Clinical effectiveness of a manual based coping strategy programme (START, STr. Ategies for Rela. Tives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial. Abstract. Objective To assess whether a manual based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia. Design Randomised, parallel group, superiority trial. Setting Three mental health community services and one neurological outpatient dementia service in London and Essex, UK. Participants 2. 60 carers of family members with dementia. Intervention A manual based coping intervention comprising eight sessions and delivered by supervised psychology graduates to carers of family members with dementia. Sample Visa invitation letter for relatives This letter is to certify that I (Henrietta Smith) have invited Annabel Wilson to spend her vacation with me at London, UK. Astrology: Chelsea Clinton, born February 27, 1980 in Little Rock (AR), Horoscope, astrological portrait, dominant planets, birth data, heights, and interactive chart. The tree below shows the evolutionary relationships between this species and all other birds. The colours of the tree indicate EDGE scores with the red shades. Effects of Insulin in Relatives of Patients with Type 1 Diabetes Mellitus. Diabetes Prevention Trial–Type 1 Diabetes Study Group*. Skyway bridge collapse disaster 7:33 a.m., friday, may 9, 1980 updated: 05.12.15: ship crashes into the skyway and knocks it down, 35 die. The programme consisted of psychoeducation about dementia, carers’ stress, and where to get emotional support; understanding behaviours of the family member being cared for, and behavioural management techniques; changing unhelpful thoughts; promoting acceptance; assertive communication; relaxation; planning for the future; increasing pleasant activities; and maintaining skills learnt. Carers practised these techniques at home, using the manual and relaxation CDs. Main outcome measures Affective symptoms (hospital anxiety and depression total score) at four and eight months. Friends & Relatives Fun Facts : Questions & Answers This category is for questions and answers related to Friends & Relatives, as asked by users of FunTrivia.com. Have You Got Castlebar Roots? From Dec 1999 - Seeking Castlebar Relatives & Friends. Free Noticeboard for those seeking their long lost cousins in and around Castlebar. Studies of Onlies as Adults. Polit and colleagues (1980) studied adult singletons, 70 women and 62 men, in a larger sample of 537 white middle-class. During Ramadan, the ninth month of the Islamic calendar, Muslims from all continents unite in a period of fasting and spiritual reflection. Secondary outcomes were depression and anxiety caseness on the hospital anxiety and depression scale; quality of life of both the carer (health status questionnaire, mental health) and the recipient of care (quality of life- Alzheimer’s disease); and potentially abusive behaviour by the carer towards the recipient of care (modified conflict tactics scale). Results 2. 60 carers were recruited; 1. Mean total scores on the hospital anxiety and depression scale were lower in the intervention group than in the treatment as usual group over the eight month evaluation period: adjusted difference in means . Carers in the intervention group were less likely to have case level depression (odds ratio 0. Carers’ quality of life was higher in the intervention group (difference in means 4. Carers in the intervention group reported less abusive behaviour towards the recipient of care compared with those in the treatment as usual group (odds ratio 0. Conclusions A manual based coping strategy was effective in reducing affective symptoms and case level depression in carers of family members with dementia. The carers’ quality of life also improved. Trial registration Current Controlled Trials ISCTRN7. Introduction. The number of people living with dementia is rising rapidly owing to increased longevity. Dementia not only affects the person with the condition but also family members and society, through increasing dependence and challenging behaviour. In the United Kingdom, dementia care is estimated to cost . In the long term the need for placement in a care home may be delayed and thus bring economic benefits. Although UK policy recognises that psychological therapy for carers of family members with dementia should be a key component of high quality dementia care, in practice resources are not available, and this is partly because so far effective therapies have been delivered only by highly trained clinical psychologists and evidence on cost effectiveness is lacking. The national agenda in the United Kingdom is to have a stepped care approach to improve access to psychological therapies, where less intensive therapy is delivered. A befriending programme delivered by former carers was ineffective in reducing the carers’ anxiety or depression. The Coping with Caregiving programme was developed in the United States. This manual based group intervention comprising 1. Therapies individualised to carers seem to be most effective in delaying admission of the recipients of care to a care facility and are more effective than group interventions in reducing morbidity in carers. Interventions that require active participation of caregivers have the greatest effect. We carried out a randomised controlled trial in the United Kingdom to test a manual based therapy for carers of family members with dementia and to test the effectiveness of using psychology graduates without clinical qualifications to deliver therapy to this group. Methods. The supplementary file provides the full protocol of this pragmatic multicentre randomised controlled trial. Our intervention, based on the US Coping with Caregiving programme, was individual and manualised and required active participation. Our primary objective was to determine the clinical effectiveness (measured by the hospital anxiety and depression scale) and cost effectiveness (reported in an accompanying paper. The secondary outcomes were depression and anxiety caseness on the hospital anxiety and depression scale; quality of life of both the carer and the recipient of the care; and abusive behaviour by the carer. We plan on analysing time to entry to 2. Recruitment and follow- up. We recruited carers to the trial from 4 November 2. June 2. 01. 1. The first four month follow- up took place on 4 March 2. February 2. 01. 2. Setting. We recruited through disparate settings: two mental health trusts’ memory services (Camden and Islington Foundation Trust, urban setting; North Essex Partnership Foundation Trust, suburban and rural); the North East London Foundation Trust Admiral nurse, suburban (specialist nurses for carers of family members with dementia); and the Dementia Research Centre- National Hospital for Neurology and Neurosurgery, a tertiary service with a high rate of referrals for young people with early onset dementia. Participants. We included carers of family members referred in the previous year who provided emotional or practical support at least weekly and identified themselves as the primary carer of a family member with dementia not living in 2. We excluded carers who were unable to give informed consent to the trial, were currently taking part in a randomised controlled trial in their capacity as a carer, or who lived more than 1. We administered the mini- mental state examination. If they scored less than 2. GL or CC to see whether this was related to cognition, mood, or education. If carers were judged to have a dementia they were not included in the study and we informed the referring clinician. Procedure. Prospective participants were initially approached by a clinician and given or sent an information sheet. Those interested in participating were referred to the research team. The referral gave the name, sex, and relationship to the family member of the prospective participant as well as the patient’s sex. The researchers telephoned the carer 2. The researchers answered any questions and then arranged to meet those who agreed to take part to obtain their informed consent and complete baseline assessment before randomisation. Allocation to trial groups. To conceal allocation we used an online computer generated randomisation system to allocate participants to the intervention or to treatment as usual. This system was set up and maintained by an independent clinical trials unit and accessed by the START trial manager. Randomisation was stratified by trust using random permuted blocks. To allow for potential clustering effects in the intervention arm we used an allocation ratio of 2: 1 (intervention: treatment as usual). A member of the therapy team then phoned the participants and informed them of their allocation, either to treatment as usual when they would be contacted for a four month follow- up or to the intervention when an appointment was made for the therapy to start. Allocation within the individual teams was according to workload. Assessments. Carers were interviewed at baseline and at four and eight months after randomisation, usually in their own home, unless they preferred to come to the research team base in University College London. We have continued to follow up carers, asking them to remain in the study for two years even if the recipient of their care had been placed in a care home or died. Results of this longer term follow- up will be reported separately. Information collected at baseline consisted of sociodemographic details about the carer and recipient of the care; and clinical and resource use items (as detailed in the accompanying paper). At both the four and eight month follow- up we repeated the collection of clinical and resource use information. Sociodemographic details obtained at baseline included age, sex, ethnicity, relationship to the recipient of care (for example, spouse, child), level of education, last occupation, and living situation. Measures regarding the carer’s health and wellbeing collected at all three study time points were: The hospital anxiety and depression scale,1. Asian and African ethnic groups. The scale determines caseness of depression and anxiety with scores ranging from 0 to 2. We chose the total score as our primary outcome because it has a better sensitivity and positive predictive value than either of the individual scales in identifying depression when compared with the international classification of diseases criteria. The anxiety and depression score was also dichotomised as “case” and “non- case,” with a cut- off point of 8/9. The Zarit burden interview, a 2. The modified conflict tactics scale is a self completed measure of potentially abusive behaviour by carers towards the recipient of their care. Ten behaviours are scored as to whether, during the previous three months, these have occurred never (0), almost never (1), sometimes (2), most of the time (3), or all of the time (4), and these items can be added to make a score. These behaviours range from shouting to threatening to shaking or slapping. A score of 2 or more on any one of the items is classified as an abusive behaviour. Sharad Pawar - Wikipedia. Sharad Govindrao Pawar (born 1. December 1. 94. 0) is an Indian politician who serves as the president of the Nationalist Congress Party which he founded in 1. Indian National Congress. He previously served as the Chief Minister of Maharashtra on three separate occasions and held the posts of Minister of Defence and Minister of Agriculture in the Government of India. Pawar hails from the town of Baramati in the Pune district of Maharashtra. He is a member of the Rajya Sabha where he leads the NCP delegation. He holds a position of prominence in national politics as well as the regional politics of Maharashtra. Pawar has served as the Chairman of the Board of Control for Cricket in India from 2. International Cricket Council from 2. Pawar studied at Brihan Maharashtra College of Commerce (BMCC), University of Pune. They have one daughter, Supriya, who is married to Sadanand Sule. Supriya currently represents the Baramati constituency in the 1. Lok Sabha. Pawar's nephew, Ajit Pawar, is also a prominent politician and served as the Deputy Chief Minister of Maharashtra. Pratap Pawar, Sharad Pawar's younger brother, runs the influential Marathi daily, Sakal. Political career. Yashwantrao Chavan was the political mentor of Sharad Pawar. This Progressive Democratic Front government was dismissed in February 1. Indira Gandhi's return to power. In the 1. 98. 0 elections Congress (I) won the majority in the state assembly, and A. R. Antulay took over as chief minister. Pawar took over the Presidency of his Indian National Congress (Socialist) (Congress(S)) party in 1. For the first time, he won the Lok Sabha election from the Baramati parliamentary constituency in 1. He also won the state assembly election of March 1. Baramati and preferred to continue in state politics for a while, resigning from the Lok Sabha. Congress (S), won 5. His returning to Congress (I) in 1. Shiv Sena at that time. Pawar had stated at the time, . In June 1. 98. 8, Prime Minister of India and Congress President Rajiv Gandhi decided to induct then Maharashtra Chief Minister Shankarrao Chavan into his Union Cabinet as Finance Minister and Sharad Pawar was chosen to replace Chavan as chief minister. Sharad Pawar had the task of checking the rise of the Shiv Sena in state politics, which was a potential challenge to the dominance of Congress in the state. In the state assembly elections of February 1. Shiv Sena and the Bharatiya Janata Party posed a stiff challenge to Congress. Congress fell short of an absolute majority in the state assembly, winning 1. Sharad Pawar was sworn in as chief minister again on 4 March 1. MLAs). Early 1. 99. There were reports in the media that Pawar's name was being considered for the prime minister's post, along with those of P. V. Narasimha Rao and N. D. Tiwari, in the event of a Congress victory. Narasimha Rao as its leader and he was sworn in as prime minister on 2. June 1. 99. 1. Rao named Pawar as Defence Minister. On 2. 6 June 1. 99. Pawar took over that portfolio, continuing till March 1. After Pawar's successor in Maharashtra, Sudhakarrao Naik, stepped down, Rao sent Pawar back as chief minister of the state. Almost immediately, Mumbai, the financial capital of India and the state capital of Maharashtra, was rocked with series of bomb blasts on 1. March 1. 99. 3. Khairnar made a series of accusations against Pawar for being involved in corruption and protecting criminals. Notable social worker Anna Hazare started a fast- unto- death to demand the expulsion of 1. Maharashtra state forest department who had been accused of corruption. The opposition parties accused Pawar's government of trying to shield the corrupt officers. The 1. 99. 4 Gowari stampede occurred at Nagpur, during the winter session of the state assembly, and killed 1. Nagpur Police were trying to disperse almost 5. Gowari and Vanjari protesters using baton charges but the police created panic and triggered a stampede amongst protesters. Though Pichad, accepting moral responsibility for the mishap, stepped down, this incident was another setback to Sharad Pawar's government. After 1. 6 years of protest by the Namantar Andolan (Name- change Movement), the state government finally renamed Marathwada University as Dr. Babasaheb Ambedkar Marathwada University on 1. January 1. 99. 4, the compromise new name being an expansion of the old name (Namvistar) rather than a complete change of name (Namanatar). As chief minister Mr Sharad Pawar announced few developments in university departments. The Shiv Sena- BJP coalition was leading Congress in the polls, and there was widespread rebellion in the Congress party. Shiv Sena- BJP won 1. Congress retained only 8. Sharad Pawar had to step down and Shiv Sena leader Manohar Joshi took over as chief minister on 1. March 1. 99. 5. Until the Lok Sabha elections of 1. Sharad Pawar served as the Leader of the Opposition in the state assembly. In the 1. 99. 6 General elections, Pawar won the Baramati seat in the Lok Sabha and left the state assembly. Political career since 1. In the mid- term parliamentary elections of 1. Pawar not only won his constituency, Baramati, but also led Congress to a win by a large majority. Congress was aligned with the Republican Party of India (Athvale) and Samajwadi Party for the Lok Sabha elections in Maharashtra. The Congress party won 3. Lok Sabha seats outright, and the allied Republican Party of India won 4 more, for a total of 3. Sharad Pawar served as Leader of Opposition in the 1. Lok Sabha. Formation of Nationalist Congress Party. Sangma, and Tariq Anwar demanded that the Congress party needed to propose someone native- born as the prime ministerial candidate and not the Italian- born Sonia Gandhi, who had entered party politics and replaced Kesri as Congress president. In June 1. 99. 9, Pawar and Sangma founded the Nationalist Congress Party. This new party had to align with the Congress party to form a coalition government in Maharashtra, as neither party could win an absolute majority on its own in the 1. Pawar, however, did not return to state politics and Vilasrao Deshmukh of Congress was chosen as chief minister, with Chagan Bhujbal representing the NCP as his deputy. Cabinet minister in UPA government. In January 2. 01. Pawar announced that he would not contest the 2. Lok Sabha election in order to make way for younger leadership. He has served as the head of various sports organisations, including. Pawar served as the president of Pune International Marathon Trust, which has hosted Pune International Marathon for last 2. Sharad Pawar Public School. These allegations were strengthened by the revelation about the involvement of Vinod Goenka, Balwa's business partner, in a controversial commercial project in Yerwada, Pune, which was being constructed under the same survey number as Pawar's family friend, Atul Chordia, had constructed the Panchshil Tech Park. BJP leader Eknath Khadse alleged that it was Balwa who had applied for environmental clearance for the two projects, a charge that Chordia refuted. Coincidentally, Chordia's Panchshil Pvt. In May 2. 00. 7, a tender floated by the Food Corporation of India (FCI) for procurement of wheat was cancelled when the lowest bid received was for 2. USD/ton. The government subsequently allowed private traders to purchase wheat directly from farmers that year resulting in a paucity of wheat to stock FCI granaries. By July 2. 00. 7 the shortage at FCI was large enough to require import of wheat at a much higher price of 3. Taking advantage of this, traders who had domestically purchased wheat at 9. INR/ton earlier, were now offering the same to FCI at 1,3. INR/ton. However he reaffirms that he is taking the necessary steps to reduce the numbers. In spite of its known negative health effects, Pawar made a remark that endosulfan is not yet proved dangerous. This remark prompted activist Vandana Shiva to call him a corrupt minister. This was done in consideration of Public Interest Litigation No. Shamsunder Potare alleging that the said 2. Pune were illegal. The institutions and properties mentioned include: Two 1. Vidya Pratishthan, an educational society headed by Sharad Pawar. A 2- acre (0. 8. 1 ha) plot allotted to Anant Smriti Pratishthan, headed by Ajit Pawar, the Maharashtra state minister for irrigation and Sharad Pawar's nephew. A 3. 2. 1. 2- acre (1. Lavasa Corporation, owned by Sule. Sule handed over his share in 2. Also in connection with the case, the respondents were directed not to create third- party interests in the property under dispute and to undertake any developments at their own risk. Pawar and his family denied the allegations, but the bidders board of the IPL contradicted their claims. According to the reports, she also told the investigative agency that Pawar may have spoken with former telecom minister A. Raja about the allocation of spectrum and licence to Swan Telecom. Radia also said that she had no documentary proof to back up her allegations. When Lavasa Corporation was receiving necessary clearances from the government of Maharashtra, relatives of Pawar had part- ownership of the company developing the project. He said to the reporters, . The place where the blast took place is an isolated area. Retrieved on 2. 01. Indian Sharad Pawar becomes new ICC president: BBC^Kotian, Harish (1. June 2. 01. 5). Retrieved 1. June 2. 01. 5. Retrieved on 3. July 2. 01. 1.^Hazarika, Sanjoy (2. May 1. 99. 1). Retrieved 5 April 2. Retrieved 5 April 2. Retrieved 5 April 2. Retrieved 5 February 2. Archived from the original on 1. May 2. 00. 8. Retrieved 1. October 2. 01. 5. Beyond Economic Development: A Case Study of Marathwada, Mittal Publications, pp. Icc- cricket. yahoo. July 1. 95. 1). Retrieved on 3. July 2. 01. 1.^. Sharad Pawar Public School. Retrieved 3. 0 October 2. Archived from the original on 2. October 2. 00. 4. Retrieved 2. 4 May 2. Retrieved 2. 2 February 2. Retrieved 2. 2 February 2. Retrieved on 6 December 2. Will Maharashtra forgive Sharad Pawar? Retrieved on 6 December 2. Retrieved 2 February 2.
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