915 resultados para ADDENBROOKE COGNITIVE EXAMINATION-REVISED (ACE-R)
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The purpose of this study was to determine the efficacy of a writing process approach for the instruction of language arts with learning disabled elementary students. A nonequivalent control group design was used. The sample included 24 students with learning disabilities who were in second and third grade. All students were instructed in resource room settings for ninety minutes per day in language arts. The students in the treatment group received instruction using the writing process steps to create complete meaningful compositions on self-chosen topics. A literature-based reading program accompanied instruction in writing to provide examples of good writing and to provide a basis for topic selection. The students in the control group received instruction through the use of the county-adopted textbooks and accompanying worksheets. The teacher followed basic textbook and curriculum guide suggestions which consisted mainly of fill in the blank and matching type exercises. The treatment group consisted of 12 students: five second-graders and seven third-graders. The control group consisted of 12 students: four second-graders and eight third-graders. All students were pretested and posttested using the Woodcock-Johnson Tests of Achievement-Revised (WJ-R ACH) for writing samples and the Woodcock Reading Mastery Test (WRMT) for reading achievement. T-tests were also done to investigate the gain from pre to post for each reading or writing variable for each group separately. The results showed a highly significant difference from pretest to posttest for all writing and reading variables for both groups. Analysis of Covariance showed that the population mean posttest achievement scores for all variables adjusted for the pretest were higher for the treatment group than those for the control group.
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Background: Autism spectrum disorder (ASD) is multifactorial and is likely the result of complex interactions between multiple environmental and genetic factors. Recently, it has been suggested that each symptom cluster of the disorder, such as poor social communication, may be mediated by different genetic influences. Genes in the oxytocin pathway, which mediates social behaviours in humans, have been studied with single nucleotide polymorphisms (SNPs) in the oxytocin receptor gene (OXTR) being implicated in ASD. This thesis examines the presence of different oxytocin receptor genotypes, and their associations with ASD and resulting social communication deficits. Methods: The relationship between four OXTR variants and ASD was evaluated in 607 ASD simplex (SPX) families. Cases were compared to their unaffected siblings using a conditional logistic approach. Odds ratios and associated 95 percent confidence intervals were obtained. A second sample of 235 individuals with a diagnosis of ASD was examined to evaluate whether these four OXTR variants were associated with social communication scores on the Autism Diagnostic Interview – Revised (ADI-R). Parameter estimates and associated 95 percent confidence intervals were generated using a linear regression approach. Multiple testing issues were addressed using false discovery adjustments. Results: The rs53576 AG genotype was significantly associated with a lower risk of ASD (OR = 0.707, 95% CI: 0.512-0.975). A single genotype (AG) provided by the rs2254298 marker was found to be significantly associated with higher social communication scores (Parameter estimate = 1.833, SE = 0.762, p = 0.0171). This association was also seen in a Caucasian only and mothers as the respondent samples. No association was significant following false discovery rate adjustments. Conclusion: The findings from these studies provide limited support for the role of OXTR SNPs in ASD, especially in social communication skills. The clinical significance of these associations remains unknown, however, it is likely that these associations do not play a role in the severity of symptoms associated with ASD. Rather, they may be important in the appearance of social deficits due to the rs2254298 markers association with enlarged amygdalas.
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Empirische studies hebben aangetoond dat bij ouderen een veilige hechting positief samenhangt met het niveau van welbevinden. Hechting is een relatief stabiel en moeilijk te beïnvloeden persoonlijk kenmerk en daarom is het belangrijk om mediatoren van het verband tussen hechting en psychologische uitkomstmaten te vinden die met interventies te beïnvloeden zijn. De vraagstelling van de studie luidde: ‘Welk verband bestaat er tussen hechting en welbevinden bij ouderen en wordt dit verband gemedieerd door mindfulness en zingeving?’. De huidige studie was een survey met één meetmoment. De 210 respondenten waren 65 jaar of ouder (M = 71.25, SD = 5.42) en thuiswonend. Daarnaast mochten ze geen ernstige geheugenproblemen of een psychiatrische stoornis hebben. Via de sneeuwbalmethode werden de respondenten mondeling of schriftelijk door de onderzoeker benaderd. De vragenlijst kon anoniem online of op papier worden ingevuld. Hechting werd gemeten met de Experiences in Close Relationships-Revised (ECR-R), mindfulness met de Five Facet Mindfulness Questionnaire (FFMQ), zingeving met de Meaning in Life Questionnaire, subschaal ‘Presence of meaning in life’ (MLQ-P) en welbevinden met de Positive Affect Negative Affect Scale (PANAS) en de Satisfaction With Life Scale (SWLS). Zowel hechtingsgerelateerde angst (‘angst’) als hechtingsgerelateerde vermijding (‘vermijding’) bleek in correlatieanalyses negatief samen te hangen met mindfulness, zingeving en welbevinden. Tussen mindfulness, zingeving en welbevinden werden positieve verbanden gevonden. De (seriële) mediatieanalyse werd uitgevoerd met behulp van de macro PROCESS 2.13. Zowel het verband tussen ‘angst’ en welbevinden als tussen ‘vermijding’ en welbevinden werd volledig (serieel) gemedieerd door mindfulness en zingeving.
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Background: Lung clearance index (LCI) has good clinimetric properties and an acceptable feasibility profile as a surrogate endpoint in Cystic Fibrosis (CF). Although most studies to date have been in children, increasing numbers of adults with CF also have normal spirometry. Further study of LCI as an endpoint in CF adults is required. Therefore, the purpose of this study was to determine the clinimetric properties of LCI over the complete age range of people with CF. Methods: Clinically stable adults and children with CF and age matched healthy controls were recruited. Results: LCI and spirometry data for 110 CF subjects and 61 controls were collected at a stable visit. CF Questionnaire-Revised (CFQ-R) was completed by 80/110 CF subjects. Fifty-six CF subjects completed a second stable visit. The LCI CV% was 4.1% in adults and 6.3% in children with CF. The coefficient of repeatability of LCI was 1.2 in adults and 1.3 in children. In both adults and children, LCI (AUCROC=0.93 and 0.84) had greater combined sensitivity and specificity to discriminate between people with CF and controls compared to FEV1 (AUCROC=0.88 and 0.60) and FEF25-75 (AUCROC=0.87 and 0.68). LCI correlated significantly with the CFQ-R treatment burden in adults (r=-0.37; p<0.01) and children (r=-0.50; p<0.01). Washout tests were successful in 90% of CF subjects and were perceived as comfortable and easy to perform in both adults and children. Conclusions: These data support the use of LCI as a surrogate outcome measure in CF clinical trials in adults as well as children.
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La présence accrue de jeunes appartenant à un groupe ethnoculturel minoritaire dans les institutions pour jeunes contrevenants au Québec est une problématique complexe et préoccupante. Lorsque les études scientifiques se penchent sur les questions liées à la délinquance juvénile et aux gangs de rue, l’accent est placé sur l’identification de groupes ethniques plus à risque de s’associer à un gang (van Gemert, Peterson, & Lien, 2008; Wortley & Tanner, 2006). L’association à un gang de rue est régulièrement considérée comme un phénomène qui toucherait principalement les groupes ethnoculturels minoritaires (Perreault & Bibeau, 2003 ; Spergel, 2009), sans toutefois préciser le rôle plus concret de l’ethnicité et de la culture dans l’association aux gangs de rue. Cette thèse, composée d’articles scientifiques, présente les résultats de deux études portant sur l’identité ethnique de jeunes contrevenants, mesurée par le Multigroup Ethnic Identity Measure – Revised (MEIM-R) de Phinney et Ong (2007). La première étude explore les effets de l’identité ethnique et de la génération d’immigration sur les comportements délinquants autorévélés de jeunes contrevenants judiciarisés. (N = 71, âge 14-20 ans). Les comportements délinquants ont été mesurés à partir du Self-Report of Offending – Revised (SRO-R) de Huizingua, Esbensen et Weihar (1991). La seconde étude explore le rôle de l’identité ethnique et de l’appartenance à un groupe de minorités racisées dans l’association autorévélée à un gang de rue et dans l’adhésion à la culture de gang (N = 69; âge 14-20 ans). L’adhésion à la culture de gang a, quant à elle, été établie à partir de la Mesure d’adhésion à la culture de gang (MACg) de Fredette (2014). Les résultats indiquent une plus forte identité ethnique chez les jeunes contrevenants issus de la première et de la seconde génération d’immigration que ceux de la troisième génération d’immigration ou plus. Lorsqu’on tient uniquement compte de l’apparence ethnique, les jeunes contrevenants appartenant à une minorité racisée présentent aussi des plus hauts scores d’identité ethnique que ceux appartenant à la majorité caucasienne. Les résultats indiquent également que les jeunes contrevenants de l’échantillon ayant immigré avant l’âge de 6 ans et qui ont tendance à présenter une identité ethnique élevée rapportent davantage de crimes contre la personne. Afin de mieux cerner les mécanismes sous-jacents à l’effet de l’identité ethnique sur les crimes reconnus plus violents, il a été convenu de prendre l’association à un gang de rue comme variable dépendante de la seconde étude. En effet, les délinquants qui se disent associés aux gangs de rue présentent une problématique de délinquance plus sévère que les autres (Laurier, Guay, Lafortune, & Toupin, 2015), notamment en ce qui a trait à la délinquance violente (Guay et al., 2015). Plus un jeune contrevenant rapporte un niveau d’exploration de l’identité ethnique élevé, plus il adhère aux dimensions signes et symboles et règles et rituels de l’adhésion à la culture de gang, et ce, peu importe son âge, ou qu’il appartienne à une minorité racisée. Cette recherche fait ressortir l’importance de s’intéresser aux questions identitaires liées à l’ethnicité, à la race et à la culture lors d’interventions auprès de jeunes contrevenants, et ce, peu importe leurs origines.
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Dissertação de Mestrado, Psicologia da Educação, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2015
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Objective: Parental chronic illness has an impact on several aspects of offspring’s life. Three major impediments to research progress in this field are undeveloped and untested theoretical frameworks, no clear conceptualization of youth caregiving, and no available instrument to assess such construct in Italian. To address these weaknesses, the aims of this PhD dissertation were: (1) to investigate the psychometric properties of the Italian version of the Young Caregiver of Parents Inventory-Revised (YCOPI-R); (2) to empirically examine a model of the effects of parental illness on youth and family functioning innovatively analyzing the role of psychological flexibility; (3) to test a refined conceptualization of youth caregiving. Methods: A total of 501 adolescents aged 11 to 24 (295 young caregivers and 206 young noncaregivers) completed a questionnaire regarding youth caregiving, parental illness, and youth adjustment. In the first study, young caregivers were compared to noncaregivers, while the other studies used only the young carers subgroup. Results: The first study indicated that the Italian version of the YCOPI-R demonstrated sound psychometric and was able to discriminate between young caregivers and noncaregivers. The second study underlined the key protective role of psychological flexibility in shaping youth adjustment and family functioning in the context of parental illness. The third study innovatively clarified the nature of youth caregiving, indicating that it is a tripartite construct related to both positive and negative youth adjustment outcomes. Conclusions. This PhD project drew attention towards youth of chronically ill parents, a segment of the young population which is presently almost completely neglected in Italy by health policies and healthcare providers. This PhD project ultimately shed light into the processes through which parental illness results in detrimental youth outcomes and highlighted avenues for interventions that target empirically supported mechanisms which ameliorate the detrimental effects of parental illness on youth.
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This study evaluated the frequency of cognitive impairment in patients with Fibromyalgia syndrome (FMS) using the Mini Mental State Examination (MMSE).
METHODS
We analyzed baseline data from all 46 patients with FMS and 92 age- and sex-matched controls per diagnosis of neuropathic (NeP) or mixed pain (MP) selected from a larger prospective study.
RESULTS
FMS had a slight but statistically significant lower score in the adjusted MMSE score (26.9; 95% CI 26.7-27.1) than either NeP (27.3; 95% CI 27.2-27.4) or MP (27.3; 27.2-27.5). The percentage of patients with congnitive impairment (adjusted MMSE
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Objective: To identify and compare perceptions of pain and how it is faced between men and women with central post-stroke pain. Methods: The participants were 25 men and 25 women of minimum age 30 years-old and minimum schooling level of four years, presenting central post-stroke pain for at least three months. The instruments used were: Mini-Mental State Examination; structured interview for the Brief Psychiatric Scale; Survey of Sociodemographic and Clinical Data; Visual Analogue Scale (VAS); Ways of Coping with Problems Scale (WCPS) in Scale; Revised Illness Perception Questionnaire (IPQ-R); and Beck Depression Inventory (BD). Results: A significantly greater number of women used the coping strategy "Turn to spiritual and religious activities" in WCPS. They associated their emotional state with the cause of pain in IPQ-R. "Distraction of attention" was the strategy most used by the subjects. Conclusion: Women used spiritual and religious activities more as a coping strategy and perceived their emotional state as the cause of pain.
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AIM: To assess the prevalence of mild cognitive impairment (MCI) in medical inpatients aged 55-85 years without known cognitive deficits, and how often ward physicians mentioned MCI in their discharge notes. Moreover, we aimed to identify variables associated with MCI and to assess the sensitivity and specificity of the Mini-Mental State Examination (MMSE) for MCI. METHODS: Two neuropsychologists administered a 60-min battery of validated tests to evaluate different cognitive domains. The diagnosis of MCI was based on a prespecified algorithm. The sensitivity and specificity of the MMSE for MCI were calculated. RESULTS: Fifteen patients showed a normal cognitive profile (21.4%), while 55 patients (78.6%) showed MCI. Ward physicians, blinded to the results of the neuropsychological evaluation, did not mention MCI in their discharge notes of any of the evaluated patients. The only variable independently associated with MCI was the MMSE. A MMSE score of < or =28 showed a sensitivity of 85.5% and a specificity of 66.7% for MCI. CONCLUSION: MCI is frequent albeit overlooked in elderly medical inpatients without previously known cognitive deficits. In view of therapies preventing the progression of MCI to dementia, MCI screening will be crucial. The MMSE represents a promising screening tool for MCI in medical inpatients.
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Organizations are increasingly relying on teams to do the work that has traditionally been done by individuals. At the same time, the environments in which these organizations and teams operate have been becoming progressively more complex and uncertain. These trends raise important questions about the factors that enable teams to adapt. In response to these questions, the current study sought to identify the cognitive, behavioral, and motivational processes and emergent states that promote a team's adaptation to unforeseen changes and novel events, and the team compositional characteristics and leadership processes that enabled these processes and emergent states. Two hundred twenty two undergraduate students from a large Southeastern University composed 74 3-person teams, and participated in a computerized decision-making simulation where each team formed the governing body (i.e., Mayor's cabinet) for two separate simulated cities, and made strategic decisions about city operations. Participants were randomly assigned to one of three roles, distributing expertise and creating mutual interdependence. External team leader sensegiving was manipulated through video recorded communications from an external team leader. Results indicate that team cognitive ability, achievement striving, and psychological collectivism, as well as external team leader sensegiving, were all related to the similarity and quality of team members' strategy-focused mental models (cognitive emergent states), and to the amount of information sharing among members (behavioral process). In turn, teams with more similar and higher quality mental models, and who shared greater levels of information, were found to have a greater ability to react and adapt to environmental changes, and to have greater levels of decision-making effectiveness. Results indicate a pattern of relationships consistent with hypotheses, and have important implications for organizations and knowledge-based teams charged with management responsibilities. Organizations should staff teams with the compositional characteristics that enable the development of similar and high quality mental models, and that promote information sharing among teammates. Similarly, organizations which train and develop leaders to engage in sensegiving behaviors enable team adaptability and promote enhanced decision-making effectiveness when faced with unforeseen changes and novel situations.
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Alzheimer’s Disease and other dementias are one of the most challenging illnesses confronting countries with ageing populations. Treatment options for dementia are limited, and the costs are significant. There is a growing need to develop new treatments for dementia, especially for the elderly. There is also growing evidence that centrally acting angiotensin converting enzyme (ACE) inhibitors, which cross the blood-brain barrier, are associated with a reduced rate of cognitive and functional decline in dementia, especially in Alzheimer’s disease (AD). The aim of this research is to investigate the effects of centrally acting ACE inhibitors (CACE-Is) on the rate of cognitive and functional decline in dementia, using a three phased KDD process. KDD, as a scientific way to process and analysis clinical data, is used to find useful insights from a variety of clinical databases. The data used are from three clinic databases: Geriatric Assessment Tool (GAT), the Doxycycline and Rifampin for Alzheimer’s Disease (DARAD), and the Qmci validation databases, which were derived from several different geriatric clinics in Canada. This research involves patients diagnosed with AD, vascular or mixed dementia only. Patients were included if baseline and end-point (at least six months apart) Standardised Mini-Mental State Examination (SMMSE), Quick Mild Cognitive Impairment (Qmci) or Activities Daily Living (ADL) scores were available. Basically, the rates of change are compared between patients taking CACE-Is, and those not currently treated with CACE-Is. The results suggest that there is a statistically significant difference in the rate of decline in cognitive and functional scores between CACE-I and NoCACE-I patients. This research also validates that the Qmci, a new short assessment test, has potential to replace the current popular screening tests for cognition in the clinic and clinical trials.
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Objective To assess the validity and the reliability of the Portuguese version of the Delirium Rating Scale-Revised-98 (DRS-R-98). Methods The scale was translated into Portuguese and back-translated into English. After assessing its face validity, five diagnostic groups (n = 64; delirium, depression, dementia, schizophrenia and others) were evaluated by two independent researchers blinded to the diagnosis. Diagnosis and severity of delirium as measured by the DRS-R-98 were compared to clinical diagnosis, Mini-Mental State Exam, Confusion Assessment Method, and Clinical Global Impressions scale (CGI). Results Mean and rnedian DRS-R-98 total scores significantly distinguished delirium from the other groups (p < 0.001). Inter-rater reliability (ICC between 0.9 and 1) and internal consistency (alpha = 0.91) were very high. DRS-R-98 severity scores correlated highly with the CGI. Mean DRS-R-98 severity scores during delirium differed significantly (p < 0.01) from the post-treatment values. The area under the curve established by ROC analysis was 0.99 and using the cut-off Value of 20 the scale showed sensitivity and specificity of 92.6% and 94.6%, respectively. Conclusion The Portuguese version of the DRS-R-98 is a valid and reliable measure of delirium that distinguishes delirium from other disorders and is sensitive to change in delirium severity, which may be of great value for longitudinal studies. Copyright (c) 2007 John Wiley & Sons, Ltd.
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The Mini-Mental State Examination (MMSE) is the most widely used instrument for the screening of cognitive impairment worldwide, but its ability to produce valid estimates of dementia in populations of low socioeconomic status and minimal literacy skills has not been adequately established. The authors investigated the psychometric properties of the MMSE in a community-based sample of older Brazilians. Cross-sectional one-phase population-based study of all residents of pre-defined areas of the city of Sao Paulo, aged 65 years or over. The Brazilian version of the MMSE was compared with DSM-IV diagnosis of dementia assessed with a harmonized one-phase procedure developed by the 10/66 Dementia Research Group. Analyses were performed with 1,933 participants of the SPAH study. Receiver operating characteristic analysis showed that the MMSE cut-point of 14/15 was associated with 78.7% sensitivity and 77.8% specificity for the diagnosis of dementia amongst participants with no formal education, and the cut-point 17/18 with 91.9% sensitivity and 89.5% specificity for those with at least 1 year of formal education (areas under the curves 0.87 and 0.94, respectively; P = 0.03). Even with these best fitting cut-points, the MMSE estimate of the prevalence of dementia was four times higher than determined by the DSM-IV criteria. Education, age, sex and income influenced MMSE scores, independently of dementia caseness. The MMSE is an adequate tool for screening dementia in older adults with minimum literacy skills, but misclassification is unacceptably high for older adults who are illiterate, which has serious consequences for research and clinical practice in low and middle income countries, where the proportion of illiteracy among older adults is high.
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Aims: To present the prevalence of cognitive and functional impairment (CFI) in community-dwelling elderly subjects from the city of Sao Paulo. Methods: The population was aged 60 years and older (n = 1,563; 68.7% women and 31.3% men) and lived in different socioeconomic areas. The following instruments were administered to the elderly: the Mini Mental State Examination and the Fuld Object Memory Evaluation. The Informant Questionnaire on Cognitive Decline in the Elderly and the Bayer-Activities of Daily Living scale were administered to an informant. Results: The prevalence of CFI (n = 250) was 16% (95% confidence interval, CI: 14.2-17.8%) or 15.8% (95% CI: 13.8-17.8%). In regression models, the increase in the odds ratio (OR) of CFI was associated with age, for elderly individuals aged 75 years or older, illiterates or with 1-4 years of schooling, and with a history of stroke and diabetes mellitus. On the other hand, for subjects with a tumor history, the OR of CFI was significantly reduced. Conclusion: CFI was high and increased at older ages and in subjects with low education. Potentially changeable factors were identified (stroke and diabetes), and the possible `protective effect` of tumor/cancer against CFI should be further investigated by longitudinal studies. Copyright (C) 2007 S. Karger AG, Basel.