Objectives: The number of couples facing a dementia diagnosis for one partner of the spousal dyad increases. Spousal caregiving can be a highly stressful experience associated with negative caregiver outcomes such as depression and poorer immune function. However, surprisingly little is known about how the illness and the required care effects patient's well-being and relational changes experienced by afflicted couples. The aim of this study was to provide a literature review on how the dyadic perspective is taken into account and on how dementia effects both parts of the dyad. Methods: In order to outline findings about individual and dyadic well-being of affected couples, we conducted a literature search to review the three types of studies. First, studies focusing on one partner's perspective, usually the perspective of the caregiver; second, studies including the caregiver's and partially the care receiver's view; third, studies directly referring to both partners' perspectives. Results: The majority of studies neglect the individual with dementia by exclusively assessing caregiver variables or only indirectly including patients' characteristics. Very few studies embrace dyadic and relational variables to execute how both partners experience the illness, spousal caregiving, and changes in the relationship. Despite the arguable validity of self reports of individuals with dementia, some studies demonstrated the usefulness of including both partners' perspectives. Discussion: Results indicate the urgent need of integrating the perspective of the individual with dementia to improve the understanding of the effects of dementia caregiving. AbstractIn the next few years, an increasing number of older couples will have to face a dementia

SUMMARY. Thus these ions probably play a primary role in bringing polymers together directly. Imine bonds formed as a result of protein oxidation also contribute substantially to the stiffness of the glue. Disrupting these bonds with hydroxylamine caused a 33% decrease in storage modulus of the glue, while stabilizing them by reduction with sodium borohydride increased the storage modulus by 40%. Thus a combination of metal-based bonds operates in this glue. Most likely, cross-links directly involving calcium play a primary role in bringing together and stabilizing the polymer network, followed by imine bond formation and possible iron coordination.

Males with BPD make more lethal suicide attempts than females with BPD, an effect not observed among the MDD sample. Our findings suggest that higher rates of suicidal behavior in BPD may be due to a specific effect of BPD on males, leading to more dangerous suicidal behaviors. This effect, together with the larger proportion of males in the BPD group compared with the MDD group may lead to higher rates of reported attempted and completed suicide.

Dementia research has frequently documented high rates of caregiver depression and distress in spouses providing care for a partner suffering from dementia. However, the role of marital communication in understanding caregiver distress has not been examined sufficiently. Studies with healthy couples demonstrated an association between marital communication and the partners' psychological well-being, depressiveness, respectively (e.g., Heene, Buysee, & Van Oost, 2005). The current study investigates the relationship between caregiver depression and communication in 37 couples in which the wives care for their partners with dementia. Nonsequential and sequential analyses revealed significant correlations between caregiver depression and marital communication quality. Caregivers whose husbands used more positive communication reported less depression and distress. Additionally, caregiver depression was negatively correlated with rates of positive reciprocal communication indicating dependence between the couples' interaction patterns. This study is one of the first to illustrate the relevance of spousal communication in understanding caregiver distress and depression.

ObjectiveDetermining the quality of narrative evaluations to assess medical student neurology clerkship performance remains a challenge. This study sought to develop a tool to comprehensively and systematically assess quality of student narrative evaluations.MethodsThe Narrative Evaluation Quality Instrument (NEQI) was created to assess several components within clerkship narrative evaluations: performance domains, specificity, and usefulness to learner. In this retrospective study, 5 investigators scored 123 narrative evaluations using the NEQI. Inter-rater reliability was estimated by calculating interclass correlation coefficients (ICC) across 615 NEQI scores.ResultsThe average overall NEQI score was 6.4 (SD 2.9), with mean component arm scores of 2.6 for performance domains (SD 0.9), 1.8 for specificity (SD 1.1), and 2.0 for usefulness (SD 1.4). Each component arm exhibited moderate reliability: performance domains ICC 0.65 (95% confidence interval [CI] 0.58–0.72), specificity ICC 0.69 (95% CI 0.61–0.77), and usefulness ICC 0.73 (95% CI 0.66–0.80). Overall NEQI score exhibited good reliability (0.81; 95% CI 0.77–0.86).ConclusionThe NEQI is a novel, reliable tool to comprehensively assess the quality of narrative evaluation of neurology clerks and will enhance the study of interventions seeking to improve clerkship evaluation.