CPTSD is highly prevalent in treatment seeking populations who have been multiply traumatised in childhood and adulthood and appropriate interventions should now be developed to aid recovery from this debilitating condition.

Among the conditions following exposure to traumatic life events proposed by ICD-11 are Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). The primary aim of this study was to provide an assessment of the reliability and validity of a newly developed self-report measure of ICD-11 PTSD and CPTSD: the ICD-11 Trauma Questionnaire (ICD-TQ). Participants in this study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland (N=193). Participants completed the ICD-TQ and measures of traumatic life events, DSM-5 PTSD, emotion dysregulation, self-esteem, and interpersonal difficulties. Confirmatory factor analysis results supported the factorial validity of the ICD-TQ with results in line with ICD-11 proposals. The ICD-TQ demonstrated satisfactory internal reliability, and correlation results indicated that the scale exhibited convergent and discriminant validity. Current results provide initial support for the psychometric properties of this initial version of the ICD-TQ. Future theoretical and empirical work will be required to generate a final version of the ICD-TQ that will match the diagnostic structure of PTSD and CPTSD when ICD-11 is published.

European Commission Seventh Framework Program.

BackgroundRecruitment to trials is complex and often protracted; selection bias may compromise generalisability. In the mental health field (as elsewhere), diverse factors have been described as hindering researcher access to potential participants and various strategies have been proposed to overcome barriers. However, the extent to which various influences identified in the literature are operational across mental health settings in England has not been systematically examined.MethodsA cross-sectional, online survey of clinical studies officers employed by the Mental Health Research Network in England to recruit to trials from National Health Service mental health services. The bespoke questionnaire invited participants to report exposure to specified influences on recruitment, the perceived impact of these on access to potential participants, and to describe additional positive or negative influences on recruitment. Analysis employed descriptive statistics, the framework approach and triangulation of data.ResultsQuestionnaires were returned by 98 (58%) of 170 clinical studies officers who reported diverse experience. Data demonstrated a disjunction between policy and practice. While the particulars of trial design and various marketing and communication strategies could influence recruitment, consensus was that the culture of NHS mental health services is not conducive to research. Since financial rewards for recruitment paid to Trusts and feedback about studies seldom reaching frontline services, clinicians were described as distanced from research. Facing continual service change and demanding clinical workloads, clinicians generally did not prioritise recruitment activities. Incentives to trial participants had variable impact on access but recruitment could be enhanced by engagement of senior investigators and integrating referral with routine practice. Comprehensive, robust feasibility studies and reciprocity between researchers and clinicians were considered crucial to successful recruitment.ConclusionsIn the mental health context, researcher access to potential trial participants is multiply influenced. Gatekeeping clinicians are faced with competing priorities and resources constrain research activity. It seems that environmental adjustment predicated on equitable resource allocation is needed if clinicians in NHS mental health services are to fully support the conduct of randomised controlled trials. Whilst cultural transformation, requiring changes in assumptions and values, is complex, our findings suggest that attention to practical matters can support this and highlight issues requiring careful consideration.

Background Nursing staff require culturally relevant and dementia‐specific education to care for the increasing number of First Nation Elders experiencing memory loss. The culturally safe dementia care (CSDC) research team, composed of researchers, decision makers and Secwepemc Elders, was formed to address this. Objectives To increase the capacity of nurses to care for First Nations Elders with memory loss in a culturally safe way. Methods Our community‐based research used purposive sampling and mixed methods to create, implement and evaluate an education programme for nurses. Thirty‐four Elders from six Secwepemc communities participated in roundtables to share views and stories of dementia and nursing care. These data were used to create four teaching stories for the storytelling sessions and talking circles with Elders which, together with the Indigenous Cultural Competency (ICC) training, comprised the CSDC education programme. Thirty‐eight nurses (healthcare aides, licensed practical nurses and registered nurses) working in Central British Columbia began the CSDC study and 15 nurses took part in the education programme, evaluated the storytelling session and completed the three pre‐ and post‐measures (Approaches to Dementia Questionnaire (ADQ), ICC knowledge quiz and self‐assessment, and Care Plans). The pre‐ and post‐tests were scored, and the data were analysed statistically. The data from the roundtables and talking circles were analysed thematically through a collaborative process. Results The scores for the ADQ Hope sub‐scale, the ICC knowledge quiz and the Care Plans increased from pre‐ to post‐test. All nurse participants judged the storytelling session to be effective and their learning outcomes reflected culturally safe dementia care. Conclusions This programme can improve the knowledge, skills and values of nurses to provide culturally safe dementia care.

Objectives: Hearing aid usage supports communication and independence; however, many do not use their hearing aids. This study explored the experiences of hearing aid use in adults with mild cognitive impairment or Alzheimer’s disease. Methods: Participants completed semi-structured interviews which were analysed using thematic analysis. Ten people (six males, age range 75–86 years old) with mild cognitive impairment or Alzheimer’s disease who had been fitted with hearing aids were recruited to the study. Results: We identified four major themes: (1) memory and other cognitive barriers to using hearing aids, (2) practical aspects of hearing aids, (3) benefits of hearing aids, and (4) ambivalence towards hearing aids. Conclusions: Participants perceived a significant impact of cognitive impairment on the experience of using hearing aids. This population may benefit from targeted strategies to support use of hearing aids. The findings from this study can inform future research to optimise use of hearing aids in this population.

There are currently major projects within the United Kingdom to increase the number of patients on dementia registers and to further involvement in dementia research. This study, to the best of our knowledge, is the first to assess the motivations of patients and carers for joining a dementia research register in the United Kingdom, and the findings highlight the importance of altruistic motives.

Abstract:Objectives: In this paper we aim to: (1) identify and review midlife risk factors that may contribute to the development of dementia and that may be amenable to intervention; (2) review advances made in our understanding of the most common cause of dementia, Alzheimer's disease (AD), where current pharmacological studies have aimed to modify the disease course; and (3) explore other interventions that may slow cognitive decline in those with AD. Methods: A review of the literature was conducted to look for interventions that may modify the risk of incident dementia or that may modify symptom progression in those with diagnosed dementia. Results: (1) Midlife risks identified as amenable to intervention include blood pressure, diabetes, elevated cholesterol, poor psychosocial and lifestyle factors. (2) The leading drugs in development can be grouped by their principal target: anti-amyloid, anti-tau and mitochondrial stability. However to date, there have been no successes in late stage Phase III trials of putative disease-modifying drugs for AD. (3) Once the diagnosis of dementia has been made there is little that can slow the rate of decline. Possible exceptions include the use of exercise and antihypertensive medication with some nootropic medication showing promise in small trials. Conclusion: (1) It is clear that there are several risk factors in midlife that may lead to a greater likelihood of developing dementia. However, there is no simple intervention to modify these risks. It seems sensible to conclude from the data that avoiding high blood pressure, controlling cholesterol and diabetes as well as maintaining a healthy diet and lifestyle may lower the risk of developing dementia. (2) The need for better outcome measures in clinical trials is evident and may, in part, explain the numerous failures in late-stage clinical trials of diseasemodifying drugs. Improved diagnostic test batteries to reduce population heterogeneity in early intervention studies will be required for robust clinical trials in the future. (3) Current research indicates that there is little that can delay decline; however, future trials may wish to focus on nootropics.