Each year more than 3,000 Canadians are diagnosed with brain cancers like glioblastoma multiforme or recurrent head and neck cancers which are difficult to treat with conventional radiotherapy techniques. One of the most clinically promising treatments for these cancers is boron neutron capture therapy (BNCT). This procedure involves selectively introducing a boron delivery agent into tumor cells and irradiating them with a neutron beam, which kills the cancer cells due to the high-LET radiation produced by the ¹⁰B(n,α)⁷Li capture reaction. The theory of BNCT has been around for a long time since 1936, but has historically been limited by poor boron delivery agents and nonoptimal neutron source facilities. Although significant improvements have been made in both of these domains, it is mainly the advancements of accelerator-based neutron sources that has led to the expansion of over 20 new BNCT facilities worldwide in the past decade. Additionally in this work, PHITS (Particle and Heavy Ion Transport Code System) simulations, in collaboration with the University of Tsukuba, were performed to examine the effectiveness of the Ibaraki-Boron Neutron Capture Therapy (iBNCT) beam shaping assembly (BSA) to moderate a neutron beam suitable for BNCT at the proposed PC-CANS (Prototype Canadian Compact Accelerator-based Neutron Source) site, which uses a similar but slightly higher energy 10 MeV proton accelerator with a 1 mA average current. The advancements of compact acceleratorbased neutron sources in recent decades has enabled significant improvements in BNCT technologies, allowing it to become a more viable clinical treatment option.

Recent literature has addressed the perceptions of individuals with dementia to understand how they experience their illness, with evidence suggesting these perceptions are impactful. Few studies, however, have used a conceptual model to explore different aspects of the illness. One aspect to consider is dyadic relationship strain, or feelings of tension, manipulation, and stress between the individual and caregiver. Little work has addressed this strain from the perspective of the individual with dementia who may have different feelings about the quality of the relationship. Cognition and function are two hallmark symptoms in dementia, however little work has addressed how the perception of these two areas impacts the illness experience. Perceptions of difficulties in these two areas may impact dyadic relationship strain as they necessitate increased care and changes in the relationship. Guided by the Stress Process Model for Individuals with Dementia, this study assessed potential predictors of dyadic relationship strain, finding personal activities of daily living (PADLs) to be impactful. In a multiple regression, PADLS (b=.319, p = 02) predicted strain above and beyond two measures of cognition: objective cognitive impairment (b =-.011, p =.93) and perceived memory difficulty (b=.003, p=.311) suggesting that perceived function is impactful for dyadic relationship strain. Because PADLS include more hands-on assistance, the perception of difficulty may create more feelings of embarrassment or stress and impact the perception of relationship strain. Future intervention work may target perceptions of function to improve the dyadic relationship by using techniques such as open communication about difficulties.

Including individuals with dementia as participants in research studies can be a challenge given the cognitive symptoms experienced, including difficulties with attention, memory, language, and executive functioning and behavioral symptoms, such as agitation and frustration. Researchers, however, have begun to include individuals with dementia as more active participants in the research process. Specifically, individuals with dementia have provided self-report information about their illness experience, including how they cope and manage with their illness and how illness-related strains are related to psychosocial outcomes. Researchers also have starting using self-report data collection protocols instead of proxy-report measures to assess the impact of non-pharmacological interventions developed for individuals with dementia on well-being outcomes such as depressive symptoms, unmet needs, and relationship strain. To date, however, there are no clear guidelines or ‘best practices’ to assist researchers in developing study protocols that facilitate the inclusion and participation of individuals with dementia. This poster will present findings from a systematic literature review of studies that have successfully included individuals with dementia as research participants. Key areas examined include: 1) the focus and type of research question studied; 2) the use and type of cognitive screening tools for determining study eligibility; 3) implementation of qualitative versus quantitative research designs; 4) objective versus subjective measures; 5) data collection tools; 6) psychometric evidence of data obtained; and 7) how data have been analyzed. Findings highlight the importance of collecting data directly from individuals with dementia to further understand the illness experience and assess the impact of non-pharmacological interventions.

Recent work has examined how individuals with dementia (IWDs) experience their illness, although few studies have looked at IWDs who report heightened depressive symptoms, a key well-being outcome. Stressing the ability of IWDs to self-report and guided by the Stress Process Model for Individuals with Dementia, this study examined the relationships between depressive symptoms and various aspects of the illness experience including objective cognition, perceived memory difficulty, perceived functional difficulty, and dyadic relationship strain. The sample includes IWDs with mild to severe dementia who are veterans (N=69). Significant positive correlations emerged between depressive symptoms and several measures of the illness experience: perceived cognition (r=.48, p<.001), perceived function (r =.43, p<.001), and dyadic relationship strain (r=.32, p=.01). In contrast, objective cognition, measured by a modified version of the Blessed Orientation Memory Concentration test, was not significant (r =-.06, p=.63). A multiple regression found the total variance explained by all independent variables was 32% (R2=.32, F(4,68)=7.58, p<.001), with perceived memory difficulty (B=.26, p<.01) and dyadic relationship strain (B=.25, p=.04) accounting for unique and significant variance in depressive symptoms. A mediation analysis indicated perceived memory difficulty fully mediated the relationship between perceived functional difficulty and depressive symptoms. Findings highlight the importance of IWDs perceptions of their illness experience for psychosocial well-being outcomes, such as depressive symptoms. Findings add to the literature by showing the importance of IWDs perceptions of their illness and their impact on well-being outcomes. Results also demonstrate the utility and feasibility of including self-reported data from IWDs in research studies.

Research supports the inclusion of individuals with mild to moderate dementia (IWDs) as study participants in providing reliable and valid self-report information about their illness experience. However, no clear guidelines or tools exist for determining study eligibility with many studies relying on brief cognitive measures (e.g., MMSE). The literature suggests not all individuals with mild/moderate dementia can participate and some individuals with severe symptoms of dementia can participate. This study piloted a new measure designed to assess whether IWDs can participate in self-report data protocols. The measure consists of 10 questions that assess relatively in-tact cognitive processes hypothesized for successful participation. Example questions include: “What is your favorite holiday?” and “Give an example of a sad occasion/event”. Questions are scored as ‘correct’ or ‘incorrect’ and summed for a total score. To examine the descriptive characteristics of the measure, IWDs (n=18) completed the measure along with the MMSE and, for some IWDs (n=12), several self-report measures. Scores on the new measure ranged from 0-10, with a M=7.61; SD=2.75. MMSE scores ranged from 2-22, with a M=13.39; SD=6.47. A significant correlation (r = .86, p< .001) was found with the MMSE, indicating a high degree of relatedness but not complete construct overlap. Results also highlight the variability of the measure, with incorrect responses ranging from 3 to 6 across participants. Additional properties of the measure will be discussed along with highlighting how study findings fit with recommendations from 2020 NIA Research Summit on Dementia Care and next-steps in refinement and testing.