1,720,963 research outputs found
La complessità dell’esperienza depressiva nell’anziano: diagnosi e terapia, una chimera?
No full textNel contesto generale delle peculiarità del paziente geriatrico si sono delineati i possibili elementi distintivi del disturbo depressivo dell’anziano.
Si sono identificate varie componenti da considerare sia nell’approccio diagnostico che in quello terapeutico: la complessità, la comorbilità psichiatrica e la comorbosita somatica, la fragilità nell’equilibrio comportamento/ambiente, infine la necessita del coinvolgimento del caregiver che può essere non solo fonte di cura per il malato, ma anche oggetto di sostegno, in associazione al malato. Si sono riassunti sia gli elementi conoscitivi legati alla EBM che alcuni elementi “narrativi” in tema sia di diagnosi che di trattament
Integrazione tra psichiatria adulti e psicogeriatria: non è un paese per vecchi?
No full textcome e perchè sia possibile il dialogo tra psichiatri e geriatri nella gestione clinica di situazioni di confin
Relation of neurocardiovascular instability to cognitive, emotional and functional domains
No full textThere is bulk of evidence suggesting that blood pressure dysregulation, as low blood pressure (LBP) or hypotension, orthostatic hypotension (OH) and high blood pressure (HPB) or hypertension are associated with alterations in cognitive and emotional domains. Some studies suggest that LBP, neurocardiovascular instability, like the OH, and atherosclerosis resulting from long standing HBP, reduces cerebral blood flow, increasing the risk of cognitive impairment, morbidity and mortality. This study aims to evaluate whether patients with cognitive impairment and cardiovascular disease would show any differences in some anamnestic indicators and/or psychometric measures of cognitive performance and affective symptoms. We recruited 36 patients over 65 years of age admitted to both psycho- and cardio-geriatric ambulatories of our hospital during the last year. The population (mean age of 80.5 years, 72.2% females, 27.8% males) was divided in 2 groups, with OH (25%), and without OH (75%). The first group was subdivided in subgroups: patients with HBP, normal BP and LBP, respectively. Cognitive and depressive domains were assessed with the mini mental state examination (MMSE) and the Italian "scala di valutazione del benessere emotivo nell'anziano" (SVEBA). Information about the present status, comorbidities (cumulative illness rating scale = CIRS), functional ability (activities of daily living = ADL, instrumental ADL = IADL) and drugs were collected during clinical examination. BP was measured 4 times, at the beginning of examination, then with the patient in clinostatic and orthostatic position (1(st) and 3(rd) minute). Data were analyzed by MANCOVA, considering age and gender as covariates, MMSE, SVEBA, CIRS, ADL, IADL and drugs as dependent variables, and presence/absence of OH as factor. Covariates were not significant sources of variance, as well as overall factor. Due to the heuristic aim of the study, we considered of interest the results of subsequent ANOVAs showing significant differences in SVEBA and ADL with respect to the factor. These data give us the basis to develop a longitudinal study to confirm the detrimental effect of OH on a wide range of health domains
The validation of the Italian version of the GPCOG (GPCOG-It): a contribution to cross-national implementation of a screening test for dementia in general practice.
Get PDFAbstract: Background: The General Practitioner Cognitive Assessment of Cognition (GPCOG), a brief, efficient dementia-screening instrument for use by general practitioners (GPs), consists of cognitive test items and historical questions asked of an informant. The validity of instruments across different cultures and languages requires confirmation and so the aim of this study was to validate the Italian version of GPCOG (GPCOG-It).Methods: The validity of the GPCOG-It was assessed against standard criteria for diagnosis of dementia (Diagnostic and Statistical Manual of Mental Disorders - 4th edition) as well as the Clinical Dementia Rating scale. The participants comprised 200 community-dwelling patients aged at least 55 years with (patient group) or without memory complaints (control group). Seven general practitioners were involved. Measurements used were the Cambridge Cognitive Assessment, Mini-mental State Examination with standard (24/25) and Italian cut-off (26/27), Alzheimer's Disease Assessment Scale-Cognitive scale and Geriatric Depression Scale.Results: The GPCOG-It, total score and two-stage method, were at least equivalent in detecting dementia to the MMSE using the standard 24/25 or the Italian 26/27 cut-offs. The two-stage method of administering the GPCOG-It (cognitive testing followed by informant questions if necessary) had a sensitivity of 82%, a specificity of 92%, a misclassification rate of 17.4%) and positive predictive value of 95%. Patient interviews took less than 4 minutes to administer and informant interviews less than 2 minutes, half the time needed for MMSE administration.Conclusions: GPCOG-It maintains the same psychometric features and time efficiency as the original English version. Despite methodological limitations (i.e. use of defined samples), the GPCOG-It performed well in detecting clear cut and borderline cognitively impaired patients and can be introduced in the daily practice of Italian GPs
INSULIN-LIKE GROWTH FACTOR-1 (IGF-1): RELATION WITH COGNITIVE FUNCTIONING AND NEUROIMAGING MARKER OF BRAIN DAMAGE IN A SAMPLE OF HYPERTENSIVE ELDERLY SUBJECTS
No full textIGF-1 decline has been related to age-dependent cognitive impairment and dementia. No study examined IGF-1 levels in subjects with a risk factor for brain damage such as hypertension. We investigated the relationship between IGF-1, cognitive functioning and neuroimaging in a sample of 75 hypertensive elderly subjects aged > 65. Cognitive performance were tested by mini mental state examination (MMSE), Cambridge cognitive examination (CAMDEX-R), and the frontal assessment battery (FAB). Among other indices, free IGF-1 in serum was assayed. The radial width of the temporal horn (rWTH) evaluates medial cerebral temporal lobe atrophy. Significant correlations between IGF-1 levels and both total and sub-domain scores of cognition were found. IGF-1 level was significantly lower in cognitively declined group. The lowest IGF-1-percentile subgroup was significantly cognitively impaired. A statistically non-significant, but lower IGF-1 level was found in the sub-sample with pathologically wider rWTH. Levels of IGF-1 below 79.4 mu g/I are associated with cognitive decline, whereas a level above 118 mu g/I seems to be a marker of normal cognitive performance. A decreasing of IGF-1 related to a widening of the rWTH suggests an involvement of this hormone in hippocampus atrophy
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Get PDF“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
Get PDFWe 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
Get PDFWe 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
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