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Sample records for national dementia strategy

  1. Prisons must develop dementia strategy.

    PubMed

    2016-08-01

    'The prison service badly needs a properly resourced national strategy for its rapidly growing population of older prisoners, to guide its staff in their management of age-related conditions, such as dementia'. PMID:27573969

  2. Developing a national strategy to prevent dementia: Leon Thal Symposium 2009

    PubMed Central

    Khachaturian, Zaven S.; Barnes, Deborah; Einstein, Richard; Johnson, Sterling; Lee, Virginia; Roses, Allen; Sager, Mark A.; Shankle, William R.; Snyder, Peter J.; Petersen, Ronald C.; Schellenberg, Gerard; Trojanowski, John; Aisen, Paul; Albert, Marilyn S.; Breitner, John C. S.; Buckholtz, Neil; Carrillo, Maria; Ferris, Steven; Greenberg, Barry D.; Grundman, Michael; Khachaturian, Ara S.; Kuller, Lewis H.; Lopez, Oscar L.; Maruff, Paul; Mohs, Richard C.; Morrison-Bogorad, Marcelle; Phelps, Creighton; Reiman, Eric; Sabbagh, Marwan; Sano, Mary; Schneider, Lon S.; Siemers, Eric; Tariot, Pierre; Touchon, Jacques; Vellas, Bruno; Bain, Lisa J.

    2015-01-01

    Among the major impediments to the design of clinical trials for the prevention of Alzheimer's disease (AD), the most critical is the lack of validated biomarkers, assessment tools, and algorithms that would facilitate identification of asymptomatic individuals with elevated risk who might be recruited as study volunteers. Thus, the Leon Thal Symposium 2009 (LTS'09), on October 27–28, 2009 in Las Vegas, Nevada, was convened to explore strategies to surmount the barriers in designing a multisite, comparative study to evaluate and validate various approaches for detecting and selecting asymptomatic people at risk for cognitive disorders/dementia. The deliberations of LTS'09 included presentations and reviews of different approaches (algorithms, biomarkers, or measures) for identifying asymptomatic individuals at elevated risk for AD who would be candidates for longitudinal or prevention studies. The key nested recommendations of LTS'09 included: (1) establishment of a National Database for Longitudinal Studies as a shared research core resource; (2) launch of a large collaborative study that will compare multiple screening approaches and biomarkers to determine the best method for identifying asymptomatic people at risk for AD; (3) initiation of a Global Database that extends the concept of the National Database for Longitudinal Studies for longitudinal studies beyond the United States; and (4) development of an educational campaign that will address public misconceptions about AD and promote healthy brain aging. PMID:20298968

  3. The Italian Dementia National Plan. Commentary.

    PubMed

    Di Fiandra, Teresa; Canevelli, Marco; Di Pucchio, Alessandra; Vanacore, Nicola

    2015-01-01

    The Italian Dementia National Plan was formulated in October 2014 by the Italian Ministry of Health in close cooperation with the regions, the National Institute of Health and the three major national associations of patients and carers. The main purpose of this strategy was to provide directive indications for promoting and improving interventions in the dementia field, not limiting to specialist and therapeutic actions, but particularly focusing on the support of patients and families throughout the pathways of care. Four main objectives are indicated: 1) promote health- and social-care interventions and policies; 2) create/strengthen the integrated network of services for dementia based on an integrated approach; 3) implement strategies for promoting appropriateness and quality of care; and 4) improve the quality of life of persons with dementia and their families by supporting empowerment and stigma reduction. These objectives and the pertaining actions are described in the present paper. PMID:26783209

  4. Formal dementia care among first nations in southwestern Ontario.

    PubMed

    Finkelstein, Sara A; Forbes, Dorothy A; Richmond, Chantelle A M

    2012-09-01

    This article explores how dementia care is provided to First Nations communities in southwestern Ontario. Data were collected through in-depth interviews with health care providers and analysed using a constructivist grounded-theory methodology. Two interrelated frameworks for understanding dementia care were identified: a care delivery framework and a knowledge framework. The care delivery framework identified care goals, care elements being provided, care barriers, and strategies and solutions to deliver care and overcome barriers. The knowledge framework defined four groups of knowledge stakeholders: persons with dementia, informal care providers, formal care providers, and the First Nations community. It identified the knowledge each stakeholder held or needed and processes of sharing - or failing to share - knowledge in dementia care. Several barriers, many created by a lack of knowledge, negatively impacted dementia care. However, health care professionals had effective strategies for providing care, designed to overcome barriers and which encompassed elements of knowledge sharing. PMID:22828489

  5. Communication Strategies to Assist Comprehension in Dementia

    PubMed Central

    2010-01-01

    Communication with individuals with dementia requires use of conversational strategies from health care providers. Strategies are provided for issues pertaining to poor comprehension. The strategies promote more successful comprehension and compliance, offset mood disorder, and create ease in the way that health information may be accepted by the patient. PMID:20397508

  6. Articulating the strategies for maximising the inclusion of people with dementia in qualitative research studies.

    PubMed

    Murphy, Kathy; Jordan, Fionnuala; Hunter, Andrew; Cooney, Adeline; Casey, Dympna

    2015-11-01

    It is essential to understand the experience of living with dementia from the perspective of the person with dementia so that services can be appropriately constructed. This review paper, drawing on prior work, identifies key strategies for the meaningful inclusion of persons with dementia within qualitative research studies, it examines the articulation of these strategies and shares how these strategies were operationalised within one national research study in Ireland. Strategies within the literature were categorised and then synthesized into a guide consisting of four main areas; gaining COnsent, maximizing Responses, Telling the story, and Ending on a high (CORTE). The CORTE guideline was used to as a tool for analysing relevant research reports. CORTE is a synthesized account of grouped strategies that could be used to maximize the meaningful involvement of persons with dementia and can also provide a guide for reporting the strategies used so that researchers can learn from each other. PMID:24403314

  7. Commentary on "Developing a national strategy to prevent dementia: Leon Thal Symposium 2009." The rationale for a National Institutional Review Board for neurodegenerative diseases.

    PubMed

    Snyder, Peter J

    2010-03-01

    The published proceedings of the second Annual Leon Thal Symposium (Alzheimers Dement 2009;5:85-92) have added to the open discussion among leaders in this field, with respect to the development of a national strategy for accelerating the discovery of preventative interventions for Alzheimer's disease. One of the recommended "action steps" detailed in that report centers on the establishment of a National Institutional Review Board for neurodegenerative diseases. The purpose of this new ethical oversight panel would be to increase the efficiency with which large-scale multi-site trials are conducted. This essay expands on this recommendation, and two potential organizational models are briefly considered. A well-designed, highly-qualified, and responsive National Institutional Review Board for neurodegenerative diseases would serve the direct interest of protecting the rights, welfare, and safety of our older citizens, who so generously contribute their time, energy, and comfort to advance research to discover new treatments for this devastating disease. PMID:20298974

  8. Methodological issues in a cost-of-dementia study in Belgium: the NAtional Dementia Economic Study (NADES).

    PubMed

    Kurz, X; Broers, M; Scuvée-Moreau, J; Salmon, E; Ventura, M; Pepin, J L; Dom, R; Franck, G; Dresse, A

    1999-09-01

    The NAtional Dementia Economic Study (NADES) is an on-going prospective, one-year cohort study developed in Belgium to assess the socio-economic consequences of dementia in a group of patients and their caregivers (n = 400). Comparison is made with a group of subjects with cognitive impairment and no dementia (n = 100) and a group of subjects without any cognitive impairment (n = 100). Recruitment of subjects is based on screening of warning signs of dementia by general practitioners, followed by a Cambridge Mental Disorders of the Elderly Examination (CAMDEX) performed at home. This paper presents an overview of the study protocol and the rationale for basic design options, such as the choice of study population, screening strategy, and methods used for the case validation. It also presents preliminary results on the prevalence of dementia in general practice, the sensitivity and specificity of the warning signs as a screening test of dementia, and the validity of a computerised case ascertainment algorithm based on DSM-III-R criteria. PMID:10544724

  9. Palliative Care for Patients with Dementia: A National Survey

    PubMed Central

    Torke, Alexia M.; Holtz, Laura R.; Hui, Siu; Castelluccio, Peter; Connor, Stephen; Eaton, Matthew A.; Sachs, Greg A.

    2011-01-01

    OBJECTIVES To determine the extent to which hospice and nonhospice palliative care (PC) programs provide services to patients with dementia and to describe barriers and facilitators to providing nonhospice PC. DESIGN Telephone and Web-based surveys. SETTING U.S. hospice and PC programs from the National Hospice and Palliative Care Organization’s program list. PARTICIPANTS Executive directors of 240 hospice programs, 173 programs providing hospice and nonhospice PC, and 13 programs providing nonhospice PC. MEASUREMENTS A telephone survey of hospice and PC providers followed by an online survey of programs providing nonhospice PC. RESULTS Ninety-four percent of hospices and 72% of PC programs had served at least one patient with a primary diagnosis of dementia within the past year. Based on 80 responses to the online survey, the most highly rated barriers to providing PC were lack of awareness of PC by families and referring providers, need for respite services, and reimbursement policies. Highly rated needs were family information, assistance with caregiver burden, and behavioral symptoms. Strategies critical for success were an interdisciplinary team, collaboration with community organizations, and alternatives to aggressive end-of-life care. CONCLUSION Almost all hospices and a majority of nonhospice PC programs serve patients with dementia. Education and policy efforts should focus on education for families and providers, support for caregivers, and reforming reimbursement structures to provide coverage for interdisciplinary PC earlier in the disease, when patients have high needs but are not hospice eligible. PMID:21054292

  10. Dementia

    MedlinePlus

    PATIENT / FAMILY TEACHING SHEET Dementia What is dementia? Dementia is a result of diseases that affect how the brain works. Alzheimer’s disease is the most common cause of dementia. Symptoms occur ...

  11. Dementia

    MedlinePlus

    ... Awards Enhancing Diversity Find People About NINDS NINDS Dementia Information Page Condensed from Dementia: Hope Through Research ... en Español Additional resources from MedlinePlus What is Dementia? Dementia is not a specific disease. It is ...

  12. Strategies for molecular imaging dementia and neurodegenerative diseases

    PubMed Central

    Schaller, Bernhard J

    2008-01-01

    Dementia represents a heterogeneous term that has evolved to describe the behavioral syndromes associated with a variety of clinical and neuropathological changes during continuing degenerative disease of the brain. As such, there lacks a clear consensus regarding the neuropsychological and other constituent characteristics associated with various cerebrovascular changes in this disease process. But increasing this knowledge has given more insights into memory deterioration in patients suffering from Alzheimer’s disease and other subtypes of dementia. The author reviews current knowledge of the physiological coupling between cerebral blood flow and metabolism in the light of state-of-the-art-imaging methods and its changes in dementia with special reference to Alzheimer’s disease. Different imaging techniques are discussed with respect to their visualizing effect of biochemical, cellular, and/or structural changes in dementia. The pathophysiology of dementia in advanced age is becoming increasingly understood by revealing the underlying basis of neuropsychological changes with current imaging techniques, genetic and pathological features, which suggests that alterations of (neuro) vascular regulatory mechanisms may lead to brain dysfunction and disease. The current view is that cerebrovascular deregulation is seen as a contributor to cerebrovascular pathologies, such as stroke, but also to neurodegenerative conditions, such as Alzheimer’s disease. The better understanding of these (patho) physiological mechanisms may open an approach to new interventional strategies in dementia to enhance neurovascular repair and to protect neurovascular coupling. PMID:18830391

  13. Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies

    PubMed Central

    Tamura, Manjula Kurella; Yaffe, Kristine

    2011-01-01

    Cognitive impairment, including dementia, is a common but poorly recognized problem among patients with end-stage renal disease (ESRD), affecting 16–38% of patients. Dementia is associated with high risks of death, dialysis withdrawal, hospitalization, and disability among patients with ESRD; thus, recognizing and effectively managing cognitive impairment may improve clinical care. Dementia screening strategies should take into account patient factors, the time available, the timing of assessments relative to dialysis treatments, and the implications of a positive screen for subsequent management (for example, transplantation). Additional diagnostic testing in patients with cognitive impairment, including neuroimaging, is largely based on the clinical evaluation. There is limited data on the efficacy and safety of pharmacotherapy for dementia in the setting of ESRD; therefore, decisions about the use of these medications should be individualized. Management of behavioral symptoms, evaluation of patient safety, and advance care planning are important components of dementia management. Prevention strategies targeting vascular risk factor modification, and physical and cognitive activity have shown promise in the general population and may be reasonably extrapolated to the ESRD population. Modification of ESRD-associated factors such as anemia and dialysis dose or frequency require further study before they can be recommended for treatment or prevention of cognitive impairment. PMID:20861818

  14. Management strategies for problem behaviors in the patient with dementia.

    PubMed

    Lehninger, F W; Ravindran, V L; Stewart, J T

    1998-04-01

    Psychiatric and behavioral problems are present in most patients with dementia and are usually the clinician's main focus of management. Differential diagnosis of these problems can be challenging, but the effort is essential for planning appropriate therapy. Pharmacologic interventions are available for treatment of depression, agitation, aggression, psychotic symptoms, wandering, and sleep disorders. Given the less than favorable risk-benefit ratio of most psychotropic drugs in the population of older patients with dementia, the importance of nonpharmacologic strategies and limiting treatment goals should not be overlooked. PMID:9559028

  15. Dementia

    MedlinePlus

    ... Dementia may also cause changes in mood and personality. Early on, lapses in memory and clear thinking ... to tears to anger in a few minutes. Personality changes. People who have dementia may have drastic ...

  16. Dementia

    MedlinePlus

    ... dementia have serious problems with two or more brain functions, such as memory and language. Although dementia is common in very elderly people, it is not part of normal aging. Many ... dementia or repair brain damage, they may improve symptoms or slow down ...

  17. Dementia

    MedlinePlus

    ... agitated or see things that are not there. Memory loss is a common symptom of dementia. However, memory loss by itself does not mean you have ... with two or more brain functions, such as memory and language. Although dementia is common in very ...

  18. Dementia

    PubMed Central

    2012-01-01

    Introduction Dementia is characterised by chronic, global, non-reversible deterioration in memory, executive function, and personality. Speech and motor function may also be impaired. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments on cognitive symptoms of dementia (Alzheimer's, Lewy body, or vascular)? What are the effects of treatments on behavioural and psychological symptoms of dementia (Alzheimer's, Lewy body, or vascular)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 49 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine), antidepressants (clomipramine, fluoxetine, imipramine, sertraline), antipsychotics (haloperidol, olanzapine, quetiapine, risperidone), aromatherapy, benzodiazepines (diazepam, lorazepam), cognitive behavioural therapy (CBT), cognitive stimulation, exercise, ginkgo biloba, memantine, mood stabilisers (carbamazepine, sodium valproate/valproic acid), music therapy, non-steroidal anti-inflammatory drugs (NSAIDs), omega 3 (fish oil), reminiscence therapy, and statins. PMID:23870856

  19. Dementia

    PubMed Central

    2010-01-01

    Introduction Dementia is characterised by chronic, global, non-reversible deterioration in memory, executive function, and personality. Speech and motor function may also be impaired. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments on cognitive symptoms of dementia (Alzheimer's, Lewy body, or vascular)? What are the effects of treatments on behavioural and psychological symptoms of dementia (Alzheimer's, Lewy body, or vascular)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 33 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine), antidepressants (clomipramine, fluoxetine, imipramine, sertraline), antipsychotics (haloperidol, olanzapine, quetiapine, risperidone), aromatherapy, benzodiazepines (diazepam, lorazepam), cognitive behavioural therapy (CBT), cognitive stimulation, exercise, ginkgo biloba, memantine, mood stabilisers (carbamazepine, sodium valproate/valproic acid), music therapy, non-steroidal anti-inflammatory drugs (NSAIDs), omega 3 (fish oil), reminiscence therapy, and statins. PMID:21726471

  20. Prevalence of Dementia and Its Correlates among Participants in the National Early Dementia Detection Program during 2006-2009

    PubMed Central

    Park, Joon-Hyuk; Lee, Chang-In; Kang, Na-Ri; Ryu, Jae-Sung; Jeon, Bong-Hee; Kim, Ki-Woong; Bahk, Won-Myong; Yoon, Bo-Hyun; Won, Seunghee; Lee, Jun Hwa; Kim, Duk-Soo; Hong, Seong-Chul

    2012-01-01

    Objective To investigate the prevalence of dementia and its correlates among people with poor socioeconomic status, poor social support systems, and poor performance on the Korean version of the Mini-Mental Status Exam (MMSE-KC). Methods We used 2006-2009 data of the National Early Dementia Detection Program (NEDDP) conducted on Jeju Island. This program included all residents >65 years old who were receiving financial assistance. We examined those who performed poorly (standard deviation from the norm of <-1.5) on the MMSE-KC administered as part of the NEDDP, using age-, gender-, and education-adjusted norms for Korean elders. A total of 1708 people were included in this category. Results The prevalence of dementia in this group was 20.5%. Multivariate logistic regression analysis revealed that the following factors were statistically significantly associated with dementia: age of 80 or older, no education, nursing home residence, and depression. Conclusion The prevalence of dementia is very high among those with lower MMSE-KC scores, and significant correlates include older age, no education, living in a nursing home, and depression. Enhancing lifetime education to improve individuals' cognitive reserves by providing intellectually challenging activities, encouraging living at home rather than in a nursing home, and preventing and treating depression in its early phase could reduce the prevalence of dementia in this population. PMID:22707963

  1. Comprehensive national energy strategy

    SciTech Connect

    1998-04-01

    This Comprehensive National Energy Strategy sets forth a set of five common sense goals for national energy policy: (1) improve the efficiency of the energy system, (2) ensure against energy disruptions, (3) promote energy production and use in ways that respect health and environmental values, (4) expand future energy choices, and (5) cooperate internationally on global issues. These goals are further elaborated by a series of objectives and strategies to illustrate how the goals will be achieved. Taken together, the goals, objectives, and strategies form a blueprint for the specific programs, projects, initiatives, investments, and other actions that will be developed and undertaken by the Federal Government, with significant emphasis on the importance of the scientific and technological advancements that will allow implementation of this Comprehensive National Energy Strategy. Moreover, the statutory requirement of regular submissions of national energy policy plans ensures that this framework can be modified to reflect evolving conditions, such as better knowledge of our surroundings, changes in energy markets, and advances in technology. This Strategy, then, should be thought of as a living document. Finally, this plan benefited from the comments and suggestions of numerous individuals and organizations, both inside and outside of government. The Summary of Public Comments, located at the end of this document, describes the public participation process and summarizes the comments that were received. 8 figs.

  2. Other Dementias

    MedlinePlus

    ... National Institute on Aging) Vascular Dementia fact sheet (University of California, San Francisco, Memory and Aging Center) ... Library of Medicine) Lewy Body Dementias fact sheet (University of California, San Francisco, Memory and Aging Center) ...

  3. Testing the psychometric properties of a Chinese version of Dementia Management Strategies Scale

    PubMed Central

    Chien, Wai Tong

    2015-01-01

    Caregiving stress and burden are universal phenomena among family caregivers of people with dementia. Family caregivers who adopted adaptive management strategies in dementia care could alleviate their own distress and the progression of neuropsychiatric symptoms in people with dementia. An understanding about the management strategies used by these caregivers in caring for their relatives with dementia would be crucial to family services in dementia care. This study aimed to validate a Chinese version of Dementia Management Strategies Scale (DMSS) in family caregivers of Hong Kong Chinese people with dementia. Face and content validity, semantic equivalence, and test–retest reliability of the translated Chinese version of 34-item DMSS were examined. A random sample of 211 family caregivers and their relatives with dementia were then recruited to identify the factor structure of the Chinese version by exploratory factor analysis followed by varimax rotation and assess its internal consistency. Reproductibility and responsiveness of the scale to changes in neuropsychiatric symptoms were also examined over a 6-month interval. Results indicated that the Chinese version of DMSS indicated very satisfactory content validity, semantic equivalence with the original English version, and test–retest reliability. Factor analysis showed that 32 items of the Chinese version had substantial loadings on one of the three identified factors (“Criticism toward older relative”, “Showing encouragement”, and “Active management strategies”), explaining 72.4% of the total variance. The three-factor Chinese version also indicated good internal consistency of its three subscales (Cronbach’s α=0.86–0.90) and satisfactory reproducibility over 6 months (intraclass correlation coefficients =0.85–0.89). Furthermore, the Chinese version demonstrated moderate effect sizes for detecting changes in symptom severity of dementia (Cohen’s d=0.50–0.60). This study provides

  4. Adapting to conversation with semantic dementia: using enactment as a compensatory strategy in everyday social interaction

    PubMed Central

    Kindell, Jacqueline; Sage, Karen; Keady, John; Wilkinson, Ray

    2014-01-01

    Background Studies to date in semantic dementia have examined communication in clinical or experimental settings. There is a paucity of research describing the everyday interactional skills and difficulties seen in this condition. Aims To examine the everyday conversation, at home, of an individual with semantic dementia. Methods & Procedures A 71-year-old man with semantic dementia and his wife were given a video camera and asked to record natural conversation in the home situation with no researcher present. Recordings were also made in the home environment, with the individual with semantic dementia in conversation with a member of the research team. Conversation analysis was used to transcribe and analyse the data. Recurring features were noted to identify conversational patterns. Outcomes & Results Analysis demonstrated a repeated practice by the speaker with semantic dementia of acting out a diversity of scenes (enactment). As such, the speaker regularly used direct reported speech along with paralinguistic features (such as pitch and loudness) and non-vocal communication (such as body posture, pointing and facial expression) as an adaptive strategy to communicate with others in conversation. Conclusions & Implications This case shows that while severe difficulties may be present on neuropsychological assessment, relatively effective communicative strategies may be evident in conversation. A repeated practice of enactment in conversation allowed this individual to act out, or perform what he wanted to say, allowing him to generate a greater level of meaningful communication than his limited vocabulary alone could achieve through describing the events concerned. Such spontaneously acquired adaptive strategies require further attention in both research and clinical settings in semantic dementia and analysis of interaction in this condition, using conversation analysis, may be helpful. PMID:24033649

  5. Strategies for managing behavioural symptomatology associated with dementia of the Alzheimer type: a systematic overview.

    PubMed

    Forbes, D A

    1998-01-01

    The purpose of this systematic overview was to summarize research findings on strategies for managing the behavioural symptomatology associated with dementia of the Alzheimer type. A search of the published and unpublished literature resulted in 265 articles, 45 of which were judged to be relevant. Using validity criteria, 1 article was judged to be strong, 6 moderate, 20 weak, and 18 poor. Strategies such as planned walking, pet therapy, an attention-focusing program, functional skills training, music, and visual barriers demonstrated promising results in improving: (a) aggressive, agitated, and disruptive behaviours, (b) social interaction, (c) self-care ability, (d) day-night disturbances, or (e) wandering. The findings indicate that there is existing research, although in its infancy, to support the use of strategies for managing the behavioural symptomatology associated with dementia of the Alzheimer type. PMID:9807289

  6. Transcultural nursing strategies for carers of people with dementia.

    PubMed

    Bunting, Melissa; Jenkins, Catharine

    2016-04-01

    Caring for a family member with dementia is stressful, and carers from all backgrounds often feel overwhelmed and under-supported. Professional and family carers' perceptions of the challenges and satisfactions of caring are influenced by culturally derived expectations. However, experiences of caring often differ from stereotypical norms. Experiences of carer stress and beliefs about the nature and extent of support that can be expected from social networks and statutory services may differ between cultural groups in the UK, but sensitive advice, information, and emotional and practical support are universally required. Transcultural comparisons reveal similarities between carers' needs and enable identification of values-based culturally congruent recommendations that nurses can use to promote black and Asian minority ethnic carers' confidence and wellbeing. This article, based on practice experience and a literature review, explores the effect of caring among different cultural groups and offers recommendations for culturally congruent interventions to support carers. It provides evidence-based guidance to enable nurses to meet their responsibilities for transcultural working, as laid out in the Care Act 2014. A scenario illustrates recommendations for practice. PMID:27029989

  7. Transitions in Care among Older Adults with Dementia in a Nationally Representative Sample of Older Americans

    PubMed Central

    Callahan, Christopher M.; Tu, Wanzhu; Unroe, Kathleen T.; LaMantia, Michael A.; Stump, Timothy E.; Clark, Daniel O.

    2016-01-01

    Background Older adults with dementia experience frequent transitions in care Objectives To describe transitions in care among older adults with dementia identified from a nationally representative cohort and to describe transition rates among subjects with more severe levels of cognitive and functional impairment Design Longitudinal cohort study Setting Health and Retirement Study (HRS) Participants 16,186 HRS respondents aged 65 years or over whose survey data were linked with Medicare claims from 1999-2008 Measurements Transitions in care between home, home with formal services, hospital, and nursing facility care, as well as cognitive function, activities of daily living, and mortality. Results The 3,447 (21.3%) HRS subjects who were ever diagnosed with dementia experienced frequent transitions. Among subjects transitioning from a hospital stay, 52.2% returned home without home care services while 33.8% transitioned to a nursing facility. Among subjects transitioning from a nursing facility, 59.2% transitioned to the hospital while 25.3% returned home without services. There were 2,139 transitions to death and 58.7% of HRS subjects with dementia died at home. Even among persons with moderate to severe dementia, we documented multiple transitions in care, including transitions from the hospital to home and back to the hospital. Conclusion In this nationally representative sample of older adults, subjects diagnosed with dementia experience frequent transitions. Those persons with dementia who are cared for at home and who transition back to home often have moderate to severe impairments in both function and cognition. PMID:26200764

  8. National Drug Control Strategy. Update

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, 2005

    2005-01-01

    The first National Drug Control Strategy set ambitious two and five-year performance based goals: (1) to lower the rate of drug use by 10 percent over 2 years among both youth and adults; and (2) to lower the rate by 25 percent over 5 years. The chapters in this updated version are keyed to the strategies three priorities: (1) Stopping Use Before…

  9. National Drug Control Strategy, 2011

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, 2011

    2011-01-01

    In May of 2010, President Obama released the Administration's inaugural "National Drug Control Strategy". Based on the premise that drug use and its consequences pose a threat not just to public safety, but also to public health, the 2010 "Strategy" represented the first comprehensive rebalancing of Federal drug control policy in the nearly 40…

  10. National Drug Control Strategy. Update.

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, Washington, DC.

    President Bush's new National Drug Control Strategy for 2003 focuses on three core priorities: stopping drug use before it starts; healing America's drug users; and disrupting the market. The 2003 strategy reports progress toward meeting the President's goals of reducing drug use by 10 percent over 2 years, and 25 percent over 5 years. With regard…

  11. Technological Strategies and National Purpose

    ERIC Educational Resources Information Center

    Gilpin, Robert

    1970-01-01

    Discusses the international and domestic implications of technological growth. Defines three basic national strategies: a broad front approach, scientific and technological specialization and importation. Analyzes the strategies followed by form countries - France, the United States, Sweden, and Japan- to illustrate the alternatives and the…

  12. National Drug Control Strategy.

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, Washington, DC.

    This report presents a comprehensive blueprint for new direction and effort in the national fight against illegal drug use. It is the result of an intensive review of federal anti-drug efforts to date and incorporates advice and recommendations from hundreds of interested and involved anti-drug leaders outside the federal government. The…

  13. Associations of Special Care Units and Outcomes of Residents with Dementia: 2004 National Nursing Home Survey

    ERIC Educational Resources Information Center

    Luo, Huabin; Fang, Xiangming; Liao, Youlian; Elliott, Amanda; Zhang, Xinzhi

    2010-01-01

    Purpose: We compared the rates of specialized care for residents with Alzheimer's disease or dementia in special care units (SCUs) and other nursing home (NH) units and examined the associations of SCU residence with process of care and resident outcomes. Design and Methods: Data came from the 2004 National Nursing Home Survey. The indicators of…

  14. Baby boomer caregiver and dementia caregiving: findings from the National Study of Caregiving

    PubMed Central

    Moon, Heehyul; Dilworth-Anderson, Peggye

    2015-01-01

    Background: previous studies have well documented the characteristics of baby boomers but less is known about the experiences of boomer caregivers (CGs) of people with dementia. Objective: the purpose of this study was to compare the characteristics of boomer CGs of people with dementia with those of boomer CGs for people without dementia and to ascertain factors associated with outcomes. Design: we selected baby boomer CGs from the National Study of Caregiving (NSOC) with 650 primary boomer CGs (138 CGs of people with dementia and 512 CGs of people without dementia). Methods: the Stress Process Model (SPM) was used to examine the effects of resources (the use of paid help and informal support) and stressors (primary: level of CG care activities and interrupted sleep; secondary: strain of caregiving on work, other care and social activities) on CGs' down, depressed or hopeless feelings and self-perceived general health. T-tests and chi-square tests were used to compare SPM domain differences and ordinary least-square multiple regression analysis was used to investigate predictors of CGs' outcomes. Results: high blood pressure and arthritis were the most prevalent chronic diseases in both groups. Boomer CGs of people with dementia reported providing more help with daily activities, higher level of caregiving and social activity conflict, experiencing more interrupted sleep and more down, depressed or hopeless feelings than CGs of people without dementia. Different factors predicted boomer CGs' outcomes. Conclusion: the current results yield important information about the considerable differences between two baby boomer CG groups within the caregiving experiences. The findings highlight the need to provide tailored interventions to boomer CGs to help them cope with caregiving stress to improve their physical and mental health. PMID:25359299

  15. National Drug Control Strategy, 2006

    ERIC Educational Resources Information Center

    The White House, 2006

    2006-01-01

    This report presents a summary of the Fiscal Year 2007 Budget for the National Drug Control Strategy within the three key priority areas; education and community action, treatment and intervention, and disruption in the illegal drug market. The first chapter, "Stopping Drug Use Before It Starts," outlines the Administration's work to prevent the…

  16. The CARE pathway model for dementia: psychosocial and rehabilitative strategies for care in young-onset dementias.

    PubMed

    Morhardt, Darby; Weintraub, Sandra; Khayum, Becky; Robinson, Jaimie; Medina, Jennifer; O'Hara, Mary; Mesulam, Marsel; Rogalski, Emily J

    2015-06-01

    The goal of the Care Pathway Model for Dementia (CARE-D) is to improve quality of life and daily functioning both for individuals diagnosed with dementia and for their families or other caregivers. This is accomplished by developing individualized recommendations focused on a person's strengths and weaknesses as determined by formal neurocognitive and psychosocial evaluations. Careful attention is given to the stage of illness and an individual's stage in life, to connecting families with services that target an individual's cognitive and behavioral symptoms, and to providing education and emotional support specific to symptoms, clinical diagnosis, and prognosis. PMID:25998120

  17. Research on treating neuropsychiatric symptoms of advanced dementia with non-pharmacological strategies, 1998–2008: a systematic literature review

    PubMed Central

    Kverno, Karan S.; Black, Betty S.; Nolan, Marie T.; Rabins, Peter V.

    2011-01-01

    Background Advanced dementia is characterized by severe cognitive and functional impairments that lead to almost total dependency in self-care. Neuropsychiatric symptoms (NPS) are common in advanced dementia, diminishing quality of life and increasing the care burden. The challenge for health care providers is to find safe and effective treatments. Non-pharmacological interventions offer the potential for safer alternatives to pharmacotherapy, but little is known about their efficacy. This review evaluates the published literature on non-pharmacological interventions for treating NPS in advanced dementia. Methods A literature search was undertaken to find non-pharmacological intervention studies published between 1998 and 2008 that measured NPS outcomes in individuals diagnosed with advanced dementia. Strict inclusion criteria initially required that all study participants have severe or very severe dementia, but this range was later broadened to include moderately severe to very severe stages. Results Out of 215 intervention studies, 21 (9.8%) specifically focused on treatments for individuals with moderately severe to very severe dementia. The studies provide limited moderate to high quality evidence for the use of sensory-focused strategies, including aroma, preferred or live music, and multi-sensory stimulation. Emotion-oriented approaches, such as simulated presence may be more effective for individuals with preserved verbal interactive capacity. Conclusions Most studies of interventions for dementia-related NPS have focused on individuals with mild to moderate cognitive impairment. Individuals with severe cognitive impairment do not necessarily respond to NPS treatments in the same manner. Future studies should be specifically designed to further explore the stage-specific efficacy of non-pharmacological therapies for patients with advanced dementia. Areas of particular need for further research include movement-based therapies, hands-on (touch) therapies

  18. A Systematic Review of Strategies to Foster Activity Engagement in Persons with Dementia

    ERIC Educational Resources Information Center

    Trahan, Maranda A.; Kuo, Julie; Carlson, Michelle C.; Gitlin, Laura N.

    2014-01-01

    Dementia is a growing public health issue. Activity, a positive therapeutic modality, has potential to enhance quality of life and reduce behavioral symptoms in persons with dementia--outcomes eluding pharmacological treatments. However, it is unclear how to effectively engage persons with dementia in activities for them to derive desired…

  19. Handling the Dilemma of Self-Determination and Dementia: A Study of Case Managers' Discursive Strategies in Assessment Meetings.

    PubMed

    Österholm, Johannes H; Taghizadeh Larsson, Annika; Olaison, Anna

    2015-01-01

    In assessment meetings concerning care services for people with dementia, Swedish case managers face a dilemma. On the one hand, according to the law, the right to self-determination of every adult citizen must be respected, but on the other hand cognitive disabilities make it difficult to fulfill obligations of being a full-fledged citizen. In this article, we examine 15 assessment meetings to identify discursive strategies used by case managers to handle this dilemma. We also examine how these affect the participation of persons with dementia, and indicate implications of our study for social work practice and research. PMID:26207822

  20. Being Dementia Smart (BDS): A Dementia Nurse Education Journey in Scotland.

    PubMed

    Macaden, Leah

    2016-01-01

    There is a global demographic transition secondary to population ageing. The number of older people living with multimorbidities including dementia has been significantly rising both in developed and developing countries. It is estimated that there would be 74.7 million people living with dementia by 2030 that would escalate to 135.46 million by 2050. 62 % of people with dementia currently live in low and middle income countries that are very poorly resourced to cope with this epidemic. Dementia is now duly recognised as a national priority within the UK and a global priority at the 2013 G8 Summit. Management and care of an individual with dementia requires a multidisciplinary approach with expertise and a competent skill base. Nurses are central to the delivery of dementia care delivery in hospitals, community and residential care settings. It is against this background that this pre-registration integrated dementia curriculum was developed to build capacity and capability with dementia expertise among the future nursing workforce in Scotland in line with the National Dementia Strategy. PMID:27341566

  1. Adapting to Conversation with Semantic Dementia: Using Enactment as a Compensatory Strategy in Everyday Social Interaction

    ERIC Educational Resources Information Center

    Kindell, Jacqueline; Sage, Karen; Keady, John; Wilkinson, Ray

    2013-01-01

    Background: Studies to date in semantic dementia have examined communication in clinical or experimental settings. There is a paucity of research describing the everyday interactional skills and difficulties seen in this condition. Aims: To examine the everyday conversation, at home, of an individual with semantic dementia. Methods &…

  2. Factors Associated with Caregiver Readiness to Use Nonpharmacologic Strategies to Manage Dementia-related Behavioral Symptoms

    PubMed Central

    Rose, Karen

    2013-01-01

    Background Nonpharmacologic strategies to manage dementia-related behavioral symptoms depend upon caregiver implementation. Caregivers may vary in readiness to use strategies. We examined characteristics associated with readiness, extent readiness changed during intervention, and predictors of change in readiness. Methods Data from a randomized trial involving 119 caregivers in a nonpharmacologic intervention for managing behavioral symptoms. Baseline measures included caregiver, patient, and treatment-related factors. At initial (2 weeks from baseline) and final (16-weeks) intervention sessions, interventionists rated caregiver readiness as pre-action (precontemplation=1; contemplation=2; preparation=3) or action (=4). Ordinal logistic regression identified baseline characteristics associated with initial readiness. Mc Nemar-Bowker test of symmetry described change in readiness; binary logistic regression identified baseline predictors of change in readiness (initial-to-final session). One-way MANOVA identified treatment factors (dose/intensity, number of strategies used, perceived benefits, therapeutic engagement) associated with change in readiness. Results At initial intervention session, 67.2% (N=80) of caregivers were in pre-action, 32.8% (N=39) in action. Initial high readiness was associated with better caregiver mood, less financial difficulty, lower patient cognition and more behavioral symptoms. By final session, 72% (N=79) were in action, 28% (N=31) in pre-action; caregivers with less financial difficulty improved in readiness (B =−.70, p=.017); those in action were more therapeutically engaged (F (2,107)=3.61, p=.030) and perceived greater intervention benefits (F (2, 88)=6.06, p=.003). Conclusion Whereas patient and caregiver-related factors were associated with initial readiness, financial stability, therapeutic engagement and perceived benefits enhanced probability of change. Understanding caregiver readiness and factors associated with its change

  3. National Drug Control Strategy. 2008 Annual Report

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, 2008

    2008-01-01

    This report presents the 2008 National Drug Control Strategy of the White House Office of National Drug Control Policy. The overarching goal of the President's Strategy is to reduce drug use in America through a balanced approach that focuses on stopping use before it starts, healing America's drug users, and disrupting the market for illegal…

  4. Key Neuropsychiatric Symptoms in Common Dementias

    PubMed Central

    Sadak, Tatiana I.; Katon, Jodie; Beck, Cornelia; Cochrane, Barbara B.; Borson, Soo

    2013-01-01

    The purpose of this study was to compare neuropsychiatric symptoms (NPS) among people with common dementias and equip interdisciplinary clinicians and health services planners with large-sample data necessary to plan care for patients and families. We analyzed selected variables from baseline assessments of older adults with dementia of one or more etiologies (N = 3,768) from the National Alzheimer's Coordinating Center data repository. Dementias included Alzheimer's disease (AD), Lewy body dementia (DLB), behavioral variant frontotemporal dementia (bvFTD), and vascular dementia (VaD). We compared the prevalence of four NPS clusters (agitation/aggression, depression/dysphoria, anxiety, irritability/lability) across dementia etiologies and stages using logistic regression and AD as the reference group. NPS profiles differed significantly across dementia types and stages. Compared with primary AD, DLB was associated with greater odds of depression/dysphoria (OR = 1.68, 95% confidence interval [CI] 1.28, 2.20) and anxiety (OR = 1.80, 95% CI 1.37, 2.36), with similar findings when DLB was diagnosed in combination with AD (depression/dysphoria: OR = 1.79, 95% CI 1.11, 2.89; anxiety: OR = 1.88, 95% CI 1.17, 3.02). Primary bvFTD was associated with greater odds of agitation/aggression (OR = 1.59, 95% CI 1.17, 2.18). The prevalence of anxiety and irritability/lability was highest in moderate stages of dementia, and agitation/aggression was most prevalent in severe dementia. Differential diagnosis and staging of dementias and inclusion of single and overlapping etiologies is important for planning and implementing appropriate strategies to anticipate, report, and intervene with key NPS that complicate home and health care. PMID:24079749

  5. Comorbidity profile in dementia with Lewy bodies versus Alzheimer’s disease: a linkage study between the Swedish Dementia Registry and the Swedish National Patient Registry

    PubMed Central

    2014-01-01

    Introduction Compared to Alzheimer’s disease (AD), dementia with Lewy bodies (DLB) is usually associated with a more complex clinical picture and higher burden of care. Yet, few investigations have been performed on comorbidities and risk factors of DLB. Therefore, we aimed to compare clinical risk factors and comorbidity profile in DLB and AD patients using two nationwide registries. Methods This is a linkage study between the Swedish dementia registry (SveDem) and the Swedish National Patient Registry conducted on 634 subjects with DLB and 9161 individuals with AD registered during the years 2007–2012. Comorbidity profile has been coded according to the International Classification of Diseases version 10 (ICD 10) in addition to the date of each event. The main chapters of the ICD-10, the Charlson score of comorbidities and a selected number of neuropsychiatric diseases were compared between the DLB and AD groups. Comorbidity was registered before and after the dementia diagnosis. Results “Mental and behavioral disorders”, “diseases of the nervous system”, “diseases of the eye and adnexa”, diseases of the “circulatory”, “respiratory”, and “genitourinary” systems, “diseases of the skin and subcutaneous tissue” and “diseases of the musculoskeletal system and connective tissue” occurred more frequently in the DLB group after multivariate adjustment. Depression [adjusted OR = 2.12 (95%CI 1.49 to 3.03)] and migraine [adjusted OR = 3.65 (95%CI 1.48 to 9.0)] were more commonly recorded before the diagnosis of dementia in the DLB group. Following dementia diagnosis, ischemic stroke [adjusted OR = 1.89 (95%CI 1.21 to 2.96)] was more likely to happen among the DLB patients compared to the AD population. Conclusions Our study indicated a worse comorbidity profile in DLB patients with higher occurrence of depression, stroke and migraine compared with the AD group. Deeper knowledge about the underlying mechanisms of these

  6. 2011 National Drug Control Strategy. Executive Summary

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, 2011

    2011-01-01

    In May of 2010, President Obama released the Administration's inaugural "National Drug Control Strategy", a comprehensive approach to combat the public health and safety consequences posed by drug use. Now, a year later, the Administration is releasing its update building upon that initial "Strategy". The "Strategy" establishes ambitious goals to…

  7. BLM Environmental Education National Strategy.

    ERIC Educational Resources Information Center

    Bureau of Land Management (Dept. of Interior), Washington, DC.

    This environmental education strategy was developed by a Bureau of Land Management (BLM) Washington Office Task Group in collaboration with staff at all levels of the BLM. The strategy calls for the BLM to expand its efforts in educating citizens about ecosystems and ecosystem management, and to establish environmental education as an integral…

  8. Pain in Community-Dwelling Older Adults with Dementia: Results from the National Health and Aging Trends Study

    PubMed Central

    Hunt, Lauren J.; Covinsky, Kenneth E.; Yaffe, Kristine; Stephens, Caroline E.; Miao, Yinghui; Boscardin, W. John; Smith, Alex K.

    2016-01-01

    OBJECTIVES To report prevalence, correlates, and medication management of pain in community-dwelling older adults with dementia. DESIGN Cross-sectional. SETTING In-person interviews with self- or proxy respondents living in private residences or non-nursing home residential care settings. PARTICIPANTS Nationally representative sample of community-dwelling Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study 2011 wave. MEASUREMENTS Dementia status was determined using a modified previously validated algorithm. Participants were asked whether they had had bothersome and activity-limiting pain over the past month. A multivariable Poisson regression model was used to determine the relationship between bothersome pain and sociodemographic and clinical characteristics. RESULTS Of the 7,609 participants with complete data on cognitive function, 802 had dementia (67.2% aged ≥80, 65.0% female, 67.9% white, 49.7% proxy response, 32.0% lived alone, 18.8% lived in residential care); 670 (63.5%) participants with dementia experienced bothersome pain, and 347 (43.3%) had pain that limited activities. These rates were significantly higher than in a propensity score–matched cohort without dementia (54.5% bothersome pain, P < .001, 27.2% pain that limited activity, P < .001). Proxies reported slightly higher rates of pain than self-respondents, but differences were statistically significant only for activity-limiting pain (46.6% proxy vs 40.1% self, P = .03). Correlates of bothersome pain included arthritis, heart and lung disease, less than high school education, activity of daily living disability, depressive and anxiety symptoms, and low energy. Of those reporting pain, 30.3% stated that they rarely or never took any medications for pain. CONCLUSION Community-living older adults with dementia are at high risk of having pain. Creative interventions and programs are needed to manage pain adequately in this vulnerable population. PMID

  9. A National Strategy for Lifelong Learning.

    ERIC Educational Resources Information Center

    Coffield, Frank, Ed.

    The first paper of this set of 12 conference papers, "Nine Learning Fallacies and Their Replacement by a National Strategy for Lifelong Learning," by Frank Coffield, synthesizes the opinions of other participants, and goes beyond them to set forth an outline of a strategy for lifelong learning in the United Kingdom. Following this introductory…

  10. Crafting citizen(ship) for people with dementia: How policy narratives at national level in Sweden informed politics of time from 1975 to 2013.

    PubMed

    Nedlund, Ann-Charlotte; Nordh, Jonas

    2015-08-01

    This article explores how policy narratives in national policy documents in Sweden inform associated politics on people with dementia. This is disentangled in terms of how people with dementia have been defined, what the problems and their imminent solutions have been, and if and how these have differed over time. Based on a textual analysis of policy documents at national level in Sweden, covering nearly 40 years the study shows how divergent policy narratives shape the construction of citizens with dementia as policy target groups. This study shows the temporal character of people with dementia as a political problem, the implications of policy narratives on people with dementia as a citizen group, and policy narratives as something being crafted rather than shaped by fixed pre-existing "facts". Dementia, and further citizens living with dementia, does not have a once and for all stabilised meaning. Instead, the meanings behind the categories continue to evolve and to be crafted, which affects the construction of citizens living with dementia, the space in which to exercise their citizenship and further belonging to the society. PMID:26162732

  11. A systematic review of strategies to foster activity engagement in persons with dementia.

    PubMed

    Trahan, Maranda A; Kuo, Julie; Carlson, Michelle C; Gitlin, Laura N

    2014-10-01

    Dementia is a growing public health issue. Activity, a positive therapeutic modality, has potential to enhance quality of life and reduce behavioral symptoms in persons with dementia--outcomes eluding pharmacological treatments. However, it is unclear how to effectively engage persons with dementia in activities for them to derive desired benefits. We present a systematic review of 28 studies involving 50 tests of different ways of modifying activities to enhance engagement and reduce behavioral and psychological symptoms for this group. Of 50 tests, 22 (44%) evaluated changes to objects and properties (e.g., introducing activities with intrinsic interest), 6 (12%) evaluated changes to space demands (e.g., lighting, noise levels), 8 (16%) evaluated changes to social demands (e.g., prompts, praise), and 14 (28%) combined two or more activity modifications. No modifications were made to the sequence and timing of activities. Although modifications to objects and properties were the most common, outcomes for engagement and behaviors were mixed. Modifications to space and social demands were less frequently tested, but consistently yielded positive outcomes. No modifications resulted in negative behavioral outcomes or decreased engagement. Methodological strengths of studies included direct observation of outcomes and fidelity assessments. Few studies however involved persons with dementia at home. Our review revealed a growing evidentiary base for different modifications to foster engagement in activities and reduce behavioral and psychological symptoms. Future studies should evaluate how contextual factors (e.g., physical environment, activity type) and caregiver ability to employ activity modifications affect engagement. PMID:25274714

  12. Observational cohort study: deprivation and access to anti-dementia drugs in the UK

    PubMed Central

    Cooper, Claudia; Lodwick, Rebecca; Walters, Kate; Raine, Rosalind; Manthorpe, Jill; Iliffe, Steve; Petersen, Irene

    2016-01-01

    Background: UK National Dementia Strategies prioritise fair access to dementia treatments for the whole population. We investigated for the first time inequalities in NHS national dementia prescribing and how they have varied between UK countries and over time. Method: we investigated the association between Townsend deprivation score and anti-dementia drug prescribing in 77,045 dementia patients from UK primary care records from 2002 to 2013. Results: we included 77,045 patients with recorded dementia diagnosis or anti-dementia drug prescription. Least deprived patients were 25% more likely to be initiated on anti-dementia drugs than the most deprived (adjusted incidence rate ratio 1.25, 95% confidence interval 1.19–1.31). This was driven by data from English practices where prescribing rates were consistently lower in more deprived patients compared with Scotland, Northern Ireland and Wales, where prescribing was not related to deprivation quintile. Compared with English practices, anti-dementia medication was prescribed more often in Northern Irish (1.81, 1.41–2.34) and less in Welsh practices (0.68, 0.55–0.82), with a trend towards more prescribing in Scottish practices (1.14, 0.98–1.32). Drug initiation rates were also higher in younger people and men. Conclusion: four years after the English National Dementia Strategy, there is no evidence that the Strategy's key objective of reducing treatment inequalities is being achieved. Higher overall anti-dementia drug prescribing in Scottish and Northern Irish practices, and differing clinical guidelines in Scotland from other UK countries might explain greater equality in prescribing in these countries. Strategies to offer treatment to more deprived people with dementia in England are needed. PMID:26582758

  13. A Systematic Review of Strategies to Foster Activity Engagement in Persons With Dementia

    PubMed Central

    Trahan, Maranda A.; Kuo, Julie; Carlson, Michelle C.; Gitlin, Laura N.

    2015-01-01

    Dementia is a growing public health issue. Activity, a positive therapeutic modality, has potential to enhance quality of life and reduce behavioral symptoms in persons with dementia—outcomes eluding pharmacological treatments. However, it is unclear how to effectively engage persons with dementia in activities for them to derive desired benefits. We present a systematic review of 28 studies involving 50 tests of different ways of modifying activities to enhance engagement and reduce behavioral and psychological symptoms for this group. Of 50 tests, 22 (44%) evaluated changes to objects and properties (e.g., introducing activities with intrinsic interest), 6 (12%) evaluated changes to space demands (e.g., lighting, noise levels), 8 (16%) evaluated changes to social demands (e.g., prompts, praise), and 14 (28%) combined two or more activity modifications. No modifications were made to the sequence and timing of activities. Although modifications to objects and properties were the most common, outcomes for engagement and behaviors were mixed. Modifications to space and social demands were less frequently tested, but consistently yielded positive outcomes. No modifications resulted in negative behavioral outcomes or decreased engagement. Methodological strengths of studies included direct observation of outcomes and fidelity assessments. Few studies however involved persons with dementia at home. Our review revealed a growing evidentiary base for different modifications to foster engagement in activities and reduce behavioral and psychological symptoms. Future studies should evaluate how contextual factors (e.g., physical environment, activity type) and caregiver ability to employ activity modifications affect engagement. PMID:25274714

  14. The National Literacy Strategy and Individual Differences.

    ERIC Educational Resources Information Center

    Stainthorp, Rhona

    2000-01-01

    Presents a discussion paper reflecting on the National Literacy Strategy (NLS) after one year of operation. Argues that once the NLS becomes established it will be necessary for all teachers to engage with the research literature so that they teach from a position of professional understanding of the processes involved in reading and writing…

  15. Improvisations around the National Literacy Strategy.

    ERIC Educational Resources Information Center

    Hanke, Veronica

    2002-01-01

    Describes how five and six year olds responded to and appropriated aspects of the National Literacy Strategy (NLS). Outlines how the children displayed increasing literacy and collaborative skills while working with consonant blends, alphabetical order, and spelling. Concludes NLS is not the whole story in regards to learning about literacy. (PM)

  16. Late-Life Risk Factors for All-Cause Dementia and Differential Dementia Diagnoses in Women

    PubMed Central

    Neergaard, Jesper Skov; Dragsbæk, Katrine; Hansen, Henrik Bo; Henriksen, Kim; Christiansen, Claus; Karsdal, Morten Asser

    2016-01-01

    Abstract Since the first evidence of a decline in dementia incidence was reported in 2011, the focus on modifiable risk factors has increased. The possibility of risk factor intervention as a prevention strategy has been widely discussed; however, further evidence in relation to risk factors is still needed. The Prospective Epidemiologic Risk Factor (PERF I) study was an observational prospective study of postmenopausal Danish women who were initially examined between 1999 and 2001 (n = 5855). Follow-up data on diagnosis and survival as of December 31, 2014 was retrieved from the National Danish Patient Registry and the National Danish Causes of Death Registry. Cox proportional hazards regression model was applied to calculate adjusted hazard ratios (HR) for selected risk factors for dementia. Of 5512 eligible subjects, 592 developed dementia within the follow-up period of maximum 15 years. The independent factors associated with increased risk of all-cause dementia were depression (HR = 1.75 [95% CI 1.32–2.34]) and impaired fasting glucose levels. A dose–response relationship was observed between fasting glucose level and risk of dementia with HRs of 1.25 [1.05–1.49] and 1.45 [1.03–2.06] for impaired (5.6–6.9 mmol/L) and hyperglycemic (≥7.0 mmol/L) glucose levels, respectively. The factors associated with a decreased risk of dementia were overweight in late-life (HR = 0.75 [0. 62–0.89]) and physical activity at least once weekly (HR = 0.77 [0.61–0.96]). The identified risk factors for dementia in women in late-life are all considered modifiable. This supports the notion that prevention strategies may improve the poor future prospects for dementias in the ageing population. PMID:26986157

  17. Trends in use of antipsychotics in elderly patients with dementia: impact of national safety warnings

    PubMed Central

    Gallini, Adeline; Andrieu, Sandrine; Donohue, Julie M; Oumouhou, Naïma; Lapeyre-Mestre, Maryse; Gardette, Virginie

    2014-01-01

    Based on evidence of an increased risk of death, drug agencies issued safety warnings about the use of second generation antipsychotics (SGAs) in the elderly with dementia in 2004. This warning was extended to all antipsychotics in 2008. Little is known about the impact of these warnings on use. We conducted a quasi-experimental study (interrupted time-series) in France, for 2003–2011, including subjects aged ≥65 with dementia and subjects aged ≥65 without dementia in the EGB database (1/97th representative random sample of claims from the main Health Insurance scheme). Outcomes were monthly rates of use of antipsychotics (by class and agent) and of 5 comparison drug classes (antidepressants, benzodiazepines, dermatologicals, antidiabetics, antiasthmatics). Trends were analyzed by joinpoint regression, impact of warnings by linear segmented regression. In patients with dementia (n=7169), there was a 40% reduction in antipsychotic use from 14.2% in 2003 to 10.2% in 2011. The reduction began before 2004 and was unaffected by the warnings. Use of first generation antipsychotics declined over the period, while use of SGAs increased and leveled off from 2007. Use of the 5 comparison drug classes increased on the period. In subjects without dementia (n=91942), rates of overall antipsychotic use decreased from 2.3% in 2003 to 1.8% in 2011 with no effect of the warnings. Meanwhile, use of SGAs continuously increased from 0.37% to 0.64%. Antipsychotic use decreased in the elderly between 2003 and 2011, especially in dementia. The timing of the decrease, however, did not coincide with safety warnings. PMID:24126116

  18. Dementia Friendly, Dementia Capable, and Dementia Positive: Concepts to Prepare for the Future

    PubMed Central

    Lin, Shih-Yin; Lewis, Frances Marcus

    2015-01-01

    With an aging global population, the number of dementia cases is growing exponentially. To address the upcoming dementia crisis, the World Health Organization and Alzheimer’s Disease International (2012) collaborated on an extensive report, Dementia: A Public Health Priority. In the United Kingdom, Prime Minster David Cameron initiated a national challenge on dementia, forming 3 dementia challenge champion groups aimed at improving health and care, creating dementia-friendly communities, and promoting dementia research. In the U.S., President Obama signed the National Alzheimer’s Project Act, which led to the formation of the Advisory Council on Alzheimer’s Research, Care, and Services and the launch of the first National Plan to Address Alzheimer’s Disease. The term “dementia capable” was introduced in the 2012 Recommendations of the Public Members of the Advisory Council and has since been adopted in both the recommendations and annual updates of the national plan. This paper will first compare and contrast government usage of the concepts dementia friendly and dementia capable, along with another valuable concept, dementia positive, that was added after reviewing the literature. Finally, a new vision statement for the U.S.’ national plan will be proposed and recommendations incorporating these 3 concepts in policy, research, and practice will be made. PMID:26035599

  19. Dementia friendly, dementia capable, and dementia positive: concepts to prepare for the future.

    PubMed

    Lin, Shih-Yin; Lewis, Frances Marcus

    2015-04-01

    With an aging global population, the number of dementia cases is growing exponentially. To address the upcoming dementia crisis, the World Health Organization and Alzheimer's Disease International (2012) collaborated on an extensive report, Dementia: A Public Health Priority. In the United Kingdom, Prime Minster David Cameron initiated a national challenge on dementia, forming 3 dementia challenge champion groups aimed at improving health and care, creating dementia-friendly communities, and promoting dementia research. In the U.S., President Obama signed the National Alzheimer's Project Act, which led to the formation of the Advisory Council on Alzheimer's Research, Care, and Services and the launch of the first National Plan to Address Alzheimer's Disease. The term "dementia capable" was introduced in the 2012 Recommendations of the Public Members of the Advisory Council and has since been adopted in both the recommendations and annual updates of the national plan. This paper will first compare and contrast government usage of the concepts dementia friendly and dementia capable, along with another valuable concept, dementia positive, that was added after reviewing the literature. Finally, a new vision statement for the U.S.' national plan will be proposed and recommendations incorporating these 3 concepts in policy, research, and practice will be made. PMID:26035599

  20. A National Strategy for Advancing Climate Modeling

    SciTech Connect

    Dunlea, Edward; Elfring, Chris

    2012-12-04

    Climate models are the foundation for understanding and projecting climate and climate-related changes and are thus critical tools for supporting climate-related decision making. This study developed a holistic strategy for improving the nation's capability to accurately simulate climate and related Earth system changes on decadal to centennial timescales. The committee's report is a high level analysis, providing a strategic framework to guide progress in the nation's climate modeling enterprise over the next 10-20 years. This study was supported by DOE, NSF, NASA, NOAA, and the intelligence community.

  1. A Bayesian Approach to Identifying New Risk Factors for Dementia

    PubMed Central

    Wen, Yen-Hsia; Wu, Shihn-Sheng; Lin, Chun-Hung Richard; Tsai, Jui-Hsiu; Yang, Pinchen; Chang, Yang-Pei; Tseng, Kuan-Hua

    2016-01-01

    Abstract Dementia is one of the most disabling and burdensome health conditions worldwide. In this study, we identified new potential risk factors for dementia from nationwide longitudinal population-based data by using Bayesian statistics. We first tested the consistency of the results obtained using Bayesian statistics with those obtained using classical frequentist probability for 4 recognized risk factors for dementia, namely severe head injury, depression, diabetes mellitus, and vascular diseases. Then, we used Bayesian statistics to verify 2 new potential risk factors for dementia, namely hearing loss and senile cataract, determined from the Taiwan's National Health Insurance Research Database. We included a total of 6546 (6.0%) patients diagnosed with dementia. We observed older age, female sex, and lower income as independent risk factors for dementia. Moreover, we verified the 4 recognized risk factors for dementia in the older Taiwanese population; their odds ratios (ORs) ranged from 3.469 to 1.207. Furthermore, we observed that hearing loss (OR = 1.577) and senile cataract (OR = 1.549) were associated with an increased risk of dementia. We found that the results obtained using Bayesian statistics for assessing risk factors for dementia, such as head injury, depression, DM, and vascular diseases, were consistent with those obtained using classical frequentist probability. Moreover, hearing loss and senile cataract were found to be potential risk factors for dementia in the older Taiwanese population. Bayesian statistics could help clinicians explore other potential risk factors for dementia and for developing appropriate treatment strategies for these patients. PMID:27227925

  2. Treatable Dementias

    PubMed Central

    Mahler, Michael E.; Cummings, Jeffrey L.; Benson, D. Frank

    1987-01-01

    Dementia is an acquired impairment of intellect produced by brain dysfunction. In the past, dementia was regarded as inevitably chronic, progressive and irreversible. More recently dementia has been viewed as a clinical syndrome that may be produced by both irreversible and reversible conditions. Recognition of the presence of a dementia syndrome should be followed by an evaluation for potentially treatable causes of the intellectual deterioration. Dementia treatment includes therapy for reversible or curable dementias and nonspecific interventions that may improve the condition of patients with progressive dementia syndromes. PMID:3617715

  3. People with dementia and carers' experiences of dementia care and services: Outcomes of a focus group study.

    PubMed

    Sutcliffe, Caroline L; Roe, Brenda; Jasper, Rowan; Jolley, David; Challis, David J

    2015-11-01

    An ageing population and an associated increase in the prevalence of dementia are of increasing concern in the United Kingdom and worldwide. Recently, the United Kingdom and other European countries implemented national dementia strategies to address this. This paper reports on the outcomes of a focus group study involving people with dementia and carers on their experiences of dementia care and support services in relation to government and third sector agencies' objectives and recommendations. Three focus groups comprising carers and people with dementia (n = 27) were undertaken covering topics related to experiences, service receipt, information sharing and service development. Some participants experienced difficulties or delays in receiving a dementia diagnosis and in accessing appropriate care. The provision of training, timeliness of information, access to appropriate advice, and consistent and flexible services were deemed important. The findings suggest that some issues raised by participants were highlighted in earlier policy objectives and recommendations but remain of central concern. The projected growth in the number of people with dementia coupled with reduced availability of informal care and increased demand for services emphasises the need to transform dementia care in the United Kingdom. PMID:24381211

  4. Healthcare Providers' Knowledge of Disordered Sleep, Sleep Assessment Tools, and Nonpharmacological Sleep Interventions for Persons Living with Dementia: A National Survey

    PubMed Central

    Brown, Cary A.; Jones, Allyson; Crick, Katelyn

    2014-01-01

    A large proportion of persons with dementia will also experience disordered sleep. Disordered sleep in dementia is a common reason for institutionalization and affects cognition, fall risk, agitation, self-care ability, and overall health and quality of life. This report presents findings of a survey of healthcare providers' awareness of sleep issues, assessment practices, and nonpharmacological sleep interventions for persons with dementia. There were 1846 participants, with the majority being from nursing and rehabilitation. One-third worked in long-term care settings and one-third in acute care. Few reported working in the community. Findings revealed that participants understated the incidence of sleep deficiencies in persons with dementia and generally lacked awareness of the relationship between disordered sleep and dementia. Their knowledge of sleep assessment tools was limited to caregiver reports, self-reports, and sleep diaries, with few using standardized tools or other assessment methods. The relationship between disordered sleep and comorbid conditions was not well understood. The three most common nonpharmacological sleep interventions participants identified using were a regular bedtime routine, increased daytime activity, and restricted caffeine. Awareness of other evidence-based interventions was low. These findings will guide evidence-informed research to develop and test more targeted and contextualized sleep and dementia knowledge translation strategies. PMID:24851185

  5. Creativity and dementia: a review.

    PubMed

    Palmiero, Massimiliano; Di Giacomo, Dina; Passafiume, Domenico

    2012-08-01

    In these last years, creativity was found to play an important role for dementia patients in terms of diagnosis and rehabilitation strategies. This led us to explore the relationships between dementia and creativity. At the aim, artistic creativity and divergent thinking are considered both in non-artists and artists affected by different types of dementia. In general, artistic creativity can be expressed in exceptional cases both in Alzheimer's disease and Frontotemporal dementia, whereas divergent thinking decreases in dementia. The creation of paintings or music is anyway important for expressing emotions and well-being. Yet, creativity seems to emerge when the right prefrontal cortex, posterior temporal, and parietal areas are relatively intact, whereas it declines when these areas are damaged. However, enhanced creativity in dementia is not confirmed by controlled studies conducted in non-artists, and whether artists with dementia can show creativity has to be fully addressed. Future research directions are suggested. PMID:22438178

  6. Greater Sage-Grouse National Research Strategy

    USGS Publications Warehouse

    Hanser, Steven E.; Manier, Daniel J.

    2013-01-01

    The condition of the sagebrush ecosystem has been declining in the Western United States, and greater sage-grouse (Centrocercus urophasianus), a sagebrush-obligate species, has experienced concurrent decreases in distribution and population numbers. This has prompted substantial research and management over the past two decades to improve the understanding of sage-grouse and its habitats and to address the observed decreases in distribution and population numbers. The amount of research and management has increased as the year 2015 approaches, which is when the U.S. Fish and Wildlife Service (FWS) is expected to make a final decision about whether or not to protect the species under the Endangered Species Act. In 2012, the Sage-Grouse Executive Oversight Committee (EOC) of the Western Association of Fish and Wildlife Agencies (WAFWA) requested that the U.S. Geological Survey (USGS) lead the development of a Greater Sage-Grouse National Research Strategy (hereafter Research Strategy). This request was motivated by a practical need to systematically connect existing research and conservation plans with persisting or emerging information needs. Managers and researchers also wanted to reduce redundancy and help focus limited funds on the highest priority research and management issues. The USGS undertook the development of this Research Strategy, which addresses information and science relating to the greater sage-grouse and its habitat across portions of 11 Western States. This Research Strategy provides an outline of important research topics to ensure that science information gaps are identified and documented in a comprehensive manner. Further, by identifying priority topics and critical information needed for planning, research, and resource management, it provides a structure to help coordinate members of an expansive research and management community in their efforts to conduct priority research.

  7. An Example of National Literacy Strategy Medium-Term Planning. The National Literacy Strategy.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    These medium-term plans have been produced to support, but not prescribe, teachers' planning. They exemplify ways in which England's National Literacy Strategy (NLS) Framework objectives (and the Early Learning Goals) can be clustered. The Key Stage 1 and Key Stage 2 medium term plans cluster the NLS text, sentence and word level objectives into…

  8. Doing dementia better: anthropological insights.

    PubMed

    Castillo, Elizabeth Herskovits

    2011-05-01

    Dementia, or neurodegenerative disease, is a disease category, and yet it is widely described in popular and professional media as a horror story. Patients with dementia and their families frequently report that they are less than pleased with their clinical encounters. This article reveals the deleterious impact that cultural assumptions about dementia have on the care provided, and, through an exploration of anthropological theories of personhood, suggests strategies for seeking improved quality of life through personhood-centered care. PMID:21641511

  9. Lack of strategy holding: a new pattern of learning deficit in cortical dementias.

    PubMed

    Benedet, María J; Lauro-Grotto, Rosapia; Giotti, Chiara

    2009-09-01

    The aim of this study was to demonstrate, by means of systematic research and qualitative data analysis, the presence, among a group of patients with fronto-temporal lobar degeneration of a subgroup that, at variance with the standard pattern, is able to devise and implement learning strategies, but appear impaired at carrying them on from a trial to the next. In order to provide evidence of the existence of a group of patients showing this type of learning disability, that we refer to as lack of strategy holding, we performed a stepwise hierarchical cluster analysis of a set of variables whose scores were selected from the subject's performance at the Test de Aprendizaje Verbal España-Complutense. Results substantiate the segregation of three groups of subjects characterized by the following patterns of performance: normal elderly individuals, who show a quite preserved ability to discover a semantic strategy along the learning trials and to carry it from a trial to the next, patients presenting with a deficit in implementing semantic learning strategies and possibly use of serial and/or phonological strategies to perform the task, and to patients who, although able to generate and implement appropriate learning strategies, appear unable to carry them over the learning trials. The presence of this new pattern raises a few questions that seem worth trying to address. PMID:19338728

  10. National launch strategy vehicle data management system

    NASA Technical Reports Server (NTRS)

    Cordes, David

    1990-01-01

    The national launch strategy vehicle data management system (NLS/VDMS) was developed as part of the 1990 NASA Summer Faculty Fellowship Program. The system was developed under the guidance of the Engineering Systems Branch of the Information Systems Office, and is intended for use within the Program Development Branch PD34. The NLS/VDMS is an on-line database system that permits the tracking of various launch vehicle configurations within the program development office. The system is designed to permit the definition of new launch vehicles, as well as the ability to display and edit existing launch vehicles. Vehicles can be grouped in logical architectures within the system. Reports generated from this package include vehicle data sheets, architecture data sheets, and vehicle flight rate reports. The topics covered include: (1) system overview; (2) initial system development; (3) supercard hypermedia authoring system; (4) the ORACLE database; and (5) system evaluation.

  11. Medical Management of Frontotemporal Dementias: The Importance of the Caregiver in Symptom Assessment and Guidance of Treatment Strategies

    PubMed Central

    2011-01-01

    There are no currently Food and Drug Administration-approved or proven off-label treatments for the frontotemporal dementias (FTD). Clinicians, care-givers, and patients struggle regularly to find therapeutic regimens that can alleviate the problematic behavioral and cognitive symptoms associated with these devastating conditions. Success is “hit or miss” and the lessons learned are largely anecdotal to date. Drug discovery in this area has been largely hampered by the heterogeneous clinical presentations and pathological phenotypes of disease that represent significant obstacles to progress in this area. Biologically, plausible treatment strategies include the use of antidepressants (selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor and monoamine oxidase inhibitors), acetylcholinesterase inhibitors, N-methyl-D-aspartic acid antagonists, mood stabilizers, antipsychotics, stimulants, antihypertensives, and agents that may ameliorate the symptoms of parkinsonism, pseudobulbar affect, and motor neuron disease that can often coexist with FTD. These medications all carry potential risks as well as possible benefits for the person suffering from FTD, and a clear understanding of these factors is critical in selecting an appropriate therapeutic regimen to maximize cognition and daily functions, reduce behavioral symptoms, and alleviate caregiver burden in an individual patient. The role of the caregiver in tracking and reporting of symptoms and the effects of individual therapeutic interventions is pivotal in this process. This manuscript highlights the importance of establishing an effective therapeutic partnership between the physician and caregiver in the medical management of the person suffering from FTD. PMID:21647712

  12. Late-Life Risk Factors for All-Cause Dementia and Differential Dementia Diagnoses in Women: A Prospective Cohort Study.

    PubMed

    Neergaard, Jesper Skov; Dragsbæk, Katrine; Hansen, Henrik Bo; Henriksen, Kim; Christiansen, Claus; Karsdal, Morten Asser

    2016-03-01

    Since the first evidence of a decline in dementia incidence was reported in 2011, the focus on modifiable risk factors has increased. The possibility of risk factor intervention as a prevention strategy has been widely discussed; however, further evidence in relation to risk factors is still needed. The Prospective Epidemiologic Risk Factor (PERF I) study was an observational prospective study of postmenopausal Danish women who were initially examined between 1999 and 2001 (n = 5855). Follow-up data on diagnosis and survival as of December 31, 2014 was retrieved from the National Danish Patient Registry and the National Danish Causes of Death Registry. Cox proportional hazards regression model was applied to calculate adjusted hazard ratios (HR) for selected risk factors for dementia. Of 5512 eligible subjects, 592 developed dementia within the follow-up period of maximum 15 years. The independent factors associated with increased risk of all-cause dementia were depression (HR = 1.75 [95% CI 1.32-2.34]) and impaired fasting glucose levels. A dose-response relationship was observed between fasting glucose level and risk of dementia with HRs of 1.25 [1.05-1.49] and 1.45 [1.03-2.06] for impaired (5.6-6.9 mmol/L) and hyperglycemic (≥7.0 mmol/L) glucose levels, respectively. The factors associated with a decreased risk of dementia were overweight in late-life (HR = 0.75 [0. 62-0.89]) and physical activity at least once weekly (HR = 0.77 [0.61-0.96]). The identified risk factors for dementia in women in late-life are all considered modifiable. This supports the notion that prevention strategies may improve the poor future prospects for dementias in the ageing population. PMID:26986157

  13. Young-Onset Dementia

    PubMed Central

    Kuruppu, Dulanji K; Matthews, Brandy R

    2014-01-01

    Young-onset dementia (YOD) is an neurological syndrome that affects behavior and cognition of patients younger than 65 years of age. Although frequently misdiagnosed, a systematic approach, reliant upon attainment of detailed medical history, collateral history from an informant, neuropsychological testing, laboratory studies, and neuroimaging, may facilitate earlier and more accurate diagnosis with subsequent intervention. The differential diagnosis of YOD is extensive and includes early-onset forms of adult neurodegenerative conditions including Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body dementias, Huntington's disease, and prion disease. Late-onset forms of childhood neurodegenerative conditions may also present as YOD and include mitochondrial disorders, lysosomal storage disorders, and leukodystrophies. Potentially reversible etiologies including inflammatory disorders, infectious diseases, toxic/metabolic abnormalities, transient epileptic amnesia, obstructive sleep apnea, and normal pressure hydrocephalus also represent important differential diagnostic considerations in YOD. This review will present etiologies, diagnostic strategies, and options for management of YOD with comprehensive summary tables for clinical reference. PMID:24234358

  14. The National Literacy Strategy--Framework for Teaching: Additional Guidance.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    England's National Literacy Strategy is intended to raise standards of literacy for every student. Teachers should aim to include each student in the Literacy Hour. Evidence from the National Literacy Project (NLP), on which the national strategy is based, shows that students with widely varying needs can expect to improve their literacy skills in…

  15. Exploring the community nurse role in family-centred care for patients with dementia.

    PubMed

    Dening, Karen Harrison; Hibberd, Penny

    2016-04-01

    A diagnosis of dementia can have a significant effect, not only on the person diagnosed, but also on the person's family. Drivers within national policy and strategy to raise awareness and promote education have improved the understanding of dementia across professional groups, as well as within the wider population. However, families living with dementia still struggle to find information and support. This paper explores the common issues faced by families, and focuses on a relationship approach to care. The role of the community nurse can be central to supporting people with dementia and their families to live well in their own communities. The paper uses a case-study approach to discuss three scenarios commonly raised by family carers and people with dementia: (1) seeking help and support at point of seeking diagnosis, (2) knowing the 'right time' to seek help and advice, and (3) when symptomatic changes affect wellbeing and relationships. PMID:27282506

  16. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease

    PubMed Central

    McKhann, Guy M.; Knopman, David S.; Chertkow, Howard; Hyman, Bradley T.; Jack, Clifford R.; Kawas, Claudia H.; Klunk, William E.; Koroshetz, Walter J.; Manly, Jennifer J.; Mayeux, Richard; Mohs, Richard C.; Morris, John C.; Rossor, Martin N.; Scheltens, Philip; Carrillo, Maria C.; Thies, Bill; Weintraub, Sandra; Phelps, Creighton H.

    2012-01-01

    The National Institute on Aging and the Alzheimer’s Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer’s disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Bio-marker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia. PMID:21514250

  17. National Drug Control Strategy. FY 2009 Budget Summary

    ERIC Educational Resources Information Center

    The White House, 2008

    2008-01-01

    The National Drug Control Budget Summary identifies resources and performance indicators for programs within the Executive Branch that are integral to the President's National Drug Control Strategy. The Strategy, which is the Administration's plan for reducing drug use and availability, is based on three pillars: (1) Stopping Use Before It Starts,…

  18. National Indigenous English Literacy and Numeracy Strategy, 2000-2004.

    ERIC Educational Resources Information Center

    Australian Dept. of Employment, Education, Training and Youth Affairs, Canberra.

    Australia's National Indigenous Literacy and Numeracy Strategy acknowledges that extra effort and resources will be required for Indigenous Australian children to achieve the recently enacted national educational goals. The principal objective of the strategy is to achieve English literacy and numeracy for Indigenous students at levels comparable…

  19. Developing and testing a strategy to enhance a palliative approach and care continuity for people who have dementia: study overview and protocol

    PubMed Central

    2012-01-01

    Background Typically, dementia involves progressive cognitive and functional deterioration, leading to death. A palliative approach recognizes the inevitable health decline, focusing on quality of life. The approach is holistic, proactive, supports the client and the family, and can be provided by the client's usual care team. In the last months of life, distressing symptoms, support needs, and care transitions may escalate. This project trialed a strategy intended to support a consistent, high quality, palliative approach for people with dementia drawing close to death. The strategy was to implement two communities of practice, drawn primarily from service provider organizations across care sectors, supporting them to address practice change. Communities comprised practitioners and other health professionals with a passionate commitment to dementia palliative care and the capacity to drive practice enhancement within partnering organizations. Project aims were to document: (i) changes driven by the communities of practice; (ii) changes in staff/practitioner characteristics during the study (knowledge of a palliative approach and dementia; confidence delivering palliative care; views on death and dying, palliative care, and a palliative approach for dementia); (iii) outcomes from perspectives of family carers, care providers, and community of practice members; (iv) the extent to which changes enhanced practice and care continuity; and (v) barriers to and facilitators of successful community of practice implementation. Methods/design This action research project was implemented over 14 months in 2010/11 in metropolitan Perth, Western Australia and regional Launceston, Tasmania. Each state based community of practice worked with the researchers to scope existing practice and its outcomes. The research team compiled a report of existing practice recommendations and resources. Findings of these two steps informed community of practice action plans and development of

  20. Response to the National Career Development Strategy Green Paper

    ERIC Educational Resources Information Center

    Australian Journal of Career Development, 2012

    2012-01-01

    The National Career Development Strategy Green Paper paper proposes a strategy that is committed to these principles: (1) quality through Career Industry Council of Australia (CICA) benchmarking, quality frameworks and processes and as a risk management strategy; (2) lifetime access to career development services; (3) development of career…

  1. Multisensory Stimulation as an Intervention Strategy for Elderly Patients With Severe Dementia: A Pilot Randomized Controlled Trial.

    PubMed

    Sánchez, Alba; Marante-Moar, M Pilar; Sarabia, Carmen; de Labra, Carmen; Lorenzo, Trinidad; Maseda, Ana; Millán-Calenti, José Carlos

    2016-06-01

    The objective of this study was to compare the effect of multisensory stimulation environment (MSSE) and one-to-one activity sessions in the symptomatology of elderly individuals with severe dementia. Thirty-two participants were randomly assigned to the following 3 groups: MSSE, activity, and control group. The MSSE and activity groups participated in two 30-minute weekly sessions over 16 weeks. Pre-, mid-, and posttrial; 8-week follow-up behavior; mood; cognitive status; and dementia severity were registered. Patients in the MSSE group demonstrated a significant improvement in the Neuropsychiatric Inventory and Bedford Alzheimer Nursing Severity Scale scores compared with the activity group. Both MSSE and activity groups showed an improvement during the intervention in the Cohen-Mansfield Agitation Inventory aggressive behavior factor and total score, with no significant differences between groups. The MSSE may have better effects on neuropsychiatric symptoms and dementia severity in comparison with one-to-one activity sessions in patients with severe dementia. PMID:26631687

  2. [Dementia and oral health].

    PubMed

    Wierink, C D; de Baat, C

    2009-02-01

    The first part of this article is a translation of an editorial which appeared in the journal Gerodontology. The author warns that a great increase is expected in the number of dementia patients in the United Kingdom and he argues that care for these patients be given a high place on the national agenda. Dementia was also a major issue at the meeting of the International Association for Dental Research in March 2007. Several international studies presented there indicated that elderly people with dementia constitute a group at risk with respect to oral health. In the evaluation of the editorial, the situation in The Netherlands is described. There is also serious concern in The Netherlands about the statistics with respect to dementia. Due to the growing number of frail elderly people having a natural dentition, the need for professional oral care will increase. General practitioners have the important task of providing adequate oral health care for elderly people suffering from dementia who are still living at home. Guidelines for Oral Care, having to do with the improvement of oral care in institutions, appeared recently. With the guidelines, a good basis for developing adequate oral health care of frail elderly people is available. However, the implementation of these guidelines will require some attention. PMID:19280891

  3. Mixed Dementia

    MedlinePlus

    ... bodies , What Is Alzheimer's? NIA-Funded Memory & Aging Project Reveals Mixed Dementia Common Data from the first ... disease. For example, in the Memory and Aging Project study involving long-term cognitive assessments followed by ...

  4. Vascular dementia

    MedlinePlus

    ... Alzheimer's Disease, and Dementia . 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 6. Gorelick PB, Scuteri A, Black ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 402. Peterson R, Graff-Radford ...

  5. The National Drug Control Strategy, 1997.

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, Washington, DC.

    This federal document offers a comprehensive approach to reduce demand for illegal drugs and decrease their availability. Supported by statistical tables and graphs, the summary is divided into six sections. "The Purpose and Nature of the Strategy" outlines a 10-year plan for drug interdiction and reduction and identifies the elements of that…

  6. 3 CFR - Implementation of the National HIV/AIDS Strategy

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 3 The President 1 2011-01-01 2011-01-01 false Implementation of the National HIV/AIDS Strategy... HIV/AIDS Strategy Memorandum for the Heads of Executive Departments and Agencies As we approach 30 years from the onset of the HIV/AIDS epidemic in the United States, new actions are needed to...

  7. Forging a National Strategy for Success

    ERIC Educational Resources Information Center

    Reed, Jack

    2009-01-01

    At the National Staff Development Council's (NSDC's) 40th Annual Conference in December 2008, former NSDC Board President Karen Dyer and Executive Director Stephanie Hirsh presented the first Policy Maker of the Year Award to Senator Jack Reed (D-RI) in recognition of his dedicated work on behalf of legislation that promotes effective professional…

  8. Social commitment robots and dementia.

    PubMed

    Roger, Kerstin; Guse, Lorna; Mordoch, Elaine; Osterreicher, Angela

    2012-03-01

    In 2010, approximately 500,000 Canadians suffered from a dementia-related illness. The number of sufferers is estimated to double in about 25 years. Due to this growing demographic, dementia (most frequently caused by Alzheimer's disease) will increasingly have a significant impact on our aging community and their caregivers. Dementia is associated with challenging behaviours such as agitation, wandering, and aggression. Care providers must find innovative strategies that facilitate the quality of life for this population; moreover, such strategies must value the individual person. Social commitment robots - designed specifically with communication and therapeutic purposes - provide one means towards attaining this goal. This paper describes a study in which Paro (a robotic baby harp seal) was used as part of a summer training program for students. Preliminary conclusions suggest that the integration of social commitment robots may be clinically valuable for older, agitated persons living with dementia in long-term care settings. PMID:22336517

  9. National mass care strategy: a national integrated approach.

    PubMed

    Mintz, Amy; Gonzalez, Waddy

    2013-01-01

    Mass care refers to a wide range of humanitarian activities that collectively provide life- sustaining services, such as emergency sheltering, feeding, reunification, distribution of emergency supplies and recovery information, before or in the aftermath of an emergency or disaster. Most services are coordinated and provided by non-governmental organisations and/or local government. Based on the lessons learned in the aftermath of Hurricanes Katrina and Rita in 2005, the American Red Cross, the Federal Emergency Management Agency and the National Voluntary Organizations Active in Disasters joined efforts to expand national mass care capabilities in order to support survivors in the wake of catastrophic events, as well as to enhance the integration of volunteers and non-governmental organisations into the broader national effort. These efforts resulted in the creation of the National Mass Care Council in 2010, with representatives of Federal and State agencies, voluntary organisations and the private sector working together to develop a unified approach to mass care and to ensure the provision of consistent and uniform services across the USA, regardless of the magnitude of the event. PMID:24113635

  10. The WHO-ITU national eHealth strategy toolkit as an effective approach to national strategy development and implementation.

    PubMed

    Hamilton, Clayton

    2013-01-01

    With few exceptions, national eHealth strategies are the pivotal tools upon which the launch or refocusing of national eHealth programmes is hinged. The process of their development obviates cross-sector ministerial commitment led by the Ministry of Health. Yet countries often grapple with the task of strategy development and best efforts frequently fail to address strategic components of eHealth key to ensure successful implementation and stakeholder engagement. This can result in strategies that are narrowly focused, with an overemphasis placed on achieving technical outcomes. Without a clear link to a broader vision of health system development and a firm commitment from partners, the ability of a strategy to shape development of a national eHealth framework will be undermined and crucial momentum for implementation will be lost. WHO and ITU have sought to address this issue through the development of the National eHealth Strategy Toolkit that provides a basis for the components and processes to be considered in a strategy development or refocusing exercise. We look at this toolkit and highlight those areas which the countries should consider in formulating their national eHealth strategy. PMID:23920691

  11. Toward a digital library strategy for a National Information Infrastructure

    NASA Technical Reports Server (NTRS)

    Coyne, Robert A.; Hulen, Harry

    1993-01-01

    Bills currently before the House and Senate would give support to the development of a National Information Infrastructure, in which digital libraries and storage systems would be an important part. A simple model is offered to show the relationship of storage systems, software, and standards to the overall information infrastructure. Some elements of a national strategy for digital libraries are proposed, based on the mission of the nonprofit National Storage System Foundation.

  12. A perfect match: Nuclear energy and the National Energy Strategy

    SciTech Connect

    Not Available

    1990-11-01

    In the course of developing the National Energy Strategy, the Department of Energy held 15 public hearings, heard from more than 375 witnesses and received more than 1000 written comments. In April 1990, the Department published an Interim Report on the National Energy Strategy, which compiles those public comments. The National Energy Strategy must be based on actual experience and factual analysis of our energy, economic and environmental situation. This report by the Nuclear Power Oversight committee, which represents electric utilities and other organizations involved in supplying electricity from nuclear energy to the American people, provides such an analysis. The conclusions here are based on hard facts and actual worldwide experience. This analysis of all the available data supports -- indeed, dictates -- expanded reliance on nuclear energy in this nation's energy supply to achieve the President's goals. 33 figs.

  13. Diabetes and dementia in older people: a Best Clinical Practice Statement by a multidisciplinary National Expert Working Group.

    PubMed

    Sinclair, A J; Hillson, R; Bayer, A J

    2014-09-01

    Both dementia and diabetes mellitus are long-term disabling conditions and each may be a co-morbidity of the other. Type 2 diabetes is associated with a 1.5- to 2-fold higher risk of dementia. Diabetes also may occur for the first time in many individuals with mental ill health, including cognitive impairment and dementia, and this may complicate management and lead to difficulties in self-care. Case finding is often poor for cognitive impairment in medical settings and for diabetes in mental health settings and this needs to be addressed in the development of care pathways for both conditions. Many other deficiencies in quality care (both for dementia and diabetes) currently exist, but we hope that this Best Clinical Practice Statement will provide a platform for further work in this area. We have outlined the key steps in an integrated care pathway for both elements of this clinical relationship, produced guidance on identifying each condition, dealt with the potentially hazardous issue of hypoglycaemia, and have outlined important competencies required of healthcare workers in both medical/diabetes and mental health settings to enhance clinical care. PMID:25131194

  14. Frontotemporal Dementia.

    PubMed

    Kelley, Roger E; El-Khoury, Ramy

    2016-02-01

    Frontotemporal dementia (FTD) is a not-uncommon explanation for progressive cognitive deficit in patients who often have a genetic susceptibility for such a neurodegenerative process. However, FTD does not seem to identify one particular pathogenetic mechanism but rather a spectrum of pathologies with particular predilection for the frontal and temporal lobes of the brain. There have been various subcategorizations of this form of dementia that have a tendency to be of earlier onset than typical Alzheimer disease and heralded by behavioral or communication manifestations. There is a behavioral variant and a language variant, referred to as primary progressive aphasia. PMID:26613998

  15. Vascular dementia

    PubMed Central

    Korczyn, Amos D; Vakhapova, Veronika; Grinberg, Lea T

    2012-01-01

    The epidemic grow of dementia causes great concern for the society. It is customary to consider Alzheimer’s disease (AD) as the most common cause of dementia, followed by vascular dementia (VaD). This dichotomous view of a neurodegenerative disease as opposed to brain damage caused by extrinsic factors led to separate lines of research in these two entities. Indeed, accumulated data suggest that the two disorders have additive effects and probably interact; however it is still unknown to what degree. Furthermore, epidemiological studies have shown “vascular” risk factors to be associated with AD. Therefore, a clear distinction between AD and VaD cannot be made in most cases, and is furthermore unhelpful. In the absence of efficacious treatment for the neurodegenerative process, special attention must be given to vascular component, even in patients with presumed mixed pathology. Symptomatic treatment of VaD and AD are similar, although the former is less effective. For prevention of dementia it is important to treat aggressively all factors, even in stroke survivors who do not show evidence of cognitive decline,. In this review, we will give a clinical and pathological picture of the processes leading to VaD and discuss it interaction with AD. PMID:22575403

  16. Healthy cognitive aging and dementia prevention.

    PubMed

    Smith, Glenn E

    2016-01-01

    Behavioral prevention strategies can help maintain high levels of cognition and functional integrity, and can reduce the social, medical, and economic burden associated with cognitive aging and age-associated neurodegenerative diseases. Interventions involving physical exercise and cognitive training have consistently shown positive effects on cognition in older adults. "Brain fitness" interventions have now been shown to have sustained effects lasting 10 years or more. A meta-analysis suggests these physical exercise and brain fitness exercises produce nearly identical impact on formal measures of cognitive function. Behavioral interventions developed and deployed by psychologists are key in supporting healthy cognitive aging. The National Institutes of Health should expand research on cognitive health and behavioral and social science to promote healthy aging and to develop and refine ways to prevent and treat dementia. Funding for adequately powered, large-scale trials is needed. Congress must maintain support for crucial dementia-related initiatives like the Centers for Disease Control and Prevention Healthy Brain Initiative and fund training programs to insure there is a work force with skills to provide high quality care for older adults. Insurers must provide better coverage for behavioral interventions. Better coverage is needed so there can be increased access to evidence-based disease prevention and health promotion services with the potential for reducing dementia risk. (PsycINFO Database Record PMID:27159433

  17. Apraxias in Neurodegenerative Dementias

    PubMed Central

    Chandra, Sadanandavalli Retnaswami; Issac, Thomas Gregor; Abbas, Mirza Masoom

    2015-01-01

    Background: Apraxia is a state of inability to carry out a learned motor act in the absence of motor, sensory or cerebellar defect on command processed through the Praxis circuit. Breakdown in default networking is one of the early dysfunction in cortical dementias and result in perplexity, awkwardness, omission, substitution errors, toying behavior and unrecognizable gestures in response to command with voluntary reflex dissociation where, when unobserved patient will carry out reflex movements normally. Awareness into the organicity of these phenomenas will help in early diagnosis, which will help in initiating appropriate treatment and slowing down the progression of the disease. Aims and Objectives: The aim was to look for the various kinds of apraxias in patients with dementia using appropriate simple tests. Patients and Methods: Three hundred patients satisfying Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for dementia were evaluated in detail with mandatory investigations for dementia followed by testing for ideational, ideomotor, limb-kinetic, buccopharyngeal, dressing apraxia, constructional apraxia and gait apraxias in addition to recording of rare apraxias when present. Results: Alzheimer's disease showed maximum association with apraxias in all the phases of the disease ideational, ideomotor, dressing and constructional apraxias early and buccopharyngeal and gait apraxia late. Frontotemporal lobe dementia showed buccopharyngeal and gait apraxias late into the disease. Cortical basal ganglionic degeneration showed limb apraxias and diffuse Lewy body disease showed more agnosias and less apraxias common apraxias seen was Ideational and Ideomotor. Conclusion: Recognition of the apraxias help in establishing organicity, categorization, caregiver education, early strategies for treatment, avoiding anti-psychotics and introducing disease modifying pharmacotherapeutic agents and also prognosticating. PMID:25722511

  18. Stroke injury, cognitive impairment and vascular dementia.

    PubMed

    Kalaria, Raj N; Akinyemi, Rufus; Ihara, Masafumi

    2016-05-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25-30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood-brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  19. Expanding Expectations for Narrative Styles in the Context of Dementia

    ERIC Educational Resources Information Center

    Guendouzi, Jackie; Davis, Boyd H.; Maclagan, Margaret

    2015-01-01

    This article uses discourse analyses to examine the narrative styles produced by 2 women with a diagnosis of dementia. Because of constrained cognitive resources, people with dementia (PWD) often use alternative strategies to weave their stories into conversations. People with dementia have difficulty in initiating and maintaining a canonical…

  20. Understanding dementia: effective information access from the Deaf community's perspective.

    PubMed

    Young, Alys; Ferguson-Coleman, Emma; Keady, John

    2016-01-01

    This study concerns older Deaf sign language users in the UK. Its aim was to explore how to enable effective information access and promote awareness and understanding of dementia from a culturally Deaf perspective. A purposive sample of 26 Deaf people without dementia participated in one of three focus groups facilitated directly in British Sign Language (BSL) without an intermediate interpreter. The sample was differentiated by age, role in the Deaf community, and diversity of educational attainment and professional experience. A phenomenological approach underpinned the thematic analysis of data. The findings demonstrate: (i) translation into (BSL) is a necessary but not sufficient condition to support understanding. Attention to culturally preferred means of engagement with information is vital; (ii) the content of information is best presented utilising structures and formats which cohere with Deaf people's visual cognitive strengths; and (iii) the importance of cultural values and cultural practices in raising awareness and building understanding of dementia. These include collective rather than individual responsibility for knowledge transfer and the pan-national nature of knowledge transfer among Deaf people(s). The discussion demonstrates how these specific features of effective information access and awareness building have universal implications relevant to public engagement and the promotion of general knowledge consistent with the National Dementia Strategy (England). PMID:25469427

  1. Teacher Stress and Coping Strategies: A National Snapshot

    ERIC Educational Resources Information Center

    Richards, Jan

    2012-01-01

    This national survey of 1,201 kindergarten through Grade-12-U.S. teachers focused on three related areas: (1) sources of teacher stress, (2) manifestations of stress, and (3) suggested coping strategies. The survey instrument was adapted from the Teacher Stress Inventory and the Coping Scale for Adults. Results indicated that teachers nationwide…

  2. Easter School Guidance. The National Literacy and Numeracy Strategies.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    This booklet explains the goals of Easter Schools, part of England's National Literacy and Numeracy Strategies. Easter Schools should be planned to cover four half-days and include four literacy and four mathematics lessons each covering the equivalent of at least an hour. The booklet addresses the following issues: why funding has been made…

  3. Year 5 Booster Units. The National Literacy Strategy.

    ERIC Educational Resources Information Center

    Department for Education and Employment, London (England).

    The eight units of work in this document are designed to complement existing literacy booster units. Each unit is based on teaching objectives from the National Literacy Strategy Framework. They have been produced with the help of Year 5 teachers and have been trialled with pupils in a range of schools. The units support teachers' work with Year 5…

  4. Response to the National Career Development Strategy Green Paper

    ERIC Educational Resources Information Center

    Australian Journal of Career Development, 2012

    2012-01-01

    The Career Development Association of Australia (CDAA) congratulates the Commonwealth Government on the development of the National Career Development Strategy Green Paper. This is a timely and important document that provides a framework to demonstrate the central contribution that career development services play in supporting individuals,…

  5. Strand Tracker: Non-Fiction Objectives. The National Literacy Strategy.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    These materials aim to help teachers make explicit links between teaching in the Literacy Hour and in the rest of the curriculum. The materials map teaching objectives from England's National Literacy Strategy's (NLS) Framework for Teaching to various text types and lists NLS resources which can be used to support teaching and learning. Text types…

  6. Long Overdue? Another Look at the National Literacy Strategy.

    ERIC Educational Resources Information Center

    Beard, Roger

    2000-01-01

    Discusses the teaching approaches which English primary schools are encouraged to use as part of the National Literacy Strategy (NLS) and the ways in which the case for their increased use is supported by research and inspection evidence. Outlines the studies which have influenced the NLS in promoting greater direct interactive teaching of…

  7. Spatial strategies for managing visitor impacts in National Parks

    USGS Publications Warehouse

    Leung, Y.-F.; Marion, J.L.

    1999-01-01

    Resource and social impacts caused by recreationists and tourists have become a management concern in national parks and equivalent protected areas. The need to contain visitor impacts within acceptable limits has prompted park and protected area managers to implement a wide variety of strategies and actions, many of which are spatial in nature. This paper classifies and illustrates the basic spatial strategies for managing visitor impacts in parks and protected areas. A typology of four spatial strategies was proposed based on the recreation and park management literature. Spatial segregation is a common strategy for shielding sensitive resources from visitor impacts or for separating potentially conflicting types of use. Two forms of spatial segregation are zoning and closure. A spatial containment strategy is intended to minimize the aggregate extent of visitor impacts by confining use to limited designated or established Iocations. In contrast, a spatial dispersal strategy seeks to spread visitor use, reducing the frequency of use to levels that avoid or minimize permanent resource impacts or visitor crowding and conflict. Finally, a spatial configuration strategy minimizes impacting visitor behavior though the judicious spatial arrangement of facilities. These four spatial strategics can be implemented separately or in combination at varying spatial scales within a single park. A survey of national park managers provides an empirical example of the diversity of implemented spatial strategies in managing visitor impacts. Spatial segregation is frequently applied in the form of camping restrictions or closures to protect sensitive natural or cultural resources and to separate incompatible visitor activities. Spatial containment is the most widely applied strategy for minimizing the areal extent of resource impacts. Spatial dispersal is commonly applied to reduce visitor crowding or conflicts in popular destination areas but is less frequently applied or

  8. The neuropathology and cerebrovascular mechanisms of dementia.

    PubMed

    Raz, Limor; Knoefel, Janice; Bhaskar, Kiran

    2016-01-01

    The prevalence of dementia is increasing in our aging population at an alarming rate. Because of the heterogeneity of clinical presentation and complexity of disease neuropathology, dementia classifications remain controversial. Recently, the National Plan to address Alzheimer’s Disease prioritized Alzheimer’s disease-related dementias to include: Alzheimer’s disease, dementia with Lewy bodies, frontotemporal dementia, vascular dementia, and mixed dementias. While each of these dementing conditions has their unique pathologic signature, one common etiology shared among all these conditions is cerebrovascular dysfunction at some point during the disease process. The goal of this comprehensive review is to summarize the current findings in the field and address the important contributions of cerebrovascular, physiologic, and cellular alterations to cognitive impairment in these human dementias. Specifically, evidence will be presented in support of small-vessel disease as an underlying neuropathologic hallmark of various dementias, while controversial findings will also be highlighted. Finally, the molecular mechanisms shared among all dementia types including hypoxia, oxidative stress, mitochondrial bioenergetics, neuroinflammation, neurodegeneration, and blood–brain barrier permeability responsible for disease etiology and progression will be discussed. PMID:26174330

  9. Parkinson's Disease Dementia

    MedlinePlus

    ... Is Dementia Types of Dementia Chronic Traumatic Encephalopathy (CTE) Creutzfeldt-Jakob Disease Dementia with Lewy Bodies Down ... Research Traumatic Brain Injury and Chronic Traumatic Encephalopathy (CTE) Awardees Year Researcher Study Name 2015 Jesse Mez ...

  10. Types of Dementia

    MedlinePlus

    ... Is Dementia Types of Dementia Chronic Traumatic Encephalopathy (CTE) Creutzfeldt-Jakob Disease Dementia with Lewy Bodies Down ... Research Traumatic Brain Injury and Chronic Traumatic Encephalopathy (CTE) Awardees Year Researcher Study Name 2015 Jesse Mez ...

  11. What to Ask: Dementia

    MedlinePlus

    ... What to Ask: Dementia Tools and Tips The memory loss and other changes seen in dementia can ... can ask your healthcare proffesional about dementia. Is memory loss a normal part of aging? If so, ...

  12. National symbols and distinctiveness: rhetorical strategies in creating distinct national identities.

    PubMed

    Finell, Eerika; Liebkind, Karmela

    2010-06-01

    The purpose of this study is to examine qualitatively how respondents create national distinctiveness using rhetorical identity strategies in the context of four Finnish national symbols. The data consist of 127 essays written by Finnish secondary school students. Analysis revealed five different strategies used to distinguish between the in-group and the out-group. These strategies differ on two dimensions: the level of polarization, and the extent to which the in-group-out-group relationship is depicted as being active versus passive. Furthermore, the analysis showed that the two dimensions of nationalism, particularism and universalism, have an important role in the differentiation processes and therefore highlighted the importance of taking into consideration ideological issues while studying social identities. The meaning of the contents of national identity in the differentiation processes is also discussed. PMID:19558753

  13. Impact on the PACOM regional command strategy of the evolving national security strategy. Final report

    SciTech Connect

    Riddle, M.H.

    1994-02-08

    This paper deals with the conclusions and recommendations of the impact the evolving United States national security strategy may have on the PACOM regional command strategy. The conclusions and recommendations are based on a survey of the January 1993 National Security Strategy of the United States presented by the outgoing Administration and the impact that the evolving strategy of the Clinton Administration is having. These conclusions and recommendations are also influenced by current events surrounding the activities and policy debate centered on the Peoples Democratic Republic of Korea. The conclusions drawn are that the objectives of national security are timeless and consistent from Administration to Administration, even when the party changes. The divergence occurs in emphasis and priority. Several impacts on the PACOM regional command strategy are identified as a result. To break the reliance on the strategy of deterrence requires refocusing of the priority from the global-international level to the regional level. The recommendation is made that the Administration should de-link the military considerations on the Korean peninsula from the international debate over the DPRK nuclear program.

  14. 76 FR 30193 - National Fish, Wildlife, and Plants Climate Adaptation Strategy; Notice of Intent: Request for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... Fish and Wildlife Service National Fish, Wildlife, and Plants Climate Adaptation Strategy; Notice of... National Fish, Wildlife, and Plants Climate Adaptation Strategy (Strategy). The Strategy will provide a... to the Office of the Science Advisor, Attn: National Fish, Wildlife, and Plants Climate...

  15. Bridge to a sustainable future: National environmental technology strategy

    SciTech Connect

    1995-04-01

    For the past two years the Administration has sought the views of Congress, the states, communities, industry, academia, nongovernmental organizations, and interested citizens on ways to spur the development and use of a new generation of environmental technologies. This document represents the views of thousands of individuals who participated in events around the country to help craft a national environmental technology strategy that will put us on the path to sustainable development.

  16. Clinical features and multidisciplinary approaches to dementia care

    PubMed Central

    Grand, Jacob HG; Caspar, Sienna; MacDonald, Stuart WS

    2011-01-01

    Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1) Alzheimer’s disease; 2) vascular dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson’s disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of pathological burden. Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by

  17. [Falls in patients with dementia].

    PubMed

    Yamaguchi, Kiyoshi

    2008-11-01

    People with cognitive impairment are at about 2 to 3 times higher risk of falling compared with cognitively intact elderly. Incidence of falls among patients with Alzheimer's disease (AD) is high, nevertheless the clinical feature common in patients with mild to moderate AD is the absence of motor impairment. Recent studies suggest that the divided attention markedly impairs the ability of patients with AD to regulate the gait. Falls are particularly common in Dementia with Lewy bodies (DLB) patients and may aid diagnosis, and the falls are associated with parkinsonism and other unclear factors. Treatment studies evaluating fall reduction strategies in dementia patients are a priority. PMID:18974447

  18. Senile dementia.

    PubMed

    Terry, R D

    1978-12-01

    The Alzheimer type of senile dementia (SDAT) accounts for more than 50% of such cases, and is a very common disorder as well as being very costly in emotional, economic, and medical terms. It carries a markedly shortened life expectancy. Gray-to-white-matter ratios change and the brain shrinks slightly in the course of normal aging, but SDAT brains may not be significantly more atrophic than are normal controls. Cortical neurons are diminished in number in normal aging, but counts from frontal and midtemporal regions of SDAT specimens are not different from age-matched controls. There is loss of dendrites and of dendritic spines in both normal and abnormal aged specimens. Neurofibrillary tangles are made up of paired helical filaments that appear to be chemically and immunologically related to normal neurofibers. Neuritic plaques are made up of an amyloid core surrounded by abnormal axonal endings. Both plaques and tangles are to be correlated with the presence of senile dementia. There is some evidence for an infectious etiology of SDAT. Choline acetyltransferase is markedly reduced in cortical tissue of these patients, but the muscarinic receptors of acetylcholine are normal. PMID:720637

  19. Validation of a Computerized, Game-based Assessment Strategy to Measure Training Effects on Motor-Cognitive Functions in People With Dementia

    PubMed Central

    Lemke, Nele; Werner, Christian; Hauer, Klaus

    2016-01-01

    cognitive tests and simple (rs=−.22 to .68, P ≤.001-.03), moderate (rs=−.33 to .71, P ≤.001-.004), and complex motor-cognitive Physiomat tasks (rs=−.22 to .83, P ≤.001-.30) indicating a good construct validity. Moderate-to-high correlations between test and retest assessments were found for simple, moderate, and complex motor-cognitive tasks (ICC=.47-.83, P ≤.001) indicating good test–retest reliability. Sensitivity to change was good to excellent for Physiomat assessment as it reproduced significant improvements (P ≤.001) with mostly moderate-to-large effect sizes (SRM=0.5-2.0) regarding all trained tasks. Completion time averaged 25.8 minutes. Completion rate was high for initial Physiomat measures. No adverse events occurred during assessment. Conclusions Overall, Physiomat proved to have good psychometric qualities in people with mild-to-moderate dementia representing a reliable, valid, responsive, and feasible assessment strategy for multimorbid older adults with or without cognitive impairment, which relates to identical and integrated performances trained by using the game. PMID:27432746

  20. Flavonoids and dementia: an update.

    PubMed

    Orhan, I E; Daglia, M; Nabavi, S F; Loizzo, M R; Sobarzo-Sánchez, E; Nabavi, S M

    2015-01-01

    Dementia is a strongly age-related syndrome due to cognitive decline that can be considered a typical example of the combination of physiological and pathological aging-associated changes occurring in old people; it ranges from intact cognition to mild cognitive impairment, which is an intermediate stage of cognitive deterioration, and dementia. The spread of this syndrome has induced to study and try to reduce dementia modifiable risk factors. They include insulin resistance and hyperinsulinaemia, high blood pressure, obesity, smoking, depression, cognitive inactivity or low educational attainment as well as physical inactivity and incorrect diet, which can be considered one of the most important factors. One emerging strategy to decrease the prevalence of mild cognitive impairment and dementia may be the use of nutritional interventions. In the last decade, prospective data have suggested that high fruit and vegetable intakes are related to improved cognitive functions and reduced risks of developing a neurodegenerative process. The protective effects against neurodegeneration could be in part due to the intake of flavonoids that have been associated with several health benefits such as antioxidant and anti-inflammatory activities, increased neuronal signaling, and improved metabolic functions. The present article is aimed at reviewing scientific studies that show the protective effects of flavonoid intake against mild cognitive impairment and dementia. PMID:25515512

  1. Climate Change Education Roundtable: A Coherent National Strategy

    NASA Astrophysics Data System (ADS)

    Storksdieck, M.; Feder, M.; Climate Change Education Roundtable

    2010-12-01

    The Climate Change Education (CCE) Roundtable fosters ongoing discussion of the challenges to and strategies for improving public understanding of climate science and climate change among federal agencies, the business community, non-profit, and academic sectors. The CCE Roundtable is provides a critical mechanism for developing a coherent, national strategy to advance climate change education guided by the best available research evidence. Through its meetings and workshops, the roundtable brings together 30 federal and state policymakers, educators, communications and media experts, and members from the business and scientific community. The roundtable includes a number of ex officio members from federal agencies with dedicated interests in climate change education, including officials from the National Science Foundation’s EHR Directorate and its collaborating partner divisions, the National Oceanic and Atmospheric Administration (NOAA), the National Aeronautics and Space Administration (NASA), the Department of Interior, the Department of Energy, and the Department of Education. The issues that are addressed by the roundtable include: - ways to incorporate knowledge about learning and understanding in developing informative programs and materials for decision-makers who must cope with climate change - the design of educational programs for professionals such as local planners, water managers, and the like, to enable them to better understand the implications of climate change for their decisions - development of training programs for scientists to help them become better communicators to decision-makers about implications of, and solutions to climate change - coordinated and collaborative efforts at the national level between federal agencies and other stakeholders This presenation will describe how the roundtable is fostering a coherent direction for climate change education.

  2. [Indonesia draws up plans for a national strategy].

    PubMed

    1991-01-01

    Dr. Sumedha Khanna, the World Health Organization representative in Indonesia, has reported that Indonesia is about to undertake a national level evaluation of maternal health care and training of midwives with the help of a UN subsidy. The results will be presented at a high level seminar planned for July 1992. The main elements of the national strategy and plan of action will also be developed at the meeting and integrated into the National Health Plan. The goal is to reduce maternal mortality to half its current level of 4500/100,000 live births by the year 2000. Part of the strategy will be to remedy the shortage of qualified midwives and of emergency services. Priority will be given to providing each village or health center with a qualified nurse-midwife. The Indonesian government expects to train 33,000 nurse-midwives within 5 years. The World Bank has agreed to subsidize training of 15,000. Physicians in district hospitals will be trained in essential obstetrical functions with the collaboration of the Indonesian Society of Obstetricians and Gynecologists. UNICEF is reportedly prepared to help. The Indonesian Association of Midwives has supported the initiative by using surveys of maternal mortality in different parts of the country to analyze the need to improve the health of Indonesian women. PMID:12284954

  3. Hypnotics and the Occurrence of Bone Fractures in Hospitalized Dementia Patients: A Matched Case-Control Study Using a National Inpatient Database

    PubMed Central

    Tamiya, Hiroyuki; Yasunaga, Hideo; Matusi, Hiroki; Fushimi, Kiyohide; Ogawa, Sumito; Akishita, Masahiro

    2015-01-01

    Background Preventing falls and bone fractures in hospital care is an important issue in geriatric medicine. Use of hypnotics is a potential risk factor for falls and bone fractures in older patients. However, data are lacking on the association between use of hypnotics and the occurrence of bone fracture. Methods We used a national inpatient database including 1,057 hospitals in Japan and included dementia patients aged 50 years or older who were hospitalized during a period of 12 months between April 2012 and March 2013. The primary outcome was the occurrence of bone fracture during hospitalization. Use of hypnotics was compared between patients with and without bone fracture in this matched case-control study. Results Of 140,494 patients, 830 patients suffered from in-hospital fracture. A 1:4 matching with age, sex and hospital created 817 cases with fracture and 3,158 matched patients without fracture. With adjustment for the Charlson comorbidity index, emergent admission, activities of daily living, and scores for level walking, a higher occurrence of fractures were seen with short-acting benzodiazepine hypnotics (odds ratio, 1.43; 95% confidence interval, 1.19–1.73; P<0.001), ultrashort-acting non-benzodiazepine hypnotics (1.66; 1.37–2.01; P<0.001), hydroxyzine (1.45; 1.15–1.82, P=0.001), risperidone and perospirone (1.37; 1.08–1.73; P=0.010). Other drug groups were not significantly associated with the occurrence of in-hospital fracture. Conclusions Short-acting benzodiazepine hypnotics and ultrashort-acting non-benzodiazepine hypnotics may increase risk of bone fracture in hospitalized dementia patients. PMID:26061231

  4. Strategy for a transparent, accessible, and sustainable national claims database.

    PubMed

    Gelburd, Robin

    2015-03-01

    The article outlines the strategy employed by FAIR Health, Inc, an independent nonprofit, to maintain a national database of over 18 billion private health insurance claims to support consumer education, payer and provider operations, policy makers, and researchers with standard and customized data sets on an economically self-sufficient basis. It explains how FAIR Health conducts all operations in-house, including data collection, security, validation, information organization, product creation, and transmission, with a commitment to objectivity and reliability in data and data products. It also describes the data elements available to researchers and the diverse studies that FAIR Health data facilitate. PMID:26014305

  5. [Normative-legal support for implementation of national strategy of glaucoma control in Ukraine].

    PubMed

    Vitovs'ka, O P; Tymchenko, O I

    2009-01-01

    The review of normative legal database for implementation of national strategy of glaucoma control has demonstrated that there are all terms and conditions for implementation of national strategy on the national level. There is no necessity to change present normative legal database in the field of public health for the purpose of strategy implementation. PMID:20455458

  6. 76 FR 29195 - National Strategy for Trusted Identities in Cyberspace (NSTIC) Governance Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-20

    ... National Institute of Standards and Technology National Strategy for Trusted Identities in Cyberspace...: Notice of public workshop. SUMMARY: NIST announces the National Strategy for Trusted Identities in... with the Strategy. The goals of this workshop are to provide a venue for discussion and...

  7. Personality and dementia.

    PubMed

    Cipriani, Gabriele; Borin, Gemma; Del Debbio, Alessandro; Di Fiorino, Mario

    2015-03-01

    Personality describes persistent human behavioral responses to broad classes of environmental stimuli. Change in personality may be an early sign of dementia. Our goal was to review scientific literature on the association between personality and dementia. Medline and Google Scholar searches were conducted for relevant articles, chapters, and books published since 1980. Search terms used included personality, dementia, Alzheimer's disease, frontotemporal dementia, dementia with Lewy bodies. People with dementia commonly exhibit changes in personality that sometimes precede the other early clinical manifestations of the condition, such as cognitive impairment. Premorbid personality might be a determining factor so that caricature or exaggeration of original personality emerges as dementia progresses. Although it is generally accepted that these personality changes reflect the impact of progressive brain damage, there are several possible patterns of personality alterations with dementia. Early identification of personality modifications might assist with the timely diagnosis of dementia. PMID:25714255

  8. Los Alamos National Laboratory accelerated tru waste workoff strategies

    SciTech Connect

    Kosiewicz, S.T.; Triay, I.R.; Rogers, P.Z.; Christensen, D.V.

    1997-03-01

    During 1996, the Los Alamos National Laboratory (LANL) developed two transuranic (TRU) waste workoff strategies that were estimated to save $270 - 340M through accelerated waste workoff and the elimination of a facility. The planning effort included a strategy to assure that LANL would have a significant quantity (3000+ drums) of TRU waste certified for shipment to the Waste Isolation Pilot Plant (WIPP) beginning in April of 1998, when WIPP was projected to open. One of the accelerated strategies can be completed in less than ten years through a Total Optimization of Parameters Scenario ({open_quotes}TOPS{close_quotes}). {open_quotes}TOPS{close_quotes} fully utilizes existing LANL facilities and capabilities. For this scenario, funding was estimated to be unconstrained at $23M annually to certify and ship the legacy inventory of TRU waste at LANL. With {open_quotes}TOPS{close_quotes} the inventory is worked off in about 8.5 years while shipping 5,000 drums per year at a total cost of $196M. This workoff includes retrieval from earthen cover and interim storage costs. The other scenario envisioned funding at the current level with some increase for TRUPACT II loading costs, which total $16M annually. At this funding level, LANL estimates it will require about 17 years to work off the LANL TRU legacy waste while shipping 2,500 drums per year to WIPP. The total cost will be $277M. This latter scenario decreases the time for workoff by about 19 years from previous estimates and saves an estimated $190M. In addition, the planning showed that a $70M facility for TRU waste characterization was not needed. After the first draft of the LANL strategies was written, Congress amended the WIPP Land Withdrawal Act (LWA) to accelerate the opening of WIPP to November 1997. Further, the No Migration Variance requirement for the WIPP was removed. This paper discusses the LANL strategies as they were originally developed. 1 ref., 3 figs., 2 tabs.

  9. Dementia in older people: an update.

    PubMed

    LoGiudice, D; Watson, R

    2014-11-01

    Dementia is a common condition of the elderly characterised by multiple cognitive deficits resulting in a decline from previous level of function. In the older person, multiple pathologies contribute, including changes commonly seen in Alzheimer disease, dementia with Lewy bodies in addition to vascular changes. Comorbid factors, such as depression, delirium and polypharmacy can contribute to cognitive decline. Novel biomarkers and neuroimaging techniques may assist in the near future to improve accuracy of diagnosis. To date, pharmacological therapies have been largely unsuccessful and provide symptomatic relief only. The timely diagnosis of dementia can facilitate important discussions regarding personal and financial planning and introduce education and supports to the person with dementia and their carers. The person with dementia commonly experiences behavioural and psychological symptoms of dementia that may cause much distress, including to families and carers. Clinical guidelines indicate non-pharmacological approaches as first line measures, including attention to pain, nutrition and the environment. Dementia is recognised as a National Health Priority in Australia, and efforts to target risk factors as preventative measures to delay onset of dementia require further urgent consideration. PMID:25367725

  10. Dietary Patterns, Cognitive Decline, and Dementia: A Systematic Review12

    PubMed Central

    van de Rest, Ondine; Berendsen, Agnes AM; Haveman-Nies, Annemien; de Groot, Lisette CPGM

    2015-01-01

    Nutrition is an important modifiable risk factor that plays a role in the strategy to prevent or delay the onset of dementia. Research on nutritional effects has until now mainly focused on the role of individual nutrients and bioactive components. However, the evidence for combined effects, such as multinutrient approaches, or a healthy dietary pattern, such as the Mediterranean diet, is growing. These approaches incorporate the complexity of the diet and possible interaction and synergy between nutrients. Over the past few years, dietary patterns have increasingly been investigated to better understand the link between diet, cognitive decline, and dementia. In this systematic review we provide an overview of the literature on human studies up to May 2014 that examined the role of dietary patterns (derived both a priori as well as a posteriori) in relation to cognitive decline or dementia. The results suggest that better adherence to a Mediterranean diet is associated with less cognitive decline, dementia, or Alzheimer disease, as shown by 4 of 6 cross-sectional studies, 6 of 12 longitudinal studies, 1 trial, and 3 meta-analyses. Other healthy dietary patterns, derived both a priori (e.g., Healthy Diet Indicator, Healthy Eating Index, and Program National Nutrition Santé guideline score) and a posteriori (e.g., factor analysis, cluster analysis, and reduced rank regression), were shown to be associated with reduced cognitive decline and/or a reduced risk of dementia as shown by all 6 cross-sectional studies and 6 of 8 longitudinal studies. More conclusive evidence is needed to reach more targeted and detailed guidelines to prevent or postpone cognitive decline. PMID:25770254

  11. Dietary patterns, cognitive decline, and dementia: a systematic review.

    PubMed

    van de Rest, Ondine; Berendsen, Agnes Am; Haveman-Nies, Annemien; de Groot, Lisette Cpgm

    2015-03-01

    Nutrition is an important modifiable risk factor that plays a role in the strategy to prevent or delay the onset of dementia. Research on nutritional effects has until now mainly focused on the role of individual nutrients and bioactive components. However, the evidence for combined effects, such as multinutrient approaches, or a healthy dietary pattern, such as the Mediterranean diet, is growing. These approaches incorporate the complexity of the diet and possible interaction and synergy between nutrients. Over the past few years, dietary patterns have increasingly been investigated to better understand the link between diet, cognitive decline, and dementia. In this systematic review we provide an overview of the literature on human studies up to May 2014 that examined the role of dietary patterns (derived both a priori as well as a posteriori) in relation to cognitive decline or dementia. The results suggest that better adherence to a Mediterranean diet is associated with less cognitive decline, dementia, or Alzheimer disease, as shown by 4 of 6 cross-sectional studies, 6 of 12 longitudinal studies, 1 trial, and 3 meta-analyses. Other healthy dietary patterns, derived both a priori (e.g., Healthy Diet Indicator, Healthy Eating Index, and Program National Nutrition Santé guideline score) and a posteriori (e.g., factor analysis, cluster analysis, and reduced rank regression), were shown to be associated with reduced cognitive decline and/or a reduced risk of dementia as shown by all 6 cross-sectional studies and 6 of 8 longitudinal studies. More conclusive evidence is needed to reach more targeted and detailed guidelines to prevent or postpone cognitive decline. PMID:25770254

  12. Dementia diagnosis and management: a narrative review of changing practice

    PubMed Central

    Koch, Tamar; Iliffe, Steve

    2011-01-01

    Background Early detection and management of dementia in primary care are difficult problems for practitioners. England's National Dementia Strategy 2009 seeks to improve these areas but there is limited evidence on how to achieve this most effectively. Aim This review aims to identify and appraise empirical studies of interventions designed to improve the performance of primary care practitioners in these areas. Design A narrative review of primary-care based studies. Method Publications up to February 2010 were identified by searching the electronic databases MEDLINE, Embase, and PsycINFO, and bibliographies. The criterion for inclusion was that studies had to be of interventions aimed at improving detection or management of dementia in primary care. Exclusion criteria included studies in non-English publications, pharmacological interventions, and screening instrument studies. Quality was assessed using the PEDro (Physiotherapy Evidence Database) scale. Results Fifteen studies were identified, of which 11 were randomised controlled trials. Eight reported educational interventions, and seven trialled service redesign, either by changing the service pathway or by introducing case management. Educationally, only facilitated sessions and decision-support software improved GPs' diagnosis of dementia, as did trials of service-pathway modification. Some of the case-management trials showed improved stakeholder satisfaction, decreased symptoms, and care that was more concordant with guidelines. Conclusion The quality of the studies varied considerably. Educational interventions are effective when learners are able to set their own educational agenda. Although modifying the service pathway and using case management can assist in several aspects of dementia care, these would require the provision of extra resources, and their value is yet to be tested in different health systems. PMID:21801564

  13. Evaluating the Association between Diabetes, Cognitive Decline and Dementia

    PubMed Central

    Ojo, Omorogieva; Brooke, Joanne

    2015-01-01

    The aim of this article is to review the association between diabetes mellitus, cognitive decline and dementia, including the effects of cognitive decline and dementia on self management of diabetes. This is a literature review of primary research articles. A number of contemporary research articles that met the inclusion criteria were selected for this review paper. These articles were selected using a number of search strategies and electronic databases, such as EBSCOhost Research and SwetsWise databases. The duration of diabetes, glycated haemoglobin levels and glycaemic fluctuations were associated with cognitive decline and dementia. Similarly, hypoglycaemia was significantly related to increased risk of developing cognitive decline and dementia. Furthermore, cognitive decline and dementia were associated with poorer diabetes management. There is evidence of the association between diabetes, cognitive decline and dementia including the shared pathogenesis between diabetes and Alzheimer’s disease. In addition, the self management of diabetes is affected by dementia and cognitive decline. It could be suggested that the association between diabetes and dementia is bidirectional with the potential to proceed to a vicious cycle. Further studies are needed in order to fully establish the relationship between diabetes, cognitive decline and dementia. Patients who have diabetes and dementia could benefit from structured education strategies, which should involve empowerment programmes and lifestyle changes. The detection of cognitive decline should highlight the need for education strategies. PMID:26193295

  14. Diabetes, Dementia and Hypoglycemia.

    PubMed

    Meneilly, Graydon S; Tessier, Daniel M

    2016-02-01

    We are experiencing an epidemic of both diabetes and dementia among older adults in this country. The risk for dementia appears to be increased in patients with diabetes, and patients with dementia and diabetes appear to be at greater risk for severe hypoglycemia. In addition, there may be an increased risk for developing dementia by older patients with diabetes who have had episodes of severe hypoglycemia, although this issue is controversial. In this article, we review the factors that contribute to the increased risk for dementia in older adults with diabetes and outline the complex relationships between hypoglycemia and dementia. PMID:26778684

  15. Anosognosia in Dementia.

    PubMed

    Wilson, Robert S; Sytsma, Joel; Barnes, Lisa L; Boyle, Patricia A

    2016-09-01

    Progressive decline in memory (and other functions) is the defining feature of late-life dementia but affected individuals are often unaware of this impairment. This article reviews recent research on anosognosia in dementia, including methods of assessing anosognosia, its prevalence and developmental course in dementia, its occurrence in different forms of dementia, neuroimaging findings, and hypothesized component mechanisms. The results suggest that anosognosia is eventually exhibited by nearly all persons with dementia. Its occurrence is robustly associated with common dementia-related pathologies and damage to memory and self-referential brain networks and their interconnections. PMID:27438597

  16. 75 FR 43528 - Seeking Public Comment on Draft National Health Security Strategy Biennial Implementation Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... . SUPPLEMENTARY INFORMATION: The National Health Security Strategy (2009) can be found at: http://www.phe.gov... HUMAN SERVICES Office of the Secretary Seeking Public Comment on Draft National Health Security Strategy... achieve national health security and to implement the first quadrennial National Health Security...

  17. 77 FR 2996 - National Fish, Wildlife, and Plants Climate Adaptation Strategy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... the Strategy in a May 24, 2011, notice of intent in the Federal Register (76 FR 30193). After we... Fish and Wildlife Service National Fish, Wildlife, and Plants Climate Adaptation Strategy AGENCY: Fish..., Wildlife, and Plants Climate Adaptation Strategy (Strategy). The purpose of the Strategy will be to...

  18. [What is dementia? 2. A fuzzy construct].

    PubMed

    Derouesné, Christian

    2003-03-01

    Since the publication of the third edition of the classification of mental disorders by the American Psychiatric Association, APA (DSM-III) in 1980, a large international consensus has been reached to define dementia as a multiple cognitive deficit centered by memory disturbances, interfering with the daily life activities and related to organic brain lesions. The DSM-III defined a diagnostic strategy in two steps. First to make the diagnosis of dementia according to the clinical criteria and then to specify its etiology. The more recent editions of the APA classification did not significantly modify these recommendations. The use of the DSM criteria has allowed important advances in epidemiological, clinical and therapeutic research. However, several criticisms should be addressed to the clinical diagnostic criteria as well as to the current concept of dementia. First, from a theoretical point of view, dementia is not a disease, not even a disorder. It only corresponds to a conventional collection of symptoms. Actually, clinical symptoms of dementia basically depend of the localization of brain lesions. Therefore, there could not be one single dementia syndrome. Similarly, the basis of the search for one "antidementia drug" should be questioned. From a clinical point of view, the DSM-IV criteria present some inaccuracies regarding the description of deficits in memory and executive functions as well as in the assessment of the interference of the cognitive decline with the activities of daily living. The definition of dementia as a purely cognitive deficit results in neglecting its psychological and relational manifestations which play a large part in the detection of dementia and its acceptance by the family. A major criticism concerns the definition of dementia as a sincle clinical entity with memory deficits as the core symptom. This definition is well adapted to Alzheimer's disease but results in delayed diagnosis or misclassification of dementias such as

  19. Dementia: Diagnosis and Tests

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Dementia Diagnosis & Tests If you or someone you care ... To determine whether an older adult might have dementia, a healthcare professional will: Ask about the person’s ...

  20. Lewy Body Dementia Diagnosis

    MedlinePlus

    ... individuals, it may also be due to the natural course of the disease. All Rights Reserved Lewy Body Dementia Association, Inc. 912 Killian Hill Road S.W., Lilburn, GA 30047 © 2016 Lewy Body Dementia Association, Inc. Connect ...

  1. Local Solutions for National Challenges? Exploring Local Solutions through the Case of a National Succession Planning Strategy

    ERIC Educational Resources Information Center

    Collins, Mike

    2013-01-01

    The notion of localism and decentralization in national policy has come increasingly to the fore in recent years. The national succession planning strategy for headteachers in England introduced by the National College for School Leadership promoted "local solutions for a national challenge". This article deals with some aspects of the…

  2. Collaborative transdisciplinary team approach for dementia care

    PubMed Central

    Galvin, James E; Valois, Licet; Zweig, Yael

    2015-01-01

    SUMMARY Alzheimer's disease (AD) has high economic impact and places significant burden on patients, caregivers, providers and healthcare delivery systems, fostering the need for an evaluation of alternative approaches to healthcare delivery for dementia. Collaborative care models are team-based, multicomponent interventions that provide a pragmatic strategy to deliver integrated healthcare to patients and families across a wide range of populations and clinical settings. Healthcare reform and national plans for AD goals to integrate quality care, health promotion and preventive services, and reduce the impact of disease on patients and families reinforcing the need for a system-level evaluation of how to best meet the needs of patients and families. We review collaborative care models for AD and offer evidence for improved patient- and family-centered outcomes, quality indicators of care and potential cost savings. PMID:25531688

  3. [Personality and Dementia].

    PubMed

    Masui, Yukie

    2016-07-01

    Previous studies have looked into the relationships between personality and dementia from three hypothetical points of views: 1) that personality type is a risk factor for dementia, 2) that personality changes occur before receiving a diagnosis of dementia, and 3) that premorbid personality traits define behavioral and psychological symptoms of dementia (BPSD) after receiving a diagnosis. This article overviews all three perspectives of the studies, after explaining the character and characteristic attributes of each perspective. PMID:27395463

  4. Implementing a national strategy for patient safety: lessons from the National Health Service in England.

    PubMed

    Lewis, R Q; Fletcher, M

    2005-04-01

    Improving patient safety has become a core issue for many modern healthcare systems. However, knowledge of the best ways for government initiated efforts to improve patient safety is still evolving, although there is considerable commonality in the challenges faced by countries. Actions to improve patient safety must operate at multiple levels of the healthcare system simultaneously. Using the example of the NHS in England, this article highlights the importance of a strategic analysis of the policy process and the prevailing policy context in the design of the national patient safety strategy. The paper identifies a range of policy "levers" (forces for change) that can be used to support the implementation of the national safety initiative and, in particular, discusses the strengths and limitations of the "business case" approach that has attracted recent interest. The paper offers insights into the implementation of national patient safety goals that should provide learning for other countries. PMID:15805460

  5. Developing a national salt reduction strategy for Mongolia

    PubMed Central

    Enkhtungalag, Batsaikhan; Batjargal, Jamayan; Chimedsuren, Ochir; Tsogzolmaa, Bayandorj; Anderson, Craig S.

    2015-01-01

    Background The increase in prevalence of risk factors such as hypertension has contributed to an incremental rise in non-communicable diseases (NCDs) in Mongolia over recent decades, such that they now account for 80% of all deaths in the country. Salt reduction is one of the most cost-effective interventions to reduce the burden of NCDs. Methods In 2011, the Ministry of Health (MOH) instigated the development of a national salt reduction strategy for Mongolia. As part of a 2-week national consultation and training program on salt reduction, it established an inter-sectoral working party and organized a series of bilateral meetings and visits to factories. Actions arising included a baseline survey of population salt consumption patterns and the implementation of a series of pilot salt reduction initiatives. Results The results of the baseline assessment revealed that average daily intake of salt, based on 24 hour urine samples from a representative national sample (n=1,027), was 11.06±5.99 g in 2011, more than double the World Health Organization (WHO) five grams recommendation. Moreover, while most participants knew that salt was bad for health, few were taking efforts to reduce intake, and many were consuming highly salty meals and tea; salt in tea alone was estimated to contribute 30% of daily salt intake. A pilot Pinch Salt intervention to reduce salt consumption of factory workers was undertaken in Ulaanbaatar (UB) city between 2012 and 2013, and was associated with a reduction of 2.8 g of salt intake. Ongoing food industry initiatives have led to significant reductions in salt levels in bread, and companies producing processed meat have indicated a willingness to reduce salt. Relevant stakeholders have also supported the campaign by participating in annual World Salt Awareness Week events. The activities to date have demonstrated the potential for action and there is now a need scale these up to a national level to ensure that Mongolia is in a strong

  6. Ageing, dementia and society - an epistemological perspective.

    PubMed

    Heese, Klaus

    2015-01-01

    Recent data show that as populations age, the number of people affected by neurodegenerative dementia is growing at an epidemic pace in various regions of the world. This cross-cultural study examined the relationships among age, gender, ethnicity, religion, and education as well as the attitudes and perceptions related to ageing and dementia. A random sample of 980 participants was selected to represent the multicultural population of Singapore. Data were collected using standardised questionnaires through online portals and by conducting interviews. These data were ultimately analysed by comparing percentage responses and correlation coefficients and by conducting a multiple regression analysis. The results indicate that the perceptions and attitudes of individuals toward ageing and dementia differ among different age groups. Moreover, the level of education attained was significantly correlated with understanding dementia; regardless of education level, Christians had the most positive mindset toward dementia, although most religious individuals did not believe in divine healing. In this study, it was determined that attitudes and perceptions about ageing and dementia are influenced by multiple factors, such as education, age, and religion, and that it is imperative that younger generations develop coping strategies, including healthy lifestyles and social and/or religious communities to provide quality care to the elderly, in general, and to dementia patients, in particular. PMID:26069868

  7. National Space Weather Program Releases Strategy for the New Decade

    NASA Astrophysics Data System (ADS)

    Williamson, Samuel P.; Babcock, Michael R.; Bonadonna, Michael F.

    2010-12-01

    The National Space Weather Program (NSWP; http://www.nswp.gov) is a U.S. federal government interagency program established by the Office of the Federal Coordinator for Meteorology (OFCM) in 1995 to coordinate, collaborate, and leverage capabilities across stakeholder agencies, including space weather researchers, service providers, users, policy makers, and funding agencies, to improve the performance of the space weather enterprise for the United States and its international partners. Two important documents released in recent months have established a framework and the vision, goals, and strategy to move the enterprise forward in the next decade. The U.S. federal agency members of the NSWP include the departments of Commerce, Defense, Energy, Interior, State, and Transportation, plus NASA, the National Science Foundation, and observers from the White House Office of Science and Technology Policy (OSTP) and the Office of Management and Budget (OMB). The OFCM is also working with the Department of Homeland Security's Federal Emergency Management Agency to formally join the program.

  8. 77 FR 76034 - National Water Program 2012 Strategy: Response to Climate Change

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... AGENCY National Water Program 2012 Strategy: Response to Climate Change AGENCY: Environmental Protection... publishing the final ``National Water Program 2012 Strategy: Response to Climate Change'' (2012 Strategy... light of climate change and charts key strategic actions to be taken to achieve the goals in 2012...

  9. How a Dead Butler Was Killed: The Way English National Strategies Maim Grammatical Parts

    ERIC Educational Resources Information Center

    Cajkler, Wasyl

    2004-01-01

    This article analyzes the way English grammar is described in documents issued between 1998 and 2002 in England for the National Literacy Strategy (NLS) and for the lower secondary Key Stage 3 (KS3) National Strategy. The analysis reveals that the NLS and KS3 Strategy do not consistently follow a recognised approach to grammatical description, and…

  10. 75 FR 31818 - National Science Board; Committee on Strategy and Budget; Sunshine Act Meetings; Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... National Science Board; Committee on Strategy and Budget; Sunshine Act Meetings; Notice The National Science Board's Committee on Strategy and Budget, pursuant to NSF regulations (45 CFR part 614), the... the National Science Board Web site ( http://www.nsf.gov/nsb ) for information or schedule updates,...

  11. The burden of dementia.

    PubMed

    Cotter, Valerie T

    2007-12-01

    Dementia care is a significant and growing healthcare need that will have major economic and medical impact as the prevalence of Alzheimer's disease (AD) and related dementias continues to increase in the United States during the next 50 years. The ability to differentiate the signs and symptoms of the most common dementing illnesses - AD, vascular dementia, frontotemporal dementia, and dementia with Lewy bodies - is essential to dementia care and management. Additionally, dementia patients in longterm care (LTC) facilities are prone to significantly greater risk of negative outcomes compared with nondemented residents as a result of a decline in activities of daily living, physical capacities, and behavioral manifestations. Careful and active assessment of risk factors and their management provides opportunities for improving outcomes. These include behavioral manifestations of pain, wandering, and risks of malnutrition, falls and injuries, and restraint use. Specific nonpharmacologic interventions to promote restraint- and pain-free care in LTC are highlighted. PMID:18095782

  12. Dementia beyond 2025: Knowledge and uncertainties.

    PubMed

    Kenigsberg, Paul-Ariel; Aquino, Jean-Pierre; Bérard, Alain; Gzil, Fabrice; Andrieu, Sandrine; Banerjee, Sube; Brémond, François; Buée, Luc; Cohen-Mansfield, Jiska; Mangialasche, Francesca; Platel, Hervé; Salmon, Eric; Robert, Philippe

    2016-01-01

    Given that there may well be no significant advances in drug development before 2025, prevention of dementia-Alzheimer's disease through the management of vascular and lifestyle-related risk factors may be a more realistic goal than treatment. Level of education and cognitive reserve assessment in neuropsychological testing deserve attention, as well as cultural, social, and economic aspects of caregiving. Assistive technologies for dementia care remain complex. Serious games are emerging as virtual educational and pleasurable tools, designed for individual and cooperative skill building. Public policies are likely to pursue improving awareness and understanding of dementia; providing good quality early diagnosis and intervention for all; improving quality of care from diagnosis to the end of life, using clinical and economic end points; delivering dementia strategies quicker, with an impact on more people. Dementia should remain presented as a stand-alone concept, distinct from frailty or loss of autonomy. The basic science of sensory impairment and social engagement in people with dementia needs to be developed. E-learning and serious games programs may enhance public and professional education. Faced with funding shortage, new professional dynamics and economic models may emerge through coordinated, flexible research networks. Psychosocial research could be viewed as an investment in quality of care, rather than an academic achievement in a few centers of excellence. This would help provide a competitive advantage to the best operators. Stemming from care needs, a logical, systems approach to dementia care environment through organizational, architectural, and psychosocial interventions may be developed, to help reduce symptoms in people with dementia and enhance quality of life. Dementia-friendly environments, culture, and domesticity are key factors for such interventions. PMID:25740575

  13. Prevalence and Incidence Rates of Dementia and Cognitive Impairment No Dementia in the Mexican Population

    PubMed Central

    Mejia-Arango, Silvia; Gutierrez, Luis Miguel

    2012-01-01

    Objective To estimate the prevalence and incidence of dementia and cognitive impairment without dementia (CIND) in the Mexican population. Methods The MHAS study is a prospective panel study of health and aging in Mexico with 7,000 elders that represent 8 million subjects nationally. Using measurements of cognition and activities of daily living of dementia cases and CIND were identified at baseline and follow up. Overall incidence rates and specific rates for sex, age and education were calculated. Results Prevalence was 6.1% and 28.7% for dementia and CIND, respectively. Incidence rates were 27.3 per 1,000 person-years for dementia and 223 per 1,000 persons-year for CIND. Rates of dementia and CIND increased with advancing age and decreased with higher educational level; sex had a differential effect depending on the age strata. Hypertension, diabetes and depression were risk factors for dementia but not for CIND. Discussion These data provide estimates of prevalence and incidence of dementia and cognitive impairment in the Mexican population for projection of future burden. PMID:21948770

  14. A national strategy for the export of US geothermal technology

    SciTech Connect

    Not Available

    1989-03-01

    This document presents a proposal for an explicit US strategy to focus this still diffuse interest into a coordinated effort by the public and private sectors to increase exports of US geothermal goods and services over the next five to ten years. This document summarizes the background and need for an explicit US strategy, the factors influencing the development of this strategy, strategy options, and a recommended strategy.

  15. Economic Impact of Dementia by Disease Severity: Exploring the Relationship between Stage of Dementia and Cost of Care in Taiwan

    PubMed Central

    Ku, Li-Jung Elizabeth; Pai, Ming-Chyi; Shih, Pei-Yu

    2016-01-01

    Objective Given the shortage of cost-of-illness studies in dementia outside of the Western population, the current study estimated the annual cost of dementia in Taiwan and assessed whether different categories of care costs vary by severity using multiple disease-severity measures. Methods This study included 231 dementia patient–caregiver dyads in a dementia clinic at a national university hospital in southern Taiwan. Three disease measures including cognitive, functional, and behavioral disturbances were obtained from patients based on medical history. A societal perspective was used to estimate the total costs of dementia according to three cost sub-categories. The association between dementia severity and cost of care was examined through bivariate and multivariate analyses. Results Total costs of care for moderate dementia patient were 1.4 times the costs for mild dementia and doubled from mild to severe dementia among our community-dwelling dementia sample. Multivariate analysis indicated that functional declines had a greater impact on all cost outcomes as compared to behavioral disturbance, which showed no impact on any costs. Informal care costs accounted for the greatest share in total cost of care for both mild (42%) and severe (43%) dementia patients. Conclusions Since the total costs of dementia increased with severity, providing care to delay disease progression, with a focus on maintaining patient physical function, may reduce the overall cost of dementia. The greater contribution of informal care to total costs as opposed to social care also suggests a need for more publicly-funded long-term care services to assist family caregivers of dementia patients in Taiwan. PMID:26859891

  16. National Energy Strategy: A compilation of public comments; Interim Report

    SciTech Connect

    Not Available

    1990-04-01

    This Report presents a compilation of what the American people themselves had to say about problems, prospects, and preferences in energy. The Report draws on the National Energy Strategy public hearing record and accompanying documents. In all, 379 witnesses appeared at the hearings to exchange views with the Secretary, Deputy Secretary, and Deputy Under Secretary of Energy, and Cabinet officers of other Federal agencies. Written submissions came from more than 1,000 individuals and organizations. Transcripts of the oral testimony and question-and-answer (Q-and-A) sessions, as well as prepared statements submitted for the record and all other written submissions, form the basis for this compilation. Citations of these sources in this document use a system of identifying symbols explained below and in the accompanying box. The Report is organized into four general subject areas concerning: (1) efficiency in energy use, (2) the various forms of energy supply, (3) energy and the environment, and (4) the underlying foundations of science, education, and technology transfer. Each of these, in turn, is subdivided into sections addressing specific topics --- such as (in the case of energy efficiency) energy use in the transportation, residential, commercial, and industrial sectors, respectively. 416 refs., 44 figs., 5 tabs.

  17. Music and dementia.

    PubMed

    Baird, Amee; Samson, Séverine

    2015-01-01

    There is an increasing incidence of dementia in our aging population, and consequently an urgent need to develop treatments and activities that may alleviate the symptoms of dementia. Accumulating evidence shows that persons with dementia enjoy music, and their ability to respond to music is potentially preserved even in the late or severe stages of dementia when verbal communication may have ceased. Media interest in this topic has contributed to the public perception that music abilities are an "island of preservation" in an otherwise cognitively impaired person with dementia. In this chapter, we review the current literature on music cognition in dementia and show that there has been very scarce rigorous scientific investigation of this issue, and that various types of music memory exist and are differentially impaired in the different types of dementia. Furthermore, we discuss the recent development of music activities as a nonpharmacological treatment for dementia and highlight the methodological limitations of the current literature on this topic. While it has been reported that music activities can improve behavior, (particularly agitation), mood, and cognition in persons with dementia, recent large-scale randomized control studies have questioned the specificity of the effect of music and found that it is no more beneficial than other pleasant activities. Nevertheless, music is unique in its powerful ability to elicit both memories and emotions. This can provide an important link to individual's past and a means of nonverbal communication with carers, which make it an ideal stimulus for persons with dementia. PMID:25725917

  18. Strategies for Overcoming Key Barriers to Development of a National Security Workforce

    SciTech Connect

    2008-06-30

    This report documents the strategies for overcoming identified key barriers to development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP) being performed under a Department of Energy (DOE) National Nuclear Security Administration (NNSA) grant. Many barriers currently exist that prevent the development of an adequate number of properly trained national security personnel. The identified strategies to address the barriers will focus on both short-term and long-term efforts, as well as strategies to capture legacy knowledge of retiring national security workforce personnel.

  19. Forecasting the Incidence of Dementia and Dementia-Related Outpatient Visits With Google Trends: Evidence From Taiwan

    PubMed Central

    2015-01-01

    Background Google Trends has demonstrated the capability to both monitor and predict epidemic outbreaks. The connection between Internet searches for dementia information and dementia incidence and dementia-related outpatient visits remains unknown. Objective This study aimed to determine whether Google Trends could provide insight into trends in dementia incidence and related outpatient visits in Taiwan. We investigated and validated the local search terms that would be the best predictors of new dementia cases and outpatient visits. We further evaluated the nowcasting (ie, forecasting the present) and forecasting effects of Google Trends search trends for new dementia cases and outpatient visits. The long-term goal is to develop a surveillance system to help early detection and interventions for dementia in Taiwan. Methods This study collected (1) dementia data from Taiwan’s National Health Insurance Research Database and (2) local Internet search data from Google Trends, both from January 2009 to December 2011. We investigated and validated search terms that would be the best predictors of new dementia cases and outpatient visits. We then evaluated both the nowcasting and the forecasting effects of Google Trends search trends through cross-correlation analysis of the dementia incidence and outpatient visit data with the Google Trends data. Results The search term “dementia + Alzheimer’s disease” demonstrated a 3-month lead effect for new dementia cases and a 6-month lead effect for outpatient visits (r=.503, P=.002; r=.431, P=.009, respectively). When gender was included in the analysis, the search term “dementia” showed 6-month predictive power for new female dementia cases (r=.520, P=.001), but only a nowcasting effect for male cases (r=.430, P=.009). The search term “neurology” demonstrated a 3-month leading effect for new dementia cases (r=.433, P=.008), for new male dementia cases (r=.434, P=.008), and for outpatient visits (r=.613, P<.001

  20. Projecting Burden of Dementia in Spain, 2010-2050: Impact of Modifying Risk Factors.

    PubMed

    Soto-Gordoa, Myriam; Arrospide, Arantzazu; Moreno-Izco, Fermín; Martínez-Lage, Pablo; Castilla, Iván; Mar, Javier

    2015-01-01

    Risk and protective factors such as obesity, hypercholesterolemia, physical activity, and hypertension can play a role in the development of dementia. Our objective was to measure the effect of modification of risk and protective factors on the prevalence and economic burden of dementia in the aging Spanish population during 2010-2050. A discrete event simulation model including risk and protective factors according to CAIDE (Cardiovascular Risk Factors, Aging and Incidence of Dementia) Risk Score was built to represent the natural history of dementia. Prevalence of dementia was calculated from 2010 to 2050 according to different scenarios of risk factor prevalence to assess the annual social and health care costs of dementia. The model also supplied hazard ratios for dementia. Aging will increase between 49% and 16% each decade in the number of subjects with dementia. The number of working-age individuals per person with dementia will decrease to a quarter by 2050. An intervention leading to a 20% change in risk and protective factors would reduce dementia by 9% , prevent over 100,000 cases, and save nearly 4,900 million euros in 2050. Switching individuals from a group with a specific risk factor to one without it nearly halved the risk of the development of dementia. Dementia prevalence will grow unmanageable if effective prevention strategies are not developed. Interventions aiming to reduce modifiable risk factor prevalence represent valid and effective alternatives to reduce dementia burden. However, further research is needed to identify causal relationships between dementia and risk factors. PMID:26402090

  1. [Carotid atherosclerosis and dementia].

    PubMed

    Harlé, Louise-Marine; Plichart, Matthieu

    2015-09-01

    Over the past decade a growing interest has been devoted to exploring the role of atherosclerosis in the development of dementia. Despite a well-known association between atherosclerosis risk factors in middle-life with later cognitive decline, the pathophysiological pathways underlying this association remain unclear. The current hypothesis is that neurodegenerative and vascular lesions coexist and have a synergistic role in the development of cognitive impairment and dementia. Carotid atherosclerosis (e.g. carotid plaques and intima-media thickness as measured by carotid ultrasonography) has been associated with cognitive decline and dementia and may help to better understand the complex interaction between the vascular and neurodegenerative processes. Furthermore, carotid atherosclerosis has been used in the recent field for dementia risk prediction. In this review, we discuss the physiopathological implications from the current available data on the relationship between carotid atherosclerosis and dementia as well as the interest of carotid biomarkers for individual dementia risk prediction. PMID:26395304

  2. Forget me not: dementia in prison.

    PubMed

    Maschi, Tina; Kwak, Jung; Ko, Eunjeong; Morrissey, Mary B

    2012-08-01

    The number of older adults with dementia in U.S. prisons is rapidly rising. Yet, the vast majority of this marginalized subgroup of the aging population is left neglected behind bars without access to adequate medical and mental health care services. We assert that proactive, interdisciplinary collaborative efforts to improve practice, policy, and research and to develop a high-quality evidence-based continuum of care for this aging population are urgently needed. The overarching goals of this paper are to raise awareness of the life and experiences of persons with dementia in prison and to stimulate discussion, research, and advocacy efforts for this forgotten subgroup of older Americans. We describe the growing number of older adults with dementia in U.S. prisons, high-risk factors for dementia present in the prison population, and the life and experience of persons with dementia in the culture and environment of prison that is primarily not designed for them. We review the current state of services and programs for dementia in prison. We conclude by proposing practice, policy, and research-related priority areas and strategies for interdisciplinary gerontological responses. PMID:22230493

  3. Vascular aspects of cognitive impairment and dementia

    PubMed Central

    Wiesmann, Maximilian; Kiliaan, Amanda J; Claassen, Jurgen AHR

    2013-01-01

    Hypertension and stroke are highly prevalent risk factors for cognitive impairment and dementia. Alzheimer's disease (AD) and vascular dementia (VaD) are the most common forms of dementia, and both conditions are preceded by a stage of cognitive impairment. Stroke is a major risk factor for the development of vascular cognitive impairment (VCI) and VaD; however, stroke may also predispose to AD. Hypertension is a major risk factor for stroke, thus linking hypertension to VCI and VaD, but hypertension is also an important risk factor for AD. Reducing these two major, but modifiable, risk factors—hypertension and stroke—could be a successful strategy for reducing the public health burden of cognitive impairment and dementia. Intake of long-chain omega-3 polyunsaturated fatty acids (LC-n3-FA) and the manipulation of factors involved in the renin–angiotensin system (e.g. angiotensin II or angiotensin-converting enzyme) have been shown to reduce the risk of developing hypertension and stroke, thereby reducing dementia risk. This paper will review the research conducted on the relationship between hypertension, stroke, and dementia and also on the impact of LC-n3-FA or antihypertensive treatments on risk factors for VCI, VaD, and AD. PMID:24022624

  4. Dementia Resulting From Traumatic Brain Injury

    PubMed Central

    Shively, Sharon; Scher, Ann I.; Perl, Daniel P.; Diaz-Arrastia, Ramon

    2013-01-01

    Traumatic brain injury (TBI) is among the earliest illnesses described in human history and remains a major source of morbidity and mortality in the modern era. It is estimated that 2% of the US population lives with long-term disabilities due to a prior TBI, and incidence and prevalence rates are even higher in developing countries. One of the most feared long-term consequences of TBIs is dementia, as multiple epidemiologic studies show that experiencing a TBI in early or midlife is associated with an increased risk of dementia in late life. The best data indicate that moderate and severe TBIs increase risk of dementia between 2-and 4-fold. It is less clear whether mild TBIs such as brief concussions result in increased dementia risk, in part because mild head injuries are often not well documented and retrospective studies have recall bias. However, it has been observed for many years that multiple mild TBIs as experienced by professional boxers are associated with a high risk of chronic traumatic encephalopathy (CTE), a type of dementia with distinctive clinical and pathologic features. The recent recognition that CTE is common in retired professional football and hockey players has rekindled interest in this condition, as has the recognition that military personnel also experience high rates of mild TBIs and may have a similar syndrome. It is presently unknown whether dementia in TBI survivors is pathophysiologically similar to Alzheimer disease, CTE, or some other entity. Such information is critical for developing preventive and treatment strategies for a common cause of acquired dementia. Herein, we will review the epidemiologic data linking TBI and dementia, existing clinical and pathologic data, and will identify areas where future research is needed. PMID:22776913

  5. Immunologically Mediated Dementias

    PubMed Central

    Rosenbloom, Michael H.; Smith, Sallie; Akdal, Gulden; Geschwind, Michael D.

    2009-01-01

    Although most dementias are due to neurodegenerative or vascular disease, it is important to diagnose immunologically mediated dementias quickly because they can be both rapidly progressive and readily treatable. They usually affect function of limbic and cortical structures, but subcortical involvement can also occur. Because of the variety of symptoms and the rapid course, these dementias present a particular challenge to the clinician and may require evaluation and intervention in the inpatient setting. Diagnostic workup typically reveals evidence of an autoimmune process and, in some cases, cancer. In contrast to the neurodegenerative processes, many of the immunologically mediated dementias respond to immunomodulatory therapy. PMID:19664365

  6. Sexual disinhibition and dementia.

    PubMed

    Cipriani, Gabriele; Ulivi, Martina; Danti, Sabrina; Lucetti, Claudio; Nuti, Angelo

    2016-03-01

    To describe inappropriate sexual behaviour (ISB) observed in patients with dementia, we conducted searches using the Cochrane Library, PubMed, and Web of Science to find relevant articles, chapters, and books published from 1950 to 2014. Search terms used included 'hypersexuality', 'inappropriate sexual behaviors', and 'dementia'. Publications found through this indexed search were reviewed for further relevant references. Sexuality is a human's need to express intimacy, but persons with dementia may not know how to appropriately meet their needs for closeness and intimacy due to their decline in cognition. Generally, the interaction among brain, physical, psychological, and environmental factors can create what we call ISB. The most likely change in the sexual behaviour of a person with dementia is indifference. However, ISB in dementia appear to be of two types--intimacy-seeking and disinhibited--that differ in their association with dementia type, dementia severity and, possibly, other concurrent behavioural disorder. Tensions develop from uncertainties regarding which, or when, behaviours are to be considered 'inappropriate' (i.e. improper) or abnormal. While most ISB occur in the moderate to severe stages of Alzheimer's dementia, they may also be seen in early stages of frontotemporal dementia because of the lack of insight and disinhibition. ISB are often better managed by non-pharmacological means, as patients may be less responsive to psychoactive therapies, but non-pharmacological interventions do not always stop the behaviour. PMID:26215977

  7. 78 FR 79071 - National Maritime Strategy Symposium: Cargo Opportunities and Sealift Capacity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... listen-only information January 10, 2014. distributed to registrants. National Maritime Strategy... additional information, insights and experience to assist in the development of a National Maritime Strategy..., 2000 (65 FR 19476, 04/11/2011) or at http://www.dot.gov/privacy.html . Authority: 5 U.S.C. 610;...

  8. U.S. ENVIRONMENTAL PROTECTION AGENCY'S NATIONAL STRATEGY FOR RADON REMEDIATION

    EPA Science Inventory

    The paper provides an historical summary of the evolution of the U.S. EPA's national strategy for indoor radon remediation, recent developments, and anticipated future directions. uring the past 10 years, EPA has pursued a national strategy to address radon remediation in buildin...

  9. Reviving the Dead Butler? Towards a Review of Aspects of National Literacy Strategy Grammar Advice

    ERIC Educational Resources Information Center

    Wales, Lynn

    2009-01-01

    In his 2004 article "How was a dead butler killed: The way English national strategies maim grammatical parts" published in "Language and Education" 18, no. 1, Wasyl Cajkler calls for a review of grammar advice to teachers in the UK National Literacy Strategy (NLS) materials. His evidence demonstrates clearly that NLS grammar advice is "a…

  10. Dance for Individuals With Dementia.

    PubMed

    Lapum, Jennifer L; Bar, Rachel J

    2016-03-01

    The movement and music associated with dance plays an important role in many individuals' lives and can become imprinted upon the body and mind. Dance is thus closely associated with memory because of these deep connections. Without conscious thought, dance has the potential to be initiated as individuals age. In the current article, the authors share narrative reflections about their experiences with, and the potential of, dance as an intervention for aging populations diagnosed with dementia-related diseases. They draw upon their experiences in working with the aging population and a dance program currently being developed by Canada's National Ballet School and Baycrest Health Sciences for individuals with dementia-related diseases in long-term care. The current article is structured as dialogue between the authors because it mimics dance as a dialogical encounter between movement and music, and/or between individuals. PMID:26935188

  11. Raising Standards in Reading and Writing: Insights from England's National Literacy Strategy.

    ERIC Educational Resources Information Center

    Shiel, Gerry

    2003-01-01

    Describes how the purpose of the National Literacy Strategy (NLS) is to provide "a steady and consistent strategy" for raising standards in literacy over a 5- to 10-year period. Discusses reading and writing in the Literacy Hour and evaluation of the strategy. Notes that the NLS in England has been successful to a point. (SG)

  12. [National health strategies in the world and its enlightenment to build healthy China].

    PubMed

    Shi, X M

    2016-08-01

    The national health strategy is a reflection of a country on overall value and development vision of national health, and conducting this strategy will enhance and promote national development and people's welfare. In the current situation of building Healthy China during the 13th Five-Year Plan, it is important to learn experiences in this area from developed countries. This article mainly presents detailed introduction of the formulation, the implementation and the characteristics of National Health Strategies from the United States, United Kingdom and Japan, and also presents suggestions for the construction of Healthy China. PMID:27539518

  13. Developing a National STEM Workforce Strategy: A Workshop Summary

    ERIC Educational Resources Information Center

    Alper, Joe

    2016-01-01

    The future competitiveness of the United States in an increasingly interconnected global economy depends on the nation fostering a workforce with strong capabilities and skills in science, technology, engineering, and mathematics (STEM). STEM knowledge and skills enable both individual opportunity and national competitiveness, and the nation needs…

  14. User Perceptions of a Dementia Risk Reduction Website and Its Promotion of Behavior Change

    PubMed Central

    2013-01-01

    Background Several modifiable health and lifestyle factors are consistently associated with dementia risk and it is estimated that significantly fewer people would develop dementia if the incidence of risk factors could be reduced. Despite this, Australians’ awareness of the health and lifestyle factors associated with dementia risk is low. Within a national community education campaign, Alzheimer’s Australia developed a dementia risk reduction website providing information about modifiable risk or protective factors for dementia. Objective This study aimed to assess the usefulness of the website content in improving knowledge and enabling adoption of recommended strategies, and to examine what additional resources consumers need. Methods Visitors to the website over a 3 month period were invited to complete an online survey, which asked them to rate their knowledge of dementia risk reduction before and after visiting the site, how important monitoring their health related behavior was to them before and after visiting the site, their current behavior related to health and lifestyle factors associated with dementia risk, their intentions to change behavior, and the usefulness of potential additional resources to help them do so. Results For this study, 123 Australian adults responded to the survey. 44.7% (55/122) were aged over 60 and 82.1% (98/119) were female. Respondents’ ratings and comments indicated they generally found the content interesting, informative, and helpful to them. Respondents’ ratings of their knowledge about the links between health and lifestyle factors and dementia risk significantly increased after visiting the website (P<.001). Their ratings of how important monitoring what they do in relation to their health and lifestyle factors were also significantly increased after visiting the website (P<.001). Average ratings for how well respondents felt they were doing at the time in relation to specific risk or protective factors were

  15. Dementia severity and the longitudinal costs of informal care in the Cache County Population

    PubMed Central

    Rattinger, Gail B.; Schwartz, Sarah; Mullins, C. Daniel; Corcoran, Chris; Zuckerman, Ilene H.; Sanders, Chelsea; Norton, Maria C.; Fauth, Elizabeth B.; Leoutsakos, Jeannie-Marie S.; Lyketsos, Constantine G.; Tschanz, JoAnn T.

    2015-01-01

    Background Dementia costs are critical for influencing healthcare policy, but limited longitudinal information exists. We examined longitudinal informal care costs of dementia in a population-based sample. Methods Data from the Cache County Study included dementia onset, duration and severity assessed by the Mini Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR) and Neuropsychiatric Inventory (NPI). Informal cost of daily care (COC) was estimated based on median Utah wages. Mixed models estimated the relationship between severity and longitudinal COC in separate models for MMSE and CDR. Results 287 subjects [53% female, mean (sd) age was 82.3(5.9) years] participated. Overall COC increased by 18%/year. COC was 6% lower per MMSE-point increase and compared with very mild dementia, COC increased over 2-fold for mild, 5-fold for moderate and 6-fold for severe dementia on the CDR. Conclusions Greater dementia severity predicted higher costs. Disease management strategies addressing dementia progression may curb costs. PMID:25614127

  16. Lewy body dementias.

    PubMed

    Walker, Zuzana; Possin, Katherine L; Boeve, Bradley F; Aarsland, Dag

    2015-10-24

    The broad importance of dementia is undisputed, with Alzheimer's disease justifiably getting the most attention. However, dementia with Lewy bodies and Parkinson's disease dementia, now called Lewy body dementias, are the second most common type of degenerative dementia in patients older than 65 years. Despite this, Lewy body dementias receive little attention and patients are often misdiagnosed, leading to less than ideal management. Over the past 10 years, considerable effort has gone into improving diagnostic accuracy by refining diagnostic criteria and using imaging and other biomarkers. Dementia with Lewy bodies and Parkinson's disease dementia share the same pathophysiology, and effective treatments will depend not only on successful treatment of symptoms but also on targeting the pathological mechanisms of disease, ideally before symptoms and clinical signs develop. We summarise the most pertinent progress from the past 10 years, outlining some of the challenges for the future, which will require refinement of diagnosis and clarification of the pathogenesis, leading to disease-modifying treatments. PMID:26595642

  17. Dealing with Dementia

    MedlinePlus

    ... an NIH-supported Alzheimer’s disease center at the University of Wisconsin. “Symptoms of dementia can include problems with memory, thinking, and language, along with impairments to social skills and some behavioral symptoms.” Several factors can raise your risk for developing dementia. These ...

  18. [Speech changes in dementia].

    PubMed

    Benke, T; Andree, B; Hittmair, M; Gerstenbrand, F

    1990-06-01

    This review analyzes the spectrum of language deficits commonly encountered in dementia. A specific communication profile is found in dementia of the "cortical" type, such as Alzheimer's disease. With advancing disease lexical, comprehension and pragmatic functions deteriorate, whereas syntax and phonology tend to be preserved. This pattern bears some resemblance to aphasia types like transcortical and Wernicke's aphasia, however, a much broader range of communicative functions is impaired in Alzheimer's disease than in aphasia. Differentiation of dementia and aphasia, especially in elderly patients requires careful neuropsychological assessment of language, memory and other psychological functions. "Subcortical" dementia commonly presents with dysarthria as the leading symptom and linguistic impairment is rarely of crucial importance until late stages. Thus, the interetiologic dissociation of language and speech impairment can be used for dementia differentiation. Aphasia batteries are not sufficient to comprehend the range of language deficits in demented patients. Testing the communication impairment in dementia requires specific tasks for spontaneous speech, naming, comprehension, reading, writing, repetition and motor speech functions. Tasks for verbal learning and metalinguistic abilities should also be performed. Language deficits are frequent initial symptoms of dementia, thus language assessment may be of diagnostic relevance. Many data support the concept that the communication deficit in dementia results from a particular impairment of semantic memory. PMID:1695887

  19. Poststroke dementia in the elderly.

    PubMed

    Mackowiak-Cordoliani, Marie-Anne; Bombois, Stéphanie; Memin, Armelle; Hénon, Hilde; Pasquier, Florence

    2005-01-01

    Risk of dementia increases after stroke, and poststroke dementia (PSD) is an important cause of disability in the elderly. The prevalence rates of PSD vary from 12.2% to 31.8% within 3 months to 1 year after stroke, depending on patient populations and the diagnostic criteria used in the numerous studies. Incidence rates of PSD increase with time after the stroke. Although vascular lesions and white matter changes can explain the cognitive disorders seen in stroke patients, an underlying neurodegenerative disorder may contribute to the development of PSD. Cognitive decline may pre-date the stroke and follow a progressive course after the stroke. The vascular and degenerative processes involved share common environmental and genetic risk factors. This review explains the mechanisms of dementia in stroke patients and identifies predictive factors for PSD. The following points are successively considered: (i) demographic characteristics of the patients, including age and level of education; (ii) prestroke cognitive decline; (iii) vascular risk factors, including diabetes mellitus and prior strokes; (iv) stroke characteristics, including severity and location of the vascular lesion; (v) co-morbid disorders; and (vi) abnormalities on brain imaging, including location, size and number of vascular lesions, white matter changes and cerebral atrophy. Older age, prestroke cognitive decline, stroke recurrence, hypoxic-ischaemic disorders, left-side infarcts, strategic infarcts and white matter lesions appear to be the main predictive factors of PSD. Prevention of stroke should reduce the morbidity and mortality associated with PSD. In addition, management of PSD with secondary prevention treatments could reduce occurrence of further strokes. Cholinesterase inhibitors may be beneficial not only in Alzheimer's disease associated with cerebrovascular lesions, but also for the treatment of cholinergic dysfunction arising from pure vascular dementia. Better knowledge of the risk

  20. Living With Semantic Dementia

    PubMed Central

    Sage, Karen; Wilkinson, Ray; Keady, John

    2014-01-01

    Semantic dementia is a variant of frontotemporal dementia and is a recently recognized diagnostic condition. There has been some research quantitatively examining care partner stress and burden in frontotemporal dementia. There are, however, few studies exploring the subjective experiences of family members caring for those with frontotemporal dementia. Increased knowledge of such experiences would allow service providers to tailor intervention, support, and information better. We used a case study design, with thematic narrative analysis applied to interview data, to describe the experiences of a wife and son caring for a husband/father with semantic dementia. Using this approach, we identified four themes: (a) living with routines, (b) policing and protecting, (c) making connections, and (d) being adaptive and flexible. Each of these themes were shared and extended, with the importance of routines in everyday life highlighted. The implications for policy, practice, and research are discussed. PMID:24532121

  1. What can imaging tell us about cognitive impairment and dementia?

    PubMed Central

    Narayanan, Leela; Murray, Alison Dorothy

    2016-01-01

    Dementia is a contemporary global health issue with far reaching consequences, not only for affected individuals and their families, but for national and global socio-economic conditions. The hallmark feature of dementia is that of irreversible cognitive decline, usually affecting memory, and impaired activities of daily living. Advances in healthcare worldwide have facilitated longer life spans, increasing the risks of developing cognitive decline and dementia in late life. Dementia remains a clinical diagnosis. The role of structural and molecular neuroimaging in patients with dementia is primarily supportive role rather than diagnostic, American and European guidelines recommending imaging to exclude treatable causes of dementia, such as tumor, hydrocephalus or intracranial haemorrhage, but also to distinguish between different dementia subtypes, the commonest of which is Alzheimer’s disease. However, this depends on the availability of these imaging techniques at individual centres. Advanced magnetic resonance imaging (MRI) techniques, such as functional connectivity MRI, diffusion tensor imaging and magnetic resonance spectroscopy, and molecular imaging techniques, such as 18F fluoro-deoxy glucose positron emission tomography (PET), amyloid PET, tau PET, are currently within the realm of dementia research but are available for clinical use. Increasingly the research focus is on earlier identification of at risk preclinical individuals, for example due to family history. Intervention at the preclinical stages before irreversible brain damage occurs is currently the best hope of reducing the impact of dementia. PMID:27029053

  2. What can imaging tell us about cognitive impairment and dementia?

    PubMed

    Narayanan, Leela; Murray, Alison Dorothy

    2016-03-28

    Dementia is a contemporary global health issue with far reaching consequences, not only for affected individuals and their families, but for national and global socio-economic conditions. The hallmark feature of dementia is that of irreversible cognitive decline, usually affecting memory, and impaired activities of daily living. Advances in healthcare worldwide have facilitated longer life spans, increasing the risks of developing cognitive decline and dementia in late life. Dementia remains a clinical diagnosis. The role of structural and molecular neuroimaging in patients with dementia is primarily supportive role rather than diagnostic, American and European guidelines recommending imaging to exclude treatable causes of dementia, such as tumor, hydrocephalus or intracranial haemorrhage, but also to distinguish between different dementia subtypes, the commonest of which is Alzheimer's disease. However, this depends on the availability of these imaging techniques at individual centres. Advanced magnetic resonance imaging (MRI) techniques, such as functional connectivity MRI, diffusion tensor imaging and magnetic resonance spectroscopy, and molecular imaging techniques, such as 18F fluoro-deoxy glucose positron emission tomography (PET), amyloid PET, tau PET, are currently within the realm of dementia research but are available for clinical use. Increasingly the research focus is on earlier identification of at risk preclinical individuals, for example due to family history. Intervention at the preclinical stages before irreversible brain damage occurs is currently the best hope of reducing the impact of dementia. PMID:27029053

  3. Strategies for Preventing Behavioral Incidents in the Nation's Secondary Schools.

    ERIC Educational Resources Information Center

    Purvis, Johnny; Leonard, Rex

    1985-01-01

    Discusses strategies that can be used to prevent the five most common behavioral problems in secondary schools: (1) failure to complete assigned work, (2) tardiness, (3) inattentiveness, (4) littering, and (5) failure to bring materials to class. (FL)

  4. Nationalism and Rights in the New Europe. Teaching Strategy.

    ERIC Educational Resources Information Center

    Chan, Adrian

    1992-01-01

    Presents a lesson plan designed to teach upper grade level secondary students about nationalism and civil rights in post-Cold War Europe. Examines the rise of nationalism and discrimination against ethnic minorities in eastern Europe since the end of Communist rule. Includes a map of Europe, suggested teaching procedures, and follow-up activities.…

  5. Depression, Dementia, and Social Supports.

    ERIC Educational Resources Information Center

    Esser, Sally R.; Vitaliano, Peter P.

    1988-01-01

    Reviews recent literature on the relationships among dementia, depression, and social support, emphasizing the diagnostic differentiation of dementia and depression, and the role of these three entities in elderly with cognitive impairment. Discusses dementia-like symptoms arising in depression and the coexistence of dementia and depression.…

  6. Dementia and amputation

    PubMed Central

    Schuch, Vera; Moysidis, Theodoros; Weiland, Dorothea; Santosa, Frans

    2012-01-01

    Objectives To our experience dementia seems to play an increasing role for major amputation in patients suffering from peripheral arterial disease (PAD). To confirm our impression, we analysed the rate of dementia associated with different surgical procedures using the information of the federal statistics in Germany. Patients and Methods Detailed lists of cases hospitalized with the principal diagnosis (PAD), abdominal aortic aneurysm (AAA), myocardial infarction (MI) and hip fracture (HF), and of the procedures minor or major amputation, endovascular aortic repair (EVAR), total endoprosthesis for hip replacement (THR) and coronary aortic bypass graft (CABG) in Germany in the years 2008 to 2010 were provided by the Federal Statistical Office. Results Dementia is documented as additional diagnosis in approximately one fourth of cases having the principal diagnosis HF, 5% to 6% of cases with the principal diagnosis MI and PAD, but only in approximately 2% of AAA cases. Dementia is documented as principal or additional diagnosis in one fourth of amputation procedures (major amputation approximately 18% and minor amputation approximately 8%), in approximately 5% THR, 2% of EVAR and only 0.3% of CABG. The rate of documentation of dementia is higher in patients treated by major amputation than in the hospitalized PAD population. Vice versa, the rate of documentation of dementia is lower in patients getting THR than in the hospitalized HF population. Conclusion The presented analysis supports the assumption that dementia plays a relevant role in older patients suffering from PAD receiving major amputation in Germany. PMID:24265873

  7. Prevention of Dementia: Focus on Lifestyle

    PubMed Central

    Polidori, Maria Cristina; Nelles, Gereon; Pientka, Ludger

    2010-01-01

    The objective of this paper is to summarize current knowledge on the possible advantages of lifestyle interventions, with particular attention to physical fitness, cognitive activity, leisure and social activity as well as nutrition. There is a large amount of published papers providing partial evidence and asserting the need for immediate, appropriate preventive lifestyle measures against dementia and AD development. Nevertheless, there are currently great difficulties in drafting effective guidelines in this field. This depends mainly upon lack of randomized controlled trials assessing benefits versus risks of particular lifestyle interventions strategies. However, due to the rapid increase of dementia burden, lifestyle factors and their amelioration should be already made part of decision making in light of their health-maintaining effects while awaiting for results of well-designed large prospective cohort studies in dementia. PMID:20721289

  8. Cannabinoids and Dementia: A Review of Clinical and Preclinical Data

    PubMed Central

    Walther, Sebastian; Halpern, Michael

    2010-01-01

    The endocannabinoid system has been shown to be associated with neurodegenerative diseases and dementia. We review the preclinical and clinical data on cannabinoids and four neurodegenerative diseases: Alzheimer’s disease (AD), Huntington’s disease (HD), Parkinson’s disease (PD) and vascular dementia (VD). Numerous studies have demonstrated an involvement of the cannabinoid system in neurotransmission, neuropathology and neurobiology of dementias. In addition, several candidate compounds have demonstrated efficacy in vitro. However, some of the substances produced inconclusive results in vivo. Therefore, only few trials have aimed to replicate the effects seen in animal studies in patients. Indeed, the literature on cannabinoid administration in patients is scarce. While preclinical findings suggest causal treatment strategies involving cannabinoids, clinical trials have only assessed the suitability of cannabinoid receptor agonists, antagonists and cannabidiol for the symptomatic treatment of dementia. Further research is needed, including in vivo models of dementia and human studies.

  9. Treatment of Frontotemporal Dementia

    PubMed Central

    Boxer, Adam L.

    2016-01-01

    Opinion statement Frontotemporal dementia (FTD) encompasses a spectrum of neurodegenerative diseases with heterogeneous clinical presentations and two predominant types of underlying neuropathology. FTD typically comprises three distinct clinical syndromes: behavioral variant frontotemporal dementia (bvFTD), semantic variant primary progressive aphasia (svPPA), and nonfluent variant primary progressive aphasia (nfvPPA). FTD also frequently overlaps both clinically and neuropathologically with three other neurodegenerative syndromes: corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), and amyotrophic lateral sclerosis (ALS). Each syndrome can be associated with one or more underlying neuropathological diagnoses and are referred to as frontotemporal lobar degeneration (FTLD). Although the various FTD syndromes can substantially differ in terms of clinical symptoms and underlying pathology, the symptoms can be broadly categorized into behavioral, cognitive and motor domains. Currently there are no Food and Drug Administration (FDA) approved therapies for the above syndromes except riluzole for ALS. FTD treatment strategies generally rely on off-label use of medications for symptomatic management, and most therapies lack quality evidence from randomized, placebo-controlled clinical trials. For behavioral symptoms, selective serotonin reuptake inhibitors may be effective, while case reports hint at possible efficacy with antipsychotics or antiepileptics, but use of these latter agents is limited due to concerns regarding side effects. There are no effective therapies for cognitive complaints in FTD, which frequently involve executive function, memory, and language. Motor difficulties associated with FTD may present with parkinsonian symptoms or motor neuron disease, for which riluzole is indicated as therapy. Compared to idiopathic Parkinson’s disease, FTD-related atypical parkinsonism is generally not responsive to dopamine replacement therapies, but a

  10. The Folkeskole Year 2000: A National Strategy for Enhanced Learning.

    ERIC Educational Resources Information Center

    Skovsgaard, Joern

    This paper describes the Danish program, Folkeskole year 2000, an educational change strategy that involves an agreement between the teachers' union, the Association of Municipalities, and the Ministry of Education to improve education. The Folkeskole stipulates that the municipal council has the overall responsibility for the municipal school…

  11. National Aeronautics and Space Administration Exploration Systems Interim Strategy

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Contents include the following: 1. The Exploration Systems Mission Directorate within NASA. Enabling the Vision for Space Exploration. The Role of the Directorate. 2. Strategic Context and Approach. Corporate Focus. Focused, Prioritized Requirements. Spiral Transformation. Management Rigor. 3. Achieving Directorate Objectives. Strategy to Task Process. Capability Development. Research and Technology Development. 4. Beyond the Horizon. Appendices.

  12. [Dementia: management and prevention].

    PubMed

    Daher, Oscar; Nguyen, Sylvain; Smith, Cindi; Büla, Christophe; Démonet, Jean-François

    2016-04-20

    Dementia represents a great challenge for health care providers. Detection of cognitive impairment is critical for early diagnosis of dementia. Early diagnosis allows to initiate individualized management that focuses on maintaining patient's autonomy and supporting their caregivers. Proposed multimodal interventions include physical activity, cognitive training, mediterranean diet, and management of cardiovascular risk factors. Before the initiation of pro-cognitive therapy, medication review is essential to evaluate current treament and determine specific therapeutic objectives, based on patient's overall health and preferences. Overall risk reduction for dementia revolves around similar measures that target physical activity, cognition, diet and management of cardiovascular risk factors. PMID:27276724

  13. Dementia with lewy bodies.

    PubMed

    Posner, H; Chin, S; Marder, K

    2001-10-17

    In this case study, we describe the symptoms, neuropsychological testing, and brain pathology of a man with dementia with Lewy bodies. Dementia with Lewy bodies might be the second most common form of degenerative dementia in the elderly. Progressive cognitive decline, well-formed visual hallucinations, and parkinsonism are core features of this disease. This case was marked by preserved verbal expression despite impairment in memory, visuospatial skills, and attention span. Development of visual symptoms and parkinsonism occurred very early in the course of the disease. PMID:14602963

  14. 77 FR 19661 - Draft National Water Program 2012 Strategy: Response to Climate Change

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... AGENCY Draft National Water Program 2012 Strategy: Response to Climate Change AGENCY: Environmental... of water resource management, including how to: address risks to drinking water, wastewater and storm water infrastructure; protect quality of surface water, ground water and drinking water;...

  15. Functionalizing Conflict: Jesse Jackson's Rhetorical Strategy at the 1984 Democratic National Convention.

    ERIC Educational Resources Information Center

    Di Mare, Lesley A.

    1987-01-01

    Examines Jesse Jackson's rhetorical strategy of functionalizing conflict among divisive Democrats during the 1984 national convention. Applies conflict theory to Jackson's convention address, which serves as the basis for this rhetorical analysis. (JD)

  16. Considering the senses in the diagnosis and management of dementia.

    PubMed

    Behrman, Sophie; Chouliaras, Leonidas; Ebmeier, Klaus P

    2014-04-01

    Associations between dementia and impairments in hearing, vision, olfaction and (to a lesser degree) taste have been identified. Hearing impairment has been shown to precede cognitive decline, but it is not clear if the hearing loss is an early marker of dementia or a modifiable risk factor. Olfactory impairment is seen in many neurodegenerative conditions, but it has been shown that those with dementia have particular difficulties with the recognition and identification of odours rather than the detection, suggesting a link to impairment of higher cognitive function. Olfactory impairment has been shown to be predictive of conversion from mild cognitive impairment to Alzheimer's disease with 85.2% sensitivity. As cognitive function deteriorates, the world is experienced at a sensory level, with reduced ability to integrate the sensory experiences to understand the context. Thus, people with dementia are very sensitive to sensory experiences and their environment needs to be managed carefully to make it understandable, comfortable, and (if possible) therapeutic. Light can be used to stabilise the circadian rhythm, which may be disturbed in dementia. Music therapy, aromatherapy, massage and multisensory stimulation are recommended by NICE for the management of behavioural and psychological symptoms of dementia (BPSD), although the mechanisms behind such interventions are poorly understood and evidence is limited. Sensory considerations are likely to play a greater role in dementia care in the future, with the development of purpose-built dementia care facilities and the focus on non-pharmacological management strategies for BPSD. PMID:24495787

  17. A national research & development strategy for biomass crop feedstocks

    SciTech Connect

    Wright, L.L.; Cushman, J.H.

    1997-07-01

    Planning was initiated in 1996 with the objective of reevaluating current biomass feedstock research and development strategies to: (1) assure that by 2005, one or more commercial lignocellulosic to ethanol projects will be able to acquire a dependable supply of biomass crop feedstocks; (2) assure that recently initiated demonstrations of crops to electricity will be successful and; (3) assure that the research base needed to support future biomass industry expansion is being developed. Multiple trends and analyses indicate that biomass energy research and development strategies must take into account the fact that competition for land will define the upper limits of available biomass energy crop supplies and will largely dictate the price of those supplies. Only crop production and utilization strategies which contribute profit to the farmer or landowner and to energy producers will be used commercially for biomass energy production. Strategies for developing biomass {open_quotes}energy{close_quotes} crop supplies must take into consideration all of the methods by which biomass crops will enter biomass energy markets. The lignocellulosic materials derived from crops can be available as primary residues or crop by-products; secondary residues or processing by-products; co-products (at both the crop production and processing stages); or, as dedicated energy crops. Basic research and development (R&D) leading to yield improvement continues to be recommended as a major long-term focus for dedicated energy crops. Many additional near term topics need attention, some of which are also applicable to by-products and co-products. Switchgrass R&D should be expanded and developed with greater collaboration of USDA and state extension groups. Woody crop research should continue with significant cost-share from industries developing the crops for other commercial products. Co-product options need more investigation.

  18. National Strategy for Violence Prevention in the Austrian Public School System: Development and Implementation

    ERIC Educational Resources Information Center

    Spiel, Christiane; Strohmeier, Dagmar

    2011-01-01

    As a result of a quick succession of several spectacular events in schools, and the ensuing public discussion on the high rates of bullying in Austria, a national strategy for violence prevention in schools and preschools has been developed. In formulating the strategy, a systematic procedure involving international experts and a number of local…

  19. Guidance for Year 6 Pupils. 2001 Revision. The National Literacy Strategy.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    England's National Literacy and Numeracy Strategies are designed to raise standards for all pupils. Though the skills they address are basic and need to be built up throughout the primary years, at the early stage of implementing the strategies, many older pupils will not have reached the standards expected of Year 6 pupils in future years. This…

  20. A Bridge to the Future. Australia's National Strategy for Vocational Education and Training 1998-2003.

    ERIC Educational Resources Information Center

    Australian National Training Authority, Brisbane.

    The National Strategy for Vocational Education and Training 1998-2003 expresses the collective commitment by Australian governments, in partnership with Australian industry, to vocational education and training. The strategy includes the following mission: to ensure that the skills of the Australian labor force are sufficient to support…

  1. 75 FR 41685 - Implementation of the National HIV/AIDS Strategy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-16

    ....) THE WHITE HOUSE, WASHINGTON, July 13, 2010 [FR Doc. 2010-17620 Filed 7-15-10; 11:15 am] Billing code... Memorandum of July 13, 2010--Implementation of the National HIV/AIDS Strategy #0; #0; #0; Presidential... HIV/AIDS Strategy Memorandum for the Heads of Executive Departments and Agencies As we approach...

  2. Interactive Whole Class Teaching in the National Literacy and Numeracy Strategies

    ERIC Educational Resources Information Center

    Smith, Fay; Hardman, Frank; Wall, Kate; Mroz, Maria

    2004-01-01

    The study set out to investigate the impact of the official endorsement of 'interactive whole class teaching' on the interaction and discourse styles of primary teachers while teaching the National Literacy and Numeracy Strategies. In both strategies, interactive whole class teaching is seen as an 'active teaching' model promoting high quality…

  3. A Strategy for Designing Instruction for Educational Television in Developing Nations.

    ERIC Educational Resources Information Center

    Awotua-Efebo, Ebi Bio

    1987-01-01

    Explains a strategy for the design and development of instructional programs for educational television in developing nations using a modified version of the Shannon-Weaver Communication Model. Highlights include design strategy, manner of presentation, and stages of program development. The importance of making materials realistic and culturally…

  4. Breaking the Cycle of Drug Abuse. 1993 Interim National Drug Control Strategy.

    ERIC Educational Resources Information Center

    Office of National Drug Control Policy, Washington, DC.

    This Interim Drug Strategy is intended to give a new sense of direction and to reinvigorate the nation's efforts against drug trafficking and abuse. The preface to the report lists eight new strategies that the Administration will implement: (1) make drug policy a cornerstone of domestic and social policy; (2) target pregnant women, children, and…

  5. A Career Practitioner's Response to the National Career Development Strategy Green Paper

    ERIC Educational Resources Information Center

    Athanasou, James A.

    2012-01-01

    The National Career Development Strategy Green Paper is a discussion paper issued by the Department of Employment, Education and Workplace Relations. It is aimed at the formulation of a coherent and structured career development strategy throughout Australia. The Green Paper seeks to lay the foundation for policy change through establishing the…

  6. Changing Practice: The National Literacy Strategy and the Politics of Literacy Policy

    ERIC Educational Resources Information Center

    Moss, Gemma

    2004-01-01

    Drawing on a recent ESRC-funded research project, this paper will explore some of the contradictory structural features of the National Literacy Strategy (NLS), which have helped shape its evolution over time, and reflect on some of the tension points which have arisen at different levels of implementation as the Strategy unfolds. In the process,…

  7. A Communications Strategy for the National Children's Study

    ERIC Educational Resources Information Center

    National Institutes of Health, 2005

    2005-01-01

    The National Children's Study is the largest long term study of children's health and development ever to be conducted in the United States, involving 100,000 children from before birth to age 21. The Study aims to better understand the link between the environments in which children are raised and their physical and mental health and development.…

  8. Clinical practice guidelines for dementia in Australia.

    PubMed

    Laver, Kate; Cumming, Robert G; Dyer, Suzanne M; Agar, Meera R; Anstey, Kaarin J; Beattie, Elizabeth; Brodaty, Henry; Broe, Tony; Clemson, Lindy; Crotty, Maria; Dietz, Margaret; Draper, Brian M; Flicker, Leon; Friel, Margeret; Heuzenroeder, Louise Mary; Koch, Susan; Kurrle, Susan; Nay, Rhonda; Pond, C Dimity; Thompson, Jane; Santalucia, Yvonne; Whitehead, Craig; Yates, Mark W

    2016-03-21

    About 9% of Australians aged 65 years and over have a diagnosis of dementia. Clinical practice guidelines aim to enhance research translation by synthesising recent evidence for health and aged care professionals. New clinical practice guidelines and principles of care for people with dementia detail the optimal diagnosis and management in community, residential and hospital settings. The guidelines have been approved by the National Health and Medical Research Council. The guidelines emphasise timely diagnosis; living well with dementia and delaying functional decline; managing symptoms through training staff in how to provide person-centred care and using non-pharmacological approaches in the first instance; and training and supporting families and carers to provide care. PMID:26985848

  9. Burden of Dementia

    MedlinePlus

    ... Us FAQs Stay Connected You are here Home Global Health and Aging The Burden of Dementia The ... this total in less developed countries ( Figure 9 ). Global efforts are underway to understand and find cures ...

  10. Dementia - home care

    MedlinePlus

    ... help improve communication skills and prevent wandering. Calming music may reduce wandering and restlessness, ease anxiety, and ... prevent falls Ways to improve bathroom safety The Alzheimer's Association's Safe Return Program requires people with dementia ...

  11. Preventing and diagnosing dementia.

    PubMed

    Keenan, Bernie; Jenkins, Catharine; Ginesi, Laura

    While dementia is an umbrella term for a range of degenerative brain disorders, many share similar presentations. Nurses are ideally placed to identify those at risk and empower them to access treatment and plan and prepare for their future needs--as such, they need up-to-date knowledge of the signs and symptoms of the different types of dementia to identify risk factors and make an informed diagnosis. This article, the third in a four-part series on dementia, examines the risk factors, signs, symptoms and diagnosis of dementia, as well as outlining lifestyle factors such as diet and exercise that may help to prevent the development of the condition. PMID:27544960

  12. Multi-Infarct Dementia

    MedlinePlus

    ... Funding Information Research Programs Training & Career Awards Enhancing Diversity Find People About NINDS NINDS Multi-Infarct Dementia ... News From NINDS | Find People | Training | Research | Enhancing Diversity Careers@NINDS | FOIA | Accessibility Policy | Contact Us | Privacy ...

  13. [Apathy and Dementia].

    PubMed

    Okada, Kazunori; Yamaguchi, Shuhei

    2016-07-01

    Apathy, which has been attracting attention since Marin's report in 1990, is ubiquitous among neuropsychiatric diseases. It has a major impact on the quality of life in both patients and their caregivers and impairs rehabilitation and outcome. Furthermore, apathy is important as a prodromal syndrome in the development of dementia in mild cognitive impairment (MCI). We reviewed the neurobiological basis, prevalence and assessment of potential benefits of non-pharmacologic and pharmacologic interventions for apathy in MCI and dementia. PMID:27395461

  14. Neuroimaging and dementia

    SciTech Connect

    Benson, D.F.

    1986-05-01

    The tremendous increase in dementia has created a need for improved diagnostic techniques, and each of the newly established brain imaging techniques has been applied to this problem. Several, particularly computerized tomography (CT), magnetic resonance imaging (MRI), and isotope emission tomography, have proved valuable. Each procedure has strengths--specific disorders that can be diagnosed--and weaknesses--types of dementia that cannot be demonstrated.

  15. Young onset dementia

    PubMed Central

    Sampson, E; Warren, J; Rossor, M

    2004-01-01

    Young onset dementia is a challenging clinical problem with potentially devastating medical and social consequences. The differential diagnosis is wide, and includes a number of rare sporadic and hereditary diseases. However, accurate diagnosis is often possible, and all patients should be thoroughly investigated to identify treatable processes. This review presents an approach to the diagnosis, investigation, and management of patients with young onset dementia, with particular reference to common and treatable causes. PMID:15016933

  16. [Post Stroke Dementia].

    PubMed

    Ihara, Masafumi

    2016-07-01

    Post-stroke dementia (PSD) is a clinical entity that encompasses all types of dementia following an index stroke. Current evidence suggests that 25-30% of ischemic stroke survivors develop immediate or delayed vascular cognitive impairment or vascular dementia. The type of stroke can be either ischemic, hemorrhagic or hypoperfusive. There are multiple risk factors for PSD including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischemic attack or recurrent stroke and depressive illness. Pre-stroke dementia refers to the occurrence of cognitive impairment before the index stroke, which may be caused by a vascular burden as well as insidious neurodegenerative changes. Neuroimaging determinants of dementia after stroke include silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Published clinical trials have not been promising and there is little information on whether PSD can be prevented using pharmacological agents. Control of vascular disease risk and prevention of recurrent strokes are key to reducing the burden of cognitive decline and post-stroke dementia. Modern imaging and analysis techniques will help to elucidate the mechanism of PSD and establish better treatment. PMID:27395459

  17. Autophagy in dementias.

    PubMed

    Kragh, Christine Lund; Ubhi, Kiren; Wyss-Coray, Tony; Wyss-Corey, Tony; Masliah, Eliezer

    2012-01-01

    Dementias are a varied group of disorders typically associated with memory loss, impaired judgment and/or language and by symptoms affecting other cognitive and social abilities to a degree that interferes with daily functioning. Alzheimer's disease (AD) is the most common cause of a progressive dementia, followed by dementia with Lewy bodies (DLB), frontotemporal dementia (FTD), (VaD) and HIV-associated neurocognitive disorders (HAND). The pathogenesis of this group of disorders has been linked to the abnormal accumulation of proteins in the brains of affected individuals, which in turn has been related to deficits in protein clearance. Autophagy is a key cellular protein clearance pathway with proteolytic cleavage and degradation via the ubiquitin-proteasome pathway representing another important clearance mechanism. Alterations in the levels of autophagy and the proteins associated with the autophagocytic pathway have been reported in various types of dementias. This review will examine recent literature across these disorders and highlight a common theme of altered autophagy across the spectrum of the dementias. PMID:22150925

  18. Early Dementia Screening.

    PubMed

    Panegyres, Peter K; Berry, Renee; Burchell, Jennifer

    2016-01-01

    As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of a dementing illness is determined as having, or not having, the hallmarks of a neurodegenerative condition. The concepts of mild cognitive impairment, or mild neurocognitive disorder, are useful in analyzing the patient in the prodromal phase of a dementing disease; however, the transformation to dementia may be as low as 10% per annum. The search for early dementia requires a comprehensive clinical evaluation, cognitive assessment, determination of functional status, corroborative history and imaging (including MRI, FDG-PET and maybe amyloid PET), cerebrospinal fluid (CSF) examination assaying Aβ1-42, T-τ and P-τ might also be helpful. Primary care physicians are fundamental in the screening process and are vital in initiating specialist investigation and treatment. Early dementia screening is especially important in an age where there is a search for disease modifying therapies, where there is mounting evidence that treatment, if given early, might influence the natural history-hence the need for cost-effective screening measures for early dementia. PMID:26838803

  19. Young onset dementia.

    PubMed

    Draper, B; Withall, A

    2016-07-01

    Young onset dementia (YOD), where symptoms of dementia have an onset before the age of 65, has become more prominent due to the population increase from the Baby Boomer generation. This clinical perspective examines key issues in the assessment, diagnosis and management of YOD. Challenges in the assessment and diagnosis of YOD are partly due to the diverse range of types of YOD, where degenerative dementias are less common and secondary dementias more common than in late onset dementia. Early symptoms are broad and include depression, behavioural change, neurological disorders, systemic disorders and mild cognitive impairment (MCI). Perceived diagnostic delay may result in frustration and distress in people with YOD and their families. Chronic depression and MCI are associated with longer time to diagnosis, and in these situations, clinicians need to establish appropriate review processes and communicate clearly. A diagnosis of YOD may have marked consequences for a younger person, including early retirement, financial impacts and the psychological challenge of coming to grips with cognitive decline. Partners, children and other supporters often have unmet needs, feel burdened by care and are at high risk of physical and emotional consequences. Concerns about the heritability of dementia may add to family distress. Recent community service developments in Australia for YOD are outlined and the challenges of residential care described. PMID:27405890

  20. Depression associated with dementia.

    PubMed

    Gutzmann, H; Qazi, A

    2015-06-01

    Depression and cognitive disorders, including dementia and mild cognitive impairment, are common disorders in old age. Depression is frequent in dementia, causing distress, reducing the quality of life, exacerbating cognitive and functional impairment and increasing caregiver stress. Even mild levels of depression can significantly add to the functional impairment of dementia patients and the severity of psychopathological and neurological impairments increases with increasing severity of depression. Depressive symptoms may be both a risk factor for, as well as a prodrome of dementia. Major depressive syndrome of Alzheimer's disease may be among the most common mood disorders of older adults. Treating depression is therefore a key clinical priority to improve the quality of life both of people with dementia as well as their carergivers. Nonpharmacological approaches and watchful waiting should be attempted first in patients who present with mild to moderate depression and dementia. In cases of severe depression or depression not able to be managed through nonpharmacological means, antidepressant therapy should be considered. PMID:25962363

  1. Early Dementia Screening

    PubMed Central

    Panegyres, Peter K.; Berry, Renee; Burchell, Jennifer

    2016-01-01

    As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of a dementing illness is determined as having, or not having, the hallmarks of a neurodegenerative condition. The concepts of mild cognitive impairment, or mild neurocognitive disorder, are useful in analyzing the patient in the prodromal phase of a dementing disease; however, the transformation to dementia may be as low as 10% per annum. The search for early dementia requires a comprehensive clinical evaluation, cognitive assessment, determination of functional status, corroborative history and imaging (including MRI, FDG-PET and maybe amyloid PET), cerebrospinal fluid (CSF) examination assaying Aβ1–42, T-τ and P-τ might also be helpful. Primary care physicians are fundamental in the screening process and are vital in initiating specialist investigation and treatment. Early dementia screening is especially important in an age where there is a search for disease modifying therapies, where there is mounting evidence that treatment, if given early, might influence the natural history—hence the need for cost-effective screening measures for early dementia. PMID:26838803

  2. Writing Organisation. Literacy Progress Unit (Adapted for Whole Class Use). Key Stage 3: National Strategy.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    Adapted for whole class use, this unit focuses on developing the writing skills pupils need if they are to progress from Level 3 to Level 4 of England's National Curriculum. It is meant to supplement, but not to replace, the English curriculum for Year 7 pupils. The unit builds on the successful approaches of the National Literacy Strategy in…

  3. Changing Classroom Practice through the English National Literacy Strategy: A Micro-Interactional Perspective

    ERIC Educational Resources Information Center

    Lefstein, Adam

    2008-01-01

    How and why is national policy translated into interactions between teachers and pupils? This article examines the enactment of the English National Literacy Strategy (NLS) in a case study of two literacy lessons, which are drawn from a yearlong ethnographic study of the NLS in one school. Although the teacher taught directly from and adhered…

  4. 76 FR 18552 - Seeking Public Comment on Two Draft Chapters of the National Health Security Strategy Biennial...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ...To help the Nation achieve national health security and to implement the first quadrennial National Health Security Strategy (NHSS) of the United States of America (2009) and build upon the NHSS Interim Implementation Guide for the National Health Security Strategy of the United States of America (2009) the U.S. Government has drafted a NHSS Biennial Implementation Plan (BIP). This document is......

  5. The National Drug Control Strategy: the first-line approach to decreasing violence in our communities.

    PubMed

    Garcia, F

    1995-01-01

    The National Drug Control Strategy is designed to address all aspects of drug abuse: drug use, drug trafficking, and drug-related crimes. The nine-pronged program encompasses efforts at the federal, state, and local levels, forming a partnership between government and the private and public sectors. The strategy includes prevention initiatives that reduce the demand for drugs; individualized treatment programs for high-risk groups; greater community policing efforts to reduce violent crimes by drug users and pushers; and education aimed at children and adults. It is a national strategy that strives to find solutions at the local level. PMID:7795031

  6. Risk of suicide in patients with dementia: a case study.

    PubMed

    Nicholson, Linda

    Evidence indicates that the risk of attempted suicide is a significant issue among people with dementia, however there is a lack of information to guide professional practice. This article uses a case study to reflect on the risk management strategies and ethics of suicide and assisted suicide in relation to a specific patient with dementia. It analyses recommendations aimed at improving the lived experience of people with dementia and those involved in their care, including providing patients with a formal diagnosis as early as possible. PMID:24219483

  7. Family physicians and dementia in Canada

    PubMed Central

    Pimlott, Nicholas J.G.; Persaud, Malini; Drummond, Neil; Cohen, Carole A.; Silvius, James L.; Seigel, Karen; Hollingworth, Gary R.; Dalziel, William B.

    2009-01-01

    ABSTRACT OBJECTIVE To assess Canadian family physicians’ awareness of, attitudes toward, and use of the 1999 Canadian Consensus Conference on Dementia (CCCD) clinical practice guidelines (CPGs); to explore the barriers and enablers to implementing dementia CPGs in clinical practice; and to identify more effective strategies for future dementia guideline development and dissemination. DESIGN Qualitative study using focus groups. SETTING Academic family practice clinics in Calgary, Alta, Ottawa, Ont, and Toronto, Ont. PARTICIPANTS Eighteen family physicians. METHODS Using a semistructured interview guide, we conducted 4 qualitative focus groups of 4 to 6 family physicians whose practices we had audited in a previous study. Transcripts were coded using an inductive data analytic strategy, and categories and themes were identified and described using the principles of thematic analysis. MAIN FINDINGS Four major themes emerged from the focus group discussions. Family physicians 1) were minimally aware of the existence and the detailed contents of the CCCD guidelines; 2) had strong views about the purposes of guidelines in general; 3) expressed strong concerns about the role of the pharmaceutical industry in the development of such guidelines; and 4) had many ideas to improve future dementia guidelines and CPGs in general. CONCLUSION Family physicians were minimally aware of the 1999 CCCD CPGs. They acknowledged, however, the potential of future CPGs to assist them in patient care and offered many strategies to improve the development and dissemination of future dementia guidelines. Future guidelines should more accurately reflect the day-to-day practice experiences and challenges of family physicians, and guideline developers should also be cognizant of family physicians’ perceptions that pharmaceutical companies’ funding of CPGs undermines the objectivity and credibility of those guidelines. PMID:19439707

  8. Evolving National Strategy Driving Nursing Informatics in New Zealand.

    PubMed

    Honey, Michelle; Westbrooke, Lucy

    2016-01-01

    An update to the New Zealand Health Strategy identifying direction and priorities for health services is underway. Three specific areas have implications for nursing informatics and link to education and practice: best use of technology and information, fostering and spreading innovation and quality improvements, and building leaders and capability for the future. An emphasis on prevention and wellness means nursing needs to focus on health promotion and the role of consumers is changing with access to their on-line information a major focus. As the modes of delivery for services such as telehealth and telenursing changes, nurses are increasingly working independently and utilizing information and communication technologies to collaborate with the health team. New Zealand, and other countries, need strong nursing leadership to sustain the nursing voice in policy and planning and ensure nurses develop the required informatics skills. PMID:27332187

  9. A National Strategy for Promoting Physical Activity in Oman

    PubMed Central

    Mabry, Ruth; Owen, Neville; Eakin, Elizabeth

    2014-01-01

    The increasing prevalence of chronic disease in Oman is a public health challenge. Available evidence in Oman on physical inactivity, the fourth leading risk factor for chronic disease, calls for urgent action to reduce physical inactivity as part of a key strategy to address chronic disease in Oman. The public health implications of this evidence for Oman are considered in light of recommendations outlined in the Toronto Charter for Physical Activity. The charter provides a systematic approach of physical activity and outlines an action plan that could be adapted to the Omani context. Urgent intersectoral action focusing on a shared goal and a more deliberate public health response addressing physical inactivity is required. Further research is needed on the determinants of physical inactivity and culturally appropriate interventions in order to guide future public health actions. PMID:24790738

  10. Prodromal dementia with Lewy bodies.

    PubMed

    Fujishiro, Hiroshige; Nakamura, Shinichiro; Sato, Kiyoshi; Iseki, Eizo

    2015-07-01

    Dementia with Lewy bodies (DLB) is the second most common neurodegenerative dementing disorder after Alzheimer's disease (AD), but there is limited information regarding the prodromal DLB state compared with that of AD. Parkinson's disease (PD) and DLB share common prodromal symptoms with Lewy body disease (LBD), allowing us to use a common strategy for identifying the individuals with an underlying pathophysiology of LBD. Dysautonomia, olfactory dysfunction, rapid eye movement sleep behavior disorder (RBD) and psychiatric symptoms antedate the onset of dementia by years or even decades in patients with DLB. Although RBD is the most potentially accurate prodromal predictor of DLB, disease progression before the onset of dementia could differ between the prodromal DLB state with and without RBD. Experts who specialize in idiopathic RBD and DLB might need communication in order to clarify the clinical relevance of RBD with the disease progression of DLB. The presence of prodromal LBD symptoms or findings of occipital hypoperfusion/hypometabolism helps us to predict the possible pathophysiological process of LBD in non-demented patients. This approach might provide the opportunity for additional neuroimaging, including cardiac (123) I-metaiodobenzylguanidine scintigraphy and dopamine transporter imaging. Although limited radiological findings in patients with prodromal DLB states have been reported, there is now a need for larger clinical multisite studies with pathological verification. The long prodromal phase of DLB provides a critical opportunity for potential intervention with disease-modifying therapy, but only if we are able to clearly identify the diversity in the clinical courses of DLB. In the present article, we reviewed the limited literature regarding the clinical profiles of prodromal DLB. PMID:25690399

  11. National Prehospital Evidence-Based Guidelines Strategy: A Summary for EMS Stakeholders.

    PubMed

    Martin-Gill, Christian; Gaither, Joshua B; Bigham, Blair L; Myers, J Brent; Kupas, Douglas F; Spaite, Daniel W

    2016-01-01

    Multiple national organizations have recommended and supported a national investment to increase the scientific evidence available to guide patient care delivered by Emergency Medical Services (EMS) and incorporate that evidence directly into EMS systems. Ongoing efforts seek to develop, implement, and evaluate prehospital evidence-based guidelines (EBGs) using the National Model Process created by a multidisciplinary panel of experts convened by the Federal Interagency Committee on EMS (FICEMS) and the National EMS Advisory Council (NEMSAC). Yet, these and other EBG efforts have occurred in relative isolation, with limited direct collaboration between national projects, and have experienced challenges in implementation of individual guidelines. There is a need to develop sustainable relationships among stakeholders that facilitate a common vision that facilitates EBG efforts. Herein, we summarize a National Strategy on EBGs developed by the National Association of EMS Physicians (NAEMSP) with involvement of 57 stakeholder organizations, and with the financial support of the National Highway Traffic Safety Administration (NHTSA) and the EMS for Children program. The Strategy proposes seven action items that support collaborative efforts in advancing prehospital EBGs. The first proposed action is creation of a Prehospital Guidelines Consortium (PGC) representing national medical and EMS organizations that have an interest in prehospital EBGs and their benefits to patient outcomes. Other action items include promoting research that supports creation and evaluates the impact of EBGs, promoting the development of new EBGs through improved stakeholder collaboration, and improving education on evidence-based medicine for all prehospital providers. The Strategy intends to facilitate implementation of EBGs by improving guideline dissemination and incorporation into protocols, and seeks to establish standardized evaluation methods for prehospital EBGs. Finally, the Strategy

  12. Dementia due to metabolic causes

    MedlinePlus

    ... Alzheimer Disease, and Dementia . 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 14. Douglas VC, Josephson SA. Dementia ... Neurology and General Medicine . 5th ed. Philadelphia, PA: Elsevier; 2014:chap 61. Knopman DS. Alzheimer disease and ...

  13. Symptoms of Lewy Body Dementia

    MedlinePlus

    ... of the environment or personal interactions, and the natural progression of the disease. All Rights Reserved Lewy Body Dementia Association, Inc. 912 Killian Hill Road S.W., Lilburn, GA 30047 © 2016 Lewy Body Dementia Association, Inc. Connect ...

  14. Implementation of Strategies to Leverage Public and Private Resources for National Security Workforce Development

    SciTech Connect

    2009-04-01

    This report documents implementation strategies to leverage public and private resources for the development of an adequate national security workforce as part of the National Security Preparedness Project (NSPP), being performed under a U.S. Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. There are numerous efforts across the United States to develop a properly skilled and trained national security workforce. Some of these efforts are the result of the leveraging of public and private dollars. As budget dollars decrease and the demand for a properly skilled and trained national security workforce increases, it will become even more important to leverage every education and training dollar. This report details some of the efforts that have been implemented to leverage public and private resources, as well as implementation strategies to further leverage public and private resources.

  15. Increased Risk of Dementia in Patients With Erectile Dysfunction

    PubMed Central

    Yang, Chun-Ming; Shen, Yuan-Chi; Weng, Shih-Feng; Wang, Jhi-Joung; Tien, Kai-Jen

    2015-01-01

    Abstract Erectile dysfunction (ED) is a well-known predictor for future cardiovascular and cerebrovascular disease. However, the relationship between ED and dementia has rarely been examined. This study investigates the longitudinal risk for Alzheimer's disease and non-Alzheimer dementia in patients with ED. We collected a random sample of 1,000,000 individuals from Taiwan's National Health Insurance database. From this sample, we identified 4153 patients with newly diagnosed ED between 2000 and 2009 and compared them with a matched cohort of 20,765 patients without ED. All patients were tracked for 7 years from the index date to identify which of them subsequently developed dementia. During the 7-year follow-up period, the incidence rate of dementia in the ED cohort was 35.33 per 10,000 person-years. In the comparison groups, it was 21.67 per 10,000 person-years. After adjustment for patients characteristics and comorbidities, patients with ED were 1.68-times more likely to develop dementia than patients without ED (95% CI = 1.34–2.10, P < 0.0001). In addition, older patients and those with diabetes, hypertension, chronic kidney disease, stroke, depression, and anxiety were found to be at increased risk for dementia. Analyzing the data by dementia type, we found the hazard risk for Alzheimer's disease and non-Alzheimer dementia to be greater in patients with ED (adjusted HR 1.68, 95% CI = 1.31–2.16, P < 0.0001 and 1.63, 95% CI = 1.02–2.62, P = 0.0429, respectively). Log-rank test revealed that patients with ED had significantly higher cumulative incidence rates of dementia than those without (P < 0.0001). Patients with ED are at an increased risk for dementia later in life.

  16. Increased Risk of Dementia in Patients With Erectile Dysfunction

    PubMed Central

    Yang, Chun-Ming; Shen, Yuan-Chi; Weng, Shih-Feng; Wang, Jhi-Joung; Tien, Kai-Jen

    2015-01-01

    Abstract Erectile dysfunction (ED) is a well-known predictor for future cardiovascular and cerebrovascular disease. However, the relationship between ED and dementia has rarely been examined. This study investigates the longitudinal risk for Alzheimer's disease and non-Alzheimer dementia in patients with ED. We collected a random sample of 1,000,000 individuals from Taiwan's National Health Insurance database. From this sample, we identified 4153 patients with newly diagnosed ED between 2000 and 2009 and compared them with a matched cohort of 20,765 patients without ED. All patients were tracked for 7 years from the index date to identify which of them subsequently developed dementia. During the 7-year follow-up period, the incidence rate of dementia in the ED cohort was 35.33 per 10,000 person-years. In the comparison groups, it was 21.67 per 10,000 person-years. After adjustment for patients characteristics and comorbidities, patients with ED were 1.68-times more likely to develop dementia than patients without ED (95% CI = 1.34–2.10, P < 0.0001). In addition, older patients and those with diabetes, hypertension, chronic kidney disease, stroke, depression, and anxiety were found to be at increased risk for dementia. Analyzing the data by dementia type, we found the hazard risk for Alzheimer's disease and non-Alzheimer dementia to be greater in patients with ED (adjusted HR 1.68, 95% CI = 1.31–2.16, P < 0.0001 and 1.63, 95% CI = 1.02–2.62, P = 0.0429, respectively). Log-rank test revealed that patients with ED had significantly higher cumulative incidence rates of dementia than those without (P < 0.0001). Patients with ED are at an increased risk for dementia later in life. PMID:26091478

  17. Frontotemporal Dementias: A Review

    PubMed Central

    Weder, Natalie D; Aziz, Rehan; Wilkins, Kirsten; Tampi, Rajesh R

    2007-01-01

    Dementia is a clinical state characterized by loss of function in multiple cognitive domains. It is a costly disease in terms of both personal suffering and economic loss. Frontotemporal dementia (FTD) is the term now preferred over Picks disease to describe the spectrum of non-Alzheimers dementias characterized by focal atrophy of the frontal and anterior temporal regions of the brain. The prevalence of FTD is considerable, though specific figures vary among different studies. It occurs usually in an age range of 35–75 and it is more common in individuals with a positive family history of dementia. The risk factors associated with this disorder include head injury and family history of FTD. Although there is some controversy regarding the further syndromatic subdivision of the different types of FTD, the three major clinical presentations of FTD include: 1) a frontal or behavioral variant (FvFTD), 2) a temporal, aphasic variant, also called Semantic dementia (SD), and 3) a progressive aphasia (PA). These different variants differ in their clinical presentation, cognitive deficits, and affected brain regions. Patients with FTD should have a neuropsychiatric assessment, neuropsychological testing and neuroimaging studies to confirm and clarify the diagnosis. Treatment for this entity consists of behavioral and pharmacological approaches. Medications such as serotonin reuptake inhibitors, antipsychotics, mood stabilizer and other novel treatments have been used in FTD with different rates of success. Further research should be directed at understanding and developing new diagnostic and therapeutic modalities to improve the patients' prognosis and quality of life. PMID:17565679

  18. The LANDFIRE Refresh strategy: updating the national dataset

    USGS Publications Warehouse

    Nelson, Kurtis J.; Connot, Joel A.; Peterson, Birgit; Martin, Charley

    2013-01-01

    The LANDFIRE Program provides comprehensive vegetation and fuel datasets for the entire United States. As with many large-scale ecological datasets, vegetation and landscape conditions must be updated periodically to account for disturbances, growth, and natural succession. The LANDFIRE Refresh effort was the first attempt to consistently update these products nationwide. It incorporated a combination of specific systematic improvements to the original LANDFIRE National data, remote sensing based disturbance detection methods, field collected disturbance information, vegetation growth and succession modeling, and vegetation transition processes. This resulted in the creation of two complete datasets for all 50 states: LANDFIRE Refresh 2001, which includes the systematic improvements, and LANDFIRE Refresh 2008, which includes the disturbance and succession updates to the vegetation and fuel data. The new datasets are comparable for studying landscape changes in vegetation type and structure over a decadal period, and provide the most recent characterization of fuel conditions across the country. The applicability of the new layers is discussed and the effects of using the new fuel datasets are demonstrated through a fire behavior modeling exercise using the 2011 Wallow Fire in eastern Arizona as an example.

  19. Engagement and disarmament: A US National Security Strategy for biological weapons of mass destruction. Strategy research project

    SciTech Connect

    Moilanen, J.H.; McIntyre, A.J.; Johnson, D.V.

    1995-04-18

    The specter of biological weapons -- one of the three weapons of mass destruction (WMD) -- is an unusual and extraordinary threat to the national security of the United States. Since the U.S. unilaterally renounced biological warfare in 1969, biotechnology advances, aggressive nation-states, and terrorism have complicated a precarious balance of world and regional stability. U.S. shortfalls in biological warfare preparedness during the Persian Gulf War may convince potential adversaries that the U.S. is incapable of protecting its vital interests from biological assault. This paper examines the menace of biological weapons and global challenges to nonproliferation and counterproliferation. Analysis concludes that the United States can dissuade, deter, and defend against biological warfare and terrorism with an integrated national security strategy for Biological Weapons Engagement and Disarmament.

  20. [Artistic creativity and dementia].

    PubMed

    Sellal, François; Musacchio, Mariano

    2008-03-01

    Artistic creativity can be defined as the ability to produce both innovative and esthetic works. Though most dementias result in a loss of instrumental functions and a deterioration in artistic production, for some established artists, dementia, most often Alzheimer's disease, changed their style and technique but preserved their creativity and prolific artistic drive. Moreover, in some cases, mainly frontotemporal dementia, Parkinson's disease, and very occasionally strokes, the disease may favour the emergence of de novo artistic talent. This phenomenon has been conceptualized as a paradoxical facilitation, a disinhibition of brain areas devoted to visuospatial processing, greater freedom in a patient who becomes less bound by social conventions, enhancement of motivation and pleasure, etc. These neurological cases provide an opportunity to shed some light on the roots of artistic creation. PMID:18364297

  1. Dementia in Down's syndrome.

    PubMed

    Ballard, Clive; Mobley, William; Hardy, John; Williams, Gareth; Corbett, Anne

    2016-05-01

    Down's syndrome is the most common genetic cause of learning difficulties, and individuals with this condition represent the largest group of people with dementia under the age of 50 years. Genetic drivers result in a high frequency of Alzheimer's pathology in these individuals, evident from neuroimaging, biomarker, and neuropathological findings, and a high incidence of cognitive decline and dementia. However, cognitive assessment is challenging, and diagnostic methods have not been fully validated for use in these patients; hence, early diagnosis remains difficult. Evidence regarding the benefits of cholinesterase inhibitors and other therapeutic options to treat or delay progressive cognitive decline or dementia is very scarce. Despite close similarities with late-onset Alzheimer's disease, individuals with Down's syndrome respond differently to treatment, and a targeted approach to drug development is thus necessary. Genetic and preclinical studies offer opportunities for treatment development, and potential therapies have been identified using these approaches. PMID:27302127

  2. Association Between Glaucoma and the Risk of Dementia

    PubMed Central

    Su, Cheng-Wen; Lin, Che-Chen; Kao, Chia-Hung; Chen, Hsin-Yi

    2016-01-01

    Abstract We investigated the association of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) with the risk of dementia by evaluating their clinical and epidemiological similarities by using a nationally representative sample in Taiwan. Data were collected from the National Health Insurance Research Database of Taiwan. In total, 6509 patients with glaucoma (3304 with POAG and 3205 with PACG) were enrolled, and a comparison cohort of 26,036 individuals without glaucoma was established after matching for age and sex. The cumulative incidence curve of overall dementia for each cohort was evaluated. The risk of dementia was analyzed using univariate and multivariate Cox proportional hazard models after adjustment for demographic characteristics and comorbidities. The patients with glaucoma exhibited a significantly higher risk of dementia than the individuals without glaucoma did (hazard ratio [HR] = 1.13, 95% confidence interval [CI] = 1.01–1.27). The patients with POAG exhibited a 1.21-fold increased risk of dementia compared with the individuals without glaucoma (HR = 1.21, 95% CI = 1.02–1.43). However, the patients with PACG were not significantly associated with an increased risk of dementia compared with the individuals without glaucoma (HR = 1.09, 95% CI = 0.95–1.26). Patients with POAG aged ≥65 years were significantly associated with an increased risk of dementia compared with the individuals without glaucoma (HR = 1.28, 95% CI = 1.07–1.54). Females with POAG exhibited a 1.34-fold increased risk of dementia compared with females without glaucoma (95% CI = 1.06–1.69). This study demonstrated that patients with POAG but not those with PACG were associated with an increased risk of dementia compared with the general population. PMID:26886642

  3. Cognitive-Behavioral Treatment for Anxiety in Patients With Dementia

    PubMed Central

    KRAUS, CYNTHIA A.; SEIGNOUREL, PAUL; BALASUBRAMANYAM, VALLI; SNOW, A. LYNN; WILSON, NANCY L.; KUNIK, MARK E.; SCHULZ, PAUL E.; STANLEY, MELINDA A.

    2008-01-01

    Anxiety is common in dementia and is associated with decreased independence and increased risk of nursing home placement. However, little is known about the treatment of anxiety in dementia. This article reports results from two patients who were treated with a modified version of cognitive-behavioral therapy for anxiety in dementia (CBT-AD). Modifications were made in the content, structure, and learning strategies of CBT to adapt skills to the cognitive limitations of these patients and include collaterals (i.e., family members, friends, or other caregivers) in the treatment process. The patients received education and awareness training and were taught the skills of diaphragmatic breathing, coping self-statements, exposure, and behavioral activation. The Clinical Dementia Rating (CDR) Scale was used to characterize dementia severity and determine eligibility for treatment (a CDR score of 0.5 to 2.0 was required for participation). Other measures included the Rating Anxiety in Dementia scale, the Neuropsychiatric Inventory Anxiety subscale, and the Mini International Neuropsychiatric Interview. Outcome data showed improvement in anxiety as measured by standardized rating scales. We conclude that CBT-AD is potentially useful in treating anxiety in dementia patients and that this technique merits further study. PMID:18520790

  4. 76 FR 50719 - Models for a Governance Structure for the National Strategy for Trusted Identities in Cyberspace...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-16

    ... National Institute of Standards and Technology Models for a Governance Structure for the National Strategy... extending the deadline for submitting comments regarding the governance structure for the National Strategy....gov . FOR FURTHER INFORMATION CONTACT: Ross J. Micheals via e-mail at ross.micheals@nist.gov...

  5. The Community College and the Human Resources Development Council: Toward a National Training Strategy for the United States.

    ERIC Educational Resources Information Center

    Eskow, Seymour

    The key to economic renewal in the United States is a national human resources development strategy in which community colleges assume the national training role. This national strategy must recognize changes in the American economy and workforce, such as a more educated labor force, the demographics of developing countries, the increased…

  6. Prevalence and Clinical Features of Dementia

    NASA Astrophysics Data System (ADS)

    Craig, David; Meiland, Franka; Passmore, Peter; Dröes, Rose-Marie

    Progressive intellectual deterioration is the hallmark of dementia. Decline is normally centred around memory failure initially but virtually all cognitive capabilities are susceptible. Rapid progress in the understanding of the underlying neurobiology is currently taking place. In most instances, prevention strategies remain unclear and treatment methods are based around social and personal support as pharmacological modalities produce only modest effects. Technological means of home assistance offer a potential route towards relief of suffering and minimisation of healthcare costs.

  7. Dementia and elder abuse.

    PubMed

    Hansberry, Maria R; Chen, Elaine; Gorbien, Martin J

    2005-05-01

    Dementia and elder abuse are relatively common and under-diagnosed geriatric syndromes. A unique relationship is observed when the two entities coexist. Special issues can confound the care of the dementia patient suspected of being abused. Impaired language or motor abilities to communicate abusive situations to a third party, lack of decisional capacity to address the abusive situation, disinhibited behavior that contributes to a cycle of violence, and coincident depression of the abused elder complicate the diagnosis and management of elder abuse. Education of the caregiver and attention to caregiver stress, including depression, may prevent onset and perpetuation of abuse. PMID:15804553

  8. [Psychosocial interventions in dementia].

    PubMed

    Kurz, A

    2013-01-01

    Psychosocial interventions improve cognitive abilities (cognitive stimulation, cognitive training), enhance emotional well-being (activity planning, reminiscence), reduce behavioral symptoms (aromatherapy, music therapy) and promote everyday functioning (occupational therapy). Through these effects they reinforce and augment pharmacological treatments for dementia. In addition, psychosocial interventions complement the treatment of patients by supporting family caregivers (educational groups, support programs). The potential of psychosocial interventions in dementia needs to be explored further in studies using improved methodology to determine effective components, clinical relevance and duration of effects, predictors of individual treatment response and health-economic implications. PMID:23306213

  9. Rapidly Progressive Dementia

    PubMed Central

    Geschwind, Michael D.; Shu, Huidy; Haman, Aissa; Sejvar, James J.; Miller, Bruce L.

    2009-01-01

    In contrast with more common dementing conditions that typically develop over years, rapidly progressive dementias can develop subacutely over months, weeks, or even days and be quickly fatal. Because many rapidly progressive dementias are treatable, it is paramount to evaluate and diagnose these patients quickly. This review summarizes recent advances in the understanding of the major categories of RPD and outlines efficient approaches to the diagnosis of the various neurodegenerative, toxic-metabolic, infectious, autoimmune, neoplastic, and other conditions that may progress rapidly. PMID:18668637

  10. Parkinson Disease and Dementia.

    PubMed

    Garcia-Ptacek, Sara; Kramberger, Milica G

    2016-09-01

    Dementia is a frequent complication of Parkinson disease (PD) with a yearly incidence of around 10% of patients with PD. Lewy body pathology is the most important factor in the development of Parkinson disease dementia (PDD) and there is evidence for a synergistic effect with β-amyloid. The clinical phenotype in PDD extends beyond the dysexecutive syndrome that is often present in early PD and encompasses deficits in recognition memory, attention, and visual perception. Sleep disturbances, hallucinations, neuroleptic sensitivity, and fluctuations are often present. This review provides an update on current knowledge of PDD including aspects of epidemiology, pathology, clinical presentation, management, and prognosis. PMID:27502301