130,384 research outputs found
Predictors of institutionalization in demented patients discharged from a rehabilitation unit
No full textBACKGROUND: The decision to place a patient with dementia in long-term care is complex and based on the patient's and the caregiver's characteristics, and on the sociocultural context. Most studies assessing predictors of nursing home placement focused primarily on the characteristics of either the patient, such as dementia severity and difficult behaviors, or the caregiver, such as subjective burden and health status. However, only a few studies comprehensively investigated how both a caregiver's and a patient's characteristics influence nursing home placement.
OBJECTIVE:
To identify the patient's and the caregiver's characteristics that influence discharge to a nursing home in demented patients consecutively admitted to an intermediate care setting.
METHODS:
Observational study of 214 patients with dementia consecutively admitted to a Rehabilitation Unit for Dementia in Northern Italy (length of stay 35.1 +/- 14.9 days). The main evaluated outcome was the final destination (home vs nursing home).
RESULTS:
In a multivariate logistic regression analysis, adjusted for age, gender, cognitive status, and behavioral disturbances, 4 predictors were associated with nursing home placement: living alone (OR 8.79, 95% CI 2.33-33.16; P = .001), degree of dementia severity (CDR, OR 1.69, 95% CI 1.02-2.83; P = .04), compromised functional status (Barthel index admission, OR 3.15, 95% CI 1.05-9.48; P = .04), and caregiver's burden (CBI, OR 2.89, 95% CI 1.15-7.29; P = .02).
CONCLUSIONS:
Data suggest that living alone, patient's functional impairment, severity of dementia, and caregiver's burden were independent predictors of institutionalization. The interaction between a patient's and a caregiver's characteristics has an important effect on the rate of nursing home placement in demented patients
A Combined Therapy with Myo-Inositol and D-Chiro-Inositol Improves Endocrine Parameters and Insulin Resistance in PCOS Young Overweight Women
No full textIntroduction. We evaluated the effects of a therapy that combines myo-inositol (MI) and D-chiro-inositol (DCI) in young overweight women affected by polycystic ovary syndrome (PCOS), characterized by oligo- or anovulation and hyperandrogenism, correlated to insulin resistance. Methods. We enrolled 46 patients affected by PCOS and, randomly, we assigned them to two groups, A and B, treated, respectively, with the association of MI plus DCI, in a 40 : 1 ratio, or with placebo (folic acid) for six months. Thus, we analyzed pretreatment and posttreatment FSH, LH, 17-beta-Estradiol, Sex Hormone Binding Globulin, androstenedione, free testosterone, dehydroepiandrosterone sulphate, HOMA index, and fasting glucose and insulin. Results. We recorded a statistically significant reduction of LH, free testosterone, fasting insulin, and HOMA index only in the group treated with the combined therapy of MI plus DCI; in the same patients, we observed a statistically significant increase of 17-beta-Estradiol levels. Conclusions. The combined therapy of MI plus DCI is effective in improving endocrine and metabolic parameters in young obese PCOS affected women.Introduction. We evaluated the effects of a therapy that combines myo-inositol (MI) and D-chiro-inositol (DCI) in young overweight women affected by polycystic ovary syndrome (PCOS), characterized by oligo- or anovulation and hyperandrogenism, correlated to insulin resistance. Methods. We enrolled 46 patients affected by PCOS and, randomly, we assigned them to two groups, A and B, treated, respectively, with the association of MI plus DCI, in a 40: 1 ratio, or with placebo (folic acid) for six months. Thus, we analyzed pretreatment and posttreatment FSH, LH, 17-beta-Estradiol, Sex Hormone Binding Globulin, androstenedione, free testosterone, dehydroepiandrosterone sulphate, HOMA index, and fasting glucose and insulin. Results. We recorded a statistically significant reduction of LH, free testosterone, fasting insulin, and HOMA index only in the group treated with the combined therapy of MI plus DCI; in the same patients, we observed a statistically significant increase of 17-beta-Estradiol levels. Conclusions. The combined therapy of MI plus DCI is effective in improving endocrine and metabolic parameters in young obese PCOS affected women
Geriatric Evaluation and Rehabilitation Unit (GERU) for dementia: A model for the care of demented patients? [L'Istituto di Riabilitazione Geriatrica (IDRG): Un modello clinico-assistenziale per le demenze?]
No full textObjectives: This study proposes a model of treatment which offers a good quality of assistance to elderly patients suffering from a moderate-severe degree of cognitive degeneration resulting in behavioural disturbances and disabilities arising from acute illnesses or resurgence of chronic illnesses. Methods: Research was carried out on 412 patients (average age 80.4 ± 7.1years, 66.3% female) admitted to a ward of geriatric rehabilitation for dementia-related problems (the IDR Alzheimer, Centro Medico Richiedei, in Palazzolo sul Oglio, Brescia, Italy) during the first two and a half years of its activity. Some of these patients (N = 125) were re-examined six months after discharge. Results: The study included a period of 30 months, starting in November 2001, during which the following topics were taken into consideration: setting, training, objectives, outcome and organization. The outcome were established after definition of the objectives. Specific instruments were utilized in the evaluation of cognition, behaviour, daily activities, motor function and comorbility. Conclusions: Data confirm that the development of a new model of treatment for patients suffering from dementia, such as that offered by a Rehabilitation Unit, is a process that requires time. The research helps to understand the methodological problems, offering some suggestions for possible solutions and future initiatives
MeSH term explosion and author rank improve expert recommendations
No full textInformation overload is an often-cited phenomenon that reduces the productivity, efficiency and efficacy of scientists. One challenge for scientists is to find appropriate collaborators in their research. The literature describes various solutions to the problem of expertise location, but most current approaches do not appear to be very suitable for expert recommendations in biomedical research. In this study, we present the development and initial evaluation of a vector space model-based algorithm to calculate researcher similarity using four inputs: 1) MeSH terms of publications; 2) MeSH terms and author rank; 3) exploded MeSH terms; and 4) exploded MeSH terms and author rank. We developed and evaluated the algorithm using a data set of 17,525 authors and their 22,542 papers. On average, our algorithms correctly predicted 2.5 of the top 5/10 coauthors of individual scientists. Exploded MeSH and author rank outperformed all other algorithms in accuracy, followed closely by MeSH and author rank. Our results show that the accuracy of MeSH term-based matching can be enhanced with other metadata such as author rank
Rehabilitation units for people suffering dementia. Reports on the development process for providing a model of care
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