1,720,975 research outputs found
Weight loss and Alzheimer's disease: temporal and aetiologic connections
No full textThe intermediate and advanced stages of Alzheimer's disease (AD) are frequently associated with weight loss (WL), but WL may even precede the onset of cognitive symptoms. This review focuses on the possible aetiologic and temporal relationships between AD and WL. When WL occurs some years before any signs of cognitive impairment, it may be a risk factor for dementia due to deficiency of several micronutrients, such as vitamins and essential fatty acids, and consequent oxidative tissue damage. The leptin reduction associated with WL may also facilitate cognitive decline. The mechanisms potentially inducing WL in AD include lower energy intake, higher resting energy expenditure, exaggerated physical activity, or combinations of these factors. A hypermetabolic state has been observed in animals with AD, but has not been confirmed in human subjects. This latter mechanism could involve amyloid assemblies that apparently increase the circulating cytokine levels and proton leakage in mitochondria. WL may be caused by patients' increased physical activity as they develop abnormal motor behaviour (restlessness and agitation) and waste energy while trying to perform daily activities. During the course of AD, patients usually find it increasingly difficult to eat, so they ingest less food. AD-related neurodegeneration also affects brain regions involved in regulating appetite. The caregiver has an important role in ensuring an adequate food intake and controlling behavioural disturbances. In conclusion, WL is closely linked to AD, making periodic nutritional assessments and appropriate dietary measures important aspects of an AD patient's treatmen
Chronic pain in the elderly with advanced dementia. Are we doing our best for their suffering?
No full textElderly subjects with advanced dementia are exposed, like any other aging individuals, to a wide range of chronic degenerative and progressive medical conditions that can cause pain and discomfort, both physical and psychological. Pain is defined as a subjective and unpleasant experience, which is generally assessed using verbal self-reporting methods. The inability to report pain verbally - a common occurrence in advanced stages of dementia - is widely recognized as the main confounding factor in identifying these patients' pain. Several previous studies on pain assessment in cognitively impaired elderly subjects systematically eliminated the noncommunicative demented patients, so it is hard to estimate the prevalence of pain in such elderly individuals. The lack of pain assessment methods that do not rely on self-reporting contributes to the underestimation of the prevalence of pain, particularly among institutionalized patients, the majority of whom suffer from some degree of dementia. Assessing chronic pain in these frail elderly would require careful monitoring of any changes in their behavior that might underlie a new source of discomfort rather than an aggravation of their cognitive impairment. Although some currently available tools for pain assessment in non-verbal older adults seem promising, no single tool has yet been sufficiently validated as reliable for widespread adoption in clinical practice. Prior research has documented a significantly lower prescription of analgesic medication in demented patients than in cognitively intact peers, and untreated or under-treated pain can have adverse physical and psychological consequences, so there is an urgent need for appropriate pain assessment methods in elderly patients with advanced dementia, since too many of them continue to suffer needlessly. The purpose of this review was to discuss the main tools developed in the last decade for pain assessment in non-communicative older individuals, highlighting the strengths and weaknesses of each tool, and providing a guide for their use in clinical practice, particularly in geriatric settings
Psychometric properties of the pain assessment in advanced dementia scale compared to self assessment of pain in elderly patients
No full textThe aims of the present study were to report on the psychometric properties of the Pain Assessment in Advanced Dementia (PAINAD) scale by comparing it with the gold standard method of self-reporting on a numerical rating scale (NRS), and to provide a categorical version of the PAINAD scale comparable with the verbal descriptor scale of the NRS. Six hundred elderly patients with various degrees of cognitive impairment consecutively admitted to the acute geriatric section at Padua University were evaluated. Cognitive, functional, and health statuses were evaluated using the Mini-Mental State Examination (MMSE), activities of daily living, and the Cumulative Illness Rating Scale (CIRS), respectively. Pain measurements were obtained by administering the NRS and the PAINAD scale. Cognitive decline was recorded in 310 subjects (52%). The internal reliability of the PAINAD scale was adequate for all items, both in patients with dementia (alpha = 0.90) and in those with no cognitive impairment (alpha = 0.94). The psychometric evaluation demonstrated a stronger level of concurrent validity (Kendall's t = 0.73, p < 0.0001) and inter-rater agreement (k = 0.74, p < 0.0001) for the PAINAD compared with the NRS. Our findings clearly indicate that the PAINAD scale is a reliable and easily administered tool for assessing pain intensity also in elderly patients with advanced dementi
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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