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Sample records for national dementia strategy

  1. National Dementia Strategy: well intentioned — but how well founded and how well directed?

    PubMed Central

    Greaves, Ian; Jolley, David

    2010-01-01

    The National Dementia Strategy was published in February 2009. It was eagerly anticipated and has generated a good deal of sustained media interest, widened awareness, and heightened expectation of better help for people with dementia. The three ambitions of the strategy — to raise awareness, facilitate assessment, and improve services — are unquestionably correct; but the assumptions, emphases, and economic predictions are questionable. Encouraging reliance on referral to secondary care centres, and exaggerated claims for the effectiveness of interventions to achieve clinical improvement and cost savings, may lead to disappointment and frustration. The infrastructure of care and treatment of people throughout the course of dementia will be better informed and delivered by a collaborative model which respects the knowledge and commitment contained within families and primary care. Better services will require substantial redirection of resources. PMID:20202364

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

    PubMed

    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

    2010-03-01

    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.

  3. Organisational space for partnership and sustainability: lessons from the implementation of the National Dementia Strategy for England.

    PubMed

    Clarke, Charlotte Laura; Keyes, Sarah Elizabeth; Wilkinson, Heather; Alexjuk, Joanna; Wilcockson, Jane; Robinson, Louise; Corner, Lynne; Cattan, Mima

    2014-11-01

    National policy initiatives are faced with challenges in their partnership development and sustainability. The National Dementia Strategy for England recommended Dementia Adviser (DA) and Peer Support Network (PSN) services and 40 demonstration sites were established. In this paper, we report on the national evaluation of these demonstration sites, with specific reference to aspects of organisational development. The research used a mixed-methods design with three main strands: (i) activity and outcome monitoring; (ii) organisational surveys and collaborative discussion; (iii) in-depth case studies in eight of the 40 sites. This paper focuses primarily on three rounds of organisational surveys distributed to all 40 demonstration sites over a period of 21 months and interviews in the case studies. Data identify the significance of infrastructure within immediate services as well as the position of services within the external infrastructure of the wider health and social care landscape. Partnership - both internally and externally - was key to establishing and sustaining services that flourished. When working well, DAs and PSNs acted as a link between services and people with dementia at the same time as filling gaps in existing support, providing information, advice and interpersonal support that was tailored to individual needs and circumstances. In conclusion, to achieve the full potential and sustainability of services requires them to be in an organisational space that allows them to work in partnership and collaboration with other services, and that values their distinct knowledge of their communities.

  4. 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.

  5. Barriers and enablers of health promotion, prevention and early intervention in primary care: evidence to inform the Australian national dementia strategy.

    PubMed

    Travers, Catherine; Martin-Khan, Melinda; Lie, David

    2009-06-01

    A comprehensive literature review was undertaken to: (i) identify and summarise the research evidence regarding barriers and enablers of health promotion, prevention and early intervention (PPEI) in primary care to reduce the risk of chronic disease in the older population; and (ii) use this evidence to make recommendations to inform the Australian national dementia prevention strategy around the translation of evidence-based care into practice. PPEI activities in primary care have the potential to not only reduce the prevalence and impact of a number of chronic diseases, but may also prevent or slow the onset of dementia given the apparent overlap in risk factors. While sizeable gaps exist regarding the most effective ways to promote the adoption of these activities, limited evidence suggests that, to be effective, PPEI activities should be quick and easy to administer, have a sound rationale and be readily incorporated into existing work processes.

  6. Antipsychotic prescribing in care homes before and after launch of a national dementia strategy: an observational study in English institutions over a 4-year period

    PubMed Central

    Szczepura, Ala; Owen, David W; Palmer, Thomas; Muhammad, Tariq; Clark, Michael D

    2016-01-01

    Objectives To assess associations between the launch of the National Dementia Strategy (NDS) and antipsychotic prescribing in long-term residential care (LTC) in England. Setting and participants Retrospective analysis of prescribing patterns in 616 LTC institutions (31 619 residents) following launch of the NDS, using information from electronic medicines management system. Primary and secondary outcome measures Antipsychotic prescribing point prevalence (PP) for all residents in a cross section of LTC settings over a 4-year period following NDS launch. Secondary outcomes included dosages, length of treatment and use of recommended second-generation antipsychotics (SGAs) versus first-generation antipsychotics (FGAs). Associations between facility-level PP values and institutional characteristics, resident demographics were explored. Variations across geographical areas examined. Prescription net ingredient costs calculated. Results No statistically significant difference was observed in overall prescribing rates over the 4-year period (Kolmogorov-Smirnov (KS) test p=0.60), and there was no significant shift towards newer SGAs (KS test p=0.32). Dosages were above the maximum indicated in only 1.3% of cases, but duration of prescribing was excessive in 69.7% of cases. Care homes in the highest prescribing quintile were more likely to be located in a deprived area (rate ratio (Q5/Q1) RR=5.89, 95% CI 4.35 to 7.99), registered for dementia (RR=3.38, 95% CI 3.06 to 3.73) and those in the lowest quintile were more likely to be served by a single general practitioner (GP) practice (RR=0.48; 95% CI 0.37 to 0.63); p<0.001 all. A sixfold variation in PP levels was observed between geographical areas. The average annual expenditure on antipsychotics was £65.6 per person resident (2012 prices). Conclusions The NDS in England was not associated with reduced PP levels or the types of antipsychotic prescribing in care homes. Further research is needed to explore why. Clear

  7. 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.

  8. Dementia

    MedlinePlus

    ... aging. Many different diseases can cause dementia, including Alzheimer's disease and stroke. Drugs are available to treat some ... they may improve symptoms or slow down the disease. NIH: National Institute of Neurological Disorders and Stroke

  9. Between practice, policy and politics: Music therapy and the Dementia Strategy, 2009.

    PubMed

    Spiro, Neta; Farrant, Camilla L; Pavlicevic, Mercédès

    2017-04-01

    Does current music therapy practice address the goals encapsulated in the UK Department of Health document, Living well with dementia: a national dementia strategy (the Dementia Strategy) published in 2009? A survey elicited the views of clients, family members, music therapists, care home staff and care home managers, about this question by focusing on the relationship between music therapy and the 17 objectives outlined in the Dementia Strategy. The results showed that the objectives that are related to direct activity of the music therapists (such as care and understanding of the condition) were seen as most fulfilled by music therapy, while those regarding practicalities (such as living within the community) were seen as least fulfilled. Although the responses from the four groups of participants were similar, differences for some questions suggest that people's direct experience of music therapy influences their views. This study suggests that many aspects of the Dementia Strategy are already seen as being achieved. The findings suggest that developments of both music therapy practices and government strategies on dementia care may benefit from being mutually informed.

  10. 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

  11. Problem-Solving Strategies in Dementia Patient-Caregiver Dyads.

    ERIC Educational Resources Information Center

    Cavanaugh, John C.; And Others

    1989-01-01

    Examined applicability of scaffolding and zone of proximal development to the study of dementia. Compared caregiver-patient dyads (n=29) to normal elderly dyads (n=16) in terms of strategies used in completing the Block Design subtest of the Wechsler Adult Intelligence Scale-Revised. Results indicated that caregiver-patient dyads can be observed…

  12. 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.

  13. Dementia

    MedlinePlus

    ... skills) Dementia usually first appears as forgetfulness. Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems ...

  14. National Port Strategy Assessment

    EPA Pesticide Factsheets

    The assessment finds that air pollution at the Nation's ports can be significantly reduced by implementing currently available strategies and technologies to reduce emissions of harmful pollutants from diesel vehicles and engines.

  15. Dementia Management Strategies and Adjustment of Family Members of Older Patients.

    ERIC Educational Resources Information Center

    Hinrichsen, Gregory A.; Niederehe, George

    1994-01-01

    Examined how strategies to manage dementia problems in 152 older people were associated with adjustment of family members while providing assistance to relative. Identified three dementia management strategies (criticism, encouragement, and active management) that were associated with three indices of family members' emotional adjustment (burden,…

  16. 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.

  17. Younger adults with dementia: a strategy to promote awareness and transform perceptions.

    PubMed

    Chaston, Denise

    2010-01-01

    Within modern society, dementia is considered to be an older person's disease yet people younger than 65 years are also diagnosed with this condition. This article describes dementia in the younger person highlighting their experiences and those of their families, along with nurses' attitudes towards and perceptions of this client group. A strategy is proposed to positively influence and enhance the attitudes of health professionals ultimately enhancing the quality of life for younger people with dementia.

  18. Dementia

    MedlinePlus

    ... him or her.What should I do if hallucinations are a problem?If hallucinations are not making your loved one scared or ... to confront people who have dementia about their hallucinations. Arguing may just upset your loved one. However, ...

  19. The effectiveness of control strategies for dementia-driven wandering, preventing escape attempts: a case report.

    PubMed

    Padilla, Daniel Valle; González, María Teresa Daza; Agis, Inmaculada Fernández; Strizzi, Jenna; Rodríguez, Raquel Alarcón

    2013-03-01

    One of the most complicated aspects of caring for patients with dementia is dementia-driven wandering due to its adverse ramifications. We report a case of an 80-year-old man who had been previously diagnosed with dementia (with a score of 6 on the Reisberg Global Deterioration Scale - GDS). The patient went to an Adult Day Care Center on a daily basis where he demonstrated wandering behavior with a high rate of escape attempts (the number of times the Center's glass exit door was approached). The objective of this study is to present effective non-pharmacological intervention strategies for dementia-driven wandering; assessed strategies included: environmental (subjective barriers), cognitive/behavioral (cognitive training with differential reinforcement), and combined (subjective barriers + cognitive/behavioral). The results showed that all of these three strategies significantly decreased the number of escape attempts.

  20. Dementia

    MedlinePlus

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latinx AIDS ...

  1. Preserving personhood: The strategies of men negotiating the experience of dementia.

    PubMed

    Tolhurst, Edward; Weicht, Bernhard

    2017-01-01

    An understanding of dementia requires sensitivity to the complex breadth of factors that comprise the person's experiential and social context. This is necessary to ensure that academic and public perspectives on dementia are not subsumed under homogenising discourses that prioritise the neurodegenerative basis of the condition. Gender is one such factor of this 'social location' that must be acknowledged. Cultural standards of masculinity have particular impacts upon men with the condition, thus generating distinctive challenges. This article draws upon qualitative research that included joint interviews with 14 men with dementia and their carers. The analytical focus is on the perspectives of the men with dementia and the strategies with which they respond to the condition. These perspectives are organised via four themes: remaining unmoved, fighting back, emphasising social contributions, and redefining services. This enables exploration of how men adopt particular strategies to preserve their own personhood, which include equable resilience, but also more agential measures to counter the influence of the condition. It is concluded that an approach to dementia research that is more sensitive to masculine-gendered experience is required so that the experience of men with the condition can be conveyed more cogently.

  2. Coping strategies and caregiving outcomes among rural dementia caregivers.

    PubMed

    Sun, Fei; Kosberg, Jordan I; Kaufman, Allan V; Leeper, James D

    2010-08-01

    We studied the coping styles by which family caregivers living in rural areas of Alabama deal with the demands of caring for an older relative with dementia. Data were obtained from a sample of 141 caregivers through the random-digit dialing telephone survey. Two coping styles were identified: deliberate coping and avoidance coping. Deliberate coping was related to higher life satisfaction scores and, avoidance coping was related to lower life satisfaction scores and higher caregiver burden scores. Avoidance coping appeared to moderate the effects of caregiver health on caregiver burden. Social workers should pay greater attention to caregivers with dysfunctional coping styles.

  3. 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

  4. National Strategy for Aviation Security

    DTIC Science & Technology

    2007-03-26

    for Aviation Security (hereafter referred to as the Strategy") to protect the Nation and its interests from threats in the Air Domain. The Secretary of... Aviation security is best achieved by integrating public and private aviation security global activities into a coordinated effort to detect, deter...might occur. The Strategy aligns Federal government aviation security programs and initiatives into a comprehensive and cohesive national effort

  5. The Lay Public's Understanding and Perception of Dementia in a Developed Asian Nation

    PubMed Central

    Tan, Wai Jia; Hong, Song-Iee; Luo, Nan; Lo, Tong Jen; Yap, Philip

    2012-01-01

    Background Early detection of dementia aims to improve treatment outcomes. However, poor perception and understanding of dementia are significant barriers. We aim to investigate the public's perception of dementia and identify variables associated with the different profiles of public perception. Methods A custom-designed questionnaire was used to assess laypersons’ knowledge and perception of dementia during a health fair at a public hospital in Singapore, a developed Asian nation. Out of a sample of 370 subjects, 32 declined to participate (response rate = 91.4%). Latent class analysis (LCA) was used to identify meaningful subgroups of subjects from significant associations with multiple indicators of dementia awareness. Multinomial logistic regression was performed exploring variables associated with each of the subgroups derived from LCA. Results The majority of the study participants were female (66.9%), 65 years or older (71.1%), and ethnic Chinese (88.1%). LCA classified the study participants into 3 subgroups: Class 1 (good knowledge, good attitude), Class 2 (good knowledge, poor attitude), and Class 3 (poor knowledge, poor attitude), in proportions of 14.28, 63.83, and 21.88%, respectively. Compared to other classes, participants with good knowledge and good attitude towards dementia (Class 1) were more likely to know someone with dementia and understand the effects of the disease, be married, live in private housing, receive higher monthly income, and not profess belief in Buddhism, Taoism, or Hinduism. Conclusion Our results show that the public in Singapore may not be ready for screening initiatives and early dementia diagnosis. Education efforts should be targeted at lower socioeconomic groups, singles, and those of certain oriental religions. PMID:23139688

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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

  11. 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…

  12. 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…

  13. Reach the Person behind the Dementia - Physical Therapists' Reflections and Strategies when Composing Physical Training

    PubMed Central

    Nordin, Ellinor; Skelton, Dawn A.; Lundin-Olsson, Lillemor

    2016-01-01

    Dementia is a disease characterized by cognitive impairment and physical decline that worsens over time. Exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia, maximizing function and independence. The purpose of this study was to explore physical therapists’ (PTs) experiences and reflections on facilitating high-intensity functional exercise with older people living with dementia, in residential care home settings. The study used a qualitative design based on interviews, individually or in small groups, with seven PTs engaged as leaders in the training of older people with dementia. The interviews were analyzed with a modified Grounded Theory method with focus on constant comparisons. To increase trustworthiness the study used triangulation within investigators and member checking. The core category “Discover and act in the moment—learn over time” reflects how the PTs continuously developed their own learning in an iterative process. They built on previous knowledge to communicate with residents and staff and to tailor the high intensity training in relation to each individual at that time point. The category "Be on your toes" highlights how the PTs searched for sufficient information about each individual, before and during training, by eliciting the person's current status from staff and by interpreting the person's body language. The category "Build a bond with a palette of strategies" describes the importance of confirmation to build up trust and the use of group members and the room to create an interplay between exercise and social interaction. These findings highlight the continuous iterative process of building on existing knowledge, sharing and reflecting, being alert to any alterations needed for individuals that day, communication skills (both with residents and staff) and building a relationship and trust with residents in the effective delivery of high

  14. 2007 National Money Laundering Strategy

    DTIC Science & Technology

    2007-03-16

    National Money Laundering Strategy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER...based inter- agency cooperation. More than a dozen Federal agen- cies, bureaus, and offices participated in these projects , each with a unique...of bulk cash smuggling along the Northern border. The project will seek to identify the areas in this region where bulk cash smuggling is taking

  15. START (STrAtegies for RelaTives) coping strategy for family carers of adults with dementia: qualitative study of participants’ views about the intervention

    PubMed Central

    Sommerlad, Andrew; Manela, Monica; Cooper, Claudia; Rapaport, Penny; Livingston, Gill

    2014-01-01

    Objectives To analyse the experience of individual family carers of people with dementia who received a manual-based coping strategy programme (STrAtegies for RelaTives, START), demonstrated in a randomised-controlled trial to reduce affective symptoms. Design A qualitative study using self-completed questionnaires exploring the experience of the START intervention. Two researchers transcribed, coded and analysed completed questionnaires thematically. Setting Three mental health and one neurology dementia clinic in South East England. Participants Participants were primary family carers of a patient diagnosed with dementia who provided support at least weekly to their relative. We invited those in the treatment group remaining in the START study at 2 years postrandomisation (n=132) to participate. 75 people, comprising a maximum variation sample, responded. Primary and secondary outcome measures (1) Important aspects of the therapy. (2) Continued use of the intervention after the end of the therapy. (3) Unhelpful aspects of the therapy and suggestions for improvement. (4) Appropriate time for intervention delivery. Results Carers identified several different components as important: relaxation techniques, education about dementia, strategies to help manage the behaviour of the person with dementia, contact with the therapist and changing unhelpful thoughts. Two-thirds of the participants reported that they continue to use the intervention's techniques at 2-year follow up. Few participants suggested changes to the intervention content, but some wanted more sessions and others wanted the involvement of more family members. Most were happy with receiving the intervention shortly after diagnosis, although some relatives of people with moderate dementia thought it should have been delivered at an earlier stage. Conclusions Participants’ varied responses about which aspects of START were helpful suggest that a multicomponent intervention is suited to the differing

  16. 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

  17. [A new strategy for preventive and functional therapeutic methods for dementia--approach using natural products].

    PubMed

    Ohizumi, Yasushi

    2015-01-01

    Alzheimer's disease (AD) has become a serious social problem in Japan. However, effective preventive and fundamental therapeutic methods for AD have not yet been developed. Using a new strategy in the course of our survey of numerous natural resouces having neurotrophic activity, we isolated a variety of active constituents and proved their pharmacological properties. As a result, we successfully found nobiletin, a compound with anti-dementia activity that comes from citrus peels. Also, we have demonstrated that nobiletin ameliorates cognitive impairment in several dementia model animals such as chronically amyloid β(Aβ) infused rats, amyloid precursor protein transgenic (APPTg) mice, olfactory-bulbectomized (OBX) mice, N-methyl-D-aspartate (NMDA) receptor antagonist (MK-801)-treated mice, senescence-accelated mice and bilaterial common carotid arteries occlusion mice. In a APPTg mouse of AD, nobiletin greatly improved memory impairment, and this was accompanied by a marked decrease in Aβ deposition. Also, in OBX mice memory impairment was markedly recoverd by nobiletin, accompanied by improvement of a decrease indensity of cholinergic neurons. Interestingly, nobiletin improves age-related congnitive impairment and decreased hyperphosphorylation of tau as well as oxidative stress in senescence-accelerated mice. In cultured cells, nobiletin reversed the Aβ-induced inhibition of glutamate-induced increases in cAMP response element binding protein (CREB) phosphorylation and modulated gen expression of thioredoxin-interacting protein and NMDA resceptor subunits. These results suggest that nobiletin prevents memory impairment and exhibits a protecting action against neurodgeneration in AD model animals. Nobiletin and citrus peels thus have potential as functional foods for prevention of dementia.

  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. Cholinergic deficiency involved in vascular dementia: possible mechanism and strategy of treatment

    PubMed Central

    Wang, Juan; Zhang, Hai-yan; Tang, Xi-can

    2009-01-01

    Vascular dementia (VaD) is a progressive neurodegenerative disease with a high prevalence. Several studies have recently reported that VaD patients present cholinergic deficits in the brain and cerebrospinal fluid (CSF) that may be closely related to the pathophysiology of cognitive impairment. Moreover, cholinergic therapies have shown promising effects on cognitive improvement in VaD patients. The precise mechanisms of these cholinergic agents are currently not fully understood; however, accumulating evidence indicates that these drugs may act through the cholinergic anti-inflammatory pathway, in which the efferent vagus nerve signals suppress pro-inflammatory cytokine release and inhibit inflammation, although regulation of oxidative stress and energy metabolism, alleviation of apoptosis may also be involved. In this paper, we provide a brief overview of the cholinergic treatment strategy for VaD and its relevant mechanisms of anti-inflammation. PMID:19574993

  20. 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…

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

    PubMed

    Macaden, Leah

    2016-06-24

    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.

  2. 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…

  3. The Clinton National Security Strategy

    DTIC Science & Technology

    1998-01-01

    second, promoting prosperity, outlrnes enhancing competltlveness through deficit reduction, gaining access to foreign markets , fostering free trade...murky Does domestic investment outweigh free trade? Will North American prosper@ count more than Asian advances? Are any markets more important than...Integration of emerging nations into free market systems to reslstrng genital mutilation find a home as national Interests Again, the order of

  4. Linking Acquisition Decisionmaking With National Military Strategy

    DTIC Science & Technology

    1990-10-01

    ICopy .17 of 146 copie; !1 AD-A235 445 I IDA REPORT R-366 LINKING ACQUISITION DECISIONMAKING I WITH NATIONAL MILITARY STRATEGY David R. Graham...National Military Strategy C-MDA-903 89 C0003 TA-T-G6-678 6. AUTHOR(S) David R. Graham, Herschel E. Kanter, Martin J. Ralley, Barbara A. Blcksler...executing acquisition programs that are consistent with national military strategy and projected budgets. Next it reviews the long-standing concerns with

  5. 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 &…

  6. National Strategy, Future Threats and Defense Spending

    DTIC Science & Technology

    1992-06-05

    AD-A256 884 NATIONAL STRATEGY, FUTURE THREATS AND DEFENSE SPENDING A thesis presented to the Faculty of the U.S. Army Command and General Staff...Jun 92 4. TITLE AND SUBTITLE S. FUNDING NUMBERS National Strategy, Future Threats and Defense Spending 6. AUTHOR(S) MAJ Daniel M. Gerstein, USA 7...Future Threats, Defense Spending , 192 Regional Threats 16. PRICE COOE 17. SECURITY CLASSIFICATION 118. SECURITY CLASSIFICATION 19. SECURITY

  7. Improving the National Strategy Process

    DTIC Science & Technology

    2013-03-01

    International Development has suffered a 75% reduction in its staffing numbers since the 1970’ s .55 By involving Congress in the strategy approval...NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) Lieutenant Colonel Jeff Stewart United States Army 5d. PROJECT...NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Professor Leonard J. Fullenkamp

  8. Person-Centered Primary Care Strategies for Assessment of and Intervention for Aggressive Behaviors in Dementia.

    PubMed

    Desai, Anand; Wharton, Tracy; Struble, Laura; Blazek, Mary

    2017-02-01

    With an increase in the number of individuals affected by dementia, it is imperative for health care providers to be well versed in the most effective ways to manage neuropsychiatric symptoms, such as aggression. Aggression can be particularly hard to manage because it creates risk of harm for formal and informal caregivers, and options for medical intervention are complex and situation dependent. Although multiple guidelines for management of aggression in dementia are available in the literature, their scope is widespread and suggested treatments often vary, making decision making difficult to navigate for busy clinicians. Using a composite case as a model, the current article provides guidelines that take outpatient providers through the steps needed to provide effective treatment for aggression in individuals with dementia. Shifting the current focal point of health care for aggressive dementia patients toward a more person-centered approach will have a positive impact on patient care. [Journal of Gerontological Nursing, 43(2), 9-17.].

  9. 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.

  10. National Strategy to Combat Terrorist Travel

    DTIC Science & Technology

    2006-05-02

    Terrorist Travel Visa Waiver Program The Visa Waiver Program (VWP) generally enables citizens of 27 countries to travel to the United States for tourism or...NATIONAL STRATEGY TO COMBAT TERRORIST TRAVEL May 2, 2006 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the...Strategy to Combat Terorist Travel 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER

  11. Diabetes mellitus and dementia.

    PubMed

    Ninomiya, Toshiharu

    2014-01-01

    Growing epidemiologic evidence has suggested that people with diabetes mellitus are at an increased risk for the development of dementia. However, the results for the subtypes of dementia are inconsistent. This review examines the risk of dementia in people with diabetes mellitus, and discusses the possible mechanism underpinning this association. Diabetes mellitus is associated with a 1.5- to 2.5-fold greater risk of dementia among community-dwelling elderly people. Notably, diabetes mellitus is a significant risk factor for not only vascular dementia, but also Alzheimer's disease. The mechanisms underpinning the association are unclear, but it may be multifactorial in nature, involving factors such as cardiovascular risk factors, glucose toxicity, changes in insulin metabolism and inflammation. The optimal management of these risk factors in early life may be important to prevent late-life dementia. Furthermore, novel therapeutic strategies will be needed to prevent or reduce the development of dementia in people with diabetes mellitus.

  12. Teaching about National Conservation Strategy for Australia.

    ERIC Educational Resources Information Center

    Greenall, Annette

    1986-01-01

    This article describes the development and content of the National Conservation Strategy for Australia (NCSA). The Australian Department of Arts, Heritage, and Environment has produced a teacher's guide designed to help teachers bring the content of the NCSA to their classroom. A description of the guide and ordering information are provided. (JDH)

  13. Home-based music strategies with individuals who have dementia and their family caregivers.

    PubMed

    Hanser, Suzanne B; Butterfield-Whitcomb, Joan; Kawata, Mayu; Collins, Brett E

    2011-01-01

    The purpose of this exploratory study was to test a caregiver-administered music program with family members who have dementia. The music protocol was designed to reduce distress and enhance satisfaction with caregiving, while offering the person with dementia the potential to improve mood and psychological state. Fourteen elders with dementia and their family caregivers were recruited, and 8 completed the protocol. Both caregivers and care recipients improved self-reported relaxation, comfort, and happiness, when mean scores were compared between baseline and music conditions. Caregivers showed the most benefit. While drop-out was high (6 families dropped), and caregiving satisfaction failed to improve over time, caregivers expressed enjoyment in reminiscing and participating in musical activities with their loved ones. More direct intervention by a music therapist is recommended to improve impact.

  14. National policies and strategies for noncommunicable diseases.

    PubMed

    Mendis, Shanthi; Fuster, Valentin

    2009-11-01

    Good public policies are vital for protecting the health of populations. For the prevention and control of noncommunicable diseases (NCD), a single national policy is essential. Such a policy ensures clarity of vision and purpose, sets the platform for joint action to address risk factors and determinants that are shared by major NCDs, and provides coherence with other health and social policies. A national NCD policy also provides an overarching framework that enables governments to combine and balance synergistic public health strategies that target the whole population and those that target high-risk groups. Given that the adopted strategies are evidence-based and cost-effective, national NCD policy development can provide a strong basis for appropriate legislation and regulation in relation to tobacco control and promotion of healthy diet and physical activity. A national policy also serves as a vehicle to facilitate efficient and effective use of available public finances for NCD-related health care, while safeguarding equity. For the reasons alluded to above, a single national NCD policy is more appropriate than separate national polices for each individual NCD, particularly in low-income and middle-income countries that have a critical shortage of human and financial resources, including those necessary for policy development and implementation.

  15. Improving Dementia Long-Term Care: A Policy Blueprint.

    PubMed

    Shih, Regina A; Concannon, Thomas W; Liu, Jodi L; Friedman, Esther M

    2014-01-01

    In 2010, 15 percent of Americans older than age 70 had dementia, and the number of new dementia cases among those 65 and older is expected to double by the year 2050. As the baby boomer generation ages, many older adults will require dementia-related long-term services and supports (LTSS). This blueprint is the only national document to date that engages local, state, and national stakeholders to specifically focus on policy options at the intersection of dementia and LTSS. The authors undertook five major tasks that resulted in a prioritized list of policy options and research directions to help decisionmakers improve the dementia LTSS delivery system, workforce, and financing. These were to (1) identify weaknesses in the LTSS system that may be particularly severe for persons with dementia; (2) review national and state strategies addressing dementia or LTSS policy; (3) identify policy options from the perspective of a diverse group of stakeholders; (4) evaluate the policy options; and (5) prioritize policy options by impact and feasibility. Stakeholders identified 38 policy options. RAND researchers independently evaluated these options against prespecified criteria, settling on 25 priority options. These policy options can be summarized into five objectives for the dementia LTSS system: (1) increase public awareness of dementia to reduce stigma and promote earlier detection; (2) improve access to and use of LTSS; (3) promote high-quality, person- and caregiver-centered care; (4) provide better support for family caregivers of people with dementia; and (5) reduce the burden of dementia LTSS costs on individuals and families. This policy blueprint provides a foundation upon which to build consensus among a larger set of stakeholders to set priorities and the sequencing of policy recommendations.

  16. 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.

  17. The role of higher education in transforming the quality of dementia care: dementia studies at the University of Bradford.

    PubMed

    Downs, M; Capstick, A; Baldwin, P C; Surr, C; Bruce, E

    2009-04-01

    There is now widespread concern about the inadequate care and support provided to people with dementia from diagnosis to death. It is acknowledged that while there is a range of effective ways to care for and support people with dementia and their families from diagnosis to death, these have yet to become integral to practice. In England, for example, the National Dementia Strategy seeks to transform the quality of dementia care. One of the key components to transforming the quality of care is to ensure we have an informed and effective workforce. We argue here that in order to transform the quality of care we need to distinguish between the aims of training and education. Whilst there is a place for skills-based workplace training, Higher Education in dementia studies has a key role to play in the provision of specialist knowledge and skills in dementia care emphasizing as it does the development of critical thinking, reflection and action. In this paper we describe dementia studies at Bradford University available at both undergraduate and postgraduate levels. We outline their aims and learning outcomes, curricula, approach to teaching, learning and assessment. We describe the nature of students who study with us, noting their fit with the Higher Education Funding Council in England's agenda for widening participation in higher education. Higher Education in dementia studies has a unique role to play in equipping practitioners and professionals with the information, skills and attitudes to realize the potential for quality of life for people with dementia and their families.

  18. 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

  19. Antipsychotic Use In a Diverse Population with Dementia: A Retrospective Review of the National Alzheimer’s Coordinating Center (NACC) database

    PubMed Central

    Xiong, Glen L.; Filshtein, Teresa; Beckett, Laurel A.; Hinton, Ladson

    2015-01-01

    A cross-sectional analysis examined medication records to Alzheimer’s Disease Centers from 2008 to 2014, in the community dwelling patients with dementia in the National Alzheimer’s Coordinating Center Database. Hispanic participants had a 1.62-fold greater use of antipsychotic medications (95% CI 1.32–1.98), largely accounted for by a higher prevalence of neuropsychiatric symptoms and more severe dementia, compared to non-Hispanic Whites. Our results are consistent with reports of later transition to nursing home care among Hispanic participants. Further studies are needed to clarify ethnic differences on how families and physicians address dementia progression and neuropsychiatric symptoms in community dwelling patients with dementia. PMID:26488486

  20. 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

  1. “The Right Way at the Right Time”: Insights on the Uptake of Falls Prevention Strategies from People with Dementia and Their Caregivers

    PubMed Central

    Meyer, Claudia; Dow, Briony; Hill, Keith D.; Tinney, Jean; Hill, Sophie

    2016-01-01

    Strong evidence exists for effective falls prevention strategies for community-dwelling older people. Understanding the translation of these strategies into practice for people with dementia has had limited research focus. People with dementia desire to have their voice heard, to engage meaningfully in the health-care decision-making process, making it a priority for researchers and practitioners to better understand how to engage them in this process. This paper reports on the qualitative aspects of a series of studies, which aimed to identify the views of people with dementia and their caregivers regarding perceptions of falls prevention and the successes and challenges of adopting falls prevention strategies. Twenty five people with dementia and their caregivers were interviewed in their homes at baseline, and 24 caregivers and 16 people with dementia were interviewed at completion of a 6-month individualized falls prevention intervention. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Five themes were identified at baseline: perceptions of falls; caregivers navigating the new and the unpredictable; recognition of decline; health services – the need for an appropriate message; and negotiating respectful relationships. At 6 months, caregivers and people with dementia decided on “what we need to know” with firm views that the information regarding falls risk reduction needed to be in “the right way … at the right time.” Rather than caregivers and people with dementia being only recipients of knowledge, they felt they were “more than just empty vessels to be filled” drawing on a “variety of resources” within their circle of influence to be able to positively “adapt to change.” The voices of people with dementia and their caregivers add an important dimension to understanding the translation of falls prevention knowledge for this population. Insights from this study will enable community care health

  2. Social policy for people with dementia in England: promoting human rights?

    PubMed

    Boyle, Geraldine

    2010-09-01

    This paper discusses whether current UK social policy promotes the human rights of people with dementia living in England. The author focuses on the role of recent legal reforms and key developments in social care policy--notably the Mental Capacity Act 2005 and the 2009 National Dementia Strategy--in facilitating their human rights to liberty and self-determination, particularly a right to choose to live at home. The extent to which the National Dementia Strategy provides access to services and support which provide an alternative to institutional care is critiqued. Whilst recent legislative change has endorsed the rights of people with dementia to liberty and self-determination, it is suggested there is a lack of commitment in government policy more generally to providing access to social care to enable people with dementia to exercise these human rights.

  3. Toward a national semiconductor strategy, volume 1

    NASA Astrophysics Data System (ADS)

    1991-02-01

    Updated here are key market data showing trends in the U.S. semiconductor industry's world market position. New information is given on three emerging semiconductor-based technologies: broadband communications, advanced display systems, and intelligent vehicles and highways. These are examples of important, high-volume markets that will consume significant numbers of semiconductor components and that must be addressed in a national semiconductor strategy. New recommendations and a summary of all Committee recommendations to date are given as well as a summary of comments received at a public forum held in Silicon Valley in may 1990.

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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.

  9. 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…

  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. US national energy strategy: Progress and viewpoint

    SciTech Connect

    1992-01-01

    Interest in energy policy is not new. President Eisenhower grappled with oil policy. President Nixon pushed {open_quotes}energy independence.{close_quotes} President Carter attempted the formulation of a comprehensive policy. All failed in one way or another. Efforts to define comprehensive national policy continue. Two years ago President Bush directed the DOE to prepare a {open_quotes}National Energy Strategy.{close_quotes} An energy package was sent to Congress in 1991, but despite compromises among competing interests, the end result was that not enough votes could be garnered to pass the legislation. Another attempt is expected in 1992. A major problem with the previous bill was that in attempting to be {open_quotes}comprehensive,{close_quotes} too many controversial issues were wrapped into a single package. The next attempt is likely to be divided into several bills; some may pass, others may not. Topics that received the most attention in the 1991 session are expected to get equal scrutiny in 1992. These topics include: (1) Mandated automobile gasoline mileage standards-raised required corporate average fuel economy (CAFE) from 24 to 40 miles per gallon. (2) Oil exploration in Alaska`s Arctic National Wildlife Refuge. (3) Simplified licensing of nuclear power plants. (4) Increased competition in electrical power production. (5) Increase of conservation and renewables development funding beyond the Administration`s proposed level. Concern about the environment, adequate supply of electrical power, and production and conservation of petroleum is the driving force behind consideration of these topics and the major underlying influence shaping debate over energy policy.

  12. 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.

  13. Vascular Dementia

    MedlinePlus

    ... attack) may increase your risk of developing dementia. Atherosclerosis. This condition occurs when deposits of cholesterol and ... in your arteries and narrow your blood vessels. Atherosclerosis can increase your risk of vascular dementia — and ...

  14. 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.

  15. 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.

  16. 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,…

  17. 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…

  18. 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

  19. National Security Science and Technology Strategy

    DTIC Science & Technology

    1995-01-01

    Infectious Disease Threats (1994); Committee on National Security—Strategic Implementation Plan (March 1995), and Committee on International Science...country’s first comprehensive Presidential statement of national security science and technology priorities . It augments the President’s National Security...this theme is a priority on engagement with other nations . Rather than isolate a state as we did the Soviet Union, we now seek to integrate states

  20. Economic Sanctions Targeting Yugoslavia - An Effective National Security Strategy Component

    DTIC Science & Technology

    2006-05-31

    USAWC STRATEGY RESEARCH PROJECT Economic Sanctions Targeting Yugoslavia – An Effective National Security Strategy Component by COL Charles J. Kacsur...Jr. U.S. Army Dr. Clayton K. S. Chun Project Advisor The views expressed in this academic research paper are those of the author and do not...National Security Strategy Component 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Charles Kacsur; 5d. PROJECT

  1. 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…

  2. Estonian National Security Strategy: Current and Future Challenges

    DTIC Science & Technology

    2013-03-01

    2013 2 . REPORT TYPE STRATEGY RESEARCH PROJECT .33 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Estonian National Security Strategy...the existing Estonian Security Strategy and offers recommendations. 2 1. Estonian Security Environment: International Relations...Copenhagen School is understood in wider terms than the political-military and state-centered view of traditional security studies. 2 According to Buzan

  3. Strategy, National Interests, and Means to an End

    DTIC Science & Technology

    2007-10-01

    STRATEGY, NATIONAL INTERESTS, AND MEANS TO AN END Stephen D. Sklenka October 2007 This publication is a work of the U.S. Government as defined in...REPORT DATE OCT 2007 2. REPORT TYPE 3. DATES COVERED 00-00-2007 to 00-00-2007 4. TITLE AND SUBTITLE Strategy, National Interests, and Means to...Non- Resident Program. v ABSTRACT This paper focuses on the interrelationship among national interests, stated ends, means to achieve those ends, and

  4. 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.

  5. National Will: Achilles Heel in United States National Strategy

    DTIC Science & Technology

    1990-05-01

    turn off our Christmas tree lights. A nation’s psyche is like a child’s: without any successes it loses confidence to act forcefully. The United States...successes. In turn, this could reduce the endemic national self-criticism, which is so damaging to our national psyche . Finally, this might allow the people...ANALYTICAL STUDY SUBMITTED TO THE FACULTY IN FULFILLMENT OF TRE CURRICULUM REQUIREMENT Advisor: Lieutenant Colonel James S. O’Rourke, IV MAXWELL AIR FORCE BASE

  6. Geo-Strategic Context: South Asia, A National Security Strategy

    DTIC Science & Technology

    1998-02-27

    ARCHIVE COPY NATIONAL DEFENSE UNIVERSITY NATIONAL WAR COLLEGE GEO-STRATEGIC CONTEXT SOUTH ASIA, A NATIONAL SECURITY STRATEGY MS Youngeun ... Anderson and Captain D Craig Wellmg/Class of 1998 Course 5604 Seminar I FACULTY SEMINAR LEADER CAPT J Kelso 27 February 1998 78-E-54 c-. I Report

  7. National Institute on Drug Abuse symposium report: drugs of abuse, dopamine, and HIV-associated neurocognitive disorders/HIV-associated dementia.

    PubMed

    Purohit, Vishnudutt; Rapaka, Rao; Frankenheim, Jerry; Avila, Albert; Sorensen, Roger; Rutter, Joni

    2013-04-01

    The National Institute on Drug Abuse organized a symposium on drugs of abuse, dopamine, and HIV-associated neurocognitive disorders (HAND)/HIV-associated dementia (HAD) in Rockville, Maryland, October 4, 2011. The purpose of this symposium was to evaluate the potential role of dopamine in the potentiation of HAND/HAD by drugs of abuse. A summary of the symposium has been presented in this report.

  8. Dementia: getting the environment right.

    PubMed

    Yates-Bolton, Natalie; Codinhoto, Ricardo

    2013-03-01

    An IHEEM-supported conference staged recently at Salford University by the University's Dementia Design Group (HEJ - November 2012), examined the impact that different hospital environments have on people with dementia. Ricardo Codinhoto of the International Dementia Design Network, a qualified architect with practical, teaching, and research experience, and his co-chair on the Network, Natalie Yates-Bolton, a lecturer in Nursing at the University, explain the thinking behind the Group's approach to well-designed mental healthcare environments, and report on some of the key topics discussed at this first ever National Dementia Design Conference.

  9. National Security Strategy: What About the Environment

    DTIC Science & Technology

    2006-02-27

    and South Korea, to seabed mining and drilling rights in countries surrounding the Caspian Sea. According to Ambassador Jan Kubis , Secretary General of...national economy, distribute wealth, and provide basic goods and services. Kubis notes, “Such environmental pressures 8 could make social polarization...the U.S. interest (Washington, D.C.: Jewish Institute for National Security Affairs, 2001), x. 21 7 Ibid. 8 Jan Kubis , “Initiative For Change,” Our

  10. National Strategy for Modernizing the Regulatory System for Biotechnology Products

    EPA Pesticide Factsheets

    This National Strategy for Modernizing the Regulatory System for Biotechnology Products sets forth a vision for ensuring that the federal regulatory system is prepared to efficiently assess the risks, if any, of the future products of biotechnology.

  11. News Note: National Strategy for Multi-wavelength Astronomy

    NASA Astrophysics Data System (ADS)

    2016-06-01

    The Department of Science and Technology (DST) has released the National Strategy for Multiwavelength Astronomy, which is intended to allow South Africa to take full advantage of its geographical advantages, and to maximise the return on investment made in astronomy.

  12. 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…

  13. National Interest: From Abstraction to Strategy

    DTIC Science & Technology

    1994-05-20

    the national values are Christianity, Communism, Islam, or vegetarianism . Only one question matters: Is the statesman acting to preserve the state...enter the capitalistic world market economy . Funny how things work out. As noted above, the real problem is when reputedly I intelligent, well

  14. From National to Theater: Developing Strategy

    DTIC Science & Technology

    2013-01-01

    important to set priorities. Hans Morgenthau differentiated between vital national interests and secondary interests, which are more dif- ficult to...Hegemony on the Cheap,” World Policy Journal 20, no. 4 (Winter 2003/2004). 12 Hans J. Morgenthau , The Impasse of Ameri- can Foreign Policy (Chicago

  15. 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…

  16. 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...

  17. Achieving National Security Strategy: An Effective Process?

    DTIC Science & Technology

    2008-01-01

    Smith , a career foreign service officer and former Deputy Chief ofMission, the strength ofDOS is its ability to operate with minimal guidance.28 The...DOS’s five-year strategic plan may offer the minimal guidance Mr. Smith suggests. This five- year plan, which is provided by the Secretary of State...outlines the departments overall strategy, which ~ves the latitude required to achieve its mission goals. Mr. Smith also recognizes that, "Most State

  18. National Military Strategy: Determinant, Resultant, or Figment.

    DTIC Science & Technology

    1981-01-01

    A IWII _A 969",l with strategy issues for fear of the attendant impact on force structure and roles and miss ions of the Services. While the study...Secretary of Defense. Thus, any study which impacts on the concepts for force employmenc or on the proposed force structure which emrges from the PPBS...President. Four executive branch studies mrit mntion because of their comprehensive nature and Significant impact . 17 In 1950, President Truman instructed

  19. Dementia as a Disability and Human Rights Issue.

    PubMed

    Rushford, Nancy; Harvey, David

    In their article "Toward a Community-Based Dementia Care Strategy: How Do We Get There from Here?" Morton-Chang et al. draw attention to the urgent need for a community-based dementia care strategy in Canada. Drawing from national and international experience, including an illustrative case study of policy in Ontario, they identify three key strategic pillars to guide strategic action: 1. Engage persons living with dementia (PLWD) to any extent possible in decisions around their own care. 2. Acknowledge and support informal caregivers in their pivotal roles supporting PLWD and consequently the formal care. 3. Enable "ground-up" change through policies and funding mechanisms designed to ensure early intervention across a continuum of care. In this paper, we aim to broaden the lens for dementia and strategic action by framing dementia in terms of disability and human rights. We contend that a human rights approach is critical to addressing the vulnerability of people with dementia and caregivers and achieving the principal goals of dementia care, as they are largely represented in the strategic pillars proposed. These pillars direct action towards key areas of change within the existing health system but may not in and of themselves create the transformative change needed across systems and levels. Through the lens of disability and human rights, we reflect upon the complexity of dementia and move from the individual to the social sphere - shifting the focus from "care" that is oriented to "maintenance" in the community, towards "enablement," "empowerment" and social change, as it involves the reconceptualization of dementia that has begun to take shape at local, national and international levels. This brings us to the central argument of this paper, that dementia is as much a human rights issue and a social problem as it is a health issue, necessitating widespread social/systems change and strategic action that "challenges and changes the defining beliefs of a

  20. Malnutrition and dementia.

    PubMed

    Wilhelm, Karen

    2016-07-13

    What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice? The CPD article outlined the effects dementia may have on a person's ability to eat and drink safely. It discussed assessment tools to identify patients at risk of malnutrition and management strategies to help maintain nutritional intake.

  1. After Iraq: The Search for a Sustainable National Security Strategy

    DTIC Science & Technology

    2009-01-01

    or cunningly applied economic coercion may remove need for the spilling of blood . However, since national security strategy has the military...great issues between nations at war have always been decided—except in the rarest of cases—either by what your army can do against your enemy’s

  2. The National Literacy Strategy: A Critical Review of Empirical Evidence

    ERIC Educational Resources Information Center

    Wyse, Dominic

    2003-01-01

    This article examines three areas that are of central importance to the pedagogy of the National Literacy Strategy Framework for Teaching (FFT) at primary level: inspection evidence; school effectiveness (SE) research; and child development evidence. Analysis of national inspection reports on the teaching of English illustrates that these cannot…

  3. How Nation-States Craft National Security Strategy Documents

    DTIC Science & Technology

    2012-10-01

    Africa, Sir David Omand in the United Kingdom, and in the United States, former National Security Advisor Steve Hadley provided time that he did not have...officials, Major General John Cantwell and Ms. Maria Fernandez, individually responsible for force structure, information technol- ogy, and human...about the need for an NSS.179 Speaking at the annual DEMOS security lec- ture in December 2006, Sir David Omand, former UK Security and Intelligence

  4. A Bayesian Approach to Identifying New Risk Factors for Dementia: A Nationwide Population-Based Study.

    PubMed

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

    2016-05-01

    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.

  5. The National Strategy to Secure Cyberspace

    DTIC Science & Technology

    2003-02-01

    became vulnerable to attacks from aircraft and missiles for the first time. The federal government responded by creating a national system to: monitor...attempt to slow the U.S. military response by disrupting systems of the Department of Defense (DoD), the Intelligence Community, and other government ...Work Unit Number Performing Organization Name(s) and Address(es) The White House Washington, DC Performing Organization Report Number Sponsoring

  6. 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.

  7. 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.

  8. A new ball game: the United Nations Convention on the Rights of Persons with Disabilities and assumptions in care for people with dementia.

    PubMed

    Smith, Anita; Sullivan, Danny

    2012-09-01

    The United Nations Convention on the Rights of Persons with Disabilities is a powerful international instrument which imposes significant responsibilities on signatories. This column discusses changes in the definition of legal capacity which will have significant impacts on decision-making related to people with dementia. Various restrictions and limitations on personal freedoms are discussed in light of the Convention. The main focus is on challenges to existing paradigms of substitute decision-making, which are in wide use through a guardianship model. Under Art 12 of the Convention, moves to supported decision-making will result in significant changes in ensuring the rights of people with dementia. There are challenges ahead in implementing supported decision-making schemes, not only due to tension with existing practices and legislation, but also the difficulty of developing and resourcing workable schemes. This is particularly so with advanced dementia, which is acknowledged as a pressing issue for Australia due to effective health care, an ageing population and changing expectations.

  9. [Development of oncogeriatry: national and international strategies].

    PubMed

    Droz, Jean-Pierre; Rodde-Dunet, Marie-Hélène; Vitoux, Anne

    2008-05-28

    Incidence of cancer increases with the recent increase of the life expectancy. Aging is characterized by health status heterogeneity. It is therefore difficult to exactly predict tolerance to treatment and to make decision. One of the major question is to classify the problems on the base of their impact on health status and outcome. It is only possible if oncologists and geriatricians work together. The objectives at the national and international levels are the same: to develop formation (teaching programs), information (for professionals and the public), clinical research. It is more difficult to develop case management, because it depends on health organisation status. A strong global program has been developed in France with the emergence of Pilot Units for the coordination of Oncogeriatrics. It begins to produce results.

  10. Mixed Dementia

    MedlinePlus

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

  11. Vascular dementia

    MedlinePlus

    ... to dementia. Risk factors for VaD include: Diabetes Hardening of the arteries ( atherosclerosis ) High blood pressure ( hypertension ) ... Control conditions that increase the risk of hardening of the ... saturated fats and salt in the diet Treating related disorders

  12. The National Military Strategy of 1864, Who was the Author

    DTIC Science & Technology

    1994-04-22

    Reduction Project (0704-01M). Washington. DC 20S03. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED I 22 April 1994...This relationship not only le~ d to a successful strategy but also masterful execution that doomed the Confederacy. ii The National Military Strategy...profile. He was an extrovert who relied on sensing, thinking and judgment over intuition, feeling and perceptions. This personality type is good at

  13. Climate Change: Implications for National Security and Strategy

    DTIC Science & Technology

    2011-11-02

    The  National  Security  Implications  of   Climate   Change       November  2,  2011   Climate Change : Implications for National Security and...00-00-2011 4. TITLE AND SUBTITLE Climate Change : Implications for National Security and Strategy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c... Change       November  2,  2011   Climate Change : Part of the Strategic Landscape Enduring  trends  and  operational  challenges  will  shape

  14. Biosurveillance: Efforts to Develop a National Biosurveillance Capability Need a National Strategy and a Designated Leader

    DTIC Science & Technology

    2010-06-01

    BIWAC will conduct the collaborative exchange of critical Biosurveillance information through an encrypted information-sharing portal called “Wildfire...GAO United States Government Accountability Office Report to Congressional Committees BIOSURVEILLANCE Efforts to Develop a...National Biosurveillance Capability Need a National Strategy and a Designated Leader June 2010 GAO-10-645 Report Documentation Page

  15. 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…

  16. National Health Insurance and Health Education: Strategies for Change.

    ERIC Educational Resources Information Center

    Dwore, Richard B.

    1980-01-01

    The concept of National Health Insurance (NHI) as one of several strategies for resolving health problems in the U.S. is discussed. NHI goals include comprehensive health care, quality health care, efficient delivery systems, phased-in benefits, and consumer representation. (JD)

  17. 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…

  18. Cybersecurity Strategy in Developing Nations: A Jamaica Case Study

    ERIC Educational Resources Information Center

    Newmeyer, Kevin Patrick

    2014-01-01

    Developing nations have been slow to develop and implement cybersecurity strategies despite a growing threat to governance and public security arising from an increased dependency on Internet-connected systems in the developing world and rising cybercrime. Using a neorealist theoretical framework that draws from Gilpin and Waltz, this qualitative…

  19. 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,…

  20. 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

  1. 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

  2. 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

  3. 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

    ... 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 Strategy... the National Health Security Strategy of the United States of America (2009) the U.S. Government...

  4. 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

  5. The National Economic Strategy: Security and Prosperity Today and Tomorrow

    DTIC Science & Technology

    2007-11-02

    Reagan and Beyond. New York: Simon and Schuster, 1984. Sunstein , Cass R. “Economic Security: A Human Right,” The American Prospect, October 2004, A24...president’s NSS provides the vision to spread economic prosperity through democracy , globalization, and free trade while improving the lives of all...but will create conditions that allow democracy , freedom, security, and prosperity to spread around the globe. 2. The National Economic Strategy in

  6. America Promises to Come Back: Our New National Security Strategy

    DTIC Science & Technology

    1991-10-23

    August 2, 1990, involving a mix of active, reserve, and reconstitutable forces, and General Colin Powell’s Base Force. If implemented, the new strategy...and force structure would return significant U.S. ground and air forces to the continental U.S. where most would be demobilized. In the event of a ...major crisis, the U.S. would rely on active and reserve forces for a contingency response, much as was done for Operation DESERT SHIELD. The new national

  7. America Promises to Come Back: A New National Strategy

    DTIC Science & Technology

    1991-08-05

    revised version will appear in issue #2 of Security Studies (Winter 1991/1992). An analysis of President Bush’s new national security strategy first...a transition period, arms control, and new requirements for military operations research and analysis . Concludes that there are four major critical...Operations Research and Analysis ..... o.......o111 Critical Success Factors ................o....................115 Impact on the Navy and Marine Corps

  8. Medical Diplomacy: A Tool for Enabling National Security Strategy Objectives

    DTIC Science & Technology

    2012-04-06

    REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 The public reporting burden for this collection of Information Is estimated to...information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. 1. REPORT DATE (DD-MM...SUBJECT TERMS Medical Diplomacy, National Security Strategy, Health Service Support ( HSS ), HSS Doctrine, HSS Engagement Programs, Global Health

  9. 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.

  10. 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).

  11. Afghanistan's national strategy for improving quality in health care

    PubMed Central

    Rahimzai, Mirwais; Amiri, Mirwais; Burhani, Nadera Hayat; Leatherman, Sheila; Hiltebeitel, Simon; Rahmanzai, Ahmed Javed

    2013-01-01

    Quality problem or issue When the Ministry of Public Health (MoPH) of the Islamic Republic of Afghanistan began reconstructing the health system in 2003, it faced serious challenges. Decades of war had severely damaged the health infrastructure and the country's ability to deliver health services. Initial assessment A national health resources assessment in 2002 revealed huge structural and resource disparities fundamental to improving health care. For example, only 9% of the population was able to access basic health services, and about 40% of health facilities had no female health providers, severely constraining access of women to health care. Multiple donor programs and the MoPH had some success in improving quality, but questions about sustainability, as well as fragmentation and poor coordination, existed. Plan of action In 2009, MoPH resolved to align and accelerate quality improvement efforts as well as build structural and skill capacity. Implementation The MoPH established a new quality unit within the ministry and undertook a year-long consultative process that drew on international evidence and inputs from all levels of the health system to developed a National Strategy for Improving Quality in Health Care consisting of a strategy implementation framework and a five-year operational plan. Lessons Learned Even in resource-restrained countries, under the most adverse circumstances, quality of health care can be improved at the front-lines and a consensual and coherent national quality strategy developed and implemented. PMID:23485422

  12. 78 FR 19514 - National Fish, Wildlife, and Plants Climate Adaptation Strategy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-01

    ... Fish and Wildlife Service National Fish, Wildlife, and Plants Climate Adaptation Strategy AGENCY: Fish..., Wildlife, and Plants Climate Adaptation Strategy (NFWPCAS or Strategy). The purpose of the Strategy is to... Advisor, Attn: National Fish, Wildlife, and Plants Climate Adaptation Strategy, U.S. Fish and...

  13. 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…

  14. The neuropathology and cerebrovascular mechanisms of dementia

    PubMed Central

    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

  15. Serum phosphorus levels and risk of incident dementia

    PubMed Central

    Li, Tingting; Xie, Yan; Bowe, Benjamin; Xian, Hong

    2017-01-01

    Higher serum phosphorous is associated with cerebral small vessel disease, an important driver of cognitive decline and dementia. Whether serum phosphorous, a potentially modifiable parameter, associates with risk of incident dementia is not known. We aimed to examine the association between serum phosphorous and risk of incident dementia and to determine if the association is modified by age. We used the United States Department of Veterans Affairs national databases to build a longitudinal observational cohort of US veterans without prior history of dementia and with at least one outpatient serum phosphorus between October 2008 and September 2010 and followed them until September 2014. Serum phosphorus was categorized into quintiles: ≤2.9, >2.9 to ≤3.2, >3.2 to ≤3.5, >3.5 to ≤3.9, >3.9 mg/dL. There were 744,235 participants in the overall cohort. Over a median follow-up of 5.07 years (Interquartile range [IQR]: 4.28, 5.63), adjusted Cox models show that compared to quintile 2, the risk of incident dementia was increased in quintile 4 (Hazard Ratio [HR] = 1.05; CI = 1.01–1.10) and quintile 5 (HR = 1.14; CI = 1.09–1.20). In cohort participants ≤60 years old, the risk of incident dementia was increased in quintile 4 (HR = 1.29; CI = 1.12–1.49) and 5 (HR = 1.45; CI = 1.26–1.68). In participants > 60 years old, the risk was not significant in quintile 4, and was attenuated in quintile 5 (HR = 1.10; CI = 1.05–1.16). Formal interaction analyses showed that the association between phosphorous and dementia was more pronounced in those younger than 60, and attenuated in those older than 60 (P for interaction was 0.004 and <0.0001 in quintiles 4 and 5; respectively). We conclude that higher serum phosphorous is associated with increased risk of incident dementia. This association is stronger in younger cohort participants. The identification of serum phosphorous as a risk factor for incident dementia has public health relevance and might inform the

  16. Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial

    PubMed Central

    Barber, Julie; Rapaport, Penny; Knapp, Martin; Griffin, Mark; King, Derek; Mummery, Cath; Walker, Zuzana; Hoe, Juanita; Sampson, Elizabeth L; Cooper, Claudia

    2013-01-01

    Objective To assess whether a manual based coping strategy compared with treatment as usual reduces depression and anxiety symptoms in carers of family members with dementia. Design Randomised, parallel group, superiority trial. Setting Three mental health community services and one neurological outpatient dementia service in London and Essex, UK. Participants 260 carers of family members with dementia. Intervention A manual based coping intervention comprising eight sessions and delivered by supervised psychology graduates to carers of family members with dementia. The programme consisted of psychoeducation about dementia, carers’ stress, and where to get emotional support; understanding behaviours of the family member being cared for, and behavioural management techniques; changing unhelpful thoughts; promoting acceptance; assertive communication; relaxation; planning for the future; increasing pleasant activities; and maintaining skills learnt. Carers practised these techniques at home, using the manual and relaxation CDs. Main outcome measures Affective symptoms (hospital anxiety and depression total score) at four and eight months. Secondary outcomes were depression and anxiety caseness on the hospital anxiety and depression scale; quality of life of both the carer (health status questionnaire, mental health) and the recipient of care (quality of life-Alzheimer’s disease); and potentially abusive behaviour by the carer towards the recipient of care (modified conflict tactics scale). Results 260 carers were recruited; 173 were randomised to the intervention and 87 to treatment as usual. Mean total scores on the hospital anxiety and depression scale were lower in the intervention group than in the treatment as usual group over the eight month evaluation period: adjusted difference in means −1.80 points (95% confidence interval −3.29 to −0.31; P=0.02) and absolute difference in means −2.0 points. Carers in the intervention group were less likely to

  17. Cost-effectiveness of nationwide opportunistic screening program for dementia in South Korea.

    PubMed

    Yu, Su-Yeon; Lee, Tae-Jin; Jang, Su-Hyun; Han, Ji Won; Kim, Tae Hui; Kim, Ki Woong

    2015-01-01

    Although more demand for screening for dementia is envisaged, the cost-effectiveness of opportunistic population screening for dementia at a nationwide level has never been directly investigated. Since 2010, Korea has implemented "the National Dementia Early Detection Program" (NDEDP) for the aged. This study aims to investigate the cost-effectiveness of the NDEDP of Korea and to explore the requirements for enhancing its cost-effectiveness. A Markov model was developed to simulate the disease progression of dementia patients. Data sources for the model parameters included the NDEDP database for cohort characteristics and other national representative data. The model's estimates of the expected costs and Quality Adjusted Life Years (QALYs) for each strategy were used to calculate the incremental cost-effectiveness ratio of screening compared to no screening, and sensitivity analysis was performed to assess the effect of key variables on the cost-effectiveness. Screening showed that the cost per QALY gained ranged from $24,150 to $35,661 depending on the age group. The probability of screening being cost-effective was highest in the group over 75 years old in a wide range of willingness to pay (WTP). The implementation of an opportunistic screening program for dementia can be cost-effective depending on disease severity, treatment effect, costs by disease stage, ages of the participants, and the societal WTP. Above all things, improving access to more effective therapies in slowing the course of the disease is essential since the main benefit of earlier diagnosis for dementia is starting early treatment and subsequent savings. Although it is too early to conclude the cost-effectiveness of opportunistic population screening for dementia, this current study may be a meaningful step toward generating practical evidence for implementing an effective and efficient dementia screening program.

  18. 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, ...

  19. 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.

  20. 75 FR 75707 - Request for Public Comment on the Draft National Nanotechnology Initiative Strategy for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

    ... TECHNOLOGY POLICY Request for Public Comment on the Draft National Nanotechnology Initiative Strategy for Nanotechnology-Related Environmental, Health, and Safety Research AGENCY: White House Office of Science and... draft National Nanotechnology Initiative (NNI) Strategy for Nanotechnology-Related Environmental,...

  1. 76 FR 2428 - Request for Public Comment on the Draft National Nanotechnology Initiative Strategy for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-13

    ... TECHNOLOGY POLICY Request for Public Comment on the Draft National Nanotechnology Initiative Strategy for Nanotechnology-Related Environmental, Health, and Safety Research AGENCY: White House Office of Science and... draft National Nanotechnology Initiative (NNI) Strategy for Nanotechnology-Related Environmental,...

  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.

  3. The National Shipbuilding Research Program. Build Strategy Development

    DTIC Science & Technology

    1994-02-01

    A301 A 3 0 2 A302 A302 A303 A303 A305 A401-A416 A401 A403 A403 A406 A411 -A411 A411 A416 A501-A504 A501 A501 A501 A501 A502 APPENDIX A - CONTENTS...to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE FEB...1994 2. REPORT TYPE N/ A 3. DATES COVERED - 4. TITLE AND SUBTITLE The National Shipbuilding Research Program, Build Strategy Development

  4. Dementia and legal competency.

    PubMed

    Filaković, Pavo; Erić, Anamarija Petek; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven

    2011-06-01

    execution, language difficulties, loosing perception of time and space, changes in mood and behaviour, personality alterations, loss of interests and initiative). Towards more accurate determination of legal competency the psychometric tests are being used. The appliance of these tests must be guided with basic question during evaluation: "For what is or is not he/she capable?" In prediction of possible dementia development, the modern diagnostic procedures are used as help for potentially demented individuals in order to plan own affairs and by oneself determine future guardian. This ensures the maximal respect and protection of rights among persons with dementia in order to independently manage life one step ahead of progressive illness. Finally, it is to be distinguished medical concept of legal capacity which is universal and judicial concept which is restricted by rules of national legal system differing from country to country.

  5. 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... ensure that we are able to consider your comments and information as we develop our draft...

  6. 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). The Strategy describes a set of long-term visions and goals for the management of water resources...

  7. 78 FR 64285 - National Maritime Strategy Symposium: Cargo Opportunities and Sealift Capacity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... Maritime Administration National Maritime Strategy Symposium: Cargo Opportunities and Sealift Capacity... national maritime strategy. The purpose of this public meeting is to gather ideas for improving the Nation... as a maritime Nation relies on its global, coastal and inland commercial fleet, its ports...

  8. 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…

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. Cost effectiveness of a manual based coping strategy programme in promoting the mental health of family carers of people with dementia (the START (STrAtegies for RelaTives) study): a pragmatic randomised controlled trial

    PubMed Central

    King, Derek; Romeo, Renee; Schehl, Barbara; Barber, Julie; Griffin, Mark; Rapaport, Penny; Livingston, Debbie; Mummery, Cath; Walker, Zuzana; Hoe, Juanita; Sampson, Elizabeth L; Cooper, Claudia; Livingston, Gill

    2013-01-01

    Objective To assess whether the START (STrAtegies for RelatTives) intervention added to treatment as usual is cost effective compared with usual treatment alone. Design Cost effectiveness analysis nested within a pragmatic randomised controlled trial. Setting Three mental health and one neurological outpatient dementia service in London and Essex, UK. Participants Family carers of people with dementia. Intervention Eight session, manual based, coping intervention delivered by supervised psychology graduates to family carers of people with dementia added to usual treatment, compared with usual treatment alone. Primary outcome measures Costs measured from a health and social care perspective were analysed alongside the Hospital Anxiety and Depression Scale total score (HADS-T) of affective symptoms and quality adjusted life years (QALYs) in cost effectiveness analyses over eight months from baseline. Results Of the 260 participants recruited to the study, 173 were randomised to the START intervention, and 87 to usual treatment alone. Mean HADS-T scores were lower in the intervention group than the usual treatment group over the 8 month evaluation period (mean difference −1.79 (95% CI −3.32 to −0.33)), indicating better outcomes associated with the START intervention. There was a small improvement in health related quality of life as measured by QALYs (0.03 (−0.01 to 0.08)). Costs were no different between the intervention and usual treatment groups (£252 (−28 to 565) higher for START group). The cost effectiveness calculations suggested that START had a greater than 99% chance of being cost effective compared with usual treatment alone at a willingness to pay threshold of £30 000 per QALY gained, and a high probability of cost effectiveness on the HADS-T measure. Conclusions The manual based coping intervention START, when added to treatment as usual, was cost effective compared with treatment as usual alone by reference to both outcome measures

  15. Development of a Nationally Coordinated Evaluation Plan for the Ghana National Strategy for Key Populations

    PubMed Central

    Reynolds, Heidi W; Atuahene, Kyeremeh; Sutherland, Elizabeth; Amenyah, Richard; Kwao, Isaiah Doe; Larbi, Emmanuel Tettey

    2015-01-01

    Objective Just as HIV prevention programs need to be tailored to the local epidemic, so should evaluations be country-owned and country-led to ensure use of those results in decision making and policy. The objective of this paper is to describe the process undertaken in Ghana to develop a national evaluation plan for the Ghana national strategy for key populations. Methods This was a participatory process that involved meetings between the Ghana AIDS Commission (GAC), other partners in Ghana working to prevent HIV among key populations, and MEASURE Evaluation. The process included three two-day, highly structured yet participatory meetings over the course of 12 months during which participants shared information about on-going and planned data and identified research questions and methods. Results An evaluation plan was prepared to inform stakeholders about which data collection activities need to be prioritized for funding, who would implement the study, the timing of data collection, the research question the data will help answer, and the analysis methods. The plan discusses various methods that can be used including the recommendation for the study design using multiple data sources. It has an evaluation conceptual model, proposed analyses, proposed definition of independent variables, estimated costs for filling data gaps, roles and responsibilities of stakeholders to carry out the plan, and considerations for ethics, data sharing and authorship. Conclusion The experience demonstrates that it is possible to design an evaluation responsive to national strategies and priorities with country leadership, regardless of stakeholders' experiences with evaluations. This process may be replicable elsewhere, where stakeholders want to plan and implement an evaluation of a large-scale program at the national or subnational level that is responsive to national priorities and part of a comprehensive monitoring and evaluation system. PMID:26120495

  16. 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.

  17. 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

    ... From the Federal Register Online via the Government Publishing Office NATIONAL SCIENCE FOUNDATION 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),...

  18. 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.

  19. 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

  20. Collaborative transdisciplinary team approach for dementia care.

    PubMed

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

    2014-01-01

    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.

  1. [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

  2. Apolipoproteins and HDL cholesterol do not associate with the risk of future dementia and Alzheimer's disease: the National Finnish population study (FINRISK).

    PubMed

    Tynkkynen, Juho; Hernesniemi, Jussi A; Laatikainen, Tiina; Havulinna, Aki S; Sundvall, Jouko; Leiviskä, Jaana; Salo, Perttu; Salomaa, Veikko

    2016-12-01

    Data on associations of apolipoproteins A-I and B (apo A-I, apo B) and HDL cholesterol (HDL-C) with dementia and Alzheimer's disease (AD) are conflicting. Our aim was to examine, whether apo B, apoA-I, their ratio, or HDL-C are significant, independent predictors of incident dementia and AD in the general population free of dementia at baseline. We analyzed the results from two Finnish prospective population-based cohort studies in a total of 13,275 subjects aged 25 to 74 years with mainly Caucasian ethnicity. The follow-up time for both cohorts was 10 years. We used Cox proportional hazards regression to evaluate hazard ratios (HR) for incident dementia (including AD) (n = 220) and for AD (n = 154). Cumulative incidence function (CIF) analysis was also performed to adjust the results for competing risks of death. Adjusted for multiple dementia and AD risk factors, log-transformed apo A-I, log HDL-C, log apo B, and log apo B/A-I ratio were not associated with incident dementia or AD. HDL-C was inversely associated with AD risk when adjusted for competing risks but no other statistically significant associations were observed in the CIF analyses. Apo A-I, HDL-C, apo B, or apo B/A-I ratio were not associated with future dementia or AD. HDL-C was inversely associated with incident AD risk when adjusted for competing risks of death, but the finding is unlikely to be of clinical relevance. Our study does not support the use of these risk markers to predict incident dementia or AD.

  3. Neuropsychiatric management of young-onset dementias.

    PubMed

    Shinagawa, Shunichiro

    2015-06-01

    A combination of pharmacologic and nonpharmacologic approaches is necessary for the appropriate neuropsychiatric management of patients with young-onset dementia. Nonpharmacologic interventions, including psychological management, environmental strategies, and caregiver's support, should be the first choice for neuropsychiatric management. Pharmacologic interventions differ according to the underlying causes of dementia; thus, differential diagnoses are very important. Antipsychotics should be prescribed carefully; they should be used for the shortest time possible, at the lowest possible dose.

  4. 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 ...

  5. A 21st Century Science, Technology, and Innovation Strategy for Americas National Security

    DTIC Science & Technology

    2016-05-01

    aspects of national security. With guidance from the President and Congress, strategic direction and investment priorities for national security science ...interconnected, fast- evolving science and technology landscape that presents new threats and opportunities, the policy directions called for in this...A 21ST CENTURY SCIENCE , TECHNOLOGY, AND INNOVATION STRATEGY FOR AMERICA’S NATIONAL SECURITY PRODUCT OF THE Committee on Homeland and National

  6. 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.

  7. 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.

  8. Imaging amyloid in Parkinson's disease dementia and dementia with Lewy bodies with positron emission tomography.

    PubMed

    Brooks, David J

    2009-01-01

    Although Parkinson's disease with later dementia (PDD) and dementia with Lewy bodies (DLB) are pathologically characterized by the presence of intraneuronal Lewy inclusion bodies, amyloid deposition is also associated to varying degrees with both these disorders. Fibrillar amyloid load can now be quantitated in vivo with positron emission tomography (PET) using imaging biomarkers. Here the reported findings of 11C-PIB PET studies concerning the amyloid load associated with PD and its influence on dementia are reviewed. It is concluded that the presence of amyloid acts to accelerate the dementia process in Lewy body disorders, though has little influence on its nature. Anti-amyloid strategies could be a relevant approach for slowing dementia in a number of DLB and PDD cases.

  9. The National Radon Action Plan - A Strategy for Saving Lives

    EPA Pesticide Factsheets

    NRAP Guide-A Strategy for Saving Lives sets out strategies to drive the changes needed to reduce exposure to radon, a naturally occurring, invisible and odorless gas. Partnership headed by ALA with feds and NGOs.

  10. 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…

  11. Changing Classroom Practice at Key Stage 2: The Impact of New Labour's National Strategies

    ERIC Educational Resources Information Center

    Webb, Rosemary; Vulliamy, Graham

    2007-01-01

    The article examines the impact of New Labour policies--particularly the National Literacy and Numeracy Strategies and the subsequent Primary National Strategy--on classroom practice at Key Stage 2 in England. Evidence is drawn from fieldwork conducted in 2003-2005 from a sample of 50 schools, replicating a study conducted a decade previously in…

  12. Recommendations of the Alzheimer's disease-related dementias conference.

    PubMed

    Montine, Thomas J; Koroshetz, Walter J; Babcock, Debra; Dickson, Dennis W; Galpern, Wendy R; Glymour, M Maria; Greenberg, Steven M; Hutton, Michael L; Knopman, David S; Kuzmichev, Andrey N; Manly, Jennifer J; Marder, Karen S; Miller, Bruce L; Phelps, Creighton H; Seeley, William W; Sieber, Beth-Anne; Silverberg, Nina B; Sutherland, Margaret; Torborg, Christine L; Waddy, Salina P; Zlokovic, Berislav V; Corriveau, Roderick A

    2014-08-26

    The National Alzheimer's Project Act, signed into law in 2011, mandates a National Plan to Address Alzheimer's Disease that is updated annually. In the Plan, the term Alzheimer disease includes not only Alzheimer disease (AD) proper, but also several specified related dementias, namely, frontotemporal, Lewy body, vascular, and mixed dementia. In response to a specific action item in the 2012 National Plan, the National Institute of Neurological Disorders and Stroke, in collaboration with the National Institute on Aging, convened panels of experts and conducted a 2-day public conference to develop research priorities and timelines for addressing Alzheimer disease-related dementias (ADRD) in 5 topic areas: multiple etiology dementias, health disparities, Lewy body dementias including dementia with Lewy bodies and Parkinson disease dementia, frontotemporal dementia and related tauopathies, and vascular contributions to ADRD. By design, the product was up to 8 prioritized research recommendations in each topic area including estimated timelines from when work on a recommendation is started to completion or to full implementation of an ongoing activity, and recognition of shared research themes across recommendations. These included increased education and training of both researchers and health care professionals, addressing health disparities, fundamental neurobiology research, advanced diagnostics, collaborative biosample repositories, and a focus on developing effective interventions to prevent or treat ADRD by the year 2025 as targeted by the National Plan.

  13. Developing and Implementing an Effective National Security Strategy for Croatia

    DTIC Science & Technology

    2013-03-01

    documents. The final analysis identifies problems in the insufficient national security system and the lack of political want to efficiently deal with...national security system and the lack of political want to efficiently deal with national security issues. The essay ends with several...Croatia and abroad, and all the political parties used every available means including their lives to achieve all national goals which is obvious from

  14. 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…

  15. 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

  16. 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.

  17. Dementia with Lewy bodies: current concepts.

    PubMed

    Buracchio, Teresa; Arvanitakis, Zoe; Gorbien, Martin

    2005-01-01

    As life expectancy continues to increase over time, dementia is becoming an increasingly more common problem and a major cause of disability in older persons. It is now more important than ever to identify and manage common causes of dementia given variations in disease course, treatments and the possibility for modification of risk factors. Dementia with Lewy bodies (DLB) is a dementia syndrome characterized by progressive cognitive decline, with fluctuating cognition, recurrent detailed and well-formed hallucinations, and parkinsonism. This article aims to provide an overview of current concepts of DLB, including a description of the key clinical features and neuropathology, neurochemistry, and genetics of DLB, then a discussion of the relationship of DLB with Alzheimer's disease and Parkinson's disease, and, finally, a summary of current management strategies available for this disorder.

  18. Maritime Commerce Security Plan for The National Strategy for Maritime Security

    DTIC Science & Technology

    2005-10-01

    MARITIME COMMERCE SECURITY PLAN FOR THE NATIONAL STRATEGY FOR MARITIME SECURITY OCTOBER 2005 Report Documentation Page Form...COVERED 00-00-2005 to 00-00-2005 4. TITLE AND SUBTITLE Maritime Commerce Security Plan for The National Strategy for Maritime Security 5a... Commerce Security Plan i FOREWORD By signing National Security Presidential Directive 41/Homeland Security Presidential Directive 13 (NSPD-41/HSPD

  19. Human gut microbiota: the links with dementia development.

    PubMed

    Alkasir, Rashad; Li, Jing; Li, Xudong; Jin, Miao; Zhu, Baoli

    2017-02-01

    Dementia is a comprehensive category of brain diseases that is great enough to affect a person's daily functioning. The most common type of dementia is Alzheimer's disease, which makes most of cases. New researches indicate that gastrointestinal tract microbiota are directly linked to dementia pathogenesis through triggering metabolic diseases and low-grade inflammation progress. A novel strategy is proposed for the management of these disorders and as an adjuvant for psychiatric treatment of dementia and other related diseases through modulation of the microbiota (e.g. with the use of probiotics).

  20. 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.

  1. 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.…

  2. 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

  3. Laughter, communication problems and dementia.

    PubMed

    Lindholm, Camilla

    2008-01-01

    This article investigates how the elderly with dementia and their professional caregivers use laughter as a device to deal with problems related to language production and comprehension. The data consist of two game-playing situations, used to engage the elderly people in memory work. The article shows how the elderly patients recurrently laugh to acknowledge communication difficulties and to show awareness of their potential non-competency. The professional caregivers are shown to use slightly different strategies for responding to laughter segments initiated by the patients, either making the shortcomings part of the conversation or avoiding referring to the lapse explicitly. The laughter strategies used by the patients are compared to those reported in the CA-literature on laughter. It is well known that laughter is used in sequences of trouble and delicacy in both ordinary and institutional contexts, but my study shows that speakers with dementia laugh when they encounter problems related to language production and comprehension. This functional expansion in relation to premorbid occurrence is evidence that laughter fits the definition of compensatory behaviour utilized to overcome communication barriers. Certain conversational skills are preserved in individuals with dementia, but due to their cognitive impairment these resources are utilized in a slightly different way than by healthy speakers.

  4. 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)

  5. Does America Need a National Human Resource Development Strategy?

    ERIC Educational Resources Information Center

    Craig, Robert L.; And Others

    1984-01-01

    Essays by Robert L. Craig, Mervyn M. Dymally, Nolen M. Ellison, Sheila M. Korhammer, Rich Redeker, Markley Roberts, and Richard F. Schubert present various perspectives on U.S. human resource development needs and strategies. (DMM)

  6. 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.

  7. 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.

  8. Canadian STI national goals and phase specific strategies.

    PubMed

    Wong, T; Sutherland, D

    2002-04-01

    National goals should be "SMART"-specific, measurable, achievable, resource sensitive, and timed. To be meaningful, these goals must be sustainable and realistic within the time frame and fiscal limitations. Multisector partnerships are essential for the goals to become operational.

  9. U.S. National Security and Strategy: A Selected Bibliography

    DTIC Science & Technology

    2007-10-01

    National Security and the Threat of Climate Change . Alexandria: CNA Corpora- tion, 2007. 68pp. (UA23. N171 2007) http://securityandclimate.cna.org/report...2005) Schwartz, Peter, and Doug Randall. An Abrupt Climate Change Scenario and Its Implications for United States National Security. New York: Time...CSIS Press, 2004. 73pp. (DS79.76 .C567 2004) Cordesman, Anthony H., and Ionut C. Popescu. The Changing Challenges of U.S. Defense Spend- ing

  10. The National Intelligence Strategy of the United States of America

    DTIC Science & Technology

    2014-01-01

    security issues , and ultimately, to make our nation more secure. We face significant changes in the domestic and global environment and must be...to the changing environment, and promotes best practices across the IC; • Provide a workplace free of discrimination, harassment , and the fear of...components, described as follows: (1) the Strategic Environment section portrays the global national security milieu; (2) the Mission Objective section

  11. Depression and dementias among military veterans.

    PubMed

    Byers, Amy L; Yaffe, Kristine

    2014-06-01

    Depression is very common throughout the course of veterans' lives, and dementia is common in late life. Previous studies suggest an association between depression and dementia in military veterans. The most likely biologic mechanisms that may link depression and dementia among military veterans include vascular disease, changes in glucocorticoid steroids and hippocampal atrophy, deposition of β-amyloid plaques, inflammatory changes, and alterations of nerve growth factors. In addition, military veterans often have depression comorbid with posttraumatic stress disorder or traumatic brain injury. Therefore, in military veterans, these hypothesized biologic pathways going from depression to dementia are more than likely influenced by trauma-related processes. Treatment strategies for depression, posttraumatic stress disorder, or traumatic brain injury could alter these pathways and as a result decrease the risk for dementia. Given the projected increase of dementia, as well as the projected increase in the older segment of the veteran population, in the future, it is critically important that we understand whether treatment for depression alone or combined with other regimens improves cognition. In this review, we summarize the principal mechanisms of this relationship and discuss treatment implications in military veterans.

  12. 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

  13. 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;...

  14. Conference takes first step toward positive national health strategy.

    PubMed

    Longe, M E

    1978-01-01

    Although scientific advancements have improved and extended our lives, we must still go one step farther--in the direction of disease prevention and health education. With that in mind, Sen. Edward Kennedy and the American Medical Association sponsored a conference to plot out a strategy for developing a healthier American life-style. Highlights of that conference are presented here.

  15. The National Drug Control Strategy: A Reality Check.

    DTIC Science & Technology

    1997-01-01

    and continue to gain support at the highest levels in the military and government. President Alberto Fujimori of Peru recently suspended all commercial...through terrorism and murder. All of this is especially frustrating to the United States whose supply side strategy requires honest, trustworthy

  16. 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…

  17. 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.

  18. Suicide Prevention in the Army National Guard: Modeling Effective Strategies

    DTIC Science & Technology

    2013-04-01

    large-scale domestic emergencies of hurricanes, wildfires , southwest border operations and even national inaugural events. The breadth, scope, and... frequency of these obligations combined with a recovering economy have exacted an extraordinary commitment from citizen Soldiers. Significantly... impact of multiple deployments causing the traditional Soldier to leave the workplace, deploy to a combat zone, and return home to resume civilian

  19. Retooling the Nation-Building Strategy in Afghanistan

    DTIC Science & Technology

    2006-02-28

    reconstruction. 3 Bob Woodward, Bush at War (New York: Simon & Schuster, 2002), 339. 4 Kurt Amend, the Director for Afghanistan on the National Security...Al Qaeda remnants). 27 Perito, 3. 28 Dylan Hendrickson, Michael Bhatia, Mark Knight, and Annabel Taylor, A Review of DFID Involvement in Provincial

  20. 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.…

  1. 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…

  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. 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,…

  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. 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…

  6. 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…

  7. 75 FR 41685 - Implementation of the National HIV/AIDS Strategy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-16

    ... 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 30 years from the onset of the HIV/AIDS epidemic in the United States, new actions are needed to...

  8. The Path to a Culturally Relevant National Security Strategy

    DTIC Science & Technology

    2008-05-22

    Theory This section discusses the key theory linking self and society. Henri Tajfel , the father of social identity theory, developed this theory as...32 John C. Turner, “An Introduction,” in Social Groups and Identities – Developing the Legacy of Henri Tajfel , ed...in Social Groups and Identities – Developing the Legacy of Henri Tajfel , 17. 13 strategies for achieving or maintaining intergroup comparisons that

  9. HOMA: Israel’s National Missile Defense Strategy (Abridged Version)

    DTIC Science & Technology

    2007-11-02

    Scud hunting sorties numbered between 75 and 160, or about 5 percent of planned daily sorties. The anti-Scud strategy had essentially three parts... oil to our main business partners in Europe and Asia as well as to the US. During the year 2000, the US imported 55% of its crude oil and its imports...world–via the disruption of the oil flow, WMD contamination, environmental disasters, loss of markets or loss of access to markets, and other

  10. Would the U.S. Benefit from a Unified National Strategy to Combat Violent Salafi Jihadism

    DTIC Science & Technology

    2015-12-01

    adhere to this violent ideology overseas. This was asserted in the 2011 National Strategy for Counterterrorism, which states, “In the global ... strategies has progressed over the years, evolving from the “ global war on terror” (GWOT) to the threat posed by “al-Qa’ida, its adherents and... Strategy for Counterterrorism. 133 Jeffrey Record, “Bounding the Global War on Terrorism,” Military Technology 28, no. 6 (2004): 17. 45 made

  11. [Hypertension and dementia].

    PubMed

    Hanon, O

    2014-06-01

    Prevention and treatment of dementia has turned into a major public health challenge. Several epidemiological studies have indicated a significant association between the presence of hypertension and the onset of dementia (vascular or Alzheimer's type) several years later. Cognitive disorder may be related to focal cerebral lesions of vascular origin (infarctus, lacunae) and/or chronic ischemia of the white matter (white matter lesions) related to arteriosclerosis and/or lipohyalinosis of small perforating arteries high blood pressure in mid-life to later cognitive decline and dementia. Moreover, disorders of cerebral microcirculation and endothelial dysfunction may be associated to blood brain barrier dysfunction and amyloid plaques formation leading to Alzheimer's process. Few randomized clinical trials have included a cognitive assessment and dementia as outcome in their design. They all raise some major criticisms: cognitive assessment was never the main outcome, too short follow-up to study dementia; incomplete assessment of cognition, lost of follow-up and a small proportion of subjects at risk for dementia at inclusion. However, the results of therapeutic trials (SYST-EUR, PROGRESS) open the way to the prevention of dementia (vascular or Alzheimer's type) or cognitive decline by antihypertensive treatments. A meta-analysis including randomized controlled studies, suggests a significant decrease in the risk of dementia with antihypertensive treatment compared to placebo.

  12. Education for National Identity: Arab Schools Principals and Teachers Dilemmas and Coping Strategies

    ERIC Educational Resources Information Center

    Arar, Khalid; Ibrahim, Fadia

    2016-01-01

    This article discusses strategies used by Arab principals and teachers in Israel to cope with dilemmas involved in education for national identity stemming from conflict between two national narratives. While the Israeli Ministry of Education expects the Arab education system to educate students according to the Jewish State's values, Palestinian…

  13. English Learning Strategies of Various Nations: A Study in Military Context

    ERIC Educational Resources Information Center

    Solak, Ekrem

    2014-01-01

    How successful learners learn English has been one of the primary interest of scientists and researchers in recent years. Therefore, this study aimed to determine what language learning strategies the military personnel from different nations used while learning English. 56 subjects from 14 different nations deployed in three different military…

  14. 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

  15. Notes on a National Strategy for Global Education

    DTIC Science & Technology

    2011-12-01

    intercultural education.51 Recommendations were made for the Executive Branch, Congress, state and local governments, the academic community , and the...economically in an increasingly global economy and to protect national security.53 Finally, the business community has expressed concerns not only for...interest to education professionals at all levels, state and local law enforcement, and the business community . E. METHOD 1. Research Method The

  16. Strategies for dealing with the national coding shortage.

    PubMed

    Schwieters, Jill

    2010-04-01

    Steps providers should consider to deal with a national coding shortage and implementation of ICD-10 include the following: Concentrate on employee retention (consider retention bonuses; upgrade pay scales; and offer flex-time and flexible work schedules). Begin a training program for ICD-10. Target other healthcare professionals and current employees to transition into coding positions. Collaborate with colleges, high schools, and middle schools to draw prospective students to this career path and your organization.

  17. Political Objective Denial: Enhancing Deterrence in the National Strategy.

    DTIC Science & Technology

    2014-09-26

    many that the Soviets would not attack Western Europe suggests a subconscious understanding of the I nature of any Soviet political decision that...the minds of * the decisionmaking elites. It is possible, however, to develop plans for dealing with political 2 objectives without knowing exact...political in nature, such as -a nation being compelled to adopt a certain ideology, form of government or alliance. Clausewitz had in mind those

  18. National Strategy of Defense: Peace and Security for Brazil

    DTIC Science & Technology

    2008-12-19

    to control the maritime access to Brazil: the strip that goes from Santos to Vitória, and the area around the mouth of the Amazon River. National...reestablish the tradition of the Tiros de Guerra [military training school for reserves]. In principle, all of the country’s town halls should be able...to take part in the renovation of the Tiros de Guerra , when the legal restrictions that still limit the list of qualified townships are eliminated

  19. National Strategy for the Southwest Border: Having the Desired Effect?

    DTIC Science & Technology

    2011-03-18

    government victories against the DTOs include the December 2009 killing of Arturo Beltrán Leyva and January 2010 capture of Teodoro Garcia Simental, the...http://www.fbi.gov/news/stories/2010/august/southwest- border3/border-violence (accessed February 12, 2011). 6 Bob Killebrew and Jennifer Bernal , Crime...2011), 1. 9 Killebrew and Bernal , Crime Wars: Gangs, Cartels and U.S. National Security, 16. 10 June S. Beittel, Mexico’s Drug-Related Violence

  20. Hearing and dementia.

    PubMed

    Hardy, Chris J D; Marshall, Charles R; Golden, Hannah L; Clark, Camilla N; Mummery, Catherine J; Griffiths, Timothy D; Bamiou, Doris-Eva; Warren, Jason D

    2016-11-01

    Hearing deficits associated with cognitive impairment have attracted much recent interest, motivated by emerging evidence that impaired hearing is a risk factor for cognitive decline. However, dementia and hearing impairment present immense challenges in their own right, and their intersection in the auditory brain remains poorly understood and difficult to assess. Here, we outline a clinically oriented, symptom-based approach to the assessment of hearing in dementias, informed by recent progress in the clinical auditory neuroscience of these diseases. We consider the significance and interpretation of hearing loss and symptoms that point to a disorder of auditory cognition in patients with dementia. We identify key auditory characteristics of some important dementias and conclude with a bedside approach to assessing and managing auditory dysfunction in dementia.

  1. Pursuing the National Interest: A National Security Strategy in a New World Order

    DTIC Science & Technology

    1992-04-19

    proudly in its true colors, as something incapable of controlling passion , insubordinate to the idea of justice, the enemy of anything superior to...terms of power, as if they were playing a game. Domestic affairs and intangibles, such as national character and the passions of nationalism...our national wealth insulates us. Hobbes Thomas Hobbes saw the nature of man as "the sum of passions , and of human reason as a cal- culating machine

  2. Understanding challenging behaviour in patients with dementia.

    PubMed

    Cunningham, C

    The fifth and final article in the series on patients with dementia in acute care examines challenging behaviour. Hospital admission, combined with unfamiliar surroundings and memory problems, can be frightening and disorientating for those with dementia. This can lead to behaviour which is perceived as 'disruptive' or 'difficult'. Aspects of the hospital environment or care practice can contribute to problems that may be misinterpreted and lead to challenging behaviour. Staff should seek to understand the cause of challenging behaviour, assess the possible causes and use strategies to reinforce familiarity and minimise distress for these patients.

  3. 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

  4. Developing an information resources management strategy for regulatory veterinary medicine: a national imperative.

    PubMed

    Miller, L E; Honeycutt, T L; Cowen, P; Morrow, W E; Hueston, W D

    1994-10-15

    Lack of a standardized information technology management strategy has resulted in state and federal information systems evolving separately, rather than in tandem. Absence of an information management strategy will eventually affect regulatory program management, epidemiologic research, and domestic and international livestock trade. Producers will ultimately pay the price for the lack of regulatory coordination of US animal health and disease information. The longer the development of state and federal information technology management strategies is postponed, the more cost-, labor-, and time-intensive correcting the deficiency will be. Development of a national information resources management environment is the first step in constructing state and federal information technology strategies.

  5. Metal homeostasis in dementia.

    PubMed

    Sensi, Stefano

    2014-10-01

    The molecular determinants of dementia of Alzheimer's tipe (DAT) are still not completely known; however, in the past two decades, a large body of evidence has indicated that an important contributing factor is represented by the unbalanced homeostasis of two cations: calcium (Ca(2) ) and zinc (Zn(2)). The two ions serve a critical role in the physiological signalling of the central nervous system. However, Alzheimer's disease-related neurodegeneration, deregulation of brain levels of Ca(2) and Zn(2) is instrumental in promoting amyloid-β (Aβ) dysmetabolism and tau phosphorylation as well as interference with additional pathogenic factors like energy production failure, hyperexcitabilty, excitotoxicity, and oxidative stress. Hyperexcitabilty and excitotoxicity are key mechanisms in the disease development and progression as an altered glutamatergic activation can further promote both Ca(2) and Zn(2) dyshomeostasis. The two cations can operate synergistically to promote the generation of free radicals that further increase intracellular Ca(2) and Zn(2) rises and set the stage for a self-perpetuating injurious loop. In the talk, we will review mechanisms of AD-related Ca(2) and Zn(2) dyshomeostasis in a preclinical model of DAT and discuss opportunity for disease-modifying strategies based on interventions aimed at restoring brain metal homeostasis.

  6. [Diabetes mellitus and dementia].

    PubMed

    Kopf, D

    2015-05-01

    Diabetes mellitus, particularly type 2 diabetes, is a risk factor for dementia and this holds true for incident vascular dementia and Alzheimer's disease. Cerebrovascular complications of diabetes and chronic mild inflammation in insulin resistant states partly account for this increased risk. In addition, cellular resistance to the trophic effects of insulin on neurons and glial cells favor the accumulation of toxic metabolic products, such as amyloid and hyperphosphorylated tau protein (pTau). Weight loss frequently precedes overt cognitive symptoms of Alzheimer's disease. This results in an increased risk of hypoglycemic episodes in stable diabetic patients who are on suitably adjusted doses of oral insulin or insulinotropic antidiabetic drugs. In turn, hypoglycemic episodes may induce further damage in the vulnerable brains of type 2 diabetes patients. Patients with unexplained weight loss, hypoglycemic episodes and subjective memory complaints must be screened for dementia. Once dementia has been diagnosed the goals of diabetes management must be reevaluated as prevention of hypoglycemia becomes more important than tight metabolic control. As weight loss accelerates the rate of cognitive decline, nutritional goals must aim at stabilizing body weight. There is no available evidence on whether drug treatment of diabetes in middle-aged persons can help to prevent dementia; however, physical exercise, mental activity and higher education have preventive effects on the risk of dementia in later life. In addition, nutritional recommendations that are effective in preventing cardiovascular events have also been shown to reduce the risk of dementia.

  7. 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.

  8. 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

  9. [Disruptive sexual behaviour among patients with dementia].

    PubMed

    Kämpf, C; Abderhalden, C

    2012-10-01

    In addition to diagnostically decisive cognitive problems, behavioural and psychological symptoms (BPSD) are frequent among people with dementia, including sexually related behavioural problems. This paper provides an overview on the state of knowledge about these problems. Research on this topic is hampered by the absence of unanimous definitions, aetiological classifications, and diagnostic instruments. The wide range of prevalence rates reported (1.8 - 18 %) originate from the heterogenity of study samples as well as in the variety of definitions and instruments employed. Regarding aetiology, dysfunctions in various cortical regions are being discussed. Sexually related behavioural problems are more prevalent in men and among patients with vascular, frontotemporal and Parkinson-associated forms of dementia, as compared with dementias of the Alzheimer type. The pharmacological and non-pharmacological treatment strategies published to date have not been sufficiently studied.

  10. Delirium Superimposed on Dementia

    PubMed Central

    Steis, Melinda R.; Fick, Donna M.

    2012-01-01

    Delirium is an acute, fluctuating confusional state that results in poor outcomes for older adults. Dementia causes a more convoluted course when coexisting with delirium. This study examined 128 days of documentation to describe what nurses document when caring for patients with dementia who experience delirium. Nurses did not document that they recognized delirium. Common descriptive terms included words and phrases indicating fluctuating mental status, lethargy, confusion, negative behavior, delusions, and restlessness. Delirium is a medical emergency. Nurses are in need of education coupled with clinical and decisional support to facilitate recognition and treatment of underlying causes of delirium in individuals with dementia. PMID:21761816

  11. [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.

  12. A national strategy to develop pragmatic clinical trials infrastructure.

    PubMed

    Concannon, Thomas W; Guise, Jeanne-Marie; Dolor, Rowena J; Meissner, Paul; Tunis, Sean; Krishnan, Jerry A; Pace, Wilson D; Saltz, Joel; Hersh, William R; Michener, Lloyd; Carey, Timothy S

    2014-04-01

    An important challenge in comparative effectiveness research is the lack of infrastructure to support pragmatic clinical trials, which compare interventions in usual practice settings and subjects. These trials present challenges that differ from those of classical efficacy trials, which are conducted under ideal circumstances, in patients selected for their suitability, and with highly controlled protocols. In 2012, we launched a 1-year learning network to identify high-priority pragmatic clinical trials and to deploy research infrastructure through the NIH Clinical and Translational Science Awards Consortium that could be used to launch and sustain them. The network and infrastructure were initiated as a learning ground and shared resource for investigators and communities interested in developing pragmatic clinical trials. We followed a three-stage process of developing the network, prioritizing proposed trials, and implementing learning exercises that culminated in a 1-day network meeting at the end of the year. The year-long project resulted in five recommendations related to developing the network, enhancing community engagement, addressing regulatory challenges, advancing information technology, and developing research methods. The recommendations can be implemented within 24 months and are designed to lead toward a sustained national infrastructure for pragmatic trials.

  13. The LANDFIRE Refresh strategy: updating the national dataset

    USGS Publications Warehouse

    Nelson, Kurtis J.; Connot, Joel A.; Peterson, Birgit E.; 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.

  14. [Patient safety: the need for a national strategy].

    PubMed

    Sousa, Paulo

    2006-01-01

    Patient safety has become a core issue for many modern healthcare systems. All healthcare systems around the world occasionally and unintentionally harm patients whom they are seeking to help. In recognition of this, patient safety has become a fundamental part of the drive to improve quality in many countries. The effects of harming a patient are widespread. There can be devastating emotional and physical consequence for patients and their families. For the staff involved too, incidents can be distressing, while members of their clinical teams can become demoralised and disaffected. Safety incidents also incur costs through litigation and extra treatment. Patient safety is nowadays a serious problem of public health, with several implications in different clinical areas and level of care. It is crucial to establish priorities, hierarchy's interventions and engaged all stakeholders who are involved around this big issue. In other word, it is important to define a strategy that could reflect a global framework, which allow us to integrate, articulate and be actors action-oriented, with the final aim of reducing the possibilities to harm patients. Consequently, these could contribute for a health care delivery of excellence and based on the best evidence. In the last few years, several studies have estimated that around 4% to 17% of patients have experienced an adverse event, and that up to half of these incidents could have been prevented. Many of them have also showed that, the best way of reducing error rates, is to target the underlying systems failures, rather than take actions against individual members of staff. We should recognise that healthcare will always involve risk, but that these risks can be reduced by analysing and tackling the root causes of patient safety incidents. It is important to promote an open and fair culture, and to encourage staff to report when things have gone wrong.

  15. 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.

  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.

  17. Dementia and driving

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000028.htm Dementia and driving To use the sharing features on this page, ... their independence is being taken away. Signs That Driving May No Longer be Safe People with signs ...

  18. Lewy Body Dementia Research

    MedlinePlus

    ... According to a new RAND Corporation study, the monetary cost of dementia in the United States ranges ... Caregivers Professionals Volunteer Shop Search Sitemap Terms and Policies Disclaimer Careers State Fundraising Notices latest tweets Tweets ...

  19. 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

  20. 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.

  1. National Security Strategy: Mandates, Execution to Date, and Issues for Congress

    DTIC Science & Technology

    2013-08-06

    defense posture and key trends, defense objectives and strategies, force posture in a constrained resource environment, and the role of arms control ...to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 06...pre-positioning, and other anticipatory deployments necessary under the national defense strategy for conflict deterrence and adequate military

  2. The design, results and future development of the National Energy Strategy Environmental Analysis Model (NESEAM)

    SciTech Connect

    Fisher, R.E.; Boyd, G.A. ); Breed, W.S. . Office of Environmental Analysis)

    1991-01-01

    The National Energy Strategy Environmental Model (NESEAM) has been developed to project emissions for the National Energy Strategy (NES). Two scenarios were evaluated for the NES, a Current Policy Base Case and a NES Action Case. The results from the NES Actions Case project much lower emissions than the Current Policy Base Case. Future enhancements to NESEAM will focus on fuel cycle analysis, including future technologies and additional pollutants to model. NESEAM's flexibility will allow it to model other future legislative issues. 7 refs., 4 figs., 2 tabs.

  3. Higher education provision for professionals working with people with dementia: a scoping exercise.

    PubMed

    Pulsford, David; Hope, Kevin; Thompson, Rachel

    2007-01-01

    This paper reports on the first national UK survey of higher education provision related to dementia care. A questionnaire was distributed to lecturers in Higher Education Institutions (HEIs) in England and Wales seeking information about the amount of coverage of dementia within their pre-registration and pre-qualifying courses for health and social care professionals, and continuing professional development (CPD) courses on dementia care. Information was sought regarding the content of courses, and their relation to a published "dementia curriculum" [Pulsford et al., The contribution of higher education to dementia care, Journal of Dementia Care 11(4) (2003) 27-29]. Results show that coverage of dementia within the mental health branch of pre-registration nursing programmes is very variable, and may be related to the presence of an experienced and committed lecturer within the HEI. Coverage of dementia on adult branch programmes is limited, and sometimes non-existent, despite reported deficits in the ability of general nurses to work effectively with people with dementia. Occupational Therapists and Social Workers receive similar input to adult branch nurses. CPD courses are provided by around 70% of HEIs overall, but there is a shortage of specialised diploma and degree level courses on dementia care. Most areas of the dementia curriculum are covered in both pre-registration and CPD courses, but culture and diversity, young onset dementia, and physical health care may be less well addressed. Recommendations are made for developing higher education provision for professionals working with this group of people.

  4. Early Dementia Screening.

    PubMed

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

    2016-01-21

    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.

  5. 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

  6. Toward a national fuels mapping strategy: Lessons from selected mapping programs

    USGS Publications Warehouse

    Loveland, T.R.

    2001-01-01

    The establishment of a robust national fuels mapping program must be based on pertinent lessons from relevant national mapping programs. Many large-area mapping programs are under way in numerous Federal agencies. Each of these programs follows unique strategies to achieve mapping goals and objectives. Implementation approaches range from highly centralized programs that use tightly integrated standards and dedicated staff, to dispersed programs that permit considerable flexibility. One model facilitates national consistency, while the other allows accommodation of locally relevant conditions and issues. An examination of the programmatic strategies of four national vegetation and land cover mapping initiatives can identify the unique approaches, accomplishments, and lessons of each that should be considered in the design of a national fuel mapping program. The first three programs are the U.S. Geological Survey Gap Analysis Program, the U.S. Geological Survey National Land Cover Characterization Program, and the U.S. Fish and Wildlife Survey National Wetlands Inventory. A fourth program, the interagency Multiresolution Land Characterization Program, offers insights in the use of partnerships to accomplish mapping goals. Collectively, the programs provide lessons, guiding principles, and other basic concepts that can be used to design a successful national fuels mapping initiative. Keywords: vegetation, land cover, fuels, mapping, United States, remote sensing.

  7. Clinical Phenotype of Dementia after Traumatic Brain Injury

    PubMed Central

    Sayed, Nasreen; Culver, Carlee; Dams-O'Connor, Kristen; Hammond, Flora

    2013-01-01

    Abstract Traumatic brain injury (TBI) in early to mid-life is associated with an increased risk of dementia in late life. It is unclear whether TBI results in acceleration of Alzheimer's disease (AD)-like pathology or has features of another dementing condition, such as chronic traumatic encephalopathy, which is associated with more-prominent mood, behavior, and motor disturbances than AD. Data from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set was obtained over a 5-year period. Categorical data were analyzed using Fisher's exact test. Continuous parametric data were analyzed using the Student's t-test. Nonparametric data were analyzed using Mann-Whitney's test. Overall, 877 individuals with dementia who had sustained TBI were identified in the NACC database. Only TBI with chronic deficit or dysfunction was associated with increased risk of dementia. Patients with dementia after TBI (n=62) were significantly more likely to experience depression, anxiety, irritability, and motor disorders than patients with probable AD. Autopsy data were available for 20 of the 62 TBI patients. Of the patients with TBI, 62% met National Institute of Aging-Reagan Institute “high likelihood” criteria for AD. We conclude that TBI with chronic deficit or dysfunction is associated with an increased odds ratio for dementia. Clinically, patients with dementia associated with TBI were more likely to have symptoms of depression, agitation, irritability, and motor dysfunction than patients with probable AD. These findings suggest that dementia in individuals with a history of TBI may be distinct from AD. PMID:23374007

  8. Nation Assistance: Does an Exercise in Guatemala by Reserve Components Support United States National Security Strategy?

    DTIC Science & Technology

    2007-11-02

    exercises called Fuertes Caminos in 1993, 1994, and 1995. The author was the aviation commander of Fuertes Caminos 95-North. This paper follows a...sequence describing the background of Guatemala and Fuertes Caminos exercises, defining nation assistance policy, then flowing through the United...called Fuertes Caminos. Two key guestions result from this analysis. Is it in the United States’ best interest to perform another Fuertes Caminos

  9. The National Security Strategy Under the United Nations and International Law

    DTIC Science & Technology

    2004-03-19

    a result of that war." This was addressed in 1951 by Hans Kelsen in a legal analysis of fundamental problems with the UN Charter. He concluded that...www.zmag.org/content/print_article.cfm>; Internet; accessed 31 January 2004. 36 Charter of the United Nations, Article 107. 37 Kearly, 27–28. 38 Hans Kelsen ...the framers introduced ambiguity reveals exactly what the framers intended. Kearly cites Hans Kelsen’s authoritative research of the charter of the

  10. Transfer Skills across a National Curriculum: The Role of Cognitive Strategies for Children with Learning Difficulties.

    ERIC Educational Resources Information Center

    Sugden, David A.

    1989-01-01

    Under the National Curriculum in the United Kingdom, children with learning difficulties will need to use transfer skills for various cross-curricular themes. To promote transfer, the use of cognitive strategies is recommended, including perceived similarity, analysis of the learning context, expert scaffolding, and detailed planning of practice…

  11. Building a National Strategy for Digital Preservation: Issues in Digital Media Archiving.

    ERIC Educational Resources Information Center

    Council on Library and Information Resources, Washington, DC.

    The United States Congress in December 2000 appropriated funds to the Library of Congress (LC) to spearhead an effort to develop a national strategy for the preservation of digital information. LC staff scheduled a series of conversations with representatives from the technology, business, entertainment, academic, legal, archival, and library…

  12. National study on faculty-to-faculty incivility: strategies to foster collegiality and civility.

    PubMed

    Clark, Cynthia M

    2013-01-01

    Faculty incivility can have lasting and devastating effects on individuals and organizations, including low morale, high turnover, increased absenteeism, isolation and alienation, diminished quality of work, and increased illness and health issues. To assess the nature and impact of faculty-to-faculty incivility, the author discusses a national study, its outcomes, and several evidence-based strategies to affectively address the problem.

  13. A Methodology for the Transition from National Strategy to Adaptive Force Packaging

    DTIC Science & Technology

    1994-06-03

    military, economic , political/diplomatic, informational and humanitarian. Examination of the environment of military operations, traditionally termed... economic , political/diplomatic, informational and humanitarian. Examination of the environment of military operations, traditionally termed "battle...development of national strategy requires an appropriate blend of all instruments of power- economic , diplomatic, informational, military and

  14. Investigating Learning English Strategies and English Needs of Undergraduate Students at the National University of Laos

    ERIC Educational Resources Information Center

    Souriyavongsa, Thongma; Abidin, Mohamad Jafre Zainol; Sam, Rany; Mei, Leong Lai; Aloysius, Ithayaraj Britto

    2013-01-01

    This paper aims to investigate learning English strategies and the requirement of English needs of the undergraduate students at the National University of Laos (NUOL). The study employed a survey design which involved in administering questionnaires of rating scales, and adapting the items from (Barakat, 2010; Chengbin, 2008; Kathleen A, 2010;…

  15. Strategic Leadership for Large-Scale Reform: The Case of England's National Literacy and Numeracy Strategy

    ERIC Educational Resources Information Center

    Leithwood, Kenneth; Jantzi, Doris; Earl, Lorna; Watson, Nancy; Levin, Benjamin; Fullan, Michael

    2004-01-01

    Both 'strategic' and 'distributed' forms of leadership are considered promising responses to the demands placed on school systems by large-scale reform initiatives. Using observation, interview and survey data collected as part of a larger evaluation of England's National Literacy and Numeracy Strategies, this study inquired about sources of…

  16. Exemplar Units of Work for English. Key Stage 3: National Strategy.

    ERIC Educational Resources Information Center

    Department for Education and Skills, London (England).

    These exemplar units of work for National Strategy Key Stage 3 English show how medium and short-term planning can be based on the Key Stage 3 Framework objectives and support the implementation of Curriculum 2000. The Key Stage 3 English strand introduces pupils to more specialist study of language and literature and supports the study of…

  17. National Offshore Wind Strategy: Facilitating the Development of the Offshore Wind Industry in the United States

    SciTech Connect

    Patrick Gilman; Maurer, Ben; Feinberg, Luke; Duerr, Alana; Peterson, Lauren; Musial, Walt; Beiter, Phillipp; Golladay, Jennifer; Stromberg, Jessica; Johnson, Isis; Boren, Doug; Moore, Annette

    2016-09-01

    The U.S. Department of Energy, through its Wind Energy Technologies Office, and U.S. Department of the Interior, through its Bureau of Ocean Energy Management, have jointly produced this updated national strategy to facilitate the responsible development of offshore wind energy in the United States.

  18. The Key Role of Educational Research in the Development and Evaluation of the National Numeracy Strategy

    ERIC Educational Resources Information Center

    Brown, Margaret; Askew, Mike; Millett, Alison; Rhodes, Valerie

    2003-01-01

    The authors contest a politician's claim that the National Numeracy Strategy (NNS) in English primary schools has been an undisputed success with no contribution from educational researchers. First, the key role of researchers and research in the development of the NNS is outlined. Then there is a description of the Leverhulme Numeracy Research…

  19. Not the Whole Story of the National Literacy Strategy: A Response to Dominic Wyse

    ERIC Educational Resources Information Center

    Beard, Roger

    2003-01-01

    There is evidence that the National Literacy Strategy (NLS) has led to a sustained increase in literacy attainment, especially in reading, although recent international comparisons also suggest some additional issues regarding pupil performance in England. The relative success of the NLS may at least partly lie in the policy application of several…

  20. Brain function, disease and dementia.

    PubMed

    Sandilyan, Malarvizhi Babu; Dening, Tom

    2015-05-27

    Dementia is a consequence of brain disease. This article, the second in this series on dementia, discusses normal brain function and how certain functions are localised to different areas of the brain. This is important in determining the symptoms of dementia, depending on which parts of the brain are most directly involved. The most common types of dementia - Alzheimer's disease, vascular dementia, dementia with Lewy bodies and frontotemporal dementia - affect the brain in different ways and cause different changes at the microscopic level. Dementia is affected by genetics, and recent advances in molecular techniques have improved our understanding of some of the mechanisms involved, which in turns suggests possibilities for new treatments in the future.

  1. Dementia screening using computerized tests.

    PubMed

    Gualtieri, C Thomas

    2004-01-01

    The preclinical phase of dementia usually precedes the clinical diagnosis by many years. Early detection of dementing conditions during this preclinical phase may provide opportunities for treatments that may slow or mitigate progression. Conventional assessment tools usually can only detect dementia when the symptoms are overt and the disease is well-established. Computerized neurocognitive screening tools hold promise for diagnosing dementia in its early phase. The use, performance and development of several computerized screening tools to diagnose and monitor patients with pre-dementias and dementia are reviewed. The ability to accurately assess the presence of dementia clearly has direct relevance to insurance risk assessment and risk management. As new treatments appear, their role in clinical management of dementia patients will increase as well. In a future issue, the differential diagnosis of dementias related to the findings on these screening tools will be reviewed.

  2. Symptoms of Lewy Body Dementia

    MedlinePlus

    ... usually memory problems, changes in their way of speaking, such as forgetting words, and personality problems. Cognitive symptoms of dementia include poor problem solving, difficulty with learning new skills and impaired decision making. Other causes of dementia ...

  3. Multiplex analyte assays to characterize different dementias: brain inflammatory cytokines in poststroke and other dementias.

    PubMed

    Chen, Aiqing; Oakley, Arthur E; Monteiro, Maria; Tuomela, Katri; Allan, Louise M; Mukaetova-Ladinska, Elizabeta B; O'Brien, John T; Kalaria, Raj N

    2016-02-01

    possible specific involvement of immunosenescence in dementia pathogenesis. In contrast, CRP was not altered between dementia and nondementia subjects or between PSD and PSND. Our study provides evidence not only for the feasibility of tracking cytokines in postmortem brain tissue but also suggests differentially impaired inflammatory mechanisms underlying dementia including AD. There was a diminished inflammatory response, possibly reflecting immunosenescence and cerebral atrophy, in all dementias. Strategies to enhance anti-inflammatory cytokines and boost the immune system of the brain may be beneficial for preventing cognitive dysfunction, especially after stroke.

  4. Making sense of dementia: Exploring the use of the Markers of Assimilation of Problematic Experiences in Dementia scale to understand how couples process a diagnosis of dementia.

    PubMed

    Snow, Katie; Cheston, Richard; Smart, Cordet

    2016-11-01

    This qualitative study aimed to see whether the Markers of Assimilation of Problematic Experiences in Dementia (MAPED) scale could be applied to couples. It aimed to explore the interactions between couples and how this affected the levels of assimilation. Semi-structured interviews were conducted with four heterosexual couples. The results suggested that MAPED can be usefully applied to couples. It highlighted the oscillating process which couples undergo as they process a dementia diagnosis. This supports the notion that making sense of a dementia diagnosis is not static, but a fluctuating and ever changing process. The strategies couples employed either facilitated or prevented the expression and integration of the Problematic Voice. The study highlights the importance of supporting couples together during a dementia diagnosis.

  5. The impact of a national strategy to increase physical activity among older adults on national organizations.

    PubMed

    Park, Chae-Hee; Chodzko-Zajko, Wojtek; Ory, Marcia G; Gleason-Senior, Jane; Bazzarre, Terry L; Mockenhaupt, Robin

    2010-10-01

    This study was designed to evaluate the impact of the National Blueprint (NB) on the policies, programs, and organizational culture of selected national organizations. The theoretical model selected to assess the impact of the NB on organizational behavior was Burke's system theory of organizational change. Three organizations, AARP, the American College of Sports Medicine (ACSM), and the Administration on Aging (AoA), were selected for the study. Two individuals in each of these organizations were selected for interview. Semistructured interviews and document reviews were used in the data-collection process. Findings showed that the publication and establishment of the NB resulted in changes in the operating procedures of AARP, ACSM, and AoA. The results were broadly consistent with Burke's system theory of organizational change. The publication of the NB was shown to affect the behavior of organizational leaders, organizational culture, policies, programs, and individual and organizational performance. The new information generated has increased our understanding of the impact of health campaigns on organizational behavior.

  6. Investigating the ways that older people cope with dementia: a qualitative study.

    PubMed

    Preston, Laura; Marshall, Ann; Bucks, Romola S

    2007-03-01

    Understanding the way that older people cope with dementia has important implications for the enhancement of the psychological well-being and quality of life of this group of people. This qualitative study explored how older people cope with dementia, by engaging 12 people with early-stage dementia in semi-structured interviews. Interpretative phenomenological analysis (IPA) was used to identify the shared themes in participants' accounts. Three major themes emerged: "managing identity in relation to dementia", "making sense of dementia", and "coping strategies and mechanisms" (the latter theme divided into "everyday, individual strategies", "coping in relation to others", and "personal attitude/approach"). There were also two additional themes in relation to process issues: issues of "conflict and control" which were evident across all other themes, as was individuality and the importance of "context" in coping with dementia. These findings are discussed in the relation to previous research in this field, and suggestions for further research and clinical practice are outlined.

  7. Dementia as a cultural metaphor.

    PubMed

    Zeilig, Hannah

    2014-04-01

    This article contributes to debates about the category "dementia," which until recently has been dominated by biomedical models. The perspectives of critical gerontology are pertinent for extending knowledge about dementia and guiding this analysis. These perspectives encourage examination of cultural and historical influences and thus question how societies have constructed and defined dementia. This article queries the stories told about dementia and the language that we use to tell these stories. Central to the article is an analysis of some of the stories about dementia that are contained within and framed by contemporary culture. A number of films, TV documentaries, news reports, theatre, memoirs, novels, and poems that portray some of the experiences associated with dementia are interrogated. These representations are examined as they either perpetrate or challenge stereotypes about living with dementia. Analysis of these representations demonstrates the sociocultural construction of dementia and the extent to which dementia is a diachronic phenomenon. Above all, the article considers (a) the social and political dimensions of dementia, (b) the ways in which the metaphors persistently used to explain dementia shape our consciousness about this condition, and (c) the extent to which dementia is an inherent part of contemporary life.

  8. Multi-infarct dementia, subcortical dementia, and hydrocephalus.

    PubMed

    Nadeau, S E

    1991-05-01

    The diagnostic evaluation of dementia is directed toward the identification of treatable causes. It can be facilitated by classification of the dementia into one of four categories: attentional, amnestic, cognitive, and intentional. Intentional dementia reflects dysfunction of frontal lobe systems, components of which include the frontal cortex, basal ganglia, thalamus, limbic structures, and subcortical white matter. Disorders that affect one or more of these components and produce intentional dementia include Binswanger's disease, Parkinson's disease, Huntington's disease, HIV infection, closed head injury, normal pressure hydrocephalus, neoplasms, syphilis, vitamin B12 deficiency, multiple sclerosis, and a number of uncommon degenerative and acquired syndromes. Depression may resemble intentional dementia. Guidelines for diagnosis and management are discussed.

  9. [Delirium and dementia].

    PubMed

    Marín Carmona, José Manuel

    2008-01-01

    Delirium and dementia are highly prevalent neurocognitive syndromes in the elderly. These syndromes are defined by level of consciousness, clinical onset, and potential reversibility, etc. Frequently, both syndromes coincide in the elderly patient and share many epidemiologic, pathogenic and clinical features, which are reviewed in this article. There is no solid scientific evidence that explains the association between delirium and dementia. The present article proposes a change of paradigm in the diagnostic, preventive and therapeutic approach to delirium in the elderly that recognizes the inherent complexity of this geriatric syndrome and, unlike dichotomic models, explores the complex interrelations between both geriatric syndromes. Delirium is viewed as an important model to investigate cognitive disorders and dementia.

  10. Hypertension and dementia.

    PubMed

    Hanon, Olivier; Seux, Marie Laure; Lenoir, Hermine; Rigaud, Anne Sophie; Forette, Françoise

    2003-11-01

    Hypertension is one of the principal risk factors for cerebrovascular diseases. Several epidemiologic studies have also indicated a positive correlation between cognitive decline or dementia and blood pressure level. Indeed, the results of most longitudinal studies show that cognitive functioning is often inversely proportional to blood pressure values measured 15 or 20 years previously. Cerebral infarcts, lacunae, and white matter changes are implicated in the pathogenesis of vascular dementia, but may also favor the development of Alzheimer's disease. Microcirculation disorders and endothelial dysfunctions are also advanced to explain the deterioration in cognitive functions in hypertensive subjects. Data from recent therapeutic trials open the way to the prevention of dementia (vascular or Alzheimer's type) by antihypertensive treatments and must be confirmed by other studies.

  11. Nutrition in Severe Dementia

    PubMed Central

    Pivi, Glaucia Akiko Kamikado; Bertolucci, Paulo Henrique Ferreira; Schultz, Rodrigo Rizek

    2012-01-01

    An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH) is likely to be beneficial for the patient. The objective of this paper is to present methods for evaluating the nutritional status of patients with severe dementia as well as measures for the treatment of nutritional disorders, the use of vitamin and mineral supplementation, and indications for ANH and pharmacological therapy. PMID:22645608

  12. National climate policies across Europe and their impacts on cities strategies.

    PubMed

    Heidrich, O; Reckien, D; Olazabal, M; Foley, A; Salvia, M; de Gregorio Hurtado, S; Orru, H; Flacke, J; Geneletti, D; Pietrapertosa, F; Hamann, J J-P; Tiwary, A; Feliu, E; Dawson, R J

    2016-03-01

    Globally, efforts are underway to reduce anthropogenic greenhouse gas emissions and to adapt to climate change impacts at the local level. However, there is a poor understanding of the relationship between city strategies on climate change mitigation and adaptation and the relevant policies at national and European level. This paper describes a comparative study and evaluation of cross-national policy. It reports the findings of studying the climate change strategies or plans from 200 European cities from Austria, Belgium, Estonia, Finland, France, Germany, Ireland, Italy, Netherlands, Spain and the United Kingdom. The study highlights the shared responsibility of global, European, national, regional and city policies. An interpretation and illustration of the influences from international and national networks and policy makers in stimulating the development of local strategies and actions is proposed. It was found that there is no archetypical way of planning for climate change, and multiple interests and motivations are inevitable. Our research warrants the need for a multi-scale approach to climate policy in the future, mainly ensuring sufficient capacity and resource to enable local authorities to plan and respond to their specific climate change agenda for maximising the management potentials for translating environmental challenges into opportunities.

  13. Creating the laboratory`s future; A strategy for Lawrence Livermore National Laboratory

    SciTech Connect

    1997-09-01

    ``Creating The Laboratory`s Future`` describes Livermore`s roles and responsibilities as a Department of Energy (DOE) national laboratory and sets the foundation for decisions about the Laboratory`s programs and operations. It summarizes Livermore`s near-term strategy, which builds on recent Lab achievements and world events affecting their future. It also discusses their programmatic and operational emphases and highlights program areas that the authors believe can grow through application of Lab science and technology. Creating the Laboratory`s Future reflects their very strong focus on national security, important changes in the character of their national security work, major efforts are under way to overhaul their administrative and operational systems, and the continuing challenge of achieving national consensus on the role of the government in energy, environment, and the biosciences.

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

    SciTech Connect

    2009-02-01

    This report documents the identification of 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).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. The leveraging of dollars serves many purposes. These include increasing the amount of training that can be delivered and therefore increasing the number of people reached, increasing the number and quality of public/private partnerships, and increasing the number of businesses that are involved in the training of their future workforce.

  15. [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.

  16. 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

  17. Chicago partners in the American dream: A local effort within the national homeownership strategy

    SciTech Connect

    Wallace, E.; Cavallo, J.; Peterson, N.; Nelson, M.

    1997-03-01

    President Clinton and the U.S. Department of Housing and Urban Development (HUD) have set a goal of increasing homeownership in America. Currently the rate of homeownership is approximately 64 percent of the population. The goal is to raise that rate to 67.5 percent by the year 2000, a higher rate than ever recorded in U.S. history. Achieving the goal will require about 8 million families to acquire homes of their own. HUD has developed a plan for reaching the national homeownership goal. The plan is known as the National Homeownership Strategy. It was formulated with input from more than 50 public- and private-sector groups and consists of 100 objectives designed to make homeownership easier and affordable for American families. Among the objectives are expanded use of energy conservation and new construction technologies. The groups participating in the formulation of the National Homeownership Strategy formed a collaboration that was named the National Partners in Homeownership. Chicago Partners in the American Dream is a collaboration of Chicago organizations implementing the National Homeownership Strategy on a local level. It has made achieving the objectives of the Strategy the foundation for its local partnership. The Chicago Partners in the American Dream is a grassroots collaboration, combining the experience, resources, and expertise of a variety of local organizations. The fundamental goal of the Chicago Partners in the American Dream is to create 5,000 homeownership opportunities in nine to twelve focused areas within Empowerment Zone/Enterprise Communities in the Chicagoland market by the end of the year 2000.

  18. 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.

  19. Montessori-based dementia care.

    PubMed

    Cline, Janet

    2006-10-01

    Montessori-based Dementia Care is an approach used in Alzheimer's care that does not involve chemical or physical restraints. This program works by giving the elder with Alzheimer/Dementia a purpose by getting them involved. When staff/families care for a confused Alzheimer/Dementia patient, who is having behaviors, the Montessori program teaches them to look at what is causing the behavior. When assessing the elder to determine what is causing the behavior, the goal is to find the answer, but the answer cannot be dementia. The goal of the program is to bring meaning to the life of an Alzheimer/Dementia elder.

  20. Proposed national strategies for the prevention of leading work-related diseases and injuries. Part 1

    SciTech Connect

    Not Available

    1986-01-01

    Preliminary strategies developed at the National Symposium on the Prevention of Leading Work Related Diseases and Injuries, held in Atlanta, Georgia on May 1 to 3, 1985 were revised, elaborated, and further developed. Strategies were developed for the prevention of occupational lung diseases, musculoskeletal injuries, occupational cancers, severe occupational traumatic injuries, and occupational cardiovascular diseases. Lung diseases considered included silicosis, asbestosis, lung cancer mesothelioma, coal workers' pneumoconiosis, byssinosis, occupational asthma, hypersensitivity pneumonitis, asphyxiation, irritation, pulmonary edema, brucellosis, psitticosis, anthrax, mycobacterioses, histoplasmosis, aspergillosis, and coccidioidomycosis. Occupational cancers were discussed as they occur in the lung, pleura, peritoneum, bladder, kidneys, blood, nasal cavity, skin, nasal sinuses, and liver.

  1. Towards National eHealth Implementation--a comparative study on WHO/ITU National eHealth Strategy Toolkit in Iran.

    PubMed

    Riazi, Hossein; Jafarpour, Maryam; Bitaraf, Ehsan

    2014-01-01

    Experiences has shown that utilization of ICT in health sector requires national commitment and planned efforts to make the best use of existing capacity. Establishing the main directions as well as planning the detailed steps needed are key to achieving longer-term goals such as health sector efficiency, reform or more fundamental transformation. Collaboration between the health and ICT sectors, both public and private, is central to this effort. As the major United Nations agencies for health and telecommunications respectively, the World Health Organization (WHO) and the International Telecommunication Union (ITU) have recognized the importance of collaboration for eHealth in their global resolutions, which encourage countries to develop national eHealth strategies; the National eHealth Strategy Toolkit is the proof of these recommendations. In this study a mapping of eHealth components in WHO/ITU National eHealth Strategy Toolkit and our national eHealth vision is presented.

  2. COMPARATIVE EFFECTIVENESS OF MCI and DEMENTIA TREATMENTS IN A COMMUNITY-BASED DEMENTIA PRACTICE

    ClinicalTrials.gov

    2016-08-04

    Mild Cognitive Impairment; Dementia; Hypoxia; Hyperhomocysteinemia; Vitamin B 12 Deficiency; Iron Deficiency; Anemia; TBI; Neurodegenerative Disorders; Alzheimer's Disease; Vascular Dementia; Brain Injuries; Tauopathies; Parkinson's Disease; Lewy Body Dementia; Frontotemporal Dementia; TDP-43 Proteinopathies

  3. Treatment for Dementia

    PubMed Central

    Taylor, Jirka; Marjanovic, Sonja; Nolte, Ellen; Pollitt, Alexandra; Rubin, Jennifer

    2016-01-01

    Abstract The past few decades have seen a number of medical breakthroughs that enabled the effective treatment of a range of conditions, transforming them from fatal into manageable ones. Examples include certain cancers and HIV. Conversely, progress on dementia has been limited. There are currently no treatments that will cure or even alter the progressive course of dementia, despite ongoing research investigating new therapies and care options. The UK Department of Health is interested in the potential to learn from other disease areas to better understand the particular social, economic, political, legislative and scientific contexts that have contributed to accelerating progress and breakthroughs in treatment. Such learning could helpfully inform dementia research and innovation efforts, and help identify levers for supportive policy development. This project analysed breakthroughs in the treatment of four selected conditions of ill health and seeks to identify potentially transferable lessons for the dementia context. Using evidence review and key informant interviews we sought to identify the series of “events” that eventually led to a given breakthrough, and the key milestones in the process that have helped improve understanding and potential for treatment. We also aimed to capture the temporal and causal relationships between “notable” events looking at a variety of factors implicated in the breakthrough pathway. The focus of this work was on political, economic, social, scientific and technological, and legal, regulatory and environmental factors. PMID:28083433

  4. Dementia and driving.

    PubMed

    O'Neill, D; Neubauer, K; Boyle, M; Gerrard, J; Surmon, D; Wilcock, G K

    1992-04-01

    Many European countries test cars, but not their drivers, as they age. There is evidence to suggest that human factors are more important than vehicular factors as causes of motor crashes. The elderly also are involved in more accidents per distance travelled than middle-aged drivers. As the UK relies on self-certification of health by drivers over the age of 70 years, we examined the driving practices of patients with dementia attending a Memory Clinic. Nearly one-fifth of 329 patients with documented dementia continued to drive after the onset of dementia, and impaired driving ability was noted in two-thirds of these. Their families experienced great difficulty in persuading patients to stop driving, and had to invoke outside help in many cases. Neuropsychological tests did not help to identify those who drove badly while activity of daily living scores were related to driving ability. These findings suggest that many patients with dementia drive in an unsafe fashion after the onset of the illness. The present system of self-certification of health by the elderly for driver-licensing purposes needs to be reassessed.

  5. Lewy Body Dementia Diagnosis

    MedlinePlus

    ... as part of their protocols. Participating in research studies is a good way to benefit others with Lewy body dementia. Medications Medications are one of the most controversial subjects in dealing with LBD. A medication that doesn't work for one person may work for another person. ...

  6. The Need to Develop a National Health Strategy - A Report on the Industry

    DTIC Science & Technology

    2007-11-02

    Report on the Industry FORMAT: Strategy Research Project DATE: 18 March 2005 PAGES: 50 CLASSIFICATION: Unclassified The quality of health care in terms of...argue that the United States can claim a quality of health care among the highest in the world, costs in fact are soaring out of proportion to the... quality of care provided to the population as a whole. Government and private industry spending on health care threatens an impending national fiscal

  7. Brazil’s National Defense Strategy -- A Deepening of Civilian Control

    DTIC Science & Technology

    2009-05-15

    Identity Crisis.” Journal of Interamerican Studies and World Affairs 42, no.3 (Autumn 2000): 149 in JSTOR (Accessed September 17, 2008). 26 Ibid. 161 27...34 Ibid. 35 Stockholm International Peace Research Institute, “Military Expenditure Database – Brazil,” http://milexdata.sipri.org/result.php4...International Peace Research Institute, “Military Expenditure Database – Brazil,” 59 Jobim and Unger, National Defense Strategy. 60 Senior SOUTHCOM

  8. The National Security Strategy of the United Kingdom: Security in an Interdependent World

    DTIC Science & Technology

    2008-03-01

    changes and globalisation . 1.4 The aim of this first National Security Strategy is to set out how we will address and manage this diverse though...also, crucially, greater legitimacy. And just as globalisation exacerbates the challenges, it also creates new opportunities for a multilateral...a world where globalisation can exacerbate domestic security challenges, but also bring new opportunities to tackle them. Similarly, the

  9. Strategies for International Cooperation in Support of Energy Development in Pacific Island Nations

    SciTech Connect

    Miller, M.; Voss, P.; Warren, A.; Baring-Gould, I.; Conrad, M.

    2012-05-01

    The U.S. Department of Energy's National Renewable Energy Laboratory (NREL) has been partnering with island communities around the world to address the technical, policy, social, and economic hurdles to deploying energy efficiency and renewable energy technologies (RETs) on small, islanded systems. The lessons learned from these partnerships are briefly summarized in this document with the goal of supporting the International Renewable Energy Agency (IRENA) in the development of specific near-term and longer-term strategies for island RET deployment.

  10. The Interagency Breakdown: Why We Need Legislative Reform to Coordinate Execution of the National Security Strategy

    DTIC Science & Technology

    2008-04-01

    core areas that the reform needs to address require analysis . The analysis starts with the fact that the National Security Strategy is the centerpiece... tinder 5om!1iI𔃻 .t>:l A:s1stanl seu.Ia’~ CltIP. /JirFtlrce Marine Corps Major Commands & Agencies Cl:iH or N>\\𔃻J1 Opemlions Navy Major Commands &A

  11. Applying change management metaphors to a national e-Health strategy.

    PubMed

    Saunders, Chad; Scott, Richard E

    2014-01-01

    Recent attempts at a collective understanding of how to develop an e-Health strategy have addressed the individual organisation, collection of organisations, and national levels. At the national level the World Health Organisation's National eHealth Strategy Toolkit serves as an exemplar that consolidates knowledge in this area, guides practical implementations, and identifies areas for future research. A key implication of this toolkit is the considerable number of organisational changes required to successfully apply their ideas in practice. This study looks critically at the confluence of change management and e-Health strategy using metaphors that underpin established models of change management. Several of Morgan's organisational metaphors are presented (highlighting varied beliefs and assumptions regarding how change is enacted, who is responsible for the change, and guiding principles for that change), and used to provide a framework. Attention is then directed to several prominent models of change management that exemplify one or more of these metaphors, and these theoretical insights are applied to evaluate the World Health Organisation's National eHealth Strategy Toolkit. The paper presents areas for consideration when using the WHO/ITU toolkit, and suggestions on how to improve its use in practice. The goal is to seek insight regarding the optimal sequence of steps needed to ensure successful implementation and integration of e-health into health systems using change management models. No single model, toolkit, or guideline will offer all the needed answers, but clarity around the underlying metaphors informing the change management models being used provides valuable insight so potentially challenging areas can be avoided or mitigated.

  12. Nutrition and Physical Activity Strategies for Cancer Prevention in Current National Comprehensive Cancer Control Program Plans.

    PubMed

    Puckett, Mary; Neri, Antonio; Underwood, J Michael; Stewart, Sherri L

    2016-10-01

    Obesity, diet and physical inactivity are risk factors for some cancers. Grantees of the National Comprehensive Cancer Control Program (NCCCP) in US states, tribes, and territories develop plans to coordinate funding and activities for cancer prevention and control. Including information and goals related to nutrition and physical activity (NPA) is a key opportunity for primary cancer prevention, but it is currently unclear to what extent NCCCP plans address these issues. We reviewed 69 NCCCP plans and searched for terms related to NPA. Plans were coded as (1) knowledge of NPA and cancer link; (2) goals to improve NPA behaviors; and (3) strategies to increase healthy NPA activities, environments, or systems changes. NPA content was consistently included in all cancer plans examined across all years. Only 4 (6 %) outlined only the relationship between NPA and cancer without goals or strategies. Fifty-nine plans (89 %) contained goals or strategies related to NPA, with 53 (82 %) including both. However, numbers of goals, strategies, and detail provided varied widely. All programs recognized the importance of NPA in cancer prevention. Most plans included NPA goals and strategies. Increasing the presence of NPA strategies that can be modified or adapted appropriately locally could help with more widespread implementation and measurement of NPA interventions.

  13. Aspirin for vascular dementia

    PubMed Central

    Rands, Gianetta; Orrell, Martin

    2014-01-01

    Background Aspirin is widely prescribed for patients with a diagnosis of vascular dementia. In a survey of UK geriatricians and psychiatrists 80% of patients with clinical diagnoses of vascular dementia were prescribed aspirin. However, a number of queries remain unanswered. Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition and behaviour, or improve prognosis? Does the risk of cerebral or gastric haemorrhage outweigh any benefit? Objectives To assess the randomised trial evidence for efficacy and safety of aspirin in the treatment of vascular dementia. Search methods We searched ALOIS: the Cochrane Dementia and Cognitive Improvement Group’s Specialized Register on 12 March 2012 using the terms: aspirin OR “acetylsalicylic acid”. ALOIS contains records of clinical trials identified from monthly searches of a number of major healthcare databases, numerous trial registries and grey literature sources. In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material and any publications found were searched for additional references. Selection criteria Randomised controlled trials investigating the effect of aspirin for vascular dementia were eligible for inclusion. Data collection and analysis Retrieved studies were analysed independently by both review authors. Methodology and results were critically appraised and outcomes scanned included cognition, behavioural change, mortality and institutionalisation. Main results No trials were eligible for inclusion in this review. Authors’ conclusions The most recent search for references to relevant research was carried out in March 2012. No trials were found for inclusion in this systematic review. Low-dose aspirin is frequently used as ‘treatment as normal’ in control groups and as a baseline treatment in pharmacological trials. There is still no good evidence that

  14. What is vascular dementia?

    PubMed

    Kurz, A F

    2001-05-01

    Cerebrovascular disease (CVD) and dementia frequently coexist in elderly patients. The question of whether the CVD causes the dementia depends on how 'dementia' is defined. Traditional definitions specified that dementia involved a decline in intellectual ability as a core feature. However, revised definitions have since stipulated two key elements: 1) a global rather than focal neurobehavioural deficit and 2) impairment in activities of daily living (ADL). When applied to CVD, these latter concepts of dementia raise difficulty: Focal cerebrovascular lesions in the cortex generate location-specific neurobehavioural deficits that are part of the dementia syndrome, but, even in combination, do not represent a global intellectual decline. Most cerebrovascular lesions are associated with physical symptoms that make it difficult to evaluate whether cognitive impairments have an independent impact on ADL. The majority of neurobehavioural symptoms in CVD are caused by small-vessel-type subcortical lesions and are dissimilar to those seen in Alzheimer's disease. There are several pathogenetic mechanisms, however, by which large-vessel or small-vessel CVD can cause global cognitive and intellectual impairments, allowing a diagnosis of vascular dementia (VaD): An accumulation of ischaemic lesions in the cortex may produce global intellectual impairment, particularly if they affect important areas of the brain. Single small infarcts, or haemorrhages in strategic subcortical locations, may interfere with specific circuits connecting the prefrontal cortex to the basal ganglia, or with nonspecific thalamocortical projections. This may generate combinations of executive dysfunction, personality change or apathy, which are associated with hypoperfusion and hypometabolism predominantly in frontal cortical areas. Extensive white matter lesions probably affect cognitive function through a loss of axons, producing a functional disconnection of the cortex. This can manifest as

  15. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE 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...

  16. Use of health economics in the development of a national radon control strategy in Ireland.

    PubMed

    Pollard, D; Fenton, D

    2014-07-01

    A health economics evaluation of different radon intervention strategies was undertaken including the incorporation of prevention into new buildings, the incorporation of potential remedial measures into new buildings and remediation of existing buildings. The analysis shows that (1) the incorporation of prevention into new houses at the time of construction is generally more cost effective than remediation of existing houses and (2) that the cost effectiveness of programmes aimed at encouraging householders to test and remediate their houses may be poor if they are not undertaken within the context of coherent radon reduction strategy. The results of this evaluation were used to identify the most cost-effective radon interventions in an Irish context in support of the development of a National Radon Control Strategy.

  17. Music Perception in Dementia.

    PubMed

    Golden, Hannah L; Clark, Camilla N; Nicholas, Jennifer M; Cohen, Miriam H; Slattery, Catherine F; Paterson, Ross W; Foulkes, Alexander J M; Schott, Jonathan M; Mummery, Catherine J; Crutch, Sebastian J; Warren, Jason D

    2017-01-01

    Despite much recent interest in music and dementia, music perception has not been widely studied across dementia syndromes using an information processing approach. Here we addressed this issue in a cohort of 30 patients representing major dementia syndromes of typical Alzheimer's disease (AD, n = 16), logopenic aphasia (LPA, an Alzheimer variant syndrome; n = 5), and progressive nonfluent aphasia (PNFA; n = 9) in relation to 19 healthy age-matched individuals. We designed a novel neuropsychological battery to assess perception of musical patterns in the dimensions of pitch and temporal information (requiring detection of notes that deviated from the established pattern based on local or global sequence features) and musical scene analysis (requiring detection of a familiar tune within polyphonic harmony). Performance on these tests was referenced to generic auditory (timbral) deviance detection and recognition of familiar tunes and adjusted for general auditory working memory performance. Relative to healthy controls, patients with AD and LPA had group-level deficits of global pitch (melody contour) processing while patients with PNFA as a group had deficits of local (interval) as well as global pitch processing. There was substantial individual variation within syndromic groups. Taking working memory performance into account, no specific deficits of musical temporal processing, timbre processing, musical scene analysis, or tune recognition were identified. The findings suggest that particular aspects of music perception such as pitch pattern analysis may open a window on the processing of information streams in major dementia syndromes. The potential selectivity of musical deficits for particular dementia syndromes and particular dimensions of processing warrants further systematic investigation.

  18. Music perception in dementia

    PubMed Central

    Nicholas, Jennifer M; Cohen, Miriam H; Slattery, Catherine F; Paterson, Ross W; Foulkes, Alexander J M; Schott, Jonathan M; Mummery, Catherine J; Crutch, Sebastian J; Warren, Jason D

    2017-01-01

    Despite much recent interest in music and dementia, music perception has not been widely studied across dementia syndromes using an information processing approach. Here we addressed this issue in a cohort of 30 patients representing major dementia syndromes of typical Alzheimer’s disease (AD, n=16), logopenic aphasia (LPA, an Alzheimer variant syndrome; n=5) and progressive nonfluent aphasia (PNFA; n=9) in relation to 19 healthy age-matched individuals. We designed a novel neuropsychological battery to assess perception of musical patterns in the dimensions of pitch and temporal information (requiring detection of notes that deviated from the established pattern based on local or global sequence features) and musical scene analysis (requiring detection of a familiar tune within polyphonic harmony). Performance on these tests was referenced to generic auditory (timbral) deviance detection and recognition of familiar tunes and adjusted for general auditory working memory performance. Relative to healthy controls, patients with AD and LPA had group-level deficits of global pitch (melody contour) processing while patients with PNFA as a group had deficits of local (interval) as well as global pitch processing. There was substantial individual variation within syndromic groups. No specific deficits of musical temporal processing, timbre processing, musical scene analysis or tune recognition were identified. The findings suggest that particular aspects of music perception such as pitch pattern analysis may open a window on the processing of information streams in major dementia syndromes. The potential selectivity of musical deficits for particular dementia syndromes and particular dimensions of processing warrants further systematic investigation. PMID:27802226

  19. Dementia with Lewy bodies.

    PubMed

    McKeith, Ian G; Burn, David J; Ballard, Clive G; Collerton, Daniel; Jaros, Evelyn; Morris, Chris M; McLaren, Andrew; Perry, Elaine K; Perry, Robert; Piggott, Margaret A; O'Brien, John T

    2003-01-01

    The objective was to summarize recent findings about the clinical features, diagnosis and investigation of dementia with Lewy (DLB) bodies, together with its neuropathology, neurochemistry and genetics. Dementia with Lewy bodies (DLB) is a primary, neurodegenerative dementia sharing clinical and pathological characteristics with both Parkinson's disease (PD) and Alzheimer's disease (AD). Antiubiquitin immunocytochemical staining, developed in the early 1990s, allowed the frequency and distribution of cortical LBs to be defined. More recently, alpha-synuclein antibodies have revealed extensive neuritic pathology in DLB demonstrating a neurobiological link with other "synucleinopathies" including PD and multiple system atrophy (MSA). The most significant correlates of cognitive failure in DLB appear to be with cortical LB and Lewy neurites (LNs) rather than Alzheimer type pathology. Clinical diagnostic criteria for DLB, published in 1996, have been subjected to several validation studies against autopsy findings. These conclude that although diagnostic specificity is high (range 79- 100%, mean 92%), sensitivity is lower (range 0- 83 %, mean, 49%). Improved methods of case detection are therefore required. Fluctuating impairments in attention, visual recognition and construction are more indicative of DLB than AD. Relative preservation of medial temporal lobe volume on structural MRI and the use of SPECT tracers for regional blood flow and the dopamine transporter are the most reliable current biomarkers for DLB. There are no genetic or CSF tests recommended for the diagnosis of DLB at present. Between 15 and 20% of all elderly demented cases reaching autopsy have DLB, making it the most common cause of degenerative dementia after AD. Exquisite, not infrequently fatal, sensitivity to neuroleptic drugs and encouraging reports of the effects of cholinesterase inhibitors on cognitive, psychiatric and neurological features, mean that an accurate diagnosis of DLB is more

  20. Internet-Based Dementia Resources: Physician Attitudes and Practices.

    PubMed

    Galvin, James E; Meuser, Thomas M; Boise, Linda; Connell, Cathleen M

    2011-08-01

    Despite the potential of the internet for informing clinical practice, little is know about physicians' use of and attitudes about internet use for dementia care. We surveyed 373 physicians to inform development of on-line dementia education resources. Two thirds reported using internet-based resources in their clinical practices at least three times per week; 61% participated in on-line continuing medical education. Three fourths agreed that internet-based resources are helpful in clinical care but most expressed mixed views about quality of available information. Respondents reported limited awareness and use of dementia-specific internet resources, but expressed an interest in such information regarding screening, treatment, community resources, and patient education. National Institute on Aging-funded Alzheimer's Disease Centers are in a unique position to disseminate on-line resources for physicians on dementia diagnosis, treatment, and care. Our study suggests that such a resource would be well received and utilized by physicians.

  1. Cholinergic and other neurotransmitter mechanisms in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies.

    PubMed

    Francis, Paul T; Perry, Elaine K

    2007-09-01

    It is now 30 years since the beginning of intensive efforts to understand the neurotransmitter biochemistry of dementia as exemplified by Alzheimer's disease and such studies have led to the development of rational treatment strategies, which are continuing to benefit patients. However, as studies became more sophisticated and clinicians rediscovered an interest in dementia, because of the potential for symptomatic treatment, it has become clear that there are several different neurodegenerative conditions that gives rise to dementia syndromes and that each has distinct neurochemical pathology. This has important treatment implications since what works for one may not work for another or at the extreme, may make matters worse. Therefore it is clear that a detailed understanding of the neurotransmitter function in each condition is not merely academic but can lead to rationale drug design and treatment strategies appropriate for that group of patients. Dementia with Lewy bodies (DLB) has clinico-pathological features, which overlap with either AD or Parkinson's disease (PD) as well as features that help to distinguish it, such as fluctuations in cognitive impairment and a higher prevalence of visual hallucinations. On this basis, it would be expected that the neurochemistry would have some similarities with both disorders.

  2. Behavioral and Psychological Symptoms of Dementia

    PubMed Central

    Cerejeira, J.; Lagarto, L.; Mukaetova-Ladinska, E. B.

    2012-01-01

    Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms, represent a heterogeneous group of non-cognitive symptoms and behaviors occurring in subjects with dementia. BPSD constitute a major component of the dementia syndrome irrespective of its subtype. They are as clinically relevant as cognitive symptoms as they strongly correlate with the degree of functional and cognitive impairment. BPSD include agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes. It is estimated that BPSD affect up to 90% of all dementia subjects over the course of their illness, and is independently associated with poor outcomes, including distress among patients and caregivers, long-term hospitalization, misuse of medication, and increased health care costs. Although these symptoms can be present individually it is more common that various psychopathological features co-occur simultaneously in the same patient. Thus, categorization of BPSD in clusters taking into account their natural course, prognosis, and treatment response may be useful in the clinical practice. The pathogenesis of BPSD has not been clearly delineated but it is probably the result of a complex interplay of psychological, social, and biological factors. Recent studies have emphasized the role of neurochemical, neuropathological, and genetic factors underlying the clinical manifestations of BPSD. A high degree of clinical expertise is crucial to appropriately recognize and manage the neuropsychiatric symptoms in a patient with dementia. Combination of non-pharmacological and careful use of pharmacological interventions is the recommended therapeutic for managing BPSD. Given the modest efficacy of current strategies, there is an urgent need to identify novel pharmacological targets and develop new non-pharmacological approaches to improve the adverse outcomes associated with

  3. The Swedish strategy and method for development of a national healthcare information architecture.

    PubMed

    Rosenälv, Jessica; Lundell, Karl-Henrik

    2012-01-01

    "We need a precise framework of regulations in order to maintain appropriate and structured health care documentation that ensures that the information maintains a sufficient level of quality to be used in treatment, in research and by the actual patient. The users shall be aided by clearly and uniformly defined terms and concepts, and there should be an information structure that clarifies what to document and how to make the information more useful. Most of all, we need to standardize the information, not just the technical systems." (eHälsa - nytta och näring, Riksdag report 2011/12:RFR5, p. 37). In 2010, the Swedish Government adopted the National e-Health - the national strategy for accessible and secure information in healthcare. The strategy is a revision and extension of the previous strategy from 2006, which was used as input for the most recent efforts to develop a national information structure utilizing business-oriented generic models. A national decision on healthcare informatics standards was made by the Swedish County Councils, which decided to follow and use EN/ISO 13606 as a standard for the development of a universally applicable information structure, including archetypes and templates. The overall aim of the Swedish strategy for development of National Healthcare Information Architecture is to achieve high level semantic interoperability for clinical content and clinical contexts. High level semantic interoperability requires consistently structured clinical data and other types of data with coherent traceability to be mapped to reference clinical models. Archetypes that are formal definitions of the clinical and demographic concepts and some administrative data were developed. Each archetype describes the information structure and content of overarching core clinical concepts. Information that is defined in archetypes should be used for different purposes. Generic clinical process model was made concrete and analyzed. For each decision

  4. Impact of Dementia-Derived Nonpharmacological Intervention Procedures on Cognition and Behavior in Older Adults with Intellectual Disabilities: A 3-Year Follow-Up Study

    ERIC Educational Resources Information Center

    De Vreese, Luc P.; Mantesso, Ulrico; De Bastiani, Elisa; Weger, Elisabeth; Marangoni, Annachiara C.; Gomiero, Tiziano

    2012-01-01

    Dementia appears at a higher rate among some adults with intellectual disabilities (ID) and this potentially poses a greater risk of nursing home admission. Yet, to date, there is no evidence on the efficacy of general dementia-derived environment-, personnel-, and patient-oriented intervention strategies in delaying onset of dementia or in…

  5. [Application of music therapy for managing agitated behavior in older people with dementia].

    PubMed

    Sung, Huei-Chuan; Chang, Anne M; Abbey, Jennifer

    2006-10-01

    Older people with dementia may display negative emotions, memory problems, sleep disturbance, and agitated behavior. Among these symptoms, agitated behavior has been identified by families and nursing staff as the care problem that presents the greatest challenge. Several studies have found that music therapy reduced agitated behaviors in those with dementia and recommended use of music as an effective strategy in managing this behavioral problem. Music therapy represents a lower cost, effective care approach that nursing staff can easily learn and apply to those with dementia. Furthermore, reductions in agitated behavior in dementia patients that result from music therapy can also alleviate caregiver stress and burden of care, leading to improvements in the health and quality of life of both dementia patients and their caregivers. This paper aims to introduce the principles and application of music therapy in the management of agitated behavior in those with dementia.

  6. Care assistant experiences of dementia care in long-term nursing and residential care environments.

    PubMed

    Talbot, Rebecca; Brewer, Gayle

    2016-11-01

    Care assistants have a unique insight into the lives of service users and those factors which may impede or enhance the delivery of high quality dementia oriented care. To address the paucity of research in this area, the present study examined care assistant experiences of dementia care in British long-term residential and nursing environments. Semi-structured interviews were conducted with eight care assistants and transcripts were analysed using interpretive phenomenological analysis. Super-ordinate themes emerging from the data were psychological wellbeing of the care assistant, barriers to effective dementia care, the dementia reality and organisational issues within the care environment. The study revealed important deficiencies in understanding and varying levels of dementia training. Whilst person centred strategies were being implemented, task orientated care remained dominant. Furthermore, care assistants reported taking the perspectives of those with dementia into account, and actively using these to develop relationship centred care.

  7. [Dementia prevention: potential treatments and how to target high risk patients].

    PubMed

    Samaras, Nikolaos; Samaras, Dimitrios; Frangos, Emilia; Forster, Alexandre

    2013-05-22

    The burden related to the ever-increasing dementia prevalence in older individuals, imposes the implementation of prevention strategies. It is now known that brain lesions related to Alzheimer's disease precede the onset of the first symptoms. Consequently, prevention strategies should be implemented early, before clinically overt dementia. Blood and spine fluid tests, electroencephalogram, brain magnetic resonance and brain nuclear imaging should help physicians to better target "high-risk" patients prone to benefit from such strategies, already in a preclinical disease stage. Since no efficient pharmacological treatments exist for the time being, lifestyle factors such as nutritionand physical exercise are the cornerstones for dementia prevention.

  8. Burnout and Coping Strategies in Male Staff from National Police in Valparaíso, Chile

    PubMed Central

    BRIONES MELLA, Daniel; KINKEAD BOUTIN, Ana P.

    2013-01-01

    Abstract Background This cross-sectional study aimed to examine the relationship between several dimensions of the burnout syndrome with certain stress-coping strategies, seniority level and marital status in male staff from National Police in Vaparaíso, Chile. Methods The sample collected in 2010 was composed of 338 male officers coming from various special units of a National Police in Valparaíso. Burnout and Coping Strategies were assessed and classified according Maslach Burnout Inventory (MBI) and COPE Inventory, respectively. Data was analyzed using Pearson product-moment correlation, t-test for independent measures and Multiple Linear Regression to generate a predictive model. Results The prevalence of the burnout syndrome disaggregated by grouping criteria, the dimensions concentrated in middle levels for emotional exhaustion with a 52.1%, a 51.8% for depersonalization and finally, personal achievement with a 48.8%. Only 28% of participants showed more exacerbated dimensions of the burnout syndrome. There was a weak and direct yet statistically significant relationship between personal achievement and active coping. Mental disconnection had a weak direct relationship between both coping strategies and emotional exhaustion also existed. Certain correlations between burnout dimensions and coping strategies focused on emotion as predictor variables over the criterion variable corresponding to emotional exhaustion were mental disconnection in first place, secondly, focusing on emotions, and emotional social support. Conclusions Burnout dimensions scored medium values ​​focusing mainly on emotional exhaustion and reduced personal accomplishment. Coping strategies are used in parallel and in general are not mutually exclusive. Finally, there were not any relationship between variables seniority level and marital status. PMID:26060656

  9. Junior doctor dementia champions in a district general hospital (innovative practice).

    PubMed

    Wilkinson, Iain; Coates, Anna; Merrick, Sophie; Lee, Chooi

    2016-03-01

    Dementia is a common condition in the UK with around 25% of patients in acute hospitals having dementia. In the UK, there is national guidance on the assessment of cognitive impairment in acute hospitals. This article is a qualitative study of junior doctors' experiences as part of a dementia and delirium team involved in changing the care of patients with dementia in a hospital in the UK. It draws on data from a focus group and follow-up questionnaire in two hospital trusts. We examine what drives doctors to become involved in such projects and the effects of this experience upon them. We suggest a typology for getting junior doctors involved in projects generating change when working with patients with dementia. Being more actively involved in caring for and developing services for patients with dementia may represent the crossing of an educational threshold for these junior doctors.

  10. Benefits of a health impact assessment in relation to fuel poverty: assessing Luton's Affordable Warmth Strategy and the need for a national mandatory strategy.

    PubMed

    Stewart, Jill; Habgood, Veronica

    2008-05-01

    The links between fuel poverty and poor health are well documented, yet there is no statutory requirement on local authorities to develop fuel poverty strategies, which tend to be patchy nationally and differ substantially in quality. Fuel poverty starts from the perspective of income, even though interventions can improve health. The current public health agenda calls for more partnership-based, cost-effective strategies based on sound evidence. Fuel poverty represents a key area where there is currently little local evidence quantifying and qualifying health gain arising from strategic interventions. As a result, this initial study sought to apply the principles of a health impact assessment to Luton's Affordable Warmth Strategy, exploring the potential to identify health impact arising--as a baseline for future research--in the context of the public health agenda. A national strategy would help ensure the promotion of targeted fuel poverty strategies.

  11. A national environmental monitoring system to support the Moroccan sustainable development strategy

    NASA Astrophysics Data System (ADS)

    Mourhir, A.; Rachidi, T.

    2010-12-01

    Morocco is a mountainous country, subject to both marine and Saharan influences. The increase in population has led to an increase of the gross domestic product (GDP), which accentuated by inadequate resource management, has been accompanied by the degradation of the environment. The annual cost of environmental damage has been estimated at nearly eight percent of Morocco’s GDP. Morocco is a country that has scarce natural resources, especially arable land and water. In recent years, intensive agricultural production, large-scale irrigation schemes, industrialization, and urbanization have been creating serious problems. The country has faced severe air, water and soil pollution, environmental health problems, deforestation and soil erosion. The country is very vulnerable to impacts of global climate change. Morocco’s approach to sustainable development (SD) is mainly environmental. The two main documents for Morocco’s SD strategy are the National Strategy for the Protection of the Environment and Sustainable Development (SNPEDD), 1995, and the National Plan of Action for the Environment (PANE), 1998. SNPEDD’s main objective is the integration and strengthening of environmental concerns in economic development activities. The activities for the formulation and implementation of the strategy include: a) studies on the state of the Moroccan environment; b) formulation of the PANE; c) preparation of a sensitization program on environmental issues and the implementation of a database and information system on the environment; (d) preparation of regional and local environmental monographies. The aim of the current work is to create an information system as an approach to complex sustainability analyses at the national level using GIS technologies. This information system includes the following: 1.Development of a database of SD indicators and historical data. Morocco has been involved in the working framework of the Mediterranean Commission for Sustainable

  12. Dementia in Ayurveda.

    PubMed

    Manyam, B V

    1999-02-01

    The ancient Indian medical system, Ayurveda, included geriatrics as 1 of 8 medical divisions. Well-documented evidence exists for treating aging and age-related disorders including dementia. Geriatrics was termed Rasayanatantra. Cognitive function was well recognized and Sanskrit terms existed such as Buddhi for intelligence and Cittanasa (Citta means mind, nasa means loss of) for dementia. A normal human life span was considered to be 100 years. It could be prolonged to 116-120 years through the use of preventive treatments, if they were started during late youth or middle age. Treatments included herbal preparations, diet, exercise, and attention to general mode of life and social behavior. Several herbal formulations are described, including details of their composition and preparation. The mode of action of antiaging drugs was believed to occur at 3 levels. Detailed descriptions of the mode of action of several herbs are provided, and recent research confirms some of this activity.

  13. Great Apes and Biodiversity Offset Projects in Africa: The Case for National Offset Strategies

    PubMed Central

    Kormos, Rebecca; Kormos, Cyril F.; Humle, Tatyana; Lanjouw, Annette; Rainer, Helga; Victurine, Ray; Mittermeier, Russell A.; Diallo, Mamadou S.; Rylands, Anthony B.; Williamson, Elizabeth A.

    2014-01-01

    The development and private sectors are increasingly considering “biodiversity offsets” as a strategy to compensate for their negative impacts on biodiversity, including impacts on great apes and their habitats in Africa. In the absence of national offset policies in sub-Saharan Africa, offset design and implementation are guided by company internal standards, lending bank standards or international best practice principles. We examine four projects in Africa that are seeking to compensate for their negative impacts on great ape populations. Our assessment of these projects reveals that not all apply or implement best practices, and that there is little standardization in the methods used to measure losses and gains in species numbers. Even if they were to follow currently accepted best-practice principles, we find that these actions may still fail to contribute to conservation objectives over the long term. We advocate for an alternative approach in which biodiversity offset and compensation projects are designed and implemented as part of a National Offset Strategy that (1) takes into account the cumulative impacts of development in individual countries, (2) identifies priority offset sites, (3) promotes aggregated offsets, and (4) integrates biodiversity offset and compensation projects with national biodiversity conservation objectives. We also propose supplementary principles necessary for biodiversity offsets to contribute to great ape conservation in Africa. Caution should still be exercised, however, with regard to offsets until further field-based evidence of their effectiveness is available. PMID:25372894

  14. Great apes and biodiversity offset projects in Africa: the case for national offset strategies.

    PubMed

    Kormos, Rebecca; Kormos, Cyril F; Humle, Tatyana; Lanjouw, Annette; Rainer, Helga; Victurine, Ray; Mittermeier, Russell A; Diallo, Mamadou S; Rylands, Anthony B; Williamson, Elizabeth A

    2014-01-01

    The development and private sectors are increasingly considering "biodiversity offsets" as a strategy to compensate for their negative impacts on biodiversity, including impacts on great apes and their habitats in Africa. In the absence of national offset policies in sub-Saharan Africa, offset design and implementation are guided by company internal standards, lending bank standards or international best practice principles. We examine four projects in Africa that are seeking to compensate for their negative impacts on great ape populations. Our assessment of these projects reveals that not all apply or implement best practices, and that there is little standardization in the methods used to measure losses and gains in species numbers. Even if they were to follow currently accepted best-practice principles, we find that these actions may still fail to contribute to conservation objectives over the long term. We advocate for an alternative approach in which biodiversity offset and compensation projects are designed and implemented as part of a National Offset Strategy that (1) takes into account the cumulative impacts of development in individual countries, (2) identifies priority offset sites, (3) promotes aggregated offsets, and (4) integrates biodiversity offset and compensation projects with national biodiversity conservation objectives. We also propose supplementary principles necessary for biodiversity offsets to contribute to great ape conservation in Africa. Caution should still be exercised, however, with regard to offsets until further field-based evidence of their effectiveness is available.

  15. A physical model for dementia

    NASA Astrophysics Data System (ADS)

    Sotolongo-Costa, O.; Gaggero-Sager, L. M.; Becker, J. T.; Maestu, F.; Sotolongo-Grau, O.

    2017-04-01

    Aging associated brain decline often result in some kind of dementia. Even when this is a complex brain disorder a physical model can be used in order to describe its general behavior. A probabilistic model for the development of dementia is obtained and fitted to some experimental data obtained from the Alzheimer's Disease Neuroimaging Initiative. It is explained how dementia appears as a consequence of aging and why it is irreversible.

  16. Priorities in national space strategies and governance of the member states of the European Space Agency

    NASA Astrophysics Data System (ADS)

    Adriaensen, Maarten; Giannopapa, Christina; Sagath, Daniel; Papastefanou, Anastasia

    2015-12-01

    The European Space Agency (ESA) has twenty Member States with a variety of strategic priorities and governance structures regarding their space activities. A number of countries engage in space activities exclusively though ESA, while others have also their own national space programme. Some consider ESA as their prime space agency and others have additionally their own national agency with respective programmes. The main objective of this paper is to provide an up-to date overview and a holistic assessment of strategic priorities and the national space governance structures in 20 ESA Member States. This analysis and assessment has been conducted by analysing the Member States public documents, information provided at ESA workshop on this topic and though unstructured interviews. The paper is structured to include two main elements: priorities and trends in national space strategies and space governance in ESA Member States. The first part of this paper focuses on the content and analysis of the national space strategies and indicates the main priorities and trends in Member States. The priorities are categorised with regards to technology domains, the role of space in the areas of sustainability and the motivators that boost engagement in space. These vary from one Member State to another and include with different levels of engagement in technology domains amongst others: science and exploration, navigation, Earth observation, human space flight, launchers, telecommunications, and integrated applications. Member States allocate a different role of space as enabling tool adding to the advancement of sustainability areas including: security, resources, environment and climate change, transport and communication, energy, and knowledge and education. The motivators motivating reasoning which enhances or hinders space engagement also differs. The motivators identified are industrial competitiveness, job creation, technology development and transfer, social benefits

  17. Home or hospital for people with dementia and one or more other multimorbidities: What is the potential to reduce avoidable emergency admissions? The HOMEWARD Project Protocol

    PubMed Central

    Voss, S; Black, S; Brandling, J; Buswell, M; Cheston, R; Cullum, S; Kirby, K; Purdy, S; Solway, C; Taylor, H; Benger, J

    2017-01-01

    Introduction Older people with multimorbidities frequently access 999 ambulance services. When multimorbidities include dementia, the risk of ambulance use, accident and emergency (A&E) attendance and hospital admission are all increased, even when a condition is treatable in the community. People with dementia tend to do poorly in the acute hospital setting and hospital admission can result in adverse outcomes. This study aims to provide an evidence-based understanding of how older people living with dementia and other multimorbidities are using emergency ambulance services. It will also provide evidence of how paramedics make decisions about taking this group of patients to hospital, and what resources would allow them to make more person-focused decisions to enable optimal patient care. Methods and analysis Phase 1: retrospective data analysis: quantitative analysis of ambulance service data will investigate: how often paramedics are called to older people with dementia; the amount of time paramedics spend on scene and the frequency with which these patients are transported to hospital. Phase 2: observational case studies: detailed case studies will be compiled using qualitative methods, including non-participant observation of paramedic decision-making, to understand why older people with multimorbidities including dementia are conveyed to A&E when they could be treated at home or in the community. Phase 3: needs analysis: nominal groups with paramedics will investigate and prioritise the resources that would allow emergency, urgent and out of hours care to be effectively delivered to these patients at home or in a community setting. Ethics and dissemination Approval for the study has been obtained from the Health Research Authority (HRA) with National Health Service (NHS) Research Ethics Committee approval for phase 2 (16/NW/0803). The dissemination strategy will include publishing findings in appropriate journals, at conferences and in newsletters. We will

  18. Rapidly Progressive Dementia

    PubMed Central

    Geschwind, Michael D.

    2016-01-01

    Purpose of Review This article presents a practical and informative approach to the evaluation of a patient with a rapidly progressive dementia (RPD). Recent Findings Prion diseases are the prototypical causes of RPD, but reversible causes of RPD might mimic prion disease and should always be considered in a differential diagnosis. Aside from prion diseases, the most common causes of RPD are atypical presentations of other neurodegenerative disorders, curable disorders including autoimmune encephalopathies, as well as some infections, and neoplasms. Numerous recent case reports suggest dural arterial venous fistulas sometimes cause RPDs. Summary RPDs, in which patients typically develop dementia over weeks to months, require an alternative differential than the slowly progressive dementias that occur over a few years. Because of their rapid decline, patients with RPDs necessitate urgent evaluation and often require an extensive workup, typically with multiple tests being sent or performed concurrently. Jakob-Creutzfeldt disease, perhaps the prototypical RPD, is often the first diagnosis many neurologists consider when treating a patient with rapid cognitive decline. Many conditions other than prion disease, however, including numerous reversible or curable conditions, can present as an RPD. This chapter discusses some of the major etiologies for RPDs and offers an algorithm for diagnosis. PMID:27042906

  19. Sleep, Cognition and Dementia.

    PubMed

    Porter, Verna R; Buxton, William G; Avidan, Alon Y

    2015-12-01

    The older patient population is growing rapidly around the world and in the USA. Almost half of seniors over age 65 who live at home are dissatisfied with their sleep, and nearly two-thirds of those residing in nursing home facilities suffer from sleep disorders. Chronic and pervasive sleep complaints and disturbances are frequently associated with excessive daytime sleepiness and may result in impaired cognition, diminished intellect, poor memory, confusion, and psychomotor retardation all of which may be misinterpreted as dementia. The key sleep disorders impacting patients with dementia include insomnia, hypersomnolence, circadian rhythm misalignment, sleep disordered breathing, motor disturbances of sleep such as periodic leg movement disorder of sleep and restless leg syndrome, and parasomnias, mostly in the form of rapid eye movement (REM) sleep behavior disorder (RBD). RBD is a pre-clinical marker for a class of neurodegenerative diseases, the "synucleinopathies", and requires formal polysomnographic evaluation. Untreated sleep disorders may exacerbate cognitive and behavioral symptoms in patients with dementia and are a source of considerable stress for bed partners and family members. When left untreated, sleep disturbances may also increase the risk of injury at night, compromise health-related quality of life, and precipitate and accelerate social and economic burdens for caregivers.

  20. Driving and dementia

    PubMed Central

    Lee, Linda; Molnar, Frank

    2017-01-01

    Abstract Objective To provide primary care physicians with an approach to driving safety concerns when older persons present with memory difficulties. Sources of information The approach is based on an accredited memory clinic training program developed by the Centre for Family Medicine Primary Care Collaborative Memory Clinic. Main message One of the most challenging aspects of dementia care is the assessment of driving safety. Drivers with dementia are at higher risk of motor vehicle collisions, yet many drivers with mild dementia might be safely able to continue driving for several years. Because safe driving is dependent on multiple cognitive and functional skills, clinicians should carefully consider many factors when determining if cognitive concerns affect driving safety. Specific findings on corroborated history and office-based cognitive testing might aid in the physician’s decisions to refer for comprehensive on-road driving evaluation and whether to notify transportation authorities in accordance with provincial reporting requirements. Sensitive communication and a person-centred approach are essential. Conclusion Primary care physicians must consider many factors when determining if cognitive concerns might affect driving safety in older drivers. PMID:28115437

  1. [Dementia and music].

    PubMed

    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Steinberg, Reinhard; Weiss, Elisabeth M

    2009-01-01

    Patients suffering from dementia are nevertheless still able to render exceptional musical performances. For example, they can recognize music from childhood and reproduce lyrics and melodies of songs with four verses. Furthermore, behavioural symptoms such as psycho- motor agitation and crying, but also aggressive behaviour can be positively influenced by music and motivation and positive emotions can be increased. A variety of physiological and psychological changes occur when patients are listening to music. Previous research could show that music activated different parts of the brain especially in the temporal cortex, but also motoric areas in the frontal cortex, thalamus and cerebellum were essential for rhythm, melody and harmony perception and processing. Music therapy is an interpersonal process in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals with various psychiatric or medical conditions. However, until now only little research has been directed towards non-pharmacological treatments like music therapy in dementia patients. Further research is warranted to investigate the long term influence of music therapy on patients suffering from dementia.

  2. Specialised design for dementia.

    PubMed

    Habell, Martin

    2013-05-01

    Demographic trends point to a fast-rising demand for elderly dementia care - but ordinary elderly care environments are unsuitable for dementia, which requires specialised accommodation. This paper concerns itself with the health and behaviour benefits of the special environment and not the available care and medication. Compared with traditional elderly care, space requirements are larger, there are security and care issues, as well as light, sleep, sensory and exercise aspects. The internal environment can be used for therapeutic benefit, using movement, memory trails, behaviour cues, signage, sun light therapy, light spectrum control and landscape. Special planning can mitigate antisocial behaviour, agitation, anxiety and confusion. It can provide scope for family involvement. To date, care has made blanket unspecialised provision. There is a need for a coherent and comprehensive approach to the total environment and to view it as a tool for care. This paper records the features developed in the design of specialised dementia care buildings by the author as part of a sequence of care homes evolved and adapted with feedback.

  3. Emotional function in dementia patients.

    PubMed

    Fujii, Masahiko; Butler, James P; Sasaki, Hidetada

    2014-09-01

    Behavioural and psychological symptoms of dementia, which can be considered as hyperreactivity of the emotional functioning of dementia, can be alleviated or aggravated by the behavioural and psychological symptoms of the caregiver. Comfortable stimulations of emotional function through sensory stimulations are effective methods for alleviating behavioural and psychological symptoms of dementia. Although cognitive function deteriorates with age, emotional function is often retained even in advanced years. Thus, it is recommended that care in patients with dementia be focused mainly on the stimulation of emotional function (e.g. sympathy and empathy, which are human traits), rather than relying solely on the stimulation of cognitive function.

  4. Quality improvement in neurology: dementia management quality measures.

    PubMed

    Odenheimer, Germaine; Borson, Soo; Sanders, Amy E; Swain-Eng, Rebecca J; Kyomen, Helen H; Tierney, Samantha; Gitlin, Laura; Forciea, Mary Ann; Absher, John; Shega, Joseph; Johnson, Jerry

    2014-03-01

    Professional and advocacy organizations have long urged that dementia should be recognized and properly diagnosed. With the passage of the National Alzheimer's Project Act in 2011, an Advisory Council for Alzheimer's Research, Care, and Services was convened to advise the Department of Health and Human Services. In May 2012, the Council produced the first National Plan to address Alzheimer's disease, and prominent in its recommendations is a call for quality measures suitable for evaluating and tracking dementia care in clinical settings. Although other efforts have been made to set dementia care quality standards, such as those pioneered by RAND in its series Assessing Care of Vulnerable Elders (ACOVE), practitioners, healthcare systems, and insurers have not widely embraced implementation. This executive summary (full manuscript available at www.neurology.org) reports on a new measurement set for dementia management developed by an interdisciplinary Dementia Measures Work Group (DWG) representing the major national organizations and advocacy organizations concerned with the care of individuals with dementia. The American Academy of Neurology (AAN), the American Geriatrics Society, the American Medical Directors Association, the American Psychiatric Association, and the American Medical Association-convened Physician Consortium for Performance Improvement led this effort. The ACOVE measures and the measurement set described here apply to individuals whose dementia has already been identified and properly diagnosed. Although similar in concept to ACOVE, the DWG measurement set differs in several important ways; it includes all stages of dementia in a single measure set, calls for the use of functional staging in planning care, prompts the use of validated instruments in patient and caregiver assessment and intervention, highlights the relevance of using palliative care concepts to guide care before the advanced stages of illness, and provides evidence-based support

  5. Announced Strategy Types in Multiagent RL for Conflict-Avoidance in the National Airspace

    NASA Technical Reports Server (NTRS)

    Rebhuhn, Carrie; Knudson, Matthew D.; Tumer, Kagan

    2014-01-01

    The use of unmanned aerial systems (UAS) in the national airspace is of growing interest to the research community. Safety and scalability of control algorithms are key to the successful integration of autonomous system into a human-populated airspace. In order to ensure safety while still maintaining efficient paths of travel, these algorithms must also accommodate heterogeneity of path strategies of its neighbors. We show that, using multiagent RL, we can improve the speed with which conflicts are resolved in cases with up to 80 aircraft within a section of the airspace. In addition, we show that the introduction of abstract agent strategy types to partition the state space is helpful in resolving conflicts, particularly in high congestion.

  6. Analysis of sheltering and evacuation strategies for a national capital region nuclear detonation scenario.

    SciTech Connect

    Yoshimura, Ann S.; Brandt, Larry D.

    2011-12-01

    Development of an effective strategy for shelter and evacuation is among the most important planning tasks in preparation for response to a low yield, nuclear detonation in an urban area. Extensive studies have been performed and guidance published that highlight the key principles for saving lives following such an event. However, region-specific data are important in the planning process as well. This study examines some of the unique regional factors that impact planning for a 10 kT detonation in the National Capital Region. The work utilizes a single scenario to examine regional impacts as well as the shelter-evacuate decision alternatives at one exemplary point. For most Washington, DC neighborhoods, the excellent assessed shelter quality available make shelter-in-place or selective transit to a nearby shelter a compelling post-detonation strategy.

  7. Strategies to Address Identified Education Gaps in the Preparation of a National Security Workforce

    SciTech Connect

    2008-06-30

    This report will discuss strategies available to address identified gaps and weaknesses in education efforts aimed at the preparation of a skilled and properly trained national security workforce.The need to adequately train and educate a national security workforce is at a critical juncture. Even though there are an increasing number of college graduates in the appropriate fields, many of these graduates choose to work in the private sector because of more desirable salary and benefit packages. This is contributing to an inability to fill vacant positions at NNSA resulting from high personnel turnover from the large number of retirements. Further, many of the retirees are practically irreplaceable because they are Cold War scientists that have experience and expertise with nuclear weapons.

  8. Development of year 2020 goals for the National HIV/AIDS Strategy for the United States.

    PubMed

    Holtgrave, David R

    2014-04-01

    In July, 2010, President Barack Obama released the National HIV/AIDS Strategy (NHAS). The NHAS set forth ambitious goals for the year 2015. These goals were potentially achievable had the appropriate level of resources been invested; however, investment at the necessary scale has not been made and the 2015 goals now may well be out of reach. Therefore, we propose that an updated NHAS be developed with goals for the year 2020 clearly articulated. For the purposes of fostering discussion on this important topic, we propose bold yet achievable quantitative 2020 goals based on previously published economic and mathematical modeling analyses.

  9. Basic science and energy research sector profile: Background for the National Energy Strategy

    SciTech Connect

    March, F.; Ashton, W.B.; Kinzey, B.R.; McDonald, S.C.; Lee, V.E.

    1990-11-01

    This Profile report provides a general perspective on the role of basic science in the spectrum of research and development in the United States, and basic research's contributions to the goals of the National Energy Strategy (NES). It includes selected facts, figures, and analysis of strategic issues affecting the future of science in the United States. It is provided as background for people from government, the private sector, academia, and the public, who will be reviewing the NES in the coming months; and it is intended to serve as the basis for discussion of basic science issues within the context of the developing NES.

  10. 75 FR 2553 - Moving Into the Future-New Dimensions and Strategies for Women's Health Research for the National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... HUMAN SERVICES National Institutes of Health Moving Into the Future--New Dimensions and Strategies for... advances in science and wider global understanding of women's health and sex/gender contributions to well... participants to consider creative strategies that need to be employed to identify areas of research that...

  11. Prescribing patterns in dementia: a multicentre observational study in a German network of CAM physicians

    PubMed Central

    2011-01-01

    Background Dementia is a major and increasing health problem worldwide. This study aims to investigate dementia treatment strategies among physicians specialised in complementary and alternative medicine (CAM) by analysing prescribing patterns and comparing them to current treatment guidelines in Germany. Methods Twenty-two primary care physicians in Germany participated in this prospective, multicentre observational study. Prescriptions and diagnoses were reported for each consecutive patient. Data were included if patients had at least one diagnosis of dementia according to the 10th revision of the International Classification of Diseases during the study period. Multiple logistic regression was used to determine factors associated with a prescription of any anti-dementia drug including Ginkgo biloba. Results During the 5-year study period (2004-2008), 577 patients with dementia were included (median age: 81 years (IQR: 74-87); 69% female). Dementia was classified as unspecified dementia (57.2%), vascular dementia (25.1%), dementia in Alzheimer's disease (10.4%), and dementia in Parkinson's disease (7.3%). The prevalence of anti-dementia drugs was 25.6%. The phytopharmaceutical Ginkgo biloba was the most frequently prescribed anti-dementia drug overall (67.6% of all) followed by cholinesterase inhibitors (17.6%). The adjusted odds ratio (AOR) for receiving any anti-dementia drug was greater than 1 for neurologists (AOR = 2.34; CI: 1.59-3.47), the diagnosis of Alzheimer's disease (AOR = 3.28; CI: 1.96-5.50), neuroleptic therapy (AOR = 1.87; CI: 1.22-2.88), co-morbidities hypertension (AOR = 2.03; CI: 1.41-2.90), and heart failure (AOR = 4.85; CI: 3.42-6.88). The chance for a prescription of any anti-dementia drug decreased with the diagnosis of vascular dementia (AOR = 0.64; CI: 0.43-0.95) and diabetes mellitus (AOR = 0.55; CI: 0.36-0.86). The prescription of Ginkgo biloba was associated with sex (female: AOR = 0.41; CI: 0.19-0.89), patient age (AOR = 1.06; CI: 1

  12. Community outreach and engagement strategies from the Wisconsin Study Center of the National Children's Study.

    PubMed

    Riesch, Susan K; Ngui, Emmanuel M; Ehlert, Carey; Miller, M Katie; Cronk, Christine A; Leuthner, Steven; Strehlow, Mary; Hewitt, Jeanne B; Durkin, Maureen S

    2013-05-01

    The purpose of this methods article was to describe and evaluate outreach and engagement strategies designed to initially build county-wide awareness and support for the National Children's Study (NCS or the study) and subsequently to target the segment communities where recruitment for the study occurred. Selected principles from community outreach, social marketing, and health care system and personal referral formed the foundation for the strategies. The strategies included a celebration event, community advisory board, community needs assessment, building relationships with health care providers and systems, eliciting a network of study supporters, newsletters, appearances at local young family-oriented events (health fairs, parades), presentations to local community leaders, community forums, "branding" with assistance from a women-owned local marketing firm, and mailings including an oversized, second-touch postcard. Six months after study launch, approximately 4,600 study-eligible women were asked in a door-to-door survey if and how they became aware of the study. On average, 40% of eligible women reported being aware of the study. The most frequently cited strategy to cultivate their awareness was study-specific mailings. Awareness of the NCS increased by 7.5% among those receiving a second-touch postcard relative to controls (95% CIs [4.9, 10.7] z = 5.347, p < 0.0000, d = 0.16). Community outreach and engagement strategies, in particular the oversized postcard as a second-touch effort, may be used effectively by researchers for participant recruitment and by public health nurses for delivery of important population-focused messages.

  13. Raising awareness of research evidence among health professionals delivering dementia care: Are knowledge translation workshops useful?

    PubMed

    Goodenough, Belinda; Fleming, Richard; Young, Michael; Burns, Kim; Jones, Cindy; Forbes, Fallon

    2016-10-24

    Providing information about the latest research via educational sessions to health professionals caring for people with dementia may be insufficient to drive change. This project explored self-reported impacts on practice change of adding information about knowledge translation (KT) to a national dementia education program. Six national workshop days were held. Each provided the option of participating in a Principles of KT and innovation implementation seminar in addition to a clinical topic update (sexualities and dementia, or managing behavioral and psychological symptoms of dementia). Six months postworkshop, 321 participants were invited to complete a research utilization survey. Seventy-five responded. KT seminar participants were more likely to report instrumental outcomes (e.g. changed policies, procedures) than those who did not participate in the KT seminar. Including KT information in educational sessions for health professionals may increase the likelihood of practice change in the field of dementia care and warrants further research.

  14. Is the Bush Doctrine the Right American National Security Strategy for the Beginning of the 21st Century?

    DTIC Science & Technology

    2005-03-18

    full support from Congress, the media, and the American people.5 In the infancy of the 21st century, multiple dreadful historical events occurred such...Praeger Publishers, 2003. Dueck, Colin. “Ideas and Alternatives in American Grand Strategy, 2000-2004.” Review of International Studies 30 (October...USAWC STRATEGY RESEARCH PROJECT IS THE BUSH DOCTRINE THE RIGHT AMERICAN NATIONAL SECURITY STRATEGY FOR THE BEGINNING OF THE 21ST CENTURY? by

  15. Increasing progranulin levels and blockade of the ERK1/2 pathway: upstream and downstream strategies for the treatment of progranulin deficient frontotemporal dementia.

    PubMed

    Alquezar, Carolina; Esteras, Noemí; de la Encarnación, Ana; Moreno, Fermín; López de Munain, Adolfo; Martín-Requero, Ángeles

    2015-03-01

    Frontotemporal lobar degeneration (FTLD) is a neurodegenerative disorder marked by mild-life onset and progressive changes in behavior, social cognition, and language. Loss-of-function progranulin gene (GRN) mutations are the major cause of FTLD with TDP-43 protein inclusions (FTLD-TDP). Disease-modifying treatments for FTLD-TDP are not available yet. Mounting evidence indicates that cell cycle dysfunction may play a pathogenic role in neurodegenerative disorders including FTLD. Since cell cycle re-entry of posmitotic neurons seems to precede neuronal death, it was hypothesized that strategies aimed at preventing cell cycle progression would have neuroprotective effects. Recent research in our laboratory revealed cell cycle alterations in lymphoblasts from FTLD-TDP patients carrying a null GRN mutation, and in PGRN deficient SH-SY5Y neuroblastoma cells, involving overactivation of the ERK1/2 signaling pathway. In this work, we have investigated the effects of PGRN enhancers drugs and ERK1/2 inhibitors, in these cellular models of PGRN-deficient FTLD. We report here that both restoring the PGRN content, by suberoylanilide hydroxamic acid (SAHA) or chloroquine (CQ), as blocking ERK1/2 activation by selumetinib (AZD6244) or MEK162 (ARRY-162), normalized the CDK6/pRb pathway and the proliferative activity of PGRN deficient cells. Moreover, we found that SAHA and selumetinib prevented the cytosolic TDP-43 accumulation in PGRN-deficient lymphoblasts. Considering that these drugs are able to cross the blood-brain barrier, and assuming that the alterations in cell cycle and signaling observed in lymphoblasts from FTLD patients could be peripheral signs of the disease, our results suggest that these treatments may serve as novel therapeutic drugs for FTLD associated to GRN mutations.

  16. Natural Phytochemicals in the Treatment and Prevention of Dementia: An Overview.

    PubMed

    Libro, Rosaliana; Giacoppo, Sabrina; Soundara Rajan, Thangavelu; Bramanti, Placido; Mazzon, Emanuela

    2016-04-21

    The word dementia describes a class of heterogeneous diseases which etiopathogenetic mechanisms are not well understood. There are different types of dementia, among which, Alzheimer's disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD) are the more common. Currently approved pharmacological treatments for most forms of dementia seem to act only on symptoms without having profound disease-modifying effects. Thus, alternative strategies capable of preventing the progressive loss of specific neuronal populations are urgently required. In particular, the attention of researchers has been focused on phytochemical compounds that have shown antioxidative, anti-amyloidogenic, anti-inflammatory and anti-apoptotic properties and that could represent important resources in the discovery of drug candidates against dementia. In this review, we summarize the neuroprotective effects of the main phytochemicals belonging to the polyphenol, isothiocyanate, alkaloid and cannabinoid families in the prevention and treatment of the most common kinds of dementia. We believe that natural phytochemicals may represent a promising sources of alternative medicine, at least in association with therapies approved to date for dementia.

  17. Final Report of the External Evaluation of England's National Literacy and Numeracy Strategies. Final Report. Watching & Learning 3.

    ERIC Educational Resources Information Center

    Earl, Lorna; Watson, Nancy; Levin, Ben; Leithwood, Ken; Fullan, Michael; Torrance, Nancy

    The National Literacy and Numeracy Strategies (NLS and NNS) represent a major government initiative to improve classroom practice and student learning in literacy and mathematics in elementary schools across England. National targets were intended to increase the percentage of 11-year-olds reaching the "expected level"--Level 4--in…

  18. [Automobile driving capacity in dementia].

    PubMed

    Seeger, Rolf

    2015-04-01

    Dementia influences at an early stage the driving aptitude of motor vehicle steering persons. Every year in Switzerland, around 16'000 driving permit holders suffer newly from dementia; therefore the driving aptitude is questioned, especially because of possibly limited executive functions. Individuals with early-stage dementia often may show a dangerous driving stile. However, a mild dementia does not a priori exclude the driving aptitude, and less than half of these drivers can continue driving for another 1 - 3 years. In contrast, there is no further driving aptitude in presence of moderate dementia. In the assessment of driving aptitude, the underlying cause of dementia is always taken into account. Cognitive short tests such as the Mini-Mental Status Exam, Clock Drawing Test and Trail-Making Test are not suitable to make reliable statements about the aptitude to drive, but these tests are very important for the initial diagnosis of dementia in primary care practice and can lead the way for further examination concerning driving aptitude. The legally prescribed regular check-up for motorists aged over 70 years in Switzerland provides an ideal opportunity for early detection of incipient dementia. The practical procedure for the assessment of aptitude to drive in the primary care practice is presented. The physician-guided on-road driving test represents a meaningful, practical and relatively cost-effective tool for the evaluation of driving aptitude in cases of doubt.

  19. "We're all thrown in the same boat … ": A qualitative analysis of peer support in dementia care.

    PubMed

    Keyes, Sarah E; Clarke, Charlotte L; Wilkinson, Heather; Alexjuk, Eva Joanna; Wilcockson, Jane; Robinson, Louise; Reynolds, Joanna; McClelland, Siobhan; Corner, Lynne; Cattan, Mima

    2016-07-01

    Peer support is well established in fields such as the disability movement and mental health and is increasingly recognised as one way of enabling support by and for people with a diagnosis of dementia and their immediate carers. It was central to the implementation of the National Dementia Strategy (NDS) for England, when 40 demonstration sites were established. This mixed-methods study included in-depth qualitative interviews with people living with dementia (n = 101) and staff/stakeholders (n = 82) at 8 of the 40 sites. Data analysis was a five-stage process: coding framework developed (using 25 transcripts); further development of the framework (using a further 70 transcripts); development of emerging themes; modelling of themes and verification of models based on the entire data set. Peer support had positive emotional and social impact that was rooted in identification with others, a commonality of experience and reciprocity of support. There was also a contrast between the quality of peer support and support from professionals. This emphasises the significance of lived experience and promoting a strength-based approach to interpersonal support that is enabling and challenges a deficit approach to understanding dementia.

  20. Mortality from dementia among gastroduodenal ulcer patients.

    PubMed Central

    Flaten, T P; Glattre, E; Viste, A; Søoreide, O

    1991-01-01

    STUDY OBJECTIVE--The aim was to examine whether a high intake of aluminium containing antacids is a risk for Alzheimer's disease. DESIGN--The mortality from dementia (1970-87), coded from death certificates as underlying or contributory cause of death, was compared with national rates in a cohort of patients who had surgery for gastroduodenal ulcer disease between 1911 and 1978. SETTING--Patient data were obtained from patient records from major hospitals in western Norway. PARTICIPANTS--4179 patients were identified who met the study criteria, which included having had a documented stomach operation, having a reliably identifiable personal number, and being alive on Jan 1, 1970. MEASUREMENTS AND MAIN RESULTS--The standardised mortality ratio for dementia was 1.10 (95% CI 0.85-1.40, n = 64) for all patients, while for patients operated on in the period 1967-78 it was 1.25 (95% CI 0.66-2.13, n = 13). CONCLUSIONS--As the majority of patients operated on after 1963 have probably been heavy consumers of aluminium containing antacids, the study provides meager evidence that a high intake of aluminium is an important risk factor for Alzheimer's disease, the major cause of dementia. However, the possibility of a raised mortality from Alzheimer's disease cannot be ruled out due to probable misclassification both in diagnosis and exposure. In addition, the observation period may have been too short to detect an effect since the latent period for Alzheimer's disease may be very long. PMID:1757761

  1. Dementia and the Power of Music Therapy.

    PubMed

    Matthews, Steve

    2015-10-01

    Dementia is now a leading cause of both mortality and morbidity, particularly in western nations, and current projections for rates of dementia suggest this will worsen. More than ever, cost effective and creative non-pharmacological therapies are needed to ensure we have an adequate system of care and supervision. Music therapy is one such measure, yet to date statements of what music therapy is supposed to bring about in ethical terms have been limited to fairly vague and under-developed claims about an improvement in well-being. This article identifies the relevant sense of wellbeing at stake in the question of dementia therapies of this type. In broad terms the idea is that this kind of therapy has a restorative effect on social agency. To the extent that music arouses a person through its rhythms and memory-inducing effects, particularly in communal settings, it may give rise to the recovery of one's narrative agency, and in turn allow for both carer and patient to participate in a more meaningful and mutually engaging social connection.

  2. Prevalence and impact of dementia-related functional limitations in the United States, 2001 to 2005.

    PubMed

    Arrighi, Henry Michael; McLaughlin, Trent; Leibman, Christopher

    2010-01-01

    These analyses examined the relationship between dementia and comorbid conditions with respect to degree of functional impairment and emotional impact. Analyses were conducted using National Health Interview Survey (2001 through 2005) data from a subset of individuals aged > or =60 years with activity limitations attributed to dementia, senility, or Alzheimer disease compared with those whose limitations were attributed to other conditions. The mean number of limited activities was 6.84 (95% confidence interval: 6.48-7.20) for persons with dementia-related limitations and 4.87 (95% confidence interval: 4.81-4.93) for those with limitations not dementia related. Both groups reported similar prevalence of diabetes, acute myocardial infarction, heart disease, prostate cancer, breast cancer, angina, and emphysema; respondents with dementia-related functional limitations were more likely to report diabetes, depression or anxiety, and vision problems as being related to functional limitations. Persons with dementia-related functional limitations were also more likely than persons with non-dementia-related functional limitations to report feeling sad, hopeless, worthless, nervous, and that "everything is an effort." Improving or maintaining functional independence in patients with dementia will likely require a multifaceted approach across disease states. Additional research will help define the impact of dementia on the development and progression of functional limitations related to comorbidities.

  3. Inactive tanks remediation program strategy and plans for Oak Ridge National Laboratory, Oak Ridge, Tennessee

    SciTech Connect

    1997-03-01

    This report presents plans and strategies for remediation of the liquid low-level waste (LLLW) tanks that have been removed from service (also known as inactive tanks) at Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee. These plans and strategies will be carried out by the Environmental Restoration Program`s Inactive LLLW Tank Program at ORNL. These tanks are defined as Category D tanks because they are existing tank systems without secondary containment that are removed from service. The approach to remediation of each tank or tank farm must be adapted in response to the specific circumstances of individual tank sites. The approach will be tailored to accommodate feedback on lessons learned from previous tank remediation activities and will not be a rigid step-by-step approach that must be conducted identically for every tank system. However, the approach will follow a multistep decision process. The overall objective of the Inactive Tank Program is to remediate all LLLW tanks that have been removed from service to the extent practicable in accordance with the FFA requirements. The Inactive Tank Program will focus on the remediation of the tank residues (i.e., contents after tank has been emptied) and tank shell. This strategy is discussed in detail in this report.

  4. Inactive tanks remediation program strategy and plans for Oak Ridge National Laboratory, Oak Ridge, Tennessee

    SciTech Connect

    1997-11-01

    This report presents plans and strategies for remediation of the liquid low-level waste (LLLW) tanks that have been removed from service (also known as inactive tanks) at Oak Ridge National Laboratory (ORNL) in Oak Ridge, Tennessee. These plans and strategies will be carried out by the Environmental Restoration Program`s Inactive LLLW Tank Program at ORNL. The approach to remediation of each tank or tank farm must be adapted in response to the specific circumstances of individual tank sites. The approach will be tailored to accommodate feedback on lessons learned from previous tank remediation activities and will not be a rigid step-by-step approach that must be conducted identically for every tank system. However, the approach will follow a multistep decision process. The overall objective of the Inactive Tank Program is to remediate all LLLW tanks that have been removed from service to the extent practicable in accordance with the FFA requirements. The Inactive Tank Program will focus on the remediation of the tank residues and tank shell. This strategy is discussed in detail in this report.

  5. Dementia in 2014. Towards early diagnosis in Alzheimer disease.

    PubMed

    Nordberg, Agneta

    2015-02-01

    Improved neuroimaging and molecular markers of Alzheimer disease (AD) have aided diagnosis of AD in the very early stages, and have facilitated differential diagnosis between AD and other neurodegenerative disorders with dementia. The finding that some older individuals can show amyloid-β pathology while remaining cognitively intact raises important questions regarding prevention strategies.

  6. [Snoezelen and animal-assisted therapy in dementia patients].

    PubMed

    Javelot, Hervé; Antoine-Bernard, Emilie; Garat, Jennifer; Javelot, Thierry; Weiner, Luisa; Mervelay, Véroníque

    2012-01-01

    A number of non medication-based methods of nursing care for geriatric patients have been developed over recent decades to treat non cognitive symptoms associated with dementia. Among these, Snoezelen rooms for multisensory behavioural therapy and animal-assisted therapy emerge as innovative strategies which could potentially complement other more frequently developed methods such as physical activity.

  7. A Strategy for Thailand's Space Technology Development: National Space Program (NSP)

    NASA Astrophysics Data System (ADS)

    Pimnoo, Ammarin; Purivigraipong, Somphop

    2016-07-01

    The Royal Thai Government has established the National Space Policy Committee (NSPC) with mandates for setting policy and strategy. The NSPC is considering plans and budget allocation for Thai space development. NSPC's goal is to promote the utilization of space technology in a manner that is congruent with the current situation and useful for the economy, society, science, technology, educational development and national security. The first proposed initiative of the National Space Program (NSP) is co-development of THEOS-2, a next-generation satellite system that includes Thailand's second and third earth observation satellite (THAICHOTE-2 and THAICHOTE-3). THEOS-1 or THAICHOTE-1 was the first Earth Observation Satellite of Thailand launched in 2008. At present, the THAICHOTE-1 is over the lifetime, therefore the THEOS-2 project has been established. THEOS-2 is a complete Earth Observation System comprising THAICHOTE-2&3 as well as ground control segment and capacity building. Thus, NSPC has considered that Thailand should manage the space system. Geo-Informatics and Space Technology Development Agency (GISTDA) has been assigned to propose the initiative National Space Program (NSP). This paper describes the strategy of Thailand's National Space Program (NSP) which will be driven by GISTDA. First, NSP focuses on different aspects of the utilization of space on the basis of technology, innovation, knowledge and manpower. It contains driving mechanisms related to policy, implementation and use in order to promote further development. The Program aims to increase economic competitiveness, reduce social disparity, and improve social security, natural resource management and environmental sustainability. The NSP conceptual framework includes five aspects: communications satellites, earth observation satellite systems, space economy, space exploration and research, and NSP administration. THEOS-2 is considered a part of NSP with relevance to the earth observation

  8. 'The living death of Alzheimer's' versus 'Take a walk to keep dementia at bay': representations of dementia in print media and carer discourse.

    PubMed

    Peel, Elizabeth

    2014-07-01

    Understanding dementia is a pressing social challenge. This article draws on the 'Dementia talking: care conversation and communication' project which aims to understand how talk about, and to people living with dementia is constructed. In this article I draw on the construction of dementia manifest in two data sets - a corpus of 350 recent UK national newspaper articles and qualitative data derived from in-depth interviews with informal carers. These data were analysed using a thematic discursive approach. A 'panic-blame' framework was evident in much of the print media coverage. Dementia was represented in catastrophic terms as a 'tsunami' and 'worse than death', juxtaposed with coverage of individualistic behavioural change and lifestyle recommendations to 'stave off' the condition. Contrary to this media discourse, in carers' talk there was scant use of hyperbolic metaphor or reference to individual responsibility for dementia, and any corresponding blame and accountability. I argue that the presence of individualistic dementia 'preventative' behaviour in media discourse is problematic, especially in comparison to other more 'controllable' and treatable chronic conditions. Engagement with, and critique of, the nascent panic-blame cultural context may be fruitful in enhancing positive social change for people diagnosed with dementia and their carers.

  9. Teaching Mands to Older Adults with Dementia

    ERIC Educational Resources Information Center

    Oleson, Chelsey R.; Baker, Jonathan C.

    2014-01-01

    Millions of Americans are diagnosed with dementia, and that number is only expected to rise. The diagnosis of dementia comes with impairments, especially in language. Furthermore, dementia-related functional declines appear to be moderated by environmental variables (Alzheimer's Association, "Alzheimer's & Dementia: The Journal of the…

  10. Oxytocin for frontotemporal dementia

    PubMed Central

    MacKinley, Julia; Blair, Mervin; Oliver, Lindsay D.; Jesso, Sarah; Tartaglia, Maria C.; Borrie, Michael; Wells, Jennie; Dziobek, Isabel; Pasternak, Stephen; Mitchell, Derek G.V.; Rankin, Katherine; Kertesz, Andrew; Boxer, Adam

    2015-01-01

    Objective: To determine the safety and tolerability of 3 doses of intranasal oxytocin (Syntocinon; Novartis, Bern, Switzerland) administered to patients with frontotemporal dementia (FTD). Methods: We conducted a randomized, parallel-group, double-blind, placebo-controlled study using a dose-escalation design to test 3 clinically feasible doses of intranasal oxytocin (24, 48, or 72 IU) administered twice daily for 1 week to 23 patients with behavioral variant FTD or semantic dementia (clinicaltrials.gov registration number NCT01386333). Primary outcome measures were safety and tolerability at each dose. Secondary measures explored efficacy across the combined oxytocin vs placebo groups and examined potential dose-related effects. Results: All 3 doses of intranasal oxytocin were safe and well tolerated. Conclusions: A multicenter trial is warranted to determine the therapeutic efficacy of long-term intranasal oxytocin for behavioral symptoms in FTD. Classification of evidence: This study provides Class I evidence that for patients with FTD, intranasal oxytocin is not significantly associated with adverse events or significant changes in the overall neuropsychiatric inventory. PMID:25503617

  11. Interrogating personhood and dementia

    PubMed Central

    Higgs, Paul; Gilleard, Chris

    2016-01-01

    ABSTRACT Objectives: To interrogate the concept of personhood and its application to care practices for people with dementia. Method: We outline the work of Tom Kitwood on personhood and relate this to conceptualisations of personhood in metaphysics and in moral philosophy. Results: The philosophical concept of personhood has a long history. The metaphysical tradition examines the necessary and sufficient qualities that make up personhood such as agency, consciousness, identity, rationality and second-order reflexivity. Alternative viewpoints treat personhood as a matter of degree rather than as a superordinate category. Within moral philosophy personhood is treated as a moral status applicable to some or to all human beings. Conclusion: In the light of the multiple meanings attached to the term in both metaphysics and moral philosophy, personhood is a relatively unhelpful concept to act as the foundation for developing models and standards of care for people with dementia. Care, we suggest, should concentrate less on ambiguous and somewhat abstract terms such as personhood and focus instead on supporting people's existing capabilities, while minimising the harmful consequences of their incapacities. PMID:26708149

  12. Cognitive decline and dementia in the oldest-old.

    PubMed

    Kravitz, Efrat; Schmeidler, James; Beeri, Michal Schnaider

    2012-10-01

    The oldest-old are the fastest growing segment of the Western population. Over half of the oldest-old will have dementia, but the etiology is yet unknown. Age is the only risk factor consistently associated with dementia in the oldest-old. Many of the risk and protective factors for dementia in the young elderly, such as ApoE genotype, physical activity, and healthy lifestyle, are not relevant for the oldest-old. Neuropathology is abundant in the oldest-old brains, but specific pathologies of Alzheimer's disease (AD) or vascular dementia are not necessarily correlated with cognition, as in younger persons. It has been suggested that accumulation of both AD-like and vascular pathologies, loss of synaptic proteins, and neuronal loss contribute to the cognitive decline observed in the oldest-old. Several characteristics of the oldest-old may confound the diagnosis of dementia in this age group. A gradual age-related cognitive decline, particularly in executive function and mental speed, is evident even in non-demented oldest-old. Hearing and vision losses, which are also prevalent in the oldest-old and found in some cases to precede/predict cognitive decline, may mechanically interfere in neuropsychological evaluations. Difficulties in carrying out everyday activities, observed in the majority of the oldest-old, may be the result of motor or physical dysfunction and of neurodegenerative processes. The oldest-old appear to be a select population, who escapes major illnesses or delays their onset and duration toward the end of life. Dementia in the oldest-old may be manifested when a substantial amount of pathology is accumulated, or with a composition of a variety of pathologies. Investigating the clinical and pathological features of dementia in the oldest-old is of great importance in order to develop therapeutic strategies and to provide the most elderly of our population with good quality of life.

  13. Caregiver- and Patient-Directed Interventions for Dementia

    PubMed Central

    2008-01-01

    Executive Summary In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry’s newly released Aging at Home Strategy. After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person’s transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series. Aging in the Community: Summary of Evidence-Based Analyses Prevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based Analysis Behavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based Analysis Caregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based Analysis Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis The Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) This report features the evidence-based analysis on caregiver- and patient-directed interventions for dementia and is broken down into 4 sections: Introduction Caregiver-Directed Interventions for Dementia Patient-Directed Interventions for Dementia Economic Analysis of Caregiver- and Patient-Directed Interventions for Dementia Caregiver-Directed Interventions for Dementia

  14. Multiplex analyte assays to characterize different dementias: brain inflammatory cytokines in poststroke and other dementias

    PubMed Central

    Chen, Aiqing; Oakley, Arthur E.; Monteiro, Maria; Tuomela, Katri; Allan, Louise M.; Mukaetova-Ladinska, Elizabeta B.; O'Brien, John T.; Kalaria, Raj N.

    2016-01-01

    possible specific involvement of immunosenescence in dementia pathogenesis. In contrast, CRP was not altered between dementia and nondementia subjects or between PSD and PSND. Our study provides evidence not only for the feasibility of tracking cytokines in postmortem brain tissue but also suggests differentially impaired inflammatory mechanisms underlying dementia including AD. There was a diminished inflammatory response, possibly reflecting immunosenescence and cerebral atrophy, in all dementias. Strategies to enhance anti-inflammatory cytokines and boost the immune system of the brain may be beneficial for preventing cognitive dysfunction, especially after stroke. PMID:26827643

  15. Molecular neuroimaging in degenerative dementias.

    PubMed

    Jiménez Bonilla, J F; Carril Carril, J M

    2013-01-01

    In the context of the limitations of structural imaging, brain perfusion and metabolism using SPECT and PET have provided relevant information for the study of cognitive decline. The introduction of the radiotracers for cerebral amyloid imaging has changed the diagnostic strategy regarding Alzheimer's disease, which is currently considered to be a "continuum." According to this new paradigm, the increasing amyloid load would be associated to the preclinical phase and mild cognitive impairment. It has been possible to observe "in vivo" images using 11C-PIB and PET scans. The characteristics of the 11C-PIB image include specific high brain cortical area retention in the positive cases with typical distribution pattern and no retention in the negative cases. This, in combination with 18F-FDG PET, is the basis of molecular neuroimaging as a biomarker. At present, its prognostic value is being evaluated in longitudinal studies. 11C-PIB-PET has become the reference radiotracer to evaluate the presence of cerebral amyloid. However, its availability is limited due to the need for a nearby cyclotron. Therefore, 18F labeled radiotracers are being introduced. Our experience in the last two years with 11C-PIB, first in the research phase and then as being clinically applied, has shown the utility of the technique in the clinical field, either alone or in combination with FDG. Thus, amyloid image is a useful tool for the differential diagnosis of dementia and it is a potentially useful method for early diagnosis and evaluation of future treatments.

  16. Brain atrophy in frontotemporal dementia.

    PubMed Central

    Frisoni, G B; Beltramello, A; Geroldi, C; Weiss, C; Bianchetti, A; Trabucchi, M

    1996-01-01

    OBJECTIVES--To evaluate the pattern of regional brain atrophy in patients with frontotemporal dementia by comparing it with that in patients with Alzheimer's disease and normal controls. METHODS--Fourteen patients with frontotemporal dementia, 13 with moderate, and 33 with mild Alzheimer's disease, and 31 controls were studied. Atrophy was evaluated with linear measures in the anterior brain, medial temporal lobe, and hippocampal formation regions using MRI. RESULTS--Patients with frontotemporal dementia had greater atrophy in the anterior brain regions than patients with Alzheimer's disease or controls. Atrophy of the hippocampal formation, which best discriminates Alzheimer's disease from controls, was present also in patients with frontotemporal dementia. By contrast, atrophy of the medial temporal lobe, which is also present in Alzheimer's disease, was absent in frontotemporal dementia. CONCLUSION--A pattern of atrophy in the frontal lobes and hippocampal formation with sparing of the medial temporal lobe might be distinctive of frontotemporal dementia. Hippocampal involvement might not be specific for Alzheimer's disease and specific patterns of atrophy might be distinctive of some forms of degenerative dementia. Images PMID:8708683

  17. [FALLS IN PATIENTS WITH DEMENTIA].

    PubMed

    Aizen, Efraim

    2015-05-01

    Older people with dementia are at increased risk of falls and their consequences. Patients with dementia fall twice as often as elderly cognitively intact people and are at greater risk of injurious falls. Falls in older people with dementia cause higher rates of morbidity, mortality and institutionalization. There is limited literature attempting to show specific risk factors for falls in this population, mainly: Lewy body dementia, dementia related to Parkinson's disease and depression, psychotropic medication, functional disability and behavioral disturbances. The Physiological Profile Assessment (PPAJ has been found to be a good fall risk screening tool in this population. There are few trials that have shown limited effectiveness of targeted fall prevention programs in community-dwelling cognitively impaired elderly. The evidence from hospitals and residential care is not conclusive. However, it has been demonstrated that some interventions, primarily exercise interventions, can modify certain risk factors in patients with dementia. Further research is required in specifically targeting fall prevention in older people with dementia.

  18. Disease-modifying therapeutic directions for Lewy-Body dementias

    PubMed Central

    Zhang, Qiang; Kim, Young-Cho; Narayanan, Nandakumar S.

    2015-01-01

    Dementia with Lewy bodies (DLB) is the second leading cause of dementia following Alzheimer's disease (AD) and accounts for up to 25% of all dementia. DLB is distinct from AD in that it involves extensive neuropsychiatric symptoms as well as motor symptoms, leads to enormous societal costs in terms of direct medical care and is associated with high financial and caregiver costs. Although, there are no disease-modifying therapies for DLB, we review several new therapeutic directions in treating DLB. We discuss progress in strategies to decrease the level of alpha-synuclein, to prevent the cell to cell transmission of misfolded alpha-synuclein, and the potential of brain stimulation in DLB. PMID:26347604

  19. The Concept of Missing Incidents in Persons with Dementia

    PubMed Central

    Rowe, Meredeth; Houston, Amy; Molinari, Victor; Bulat, Tatjana; Bowen, Mary Elizabeth; Spring, Heather; Mutolo, Sandra; McKenzie, Barbara

    2015-01-01

    Behavioral symptoms of dementia often present the greatest challenge for informal caregivers. One behavior, that is a constant concern for caregivers, is the person with dementia leaving a designated area such that their whereabouts become unknown to the caregiver or a missing incident. Based on an extensive literature review and published findings of their own research, members of the International Consortium on Wandering and Missing Incidents constructed a preliminary missing incidents model. Examining the evidence base, specific factors within each category of the model were further described, reviewed and modified until consensus was reached regarding the final model. The model begins to explain in particular the variety of antecedents that are related to missing incidents. The model presented in this paper is designed to be heuristic and may be used to stimulate discussion and the development of effective preventative and response strategies for missing incidents among persons with dementia. PMID:27417817

  20. Management of behavioral symptoms in progressive degenerative dementias.

    PubMed

    Volicer, Ladislav; Hurley, Ann C

    2003-09-01

    Management of behavioral symptoms of Alzheimer's disease and other progressive degenerative dementias poses continuous challenge to both family and professional caregivers. Behavioral symptoms are complex in nature and require that caregivers understand their presumed causes and intervene appropriately using validated caregiving techniques. Unfortunately, confusing terminology hampers improvement in management techniques. This review attempts to clarify terminology and specifically the behavioral symptoms "agitation" and "resistiveness to care" that require different management techniques. Several conceptual frameworks for behavioral symptoms of dementia are presented. These frameworks include behavioral models, a psychiatric model, and a comprehensive model that combines both behavioral and psychiatric strategies. Using precise terminology consistently and providing care based on a conceptual framework will facilitate the education of caregivers in appropriate techniques for management of behavioral symptoms of dementias.

  1. [Non cognitive symptoms in dementias].

    PubMed

    Vilalta Franch, J; López Pousa, S; Llinas Reglà, J

    1999-01-01

    In the phenomenology of dementia, the cognitive symptoms surround most of the interests both for investigators as clinicians. However, the non cognitive symptoms are shown so often they should become a major one in the clinical evaluation of the dementia syndrome. Moreover, the presence of this symptoms means more clinical severity, increases the institutionalization risk and causes a larger emotional burden for demented carers. On this work, the authors argue about the possible physiopathogenic causes related to cognitive and non cognitive aspects of dementia.

  2. Distributed cognition, dementia, and technology.

    PubMed

    Alm, Norman

    2015-01-01

    The devastating effects of dementia result from cognitive degradation, in particular, working-memory (short-term memory) and planning processes. In supporting people with dementia, carers must take over these cognitive functions on behalf of the other person. This is an exhausting job. Technology may be able to offer assistance here. Its development will be encouraged by viewing cognition as a distributed process, and not just as something that happens inside one person's head. This paper argues for this approach, with examples from existing technical and non-technical systems of support for people with dementia which have been proven to work.

  3. The 'ripple effect': Towards researching improvisational music therapy in dementia care homes.

    PubMed

    Pavlicevic, Mercédès; Tsiris, Giorgos; Wood, Stuart; Powell, Harriet; Graham, Janet; Sanderson, Richard; Millman, Rachel; Gibson, Jane

    2015-09-01

    Increased interest in, and demand for, music therapy provision for persons with dementia prompted this study's exploration of music therapists' strategies for creating musical communities in dementia care settings, considering the needs and resources of people affected by dementia. Focus group discussions and detailed iterative study of improvisational music therapy work by six experienced practitioners clarify the contextual immediacy and socio-musical complexities of music therapy in dementia care homes. Music therapy's 'ripple effect', with resonances from micro (person-to-person musicking), to meso (musicking beyond 'session time') and macro level (within the care home and beyond), implies that all who are part of the dementia care ecology need opportunities for flourishing, shared participation, and for expanded self-identities; beyond 'staff', 'residents', or 'being in distress'. On such basis, managers and funders might consider an extended brief for music therapists' roles, to include generating and maintaining musical wellbeing throughout residential care settings.

  4. Optimizing patient care and research: the Amsterdam Dementia Cohort.

    PubMed

    van der Flier, Wiesje M; Pijnenburg, Yolande A L; Prins, Niels; Lemstra, Afina W; Bouwman, Femke H; Teunissen, Charlotte E; van Berckel, Bart N M; Stam, Cornelis J; Barkhof, Frederik; Visser, Pieter Jelle; van Egmond, Evan; Scheltens, Philip

    2014-01-01

    Since its opening in 2000, patient care and research go hand in hand at the Alzheimer center of the VU University Medical Center, both organized in such a way that they mutually strengthen each other. Our mission is to give patients a voice by lifting the stigma on dementia, to find new diagnostic and treatment strategies, and, ultimately, to cure diseases that cause dementia. Our healthcare pathway is uniquely designed to accommodate all necessary investigations for the diagnostic work-up of dementia in one day (one-stop shop). A second unique feature is that research has been fully integrated in the healthcare pathway. The resulting Amsterdam Dementia Cohort now includes over 4000 patients, and for the majority of these, we have MRI, EEG, blood (serum, plasma), DNA, and CSF available. The Amsterdam Dementia Cohort forms the basis of much of our research, which focuses on four major research lines: 1) variability in manifestation, 2) early diagnosis, 3) vascular factors, and 4) interventions. By answering research questions closely related to clinical practice, the results of our research can be looped back to improve clinical work-up for our patients.

  5. The role of pulmonology in the National Health System Chronicity Strategy.

    PubMed

    Soler-Cataluña, Juan José; Sánchez Toril, Fernando; Aguar Benito, M Carmen

    2015-08-01

    Longer life expectancy and the progressive aging of the population is changing the epidemiological pattern of healthcare, with a reduction in the incidence of acute diseases and a marked increase in chronic diseases. This change brings important social, healthcare and economic consequences that call for a reorganization of patient care. In this respect, the Spanish National Health System has developed a Chronicity strategy that proposes a substantial change in focus from traditional rescue medicine to patient- and environment-centered care, with a planned, proactive, participative and multidisciplinary approach. Some of the more common chronic diseases are respiratory. In COPD, this integrated approach has been effective in reducing exacerbations, improving quality of life, and even reducing costs. However, the wide variety of management strategies, not only in COPD but also in asthma and other respiratory diseases, makes it difficult to draw definitive conclusions. Pulmonologists can and must participate in the new chronicity models and contribute their knowledge, experience, innovation, research, and special expertise to the development of these new paradigms.

  6. [The management strategy of the Brazilian National Network of Human Milk Banks].

    PubMed

    Maia, Paulo Ricardo da Silva; Novak, Franz Reis; Almeida, João Aprígio Guerra de; Silva, Danielle Aparecida da

    2004-01-01

    The Brazilian National Network of Human Milk Banks (REDEBLH), with its headquarters in the Oswaldo Cruz Foundation in Rio de Janeiro, is experiencing rapid growth. The Network's activity has been acknowledged by the World Health Organization and received the Sasakawa Health Award in 2001 for best public health project. One of the main challenges is to ensure continuing development of competencies to respond to the needs arising from such growth. A new strategy is being pursued to deal with the Network's management issues. This article aims to develop a conceptual framework to contribute to the elaboration of a theoretical framework for new management strategies in the REDEBLH. Using such concepts, the aim is to draw on the typology of networks described in the specialized literature to identify the institutional profile of the REDEBLH. Based on the understanding that it is necessary to identify and understand the processes occurring within networks, and after which to consider management-related issues, the study used a proposal developed for the formation of innovation networks as its analytical tool.

  7. [National strategy in the battle against scorpion stings and envenomations. Application and evaluation].

    PubMed

    Soulaymani Bencheikh, R; Faraj, Z; Semlali, I; Ouammi, L; Badri, M

    2003-11-01

    Scorpion stings represent the first cause of poisoning with an incidence of 30 to 50% of all declared cases in the Centre Anti Poison of Morocco (CAPM). Aware of this increasing problem, the CAPM paid special attention to this pathology. Thanks to its retrospective and prospective studies, the scorpion species mapping has been determined as well as the demographic features of stung patients, the nature and the chronology of clinical events in scorpion envenimation, and the epidemiological, clinical and therapeutical factors of severity. On this basis, the CAPM worked out a national strategy to struggle against scorpion stings whose aim was to decrease the morbidity and mortality caused by stings of scorpion as well as to rationalise economic expenses. The components of this strategy were based on the training of the medical and paramedical staff, on information, education, communication involving different sectors, on identification of needs and on follow-up and assessment. A nationwide campaign was implemented to change the population and health-care staff's behaviour regarding this pathology. Its evaluation permitted to improve the compilation of cases with census of 14104 cases, to reduce lethality rate and to rationalise expenses while banishing some medicines and avoiding useless hospitalization.

  8. The National Energy Strategy: A balanced program?. Proceedings of the nineteenth annual Illinois energy conference

    SciTech Connect

    Not Available

    1991-12-31

    The Nineteenth Annual Illinois Energy Conference was held in Chicago, Illinois November 1991. It was organized by the Energy Resources Center, University of Illinois at Chicago with major support provided by the US Environmental Protection Agency, the US Department of Energy, the Illinois Commerce Commission, the Illinois Department of Energy and Natural Resources, and the Citizens Council on Energy Resources. The conference program was developed by a planning committee who drew upon Illinois energy and environmental specialists from the major sectors including energy industries, environmental organizations, research universities, utility companies, federal, state and local government agencies, and public interest groups. The members of the planning committee were brought together for a full-day session where they were asked to assess the political, economic, and social impacts of the proposed National Energy Strategy as it relates to Illinois and the Midwest region. Within this context, the planning committee identified several major issues including: (1) Is the proposed plan a balanced strategy; (2) What are the NES impacts on the transportation sector; (3) What are the opportunities for improved efficiency in the Electric Utility Sector; and (4) What is the role of advanced research and development.

  9. Post-stroke dementia - a comprehensive review.

    PubMed

    Mijajlović, Milija D; Pavlović, Aleksandra; Brainin, Michael; Heiss, Wolf-Dieter; Quinn, Terence J; Ihle-Hansen, Hege B; Hermann, Dirk M; Assayag, Einor Ben; Richard, Edo; Thiel, Alexander; Kliper, Efrat; Shin, Yong-Il; Kim, Yun-Hee; Choi, SeongHye; Jung, San; Lee, Yeong-Bae; Sinanović, Osman; Levine, Deborah A; Schlesinger, Ilana; Mead, Gillian; Milošević, Vuk; Leys, Didier; Hagberg, Guri; Ursin, Marie Helene; Teuschl, Yvonne; Prokopenko, Semyon; Mozheyko, Elena; Bezdenezhnykh, Anna; Matz, Karl; Aleksić, Vuk; Muresanu, DafinFior; Korczyn, Amos D; Bornstein, Natan M

    2017-01-18

    Post-stroke dementia (PSD) or post-stroke cognitive impairment (PSCI) may affect up to one third of stroke survivors. Various definitions of PSCI and PSD have been described. We propose PSD as a label for any dementia following stroke in temporal relation. Various tools are available to screen and assess cognition, with few PSD-specific instruments. Choice will depend on purpose of assessment, with differing instruments needed for brief screening (e.g., Montreal Cognitive Assessment) or diagnostic formulation (e.g., NINDS VCI battery). A comprehensive evaluation should include assessment of pre-stroke cognition (e.g., using Informant Questionnaire for Cognitive Decline in the Elderly), mood (e.g., using Hospital Anxiety and Depression Scale), and functional consequences of cognitive impairments (e.g., using modified Rankin Scale). A large number of biomarkers for PSD, including indicators for genetic polymorphisms, biomarkers in the cerebrospinal fluid and in the serum, inflammatory mediators, and peripheral microRNA profiles have been proposed. Currently, no specific biomarkers have been proven to robustly discriminate vulnerable patients ('at risk brains') from those with better prognosis or to discriminate Alzheimer's disease dementia from PSD. Further, neuroimaging is an important diagnostic tool in PSD. The role of computerized tomography is limited to demonstrating type and location of the underlying primary lesion and indicating atrophy and severe white matter changes. Magnetic resonance imaging is the key neuroimaging modality and has high sensitivity and specificity for detecting pathological changes, including small vessel disease. Advanced multi-modal imaging includes diffusion tensor imaging for fiber tracking, by which changes in networks can be detected. Quantitative imaging of cerebral blood flow and metabolism by positron emission tomography can differentiate between vascular dementia and degenerative dementia and show the interaction between

  10. Developing a national dental education research strategy: priorities, barriers and enablers

    PubMed Central

    Barton, Karen L; Dennis, Ashley A; Rees, Charlotte E

    2017-01-01

    Objectives This study aimed to identify national dental education research (DER) priorities for the next 3–5 years and to identify barriers and enablers to DER. Setting Scotland. Participants In this two-stage online questionnaire study, we collected data with multiple dental professions (eg, dentistry, dental nursing and dental hygiene) and stakeholder groups (eg, learners, clinicians, educators, managers, researchers and academics). Eighty-five participants completed the Stage 1 qualitative questionnaire and 649 participants the Stage 2 quantitative questionnaire. Results Eight themes were identified at Stage 1. Of the 24 DER priorities identified, the top three were: role of assessments in identifying competence; undergraduate curriculum prepares for practice and promoting teamwork. Following exploratory factor analysis, the 24 items loaded onto four factors: teamwork and professionalism, measuring and enhancing performance, dental workforce issues and curriculum integration and innovation. Barriers and enablers existed at multiple levels: individual, interpersonal, institutional structures and cultures and technology. Conclusions This priority setting exercise provides a necessary first step to developing a national DER strategy capturing multiple perspectives. Promoting DER requires improved resourcing alongside efforts to overcome peer stigma and lack of valuing and motivation. PMID:28360237

  11. Effectiveness of a confinement strategy for reducing campsite impacts in Shenandoah National Park

    USGS Publications Warehouse

    Reid, S.E.; Marion, J.L.

    2004-01-01

    The expansion and proliferation of backcountry campsites is a persistent problem in many parks and protected areas. Shenandoah National Park (SNP) has one of the highest backcountry overnight use densities in the USA national parks system. SNP managers implemented a multi-option backcountry camping policy in 2000 that included camping containment with established campsites. These actions were intended to reduce the number of campsites and the area of camping disturbance at each site. This paper describes a longitudinal adaptive management assessment of the new campsite policies, applying quantitative measures of campsite conditions to evaluate the efficacy of management interventions. Physical campsite measurements combined with qualitative visitor interviews indicated SNP had successfully reduced the number of campsites and aggregate measures of camping-related disturbance in the Park, while minimizing the use of regulations, site facilities and staff resources. Implications for managers of other protected areas are that an established site camping policy can minimize camping disturbance, including the number and size of campsites, provided managers can sustain rehabilitation efforts to close and restore unneeded campsites. Experiential attributes, such as the potential for solitude, can also be manipulated through control over the selection of established campsites. Integrating resource and social science methods also provided a more holistic perspective on management policy assessments. Adaptive management research provided a timely evaluation of management success while facilitating effective modifications in response to unforeseen challenges. Conclusions regarding the effectiveness of a visitor impact containment strategy involving an established site camping option are offered.

  12. Public health strategy against overweight and obesity in Mexico's National Agreement for Nutritional Health.

    PubMed

    Latnovic, L; Rodriguez Cabrera, L

    2013-06-01

    Overweight and obesity are major world global health challenges of the 21st century. Mexico is not an exception. Approximately 70% of the adult Mexican population has an excessive body weight. The prevalence of obesity and overweight in Mexican school children aged 5-11 is also high: one child in four is overweight. In light of the seriousness of the situation, the solutions for this problem are based on modification of the environments and change of individual habits and behaviors related to nutrition and physical activity. As a result, the Mexican government, public sector and academy established three common goals and 10 priority objectives that are expressed in the National Agreement for Nutritional Health-Strategy to Control Overweight and Obesity. The obesity problem requires interventions and policies that reside outside of the health sector domain, key aspects of this public health policy was agreement among all stakeholders on cross-cutting actions. The best examples of National Agreement's inter-sectorial action implementation is in the school setting and Code of 'Self Regulation' on Advertising of Food and Non-Alcoholic Beverages to Children introduced by the food and beverage industry. The ultimate goal of this national policy is to provide the strategic plan for healthy weight and better health, by promoting healthy lifestyles focused on correct diet and physical activity in all life stages, from pregnancy and early childhood and on into adulthood by a multi stakeholder approach. Although there have been great achievements in some areas of implementation, there are still challenges to confront.

  13. Effective post-literacy learning: A question of a national human resource strategy

    NASA Astrophysics Data System (ADS)

    Ahmed, Manzoor

    1989-12-01

    Initial literacy courses must be followed by opportunities for consolidating the mechanics of literacy skills and practical application of three skills in life. Experience has shown that these `post-literacy' objectives can be achieved, not by a second stage of the literacy course, but by a range of opportunities for learning and application of learning through a network of continuing education opportunities geared to the diverse needs and circumstances of different categories of neo-literates. A taxonomy of learner categories and learning needs is seen as a basis for planning and supporting the network of post-literacy learning. Examples from China, India and Thailand demonstrate the importance of recognizing the continuity of literacy and post-literacy efforts, the need for commitment of resources for this continuum of learning, the role of an organizational structure to deal with this continuum in a coordinated way, and the value of a comprehensive range of learning opportunities for neo-literates. A necessary condition for success in building a network of continuing learning opportunities and contributing to the creation of a `learning society' is to make human resource development the core of national development. It is argued that the scope and dimensions of post-literacy continuing education are integrally linked with the goal of mass basic education and ultimately with the vision of a `learning society'. Such a vision can be a reality only with a serious human resource development focus in national development that will permit the necessary mobilization of resources, the coordination of sectors of government and society and the generation of popular enthusiasm. A radical or an incremental approach can be taken to move towards the primacy of a human resource strategy in national development. In either case, a functioning coordination and support mechanism has to be developed for the key elements of mass basic education including post-literacy learning.

  14. Public health strategy against overweight and obesity in Mexico's National Agreement for Nutritional Health

    PubMed Central

    Latnovic, L; Rodriguez Cabrera, L

    2013-01-01

    Overweight and obesity are major world global health challenges of the 21st century. Mexico is not an exception. Approximately 70% of the adult Mexican population has an excessive body weight. The prevalence of obesity and overweight in Mexican school children aged 5–11 is also high: one child in four is overweight. In light of the seriousness of the situation, the solutions for this problem are based on modification of the environments and change of individual habits and behaviors related to nutrition and physical activity. As a result, the Mexican government, public sector and academy established three common goals and 10 priority objectives that are expressed in the National Agreement for Nutritional Health—Strategy to Control Overweight and Obesity. The obesity problem requires interventions and policies that reside outside of the health sector domain, key aspects of this public health policy was agreement among all stakeholders on cross-cutting actions. The best examples of National Agreement's inter-sectorial action implementation is in the school setting and Code of ‘Self Regulation' on Advertising of Food and Non-Alcoholic Beverages to Children introduced by the food and beverage industry. The ultimate goal of this national policy is to provide the strategic plan for healthy weight and better health, by promoting healthy lifestyles focused on correct diet and physical activity in all life stages, from pregnancy and early childhood and on into adulthood by a multi stakeholder approach. Although there have been great achievements in some areas of implementation, there are still challenges to confront. PMID:27152155

  15. Addressing the Surveillance Goal in the National Strategy for Suicide Prevention: The Department of Defense Suicide Event Report

    PubMed Central

    Reger, Mark A.; Kinn, Julie T.; Luxton, David D.; Skopp, Nancy A.; Bush, Nigel E.

    2012-01-01

    The US National Strategy for Suicide Prevention (National Strategy) described 11 goals across multiple areas, including suicide surveillance. Consistent with these goals, the Department of Defense (DoD) has engaged aggressively in the area of suicide surveillance. The DoD's population-based surveillance system, the DoD Suicide Event Report (DoDSER) collects information on suicides and suicide attempts for all branches of the military. Data collected includes suicide event details, treatment history, military and psychosocial history, and psychosocial stressors at the time of the event. Lessons learned from the DoDSER program are shared to assist other public health professionals working to address the National Strategy objectives. PMID:22390595

  16. Addressing the surveillance goal in the National Strategy for Suicide Prevention: the Department of Defense Suicide Event Report.

    PubMed

    Gahm, Gregory A; Reger, Mark A; Kinn, Julie T; Luxton, David D; Skopp, Nancy A; Bush, Nigel E

    2012-03-01

    The US National Strategy for Suicide Prevention (National Strategy) described 11 goals across multiple areas, including suicide surveillance. Consistent with these goals, the Department of Defense (DoD) has engaged aggressively in the area of suicide surveillance. The DoD's population-based surveillance system, the DoD Suicide Event Report (DoDSER) collects information on suicides and suicide attempts for all branches of the military. Data collected includes suicide event details, treatment history, military and psychosocial history, and psychosocial stressors at the time of the event. Lessons learned from the DoDSER program are shared to assist other public health professionals working to address the National Strategy objectives.

  17. Reporting of clinically diagnosed dementia on death certificates: retrospective cohort study

    PubMed Central

    Perera, Gayan; Stewart, Robert; Higginson, Irene J.; Sleeman, Katherine E.

    2016-01-01

    Background: mortality statistics are a frequently used source of information on deaths in dementia but are limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed dementia is recorded on death certificates, including predictive factors. Methods: a retrospective cohort study assembled using a large mental healthcare database in South London, linked to Office for National Statistics mortality data. People with a clinical diagnosis of dementia, aged 65 or older, who died between 2006 and 2013 were included. The main outcome was death certificate recording of dementia. Results: in total, 7,115 people were identified. Dementia was recorded on 3,815 (53.6%) death certificates. Frequency of dementia recording increased from 39.9% (2006) to 63.0% (2013) (odds ratio (OR) per year increment 1.11, 95% CI 1.07–1.15). Recording of dementia was more likely if people were older (OR per year increment 1.02, 95% CI 1.01–1.03), and for those who died in care homes (OR 1.89, 95% CI 1.50–2.40) or hospitals (OR 1.14, 95% CI 1.03–1.46) compared with home, and less likely for people with less severe cognitive impairment (OR 0.95, 95% CI 0.94–0.96), and if the diagnosis was Lewy body (OR 0.30, 95% CI 0.15–0.62) or vascular dementia (OR 0.79, 95% CI 0.68–0.93) compared with Alzheimer's disease. Conclusions: changes in certification practices may have contributed to the rise in recorded prevalence of dementia from mortality data. However, mortality data still considerably underestimate the population burden of dementia. Potential biases affecting recording of dementia need to be taken into account when interpreting mortality data. PMID:27146301

  18. [Healthcare of children and adolescents in national strategy for action for children for 2012-2017].

    PubMed

    Kuchma, V R

    2013-01-01

    The National Strategy defines the main directions and objectives of public policy in the interests of children and the key mechanisms for its implementation. The strategy is based on the universally recognized principles and norms of international law. Implementation of the National Strategy will be realized in the following areas: Family Child Welfare Policy, availability to quality education and training, cultural development, and information security of children, child-friendly health care, and healthy lifestyle; equal opportunities for children in need of special care of the State, the creation of protection and safeguarding the rights and interests of children and child-friendly justice, and children - members of the realization of National Strategy. School health care is intended to be actively involved in two directions: availability to quality education and training, cultural development, and information security of children, health care, child-friendly and healthy lifestyle. The main tasks in the part of hygiene and children's health are: state support for the construction of new preschool educational institutions and the development of all forms of safe preschool education, including non-state sector, providing for every upperclassman safe choice of training profile corresponding to his inclinations and life plans, as well as the functional possibilities and health state; providing quality psychological, correctional and pedagogical aid to children in educational institutions; renewal of forms and methods of control of child neglect, drug addiction, alcoholism, crime, prostitution; the development of effective mechanisms in prevention of deviant behavior in childhood; the creation and implementation of training programs for children and adolescents on rules of safety behavior in the World Wide Web, prevention of Internet addiction; the introduction of the system for monitoring of the educational environment; the creation of portals and sites accumulating

  19. Dementia with Lewy bodies

    PubMed Central

    Ferman, Tanis J.; Boeve, Bradley F.

    2009-01-01

    Synopsis The advent of new immunostains have improved our ability to detect limbic and cortical Lewy bodies, and it is now evident that Dementa with Lewy bodies (DLB) is the second most common neurodegenerative dementia, after Alzheimer’s disease (AD). Distinguishing DLB from AD has important implications for treatment, in terms of substances that may worsen symptoms (i.e., anticholinergic and certain neuroleptic medications) and those that may improve them (i.e., cholinesterase inhibitors, carbidopa-levodopa). Neurocognitive patterns, psychiatric features, extrapyramidal signs and sleep disturbance are helpful in differentiating DLB from AD early in the disease course. Differences in the severity of cholinergic depletion as well as type and distribution of neuropathology contribute to these clinical differences, though DLB patients with a high density of co-occuring AD pathology are less clinical distinguishable from AD. PMID:17659188

  20. Prevalence of dementia in Al-Quseir city, Red Sea Governorate, Egypt

    PubMed Central

    El Tallawy, Hamdy N; Farghly, Wafaa M; Badry, Reda; Rageh, Tarek A; Shehata, Ghaydaa A; Hakeem M, N Abdel; El Hamed, Mohamed Abd; Sayd, Mohamed AM; Hamed, Yasser; Kandil, Mahmoud R

    2014-01-01

    Dementia is one of the most important public health problems as a result of the rapid increase in the number of elderly persons worldwide. Improvement of prevention strategies and caring for people with dementia should be undertaken. We performed a door-to-door study to screen all subjects aged 50 years and older (n=4,329 of 33,285 inhabitants) in Al-Quseir city. The screening was performed by 3 neuropsychiatrists, using a modified form of the Mini-Mental State Examination. Suspected cases were subjected to case ascertainment according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria for dementia; full clinical assessment; psychometric assessment using Cognitive Abilities Screening Instruments, Hachinski Ischaemic Score, Instrumental Activities of Daily Living Scale and the Geriatric Depression Scale; neuroimaging (computed tomography and/or magnetic resonance imaging); and laboratory investigations for selected patients when indicated. The prevalence of dementia was 2.01% for participants aged 50 years or older and 3.83% for those aged 60 years or older. It increased steeply with increasing age to a maximum of 13.5% for those aged 80 years or older. Alzheimer’s dementia (48.3%) was the most common subtype, followed by vascular dementia (36.8%), dementia resulting from general medical conditions (11.5%), and last, dementia resulting from multiple etiologies (3.4%). PMID:24353410

  1. Dementia - behavior and sleep problems

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000029.htm Dementia - behavior and sleep problems To use the sharing features on this ... get to sleep and stay asleep Tips for Behavior and Sleep Problems Having a daily routine may help. Calmly ...

  2. [The cost of severe dementia].

    PubMed

    Joël, Marie-Eve

    2005-03-01

    The aim of the present article is to analyse the methodological difficulties to assess the economic cost of severe dementia from the available data, and the shortcomings of an exclusively economic approach. It is very difficult to provide a reliable account of the cost of severe dementia, when ignoring the initial assessment of the severity and the socio-economic context of the care given to demented persons. When assessing the cost of severe dementia, one needs to know who are the affected individuals, and what medical care they are given - whether at home or inside an institution. While the direct cost can be easily assessed, the indirect cost is more difficult to calculate, and particularly the productivity loss for the caring persons, when they are in occupational activity. Setting up reliable indicators for the cost of dementia is a long process, which needs a clear definition of the target population of the measurement.

  3. Current issues in dementia pharmacotherapy.

    PubMed

    Daiello, Lori A

    2007-12-01

    Diagnosis and treatment of dementia in nursing homes and assisted living facilities remains challenging since response to treatment and disease course varies for the common degenerative dementias. Four cholinesterase inhibitors and an N-methyl-D-aspartate glutamate receptor antagonist are approved by the US Food and Drug Administration for the treatment of Alzheimer's disease (AD). Treatment with AD medications is clinically efficacious and associated with reduced caregiver burden. Some controlled trials have reported that cholinesterase inhibitors and memantine ameliorate dementia-related behavioral symptoms. Antipsychotic therapy is often used for intractable behavioral symptoms or psychosis not responding to nonpharmacologic interventions and antidementia medications; however, the risk/benefit ratio for each patient should be critically evaluated, because treatment with atypical antipsychotics has been associated with serious adverse events, including increased risk for death in older adults with dementia.

  4. Dementia: Unique to Older Adults

    MedlinePlus

    ... other diseases, thyroid gland problems, serious head injuries, vitamin deficiencies, and long-term heavy drinking. Dementia caused by infections, vitamin deficiencies, and medications can be cured by treating the ...

  5. Dementia due to metabolic causes

    MedlinePlus

    ... a medical condition causing the dementia may include: Ammonia level in the blood Blood chemistry , electrolytes Blood ... Liver disease Low blood sugar Low sodium level Metabolism Pellagra Pheochromocytoma Porphyria Prerenal azotemia Vitamin B12 Review ...

  6. The `subcortical dementia' of progressive supranuclear palsy

    PubMed Central

    Albert, Martin L.; Feldman, Robert G.; Willis, Anne L.

    1974-01-01

    Progressive supranuclear palsy (Steele et al.) has a characteristic pattern of dementia: (1) forgetfulness, (2) slowing of thought processes, (3) emotional or personality changes (apathy or depression with occasional outbursts of irritability), and (4) impaired ability to manipulate acquired knowledge. In many neurological disease states associated with subcortical pathology a similar pattern of dementia exists. The neurobehavioural changes of progressive supranuclear palsy thus typify a clinical pattern which may be referred to as subcortical dementia. The subcortical dementias have a striking clinical resemblance to the dementia which occurs after bifrontal lobe disease. However, the subcortical dementias can be clearly distinguished clinically from cortical dementias, other than frontal dementias. We propose as a tentative hypothesis that there may be common pathophysiological mechanisms underlying the subcortical dementias—in particular, disturbances of timing and activation. There are immediate practical implications of this hypothesis: drugs which have an effect on subcortical timing and activating mechanisms may be useful in the treatment of subcortical dementias. PMID:4819905

  7. Presenile dementia presenting as aphasia.

    PubMed Central

    Wechsler, A F

    1977-01-01

    A focal aphasic syndrome was the first and outstanding manifestation of a degenerative, presenile dementia in a 67 year old man. Computerised axial tomography showed a strikingly dilated left Sylvian fissure--particularly in its posterior aspect--in the presence of moderate diffuse cortical atrophy. The radiographic findings correlated well with the clinical data. This is the first report of an aphasic disturbance of language as the initial symptom is presenile dementia. Images PMID:886357

  8. A review of ethical issues in dementia.

    PubMed

    Johnson, Rebecca A; Karlawish, Jason

    2015-10-01

    Dementia raises many ethical issues. The present review, taking note of the fact that the stages of dementia raise distinct ethical issues, focuses on three issues associated with stages of dementia's progression: (1) how the emergence of preclinical and asymptomatic but at-risk categories for dementia creates complex questions about preventive measures, risk disclosure, and protection from stigma and discrimination; (2) how despite efforts at dementia prevention, important research continues to investigate ways to alleviate clinical dementia's symptoms, and requires additional human subjects protections to ethically enroll persons with dementia; and (3) how in spite of research and prevention efforts, persons continue to need to live with dementia. This review highlights two major themes. First is how expanding the boundaries of dementias such as Alzheimer's to include asymptomatic but at-risk persons generate new ethical questions. One promising way to address these questions is to take an integrated approach to dementia ethics, which can include incorporating ethics-related data collection into the design of a dementia research study itself. Second is the interdisciplinary nature of ethical questions related to dementia, from health policy questions about insurance coverage for long-term care to political questions about voting, driving, and other civic rights and privileges to economic questions about balancing an employer's right to a safe and productive workforce with an employee's rights to avoid discrimination on the basis of their dementia risk. The review highlights these themes and emerging ethical issues in dementia.

  9. The Asia-Pacific Maritime Security Strategy: Achieving U.S. National Security Objectives in a Changing Environment

    DTIC Science & Technology

    2015-07-27

    ACHIEVING U.S. NATIONAL SECURITY OBJECTIVES IN A CHANGING ENVIRONMENT Indian Ocean In sharp contrast to the South and East China Seas, the Indian ... ENVIRONMENT Second, we are working together with our allies and partners from Northeast Asia to the Indian Ocean to build their maritime capacity. We...Pacific Maritime Security Strategy: Achieving U.S. National Security Objectives in a Changing Environment 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  10. Increased Long-Term Risk of Dementia in Patients With Carbon Monoxide Poisoning

    PubMed Central

    Wong, Chung-Shun; Lin, Ying-Chin; Hong, Li-Yee; Chen, Tzu-Ting; Ma, Hon-Ping; Hsu, Yung-Ho; Tsai, Shin-Han; Lin, Yuh-Feng; Wu, Mei-Yi

    2016-01-01

    Abstract Carbon monoxide (CO) poisoning may cause toxicity of the central nervous system and heart. However, the association between CO poisoning and long-term dementia risk remains unestablished. We investigated the incidence of dementia in patients with CO poisoning in Taiwan and evaluated whether they had a higher risk of dementia than did the general population. A nationwide population-based cohort study was conducted among patients with CO poisoning identified using Taiwan's National Health Insurance Research Database (NHIRD) during 2004 to 2013. CO poisoning was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. The study cohort comprised patients with CO poisoning between 2005 and 2010 (N = 14,590). Each patient was age-, sex-, and index date-matched with 4 randomly selected controls from the comparison cohort (N = 58,360). All patients were followed from the study date until dementia development, death, or the end of 2013. Cox proportional hazards regressions were performed for comparing the hazard ratios for dementia between the 2 cohorts. Incident cases of dementia were identified from the NHIRD. After adjustment for potential confounders, the study cohort was independently associated with a higher dementia risk (adjusted hazard ratio, 2.75; 95% confidence interval, 2.26–3.35). This population-based cohort study indicated that patients with CO poisoning have a higher risk of dementia than do people without CO poisoning. PMID:26817904

  11. Sense of Place and the National Parks, Strategies for Communicating the Interconnected Nature of Earth Science

    NASA Astrophysics Data System (ADS)

    Vye, E. C.; Rose, W. I.; Huntoon, J. E.; Nash, B. L.

    2010-12-01

    Using sense of place can help scientists improve their communication of complex concepts related to the connectivity of the environment, geological processes, and human societies. National parks afford excellent examples of places that contain intellectual and emotional stimuli for diverse individuals - in other words, they foster a sense of place. Parks contain spectacular examples of how the processes that shape the earth influence ecosystem and societal development. Parks can therefore be used as outdoor classrooms to engage people in place-based Earth Science education. Incorporating place-based teaching methods can promote learning about Earth’s processes that ensures that a wider audience can be reached than by traditional instructional methods. Specific examples of using national parks on the Colorado Plateau, in the Rocky Mountains and the Keweenaw Peninsula for K-12 teacher training have resulted in a deepening of Earth Science content-area knowledge. The National Parks “Views of the National Park (Views)” multimedia education program can subsequently be used to promote engagement of students in the teachers’ classrooms. Teachers who wish to continue their education as interns in the parks are served by programs such as Geoscientists-in-the-Parks, Volunteers-in-Parks, and Teacher-Ranger-Teacher programs. The Michigan Teaching Excellence Program (MiTEP), multi-year teacher leadership and professional development program is working with middle-grade science teachers from selected urban districts and using the parks of the Midwest as natural classrooms. MiTEP has partnered with the NPS to develop internship opportunities for teachers in the parks. These internships will result in educational materials that can be hosted by “Views”. The goal of the internships are to improve teachers’ understanding of the natural environment and the processes that it reflects, and to assist park personnel in producing materials that are standards-based, age

  12. Commentary on "Developing a national strategy to prevent dementia: Leon Thal Symposium 2009." Developing a blood test for Alzheimer's disease using advanced genomic expression technology.

    PubMed

    Einstein, Richard

    2010-03-01

    There is a significant need for reliable molecular biomarkers to aid in Alzheimer's disease (AD) clinical diagnosis. RNA transcriptional profiling, although extensively applied for biomarker development in other diseases, is first defining its role in AD. Application of this technology has the sensitivity and power to provide sufficient information for the development of tests to determine disease severity, progression, heterogeneity, and potential for therapeutic response in the AD population. In order to bring forth the potential of this technology, however, the community needs to make a concerted effort to begin sample collection as soon as patients/subjects are identified. Only then can these powerful technologies be applied in a well controlled study for the development of novel diagnostics.

  13. Evaluating abuse in the patient with dementia.

    PubMed

    Tronetti, Pamela

    2014-11-01

    For patients with dementia, abuse ranges from subtle scams to outright physical violence. As dementia progresses, abuse escalates. The stages of dementia--mild cognitive impairment, mild dementia, moderate dementia, and severe dementia--lend themselves to varied presentations of abuse. Knowing which types of abuse are more prominent at each stage aids the clinician in anticipating risk of abuse and patient and caregiver needs. Interviewing the victim is crucial in uncovering, documenting, and intervening in an abuse situation. A clinician who is skilled in drawing out the facts while remaining supportive of the patient is key in ending the victimization.

  14. Moving People from Welfare to Work: Lessons from the National Evaluation of Welfare-to-Work Strategies.

    ERIC Educational Resources Information Center

    Hamilton, Gayle

    The findings of the National Evaluation of Welfare-to-Work Strategies (NEWWS) were analyzed to identify ways of improving the process of moving people from welfare to work. Selected lessons from the analysis were as follows: (1) welfare-to-work programs that rely on adult basic education programs for the general population are unlikely to improve…

  15. The Role of National Strategy Behaviour and Attendance Consultants with Regard to Training and Professional Development in Special Educational Needs

    ERIC Educational Resources Information Center

    Frost, Barry

    2009-01-01

    The year 2003 saw Behaviour and Attendance (B&A) consultants beginning work across the country, supporting (mostly) mainstream secondary schools. They are part of an extensive advisory team which is instrumental in improving standards in schools through the Government's Secondary National Strategy. Their brief was to develop and improve the…

  16. The Search for Quality: A Five Country Study of National Strategies to Improve Educational Quality in Central Asia

    ERIC Educational Resources Information Center

    Chapman, D.W.; Weidman, J.; Cohen, M.; Mercer, M.

    2005-01-01

    This paper presents a comparative analysis of the strategies employed over the last decade by governments of five Central Asia republics-Azerbaijan, Kazakhstan, Kyrgyz Republic, Tajikistan, and Uzbekistan-to raise educational quality at the primary and secondary levels. Data are drawn from a 2002 cross-national study sponsored by the Asian…

  17. University Leaders' Strategies in the Global Environment: A Comparative Study of Universitas Indonesia and the Australian National University

    ERIC Educational Resources Information Center

    Marginson, Simon; Sawir, Erlenawati

    2006-01-01

    In a global environment in which global, national and local nodes relate freely within common networks, all research universities must pursue strategies for building global capacity and facilitating cross-border staff and student movement and research collaboration. The study compares readings of the global environment, global and international…

  18. Risk of decline in functional activities in dementia with Lewy bodies and Alzheimer disease.

    PubMed

    Gill, Dawn P; Koepsell, Thomas D; Hubbard, Rebecca A; Kukull, Walter A

    2011-01-01

    We examined the risk of 1-year decline in 4 everyday activities in patients with dementia with Lewy bodies (DLB), relative to patients with Alzheimer disease (AD). Data were from the National Alzheimer's Coordinating Center, gathered from 32 Alzheimer's Disease Centers. Participants (n=1880) were: aged 60+ years, demented with a primary clinical diagnosis of probable AD or DLB, and had a global Clinical Dementia Rating of 0.5 to 2. The activities were measured with the Functional Activities Questionnaire. In modified Poisson regression models adjusted for demographics, baseline activity, years from symptom onset, cognitive impairment, and comorbidities; DLB participants aged 67 to 81 years had 1.5 to 2 times increased risk of decline in performing basic kitchen tasks, engaging in games/hobbies, and paying attention/understanding, relative to AD participants of the same age (P<0.05). There was no significant difference between AD and DLB participants beyond this age range. For decline in ability to go shopping alone, there was also no significant difference between AD and DLB participants. In summary, the functional course of DLB, relative to AD, may depend on the age of the patient. These findings may provide anticipatory guidance to families and healthcare providers, which may be useful in the planning of care strategies.

  19. Frontotemporal dementia: a bridge between dementia and neuromuscular disease

    PubMed Central

    Ng, Adeline SL; Rademakers, Rosa; Miller, BL

    2015-01-01

    The concept that frontotemporal dementia (FTD) is a purely “cortical” dementia has largely been refuted by the recognition of its close association with motor neuron disease, and the identification of transactive response DNA-binding protein 43 (TDP-43) as a major pathological substrate underlying both diseases. Genetic findings have transformed this field and revealed connections between disorders that were previous thought clinically unrelated. The discovery of the C9ORF72 locus as responsible for majority of hereditary FTD, ALS and FTD-ALS cases and the understanding that repeat-containing RNA plays a crucial role in pathogenesis of both disorders has paved the way for development of potential biomarkers and therapeutic targets for these devastating diseases. In this review, we summarize the historical aspects leading up to our current understanding of the genetic, clinical and neuropathological overlap between FTD and ALS, and include brief discussions on chronic traumatic encephalopathy (CTE) given its association with TDP-43 pathology, increased dementia risk and reports of ALS in CTE patients. Additionally we describe other genetic associations between dementia and neuromuscular disease, such as inclusion body myositis with Paget’s disease and frontotemporal dementia (IBMPFD). PMID:25557955

  20. [Implementing strategies to improve the institutional governance of the Spanish National Health System].

    PubMed

    Repullo, José Ramón; Freire, José Manuel

    2016-11-01

    The 2008 economic crisis made the issue of good governance more present and visible, but the debate risks stalling in an academic and political discourse that barely exceeds the declarative. We acknowledge the existence of noteworthy documents from scientific medical societies and some institutional proposals that point towards promising changes. Viewing good governance as accountability, participation, transparency, intelligence and integrity, our objective is to identify the determinants of inaction and remove the barriers that prevent the adoption of rational and widely agreed-upon proposals. This led us: 1) to allocate the proposals to their appropriate governance level (macro, meso, micro and system environment) so as to more directly engage the agents of change; and 2) to highlight some decision nodes that can act as levers to catalyse selective transformations and to initiate the change processes. Taking into account the diversity of actors and scenarios, a top-down rational, integrated and reformist strategy for the whole Spanish National Health System does not seem likely or viable. Therefore, the purpose of this paper is to promote changes, setting a targeted and reasoned agenda to visualise key issues and to enable multilevel and multidimensional thinking and advocacy of health-sector and society stakeholders.

  1. The communication of physical science uncertainty in European National Adaptation Strategies.

    PubMed

    Lorenz, S; Dessai, S; Paavola, J; Forster, P M

    Many European countries have developed National Adaptation Strategies (NAS) to guide adaptation to the expected impacts of climate change. There is a need for more structured communication of the uncertainties related to future climate and its impacts so that adaptation actions can be planned and implemented effectively and efficiently. We develop a novel uncertainty assessment framework for comparing approaches to the inclusion and communication of physical science uncertainty, and use it to analyse ten European NAS. The framework is based on but modifies and integrates the notion of the "cascade of uncertainties" and the NUSAP (Numeral Unit Spread Assessment Pedigree) methodology to include the overarching assessment categories of Numerical Value, Spread, Depth and Substantiation. Our assessment indicates that there are marked differences between the NAS in terms of inclusion and communication of physical science uncertainty. We find that there is a bias towards the communication of quantitative uncertainties as opposed to qualitative uncertainties. Through the examination of the English and German NAS, we find that similar stages of development in adaptation policy planning can nevertheless result in differences in handling physical science uncertainty. We propose that the degree of transparency and openness on physical science uncertainty is linked to the wider socio-political context within which the NAS are framed. Our methodology can help raise awareness among NAS users about the explicit and embedded information on physical science uncertainty within the existing NAS and would help to design more structured uncertainty communication in new or revised NAS.

  2. Emergency care and the national quality strategy: highlights from the Centers for Medicare & Medicaid Services.

    PubMed

    Venkatesh, Arjun K; Goodrich, Kate

    2015-04-01

    The Centers for Medicare & Medicaid Services (CMS) of the US Department of Health and Human Services seeks to optimize health outcomes by leading clinical quality improvement and health system transformation through a variety of activities, including quality measure alignment, prioritization, and implementation. CMS manages more than 20 federal quality measurement and public reporting programs that cover the gamut of health care providers and facilities, including both hospital-based emergency departments (EDs) and individual emergency physicians. With more than 130 million annual visits, and as the primary portal of hospital admission, US hospital-based EDs deliver a substantial portion of acute care to Medicare beneficiaries. Given the position of emergency care across clinical conditions and between multiple settings of care, the ED plays a critical role in fulfilling all 6 priorities of the National Quality Strategy. We outline current CMS initiatives and future opportunities for emergency physicians and EDs to effect each of these priorities and help CMS achieve the triple aim of better health, better health care, and lower costs.

  3. Is the U.S. National Security Strategy Balanced? An Assessment of the Role of Domestic Issues as Part of the National Security Strategy

    DTIC Science & Technology

    1992-04-10

    Budget Office, 82. 16Nye, 220-222. 17 Edward M. Earle, " Adam Smith , Alexander Hamilton, Friedrich List: The Economic Foundations of Military Power...34 Adam Smith , Alexander Hamilton, Friedrich List: the Economic Foundations of Military Power." Makers of Modern Strategy. Princeton; NJ: Princeton

  4. Pronunciation of irregular words is preserved in dementia, validating premorbid IQ estimation.

    PubMed

    McGurn, B; Starr, J M; Topfer, J A; Pattie, A; Whiteman, M C; Lemmon, H A; Whalley, L J; Deary, I J

    2004-04-13

    The National Adult Reading Test (NART), used to estimate premorbid mental ability, involves pronunciation of irregular words. The authors demonstrate that, after controlling for age 11 IQ test scores, mean NART scores do not differ in people with and without dementia. The correlation between age 11 IQ and NART scores at about age 80 was similar in the groups with (r = 0.63, p < 0.001) and without (r = 0.60, p < 0.001) dementia. These findings validate the NART as an estimator of premorbid ability in mild to moderate dementia.

  5. Prevention of work-related psychological disorders. A national strategy proposed by the National Institute for Occupational Safety and Health (NIOSH).

    PubMed

    Sauter, S L; Murphy, L R; Hurrell, J J

    1990-10-01

    The National Institute for Occupational Safety and Health (NIOSH) recognizes psychological disorders as a leading occupational health problem. This document, developed by a NIOSH working group led by the present authors, represents a first attempt to fashion a comprehensive national strategy to protect and promote the psychological health of workers. Roles are identified for industry, labor, government, and academia. Key initiatives include (a) steps to improve working conditions and employee mental health services and (b) increased research and surveillance to advance understanding of the problem. Because work-related psychological disorders appear to be a rapidly developing problem lacking complete definition in terms of scope and etiology, this strategy is not to be considered a final statement of NIOSH policy.

  6. Therapeutic interactions to enhance the mental health and wellness of dementia caregivers and patients.

    PubMed

    Clarke, Philip B; Shaw, Edward G; Villalba, Jose A; Alli, Rabeena; Sink, Kaycee M

    2013-11-01

    Individuals with dementia and their family caregivers have higher rates of stress and mental health concerns than the general population. Gerontological nurses have unique and valuable opportunities to conduct therapeutic interactions that support the mental health and well-being of patients and family members. Information regarding dementia patient and family caregiver stressors are presented, followed by engaging strategies for opening therapeutic conversations about these topics. Ways in which gerontological nurses can facilitate coping skills and strengths identification are also outlined.

  7. Marital Status, Lifestyle and Dementia: A Nationwide Survey in Taiwan

    PubMed Central

    Fan, Ling-Yun; Sun, Yu; Lee, Huey-Jane; Yang, Shu-Chien; Chen, Ta-Fu; Lin, Ker-Neng; Lin, Chung-Chi; Wang, Pei-Ning; Tang, Li-Yu; Chiu, Ming-Jang

    2015-01-01

    Background Evidence of an association between lifestyle and marital status and risk of dementia is limited in Asia. Methods In this nationwide population-based cross-sectional survey, participants were selected by computerized random sampling from all 19 counties in Taiwan. A total of 10432 residents were assessed by a door-to-door in-person survey, among whom 7035 were normal and 929 were diagnosed with dementia using the criteria recommended by National Institute on Aging-Alzheimer’s Association. Premorbid lifestyle habits and demographic data including marital status were compared between normal subjects and participants with dementia. Results After adjustment for age, gender, education, body mass index, smoking, drinking, marital status, sleep habits, exercise, social engagement and co-morbidities including hypertension, diabetes and cerebrovascular diseases, an increased risk for dementia was found in people with widow or widower status (OR 1.42, 95% CI 1.15–1.77) and people who used to take a nap in the afternoon (OR 1.33, 95% CI 1.02–1.72). Decreased risk was found in people with the habit of regular exercise (OR 0.12, 95% CI 0.09–0.16), adequate night sleep (OR 0.55, 95% CI 0.39–0.76) and regular social engagement (OR 0.53, 95% CI 0.36–0.77). Conclusions Our results provide preliminary evidence of possible risk-reduction effects for dementia, including regular exercise even in modest amounts, social engagement and adequate night sleep, whereas people with the widow/widower status or who used to take an afternoon nap might have increased risk of dementia. PMID:26413719

  8. Dementia - what to ask your doctor

    MedlinePlus

    What to ask your doctor about dementia; Alzheimer disease - what to ask your doctor; Cognitive impairment - what to ask your doctor ... AE, Solomon PR. Life adjustments for memory loss, Alzheimer's disease, and dementia. In: Budson AE, Solomon PR, eds. ...

  9. Lack of Exercise Might Invite Dementia

    MedlinePlus

    ... the two. The APOE mutation is the strongest genetic risk factor for vascular dementia, Lewy body dementia, Parkinson's disease and, especially, Alzheimer's disease, the researchers said. People with a single ...

  10. SveDem, the Swedish Dementia Registry – A Tool for Improving the Quality of Diagnostics, Treatment and Care of Dementia Patients in Clinical Practice

    PubMed Central

    Religa, Dorota; Fereshtehnejad, Seyed-Mohammad; Cermakova, Pavla; Edlund, Ann-Katrin; Garcia-Ptacek, Sara; Granqvist, Nicklas; Hallbäck, Anne; Kåwe, Kerstin; Farahmand, Bahman; Kilander, Lena; Mattsson, Ulla-Britt; Nägga, Katarina; Nordström, Peter; Wijk, Helle; Wimo, Anders; Winblad, Bengt; Eriksdotter, Maria

    2015-01-01

    Background The Swedish Dementia Registry (SveDem) was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden. Methods SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se). The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes. Results The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007–2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden. Conclusion SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses. PMID:25695768

  11. Dementia in the oldest old: a multi-factorial and growing public health issue.

    PubMed

    Gardner, Raquel C; Valcour, Victor; Yaffe, Kristine

    2013-01-01

    The population of oldest old, or people aged 85 and older, is growing rapidly. A better understanding of dementia in this population is thus of increasing national and global importance. In this review, we describe the major epidemiological studies, prevalence, clinical presentation, neuropathological and imaging features, risk factors, and treatment of dementia in the oldest old. Prevalence estimates for dementia among those aged 85+ ranges from 18 to 38%. The most common clinical syndromes are Alzheimer's dementia, vascular dementia, and mixed dementia from multiple etiologies. The rate of progression appears to be slower than in the younger old. Single neuropathological entities such as Alzheimer's dementia and Lewy body pathology appear to have declining relevance to cognitive decline, while mixed pathology with Alzheimer's disease, vascular disease (especially cortical microinfarcts), and hippocampal sclerosis appear to have increasing relevance. Neuroimaging data are sparse. Risk factors for dementia in the oldest old include a low level of education, poor mid-life general health, low level of physical activity, depression, and delirium, whereas apolipoprotein E genotype, late-life hypertension, hyperlipidemia, and elevated peripheral inflammatory markers appear to have less relevance. Treatment approaches require further study, but the oldest old may be more prone to negative side effects compared with younger patients and targeted therapies may be less efficacious since single pathologies are less frequent. We also highlight the limitations and challenges of research in this area, including the difficulty of defining functional decline, a necessary component for a dementia diagnosis, the lack of normative neuropsychological data, and other shortcomings inherent in existing diagnostic criteria. In summary, our understanding of dementia in the oldest old has advanced dramatically in recent years, but more research is needed, particularly among varied racial

  12. [Novel methods for dementia diagnostics].

    PubMed

    Wiltfang, J

    2015-04-01

    Novel diagnostic methods, such as cerebrospinal fluid-based neurochemical dementia diagnostics (CSF-NDD) and [18F] amyloid positron emission tomography (PET) are meanwhile recommended for specific indications by international guidelines for the improved early and differential diagnostics of multigenic (sporadic) Alzheimer's dementia (AD). In the case of CSF-NDD the German neuropsychiatric guidelines have already been validated on the S3 level of evidence (http://www.DGPPN.de) and the additional consideration of [18F] amyloid-PET in the current update of the guidelines is to be expected. By means of CSF-NDD and/or [18F] amyloid-PET a predictive diagnosis of incipient (preclinical) AD is also possible for patients at high risk for AD who are in prodromal stages, such as mild cognitive impairment (MCI). As accompanying (secondary) preventive therapy of AD cannot be offered a predictive molecular dementia diagnostics is not recommended by the German neuropsychiatric dementia guidelines (http://www.DGPPN.de). However, novel diagnostic approaches, which offer molecular positive diagnostics of AD have already gained high relevance in therapy research as they allow promising preventive treatment avenues to be validated directly in the clinical trial. Moreover, future blood-based dementia diagnostics by means of multiplex assays is becoming increasingly more feasible; however, so far corresponding proteomic or epigenetic assays could not be consistently validated in independent studies.

  13. Recognition of dementia in hospitalized older adults.

    PubMed

    Maslow, Katie; Mezey, Mathy

    2008-01-01

    Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.

  14. Driving and dementia: a clinical decision pathway

    PubMed Central

    Carter, Kirsty; Monaghan, Sophie; O'Brien, John; Teodorczuk, Andrew; Mosimann, Urs; Taylor, John-Paul

    2015-01-01

    Objective This study aimed to develop a pathway to bring together current UK legislation, good clinical practice and appropriate management strategies that could be applied across a range of healthcare settings. Methods The pathway was constructed by a multidisciplinary clinical team based in a busy Memory Assessment Service. A process of successive iteration was used to develop the pathway, with input and refinement provided via survey and small group meetings with individuals from a wide range of regional clinical networks and diverse clinical backgrounds as well as discussion with mobility centres and Forum of Mobility Centres, UK. Results We present a succinct clinical pathway for patients with dementia, which provides a decision-making framework for how health professionals across a range of disciplines deal with patients with dementia who drive. Conclusions By integrating the latest guidance from diverse roles within older people's health services and key experts in the field, the resulting pathway reflects up-to-date policy and encompasses differing perspectives and good practice. It is potentially a generalisable pathway that can be easily adaptable for use internationally, by replacing UK legislation for local regulations. A limitation of this pathway is that it does not address the concern of mild cognitive impairment and how this condition relates to driving safety. © 2014 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. PMID:24865643

  15. Antidepressants and risk of dementia in migraine patients: A population-based case-control study.

    PubMed

    Lee, Cynthia Wei-Sheng; Lin, Cheng-Li; Lin, Pan-Yen; Thielke, Stephen; Su, Kuan-Pin; Kao, Chia-Hung

    2017-04-06

    To ascertain the relationship between receipt of antidepressant agents and the risk of subsequent dementia in migraine patients. A population-based case-control analysis, using the Taiwan National Health Insurance Research Database. We identified 1774 patients with dementia and 1774 matched nondementia controls from migraine patients enrolled in the Taiwan National Health Insurance program between 2005 and 2011. The proportional distributions of exposure to three classes of antidepressant were compared between dementia and nondementia groups. Univariable and multivariable logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of dementia based on antidepressant exposure. The proportions of subjects taking tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and new-generation antidepressants (NGAs) in dementia versus nondementia groups are 52.3 vs 51.2%, 25.5 vs 30.7%, and 18.8 vs 6.26%, respectively. The adjusted ORs of dementia were 1.02 (95% CI=0.89, 1.17; P=0.56) for TCAs, 0.58 (95% CI=0.50, 0.69; P<0.001) for SSRIs, and 4.23 (95% CI=3.34, 5.37; P<0.001) for NGAs. Treatment with SSRIs was associated with a decreased risk of dementia in migraine patients. TCAs showed no association with dementia risk, and NGAs showed increased risk. Given the possibility of confounding by indication, additional prospective trials and basic research are needed before drawing conclusions about the population-level risks for dementia onset conferred by antidepressant medications.

  16. Revisiting Regression in Autism: Heller's "Dementia Infantilis"

    ERIC Educational Resources Information Center

    Westphal, Alexander; Schelinski, Stefanie; Volkmar, Fred; Pelphrey, Kevin

    2013-01-01

    Theodor Heller first described a severe regression of adaptive function in normally developing children, something he termed dementia infantilis, over one 100 years ago. Dementia infantilis is most closely related to the modern diagnosis, childhood disintegrative disorder. We translate Heller's paper, Uber Dementia Infantilis, and discuss…

  17. Patterns of striatal degeneration in frontotemporal dementia

    PubMed Central

    Halabi, Cathra; Halabi, Anasheh; Dean, David L.; Wang, Pei-Ning; Boxer, Adam L.; Trojanowski, John Q.; DeArmond, Stephen J.; Miller, Bruce L.; Kramer, Joel H.; Seeley, William W.

    2012-01-01

    Behavioral variant frontotemporal dementia and semantic dementia have been associated with striatal degeneration, but few studies have delineated striatal subregion volumes in vivo or related them to clinical phenotype. We traced caudate, putamen, and nucleus accumbens on MR images to quantify volumes of these structures in behavioral variant frontotemporal dementia, semantic dementia, Alzheimer’s disease, and healthy controls (n = 12 per group). We further related these striatal volumes to clinical deficits and neuropathological findings in a subset of patients. Behavioral variant frontotemporal dementia and semantic dementia showed significant overall striatal atrophy compared with controls. Moreover, behavioral variant frontotemporal dementia showed panstriatal degeneration whereas semantic dementia featured a more focal pattern involving putamen and accumbens. Right-sided striatal atrophy, especially in the putamen, correlated with overall behavioral symptom severity and with specific behavioral domains. At autopsy, patients with behavioral variant frontotemporal dementia and semantic dementia showed striking and severe tau or TAR DNA-binding protein of 43 kDa pathology, especially in ventral parts of the striatum. These results demonstrate that ventral striatum degeneration is a prominent shared feature in behavioral variant frontotemporal dementia and semantic dementia and may contribute to social-emotional deficits common to both disorders. PMID:22367382

  18. [Ethical and legal issues in late stage of dementia].

    PubMed

    Fernandes, Lia

    2008-01-01

    people with severe dementia will be preserved, mostly when this influences patient's behaviour, maximizing individual Independence in daily living activities. Finally, comfort is the last and the most important goal of care in late stages of dementia, using appropriate medical strategies and eliminating aggressive interventions (cardiopulmonary resuscitation, acute care setting, tube feeding and antibiotic treatment). The future work will focus on promoting more evidence-based decision-making on treatment and guidelines for prognostic information. Physician must be knowledgeable about broadly intersecting medical, legal, finance and ethics, underlying the long-term management of dementia.

  19. Land-Based Air in a National Maritime Strategy: The Need for a Joint Strategic Doctrine.

    DTIC Science & Technology

    1986-05-30

    Scene i Granting the same aggregate of force, It Is never as great in two hands as in one, because it is not perfectly concentrated.1 Alfred Thayer Mahan... Alfred Thayer Mahan, Naval Strategy (Boston: Little, Brown and Co., 1911). 2. See Peter M. Swartz, "Contemporary U.S. Naval Strategy: A Bibliography...Principles of Maritime Strategy (London: Longmans, Green and Co., 1918), p. 21. 4. Corbett, p. 13. 5. See Edward Wegener , "Theory of Naval Strategy in

  20. Who has undiagnosed dementia? A cross-sectional analysis of participants of the Aging, Demographics and Memory Study

    PubMed Central

    Savva, George M.; Arthur, Antony

    2015-01-01

    Background: delays in diagnosing dementia may lead to suboptimal care, yet around half of those with dementia are undiagnosed. Any strategy for case finding should be informed by understanding the characteristics of the undiagnosed population. We used cross-sectional data from a population-based sample with dementia aged 71 years and older in the United States to describe the undiagnosed population and identify factors associated with non-diagnosis. Methods: the Aging, Demographics and Memory Study (ADAMS) Wave A participants (N = 856) each underwent a detailed neuropsychiatric investigation. Informants were asked whether the participant had ever received a doctor's diagnosis of dementia. We used multiple logistic regression to identify factors associated with informant report of a prior dementia diagnosis among those with a study diagnosis of dementia. Results: of those with a study diagnosis of dementia (n = 307), a prior diagnosis of dementia was reported by 121 informants (weighted proportion = 42%). Prior diagnosis was associated with greater clinical dementia rating (CDR), from 26% (CDR = 1) to 83% (CDR = 5). In multivariate analysis, those aged 90 years or older were less likely to be diagnosed (P = 0.008), but prior diagnosis was more common among married women (P = 0.038) and those who had spent more than 9 years in full-time education (P = 0.043). Conclusions: people with dementia who are undiagnosed are older, have fewer years in education, are more likely to be unmarried, male and have less severe dementia than those with a diagnosis. Policymakers and clinicians should be mindful of the variation in diagnosis rates among subgroups of the population with dementia. PMID:25758406

  1. Is There Room in Math Reform for Preservice Teachers to Use Reading Strategies? National Implications

    ERIC Educational Resources Information Center

    Franz, Dana Pomykal; Hopper, Peggy F.

    2007-01-01

    Background: Research is proposed for preservice secondary mathematics teachers to develop and use reading strategies in math classrooms. Purpose: to determine if increased instruction on using specific reading strategies in secondary mathematics classrooms significantly impacts a) the type of reading-specific instructional strategies used, b)…

  2. 77 FR 2996 - National Fish, Wildlife, and Plants Climate Adaptation Strategy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-20

    ... natural systems provide, in a changing climate. In addition to this request for written comments, several..., Wildlife, and Plants Climate Adaptation Strategy (Strategy). The adverse impacts of climate change... wildlife and society against the effects of climate change. When finalized, this draft Strategy...

  3. The National Cholesterol Education Program. A Communications Strategy for Public Education. National Heart, Lung, and Blood Institute Health Communications Series.

    ERIC Educational Resources Information Center

    National Heart, Lung, and Blood Inst. (DHHS/NIH), Bethesda, MD.

    This guide presents an overall direction for mass media messages and materials developed for public audiences under the National Cholesterol Education Program (NCEP), with particular emphasis on overall consistency and coherence in broadcast and print materials. Section 1 introduces the program and presents overall objectives, purpose, and scope…

  4. Dementia: Continuum or Distinct Entity?

    PubMed Central

    Walters, Glenn D.

    2009-01-01

    The latent structure of dementia was examined in a group of 10,775 older adults with indicators derived from a neuropsychological test battery. Subjecting these data to taxometric analysis using mean above minus below a cut (MAMBAC), maximum covariance (MAXCOV), and latent mode factor analysis (L-Mode) produced results more consistent with dementia as a dimensional (lying along a continuum) than categorical (representing a distinct entity) construct. A second study conducted on a group of 2375 21-to-64-year olds produced similar results. These findings denote that dementia, as measured by deficits in episodic memory, attention/concentration, executive function, and language, differs quantitatively rather than qualitatively from the cognitive status of non-demented adults. The implications of these results for classification, assessment, etiology, and prevention are discussed. PMID:20677881

  5. The pathobiology of vascular dementia

    PubMed Central

    Iadecola, Costantino

    2013-01-01

    Vascular cognitive impairment defines alterations in cognition, ranging from subtle deficits to full-blown dementia, attributable to cerebrovascular causes. Often coexisting with Alzheimer’s disease, mixed vascular and neurodegenerative dementia has emerged as the leading cause of age-related cognitive impairment. Central to the disease mechanism is the crucial role that cerebral blood vessels play in brain health, not only for the delivery of oxygen and nutrients, but also for the trophic signaling that links inextricably the well being of neurons and glia to that of cerebrovascular cells. This review will examine how vascular damage disrupts these vital homeostatic interactions, focusing on the hemispheric white matter, a region at heightened risk for vascular damage, and on the interplay between vascular factors and Alzheimer’s disease. Finally, preventative and therapeutic prospects will be examined, highlighting the importance of midlife vascular risk factor control in the prevention of late-life dementia. PMID:24267647

  6. Nutrition and foraging strategies of the black howler monkey (Alouatta pigra) in Palenque National Park, Mexico.

    PubMed

    Amato, Katherine R; Garber, Paul A

    2014-08-01

    Food resources consumed by primates vary markedly in nutritional content. As a result, foragers must develop a feeding strategy to select resources that balance energy and macronutrient intake and reduce the consumption of fiber and toxins. In this study, we collected data on dietary patterns, rates of food consumption, and weight of food items consumed and combined them with published values of the nutritional content of Neotropical foods to estimate energy and nutrient intake during a 10-month period in two groups (N=16 individuals) of black howler monkeys (Alouatta pigra) inhabiting Palenque National Park, Mexico. Although howler monkeys are generally assumed to exploit a leaf-dominated diet and be energy-limited, our results indicated that black howlers met their estimated energy requirements, consuming an average of 0.58 MJ of overall energy per metabolic body mass per day. The howlers also surpassed protein requirements by consuming an average of 8.2 g of protein per metabolic body mass per day. The amount of time they spent resting was not correlated with the amount of leaves or fruit in the diet or with overall energy intake. Therefore, despite consuming a leaf-heavy diet during some months of the year, black howlers do not appear to be energy-limited. Additionally, the howlers maintained a relatively consistent level of average daily protein energy intake regardless of diet composition, while non-protein energy intake varied in response to the amount of ripe fruits consumed. Although our use of published nutritional data introduces error, these findings suggest that black howler feeding ecology is more similar to other fruit-eating atelines than previously suspected, and several common assumptions regarding howler behavior and feeding ecology need to be reexamined.

  7. Criticality safety strategy for the Fuel Cycle Facility electrorefiner at Argonne National Laboratory, West

    SciTech Connect

    Mariani, R.D.; Benedict, R.W.; Lell, R.M.; Turski, R.B.; Fujita, E.K.

    1993-09-01

    The Integral Fast Reactor being developed by Argonne National Laboratory (ANL) combines the advantages of metal-fueled, liquid-metal-cooled reactors and a closed fuel cycle. Presently, the Fuel Cycle Facility (FCF) at ANL-West in Idaho Falls, Idaho is being modified to recycle spent metallic fuel from Experimental Breeder Reactor II as part of a demonstration project sponsored by the Department of Energy. A key component of the FCF is the electrorefiner (ER) in which the actinides are separated from the fission products. In the electrorefining process, the metal fuel is anodically dissolved into a high-temperature molten salt and refined uranium or uranium/plutonium products are deposited at cathodes. In this report, the criticality safety strategy for the FCF ER is summarized. FCF ER operations and processes formed the basis for evaluating criticality safety and control during actinide metal fuel refining. In order to show criticality safety for the FCF ER, the reference operating conditions for the ER had to be defined. Normal operating envelopes (NOES) were then defined to bracket the important operating conditions. To keep the operating conditions within their NOES, process controls were identified that can be used to regulate the actinide forms and content within the ER. A series of operational checks were developed for each operation that wig verify the extent or success of an operation. The criticality analysis considered the ER operating conditions at their NOE values as the point of departure for credible and incredible failure modes. As a result of the analysis, FCF ER operations were found to be safe with respect to criticality.

  8. Lessons for a national pharmaceuticals strategy in Canada from Australia and New Zealand

    PubMed Central

    LeLorier, Jacques; Rawson, Nigel SB

    2007-01-01

    BACKGROUND: The provincial formulary review processes in Canada lead to the slow and inequitable availability of new products. In 2004, the exploration of a national pharmaceuticals strategy (NPS) was announced. The pricing policies of New Zealand and Australia have been suggested as possible models for the NPS. OBJECTIVE: To compare health care indexes and health care use information from Canada, Australia and New Zealand. METHODS: The 2006 Organisation for Economic Co-operation and Development health data were used to compare health and health care indexes from Canada, Australia and New Zealand between 1994 and 2002 to 2004. The principal focus of the evaluation was cardiovascular and respiratory disorders. RESULTS: Although the mortality rate from acute myocardial infarction decreased in each country from 1994, it levelled off in New Zealand in 1997, 1998 and 1999. Between 1994 and 2003, the average length of hospital stay for any cause and for cardiovascular disorders was stable in Australia and Canada, but increased in New Zealand, while the rate of hospital discharges for cardiovascular diseases decreased in Canada and Australia, but strongly increased in New Zealand. Over the same period, sales of cardiovascular drugs decreased in New Zealand, while sharply increasing in Canada and Australia. CONCLUSIONS: Although only circumstantial, our results suggest an association between decreasing cardiovascular drug sales and markers of declining cardiovascular health in New Zealand. Careful consideration must be given to the potential consequences of any model for an NPS in Canada, as well as to opportunities provided for discussion and input from health care professionals and patients. PMID:17622393

  9. Analyzing US transportation efficiency standards, beyond the National Energy Strategy (NES)

    SciTech Connect

    Callaway, J.M.; Edmonds, J.A.

    1991-08-01

    Considerable attention has been focused on increasing fuel efficiency standards through new corporate average fuel efficiency (CAFE) standards. This has been justified by its proponents on the basis of saving energy to enhance energy security and increasing environmental quality through reduced emissions of air pollutants, including CO{sub 2}. Opponents of this approach argue that the energy security and environmental benefits obtained by increasing CAFE standards are not high enough, or in the case of CO{sub 2} too uncertain, to justify the costs of this action and that the best approach is to allow energy efficiency to be determined uncertain, to justify the costs of this action and that the best approach is to allow energy efficiency to be determined by long-run market forces. A part of the current debate about CAFE standards is centered on the relationship between the impacts of CAFE standards on energy consumption and CO{sub 2} emissions and the corresponding effects of the President's National Energy Strategy (NES). While analyses have been conducted of CAFE standards in conjunction with existing policies, the purpose of this paper is to investigate the impacts of imposing CAFE standards in conjunction with the actions contained in the NES. Methodology and assumptions used to model increased fuel efficiency are presented. Effects of these standards on greenhouse gas warming potential (GWP) are discussed. The impacts of these standards on the US energy economy and the cost of imposing these standards on the economy are examined. Analysis reveals additional effects of mandated fuel efficiency standards on emissions and energy use are relatively small. This is because substantial reductions in non-renewable energy use and transportation-related emissions are achieved in the NES Actions Case by the introduction and rapid growth of passenger vehicles using electricity, methanol and natural gas. 4 refs., 16 tabs.

  10. Alaska North Slope National Energy Strategy initiative: Analysis of five undeveloped fields

    SciTech Connect

    Thomas, C.P.; Allaire, R.B.; Doughty, T.C.; Faulder, D.D.; Irving, J.S.; Jamison, H.C.; White, G.J.

    1993-05-01

    The US Department of Energy was directed in the National Energy Strategy to establish a federal interagency task force to identify specific technical and regulatory barriers to the development of five undeveloped North Slope Alaska fields and make recommendations for their resolution. The five fields are West Sak, Point Thomson, Gwydyr Bay, Seal Island/Northstar, and Sandpiper Island. Analysis of environmental, regulatory, technical, and economic information, and data relating to the development potential of the five fields leads to the following conclusions: Development of the five fields would result in an estimated total of 1,055 million barrels of oil and 4.4 trillion cubic feet of natural gas and total investment of $9.4 billion in 1992 dollars. It appears that all five of the fields will remain economically marginal developments unless there is significant improvement in world oil prices. Costs of regulatory compliance and mitigation, and costs to reduce or maintain environmental impacts at acceptable levels influence project investments and operating costs and must be considered in the development decision making process. The development of three of the fields (West Sak, Point Thomson, and Gwydyr Bay) that are marginally feasible would have an impact on North Slope production over the period from about 2000 to 2014 but cannot replace the decline in Prudhoe Bay Unit production or maintain the operation of the Trans-Alaska Pipeline System (TAPS) beyond about 2014 with the assumption that the TAPS will shut down when production declines to the range of 400 to 200 thousand barrels of oil/day. Recoverable reserves left in the ground in the currently producing fields and soon to be developed fields, Niakuk and Point McIntyre, would range from 1 billion to 500 million barrels of oil corresponding to the time period of 2008 to 2014 based on the TAPS shutdown assumption.

  11. Cognitive-behavioral treatment for anxiety in patients with dementia: two case studies.

    PubMed

    Kraus, Cynthia A; Seignourel, Paul; Balasubramanyam, Valli; Snow, A Lynn; Wilson, Nancy L; Kunik, Mark E; Schulz, Paul E; Stanley, Melinda A

    2008-05-01

    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.

  12. Gender, citizenship and dementia care: a scoping review of studies to inform policy and future research.

    PubMed

    Bartlett, Ruth; Gjernes, Trude; Lotherington, Ann-Therese; Obstefelder, Aud

    2016-03-17

    Gender is a neglected dimension in public discourse related to people with dementia. Those living with this condition are typically portrayed in policies and strategies in gender neutral terms as 'people with dementia' and 'family carers' as if gender does not matter, when clearly it does. The purpose of this scoping review was to take stock of knowledge about gender differences in relation to dementia care to inform policy and future research. The work is grounded in a feminist perspective to citizenship, as this provide a lens with which to expose and examine gendered assumptions within dementia studies. A search of four databases, including CINAHL, Web of Science, Medline and Cochrane was conducted using systematic techniques between May and July 2014. A repeat search was conducted in February 2015. We found a significant amount of valuable research concerned with gender differences in relation to dementia care published from 1990 to 2014; the majority of which lacks a feminist citizenship perspective. Moreover, a disproportionate number of studies focused solely on caregivers rather than citizens with dementia. As such, questions about gender equality are not being raised and the voices of men and women with dementia are silent. Thus we argue for increased gender-sensitivity in policy making and recommend that social scientists inject a feminist citizenship perspective into their work.

  13. Citizenship as practice: Handling communication problems in encounters between persons with dementia and social workers.

    PubMed

    Jh, Österholm; L-C, Hydén

    2016-11-01

    The overall aim of the study was to investigate if and how persons with dementia were able to take part in negotiations for formal support, as cases of citizenship as practice The transcripts used for analysis were from 11 assessment meetings conducted in Sweden, in which the formal applicant was a person with dementia. The findings suggest that the actual participation of persons with dementia in assessment meetings varies. Communication problems were found in the meetings to different degrees and were dealt with differently and with various consequences. For those persons with dementia contributing at the same levels as the other participants, there was an attempt at mutual understanding. For those making fewer contributions, the other interlocutors took over the initiative and thus affected the practice of citizenship by persons with dementia in a negative way. The practice of citizenship is situation based and varies depending on all participants. When the person with dementia is able to participate in the conversation, social workers can facilitate for them to overcome communication problems by giving them more time and signaling acceptance. If the person with dementia has great problems in participating, the other participants can find different strategies to at least involve her or him in the conversation.

  14. Functional MRI of music emotion processing in frontotemporal dementia

    PubMed Central

    Agustus, Jennifer L; Mahoney, Colin J; Downey, Laura E; Omar, Rohani; Cohen, Miriam; White, Mark J; Scott, Sophie K; Mancini, Laura; Warren, Jason D

    2015-01-01

    Frontotemporal dementia is an important neurodegenerative disorder of younger life led by profound emotional and social dysfunction. Here we used fMRI to assess brain mechanisms of music emotion processing in a cohort of patients with frontotemporal dementia (n = 15) in relation to healthy age-matched individuals (n = 11). In a passive-listening paradigm, we manipulated levels of emotion processing in simple arpeggio chords (mode versus dissonance) and emotion modality (music versus human emotional vocalizations). A complex profile of disease-associated functional alterations was identified with separable signatures of musical mode, emotion level, and emotion modality within a common, distributed brain network, including posterior and anterior superior temporal and inferior frontal cortices and dorsal brainstem effector nuclei. Separable functional signatures were identified post-hoc in patients with and without abnormal craving for music (musicophilia): a model for specific abnormal emotional behaviors in frontotemporal dementia. Our findings indicate the potential of music to delineate neural mechanisms of altered emotion processing in dementias, with implications for future disease tracking and therapeutic strategies. PMID:25773639

  15. Sundowning in Dementia: Clinical Relevance, Pathophysiological Determinants, and Therapeutic Approaches

    PubMed Central

    Canevelli, Marco; Valletta, Martina; Trebbastoni, Alessandro; Sarli, Giuseppe; D’Antonio, Fabrizia; Tariciotti, Leonardo; de Lena, Carlo; Bruno, Giuseppe

    2016-01-01

    Sundowning means the emergence or worsening of neuropsychiatric symptoms (NPS) in the late afternoon or early evening. This syndrome has been recognized since a long time in the field of dementing illnesses and is well known among most of health-care providers involved in the assistance of people with dementia. Indeed, it represents a common manifestation among persons with dementia and is associated with several adverse outcomes (such as institutionalization, faster cognitive worsening, and greater caregiver burden). Its occurrence and phenotypic characteristics may be influenced by diverse neurobiological, psychosocial, and environmental determinants. Moreover, it may pose diagnostic challenges in relation to other common causes of behavioral disruptions. Beside these considerations, this phenomenon has so far drawn limited clinical and scientific interest compared to other specific NPS occurring in dementias, as indicated by the lack of commonly agreed definitions, specific screening/assessment tools, and robust estimates on its prevalence. Accordingly, no randomized controlled trial specifically investigating the effectiveness of pharmacological and non-pharmacological strategies in managing this condition among demented patients has been yet conducted. In the present narrative review, we present and discuss available evidence concerning sundowning occurring in people with dementia. A special focus is given to its definitions, pathophysiological determinants, and clinical relevance, as well as to the clinical and therapeutic approaches required for its management in the daily practice. PMID:28083535

  16. Functional MRI of music emotion processing in frontotemporal dementia.

    PubMed

    Agustus, Jennifer L; Mahoney, Colin J; Downey, Laura E; Omar, Rohani; Cohen, Miriam; White, Mark J; Scott, Sophie K; Mancini, Laura; Warren, Jason D

    2015-03-01

    Frontotemporal dementia is an important neurodegenerative disorder of younger life led by profound emotional and social dysfunction. Here we used fMRI to assess brain mechanisms of music emotion processing in a cohort of patients with frontotemporal dementia (n = 15) in relation to healthy age-matched individuals (n = 11). In a passive-listening paradigm, we manipulated levels of emotion processing in simple arpeggio chords (mode versus dissonance) and emotion modality (music versus human emotional vocalizations). A complex profile of disease-associated functional alterations was identified with separable signatures of musical mode, emotion level, and emotion modality within a common, distributed brain network, including posterior and anterior superior temporal and inferior frontal cortices and dorsal brainstem effector nuclei. Separable functional signatures were identified post-hoc in patients with and without abnormal craving for music (musicophilia): a model for specific abnormal emotional behaviors in frontotemporal dementia. Our findings indicate the potential of music to delineate neural mechanisms of altered emotion processing in dementias, with implications for future disease tracking and therapeutic strategies.

  17. National Summit on Campus Public Safety. Strategies for Colleges and Universities in a Homeland Security Environment

    ERIC Educational Resources Information Center

    US Department of Justice, 2005

    2005-01-01

    The aftermath of September 11, 2001 prompted the reexamination of the nation's defenses and vulnerabilities in light of new realities. Every sector of society, particularly those who protect the well being of communities, required change. Safety and security operations on the nation's college and university campuses are no exception. The nation's…

  18. Elder abuse and dementia: a review of the research and health policy.

    PubMed

    Dong, XinQi; Chen, Ruijia; Simon, Melissa A

    2014-04-01

    Older adults with dementia may be at high risk for abuse, but the topic has not been well studied. We conducted a literature review to examine the relationships between elder abuse and dementia. We found that psychological abuse was the most common form of abuse among older adults, with estimates of its prevalence ranging from 27.9 percent to 62.3 percent. Physical abuse was estimated to affect 3.5-23.1 percent of older adults with dementia. We also found that many older adults experienced multiple forms of abuse simultaneously, and the risk of mortality from abuse and self-neglect may be higher in older adults with greater levels of cognitive impairment. We summarize programs and policies related to the abuse of older adults with dementia, including adult protective services, mandatory elder abuse reporting, and the Long-Term Care Ombudsman Program. We also summarize aspects of the National Alzheimer's Project Act, the Older Americans Act, and the Elder Justice Act. In spite of a recent increase in research and policy developments on elder abuse, challenges such as insufficient funding, limited knowledge about elder abuse, a lack of funding for the implementation of federal and state programs relevant to elder abuse and dementia, and a lack of dementia-specific training for front-line health care staff persist. Stronger programs targeting the well-being of older adults with dementia are needed.

  19. The Effects of U.S. National Security Strategy on Force Structure and the National Industrial Base: 1945-1960

    DTIC Science & Technology

    2014-05-22

    statistics, tax codes, health care structures, and national debt. The effects of the decisions made by President Obama when shaping these and other...requests as Chinese attacks began to punish Eighth Army troops, the plan, code- named OPERATION PINK , was to combat load an entire division’s worth of...future Cabinet while aboard the USS Helena in December 1952 was clear: end the Korean War, balance the budget, and reduce taxes while continuing many

  20. Oskar Fischer and the study of dementia

    PubMed Central

    2009-01-01

    The centenary of Alois Alzheimer's description of the case of Auguste Deter has renewed interest in the early history of dementia research. In his 1907 paper Alzheimer described the presence of plaques and tangles in one case of presenile dementia. In the same year, Oskar Fischer reported neuritic plaques in 12 cases of senile dementia. These were landmark findings in the history of research in dementia because they delineated the clinicopathological entity that is now known as Alzheimer's disease. Although much has been written about Alzheimer, only little is known about Fischer. The present article discusses Fischer's work on dementia in the context of his life and time. PMID:18952676

  1. Treating senile dementia with traditional Chinese medicine

    PubMed Central

    Yan, Han; Li, Lin; Tang, Xi Can

    2007-01-01

    Senile dementia is a syndrome in the elderly involving deficits in memory and cognition. There has been a long history of research and medical practice in dementia in China, during which the ancient Chinese people have formed a whole theory and accumulated abundant experience in the treatment of dementia. During recent decades, with new theories and technologies being digested and integrated, progress has been made in the medical and pharmacy research on senile dementia in China. In this review, we will focus on the traditional opinion, clinical practice, and recent progress in pharmacological research in China towards the treatment of dementia. We also discuss the potential trends of global convergence. PMID:18044136

  2. Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data

    PubMed Central

    van Bussel, Emma F.; Richard, Edo; Coloma, Preciosa M.; de Waal, Margot W. M.; van den Akker, Marjan; Nielen, Markus M. J.; van Boven, Kees; Busschers, Wim B.; van Gool, Willem A.

    2017-01-01

    Background Recent reports have suggested declining age-specific incidence rates of dementia in high-income countries over time. Improved education and cardiovascular health in early age have been suggested to be bringing about this effect. The aim of this study was to estimate the age-specific dementia incidence trend in primary care records from a large population in the Netherlands. Methods and findings A dynamic cohort representative of the Dutch population was composed using primary care records from general practice registration networks (GPRNs) across the country. Data regarding dementia incidence were obtained using general-practitioner-recorded diagnosis of dementia within the electronic health records. Age-specific dementia incidence rates were calculated for all persons aged 60 y and over; negative binomial regression analysis was used to estimate the time trend. Nine out of eleven GPRNs provided data on more than 800,000 older people for the years 1992 to 2014, corresponding to over 4 million person-years and 23,186 incident dementia cases. The annual growth in dementia incidence rate was estimated to be 2.1% (95% CI 0.5% to 3.8%), and incidence rates were 1.08 (95% CI 1.04 to 1.13) times higher for women compared to men. Despite their relatively low numbers of person-years, the highest age groups contributed most to the increasing trend. There was no significant overall change in incidence rates since the start of a national dementia program in 2003 (−0.025; 95% CI −0.062 to 0.011). Increased awareness of dementia by patients and doctors in more recent years may have influenced dementia diagnosis by general practitioners in electronic health records, and needs to be taken into account when interpreting the data. Conclusions Within the clinical records of a large, representative sample of the Dutch population, we found no evidence for a declining incidence trend of dementia in the Netherlands. This could indicate true stability in incidence rates, or

  3. Barriers to leisure participation for people with dementia and their carers: An exploratory analysis of carer and people with dementia's experiences.

    PubMed

    Innes, Anthea; Page, Stephen J; Cutler, Clare

    2016-11-01

    Leisure has emerged as a prominent research theme within the growing body of knowledge on dementia, with a focus on physical activity. Yet participation in any form of leisure presupposes an ability to freely choose to partake in activities and to negotiate one's way around key barriers. In the case of dementia, the ability to undertake leisure activities is subject to a greater range of barriers, structured in a hierarchical manner that contributes to social exclusion if not addressed. This study based on focus groups with people with dementia and their family members conducted in Dorset, UK illustrates a range of barriers to leisure participation. How to create or maintain leisure opportunities for those living with dementia where households affected by dementia do not adopt avoidance behaviour, compounding a sense of isolation and exclusion is a challenge. Leisure can be an important strategy framed as a form of resistance to the social disabilities experienced by those living with dementia and it is potentially isolating impact.

  4. Goal Setting for Cognitive Rehabilitation in Mild to Moderate Parkinson's Disease Dementia and Dementia with Lewy Bodies.

    PubMed

    Watermeyer, Tamlyn J; Hindle, John V; Roberts, Julie; Lawrence, Catherine L; Martyr, Anthony; Lloyd-Williams, Huw; Brand, Andrew; Gutting, Petra; Hoare, Zoe; Edwards, Rhiannon Tudor; Clare, Linda

    2016-01-01

    Alongside the physical symptoms associated with Parkinson's disease dementia and dementia with Lewy bodies, health services must also address the cognitive impairments that accompany these conditions. There is growing interest in the use of nonpharmacological approaches to managing the consequences of cognitive disorder. Cognitive rehabilitation is a goal-orientated behavioural intervention which aims to enhance functional independence through the use of strategies specific to the individual's needs and abilities. Fundamental to this therapy is a person's capacity to set goals for rehabilitation. To date, no studies have assessed goal setting in early-stage Parkinson's disease dementia or dementia with Lewy bodies. Semistructured interviews were carried out with 29 participants from an ongoing trial of cognitive rehabilitation for people with these conditions. Here, we examined the goal statements provided by these participants using qualitative content analysis, exploring the types and nature of the goals set. Participants' goals reflected their motivations to learn new skills or improve performance in areas such as technology-use, self-management and orientation, medication management, and social and leisure activities. These results suggest that goal setting is achievable for these participants, provide insight into the everyday cognitive difficulties that they experience, and highlight possible domains as targets for intervention. The trial is registered with ISRCTN16584442 (DOI 10.1186/ISRCTN16584442 13/04/2015).

  5. Neuroeconomic dissociation of semantic dementia and behavioural variant frontotemporal dementia

    PubMed Central

    Wood, Kristie A.; Beagle, Alexander J.; Hsu, Ming; Kayser, Andrew S.; Miller, Bruce L.; Kramer, Joel H.

    2016-01-01

    Many neuropsychiatric disorders are marked by abnormal behaviour and decision-making, but prevailing diagnostic criteria for such behaviours are typically qualitative and often ambiguous. Behavioural variant frontotemporal dementia and semantic variant primary progressive aphasia (also called semantic dementia) are two clinical variants of frontotemporal dementia with overlapping but distinct anatomical substrates known to cause profound changes in decision-making. We investigated whether abnormal decision-making in these syndromes could be more precisely characterized in terms of dissociable abnormalities in patients’ subjective evaluations of valence (positive versus negative outcome) and of time (present versus future outcome). We presented 28 patients with behavioural variant frontotemporal dementia, 14 patients with semantic variant primary progressive aphasia, 25 patients with Alzheimer’s disease (as disease controls), and 61 healthy older control subjects with experimental tasks assaying loss aversion and delay discounting. In general linear models controlling for age, gender, education and Mini-Mental State Examination score, patients with behavioural variant frontotemporal dementia were less averse to losses than control subjects (P < 0.001), while patients with semantic variant primary progressive aphasia discounted delayed rewards more steeply than controls (P = 0.019). There was no relationship between loss aversion and delay discounting across the sample, nor in any of the subgroups. These findings suggest that abnormal behaviours in neurodegenerative disease may result from the disruption of either of two dissociable neural processes for evaluating the outcomes of action. More broadly, these findings suggest a role for computational methods to supplement traditional qualitative characterizations in the differential diagnosis of neuropsychiatric disorders. PMID:26667277

  6. Learning from the Disease: Lessons Drawn from Adolescents Having a Grandparent Suffering Dementia

    ERIC Educational Resources Information Center

    Celdran, Montserrat; Triado, Carme; Villar, Feliciano

    2009-01-01

    The objective of this study was to explore what adolescent grandchildren have learned from having a grandparent who suffers dementia and what coping strategies they might recommend for other adolescents in similar situations. We also present information on background factors influencing lessons learned and coping strategies. Adolescent…

  7. Averting Dementia of the Alzheimer's Type in Women: Can Counselors Help?

    ERIC Educational Resources Information Center

    Douthit, Kathryn Z.

    2007-01-01

    Alzheimer's disease (AD) is the most common cause of dementia in late life, taking its greatest toll on women over age 80. This article provides an overview of AD, including risk factors and counseling strategies targeting risk. Counseling strategies address stress, cardiovascular health, social integration, depression, and holistic wellness.

  8. Dementia-friendly communities’ and being dementia friendly in healthcare settings

    PubMed Central

    Lin, Shih-Yin

    2017-01-01

    Purpose of review This review discusses the concept of ‘dementia-friendly communities’ and summarizes the latest research and practice around such communities. This review also highlights important topic areas to be considered to promote dementia friendliness in healthcare settings. Recent findings Definitions of ‘dementia-friendly communities’ reflect the contemporary thinking of living with dementia (e.g., dementia as a disability, equal human rights, a sense of meaning). Existing research has covered a wide range of topic areas relevant to ‘dementia-friendly communities’. However, these studies remain qualitative and exploratory by nature and do not evaluate how dementia-friendly communities impact health and quality of life of people living with dementia and their caregivers. In healthcare settings, being dementia friendly can mean the inclusion of people with dementia in treatment discussion and decision-making, as well as the provision of first, adequate and appropriate service to people with dementia at an equivalent standard of any patient, second, person-centered care, and third, a physical environment following dementia-friendly design guidelines. Summary Research incorporating more robust study designs to evaluate dementia-friendly communities is needed. Being dementia-friendly in healthcare settings requires improvement in multiple areas – some may be achieved by environmental modifications while others may be improved by staff education. PMID:27997454

  9. Dementia - daily care

    MedlinePlus

    ... Eating Handling their own personal care Help With Memory Loss People who have early memory loss can ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  10. Subsonic Transonic Applied Refinements By Using Key Strategies - STARBUKS In the NASA Langley Research Center National Transonic Facility

    NASA Technical Reports Server (NTRS)

    Paryz, Roman W.

    2014-01-01

    Several upgrade projects have been completed at the NASA Langley Research Center National Transonic Facility over the last 1.5 years in an effort defined as STARBUKS - Subsonic Transonic Applied Refinements By Using Key Strategies. This multi-year effort was undertaken to improve NTF's overall capabilities by addressing Accuracy and Validation, Productivity, and Reliability areas at the NTF. This presentation will give a brief synopsis of each of these efforts.

  11. Breaking the Code for Operational Planners: A Comparative Analysis of National Security Strategies Since the End of the Cold War

    DTIC Science & Technology

    2007-04-04

    Presidents articulated in the post-Cold War era is that America cannot return to a strategy of protectionism nor isolationism . But even more important...responsibilities. As our nation learned after World War I, we can find no security for America in isolationism , nor prosperity in protectionism …Without...of America, (September 2002), preface. 54 Speaking to the disadvantages of fear, isolationism , and protectionism , President Bush reconfirmed

  12. Economic and Technological Role of Kuzbass Industry in the Implementation of National Energy Strategy of Russian Federation

    NASA Astrophysics Data System (ADS)

    Zhironkin, S. A.; Khoreshok, A. A.; Tyulenev, M. A.; Barysheva, G. A.; Hellmer, M. C.

    2016-08-01

    This article describes the problems and prospects of development of coal mining in Kuzbass - the center of coal production in Siberia and Russia, in the framework of the major initiatives of the National Energy Strategy for the period until 2035. The structural character of the regional coal industry problems, caused by decline in investment activity, high level of fixed assets depreciation, slow development of deep coal processing and technological reduction of coal mining is shown.

  13. The creation of a Dementia Nurse Specialist role in an acute general hospital.

    PubMed

    Elliot, R; Adams, J

    2011-09-01

    Older people form the largest group occupying acute hospital beds and many of them will have undiagnosed mental health problems. The creation of a Dementia Nurse Specialist role in a district general hospital provided the opportunity to assess the extent of the previously unmet need among patients, carers and nursing staff. Over 30 patients were seen each month, while around 6 to 12 were diagnosed as having dementia. Other activities undertaken as part of the role included providing information and support for carers, and advice on management of behaviours and support for ward staff. The role also involved policy writing, pathway and local strategy planning, care plan development, and formal and informal teaching on dementia. It is argued that this fixed-term post demonstrated that a Dementia Nurse Specialist could provide significant input in an acute hospital setting, by improving the experience of hospitalization for vulnerable older people and their carers.

  14. Predictors of dementia in Parkinson disease

    PubMed Central

    Anang, Julius B.M.; Bertrand, Josie-Anne; Romenets, Silvia Rios; Latreille, Veronique; Panisset, Michel; Montplaisir, Jacques

    2014-01-01

    Objective: We investigated an array of possible markers of early dementia in Parkinson disease. Methods: We performed a comprehensive assessment of autonomic, sleep, psychiatric, visual, olfactory, and motor manifestations in 80 patients with Parkinson disease who were dementia-free at baseline. After 4.4 years’ follow-up, patients were evaluated for dementia. Predictive variables were assessed using logistic regression adjusting for disease duration, follow-up duration, age, and sex. Results: Of 80 patients, 27 (34%) developed dementia. Patients destined to develop dementia were older and more often male (odds ratio [OR] = 3.64, p = 0.023). Those with baseline mild cognitive impairment had increased dementia risk (OR = 22.5, p < 0.001). REM sleep behavior disorder at baseline dramatically increased dementia risk (OR = 49.7, p = 0.001); however, neither daytime sleepiness nor insomnia predicted dementia. Higher baseline blood pressure increased dementia risk (OR = 1.37 per 10 mm Hg, p = 0.032). Orthostatic blood pressure drop was strongly associated with dementia risk (OR = 1.84 per 10 mm Hg, p < 0.001); having a systolic drop of >10 mm Hg increased dementia odds 7-fold (OR = 7.3, p = 0.002). Abnormal color vision increased dementia risk (OR = 3.3, p = 0.014), but olfactory dysfunction did not. Among baseline motor variables, proportion of gait involvement (OR = 1.12, p = 0.023), falls (OR = 3.02, p = 0.042), and freezing (OR = 2.63, p = 0.013), as well as the Purdue Pegboard Test (OR = 0.67, p = 0.049) and alternate tap test (OR = 0.97, p = 0.033) predicted dementia. Conclusion: Cardiovascular autonomic dysfunction, REM sleep behavior disorder, color discrimination ability, and gait dysfunction strongly predict development of dementia in Parkinson disease. PMID:25171928

  15. [Depression: A predictor of dementia].

    PubMed

    Deví Bastida, Josep; Puig Pomés, Núria; Jofre Font, Susanna; Fetscher Eickhoff, Albert

    2016-01-01

    Many studies suggest that in 10-25% of cases of Alzheimer's, the most common dementia in our society, can be prevented with the elimination of some risk factors. Barnes and Yaffe found that one-third of Alzheimer's cases are attributable to depression, but in the scientific literature it is not clear if it has a real causal effect on the development of dementia. The purpose of this study is to analyse the scientific evidence on the hypothesis that depression increases the risk of developing dementia. A systematic review and a meta-analysis were performed on the scientific literature published up until the present day, searching articles that were published between 1990 and 2014. Ten of the studies found met the selection criteria -similar to a) size and characteristics of the sample (origin, age…), b) process of gathering data c) method of studying the relationship (within and/or between group comparison), and d) statistical analysis of the results- and the previously established quality. The value of odds ratio varied from 1.72 to 3.59, and the hazard ratio from 1,72 to 5.44. This indicates that the subjects with a history of depression have a higher risk of developing dementia than others who did not suffer depression.

  16. Sociosexuality from Argentina to Zimbabwe: a 48-nation study of sex, culture, and strategies of human mating.

    PubMed

    Schmitt, David P

    2005-04-01

    The Sociosexual Orientation Inventory (SOI; Simpson & Gangestad 1991) is a self-report measure of individual differences in human mating strategies. Low SOI scores signify that a person is sociosexually restricted, or follows a more monogamous mating strategy. High SOI scores indicate that an individual is unrestricted, or has a more promiscuous mating strategy. As part of the International Sexuality Description Project (ISDP), the SOI was translated from English into 25 additional languages and administered to a total sample of 14,059 people across 48 nations. Responses to the SOI were used to address four main issues. First, the psychometric properties of the SOI were examined in cross-cultural perspective. The SOI possessed adequate reliability and validity both within and across a diverse range of modem cultures. Second, theories concerning the systematic distribution of sociosexuality across cultures were evaluated. Both operational sex ratios and reproductively demanding environments related in evolutionary-predicted ways to national levels of sociosexuality. Third, sex differences in sociosexuality were generally large and demonstrated cross-cultural universality across the 48 nations of the ISDP, confirming several evolutionary theories of human mating. Fourth, sex differences in sociosexuality were significantly larger when reproductive environments were demanding but were reduced to more moderate levels in cultures with more political and economic gender equality. Implications for evolutionary and social role theories of human sexuality are discussed.

  17. [Strategies by civil society organizations for access to breast cancer drugs in the Brazilian Unified National Health System].

    PubMed

    Deprá, Aline Scaramussa; Ribeiro, Carlos Dimas Martins; Maksud, Ivia

    2015-07-01

    This study aims to identify and analyze strategies by civil society organizations working with breast cancer (CSOs) on access to drugs in Brazilian Unified National Health System (SUS) and the main social actors. A qualitative approach used the snowball technique, semi-structured interviews, and participant observation. Thematic analysis was based on the following categories: access to drugs for breast cancer treatment, relationship between CSOs and government, relationship between CSOs and the pharmaceutical industry, and other strategies used by CSOs. The results showed that civil society organizations have influenced access to drugs for breast cancer in the SUS and that their main strategies have focused on pressuring government at all levels. Meanwhile, the pharmaceutical industry sponsors some CSOs in order to strengthen them and expand its own market. The main difficulties in access to such drugs involve insufficient services, unequal treatment, and inclusion of technology in the SUS.

  18. Language networks in semantic dementia.

    PubMed

    Agosta, Federica; Henry, Roland G; Migliaccio, Raffaella; Neuhaus, John; Miller, Bruce L; Dronkers, Nina F; Brambati, Simona M; Filippi, Massimo; Ogar, Jennifer M; Wilson, Stephen M; Gorno-Tempini, Maria Luisa

    2010-01-01

    Cognitive deficits in semantic dementia have been attributed to anterior temporal lobe grey matter damage; however, key aspects of the syndrome could be due to altered anatomical connectivity between language pathways involving the temporal lobe. The aim of this study was to investigate the left language-related cerebral pathways in semantic dementia using diffusion tensor imaging-based tractography and to combine the findings with cortical anatomical and functional magnetic resonance imaging data obtained during a reading activation task. The left inferior longitudinal fasciculus, arcuate fasciculus and fronto-parietal superior longitudinal fasciculus were tracked in five semantic dementia patients and eight healthy controls. The left uncinate fasciculus and the genu and splenium of the corpus callosum were also obtained for comparison with previous studies. From each tract, mean diffusivity, fractional anisotropy, as well as parallel and transverse diffusivities were obtained. Diffusion tensor imaging results were related to grey and white matter atrophy volume assessed by voxel-based morphometry and functional magnetic resonance imaging activations during a reading task. Semantic dementia patients had significantly higher mean diffusivity, parallel and transverse in the inferior longitudinal fasciculus. The arcuate and uncinate fasciculi demonstrated significantly higher mean diffusivity, parallel and transverse and significantly lower fractional anisotropy. The fronto-parietal superior longitudinal fasciculus was relatively spared, with a significant difference observed for transverse diffusivity and fractional anisotropy, only. In the corpus callosum, the genu showed lower fractional anisotropy compared with controls, while no difference was found in the splenium. The left parietal cortex did not show significant volume changes on voxel-based morphometry and demonstrated normal functional magnetic resonance imaging activation in response to reading items that

  19. Language networks in semantic dementia

    PubMed Central

    Agosta, Federica; Henry, Roland G.; Migliaccio, Raffaella; Neuhaus, John; Miller, Bruce L.; Dronkers, Nina F.; Brambati, Simona M.; Filippi, Massimo; Ogar, Jennifer M.; Wilson, Stephen M.

    2010-01-01

    Cognitive deficits in semantic dementia have been attributed to anterior temporal lobe grey matter damage; however, key aspects of the syndrome could be due to altered anatomical connectivity between language pathways involving the temporal lobe. The aim of this study was to investigate the left language-related cerebral pathways in semantic dementia using diffusion tensor imaging-based tractography and to combine the findings with cortical anatomical and functional magnetic resonance imaging data obtained during a reading activation task. The left inferior longitudinal fasciculus, arcuate fasciculus and fronto-parietal superior longitudinal fasciculus were tracked in five semantic dementia patients and eight healthy controls. The left uncinate fasciculus and the genu and splenium of the corpus callosum were also obtained for comparison with previous studies. From each tract, mean diffusivity, fractional anisotropy, as well as parallel and transverse diffusivities were obtained. Diffusion tensor imaging results were related to grey and white matter atrophy volume assessed by voxel-based morphometry and functional magnetic resonance imaging activations during a reading task. Semantic dementia patients had significantly higher mean diffusivity, parallel and transverse in the inferior longitudinal fasciculus. The arcuate and uncinate fasciculi demonstrated significantly higher mean diffusivity, parallel and transverse and significantly lower fractional anisotropy. The fronto-parietal superior longitudinal fasciculus was relatively spared, with a significant difference observed for transverse diffusivity and fractional anisotropy, only. In the corpus callosum, the genu showed lower fractional anisotropy compared with controls, while no difference was found in the splenium. The left parietal cortex did not show significant volume changes on voxel-based morphometry and demonstrated normal functional magnetic resonance imaging activation in response to reading items that

  20. Cobalamin deficiency, hyperhomocysteinemia, and dementia

    PubMed Central

    Werder, Steven F

    2010-01-01

    Introduction Although consensus guidelines recommend checking serum B12 in patients with dementia, clinicians are often faced with various questions: (1) Which patients should be tested? (2) What test should be ordered? (3) How are inferences made from such testing? (4) In addition to serum B12, should other tests be ordered? (5) Is B12 deficiency compatible with dementia of the Alzheimer’s type? (6) What is to be expected from treatment? (7) How is B12 deficiency treated? Methods On January 31st, 2009, a Medline search was performed revealing 1,627 citations related to cobalamin deficiency, hyperhomocysteinemia, and dementia. After limiting the search terms, all abstracts and/or articles and other references were categorized into six major groups (general, biochemistry, manifestations, associations and risks, evaluation, and treatment) and then reviewed in answering the above questions. Results The six major groups above are described in detail. Seventy-five key studies, series, and clinical trials were identified. Evidence-based suggestions for patient management were developed. Discussion Evidence is convincing that hyperhomocysteinemia, with or without hypovitaminosis B12, is a risk factor for dementia. In the absence of hyperhomocysteinemia, evidence is less convincing that hypovitaminosis B12 is a risk factor for dementia. B12 deficiency manifestations are variable and include abnormal psychiatric, neurological, gastrointestinal, and hematological findings. Radiological images of individuals with hyperhomocysteinemia frequently demonstrate leukoaraiosis. Assessing serum B12 and treatment of B12 deficiency is crucial for those cases in which pernicious anemia is suspected and may be useful for mild cognitive impairment and mild to moderate dementia. The serum B12 level is the standard initial test: 200 picograms per milliliter or less is low, and 201 to 350 picograms per milliliter is borderline low. Other tests may be indicated, including plasma

  1. The Decline of Intelligence in America: A Strategy for National Renewal.

    ERIC Educational Resources Information Center

    Itzkoff, Seymour W.

    It is argued that the United States is declining as a nation, a decline that can be confirmed by any of the criteria that historians have ever used to measure the state and condition of a nation and its people, and it is asserted that this decline is rooted in the overall decline of the intelligence capital of the nation, a decline in the levels…

  2. The economic burden of dementia in China, 1990–2030: implications for health policy

    PubMed Central

    Xu, Junfang; Wang, Jian; Wimo, Anders; Fratiglioni, Laura

    2017-01-01

    Abstract Objective To quantify and predict the economic burden of dementia in China for the periods 1990–2010 and 2020–2030, respectively, and discuss the potential implications for national public health policy. Methods Using a societal, prevalence-based, gross cost-of-illness approach and data from multiple sources, we estimated or predicted total annual economic costs of dementia in China. We included direct medical costs in outpatient and inpatient settings, direct non-medical costs – e.g. the costs of transportation – and indirect costs due to loss of productivity. We excluded comorbidity-related costs. Findings The estimated total annual costs of dementia in China increased from 0.9 billion United States dollars (US$) in 1990 to US$ 47.2 billion in 2010 and were predicted to reach US$ 69.0 billion in 2020 and US$ 114.2 billion in 2030. The costs of informal care accounted for 94.4%, 92.9% and 81.3% of the total estimated costs in 1990, 2000 and 2010, respectively. In China, population ageing and the increasing prevalence of dementia were the main drivers for the increasing predicted costs of dementia between 2010 and 2020, and population ageing was the major factor contributing to the growth of dementia costs between 2020 and 2030. Conclusion In China, demographic and epidemiological transitions have driven the growth observed in the economic costs of dementia since the 1990s. If the future costs of dementia are to be reduced, China needs a nationwide dementia action plan to develop an integrated health and social care system and to promote primary and secondary prevention. PMID:28053361

  3. Population Surveillance of Dementia Mortality

    PubMed Central

    Gillum, Richard F.; Yorrick, Ralston; Obisesan, Thomas O.

    2011-01-01

    Geographic and temporal variation in occurrence of dementia within the US has received little attention despite its importance for generation of new etiologic hypotheses and health services research. We examine methodological problems in the use of vital statistics data for assessing variation over time, among states and within states in the US. We analyzed the US multiple cause of death files for 2005–2006 and 1999–2000 US deaths with Alzheimer’s Disease (International Classification of Disease 10th revision code G30) and other dementias (codes F01, F02, R54) coded as underlying or contributing cause of death based on the death certificate. Age-adjusted death rates were computed by year, state or county for persons aged 65 years and over. In 2005–2006 combined, 555,904 total deaths occurred with any dementia type (212,386 for Alzheimer’s disease) coded as underlying or contributing cause. Among the states, age-adjusted rates per 100,000 per year varied by two fold ranging from 458 in New York to 921 in Oregon. Similar geographic patterns were seen for Alzheimer’s disease. However, between 1999–2000 and 2005–2006 the US death rate for all dementia increased only from 559 to 695 (24%) while that for Alzheimer’s disease doubled from 135 to 266. Use of specific (G30, F01) versus non-specific diagnoses (F02, R54) varied among states and over time, explaining most of the temporal increase in rate of Alzheimer’s disease. Further research is needed to assess artifacts of diagnosis, certification or coding, utilization of health services, versus biological variation as possible causes of temporal and geographic variation to enhance utility of mortality data for dementia monitoring and research. PMID:21695038

  4. The provision of assistive technology products and services for people with dementia in the United Kingdom.

    PubMed

    Gibson, Grant; Newton, Lisa; Pritchard, Gary; Finch, Tracy; Brittain, Katie; Robinson, Louise

    2016-07-01

    In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources.

  5. Alternative Strategies to William Bennett's Plan for a National War on Drugs: A Comprehensive Systems Approach.

    ERIC Educational Resources Information Center

    D'Andrea, Michael

    As this country's first appointed "drug czar," William Bennett developed a set of proposals for a national campaign against drug abuse. These included: expanding the national prison capacity by 85 percent; providing additional fiscal support for states and local areas that adopt anti-drug laws; and increasing the availablility of…

  6. IN UTERO ENVIRONMENTAL EXPOSURES IN THE NATIONAL CHILDREN'S STUDY - MEASUREMENT STRATEGIES

    EPA Science Inventory

    The National Children¿s Study (NCS) is a longitudinal cohort study which is designed to follow a nationally representative sample of American children from prior to conception or early pregnancy until age 21 years. The Children's Health Act of 2000 directs a consortium of United...

  7. Patterns of Neuropsychiatric Symptoms in MCI and Risk of Dementia

    PubMed Central

    Forrester, Sarah N.; Gallo, Joseph J.; Smith, Gwenn S.; Leoutsakos, Jeannie-Marie S.

    2015-01-01

    Objectives To identify clusters of patients with incident mild cognitive impairment based on their neuropsychiatric symptoms (NPS) and to examine the risk of progression to dementia, based on these clusters. Design Cohort study with 2 years median length follow-up. Setting: Alzheimer’s disease Centers from the National Alzheimer’s Coordinating Center (NACC). Participants Patients with MCI who were at least 60 years old with complete data and follow-up (n = 540). Measurements Latent class analysis was used to identify clusters of patients based on their NPS, and Cox proportional hazards models were used to examine risk of progression to dementia based on clusters. Incident MCI was defined as a participant having MCI at a current visit, but having been cognitively normal at his or her previous (yearly) visit. NPI-Q assessed presence of twelve neuropsychiatric behavioral domains. Results Three clusters were identified: a severe cluster (agitation, anxiety, apathy, nighttime behaviors, inhibition), an affective cluster (depression, anxiety, irritability, nighttime behaviors), and an asymptomatic cluster. The prevalence of each class was 56% for the asymptomatic class followed by the affective class (37%) and finally the severe class (7%). Compared to the asymptomatic class, the severe class had more than twice the hazard of progression to dementia (2.69, CI: 1.12–2.70) and the affective class had over one and a half times the hazard of progression to dementia (1.79, CI: 1.12–2.70). Conclusions Among persons with incident MCI, patterns of NPS may increase the likelihood of progression to dementia. Implications for early detection and treatment are discussed. PMID:26209222

  8. Geographical variation in dementia: systematic review with meta-analysis

    PubMed Central

    Russ, Tom C; Batty, G David; Hearnshaw, Gena F; Fenton, Candida; Starr, John M

    2012-01-01

    Background Geographical variation in dementia prevalence and incidence may indicate important socio-environmental contributions to dementia aetiology. However, previous comparisons have been hampered by combining studies with different methodologies. This review systematically collates and synthesizes studies examining geographical variation in the prevalence and incidence of dementia based on comparisons of studies using identical methodologies. Methods Papers were identified by a comprehensive electronic search of relevant databases, scrutinising the reference sections of identified publications, contacting experts in the field and re-examining papers already known to us. Identified articles were independently reviewed against inclusion/exclusion criteria and considered according to geographical scale. Rural/urban comparisons were meta-analysed. Results Twelve thousand five hundred and eighty records were reviewed and 51 articles were included. Dementia prevalence and incidence varies at a number of scales from the national down to small areas, including some evidence of an effect of rural living [prevalence odds ratio (OR) = 1.11, 90% confidence interval (CI) 0.79–1.57; incidence OR = 1.20, 90% CI 0.84–1.71]. However, this association of rurality was stronger for Alzheimer disease, particularly when early life rural living was captured (prevalence OR = 2.22, 90% CI 1.19–4.16; incidence OR = 1.64, 90% CI 1.08–2.50). Conclusions There is evidence of geographical variation in rates of dementia in affluent countries at a variety of geographical scales. Rural living is associated with an increased risk of Alzheimer disease, and there is a suggestion that early life rural living further increases this risk. However, the fact that few studies have been conducted in resource-poor countries limits conclusions. PMID:22798662

  9. [Dementia in the focus of health research : A comparative analysis of current ageing studies].

    PubMed

    Illiger, Kristin; Walter, Ulla; Koppelin, Frauke

    2017-03-23

    Health research on an increasingly aging population calls for careful consideration of aging-associated phenomena, such as dementia. Accounting for such diseases is a necessary step for gaining a view of health in the elderly. It is moreover imperative to gather data on subjects' mental limitations in surveys to better evaluate the validity of answers disclosed by elderly participants. This article discusses the availability of data on individuals suffering from dementia in national studies on aging. It centers on the question of how surveys respond to the challenge of diagnosing dementia. The analysis is based on a literature review, which focuses on national studies on aging that were conducted no later than 2005, and that enforced an upper age limit of at least 79 years old for their subjects. By evaluating these published studies, and analyzing their data descriptively, it was determined how many subjects suffering from dementia were part of each sample, and which methods were applied to diagnose such illnesses. Overall, the availability of data on age and aging is satisfactory in Germany. The literature review discovered seven studies on aging, as well as five that lend themselves to a framework oriented toward research on aging. The number of subjects suffering from dementia in the samples is between 0 and 14% - over half of the studies reach less than 1.5% of those affected. These results thus point out problems in surveying individuals suffering from dementia. They highlight the limitations of studies on aging that do not account for dementia in their subjects. The following discussion aims to contribute to the debate on relevant research methodology, and to the development of methodological approaches that consider dementia as a crucial factor.

  10. Risk of dementia from proton pump inhibitor use in Asian population: A nationwide cohort study in Taiwan

    PubMed Central

    Tai, Shu-Yu; Chien, Chen-Yu; Wu, Deng-Chyang; Lin, Kun-Der; Ho, Bo-Lin; Chang, Yu-Han

    2017-01-01

    Introduction Concerns have been raised regarding the potential association between proton pump inhibitor (PPI) use and dementia. Objective This study aimed to examine this association in an Asian population. Methods Patients initiating PPI therapy between January 1, 2000 and December 31, 2003 without a prior history of dementia were identified from Taiwan’s National Health Insurance Research Database. The outcome of interest was all-cause dementia. Cox regression models were applied to estimate the hazard ratio (HR) of dementia. The cumulative PPI dosage stratified by quartiles of defined daily doses and adjusted for baseline disease risk score served as the primary variables compared against no PPI use. Results We analyzed the data of 15726 participants aged 40 years or older and free of dementia at baseline. PPI users (n = 7863; average follow-up 8.44 years) had a significantly increased risk of dementia over non—PPI users (n = 7863; average follow-up 9.55 years) (adjusted HR [aHR] 1.22; 95% confidence interval: 1.05–1.42). A significant association was observed between cumulative PPI use and risk of dementia (P for trend = .013). Subgroup analysis showed excess frequency of dementia in PPI users diagnosed with depression (aHR 2.73 [1.91–3.89]), hyperlipidemia (aHR 1.81 [1.38–2.38]), ischemic heart disease (aHR 1.55 [1.12–2.14]), and hypertension (aHR 1.54 [1.21–1.95]). Conclusions An increased risk for dementia was identified among the Asian PPI users. Cumulative PPI use was significantly associated with dementia. Further investigation into the possible biological mechanisms underlying the relationship between dementia and PPI use is warranted. PMID:28199356

  11. [Relation between dementia and circadian rhythm disturbance].

    PubMed

    Nakamura, Kei; Meguro, Kenichi

    2014-03-01

    Dementia and circadian rhythm disturbance are closely linked. First, dementia patient shows circadian rhythm disorders (e.g. insomnia, night wandering, daytime sleep). These symptoms are a burden for caregivers. Circadian rhythm disturbance of dementia relates ADL and cognitive impairment, and diurnal rhythm disorder of blood pressure and body temperature. Some study shows that circadian rhythm disorders in dementia are a disturbance of neural network between suprachiasmatic nucleus and cerebral white matter, and involvement of both frontal lobes, left parietal and occipital cortex, left temporoparietal region. The first-line treatment of circadian rhythm disturbance should be non-drug therapy (e.g. exercise, bright light exposure, reduce caffeine intake, etc.). If physician prescribe drugs, keep the rule of low-dose and short-term and avoid benzodiazepines. Atypical antipsychotic drugs like risperidone and some antidepressants are useful for treatment of insomnia in dementia. But this usage is off-label. So we must well inform to patient and caregiver, and get consent about treatment. Second, some study shows circadian rhythm disorder is a risk factor of dementia. However, we should discuss that circadian rhythm disturbance is "risk factor of dementia" or "prodromal symptom of dementia". If a clinician finds circadian rhythm disorder in elderly people, should be examined cognitive and ADL function, and careful about that patients have dementia or will develop dementia.

  12. Biological Risks to Public Health: Lessons from an International Conference to Inform the Development of National Risk Communication Strategies

    PubMed Central

    Bhatiasevi, Aphaluck; Chaib, Fadela; Baggio, Ombretta; Banluta, Christina; Hollenweger, Lilian; Maaroufi, Abderrahmane

    2016-01-01

    Biological risk management in public health focuses on the impact of outbreaks on health, the economy, and other systems and on ensuring biosafety and biosecurity. To address this broad range of risks, the International Health Regulations (IHR, 2005) request that all member states build defined core capacities, risk communication being one of them. While there is existing guidance on the communication process and on what health authorities need to consider to design risk communication strategies that meet the requirements on a governance level, little has been done on implementation because of a number of factors, including lack of resources (human, financial, and others) and systems to support effective and consistent capacity for risk communication. The international conference on “Risk communication strategies before, during and after public health emergencies” provided a platform to present current strategies, facilitate learning from recent outbreaks of infectious diseases, and discuss recommendations to inform risk communication strategy development. The discussion concluded with 4 key areas for improvement in risk communication: consider communication as a multidimensional process in risk communication, broaden the biomedical paradigm by integrating social science intelligence into epidemiologic risk assessments, strengthen multisectoral collaboration including with local organizations, and spearhead changes in organizations for better risk communication governance. National strategies should design risk communication to be proactive, participatory, and multisectoral, facilitating the connection between sectors and strengthening collaboration. PMID:27875654

  13. Biological Risks to Public Health: Lessons from an International Conference to Inform the Development of National Risk Communication Strategies.

    PubMed

    Dickmann, Petra; Bhatiasevi, Aphaluck; Chaib, Fadela; Baggio, Ombretta; Banluta, Christina; Hollenweger, Lilian; Maaroufi, Abderrahmane

    Biological risk management in public health focuses on the impact of outbreaks on health, the economy, and other systems and on ensuring biosafety and biosecurity. To address this broad range of risks, the International Health Regulations (IHR, 2005) request that all member states build defined core capacities, risk communication being one of them. While there is existing guidance on the communication process and on what health authorities need to consider to design risk communication strategies that meet the requirements on a governance level, little has been done on implementation because of a number of factors, including lack of resources (human, financial, and others) and systems to support effective and consistent capacity for risk communication. The international conference on "Risk communication strategies before, during and after public health emergencies" provided a platform to present current strategies, facilitate learning from recent outbreaks of infectious diseases, and discuss recommendations to inform risk communication strategy development. The discussion concluded with 4 key areas for improvement in risk communication: consider communication as a multidimensional process in risk communication, broaden the biomedical paradigm by integrating social science intelligence into epidemiologic risk assessments, strengthen multisectoral collaboration including with local organizations, and spearhead changes in organizations for better risk communication governance. National strategies should design risk communication to be proactive, participatory, and multisectoral, facilitating the connection between sectors and strengthening collaboration.

  14. ‘The living death of Alzheimer's’ versus ‘Take a walk to keep dementia at bay’: representations of dementia in print media and carer discourse

    PubMed Central

    Peel, Elizabeth

    2014-01-01

    Understanding dementia is a pressing social challenge. This article draws on the ‘Dementia talking: care conversation and communication’ project which aims to understand how talk about, and to people living with dementia is constructed. In this article I draw on the construction of dementia manifest in two data sets – a corpus of 350 recent UK national newspaper articles and qualitative data derived from in-depth interviews with informal carers. These data were analysed using a thematic discursive approach. A ‘panic-blame’ framework was evident in much of the print media coverage. Dementia was represented in catastrophic terms as a ‘tsunami’ and ‘worse than death’, juxtaposed with coverage of individualistic behavioural change and lifestyle recommendations to ‘stave off’ the condition. Contrary to this media discourse, in carers' talk there was scant use of hyperbolic metaphor or reference to individual responsibility for dementia, and any corresponding blame and accountability. I argue that the presence of individualistic dementia ‘preventative’ behaviour in media discourse is problematic, especially in comparison to other more ‘controllable’ and treatable chronic conditions. Engagement with, and critique of, the nascent panic-blame cultural context may be fruitful in enhancing positive social change for people diagnosed with dementia and their carers. PMID:24935028

  15. National Aviation Security Policy, Strategy, and Mode-Specific Plans: Background and Considerations for Congress

    DTIC Science & Technology

    2008-01-02

    aviation security . The approach to aviation security was largely shaped by past events, such as the bombing of Pan Am flight 103 in December 1988, rather...2001 attacks, U.S. aviation security policy and strategy was closely linked to the changes called for in the Aviation and Transportation Security Act...sensitive thus limiting public discourse on the DHS strategy for aviation security . However, in June 2006 President Bush directed the DHS to establish and

  16. National Aviation Security Policy, Strategy, and Mode-Specific Plans: Background and Considerations for Congress

    DTIC Science & Technology

    2009-02-02

    aviation security . The approach to aviation security was largely shaped by past events, such as the bombing of Pan Am flight 103 in December 1988, rather...community. Following the September 11, 2001, attacks, U.S. aviation security policy and strategy was closely linked to the changes called for in the...have been considered security sensitive thus limiting public discourse on the DHS strategy for aviation security . However, in June 2006 President

  17. Attributes of researchers and their strategies to recruit minority populations: results of a national survey.

    PubMed

    Quinn, Sandra Crouse; Butler, James; Fryer, Craig S; Garza, Mary A; Kim, Kevin H; Ryan, Christopher; Thomas, Stephen B

    2012-11-01

    Despite NIH mandates for inclusion, recruiting minorities is challenging for biomedical and public health researchers. Little is known about how attributes of researchers affect their choice of recruitment strategies. The purpose of this study was to address this gap by examining how use of recruitment strategies relates to other researcher characteristics. To do this, we conducted an online survey from May to August 2010 with researchers (principal investigators, research staff, and IRB members) in which we measured the number and types of recruitment strategies utilized, along with other characteristics of the researchers and their research. We identified two clusters of researchers: comprehensive researchers who utilized a greater number and more diverse and active recruitment strategies, and traditional researchers, who utilized fewer and more passive strategies. Additional characteristics that distinguished the two groups were that comprehensive researchers were more likely than traditional researchers to 1) report racial and ethnic differences as one of their specific aims or hypotheses, 2) receive federal (CDC and NIH) funding, 3) conduct behavioral or epidemiological research, and 4) have received training in conducting research with and recruiting minorities. Traditional researchers, on the other hand, were more likely to conduct clinical research and a greater (though non-significant) percentage received funding from pharmaceutical sources. This study provides a novel description of how researcher attributes are related to their recruitment strategies and raises a number of future research questions to further examine the implications of this relationship.

  18. Discovering the dementia evidence base: Tools to support knowledge to action in dementia care (innovative practice).

    PubMed

    Hayman, Sarah L; Tieman, Jennifer J

    2016-09-01

    Dementia requires expert care and decision making, based on sound evidence. Reliable evidence is difficult for busy dementia care professionals to find quickly. This study developed an experimentally tested search filter as an innovative tool to retrieve literature on dementia. It has a known retrieval performance and can be provided as an open access web link directly to current literature. The Dementia Search Filter was developed using validated methodology. An Expert Advisory Group of dementia care practitioners and researchers ratified a representative set of relevant studies and undertook post hoc relevance assessment, to ensure the usefulness of the search filter. The Dementia Search Filter is published on two websites and combined with expert searches to link to evidence on dementia, at end of life in aged care settings and more generally. Evidence accessed by the Dementia Search Filter will help overcome barriers to finding current relevant research in the field, for practitioners, researchers and decision makers.

  19. Wearable Technology to Garner the Perspective of Dementia Family Caregivers

    PubMed Central

    Matthews, Judith T.; Campbell, Grace B.; Hunsaker, Amanda E.; Klinger, Julie; Mecca, Laurel Person; Hu, Lu; Hostein, Sally; Lingler, Jennifer H.

    2015-01-01

    Family caregivers of persons with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions that they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. We describe a prototype wearable camera system used to gather image and voice data from the caregiver’s perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that incorporate salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by our team during screening) identified in the resulting video. We anticipate that future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses. PMID:26468655

  20. Hospital Admissions for Malnutrition and Dehydration in Patients With Dementia.

    PubMed

    Marshall, Katherine A; Burson, Rosanne; Gall, Kristyn; Saunders, Mitzi M

    2016-01-01

    Dehydration and malnutrition are commonly experienced by patients with dementia and can result in hospitalizations and decreased quality of life. The purpose of this study was to explore and describe retrospectively, the incidence and correlations of variables that may precede hospitalizations for dehydration/malnutrition in the community-dwelling patient with dementia. Data from the Outcome and Assessment Information Set (OASIS) Start of Care (SOC) on 44 patients served by a Michigan home care agency were retrieved for analysis. This study did not reveal any single or collection of variables that would predict risk for hospitalization for dehydration/malnutrition. With the lack of specific predictors of hospitalization related to dehydration and malnutrition, clinicians need to place high priority on risk-lowering strategies and preventive education for patients, family, and caregivers.

  1. Relational citizenship: supporting embodied selfhood and relationality in dementia care.

    PubMed

    Kontos, Pia; Miller, Karen-Lee; Kontos, Alexis P

    2017-02-01

    We draw on findings from a mixed-method study of specialised red-nosed elder-clowns in a long-term care facility to advance a model of 'relational citizenship' for individuals with dementia. Relational citizenship foregrounds the reciprocal nature of engagement and the centrality of capacities, senses, and experiences of bodies to the exercise of human agency and interconnectedness. We critically examine elder-clown strategies and techniques to illustrate how relational citizenship can be supported and undermined at the micro level of direct care through a focus on embodied expressions of creativity and sexuality. We identify links between aesthetic enrichment and relational practices in art, music and imagination. Relational citizenship offers an important rethinking of notions of selfhood, entitlement, and reciprocity that are central to a sociology of dementia, and it also provides new ethical grounds to explore how residents' creative and sexual expression can be cultivated in the context of long-term care.

  2. Wearable Technology to Garner the Perspective of Dementia Family Caregivers.

    PubMed

    Matthews, Judith T; Campbell, Grace B; Hunsaker, Amanda E; Klinger, Julie; Mecca, Laurel Person; Hu, Lu; Hostein, Sally; Lingler, Jennifer H

    2016-04-01

    Family caregivers of individuals with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. The current article describes a prototype wearable camera system used to gather image and voice data from the caregiver's perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that include salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by the research team during screening) captured in the resulting video. The current authors anticipate future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses.

  3. Promoting Intergenerational Strategies: The Role of the Corporation for National Service.

    ERIC Educational Resources Information Center

    Wofford, Harris

    1999-01-01

    Describes the programs of the Corporation for National Service such as Senior Service Corps, Learn and Serve America, AmeriCorps, Foster Grandparents, Retired and Senior Volunteer Program, and Seniors for Schools. (JOW)

  4. Science, environment and technology summit: A long term national science strategy

    SciTech Connect

    Trivelpiece, A.W.

    1995-06-01

    This document contains the text of the testimony given by Alvin W. Trivelpiece, Director, Oak Ridge National Laboratory, before the Subcommittee on Basic Research, Committee on Science, US House of Representatives in Oak Ridge, TN on June 1, 1995.

  5. Improved Wavelength Detuning Cross-Beam Energy Transfer Mitigation Strategy for Polar Direct Drive at the National Ignition Facility

    NASA Astrophysics Data System (ADS)

    Marozas, J. A.; Collins, T. J. B.; McKenty, P. W.; Zuegel, J. D.

    2015-11-01

    Cross-beam energy transfer (CBET) reduces absorbed light and implosion velocity, alters time-resolved scattered-light spectra, and redistributes absorbed and scattered light. These effects reduce target performance in both symmetric direct-drive and polar-direct-drive (PDD) experiments on the OMEGA Laser System and the National Ignition Facility (NIF). The CBET package (Adaawam) incorporated into the 2-D hydrodynamics code DRACO is an integral part of the 3-D ray-trace package (Mazinisin). The CBET exchange occurs primarily over the equatorial region in PDD, where successful mitigation strategies concentrate. Detuning the initial laser wavelength (dλ0) reduces the CBET interaction volume, which can be combined with other mitigation domains (e.g., spatial and temporal). By judiciously selecting the ring and/or port +/-dλ0 in each hemisphere, using new DRACO diagnostic abilities, improved wavelength detuning strategies trade-off overall energy absorption for improved hemispherical energy balance control. These balanced-wavelength detuning strategies improve performance for high-convergence implosions. Simulations (2-D DRACO) predict improved implosion performance and control in both the shell trajectory and morphology for planned intermediate PDD experiments on the NIF. This material is based upon work supported by the Department of Energy National Nuclear Security Administration under Award Number DE-NA0001944.

  6. Recruiting Dementia Caregivers Into Clinical Trials: Lessons Learnt From the Australian TRANSCENDENT Trial.

    PubMed

    Leach, Matthew J; Ziaian, Tahereh; Francis, Andrew; Agnew, Tamara

    2016-01-01

    The burden on those caring for a person with dementia is substantial. Although quality research assists in addressing the needs of these caregivers, recruiting caregivers into clinical studies is often problematic. This investigation explores the difficulties and successes in recruiting dementia caregivers into community-based clinical research by reporting the findings of a mixed-method substudy of a multicenter randomized controlled trial involving 40 community-dwelling dementia caregivers living in Adelaide, South Australia. Data for the substudy were derived from standardized trial monitoring documentation and structured telephone interviews. From a total of 16 distinct methods used across a 12-month recruitment campaign, the most cost-effective strategy was the distribution of flyers through a single study site. This approach generated the greatest number of enrollments of all methods used, achieving a 67% recruitment yield. The least cost-effective strategy, with a 0% recruitment yield, was the publication of a newspaper advertisement. Themes that emerged from the interviews pointed toward 5 key facilitators and 3 barriers to future trial recruitment. This study has generated new insights into the effective recruitment of dementia caregivers into clinical trials. We anticipate that these lessons learnt will assist in shaping the recruitment strategies of future studies of dementia caregivers.

  7. The diagnosis of young-onset dementia

    PubMed Central

    Rossor, Martin N; Fox, Nick C; Mummery, Catherine J; Schott, Jonathan M; Warren, Jason D

    2010-01-01

    A diagnosis of dementia is devastating at any age but diagnosis in younger patients presents a particular challenge. The differential diagnosis is broad as late presentation of metabolic disease is common and the burden of inherited dementia is higher in these patients than in patients with late-onset dementia. The presentation of the common degenerative diseases of late life, such as Alzheimer's disease, can be different when presenting in the fifth or sixth decade. Moreover, many of the young-onset dementias are treatable. The identification of causative genes for many of the inherited degenerative dementias has led to an understanding of the molecular pathology, which is also applicable to later-onset sporadic disease. This understanding offers the potential for future treatments to be tailored to a specific diagnosis of both young-onset and late-onset dementia. PMID:20650401

  8. Staging casual conversations for people with dementia.

    PubMed

    Mok, Zaneta; Müller, Nicole

    2014-11-01

    Social isolation is a key concern for individuals with dementia in long-term care. A possible solution is to promote social interaction between residents. A first step toward facilitating positive relationships between residents with dementia is to understand the mechanisms behind their interactions with each other, and also how their relationships with each other are built through such interactions. Drawing on casual conversations between residents in a special care unit for dementia, this paper uses systemic functional linguistics to examine how people with dementia use language to enact and construct their role-relations with each other. Results suggest people with dementia are able and willing conversationalists. However, factors such as the extent of communication breakdown and compatibility of the interlocutors may influence whether positive relations develop or not. Casual conversation is suggested to be a promising activity to encourage positive interpersonal processes between individuals with dementia in residential care.

  9. The role of neuroinflammation in dementias.

    PubMed

    Pasqualetti, Giuseppe; Brooks, David J; Edison, Paul

    2015-04-01

    The molecular mechanism of neuronal loss and synaptic damage in Alzheimer's disease (AD), Parkinson's disease dementia (PDD), frontotemporal dementia (FTD) and Lewy body dementia (LBD) is poorly understood and could differ among different types of neurodegenerative processes. However, the presence of neuroinflammation is a common feature of dementia. In this setting, reactive microgliosis, oxidative damage and mitochondrial dysfunction are associated with the pathogenesis of all types of neurodegenerative dementia. Moreover, an increased body of evidence suggests that microglia may play a central role in AD progression. In this paper, we review the scientific literature on neuroinflammation related to the most common neurodegenerative dementias (AD, PDD, FTD and LBD) focussing on the possible molecular mechanisms and the available clinical evidence. Furthermore, we discuss the neuroimaging techniques that are currently used for the study of neuroinflammation in human brain.

  10. Hearing and music in dementia.

    PubMed

    Johnson, Julene K; Chow, Maggie L

    2015-01-01

    Music is a complex acoustic signal that relies on a number of different brain and cognitive processes to create the sensation of hearing. Changes in hearing function are generally not a major focus of concern for persons with a majority of neurodegenerative diseases associated with dementia, such as Alzheimer disease (AD). However, changes in the processing of sounds may be an early, and possibly preclinical, feature of AD and other neurodegenerative diseases. The aim of this chapter is to review the current state of knowledge concerning hearing and music perception in persons who have a dementia as a result of a neurodegenerative disease. The review focuses on both peripheral and central auditory processing in common neurodegenerative diseases, with a particular focus on the processing of music and other non-verbal sounds. The chapter also reviews music interventions used for persons with neurodegenerative diseases.

  11. Hearing and music in dementia

    PubMed Central

    Johnson, Julene K; Chow, Maggie L

    2016-01-01

    Music is a complex acoustic signal that relies on a number of different brain and cognitive processes to create the sensation of hearing. Changes in hearing function are generally not a major focus of concern for persons with a majority of neurodegenerative diseases associated with dementia, such as Alzheimer disease (AD). However, changes in the processing of sounds may be an early, and possibly preclinical, feature of AD and other neurodegenerative diseases. The aim of this chapter is to review the current state of knowledge concerning hearing and music perception in persons who have a dementia as a result of a neurodegenerative disease. The review focuses on both peripheral and central auditory processing in common neurodegenerative diseases, with a particular focus on the processing of music and other non-verbal sounds. The chapter also reviews music interventions used for persons with neurodegenerative diseases. PMID:25726296

  12. Caffeine, diabetes, cognition, and dementia.

    PubMed

    Biessels, Geert Jan

    2010-01-01

    People with diabetes mellitus are at increased risk of cognitive dysfunction. This review explores the relation between caffeine intake, diabetes, cognition and dementia, focusing on type 2 diabetes (T2DM). Epidemiological studies on caffeine/coffee intake and T2DM risk are reviewed. Next, the impact of T2DM on cognition is addressed. Finally, the potential for caffeine to modulate the risk of cognitive decline in the context of diabetes is explored. The conclusion is that, although epidemiological studies indicate that coffee/caffeine consumption is associated with a decreased risk of T2DM and possibly also with a decreased dementia risk, we can at present not be certain that these associations are causal. For now, recommendations for coffee consumption in individuals with T2DM or pre-diabetic stages are therefore difficult to establish, but it should be acknowledged that caffeine does appear to have several properties that warrant further investigations in this field.

  13. Shared decision-making for people living with dementia in extended care settings: protocol for a systematic review

    PubMed Central

    Bunn, Frances; Goodman, Claire

    2016-01-01

    Introduction Approximately 450 000 people in the UK are living in care homes, 70% of whom are thought to have dementia or significant memory problems. This means that they may need support with day-to-day decisions about their health and care. Shared decision-making interventions can have a positive impact on patient outcomes. They recognise an individual's rights to make decisions about their care or treatment and support person-centred approaches to care delivery. Methods A systematic review of studies designed to assess, implement, measure and/or explore shared decision-making with cognitively impaired adults in (or transferrable to) an extended care setting, with a view to answering the research question: How can people living with dementia and cognitive impairment be included in day-to-day decisions about their health and care in extended care settings? The systematic review will be started in May 2016. Studies are excluded that focus on advance decision-making. The search strategy is limited to a 20-year timeframe and English language and includes electronic databases; CINAHL, PubMed, the Cochrane Library, NICE Evidence, OpenGrey, Autism Data, Google Scholar, Scopus and MedicinesComplete. Ethics and dissemination Ethical approval not required. Planned dissemination routes for protocol and systematic review through conference presentations, peer-reviewed journals and research networks including the East of England CLAHRC, INTERDEM, and the National Care Homes Research and Development Forum. Discussion The review will explore how shared decision-making is characterised and constructed in extended care settings for people living with cognitive impairment and their staff and family carers, in relation to their preferences and desires, the roles people play, facilitators, barriers, risk and benefits. The findings will inform an intervention study facilitating shared decision-making for people living with dementia in care homes and have the potential to inform

  14. Retinal vascular caliber and risk of dementia

    PubMed Central

    de Jong, F.J.; Schrijvers, E.M.C.; Ikram, M.K.; Koudstaal, P.J.; de Jong, P.T.V.M.; Hofman, A.; Vingerling, J.R.

    2011-01-01

    Background: Retinal vessels provide a unique opportunity to study both systemic and cerebrovascular disease. Smaller retinal arteriolar calibers are strongly related to hypertension, whereas larger retinal venular calibers are more related to inflammation, cerebral hypoperfusion, and cerebrovascular disease. Whether retinal vessel calibers are related to dementia remains unclear. Methods: We investigated whether retinal arteriolar and venular calibers are associated with risk of dementia, and its subtypes Alzheimer disease (AD) and vascular dementia, in the prospective population-based Rotterdam Study. Digitized retinal images were available in 5,553 participants aged 55 years or over and dementia-free at baseline (1990–1993). Participants were re-examined in 1993–1994, 1997–1999, and 2002–2004 and were continuously monitored for development of dementia. Results: During a mean follow-up of 11.6 years, 655 participants developed dementia. AD was diagnosed in 519 and vascular dementia in 73 participants. Larger venular calibers were associated with an increased risk of dementia, in particular vascular dementia (age- and sex-adjusted hazard ratio per SD increase: 1.31; 95% confidence interval 1.06–1.64), but not AD. The association remained significant after adjustment for stroke and cardiovascular risk factors. Smaller arteriolar calibers were also associated with an increased risk of vascular dementia, yet only when adjusted for venular calibers. Conclusions: Retinal venular widening is associated with an increased risk of vascular dementia. Our findings are in line with previous observations in stroke and cerebral small-vessel disease and suggest that the association between larger retinal venular calibers and dementia may reflect cerebral hypoperfusion and subsequent ischemia. PMID:21288987

  15. Motor neuron dysfunction in frontotemporal dementia.

    PubMed

    Burrell, James R; Kiernan, Matthew C; Vucic, Steve; Hodges, John R

    2011-09-01

    Frontotemporal dementia and motor neuron disease share clinical, genetic and pathological characteristics. Motor neuron disease develops in a proportion of patients with frontotemporal dementia, but the incidence, severity and functional significance of motor system dysfunction in patients with frontotemporal dementia has not been determined. Neurophysiological biomarkers have been developed to document motor system dysfunction including: short-interval intracortical inhibition, a marker of corticospinal motor neuron dysfunction and the neurophysiological index, a marker of lower motor neuron dysfunction. The present study performed detailed clinical and neurophysiological assessments on 108 participants including 40 consecutive patients with frontotemporal dementia, 42 age- and gender-matched patients with motor neuron disease and 26 control subjects. Of the 40 patients with frontotemporal dementia, 12.5% had concomitant motor neuron disease. A further 27.3% of the patients with frontotemporal dementia had clinical evidence of minor motor system dysfunction such as occasional fasciculations, mild wasting or weakness. Biomarkers of motor system function were abnormal in frontotemporal dementia. Average short-interval intracortical inhibition was reduced in frontotemporal dementia (4.3 ± 1.7%) compared with controls (9.1 ± 1.1%, P < 0.05). Short-interval intracortical inhibition was particularly reduced in the progressive non-fluent aphasia subgroup, but was normal in patients with behavioural variant frontotemporal dementia and semantic dementia. The neurophysiological index was reduced in frontotemporal dementia (1.1) compared with controls (1.9, P < 0.001), indicating a degree of lower motor neuron dysfunction, although remained relatively preserved when compared with motor neuron disease (0.7, P < 0.05). Motor system dysfunction in frontotemporal dementia may result from pathological involvement of the primary motor cortex, with secondary

  16. Semantic and gender priming in frontotemporal dementia.

    PubMed

    Repetto, Claudia; Manenti, Rosa; Cappa, Stefano; Miniussi, Carlo; Riva, Giuseppe

    2009-01-01

    Modifications of language processing can be observed both in normal aging and in the most common forms of degenerative dementia, such as Alzheimer's disease and the spectrum of frontotemporal dementias. The present experiment tests at the same time semantic and syntactic aspects of language processing in patients with frontotemporal dementia, using an online paradigm that allows researchers to evaluate the real linguistic competence of the patients.

  17. Vascular lesions in mixed dementia, vascular dementia, and Alzheimer disease with cerebrovascular disease: the Kurihara Project.

    PubMed

    Meguro, Kenichi; Tanaka, Naofumi; Nakatsuka, Masahiro; Nakamura, Kei; Satoh, Masayuki

    2012-11-15

    The concept and diagnosis for mixed dementia is not simple, since it is difficult to identify the type and regions of cerebrovascular disease (CVD) responsible for causing dementia. An investigation is needed to confirm the presence of mixed dementia, those who met the criteria for Alzheimer's disease (AD) and those for vascular dementia (VaD). According to the community-based stroke, dementia, and bed-confinement prevention in Kurihara, northern Japan (Kurihara Project), the prevalence of dementia and dementing diseases was surveyed in 2008-2010. Five hundred and ninety people finally agreed to participate (47.0%), and 73 (12.4%) people were diagnosed with dementia according to the DSM-IV. Using MRI, intensive evaluations on CVDs were performed for the 49 dementia patients associated with CVDs (mixed dementia, VaD, and AD with CVD). For the mixed dementia group, all had left subcortical strategic CVDs. These included the caudate head and thalamus. For the VaD group, all patients had at least cortical CVDs or subcortical strategic CVDs. The AD with CVD group had non-strategic CVDs in cortical, subcortical, or other areas in 5 or 6 patients each. Two extreme concepts regarding CVD and dementia are possible. One is that there is no concept for mixed dementia or VaD. An alternative is that the vascular factor should be considered as primary. Our data showed an importance of cortical and subcortical "strategic" areas, the latter included thalamus and caudate head.

  18. Extrapyramidal signs by dementia severity in Alzheimer disease and dementia with Lewy bodies.

    PubMed

    Kaur, Berneet; Harvey, Danielle J; Decarli, Charles S; Zhang, Lin; Sabbagh, Marwan N; Olichney, John M

    2013-01-01

    Alzheimer disease (AD) and dementia with Lewy bodies (DLB) are common etiologies of dementia with overlapping clinical features. Our objective was to determine which extrapyramidal signs (EPSs) are most helpful in identifying DLB. We analyzed data from the National Alzheimer's Coordinating Center, including demographics, Unified Parkinson's Disease Rating Scale (UPDRS) scores, Mini-Mental State Examination (MMSE) scores, and clinical diagnosis. The subjects were divided into 3 groups: AD, DLB, or Lewy body variant (LBV). The UPDRS motor scores were totaled and analyzed within and across the MMSE strata using regression techniques. Further, we divided UPDRS subscores into 9 EPSs, dichotomized as either present or absent. Logistic regression analysis was used to compare each of the EPS in the AD and Lewy body (DLB+LBV) groups. DLB subjects (n=130) were more likely to be male individuals, younger, and have higher MMSE scores (P<0.001) compared with that in AD (n=1826) or LBV (n=105) subjects. Differences were found for total UPDRS score and number of EPSs (P<0.001), after controlling for age, sex, and MMSE. Logistic regression models demonstrated that masked facies best differentiated AD from Lewy body (odds ratio=6.5, P<0.001, 95% confidence interval, 3.8-11.1). If these findings are neuropathologically validated, then the presence of specific EPS may help clinicians better differentiate AD and DLB.

  19. Uncommon neurodegenerative causes of dementia.

    PubMed

    Kurz, Alexander F

    2005-01-01

    A group of neurodegenerative diseases is outlined that affect cortical and subcortical areas of the brain. These diseases give rise to atypical forms of dementia and, unlike Alzheimer's disease (AD), are often associated with neurological symptoms. Clinical symptoms reflect the localization of the degenerative process rather than the nature of the underlying histopathology. Degeneration of the frontal and anterior temporal lobe presents initially with behavioral alterations, but later in the course, impairment of cognition and activities of daily living develops. Posterior cortical atrophy affects the parietal and occipital association cortices and causes complex visual disturbances. In corticobasal degeneration (CBD) the focus of pathology includes the frontoparietal cortex and several subcortical nuclei, causing symmetrical rigidity, bradykinesia, myoclonus and dystonia. Progressive supranuclear palsy (PSP) involves the frontal, temporal and parietal cortex as well as parts of the brain stem. Clinical features include a hypokinetic rigid syndrome with nuchal dystonia and vertical gaze palsy. Huntington's disease is a prototypical autosomal dominant disorder that affects the extrapyramidal system and causes choreatic movements in combination with personality changes and cognitive deterioration. Amyotrophic lateral sclerosis (ALS) with dementia is a neurodegeneration of the frontotemporal cortex and of the anterior horn of the spinal cord. Behavioral change similar to frontotemporal dementia (FTD) is paralleled or followed by the classic features of motor neuron disease.

  20. Stereotypic behaviors in degenerative dementias.

    PubMed

    Prioni, S; Fetoni, V; Barocco, F; Redaelli, V; Falcone, C; Soliveri, P; Tagliavini, F; Scaglioni, A; Caffarra, P; Concari, L; Gardini, S; Girotti, F

    2012-11-01

    Stereotypies are simple or complex involuntary/unvoluntary behaviors, common in fronto-temporal dementia (FTD), but not studied in other types of degenerative dementias. The aim was to investigate stereotypy frequency and type in patients with FTD, Alzheimer's disease (AD), progressive supranuclear palsy (PSP) and Parkinson's disease with dementia (PDD) in a multicenter observational study; and to investigate the relation of stereotypies to cognitive, behavioral and motor impairment. One hundred fifty-five consecutive outpatients (45 AD, 40 FTD, 35 PSP and 35 PDD) were studied in four hospitals in northern Italy. Stereotypies were examined by the five-domain Stereotypy Rating Inventory. Cognition was examined by the Mini Mental State and Frontal Assessment Battery, neuropsychiatric symptoms by the Neuropsychiatric Inventory, and motor impairment and invalidity by the Unified Parkinson's Disease Rating Scale part III, and activities of daily living. Stereotypies were present in all groups. FTD and PDD had the greatest frequency of one-domain stereotypies; FTD also had the greatest frequency of two-or-more domain stereotypies; movement stereotypies were the most common stereotypies in all groups. AD patients had fewer stereotypies than the other groups. Stereotypies are not exclusive to FTD, but are also fairly common in PSP and PDD, though less so in AD. Stereotypies may be underpinned by dysfunctional striato-frontal circuits, known to be damaged in PSP and PDD, as well as FTD.