A systematic review of the psychobiological burden of informal caregiving for patients with dementia: focus on cognitive and biological markers of chronic stress

As the physiological impact of chronic stress is difficult to study in humans, naturalistic stressors are invaluable sources of information in this area. This review systematically evaluates the research literature examining biomarkers of chronic stress, including neurocognition, in informal dementia caregivers. We identified 151 papers for inclusion in the final review, including papers examining differences between caregivers and controls as well as interventions aimed at counteracting the biological burden of chronic caregiving stress. Results indicate that cortisol was increased in caregivers in a majority of studies examining this biomarker. There was mixed evidence for differences in epinephrine, norepinephrine and other cardiovascular markers. There was a high level of heterogeneity in immune system measures. Caregivers performed more poorly on attention and executive functioning tests. There was mixed evidence for memory performance. Interventions to reduce stress improved cognition but had mixed effects on cortisol. Risk of bias was generally low to moderate. Given the rising need for family caregivers worldwide, the implications of these findings can no longer be neglected.

Investigating key decision problems to optimize the operation and maintenance strategy of offshore wind farms

This paper investigates three decision problems with potential to optimize operation and maintenance and logistics strategies for offshore wind farms: the timing of pre-determined jack-up vessel campaigns; selection of crew transfer vessel fleet; and timing of annual services. These problems are compared both in terms of potential cost reduction and the stochastic variability and associated uncertainty of the outcome. Pre-determined jack-up vessel campaigns appear to have a high cost reduction potential but also a higher stochastic variability than the other decision problems. The paper also demonstrates the benefits and difficulties of considering problems together rather than solving them in isolation.