The dementia cognitive fluctuation scale, a new psychometric test for clinicians to identify cognitive fluctuations in people with dementia.

OBJECTIVES Cognitive fluctuation (CF) is a common feature of dementia and a core diagnostic symptom for dementia with Lewy bodies (DLB). CF remains difficult to accurately and reliably detect clinically. This study aimed to develop a psychometric test that could be used by clinicians to facilitate the identification of CF and improve the recognition and diagnosis of DLB and Parkinson disease, and to improve differential diagnosis of other dementias. METHODS We compiled a 17-item psychometric test for identifying CF and applied this measure in a cross-sectional design. Participants were recruited from the North East of England, and assessments were made in individuals' homes. We recruited people with four subtypes of dementia and a healthy comparison group, and all subjects were administered this pilot scale together with other standard ratings. The psychometric properties of the scale were examined with exploratory factor analysis. We also examined the ability of individual items to identify CF to discriminate between dementia subtypes. The sensitivity and specificity of discriminating items were explored along with validity and reliability analyses. RESULTS Participants comprised 32 comparison subjects, 30 people with Alzheimer disease, 30 with vascular dementia, 29 with DLB, and 32 with dementia associated with Parkinson disease. Four items significantly discriminated between dementia groups and showed good levels of sensitivity (range: 78.6%-80.3%) and specificity (range: 73.9%-79.3%). The scale had very good levels of test-retest (Cronbach's alpha: 0.82) and interrater (0.81) reliabilities. The four items loaded onto three different factors. These items were: 1) marked differences in functioning during the daytime; 2) daytime somnolence; 3) daytime drowsiness; and 4) altered levels of consciousness during the day. CONCLUSIONS We identified four items that provide valid, sensitive, and specific questions for reliably identifying CF and distinguishing the Lewy body dementias from other major causes of dementia (Alzheimer disease and vascular dementia).

Le genre comme ressource politique en Suisse. La perception de l'élite politique

Traditionnellement un monde d’homme, la politique fonctionne encore aujourd’hui selon des règles faites par et pour les hommes. Malgré cet univers hostile à la gente féminine, les femmes sont entrées en politique dès que les pays leurs ont accordés les droits politiques. Toujours minoritaire, les femmes se sont aujourd’hui faites une place dans les parlements et gouvernements du monde. L’augmentation de la proportion de femmes dans les instances politiques laisse supposer qu’être une femme ne constitue pas obligatoirement un handicap en politique. Ce livre s’intéresse à ce changement de signification du genre féminin en politique et montre, à l’exemple de la Suisse, comment les membres de l’élite politique perçoivent le rôle du genre dans les affaires publiques. Cette étude s’adresse à toute personne intéressée par les rapports de genre dans le monde du pouvoir.

Genre et protection sociale

L'histoire du genre, en pleine explosion, permet elle aussi de repenser la protection sociale, bien au-delà de la maternité, de la famille et du travail féminin