1,720,966 research outputs found
Tele-Neuropsychological assessments in Alzheimer's disease: a comparison of “face to face” versus Video-Conferencing
No full textTelemedicine consists in the use of telecommunication technologies to provide healthcare services, overcoming geographic, temporal, social, and cultural barriers. Today telemedicine is a developed field which includes about 50 different subspecialties: neuropsychology is one of them. Allowing the objective evaluation of the cognitive state of individuals, neuropsychology is a discipline of wide application; it also contributes significantly to an early diagnosis of subjects suspected to develop cognitive impairments due to Alzheimer disease or other degenerative dementias. Subjects at risk, and subjects who have already develop the illness, would particularly benefit of a telehealth intervention, which allows to overcome the barriers of space and time, and to provide an evaluation, as well as the therapy monitoring. These aspects would be particularly important for subjects who live far from health institutions , as those of rural areas. Obviously, we need to be sure that the results of the Tele-Neuropsychological assessment are comparable to those obtained via the classic “ face to face “ administration. This is the purpose of this research. We aimed in fact to compare the performances obtained in the two conditions at the MMSE test and the ADAS Cog test. To this purpose, we submitted a group of subjects affected by mild to moderate Alzheimer disease with associated vascular damages, to MMSE and the ADAS COG test, and performed a statistical analysis of data through a two sided Student “t” test. We found that the administration modality had no significant impact on the results. In fact, no significant difference was found neither in the MMSE, or in the ADAS_Cog scores administered by telehealth versus “face to face”. While the results obtained at the MMSE confirm some previous data, this is, at our knowledge, the first study done on the ADAS_Cog, a test. Even if the conditions we employed in this research are not entirely superposable to those of patients staying at home (we evaluated the feasibility of teleheath by locating the patient and his caregiver in another room of the memory clinic ), we are confident that telehealth methodology, by video-conferencing, is as much reliable as the face to face modality. The small number of the subjects evaluated represents an obvious limitation of this study and suggests further studies involving larger number of subjects. However, our preliminary results give support to the idea that by tehealth the screening and the follow-up of the cognitive impairments age associated is feasible and valid
The ASCOMALVA trial: Association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease with cerebrovascular injury: Interim results.
Full text linkBACKGROUND: Cholinesterase inhibitors (ChE-Is) are among the drugs more largely
used for the treatment of mild-to-moderate symptoms of Alzheimer's disease (AD),
but beneficial long-term effects of these compounds on the cognitive, functional,
and behavioural symptoms of the disease are small and not always apparent in
practice. Preclinical investigations have suggested that association between
ChE-Is and the cholinergic precursor choline alphoscerate enhances cholinergic
neurotransmission more effectively than single compounds alone. The ongoing
clinical trial on the "Effect of association between a ChE-I and choline
alphoscerate on cognitive deficits in Alzheimer's disease associated with
cerebrovascular injury" (ASCOMALVA) was designed to assess if association of the
ChE-I donepezil with choline alphoscerate has a more favourable clinical profile
than monotherapy with donepezil alone.
METHODS: ASCOMALVA is a double-blind multicentre trial that has completed the
first 12 months of observation of 91 patients of the 210 planned. Patients were
aged between 56 and 91 years (mean 75 ± 10 years) and were included in the
protocol with a MMSE score between 15 and 24. Patients with AD diagnosed
according to the DSM IV criteria suffer from ischemic brain damage documented by
neuroimaging (MRI and CT scan), with a score≥2 in at least one subfield of the
New Rating Scale for Age-Related White Matter Changes (ARWMC). Patients were
randomly allotted to an active treatment group (donepezil+choline alphoscerate)
or to a reference treatment group (donepezil+placebo) and were examined after 3,
6, 9 and 12 months of treatment.
RESULTS: Cognitive functions, patient's daily activities and behavioural symptoms
were assessed by the Mini-Mental State Evaluation (MMSE), Alzheimer's Disease
Assessment Scale Cognitive subscale (ADAS-cog), Basic Activities of Daily Living
(BADL), Instrumental Activities of Daily Living (IADL) and Neuropsychiatric
Inventory (NPI), of severity and of caregiver distress measures (NPI-F and
NPI-D). Patients of the reference group (donepezil+placebo) showed along the
course of the 12months of observation, a slight time-dependent worsening of MMSE,
ADAS-cog, IADL and NPI-D scores and no changes in the BADL and NPI-F scores.
Donepezil plus choline alphoscerate improved compared to donepezil alone the
different items analysed except the BADL.
CONCLUSIONS: The first results of the ASCOMALVA trial suggest that association of
choline alphoscerate to the standard treatment with a ChE-I may represent an
option to prolong beneficial effects of cholinergic therapies in AD with
concomitant ischemic cerebrovascular injury
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
The Effect of the Association between Donepezil and Choline Alphoscerate on Behavioral Disturbances in Alzheimer's Disease: Interim Results of the ASCOMALVA Trial
Full text linkBACKGROUND:
Behavioral and psychological symptoms of dementia (BPSD) are a group of psychological reactions, psychiatric symptoms, and behaviors commonly found in Alzheimer's disease (AD). Four clusters of BPSD have been described: mood disorders (depression, anxiety, and apathy), psychotic symptoms (delusions and hallucinations), aberrant motor behaviors (pacing, wandering, and other purposeless behaviors), and inappropriate behaviors (agitation, disinhibition, and euphoria). Most of them are attributed to acetylcholine deficiency.
OBJECTIVE:
To evaluate if a higher amount of acetylcholine obtained by associating donepezil and choline alphoscerate might have a favorable effect on BPSD.
METHODS:
BPSD were measured at baseline and after 24 months in 113 mild/moderate AD patients, included in the double-blind randomized trial ASCOMALVA, by the Neuropsychiatric Inventory (NPI). Two matched groups were compared: group A treated with donepezil (10 mg/day) plus choline alphoscerate (1200 mg/day), and group B treated with donepezil (10 mg/day) plus placebo.
RESULTS:
Data of NPI revealed a significant decrease of BPSD severity and distress of the caregiver in patients of group A compared with group B. Mood disorders (depression, anxiety and apathy) were significantly decreased in subjects treated with donepezil and choline alphoscerate, while their severity and frequency was increased in the other group.
CONCLUSIONS:
Patients treated with donepezil plus choline alphoscerate showed a lower level of behavioral disturbances than subjects treated with donepezil only, suggesting that the association can have beneficial effect
Apathy Treatment in Alzheimer's Disease: Interim Results of the ASCOMALVA Trial
No full textApathy is a common symptom in Alzheimer's disease (AD), but no treatment has proven to be effective, although administration of cholinesterase inhibitors has been associated with moderate improvements in the short term
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
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