6 resultados para longitudinal Poisson data
em AMS Tesi di Dottorato - Alm@DL - Universit
Resumo:
This work is part of a project promoted by Emilia-Romagna that aims at encouraging research activities in order to support the innovation strategies of the regional economic system through the exploitation of new data sources. To gain this scope, a database containing administrative data is provided by the Municipality of Bologna. This is achieved by linking data from the Register Office of the Municipality and fiscal data coming from the tax returns submitted to the Revenue Agency and released by the Ministry of Economy and Finance for the period 2002-2017. The main purpose of the project is the analysis of the medium term financial and distributional trends of income of the citizens residing in the Municipality of Bologna. Exploiting this innovative source of data allow us to analyse the dynamics of income at municipal level, overcoming the lack of information in official survey-based statistic. We investigate these trends by building inequality indicators and by examining the persistence of in-work poverty. Our results represent an important informative element to improve the effectiveness and equity of welfare policies at the local level, and to guide the distribution of economic and social support and urban redevelopment interventions in different areas of the Municipality.
Resumo:
Introduction and Background: Multiple system atrophy (MSA) is a sporadic, adult-onset, progressive neurodegenerative disease characterized clinically by parkinsonism, cerebellar ataxia, and autonomic failure. We investigated cognitive functions longitudinally in a group of probable MSA patients, matching data with sleep parameters. Patients and Methods: 10 patients (7m/3f) underwent a detailed interview, a general and neurological examination, laboratory exams, MRI scans, a cardiovascular reflexes study, a battery of neuropsychological tests, and video-polysomnographic recording (VPSG). Patients were revaluated (T1) a mean of 16±5 (range: 12-28) months after the initial evaluation (T0). At T1, the neuropsychological assessment and VPSG were repeated. Results: The mean patient age was 57.8±6.4 years (range: 47-64) with a mean age at disease onset of 53.2±7.1 years (range: 43-61) and symptoms duration at T0 of 60±48 months (range: 12-144). At T0, 7 patients showed no cognitive deficits while 3 patients showed isolated cognitive deficits. At T1, 1 patient worsened developing multiple cognitive deficits from a normal condition. At T0 and T1, sleep efficiency was reduced, REM latency increased, NREM sleep stages 1-2 slightly increased. Comparisons between T1 and T0 showed a significant worsening in two tests of attention and no significant differences of VPSG parameters. No correlation was found between neuropsychological results and VPSG findings or RBD duration. Discussion and Conclusions: The majority of our patients do not show any cognitive deficits at T0 and T1, while isolated cognitive deficits are present in the remaining patients. Attention is the cognitive function which significantly worsened. Our data confirm the previous findings concerning the prevalence, type and the evolution of cognitive deficits in MSA. Regarding the developing of a condition of dementia, our data did not show a clear-cut diagnosis of dementia. We confirm a mild alteration of sleep structure. RBD duration does not correlate with neuropsychological findings.
Resumo:
The general aim of this dissertation was to uncover the association between psychosocial factors and rehabilitation outcome after stroke. METHOD. A sample of patients with stroke (n=40) and their caregivers (n=36) were assessed at admission to and six months after discharge from rehabilitation hospital, using the following instruments: Structured Clinical Interview for DSM-IV, structured interview based on Diagnostic Criteria for Psychosomatic Research, Symptom Questionnaire, Psychosocial Index, Psychological Well-Being Scales, and Family Assessment Device. 40 subjects from the general population underwent the same psychological assessment. In addition, patients' functional status was measured using the Functional Independence Measure. RESULTS. Stroke survivors reported lower education and higher alcohol consumption than controls. No significant differences emerged between the two groups in the prevalence of psychiatric diagnoses or psychosomatic syndromes, however patients reported significantly higher levels of anxiety, depression, somatic symptoms, and lower autonomy than controls. Caregivers reported significantly higher scores in anxiety, depression, and somatic symptoms compared to normative data, while no impairments emerged in psychological well-being and family functioning. At six-month follow-up, in patients a significant decrease in smoking habit and an increase in DSM diagnoses were reported. Both stroke survivors and caregivers showed significant reductions in anxiety, with patients displaying also a decrease in somatic symptoms, an increase in stress and a deterioration in quality of life. Significant deteriorations in several aspects of family functioning was perceived only by patients. An association between patients' functional recovery in the cognitive domain and family behavior control emerged. For caregivers, family functioning significantly predicted hostility and somatic symptoms were associated with family affective involvement. CONCLUSIONS. These data highlight the utility in the Italian setting of the adoption of a psychosocial assessment and a family-systems approach in stroke rehabilitation, in order to development interventions properly targeted to the characteristics of patients and their family members.
Resumo:
Introduction: A higher frequency of sleep and breathing disorders in Multiple System Atrophy (MSA) populations is documented in literature. The analysis of disease progression and prognosis in patients with sleep and breathing disorders could shed light on specific neuropathology and pathophysiology of MSA. Objective: To characterize sleep disorders and their longitudinal modifications during disease course in MSA patients, and to determine their prognostic value. Methods: This is a retrospective and prospective cohort study including 182 MSA patients (58.8% males). Type of onset was defined by the first reported motor or autonomic symptom/sign related to MSA. The occurrence of symptoms/signs and milestones of disease progression and their latency were collected. REM sleep behaviour disorder (RBD) and stridor were video-polysomnography (VPSG)-confirmed. VPSG recordings were analysed in a standardized fashion during the disease course. Survival data were based on time to death from the first symptom of disease. Results: Isolated RBD represented the first MSA symptom in 30% of patients, preceding disease onset according to international criteria with a median of 3(1–5) years. Patients developing early stridor or presenting with RBD at disease onset showed a more rapid and severe disease progression. These features had independent negative prognostic value for survival. Sleep architecture was characterized by peculiar features which could represent negative markers in MSA prognosis. Patients with stridor treated with tracheostomy showed a reduced risk of death. Conclusions: This is one of the first studies focusing on longitudinal progression of sleep in MSA. Sleep disorders are key features of disease, playing a role in presentation, prognosis and progression. In our MSA cohort, RBD represented the most frequent mode of disease presentation. Moreover, some specific clinical and instrumental sleep features could represent a hallmark of MSA and could be involved in prognosis and, in particular, in sudden death and death during sleep.
Resumo:
This research aims at contributing to a better understanding of changes in local governments’ accounting and reporting practices. Particularly, ‘why’, ‘what’ and ‘how’ environmental aspects are included and the significance of changes across time. It adopts an interpretative approach to conduct a longitudinal analysis of case studies. Pettigrew and Whipp’s framework on context, content and process is used as a lens to distinguish changes under each dimension and analyse their interconnections. Data is collected from official documents and triangulated with semi-structured interviews. The legal framework defines as boundaries of the accounting information the territory under local governments’ jurisdiction and their immediate surrounding area. Organisational environmental performance and externalities are excluded from the requirements. An interplay between the local outer context, political commitment and organisational culture justifies the implementation of changes beyond what is regulated and the implementation of transformational changes. Local governments engage in international networks to gain access to funding and implement changes, leading to adopting the dominant environmental agenda. Key stakeholders, like citizens, are not engaged in the accounting and reporting process. Thus, there is no evidence that the environmental aspects addressed and related changes align with stakeholders’ needs and expectations, which jeopardises its significance. Findings from the current research have implications in other EU member states due to the harmonisation of accounting and reporting practices and the common practice across the EU in using external funding to conceptualise and implement changes. This implies that other local governments could also be representing a limited account related to environmental aspects.
Resumo:
This dissertation explores the link between hate crimes that occurred in the United Kingdom in June 2017, June 2018 and June 2019 through the posts of a robust sample of Conservative and radical right users on Twitter. In order to avoid the traditional challenges of this kind of research, I adopted a four staged research protocol that enabled me to merge content produced by a group of randomly selected users to observe the phenomenon from different angles. I collected tweets from thirty Conservative/right wing accounts for each month of June over the three years with the help of programming languages such as Python and CygWin tools. I then examined the language of my data focussing on humorous content in order to reveal whether, and if so how, radical users online often use humour as a tool to spread their views in conditions of heightened disgust and wide-spread political instability. A reflection on humour as a moral occurrence, expanding on the works of Christie Davies as well as applying recent findings on the behavioural immune system on online data, offers new insights on the overlooked humorous nature of radical political discourse. An unorthodox take on the moral foundations pioneered by Jonathan Haidt enriched my understanding of the analysed material through the addition of a moral-based layer of enquiry to my more traditional content-based one. This convergence of theoretical, data driven and real life events constitutes a viable “collection of strategies” for academia, data scientists; NGO’s fighting hate crimes and the wider public alike. Bringing together the ideas of Davies, Haidt and others to my data, helps us to perceive humorous online content in terms of complex radical narratives that are all too often compressed into a single tweet.