904 resultados para Visual impairment and blindness
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RESUMO: Introdução: A visão é um sentido fundamental na relação do indivíduo com os mais variados ambientes, sendo elemento central na funcionalidade e independência do idoso, qualquer perturbação da função visual provoca limitações na qualidade de vida. As alterações demográficas em curso caracterizam-se pelo envelhecimento progressivo da população, paralelamente constata-se um aumento da prevalência de perturbações do sistema visual com alteração da função e do funcionamento visual. Considerando que os indivíduos idosos são mais dependentes da visão, e que não existem para esta área estudos desenvolvidos em Portugal, esta investigação tem como fundamento analisar a influência que a perturbação da função visual em indivíduos com 65 ou mais anos tem na qualidade de vida relacionada com a saúde. Estudaram-se também as características sócio-demográficas dos indivíduos participantes, da saúde visual e a percepção da saúde geral, bem como identificaram se junto dos idosos participantes e de Médicos especialistas em Medicina Geral e Familiar perspectivas sobre perturbações da função visual e envelhecimento. Desenho de estudo: Estudo transversal, caso-controlo e descritivo-exploratório. Materiais e Métodos: A partir de uma população de 112 indivíduos com 65 ou mais anos, frequentadores de várias instituições de apoio social do Concelho de Loures e de idosos frequentadores/institucionalizados da Mansão de Santa Maria de Marvila, unidade orgânica da Fundação D. Pedro IV, foram incluídos no estudo 90 (80,4%). Após consentimento informado, procedeu-se à avaliação da função visual nos Laboratórios de Ortóptica da Escola Superior de Tecnologia de Saúde de Lisboa, onde também se aplicaram o Questionário de Funcionamento Visual VFQ-25 e uma questão aberta para o tipo de dificuldades de visão sentidas durante o último ano. Aplicou-se ainda, em ambiente virtual, uma pergunta aberta a Médicos especialistas em Medicina Geral e Familiar para aspectos relacionados com o diagnóstico/suspeita relativamente tardio de perturbações da função visual. Procedeu-se ao tratamento descritivo das características sócio-demográficas, da percepção de saúde geral e da saúde visual e das respostas dos idosos e dos médicos. Analisou-se a relação entre função visual e qualidade de vida relacionada com a saúde aplicando o teste não-paramétrico de Mann-Whitney. Resultados: Constatou-se que os indivíduos da amostra são maioritariamente do género feminino (71,1%), casados (41,1%), detentores de baixos níveis de escolaridade em que 63,3% apenas frequentou/concluiu o 1º ciclo do ensino básico e quase na sua totalidade reformados (88,9%). Verifica-se que 77,8% dos idosos percepciona a sua saúde geral como razoável ou boa. Da mesma forma, 86,7% dos indivíduos têm a função visual alterada devido principalmente à alteração da acuidade visual para longe (86,7%), registando-se que 65,5% dos olhos tinham uma acuidade visual igual ou superior a 5/10. Outras dimensões que contribuíram para a alteração da função visual contam-se a sensibilidade ao contraste (63,3%), estereopsia (51,1%), visão cromática (38,9%) e a motilidade ocular (25,6%). Obtiveram-se assim maiores pontuações para as diversas escalas do questionário VFQ-25 em indivíduos com função visual alterada exceptuando nas escalas actividades de perto, condução e dependência. Verificou-se portanto existir relação entre alteração da função visual e perturbação da qualidade de vida relacionada com a saúde. À questão colocada aos idosos, 42,6% não manifestou qualquer razão para que visse mal/sentisse dificuldades de visão durante o último ano. A diminuição da acuidade visual para longe/perto foi referida por 20,5% dos indivíduos, seguido pela deterioração do estado de saúde geral e ocular por 15%. As respostas do Médicos especialistas em Medicina Geral e Familiar sobre razões para a suspeita/diagnóstico relativamente tardia das perturbações da função visual, indicam a iliteracia dos idosos para a saúde da visão e semiologia ocular (34%), a baixa formação/informação dos Médicos de Medicina Geral e Familiar na área da saúde da visão (22%) e a pouca acessibilidade e resposta demorada/ineficaz dos serviços de oftalmologia do SNS (20%) como principais motivos para os assuntos questionados.Conclusões: As alterações do sistema visual com impacto na função e no funcionamento visual alteram a qualidade de vida relacionada com a saúde, devido principalmente à alteração da acuidade visual para longe. Os idosos do estudo não valorizam a saúde visual ao percepcionarem positivamente a saúde geral e a saúde visual relativamente à avaliação da função visual. É fundamental definir estratégias e programas de literacia para a saúde da visão para toda a população, não apenas destinados a idosos. Sugere-se repensar o modelo de formação base dos Médicos com especial incidência na área da saúde da visão, com necessidades sentidas de formação/informação. As respostas obtidas dos idosos e dos Médicos indicaram existir fragilidades na saúde da visão, necessário repensar o modelo de prestação de cuidados de saúde nesta área. Esta investigação permitiu ao autor uma reflexão sobre as temáticas relacionadas com o envelhecimento levando a uma mudança de atitudes e comportamento na abordagem profissional a indivíduos idosos, promovendo autonomia nas escolhas e decisões em questões de saúde, na criação de estratégias para lidar com o problema de visão e na adaptação à nova condição de saúde da visão.---------------ABSTRACT:Purpose: The vision is a fundamental sense in the individual's relationship with the most varied environments, a central element in the functionality and independence of the elderly, any disturbance of visual function causes limitations in quality of life. The current demographic changes are characterized by progressive aging of population, there has been a parallel increase in the prevalence of disorders of the visual system by changing the visual function and functioning. Whereas the elderly are more dependent on vision, and there are no studies in this area developed in Portugal, this research is based analyze the influence that the disturbance of visual function in subjects aged 65 years or more has on the health related quality of life. We studied also the socio-demographic characteristics of the subjects, the eye health and general health perception, and identified themselves with the elderly participants and medical specialists in Family General Medicine perspective on disorders of visual function and aging. Design: Cross-sectional study, case control, descriptive and exploratory. Methods: From a population of 112 people with 65 or more years, regulars of various social welfare institutions of the Municipality of Loures and elderly regulars/institutionalized the Mansion of Santa Maria de Marvila, organic unity of the Foundation D. Pedro IV, were included 90 (80.4%). After informed consent, proceeded to the assessment of visual function in the Laboratories of Orthopticsof the School of Health Technology of Lisbon, where he also applied the Visual Functioning Questionnaire VFQ-25 and an open question for the type of vision difficulties experienced during the last year. Was applied also in a virtual environment, an open question to Doctors specialists in family general medicine related to the diagnosis/suspected relatively late disturbance of visual function. We carried out the descriptive treatment of socio-demographic characteristics, perception of general health and eye health and the responses of older people and doctors. We analyzed the relationship between visual function and quality of life related to health by applying the nonparametric Mann-Whitney test. Results: We found that individuals in the sample are mostly female (71.1%), married (41.1%), holders of low levels of education in which only 63.3% frequented / completed the 1st cycle of primary and almost entirely retired (88.9%). It is found that 77.8% of the elderly perceive their general health as fair or good. Likewise, 86.7% of individuals have altered vision mainly due to the change in visual acuity away (86.7%),up to 65.5% of eyes had a visual acuity of 5/10 or greater. Other dimensions that contributed to the alteration of visual function include contrast sensitivity (63.3%), stereopsis (51.1%), color vision (38.9%) and ocular motility (25.6%). There was thus obtained the highest scores for different scales of the questionnaire VFQ-25 in patients with altered vision except for scales related to near activities, driving and dependence. It is therefore a relationship between alteration in visual function and disturbance of quality of life related to health. To question for the elderly, 42.6% expressed no reason to see evil/feel difficulty seeing over the last year. The decrease in visual acuity for distance/near was reported by 20.5% of subjects, followed by the deterioration of general health and eye for 15%. The responses of medical specialists in general practice about reasons for the suspicion/diagnosis relatively late disturbance of visual function, indicate the illiteracy of the elderly for healthy vision and ocular semiology (34%), low education/information for Doctors in the health of vision (22%) and poor accessibility and response timeconsuming/ inefficient NHS ophthalmology services (20%) as main reasons for the subjects questioned. Conclusion: Changes in the visual system with an impact on visual function and the functioning change the health related quality of life, mainly due to the change in distance visual acuity. Older people do not value the visual health perceiving the general health and eye health positively relatively of visual function. It is essential to define strategies and literacy programs for eye health for the entire population, not just for the elderly. It is suggested reconsider the model of basic training of Doctors with special focus on the health of the vision, with special needs sensed training/information. The responses of older people and doctors have indicated there is weakness in eye health, need to rethink the model of health care in this area. This research allowed the author to reflect on issues related to aging leading to a change in attitudes and behavior in professional approach to the elderly, promoting autonomy in choices and decisions in health issues, creating strategies to deal with the problem of vision and adaptation to new conditions of eye health.
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Dissertação para obtenção do Grau de Mestre em Engenharia Electrotécnica e de Computadores
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RESUMO: A reprogramação celular permite que uma célula somática seja reprogramada para outra célula diferente através da expressão forçada de factores de transcrição (FTs) específicos de determinada linhagem celular, e constitui uma área de investigação emergente nos últimos anos. As células somáticas podem ser experimentalmente manipuladas de modo a obter células estaminais pluripotentes induzidas (CEPi), ou convertidas directamente noutro tipo de célula somática. Estas descobertas inovadoras oferecem oportunidades promissoras para o desenvolvimento de novas terapias de substituição celular e modelos de doença, funcionando também como ferramentas valiosas para o estudo dos mecanismos moleculares que estabelecem a identidade celular e regulam os processos de desenvolvimento. Existem várias doenças degenerativas hereditárias e adquiridas da retina que causam deficiência visual devido a uma disfunção no tecido de suporte da retina, o epitélio pigmentar da retina (EPR). Uma destas doenças é a Coroideremia (CHM), uma doença hereditária monogénica ligada ao cromossoma X causada por mutações que implicam a perda de função duma proteína com funções importantes na regulação do tráfico intracelular. A CHM é caracterizada pela degenerescência progressiva do EPR, assim como dos foto-receptores e da coróide. Resultados experimentais sugerem que o EPR desempenha um papel importante na patogénese da CHM, o que parece indicar uma possível vantagem terapêutica na substituição do EPR nos doentes com CHM. Por outro lado, existe uma lacuna em termos de modelos in vitro de EPR para estudar a CHM, o que pode explicar o ainda desconhecimento dos mecanismos moleculares que explicam a patogénese desta doença. Assim, este trabalho focou-se principalmente na exploração das potencialidades das técnicas de reprogramação celular no contexto das doenças de degenerescência da retina, em particular no caso da CHM. Células de murganho de estirpe selvagem, bem como células derivadas de um ratinho modelo de knockout condicional de Chm, foram convertidos com sucesso em CEPi recorrendo a um sistema lentiviral induzido que permite a expressão forçada dos 4 factores clássicos de reprogramação, a saber Oct4, Sox2, Klf4 e c-Myc. Estas células mostraram ter equivalência morfológica, molecular e funcional a células estaminais embrionárias (CES). As CEPi obtidas foram seguidamente submetidas a protocolos de diferenciação com o objectivo final de obter células do EPR. Os resultados promissores obtidos revelam a possibilidade de gerar um valioso modelo de EPR-CHM para estudos in vitro. Em alternativa, a conversão directa de linhagens partindo de fibroblastos para obter células do EPR foi também abordada. Uma vasta gama de ferramentas moleculares foi gerada de modo a implementar uma estratégia mediada por FTs-chave, seleccionados devido ao seu papel fundamental no desenvolvimento embrionário e especificação do EPR. Conjuntos de 10 ou menos FTs foram usados para transduzir fibroblastos, que adquiriram morfologia pigmentada e expressão de alguns marcadores específicos do EPR. Adicionalmente, observou-se a activação de regiões promotoras de genes específicos de EPR, indicando que a identidade transcricional das células foi alterada no sentido pretendido. Em conclusão, avanços significativos foram atingidos no sentido da implementação de tecnologias de reprogramação celular já estabelecidas, bem como na concepção de novas estratégias inovadoras. Metodologias de reprogramação, quer para pluripotência, quer via conversão directa, foram aplicadas com o objectivo final de gerar células do EPR. O trabalho aqui descrito abre novos caminhos para o estabelecimento de terapias de substituição celular e, de uma maneira mais directa, levanta a possibilidade de modelar doenças degenerativas da retina com disfunção do EPR numa placa de petri, em particular no caso da CHM.---------------ABSTRACT: Cellular reprogramming is an emerging research field in which a somatic cell is reprogrammed into a different cell type by forcing the expression of lineage-specific transcription factors (TFs). Cellular identities can be manipulated using experimental techniques with the attainment of pluripotency properties and the generation of induced Pluripotent Stem (iPS) cells, or the direct conversion of one somatic cell into another somatic cell type. These pioneering discoveries offer new unprecedented opportunities for the establishment of novel cell-based therapies and disease models, as well as serving as valuable tools for the study of molecular mechanisms governing cell fate establishment and developmental processes. Several retinal degenerative disorders, inherited and acquired, lead to visual impairment due to an underlying dysfunction of the support cells of the retina, the retinal pigment epithelium (RPE). Choroideremia (CHM), an X-linked monogenic disease caused by a loss of function mutation in a key regulator of intracellular trafficking, is characterized by a progressive degeneration of the RPE and other components of the retina, such as the photoreceptors and the choroid. Evidence suggest that RPE plays an important role in CHM pathogenesis, thus implying that regenerative approaches aiming at rescuing RPE function may be of great benefit for CHM patients. Additionally, lack of appropriate in vitro models has contributed to the still poorly-characterized molecular events in the base of CHM degenerative process. Therefore, the main focus of this work was to explore the potential applications of cellular reprogramming technology in the context of RPE-related retinal degenerations. The generation of mouse iPS cells was established and optimized using an inducible lentiviral system to force the expression of the classic set of TFs, namely Oct4, Sox2, Klf4 and c-Myc. Wild-type cells, as well as cells derived from a conditional knockout (KO) mouse model of Chm, were successfully converted into a pluripotent state, that displayed morphology, molecular and functional equivalence to Embryonic Stem (ES) cells. Generated iPS cells were then subjected to differentiation protocols towards the attainment of a RPE cell fate, with promising results highlighting the possibility of generating a valuable Chm-RPE in vitro model. In alternative, direct lineage conversion of fibroblasts into RPE-like cells was also tackled. A TF-mediated approach was implemented after the generation of a panoply of molecular tools needed for such studies. After transduction with pools of 10 or less TFs, selected for their key role on RPE developmental process and specification, fibroblasts acquired a pigmented morphology and expression of some RPE-specific markers. Additionally, promoter regions of RPE-specific genes were activated indicating that the transcriptional identity of the cells was being altered into the pursued cell fate. In conclusion, highly significant progress was made towards the implementation of already established cellular reprogramming technologies, as well as the designing of new innovative ones. Reprogramming into pluripotency and lineage conversion methodologies were applied to ultimately generate RPE cells. These studies open new avenues for the establishment of cell replacement therapies and, more straightforwardly,raise the possibility of modelling retinal degenerations with underlying RPE defects in apetri dish, particularly CHM.
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ABSTRACT: Background. In India, prevalence rates of dementia and prodromal amnestic Mild Cognitive Impairment (MCI) are 3.1% and 4.3% respectively. Most Indians refer to the full spectrum of cognitive disorders simply as ‘memory loss.’ Barring prevention or cure, these conditions will rise rapidly with population aging. Evidence-based policies and practices can improve the lives of affected individuals and their caregivers, but will require timely and sustained uptake. Objectives. Framed by social cognitive theories of health behavior, this study explores the knowledge, attitudes and practices concerning cognitive impairment and related service use by older adults who screen positive for MCI, their primary caregivers, and health providers. Methods. I used the Montreal Cognitive Assessment to screen for cognitive impairment in memory camps in Mumbai. To achieve sampling diversity, I used maximum variation sampling. Ten adults aged 60+ who had no significant functional impairment but screened positive for MCI and their caregivers participated in separate focus groups. Four other such dyads and six doctors/ traditional healers completed in-depth interviews. Data were translated from Hindi or Marathi to English and analyzed in Atlas.ti using Framework Analysis. Findings. Knowledge and awareness of cognitive impairment and available resources were very low. Physicians attributed the condition to disease-induced pathology while lay persons blamed brain malfunction due to normal aging. Main attitudes were that this condition is not a disease, is not serious and/or is not treatable, and that it evokes stigma toward and among impaired persons, their families and providers. Low knowledge and poor attitudes impeded help-seeking. Conclusions. Cognitive disorders of aging will take a heavy toll on private lives and public resources in developing countries. Early detection, accurate diagnosis, systematic monitoring and quality care are needed to compress the period of morbidity and promote quality of life. Key stakeholders provide essential insights into how scientific and indigenous knowledge and sociocultural attitudes affect use and provision of resources.
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Introduction Thrombocytopenia is a common complication in malaria patients. The relationship between abnormal platelet profile and clinical status in malaria patients is unclear. In low and unstable endemic regions where vivax malaria predominates, the hematologic profiles of malaria patients and their clinical utility are poorly understood. The aim of this study was to characterize the thrombograms of malaria patients from Colombia, where Plasmodium vivax infection is common, and to explore the relationship between thrombograms and clinical status. Methods Eight hundred sixty-two malaria patients were enrolled, including 533 (61.8%) patients infected with Plasmodium falciparum, 311 (36.1%) patients infected with Plasmodium vivax and 18 (2.1%) patients with mixed infections. Results The most frequently observed changes were low platelet count (PC) and high platelet distribution width (PDW), which were observed in 65% of patients; thrombocytopenia with <50,000 platelets/µL was identified in 11% of patients. Patients with complications had lower PC and plateletcrit (PT) and higher PDW values. A higher risk of thrombocytopenia was identified in patients with severe anemia, neurologic complications, pulmonary complications, liver dysfunction, renal impairment and severe hypoglycemia. The presence of thrombocytopenia (<150,000 platelets/µL) was associated with a higher probability of liver dysfunction. Conclusions Young age, longer duration of illness and higher parasitemia are associated with severe thrombocytopenia. Our study showed that thrombocytopenia is related to malaria complications, especially liver dysfunction. High PDW in patients with severe malaria may explain the mechanisms of thrombocytopenia that is common in this group of patients.
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Doctoral Thesis for PhD degree in Industrial and Systems Engineering
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Alzheimer's disease (AD) is a neurodegenerative disorder characterized by a marked decline in cognition and memory function. Increasing evidence highlights the essential role of neuroinflammatory and immune-related molecules, including those produced at the brain barriers, on brain immune surveillance, cellular dysfunction and amyloid beta (Aß) pathology in AD. Therefore, understanding the response at the brain barriers may unravel novel pathways of relevance for the pathophysiology of AD. Herein, we focused on the study of the choroid plexus (CP), which constitutes the blood-cerebrospinal fluid barrier, in aging and in AD. Specifically, we used the PDGFB-APPSwInd (J20) transgenic mouse model of AD, which presents early memory decline and progressive Aß accumulation, and littermate age-matched wild-type (WT) mice, to characterize the CP transcriptome at 3, 5-6 and 11-12months of age. The most striking observation was that the CP of J20 mice displayed an overall overexpression of type I interferon (IFN) response genes at all ages. Moreover, J20 mice presented a high expression of type II IFN genes in the CP at 3months, which became lower than WT at 5-6 and 11-12months. Importantly, along with a marked memory impairment and increased glial activation, J20 mice also presented a similar overexpression of type I IFN genes in the dorsal hippocampus at 3months. Altogether, these findings provide new insights on a possible interplay between type I and II IFN responses in AD and point to IFNs as targets for modulation in cognitive decline.
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Tese de Doutoramento em Psicologia (Especialidade de Psicologia Clínica)
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Dissertação de mestrado Internacional em Sustentabilidade do Ambiente Construído
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The Symbol Digit Modalities Test (SDMT) is a widely used instrument to assess information processing speed, attention, visual scanning, and tracking. Considering that repeated evaluations are a common need in neuropsychological assessment routines, we explored test–retest reliability and practice effects of two alternate SDMT forms with a short inter-assessment interval. A total of 123 university students completed the written SDMT version in two different time points separated by a 150-min interval. Half of the participants accomplished the same form in both occasions, while the other half filled different forms. Overall, reasonable test–retest reliabilities were found (r = .70), and the subjects that completed the same form revealed significant practice effects (p < .001, dz = 1.61), which were almost non-existent in those filling different forms. These forms were found to be moderately reliable and to elicit a similar performance across participants, suggesting their utility in repeated cognitive assessments when brief inter-assessment intervals are required.
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Dissertação de mestrado em Ciências da Comunicação (área de especialização em Audiovisuais e Multimédia)
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This research uses the textile/text axis concept as a conceptual tool to investigate the role of textile and text in contemporary women’s art practice and theorizing, investigating textile as a largely hitherto unacknowledged element in women’s art practice of the late 20th and early 21st centuries. Textile and text share a common etymological root, from the Latin textere to weave, textus a fabric. The thesis illuminates the pathways whereby textile and text played an important role in women reclaiming a speaking voice as creators of culture and signification during a revolutionary period of renewal in women’s cultural contribution and positioning. The methodological approach used in the research consisted of a comprehensive literature review, the compilation of an inventory of relevant women artists, developing a classificatory system differentiating types of approaches, concerns and concepts underpinning women’s art practice vis a vis the textile/text axis and a series of three in-depth case studies of artists Tracey Emin, Louise Bourgeois and Faith Ringgold. The thesis points to the fact that contemporary women artists and theorists have rounded their art practice and aesthetic discourse in textile as prime visual metaphor and signifier, turning towards the ancient language of textile not merely to reclaim a speaking voice but to occupy a ground breaking locus of signification and representation in contemporary culture. The textile/text axis facilitated women artists in powerfully countering a culturally inscribed status of Lacanian ‘no-woman’ (a position of abjection, absence and lack in the phallocentric symbolic). Turning towards a language of aeons, textile as fertile wellspring, the thesis identifies the methodologies and strategies whereby women artists have inserted their webs of subjectivities and deepest concerns into the records and discourses of contemporary culture. Presenting an anatomy of the textile/text axis, the thesis identifies nine component elements manifesting in contemporary women’s aesthetic practice and discourse. In this cultural renaissance, the textile/text axis, the thesis suggests, served as a complex lexicon, a system of labyrinthine references and signification, a site of layered meanings and ambiguities, a body proxy and a corporeal cartography, facilitating a revolution in women’s aesthetic praxis.
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This study analyses the area of construction and demolition waste (C & D W) auditing. The production of C&DW has grown year after year since the Environmental Protection Agency (EPA) first published a report in 1996 which provided data for C&D W quantities for 1995 (EPA, 1996a). The most recent report produced by the EPA is based on data for 2005 (EPA, 2006). This report estimated that the quantity of C&DW produced for that period to be 14 931 486 tonnes. However, this is a ‘data update’ report containing an update on certain waste statistics so any total provided would not be a true reflection of the waste produced for that period. This illustrates that a more construction site-specific form of data is required. The Department of Building and Civil Engineering in the Galway-Mayo Institute of Technology have carried out two recent research projects (Grimes, 2005; Kelly, 2006) in this area, which have produced waste production indicators based on site-specific data. This involved the design and testing of an original auditing tool based on visual characterisation and the application of conversion factors. One of the main recommendations of these studies was to compare this visual characterisation approach with a photogrammetric sorting methodology. This study investigates the application of photogrammetric sorting on a residential construction site in the Galway region. A visual characterisation study is also carried out on the same project to compare the two methodologies and assess the practical application in a construction site environment. Data collected from the waste management contractor on site was also used to provide further evaluation. From this, a set of waste production indicators for new residential construction was produced: □ 50.8 kg/m2 for new residential construction using data provided by the visual characterisation method and the Landfill Levy conversion factors. □ 43 kg/m2 for new residential construction using data provided by the photogrammetric sorting method and the Landfill Levy conversion factors. □ 23.8 kg/m2 for new residential construction using data provided by Waste Management Contractor (WMC). The acquisition of the data from the waste management contractor was a key element for testing of the information produced by the visual characterisation and photogrammetric sorting methods. The actual weight provided by the waste management contractor shows a significant difference between the quantities provided.
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Here we examine major anatomical characteristics of Corydoras aff. paleatus (Jenyns, 1842) post-hatching development, in parallel with its neurobehavioral evolution. Eleutheroembryonic phase, 4.3-8.8 days post-fertilization (dpf); 4.3-6.4 mm standard length (SL) encompasses from hatching to transition to exogenous feeding. Protopterygiolarval phase (8.9-10.9 dpf; 6.5-6.7 mm SL) goes from feeding transition to the commencement of unpaired fin differentiation, which marks the start of pterygiolarval phase (11-33 dpf; 6.8-10.7 mm SL) defined by appearance of lepidotrichia in the dorsal part of the median finfold. This phase ends with the full detachment and differentiation of unpaired fins, events signaling the commencement of the juvenile period (34-60 dpf; 10.8-18.0 mm SL). Eleutheroembryonic phase focuses on hiding and differentiation of mechanosensory, chemosensory and central neural systems, crucial for supplying the larval period with efficient escape and nutrient detection-capture neurocircuits. Protopterygiolarval priorities include visual development and respiratory, digestive and hydrodynamic efficiencies. Pterygiolarval priorities change towards higher swimming efficacy, including carangiform and vertical swimming, necessary for the high social interaction typical of this species. At the end of the protopterygiolarval phase, simple resting and foraging aggregations are seen. Resting and foraging shoals grow in complexity and participant number during pterygiolarval phase, but particularly during juvenile period.
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BACKGROUND: The number of nonagenarians and centenarians is rising dramatically, and many of them live in nursing homes. Very little is known about psychiatric symptoms and cognitive abilities other than memory in this population. This exploratory study focuses on anosognosia and its relationship with common psychiatric and cognitive symptoms. METHODS: Fifty-eight subjects aged 90 years or older were recruited from geriatric nursing homes and divided into five groups according to Mini-Mental State Examination scores. Assessment included the five-word test, executive clock-drawing task, lexical and categorical fluencies, Anosognosia Questionnaire-Dementia, Neuropsychiatric Inventory, and Charlson Comorbidity Index. RESULTS: Subjects had moderate cognitive impairment, with mean ± SD Mini-Mental State Examination being 15.41 ± 7.04. Anosognosia increased with cognitive impairment and was associated with all cognitive domains, as well as with apathy and agitation. Subjects with mild global cognitive decline seemed less anosognosic than subjects with the least or no impairment. Neither anosognosia nor psychopathological features were related to physical conditions. CONCLUSIONS: Anosognosia in oldest-old nursing home residents was mostly mild. It was associated with both cognitive and psychopathological changes, but whether anosognosia is causal to the observed psychopathological features requires further investigation.