomes are to be achieved.     

Reconceptualising the outcomes of Continuing Professional Development

This paper considers the potential outcomes, both positive and negative, of continuing professional development from the perspectives of practitioners and managers. Following a consideration of the literature it draws upon data collected during a 3-year evaluation of the English National Board Framework and Higher Award to highlight divergent views and tensions within Continuing Professional Development (CPD). Considerable discrepancies between practitioners and managers emerge which raise a number of searching questions about the value each group accords to continuing professional development. Based on the data a new framework for conceptualizing the outcomes of CPD is presented which fundamentally undermines a quasi-market approach.     

Cell surface organization of stress-inducible proteins ULBP and MICA that stimulate human NK cells and T cells via NKG2D

Cell surface proteins major histocompatibility complex (MHC) class I-related chain A (MICA) and UL16-binding proteins (ULBP) 1, 2, and 3 are up-regulated upon infection or tumor transformation and can activate human natural killer (NK) cells. Patches of cross-linked raft resident ganglioside GM1 colocalized with ULBP1, 2, 3, or MICA, but not CD45. Thus, ULBPs and MICA are expressed in lipid rafts at the cell surface. Western blotting revealed that glycosylphosphatidylinositol (GPI)-anchored ULBP3 but not transmembrane MICA, MHC class I protein, or transferrin receptor, accumulated in detergent-resistant membranes containing GM1. Thus, MICA may have a weaker association with lipid rafts than ULBP3, yet both proteins accumulate at an activating human NK cell immune synapse. Target cell lipid rafts marked by green fluorescent protein-tagged GPI also accumulate with ULBP3 at some synapses. Electron microscopy reveals constitutive clusters of ULBP at the cell surface. Regarding a specific molecular basis for the organization of these proteins, ULBP1, 2, and 3 and MICA are lipid modified. ULBP1, 2, and 3 are GPI anchored, and we demonstrate here that MICA is S-acylated. Finally, expression of a truncated form of MICA that lacks the putative site for S-acylation and the cytoplasmic tail can be expressed at the cell surface, but is unable to activate NK cells.