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Stanciu, Oana Maria, Cristian Teodorescu, Sorin Riga, Magdalena Budişteanu, Bogdan Budişteanu, and Dan Riga. "Cognitive fragility – predictive factor for neurocognitive disorders. Methods of evaluation and prevention of cognitive fragility in clinical practice." Romanian Journal of Medical Practice 15, no. 2 (June 30, 2019): 140–43. http://dx.doi.org/10.37897/rjmp.2019.2.9.
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Dretske, Fred. "The Fragility of Reason." Dialogue 31, no. 2 (1992): 311–20. http://dx.doi.org/10.1017/s0012217300038579.
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Steven Stich's The Fragmentation of Reason will get the adrenalin pumping. At least it will for-reactionaries (like me) who cling to truth, reason and knowledge as cognitive values.Steve Stich sets himself to undermine the entire analytic tradition in epistemology. His book is infused with the spirit of the “radical epistemic reformer.” I do not think he succeeds. Reformations are hard to launch in philosophy. Nonetheless, he raises some deep and troubling issues.
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Krolak-Salmon, P. "Cognition et fragilité chez la personne âgée." Les cahiers de l'année gérontologique 4, no. 1 (March 19, 2012): 13–16. http://dx.doi.org/10.1007/s12612-012-0257-y.
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Cuéllar Álvarez, Jesús, Aguedo Medardo Treto, and Vivian Margarita Guerra Morales. "Characterization of the Functional State in Fragile Bigger Adults from the Medical Practice." General Medicine and Clinical Practice 1, no. 2 (October 22, 2018): 01–03. http://dx.doi.org/10.31579/2639-4162/009.
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Context: the fragility of the elderly served in a community health area and to characterize elderlies according to fragility criteria. Objective: to characterize the functional state in fragile bigger adults from the medical practice. Material and Methods: a descriptive, cross-sectional investigation with a quantitative approach was carried out between April 2017 and April 2018. Results: prevailed the alterations of mobility and balance in 54,8 %, only 16,1 % was alterations of the emotional state and 29,0 % was alterations functional cognitive. Conclusion: the presence of several fragility criteria such as elderlies older female sex with associated pathologies as hypertension.
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Kupske, Juliedy Waldow, Fernanda Basílio Uggeri, Leticia Flores Trindade, Natascha Fill Izolan, Kalina Durigon Keller, Paulo Ricardo Moreira, and Rodrigo De Rosso Krug. "Relação da fragilidade com variáveis clínicas de pacientes com insuficiência renal crônica." Revista Recien - Revista Científica de Enfermagem 11, no. 33 (March 29, 2021): 169–77. http://dx.doi.org/10.24276/rrecien2021.11.33.169-177.
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Relacionar a fragilidade com variáveis clínicas de pacientes com Insuficiência Renal Crônica. Pesquisa transversal de caráter analítico, de abordagem quantitativa, com pacientes portadores de Insuficiência Renal Crônica em tratamento hemodialítico. Como instrumento de avaliação utilizou-se o prontuário físico funcional, e questionários para avaliação de fragilidade, função cognitiva, atividades de vida diária, depressão e atividade física no lazer, sendo os mesmos analisados por estatística descritiva e teste de correlação linear de Spearman, considerou-se p≤0,05. O aumento da fragilidade relacionou-se com o avanço da idade, com a redução da força de membros inferiores e da flexibilidade, além da redução da função cognitiva, dependência para a realização das atividades básicas de vida diária, bem como de sintomas depressivos. A fragilidade é uma síndrome frequente em paciente em HD, dessa forma, a avaliação e monitoramento das condições de saúde é essencial a fim de proporcionar uma melhor qualidade de vida a esta população.Descritores: Insuficiência Renal Crônica, Fragilidade, Hemodiálise. Relationship of fragility with clinical variables of patients with chronic kidney insufficiencyAbstract: To relate frailty with clinical variables of patients with Chronic Renal Failure. Cross-sectional research of an analytical character, with a quantitative approach, with patients with chronic renal failure undergoing hemodialysis. As an assessment instrument, the functional physical record and questionnaires were used to assess frailty, cognitive function, activities of daily living, depression and leisure-time physical activity, which were analyzed using descriptive statistics and Spearman's linear correlation test, considered up p≤0.05. The increase in frailty was related to advancing age, with the reduction of strength of the lower limbs and flexibility, in addition to the reduction of cognitive function, dependence for performing basic activities of daily living, as well as depressive symptoms. Frailty is a frequent syndrome in HD patients, so the evaluation and monitoring of health conditions is essential in order to provide a better quality of life for this population.Descriptors: Chronic Kidney Failure, Fragility, Hemodialysis. Relación de fragilidad con variables clínicas de pacientes con insuficiencia crónica de riñónResumen: Relacionar la fragilidad con las variables clínicas de pacientes con insuficiencia renal crónica. Investigación analítica transversal, con un enfoque cuantitativo, con pacientes con insuficiencia renal crónica sometidos a hemodiálisis. Como herramienta de evaluación, el registro físico funcional y los cuestionarios se utilizaron para evaluar la fragilidad, la función cognitiva, las actividades de la vida diaria, la depresión y la actividad física en el tiempo libre, que se analizaron mediante estadística descriptiva y la prueba de correlación lineal de Spearman arriba p≤0.05. El aumento de la fragilidad se relacionó con el avance de la edad, con la reducción de la fuerza de las extremidades inferiores y la flexibilidad, además de la reducción de la función cognitiva, la dependencia para realizar actividades básicas de la vida diaria, así como los síntomas depresivos. La fragilidad es un síndrome frecuente en pacientes con EH, por lo que la evaluación y el monitoreo de las condiciones de salud son esenciales para proporcionar una mejor calidad de vida a esta población.Descriptores: Insuficiencia Renal Crónica, Fragilidad, Hemodiálisis.
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Au, Anita, Martine T. E. Puts, John D. Fletcher, Nadia Sourial, and Howard Bergman. "Frailty Markers Predicting Emergency Department Visits in a Community-Dwelling Sample of Vulnerable Seniors in Montreal." Canadian Journal on Aging / La Revue canadienne du vieillissement 30, no. 4 (October 3, 2011): 647–55. http://dx.doi.org/10.1017/s0714980811000511.
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RÉSUMÉLa fragilité met les individus à un risque accru de mauvaise santé. Les personnes âgées consomment une quantité disproportionnée des ressources du service des urgence [SU]. Afin d’étudier la relation entre les marqueurs de fragilité et l’effet sur l’utilisation des services des urgence par les personnes âgées vivant dans les communautés, nous avons mené une analyse secondaire d’un essai prospectif randomisé contrôlé de 22 mois à Montreal, au Canada, en utilisant la base de données du Système de services intégrés pour personnes âgées en perte d’autonomie (SIPA). Nous avons evalué un échantillon de 565 individus, avec cinq marqueurs de fragilité : l’activité physique, la force, la cognition, l’énérgie et la mobilité. Une régression logistique univariée et multivariée a été réalisée afin d’évaluer la relation potentielle entre les marqueurs de fragilité et les visites aux urgences. Les résultats ont révelé que 70 pour cent des participants avaient au moins trois marqueurs de fragilité. Cependant, aucune relation n’a été trouvée entre les marqueurs de fragilité et les visites aux urgences. Ces résultats suggèrent, donc, que parmi les personnes âgées fonctionellement sévèrement handicapés au sein des communautés, la présence de marqueurs de fragilité ne semble pas prévoir les visites aux urgences.
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Khan, Mohammad Zahidul Islam, and Dominik Zaum. "A Structural Explanation of State Fragility: Theorizing the Causal Pathways." Making of Contemporary Maldives: Isolation, Dictatorship and Democracy 1, no. 1 (July 1, 2020): 1–27. http://dx.doi.org/10.52823/ewnm1242.
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Any global structure comprises of ideational and material elements. To put the idea into practice, members of the global community formulate rules and regulations and marshal resources to build capacities and institutions that can affect states and societies. Although the effects of the global structures on the state fragility are increasingly being recognized, the pathways through which they can affect the states contributing to its fragility or strengthening its resilience have been rarely examined. This paper aims at filling the void in the literature by offering a structural explanation of state fragility. The post 9/11 structure of the Global War on Terrorism (GWoT) has been taken as a proxy to theorize the pathways. It argues that the ideational and material factors of the GWoT operate through: (i) the cognitive pathway shaping the states’ thinking, interpreting and reasoning process (ii) the regulatory pathway creating demand for policy coordination, cooperation and compatible legal and procedural instruments for counter terrorism (CT) and their compliance (iii) the capability pathway shaping the states’ coercive capability, institutions and CT alliance building. The theorized pathways are illustrated through schematic diagrams showing how they can impact the states’ legitimacy and capacity dimensions contributing to the increase or decrease of the state fragility to facilitate their tracing in individual case studies. Finally, the paper makes comparative analysis of the cognitive, regulatory and capability pathways highlighting their relationship and relative significance.
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Soric, Gabriela, Felicia Lupascu-Volentir, Ana Popescu, Elena Cosciug, Ana Popa, Irina Stoicova, and Anatolie Negara. "Nutritional status and determinants of malnutrition in institutionalized elderly people, provisional data." Public Health, Economy and Management in Medicine, no. 2(89) (August 2021): 21–25. http://dx.doi.org/10.52556/2587-3873.2021.2(89).04.
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Nutrition is an important factor for health, physical and cognitive function, vitality, quality of life and longevity. Elderly people oft en have low food intake, induced by multifactorial causes, as a result, malnutrition is an independent risk factor for increased morbidity and mortality, regardless of the underlying pathologies (chronic organ failure, cognitive impairment, cancer, cardiovascular disease, type 2 diabetes etc.) including overweight or obese subjects.The prevalence of malnutrition varies from 4% to 10% in the elderly population from the community, from 15% to 38% for institutionalized elderly people and from 30% to 70% for hospitalized ones. The purpose of this study was to assess the nutritional status of institutionalized elderly people and establish correlations between the determinants of malnutrition and fragility syndrome.Th e epidemiological study is part of the project 20.80009.8007.25 “Fragility: diagnosis and prophylaxis in relation to medicopsychosocial problems of the vulnerable elderly”, included 50 patients institutionalized in the Republican Asylum for the Disabled and Retired in Chisinau.All persons were examined by the complex geriatric evaluation, approved by the order of the Ministry of Health no. 619 of 07.09.2010. According to the results, both malnutrition and the risk of malnutrition were high in institutionalized elderly people.Among the determinants of malnutrition, the highest association had the number of concomitant diseases, decreased functionality of the elderly, the presence of depression syndrome and cognitive disorders. At the same time, the malnutrition syndrome correlated with the fragility criteria but also with the degree of severity of frailty of the institutionalized elderly people.
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St. John, Philip D., Patrick R. Montgomery, and Suzanne L. Tyas. "Social Position and Frailty." Canadian Journal on Aging / La Revue canadienne du vieillissement 32, no. 3 (August 20, 2013): 250–59. http://dx.doi.org/10.1017/s0714980813000329.
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RÉSUMÉCette étude visait à déterminer (1) si des mesures de position sociale sont associées à la fragilité, (2) si une association observée entre la position sociale et la fragilité est un effet de seuil ou de gradient, et (3) si une relation observée est indépendante des facteurs de confusion possibles. Les données ont été tirées d’un échantillon de 1 751 adultes, habitants des communautés, âgés de 65 ans et plus, habitant la province canadienne de Manitoba en 1991. On a utilisé, comme mesures de la position sociale l’éducation, et la suffisance et la satisfaction du revenu selon auto-évaluation personnelle. La précarité a été classée selon la perte fontionnelle, la cognition et l’incontinence urinaire. Des analyses de régressions multiples ont révelés, après ajustement pour les facteurs possibles de confusion, que toutes les mesures de la position sociale étaient fortement associées à la fragilité par gradient d’effet, plutôt que d’effet de seuil. Nous concluons que les gradients sociaux de la fragilité sont présents chez les adultes âgés, même si un mécanisme causatif n’est pas encore clair.
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Kennedy, Grace E. M., Parvathy Mohandas, Lesley A. Anderson, Maurice Kennedy, and Denise S. L. Shirley. "Improving Identification of Cognitive Impairment in Fragility Fracture Patients: Impact of Educational Guidelines on Current Practice." Geriatric Orthopaedic Surgery & Rehabilitation 11 (January 1, 2020): 215145932093509. http://dx.doi.org/10.1177/2151459320935095.
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Introduction: Cognitive impairment can hinder a fracture patient’s capacity to consent to surgery and negatively impact their postoperative recovery and rehabilitation. National guidelines recommend screening for cognitive impairment upon admission, and the Abbreviated Mental Test Score (AMTS) is a commonly used tool for this. This project aimed to assess current practice regarding documentation of AMTS among frail fracture patients upon admission and to improve AMTS documentation following a simple intervention. Methods: Baseline data were obtained by inpatient chart review throughout November to December 2018 in a district general hospital with emergency fracture services. All patients admitted with a fragility hip fracture and patients over 65 years with any fracture were included. National guidelines and baseline results were then distributed among junior doctors. Following an intervention, further data were collected throughout January to February 2019. Results: Preintervention, 40 suitable patients (mean age: 82 years) were identified; 9 (22.0%) of whom had an AMTS recorded upon admission. Among the hip fracture subgroup (n = 25), 7 (26.9%) had an AMTS recorded. Postintervention, 39 patients (mean age: 80 years) were identified; 15 (38.5%) of whom had an AMTS recorded. Among the hip fracture subgroup (n = 30), 11 (36.7%) had an AMTS recorded. Statistical analysis demonstrated a significant improvement in AMTS documentation both among the overall cohort ( P = .001) and hip fracture patients ( P = .019). No significant association was found between AMTS documentation and patient age ( P = .566), grade of admitting doctor ( P = .058), or prior cognitive/mental health disorder ( P = .256). Discussion: A small yet significant improvement in AMTS documentation among elderly/hip fracture patients was observed following distribution of educational material. Further work should explore the effect of cognitive impairment on outcomes related to orthopedic injuries beyond hip fractures.
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Park, Jin-Hyuck, and Sang Ah Lee. "The Fragility of Temporal Memory in Alzheimer’s Disease." Journal of Alzheimer's Disease 79, no. 4 (February 16, 2021): 1631–46. http://dx.doi.org/10.3233/jad-200892.
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Background: Although episodic memory impairment is one of the hallmarks of Alzheimer’s disease (AD), the relative decline in the components of episodic memory (What, Where, and When) and the effects of cognitive training on each of them are still unknown. Objective: We aimed to independently assess the impairment in each component of episodic memory in early to moderate AD and address whether it can be enhanced through active, spatiotemporal episodic training. Methods: A non-verbal scene-based episodic memory task was developed to assess the ability to remember What, Where, and When information. Experiment 1 tested whether this task can differentiate AD subjects (N = 16) from healthy controls (N = 16). In Experiment 2, 13 AD subjects underwent 16 training sessions, followed by a re-administration of the scene-based memory task. Experiment 3 tested 42 healthy older adults and 51 younger adults on the same task to investigate the effects of normal aging. Results: Of the three components, When memory had the highest predictive power in distinguishing AD from normal aging. Following training of AD subjects, only Where memory improved. Only What memory revealed a significant decline in healthy subjects from 65–85 years of age. Conclusion: These findings shed new light on the importance of the temporal component of episodic memory as a behavioral marker of AD. The selective improvement of spatial but not temporal memory through training further demonstrates the fragility of temporal memory even in early AD. Neuroscientific research is needed to distinguish whether the Where component was enhanced by improvements in hippocampal spatial representation or by other compensatory mechanisms.
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Soto-Faraco, Salvador, Sharon Morein-Zamir, and Alan Kingstone. "On audiovisual spatial synergy: The fragility of the phenomenon." Perception & Psychophysics 67, no. 3 (April 2005): 444–57. http://dx.doi.org/10.3758/bf03193323.
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Tordjman, Sylvie, Maria Pereira Da Costa, and Silke Schauder. "Rethinking Human Potential in Terms of Strength and Fragility: A Case Study of Michael Jackson." Journal for the Education of the Gifted 43, no. 1 (January 8, 2020): 61–78. http://dx.doi.org/10.1177/0162353219894645.
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The case study of Michael Jackson illustrates the concepts of high potential, talent, and precocity in the musical domain. Studying this case of exceptional musical talent highlights the usefulness of a multidimensional approach to exploring human potential, which is not limited to academic abilities. It offers a better understanding of the process of transforming a gift into talent and allows us to examine the asynchronies observed in some high-potential individuals between extreme talent and impaired socioaffective development—the interplay between strength and fragility where cognitive functioning cannot be dissociated from emotional functioning.
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Ghafoor, Huma, and Insoo Koo. "Cognitive Routing in Software-Defined Maritime Networks." Wireless Communications and Mobile Computing 2020 (November 21, 2020): 1–15. http://dx.doi.org/10.1155/2020/8820838.
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Due to the constantly changing sea surface, there is a high risk of link fragility caused by sea waves when different marine users are intended to establish stable links for communication. To ensure stability with less delay, finding a stable route is one of the crucial aspects of maritime networks. In order to achieve this aim, we propose a routing protocol for cognitive maritime networks based on software-defined networking (SDN). This SDN-based cognitive routing protocol provides stable routes among different marine users. To provide the global view of the whole network, a main controller is placed close to the seashore, whereas the localized views are provided by the cluster heads. Autonomous surface vehicles are used as gateways under sparse network conditions to collect and transport data among clusters, and to and from the main controller. This is an SDN-based ship-to-ship communication scheme where two ships can only establish a link when they not only have consensus about a common idle channel but are also within the communication range of each other. We perform extensive simulations to test the proposed scheme with different parameters and find better performance in comparison with both SDN-based and non-SDN-based schemes in terms of end-to-end delay, packet delivery ratio, and routing overhead ratio.
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Gilboa, Asaf. "Long-term fragility: Interference susceptibility may be an inherent characteristic of memory traces acquired through fast mapping." Cognitive Neuroscience 10, no. 4 (March 21, 2019): 218–20. http://dx.doi.org/10.1080/17588928.2019.1593122.
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Wolters, Nigel C. W., and Diane J. Schiano. "On listening where we look: The fragility of a phenomenon." Perception & Psychophysics 45, no. 2 (March 1989): 184–86. http://dx.doi.org/10.3758/bf03208053.
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Fukushima-Nakayama, Y., Takehito Ono, M. Hayashi, M. Inoue, H. Wake, Takashi Ono, and T. Nakashima. "Reduced Mastication Impairs Memory Function." Journal of Dental Research 96, no. 9 (June 16, 2017): 1058–66. http://dx.doi.org/10.1177/0022034517708771.
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Mastication is an indispensable oral function related to physical, mental, and social health throughout life. The elderly tend to have a masticatory dysfunction due to tooth loss and fragility in the masticatory muscles with aging, potentially resulting in impaired cognitive function. Masticatory stimulation has influence on the development of the central nervous system (CNS) as well as the growth of maxillofacial tissue in children. Although the relationship between mastication and cognitive function is potentially important in the growth period, the cellular and molecular mechanisms have not been sufficiently elucidated. Here, we show that the reduced mastication resulted in impaired spatial memory and learning function owing to the morphological change and decreased activity in the hippocampus. We used an in vivo model for reduced masticatory stimuli, in which juvenile mice were fed with powder diet and found that masticatory stimulation during the growth period positively regulated long-term spatial memory to promote cognitive function. The functional linkage between mastication and brain was validated by the decrease in neurons, neurogenesis, neuronal activity, and brain-derived neurotrophic factor (BDNF) expression in the hippocampus. These findings taken together provide in vivo evidence for a functional linkage between mastication and cognitive function in the growth period, suggesting a need for novel therapeutic strategies in masticatory function–related cognitive dysfunction.
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Dickerson, Anne. "Using a Performance Based Assessment Tool of Everyday IADL to Determine Driving Risk in Older Adults." Innovation in Aging 4, Supplement_1 (December 1, 2020): 731. http://dx.doi.org/10.1093/geroni/igaa057.2596.
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Abstract For older adults living in rural/suburban communities, driving is often their only means of transportation. Although considered safe drivers, drivers older than 70 years have higher crash rates with fatality rates amplified due to the increased frailty/fragility. However, research evidence clearly indicates that cognitive factors contribute to driving impairment in older adults. Occupational therapists, as experts in observation of functional performance, use the Assessment of Motor and Process Skills (AMPS), for measurement of performance in everyday activities using two scales (motor and process). Previously demonstrated as a sensitive tool for cognitive changes, this presentation will summarize the research outcomes between older adults with cognitive impairment (N=57+) and without (N=53) who completed a comprehensive driving evaluation. Analysis of the two samples using receiving operating curves suggests the AMPS has potentially excellent specificity and sensitivity, specifically AUC = 0.826(0.73-0.92) for motor, AUC = 0.909(0.84-0.98) for process, and AUC = 0.936(0.88-0.99) together. Part of a symposium sponsored by Transportation and Aging Interest Group.
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Coșman, Andrei, Alexandru Pană, and Ioana Rădulescu. "Interferences between psychology and psychiatry - vulnerability versus mental fragility in schizophrenia and delusional disorder." Journal of Educational Sciences & Psychology 11 (73), no. 1 (2021): 178–92. http://dx.doi.org/10.51865/jesp.2021.1.16.
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The aim of this paper is a didactic one, namely the separation of concepts of vulnerability in psychosis, with cognitive, thinking, affective, relational and motivational patterns of patients with schizophrenia, explaining the diagnosis of emotional schizophrenia after DSM VI, which although has a long history, is still a controversial one and excluded from DSM V. The paper also discusses brief psychoses. Vulnerability in psychoses is both psychological, hereditary, genetic or potentially related to the pathology of the neurotransmitters involved, and it is also based on concepts such as: social rejection, disabilities (predominantly auditory), immigration, inability to adapt to cultural patterns, an emotional climate characterized by expressing excessive emotions, an onset with significant stressors or a postpartum hormonal situation.
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Sritharan, Duluxan, and Sridevi V. Sarma. "Fragility in Dynamic Networks: Application to Neural Networks in the Epileptic Cortex." Neural Computation 26, no. 10 (October 2014): 2294–327. http://dx.doi.org/10.1162/neco_a_00644.
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Epilepsy is a network phenomenon characterized by atypical activity at the neuronal and population levels during seizures, including tonic spiking, increased heterogeneity in spiking rates, and synchronization. The etiology of epilepsy is unclear, but a common theme among proposed mechanisms is that structural connectivity between neurons is altered. It is hypothesized that epilepsy arises not from random changes in connectivity, but from specific structural changes to the most fragile nodes or neurons in the network. In this letter, the minimum energy perturbation on functional connectivity required to destabilize linear networks is derived. Perturbation results are then applied to a probabilistic nonlinear neural network model that operates at a stable fixed point. That is, if a small stimulus is applied to the network, the activation probabilities of each neuron respond transiently but eventually recover to their baseline values. When the perturbed network is destabilized, the activation probabilities shift to larger or smaller values or oscillate when a small stimulus is applied. Finally, the structural modifications to the neural network that achieve the functional perturbation are derived. Simulations of the unperturbed and perturbed networks qualitatively reflect neuronal activity observed in epilepsy patients, suggesting that the changes in network dynamics due to destabilizing perturbations, including the emergence of an unstable manifold or a stable limit cycle, may be indicative of neuronal or population dynamics during seizure. That is, the epileptic cortex is always on the brink of instability and minute changes in the synaptic weights associated with the most fragile node can suddenly destabilize the network to cause seizures. Finally, the theory developed here and its interpretation of epileptic networks enables the design of a straightforward feedback controller that first detects when the network has destabilized and then applies linear state feedback control to steer the network back to its stable state.
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Martin, Matthew S., Brandon Huard-Nicholls, and Aaron P. Johnson. "Gaze and pupil size variability predict difficulty-level and safe intersection crosses in a driving simulator." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 65, no. 1 (September 2021): 843–47. http://dx.doi.org/10.1177/1071181321651289.
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Western populations are ageing. With age comes an increased risk of mild cognitive impairment (MCI) and fragility that leads to higher fatal car crashes. This study develops a driving simulation paradigm that seeks to detect unsafe drivers, particularly among older drivers with MCI. The paradigm includes repeated urban intersection crossings at three difficulty levels while eye movements are tracked. The internal validity of this part of the paradigm was tested with young adults ( N = 7). Results indicated that the simulator tests elicited unsafe driving behaviors that varied across difficulty and avoided ceiling and floor effects. Eye movement metrics associated with cognitive load also varied with difficulty and predicted safe crosses. The strongest predictors were gaze transition entropy, gaze variability, and pupil size entropy. These findings indicate internal validity of the tests. Future research should test the external validity of this paradigm with a larger, more diverse sample.
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Beilock, Sian L., and Thomas H. Carr. "On the fragility of skilled performance: What governs choking under pressure?" Journal of Experimental Psychology: General 130, no. 4 (2001): 701–25. http://dx.doi.org/10.1037/0096-3445.130.4.701.
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Eruslanova, K. A., N. V. Sharashkina, I. V. Permikina, A. V. Luzina, Y. S. Onuchina, V. S. Ostapenko, Y. V. Kotovskaya, O. N. Tkacheva, and N. K. Runikhina. "Centanarians of Moscow: functional, cognitive and emotional state." Russian Journal of Geriatric Medicine, no. 1 (February 14, 2020): 57–63. http://dx.doi.org/10.37586/2686-8636-1-2020-57-63.
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The long-livers of Moscow: functional, cognitive and emotional status. Aim: To evaluate the functional, cognitive and emotional state of long-livers for determining the amount of necessary assistance from social services and medical personnel.Methods: According to the register of super-long-livers of Moscow, 82 people aged from 95 to 105 years were recruited. Participants looked around at home. When visiting, the comprehensive geriatric assessment were performed for each paitent, including an assessment of the overall level of physical and instrumental activity, mental status and cognitive functions. The following questionnaires were used for the assessment: a brief scale of mental status assessment (MMSE), a geriatric scale of depression, the Barthel index (activity in everyday life), IADL (assessment of instrumental activity), to assess the quality of life, a visual assessment scale (VAS) was used.Result: The study showed that, on average, people who reached or were approaching the 100th anniversary had a high level of instrumental (15.6 +/–5.4) and daily activity (72 +/–27.8). In general, no significant decrease in cognitive functions (21.8 +/–5.6) and emotional level (6.3 +/–4.1) was detected in the study participants.Conclusion: The first data showed the uniqueness and fragility of people in this age group. Future work using a similar integrated and multidimensional approach is necessary for a better understanding of aging processes and risk factors worsening the condition of patients, ensuring an increase in the number of centenarians with a high level of life satisfaction.
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Mazzolini, Anna, Valeria Fedeli, and Grazia Concilio. "Fragilità urbane, mobilità e politiche di contrasto al Covid in Africa." TERRITORIO, no. 97 (February 2022): 61–66. http://dx.doi.org/10.3280/tr2021-097-supplementooa12928.
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Alcuni contesti urbani necessitano di una mobilità permanente e flessibile di beni e persone come condizione per la vita collettiva e il sostentamento di base. Per questi contesti la pandemia ha concretizzato sfide che non possono essere analizzate con paradigmi cognitivi di origine americo-euro-centrica.Per la città di Maputo, l'articolo riflette sulle fragilità urbane dell'Africa subsahariana, analizzando le misure di prevenzione della pandemia in relazione alla mobilità come fattore di co-produzione della città. In tal senso si ridefiniscono i concetti di urbano e dimobilità e si propongono strategie di analisi e strumenti di osservazione capillari da supportare con una oculata governance dei dati.
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Martinez-Ruiz, Adrian, Gary Cheung, Paloma Roa-Rojas, and Oscar Rosas-Carrasco. "[P1-292]: COGNITIVE FRAGILITY AND ITS ASSOCIATION WITH DEPRESSION: AN EXPLORATORY ANALYSIS IN OLDER ADULTS IN MEXICO." Alzheimer's & Dementia 13, no. 7S_Part_7 (July 2017): P363. http://dx.doi.org/10.1016/j.jalz.2017.06.308.
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Ilie, Adina Carmen, Sabinne Marie Taranu, Ramona Stefaniu, Ioana Alexandra Sandu, Anca Iuliana Pislaru, Calina Anda Sandu, Ana-Maria Turcu, and Ioana Dana Alexa. "Chronic Coronary Syndrome in Frail Old Population." Life 12, no. 8 (July 27, 2022): 1133. http://dx.doi.org/10.3390/life12081133.
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The demographic trend of aging is associated with an increased prevalence of comorbidities among the elderly. Physical, immunological, emotional and cognitive impairment, in the context of the advanced biological age segment, leads to the maintenance and precipitation of cardiovascular diseases. Thus, more and more data are focused on understanding the pathophysiological mechanisms underlying each fragility phenotype and how they potentiate each other. The implications of inflammation, sarcopenia, vitamin D deficiency and albumin, as dimensions inherent in fragility, in the development and setting of chronic coronary syndromes (CCSs) have proven their patent significance but are still open to research. At the same time, the literature speculates on the interdependent relationship between frailty and CCSs, revealing the role of the first one in the development of the second. In this sense, depression, disabilities, polypharmacy and even cognitive disorders in the elderly with ischemic cardiovascular disease mean a gradual and complex progression of frailty. The battery of tests necessary for the evaluation of the elderly with CCSs requires a permanent update, according to the latest guidelines, but also an individualized approach related to the degree of frailty and the conditions imposed by it. By summation, the knowledge of frailty screening methods, through the use of sensitive and individualized tools, is the foundation of secondary prevention and prognosis in the elderly with CCSs. Moreover, a comprehensive geriatric assessment remains the gold standard of the medical approach of these patients. The management of the frail elderly, with CCSs, brings new challenges, also from the perspective of the treatment particularities. Sometimes the risk–benefit balance is difficult to achieve. Therefore, the holistic, individualized and updated approach of these patients remains a desired objective, by understanding and permanently acquiring knowledge on the complexity of the frailty syndrome.
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Dixe, Maria dos Anjos, Carla Madeira, Silvia Alves, Maria Adriana Henriques, and Cristina Lavareda Baixinho. "Gait Ability and Muscle Strength in Institutionalized Older Persons with and without Cognitive Decline and Association with Falls." International Journal of Environmental Research and Public Health 18, no. 21 (November 3, 2021): 11543. http://dx.doi.org/10.3390/ijerph182111543.
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Falls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, and increases in pain prevalence, and other comorbidities in older populations. The objectives of the present quantitative and longitudinal study were: (a) to characterize the cognitive state and fall frequency of older persons living in nursing homes; (b) to analyze the relationship between cognitive status and some fall risk factors; and (c) to associate cognitive decline, gait ability, and muscle strength of the examined institutionalized older persons with fall occurrence and recurrence over 12 months. The participants were 204 older persons who lived in Portuguese nursing homes, and data were collected from January 2019 to February 2020 by consulting medical records and applying the following instruments: the Mini-Mental State Examination, Timed Up and Go Test, and Medical Research Council Manual Muscle Testing Scale. Fall prevalence, assessed in two periods, 12 months apart, was similar in both samples (with and without cognitive decline) and close to 42%, and the annual recurrence rate was 38.3%. Older persons with no cognitive decline showed an association between gait speed and occurrence of first fall and recurrent fall (p < 0.05). Muscle strength and use of gait aid devices were not related to falls and their recurrence, regardless of mental state.
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José LLagunes Herrero. "Retos en la UCI: El paciente muy anciano." Revista Electrónica AnestesiaR 11, no. 2 (February 28, 2019): 3. http://dx.doi.org/10.30445/rear.v11i2.725.
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Debido a las limitaciones de recursos disponibles y la divergencia en el resultado final de los pacientes muy ancianos (edad > 80 años), estos son evaluados para valorar el pronostico y el beneficio antes de proceder a su admisión en la UCI. Según los estudios de población es previsible un elevado aumento de pacientes de edad avanzada que requieran cuidados intensivos en un futuro próximo. Las decisiones de la admisión deberían orientarse según el pronóstico determinado por la fragilidad y la comorbilidad, pero con un enfoque más funcional. Siendo el índice de fragilidad un predictor independiente más significativo que la edad, la gravedad de la enfermedad e incluso la comorbilidad. La fragilidad es multidimensional, pero implica caracteristicas cognitivas y de discapacidad que ayudan en la toma de decisiones para admitir a un paciente anciano en la UCI. El estudio ICE-CUB 1 y el reciente estudio ICE-CUB 2 se mantienen los mismos resultados e implica que es necesario evaluar los posibles beneficios y daños de la admisión en la UCI de los pacientes muy ancianos. El presente articulo que solicito evaluen intenta orientar y ayudar para esa toma de decisiones en estos pacientes. ABSTRACT ICU challenges: elderly patient Due to the limitations of available resources and the divergence in the final result of very elderly patients (age> 80 years), these are evaluated to assess the prognosis and benefit before proceeding to their admission to the ICU. According to studies on population, a high increase in elderly patients requiring intensive care is foreseeable in the near future. Admission decisions should be oriented according to the prognosis determined by frailty and comorbidity, but with a more functional approach. Being the fragility index a more significant independent predictor than age, the severity of the disease and even comorbidity. Fragility is multidimensional, but it implies cognitive and physical characteristics that intervene in a decision-making process in order to admit elderly patients in the ICU. The ICE-CUB 1 study and the recent ICE-CUB 2 study reaffirm the same results and imply that it is necessary to evaluate the possible benefits and harms of the admission in the ICU of very elderly patients. The present article that I request an evaluation for is meant to be a guide for that decision-making process in these patients.
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Biswas, Shreyan, Lorenzo Corti, Stefan Buijsman, and Jie Yang. "CHIME: Causal Human-in-the-Loop Model Explanations." Proceedings of the AAAI Conference on Human Computation and Crowdsourcing 10, no. 1 (October 14, 2022): 27–39. http://dx.doi.org/10.1609/hcomp.v10i1.21985.
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Explaining the behaviour of Artificial Intelligence models has become a necessity. Their opaqueness and fragility are not tolerable in high-stakes domains especially. Although considerable progress is being made in the field of Explainable Artificial Intelligence, scholars have demonstrated limits and flaws of existing approaches: explanations requiring further interpretation, non-standardised explanatory format, and overall fragility. In light of this fragmentation, we turn to the field of philosophy of science to understand what constitutes a good explanation, that is, a generalisation that covers both the actual outcome and, possibly multiple, counterfactual outcomes. Inspired by this, we propose CHIME: a human-in-the-loop, post-hoc approach focused on creating such explanations by establishing the causal features in the input. We first elicit people's cognitive abilities to understand what parts of the input the model might be attending to. Then, through Causal Discovery we uncover the underlying causal graph relating the different concepts. Finally, with such a structure, we compute the causal effects different concepts have towards a model's outcome. We evaluate the Fidelity, Coherence, and Accuracy of the explanations obtained with CHIME with respect to two state-of-the-art Computer Vision models trained on real-world image data sets. We found evidence that the explanations reflect the causal concepts tied to a model's prediction, both in terms of causal strength and accuracy.
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McCorkle, William (Lee) W. "The fragility of science: creating dialectical space for the naturalness of religiosity in the cognitive science of culture." Religion, Brain & Behavior 3, no. 2 (June 2013): 125–28. http://dx.doi.org/10.1080/2153599x.2013.767035.
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Meira, Saulo Sacramento, Alba Benemérita Alves Vilela, Claudia Ribeiro Santos Lopes, Jeorgia Pereira Alves, and Hernane Borges de Barros Pereira. "Cognitive analysis of the social representations of suicide among hospital emergency professionals." SMAD Revista Eletrônica Saúde Mental Álcool e Drogas (Edição em Português) 16, no. 4 (August 31, 2020): 3–12. http://dx.doi.org/10.11606/issn.1806-6976.smad.2020.166424.
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Objective: to analyze the constitutive contents of the social representations of suicide by health professionals in the emergency department through an analysis of the cognitive network. Method: study based on the Theory of Social Representations carried out with 104 emergency room professionals from a hospital in Bahia, Brazil. A free word association task was conducted using the term suicide enabling the creation of a semantic network that was analyzed using the Cognitive Network Analysis model. Results: this network was composed of 42 vertices (i.e., words evoked by the professionals) and 273 edges (i.e., connections between words), with a mean degree of 13. The representational structure was formed by four dimensions (biological, affective-psychological, social, and religious) that explained the interface between the primary (i.e., central core) terms “despair,” “depression,” “disease,” “sadness,” “death,” “absence of God,” and “family fragility” and the secondary (i.e., periphery) terms “loneliness,” “lack of love,” “weakness,” “emotional distress,” “frustration,” “conflict,” “solution,” “mistake,” “fear,” “non-acceptance,” “anxiety,” “lack of control,” and “kill.” Conclusion: despite the presence of reductionist aspects, the representational structure created by the healthcare professionals of the investigated hospital conveyed the meaning and image of suicide across its multidimensional aspects, favoringchanges in individual and collective practices ...
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Beilock, Sian L., Catherine A. Kulp, Lauren E. Holt, and Thomas H. Carr. "More on the Fragility of Performance: Choking Under Pressure in Mathematical Problem Solving." Journal of Experimental Psychology: General 133, no. 4 (2004): 584–600. http://dx.doi.org/10.1037/0096-3445.133.4.584.
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Todorović, Jelena, and Mirjana Petrović-Lazić. "Sensory processing disorders in premature infants." Praxis medica 50, no. 1-2 (2021): 19–23. http://dx.doi.org/10.5937/pramed2102019t.
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Introduction. Children born prematurely have an increased risk of immediate medical complications, as well as socioemotional, cognitive, linguistic and sensory processing disorders later in life. Studies have examined the effects of prematurity on developmental outcomes, such as cognition, however, there is a need for a more detailed examination of sensory processing disorders in preterm infants. Not only is prenatal neurosensory development interrupted in utero, but these children may also experience intense stimulation in the neonatal unit, which can further alter the development and function of the sensory system. Objective. The paper presents an overview of research on sensory processing disorders in premature infants, with special emphasis on the impact of the environment of the neonatal unit. Method. Insight into the relevant literature was performed by specialized search engines on the Internet and insight into the electronic database. Results. Sensory processing disorders affect 39% to 52% of newborns born prematurely, with some evidence to suggest that children born before 32 weeks are most at risk. The literature to date has consistently reported difficulties in sensory modulation of preterm infants, within the tactile, vestibular, auditory, oral, and visual domains. Conclusion. Sensory processing disorders in preterm infants appear to occur as a result of their immature neurological and biological system and being in the environment of a neonatal intensive care unit, which is unable to meet the sensory needs of preterm infants. Altered sensory experiences, during periods of neurodevelopmental vulnerability and fragility, can result in sensory processing disorders, which may include enhanced responses or less response to stimuli (hyper or hyposensitivity).
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Uchiyama, Shigeharu, Fumiki Kamoi, Manabu Tanaka, Itsuo Joko, Kazuo Kasuga, Kenta Suzuki, Naoko Tachibana, Tomoki Kaneko, and Naoji Amano. "What is the subtype of dementia in patients with fragility hip fracture?" PLOS ONE 17, no. 4 (April 5, 2022): e0265636. http://dx.doi.org/10.1371/journal.pone.0265636.
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Introduction Cognitive function is an important factor that affects functional recovery after hip fracture (HipFx) surgery. The literature on the pathophysiology of dementia in HipFx patients is scarce. We performed a differential diagnosis of dementia in HipFx patients using clinical and brain MRI findings. Methods This is a prospective study in which brain MRI was evaluated for patients with HipFx for research purposes. One-hundred-and-five HipFx patients (85 females and 20 males) who underwent surgery and were subsequently able to undergo brain MRI at our hospital were evaluated. The mean age was 84 years. The presence of dementia was determined based on clinical findings and whether the patient meets its diagnostic criteria according to the International Classification of Diseases 10th Edition (ICD-10). The differential diagnosis of dementia was made based on brain MRI findings and the dementia diagnostic flow chart published in the Clinical Practice Guideline for Dementia 2017 (Japanese Society of Neurology). The Voxel-based Specific Regional Analysis System for Alzheimer’s Disease (VSRAD) advance 2 diagnostic software was used to evaluate atrophy of the para-hippocampal gyrus. Results Fifty-six (53%) patients were clinically diagnosed with dementia according to the ICD-10 criteria. The MRI findings were diverse: Alzheimer’s disease (AD)-type, asymptomatic multiple ischemic cerebral lesions, past symptomatic cerebral infarction or cerebral hemorrhage, Binswanger’s disease (BW)-type, chronic subdural hematoma, disproportionately enlarged subarachnoidal hydrocephalus (DESH), and their combinations thereof. A combination of MRI and clinical findings of dementia patients demonstrated the following distribution of dementia subtypes: AD (n = 20), vascular dementia (n = 33), AD and BW vascular dementia (n = 3). Conclusion This study revealed that the brain MRI findings of HipFx patients were diverse. Although vascular dementia is found to be common in this particular population, this could be an incidental finding. Further study is warranted to clarify the specificity of our findings by increasing the number of patients, setting the control, and investigating whether dementia subtypes affect postoperative gait acquisition and fall risk.
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Hachinski, Vladimir. "Brain Health—Curbing Stroke, Heart Disease, and Dementia." Neurology 97, no. 6 (April 21, 2021): 273–79. http://dx.doi.org/10.1212/wnl.0000000000012103.
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There is no health without brain health, which is threatened by rising curves of stroke, ischemic heart disease, and dementia (the triple threat). The fastest growing and intractable threat has been dementia. Focusing on finding a drug to stop Alzheimer disease has yielded growing knowledge but no treatments, partly because in the elderly, cognitive impairment results from multiple interactive pathologies aggravated by fragility and tempered by resilience on the advancing background of aging. The concept of vascular cognitive impairment (VCI) cuts pragmatically through this complexity. VCI is any cognitive impairment caused by or associated with vascular factors. It spans the spectrum of undetected cognitive impairment to full-blown dementia. The vascular component represents the only major current, treatable, and preventable contributor to dementia and offers the possibility of delaying, mitigating, or preventing more dementias in the near future. The triple threat conditions share the same protective and treatable risk factors and can be prevented together. The approach needs to be comprehensive, identifying all relevant environmental, socioeconomic, health care, and individual factors; targeted, as risks and protective factors differ among populations and individuals; and and investment valued, yielding worthwhile returns in terms of money, effort, or time. The World Stroke Organization's proclamation calling for the joint prevention of stroke and potentially preventable dementias has been endorsed by 23 international, regional, and national brain and heart organizations, including the American Academy of Neurology. We need to develop joint prevention programs to curb the triple threat. Millions of brains depend on it.
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La Marca, Alessandra, and Leonarda Longo. "The project No one is left behind: teaching educational research." Form@re - Open Journal per la formazione in rete 22, no. 1 (April 30, 2022): 120–37. http://dx.doi.org/10.36253/form-12700.
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School closures due to COVID-19 have brought significant disruptions to education. Service-learning interventions have offered significant opportunities to reduce and reverse the long-term negative effects and to empower the recovery process of pupils in difficulty. The study was carried out with 869 students enrolled in the Primary Education Sciences master’s degree course at the University of Palermo. The participants have been involved in the planning and implementation of targeted educational courses designed for the “fragile” pupils from 33 different schools in Palermo. The primary level pupils were provided with a total of 60,000 hours of recovery and learning enhancement activities in remote mode. Challenging teaching activities fostered cognitive and learning development of the pupils and responsibility in teaching educational research.
Il progetto Nessuno resta indietro: formazione alla ricerca didattica.
La chiusura delle scuole che ha provocato un incremento significativo della povertà educativa ha sollecitato l’opportunità di progettare interventi integrati di service learning per favorire il recupero e il potenziamento dei minori in difficoltà. 869 studenti del Corso di Laurea Magistrale in Scienze della Formazione Primaria dell’Università degli Studi di Palermo, sono stati coinvolti nella progettazione e nella realizzazione di percorsi didattici mirati, rivolti agli alunni “fragili” di 33 scuole palermitane. Complessivamente sono state erogate 60,000 ore in DAD di attività di recupero e di potenziamento dell’apprendimento di alunni della scuola primaria di Palermo. Le attività didattiche sfidanti hanno favorito la stimolazione cognitiva e lo sviluppo della motivazione per l’apprendimento degli alunni e la responsabilità nella formazione alla ricerca didattica.
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Iavarone, Maria Luisa, and Luigi Aruta. "Digital skills between soft and hard. The Media Educator among critical issues and opportunities." Form@re - Open Journal per la formazione in rete 22, no. 3 (December 31, 2022): 242–51. http://dx.doi.org/10.36253/form-13763.
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This era is marked by a profound mutation in the forms and expression of human life that reflects a substantial alteration of the traditional coordinates of space and time, axes of thought con-fused into a third dimension imposed by the digital environment: immediacy. This transition implies a reflection on educational potential of technologies in response to contemporary emergencies and fragilities. Therefore, in this historical-cultural context, it might be appropriate to rethink digital skills no longer as hard skills, i.e., as mere technical-computational skills, but as soft skills, i.e., cognitive-operational skills, , indispensable for inhabiting in onlife era. Hence, the need to have Media Educators with a strong educative and cultural, as well as technological, identity, who know how to operate especially in the non-formal and informal sphere, in the third sector and in the territories of risk, moving effectively and efficiently, between criticalities and opportunities, in the living platforms of digital, a potential place for the development of digital soft skills.
Le digital skills tra soft e hard. L’Educatore Mediale tra criticità e opportunità.
L’epoca che viviamo sembra attraversata da una profonda mutazione nelle forme e nell’espressione della vita umana che riflettono una sostanziale alterazione delle coordinate tradizionali di spazio e tempo, assi del pensiero con-fusi in una terza dimensione imposta dall’ambiente digitale: l’istantaneità. Questa transizione implica una riflessione circa le potenzialità educative delle tecnologie in risposta alle emergenze e alle fragilità contemporanee. Quindi, in questo contesto storico-culturale, potrebbe essere opportuno ripensare le competenze digitali non più come hard skills, ossia come mere abilità di natura tecnico-computazionale, bensì come soft skills, ossia abilità cognitivo-operazionali, indispensabili per abitare in epoca onlife. Di qui, la necessità di disporre di Educatori Mediali con una forte identità educativo-culturale, oltre che tecnologica, che sappiano operare soprattutto in ambito non formale e informale, nel terzo settore e nei territori del rischio, muovendosi con efficacia ed efficienza, tra criticità e opportunità, nelle piattaforme abitative del digitale, potenziale luogo di sviluppo delle digital soft skills.
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Dato, Serena, Paolina Crocco, Francesca Iannone, Giuseppe Passarino, and Giuseppina Rose. "Biomarkers of Frailty: miRNAs as Common Signatures of Impairment in Cognitive and Physical Domains." Biology 11, no. 8 (July 31, 2022): 1151. http://dx.doi.org/10.3390/biology11081151.
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The past years have seen an increasing concern about frailty, owing to the growing number of elderly people and the major impact of this syndrome on health and social care. The identification of frail people passes through the use of different tests and biomarkers, whose concerted analysis helps to stratify the populations of patients according to their risk profile. However, their efficiency in prognosis and their capability to reflect the multisystemic impairment of frailty is discussed. Recent works propose the use of miRNAs as biological hallmarks of physiological impairment in different organismal districts. Changes in miRNAs expression have been described in biological processes associated with phenotypic outcomes of frailty, opening intriguing possibilities for their use as biomarkers of fragility. Here, with the aim of finding reliable biomarkers of frailty, while considering its complex nature, we revised the current literature on the field, for uncovering miRNAs shared across physical and cognitive frailty domains. By applying in silico analyses, we retrieved the top-ranked shared miRNAs and their targets, finally prioritizing the most significant ones. From this analysis, ten miRNAs emerged which converge into two main biological processes: inflammation and energy homeostasis. Such markers, if validated, may offer promising capabilities for early diagnosis of frailty in the elderly population.
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Majou, Didier. "Evolution of the Human Brain: the key roles of DHA (omega-3 fatty acid) and Δ6-desaturase gene." OCL 25, no. 4 (January 23, 2018): A401. http://dx.doi.org/10.1051/ocl/2017059.
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The process of hominization involves an increase in brain size. The development of hominids’ cognitive capital up to the emergence ofHomo sapienswas due to interactive, iterative, and integrative coevolution, allowing positive selection. Although this depends on many factors, in this position paper we show three categories that stand out: gene mutations, food resources, and cognitive and behavioral stimulation.Australopithecusbenefited both from the inactivation of theGULOanduricasegenes and from bipedalism causing the cognitive capital of theHomo genus to develop advantageously. This evolution depended on two factors. Firstly, a triggering factor: gradual climate change.Homostarted to regularly consume meat in addition to plants and insects. Secondly, a stimulating factor: mutations in theFADS2gene, which encodes Δ6-desaturase; a key enzyme for the synthesis of DHA and sapienic acid. The polymorphism of this gene appears to have been essential in allowing theHomo genus to adapt to its food, and for its evolution. It provides an undeniable advantage in terms of the productivity of fat synthesis (DHA), and may partly explain positive selection. With the advent of cooking and new mutations producing even moreFADS2, the brain reached its maximum size inHomo neanderthalensis, in a food ecosystem that provided favorable quantities of α-Linolenic acid and DHA. However, the Würm glaciation upset this equilibrium, revealing its fragility as regards to the brain and fertility.Homo sapiens, benefiting from new variants of theFADS2gene, were able to adapt to this harsh environment, whereas Neanderthal man was unable to do so and became extinct.
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Perry, Cody, Stephen Rossettie, Dan Hayward, Aaron Folsom, Andrew Jacobson, Adam Adler, and Michael Polmear. "Medical Management of Common Comorbidities in Elderly Patients with Proximal Femur Fractures." Journal of Orthopaedic Business 2, no. 2 (April 1, 2022): 19–36. http://dx.doi.org/10.55576/job.v2i2.17.
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Objectives: Provide a framework for the medical treatment of patients with proximal femur fractures. Design: Literature review and evidence based note template. Intervention: Medical management of patient undergoing operative fixation of proximal femur fracture. Main outcome measurement: Perioperative morbidity. Results and conclusions: Proximal femur fractures are common orthopaedic injuries in the geriatric population and present with morbidity and portend mortality. The current evidence suggests that most patients should be surgically managed 24-48 hours from injury in accordance with patient preferences and medical risk stratification. Doing so is likely to improve postoperative outcomes and save both patients and hospital systems financial resources. After proper history and physical examination, imaging with plain radiographs is recommended, with MRI indicated in occult fractures. There are numerous cardiovascular, cognitive, and endocrinologic comorbidities that may delay or impact surgical treatment of hip fracture patients. This review discusses informed consent, cardiovascular implantable electronic devices, anticoagulation, preoperative cardiovascular evaluation, anemia, congenital heart disease, cerebrovascular accident, hyponatremia, diabetes mellitus, end-stage renal disease, osteoporosis, COVID-19 and chronic obstructive pulmonary disease, and history of bariatric surgery. A proper understanding of how these conditions affect hip fracture patients may help orthopaedic surgeons to expedite surgery safely and effectively and may also serve as a framework in the management of other fragility fractures in patients with comorbidities. Level of Evidence: IV, systematic review Keywords: Hip Fracture, Medical co-management, Geriatrics, Fragility fracture, Osteoporosis, Comorbidity, Comorbidity management, Anesthesia, Perioperative morbidity, Cardiovascular, Cerebrovascular, Renal disease, Surgical timing. (J Ortho Business 2022; Volume 2, Issue 2
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Santangelo, A., M. Testai, S. Albani, A. Cappello, R. Castelli, S. Pavano, M. Tomarchio, and D. Maugeri. "The elderly over 90yr affected by deperession post-stroke respond well to antidepressant therapy with SSRI? study on a population admitted in nursing home (RSA)." European Psychiatry 26, S2 (March 2011): 851. http://dx.doi.org/10.1016/s0924-9338(11)72556-1.
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IntroductionThe frailty of elderly in Tenth Decade with stroke was considered a certainty for many years ruling, and the stroke in 90 year old was a paradigm of fragility in gerontology. However soon enough the existing data on the population in nursing homes.MethodThe aim of this study was to evaluate the response to therapy SSRI antidepressants (fluoxetine 20–40 mg; sertraline 25–100 mg,; citalopram 10–40 mg) in a population of olds with depression after-stroke hospitalized in Nursing Home (RSA) at Catania (Sicily). We evaluated a total sample of 66 patients comparing the 13 patients 90yr-old with the 53 patients younger pertaining to the same RSA for stroke.ResultsStackable with somatic comorbidity and the post-stroke depression between the two populations, we founded:1.Both populations are responsive to antidepressant treatment with SSRIs2.The ninety recover more and more 'rapid cognitive impairment3.Both Populations improves the performances with rehabilitation recovering functional self-autonomy, albeit from different levels.4.The nutrient levels overlap in both populations and increased fragility biological of over 90-year old is evident for among of Prevalence and incidence of Delirium and Presence of Pressure Sores.ConclusionAccording to this data the response to antidepressants seems to be good and totally overlapped with the population most 'young studied as a reference.This data also confirms that it is not age itself but the comorbidity of diseases present that make it’ a frail old man and that probably the frailty of the nineties is a biological myth.
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García-Esparza, J. A., and Pablo Altaba. "Time, Cognition, and Approach: Sustainable Tourism Strategies for Abandoned Vernacular Landscapes." Sustainability 10, no. 8 (August 1, 2018): 2712. http://dx.doi.org/10.3390/su10082712.
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The main objective of the study is to challenge previous approaches to heritage, both in terms of management and conceptualization. It aims to highlight the importance and articulation of the different attributes in abandoned vernacular landscapes in search of a sustainable approach. To do so, the study focuses on a specific landscape in the Mediterranean basin where three areas of intensity have been selected for an eventual assessment of the principles of integration and consistency of the landscape. These areas have helped to establish the importance of distance and cognition in determining strategies for sustainable tourism. Geographic Information Systems (GIS) have allowed us to ascertain the extent to which values, previously acquired from participatory fieldwork, can be detected depending on proximity or remoteness, as well as their application in the three cases for assessment. Thus, five criteria have been established to analyse these values: (1) overview of the landscape, (2) dominance or intensity of elements, (3) the aesthetic composition of space, (4) the selective interpretation of the visual variables, and (5) the fragility of specific areas in the landscape. Finally, the discussed criteria provide new insights into the dynamic and static realms of authenticity and integrity, which have helped in the analysis of previous rigid conventions on values, time, perception, and approach.
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Navlakha, Saket. "Learning the Structural Vocabulary of a Network." Neural Computation 29, no. 2 (February 2017): 287–312. http://dx.doi.org/10.1162/neco_a_00924.
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Networks have become instrumental in deciphering how information is processed and transferred within systems in almost every scientific field today. Nearly all network analyses, however, have relied on humans to devise structural features of networks believed to be most discriminative for an application. We present a framework for comparing and classifying networks without human-crafted features using deep learning. After training, autoencoders contain hidden units that encode a robust structural vocabulary for succinctly describing graphs. We use this feature vocabulary to tackle several network mining problems and find improved predictive performance versus many popular features used today. These problems include uncovering growth mechanisms driving the evolution of networks, predicting protein network fragility, and identifying environmental niches for metabolic networks. Deep learning offers a principled approach for mining complex networks and tackling graph-theoretic problems.
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Coêlho, Matheus Diniz Gonçalves. "Multidimensional Evaluation and Profile of Institutionalized Elderly in Pindamonhangaba-SP, Brazil." Epidemiology International Journal 6, no. 4 (2022): 1–8. http://dx.doi.org/10.23880/eij-16000251.
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Introduction: With the increase in the elderly population, it is necessary to use tools that identify health problems efficiently, in primary care and in Long-stay institution for the elderly (LSIE). Objective: The present study aimed to identify and characterize functional alterations through multidimensional assessment of the elderly (MAE) and to estimate the prevalence of elderly people with a suggestion of Dynapenia. Methods: This is a descriptive cross-sectional observational study. Thirty-one elderly people of both sexes, living in two LSIEs in the municipality of Pindamonhangaba, were included. The instrument for the multidimensional assessment of the elderly proposed for this study was developed to be used in a primary health care outpatient clinic. Information on sociodemographic characteristics, history of personal morbidity, musculoskeletal symptoms, quality of balance, functionality, lifestyle, medication use, anthropometric measurements and quality of life were searched. Data were statistically analyzed using the chi-square method and the Bioestat 5.0 software as a support tool. Results: When evaluating the domains in the AMI, we identified: absence of upper limb dysfunction and a significantly high rate (p<0.0001) of lower limbs (90.3%), in addition to other disorders, including: hearing loss (29%); urinary incontinence (29%); weight loss (38.7%); cognition and memory difficulties (45.2%) and vision deficit (51.6%). Through anthropometric assessment, the high prevalence of overweight and obesity was identified. In average HGS of 15.7 Kg and SD of 7.9 Kg. Conclusion: The present study identified an important prevalence of physiological and cognitive alterations in institutionalized elderly people, allowing us to highlight the importance of making the screening of functional alterations in the elderly habitual, in order to allow the adoption of preventive measures to minimize the risks inherent to such disorders. , given the natural fragility of health related to the physiological condition of these patients, which may contribute to improving their quality of life.
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Scoggins, Chris, Ciera Scott, and Lee Hyer. "The Millon Behavioral Medicine Diagnostic: Profiles of Dementia and Depression." Journal of Student Research 1, no. 1 (March 25, 2012): 60–69. http://dx.doi.org/10.47611/jsr.v1i1.69.
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Dementia (or cognitive decline) either results in or causes changes in personality and treatment patterns as the person declines. From a sample of older adults with memory complaints who have varying problems of dementia, depression or both, we address two issues: (1) we provide a personality, stress moderator and treatment prognostic profile of older adults with and without dementia; and (2) we consider the question of the added influence of depression related to these variables. For question 1, older subjects (N=112) were disaggregated by dementia and non-dementia status; for question 2, the older adults (N=62) were further separated into those with a dementia, those who are depressed, and those with both dementia and depression. Patients were interviewed and self-report scales were given to all subjects. All patients had a caregiver. Cognitive and personality styles, treatment and stress markers, and Axis I variables, as well as background and adjustment, were measured. For dementia/non-dementia groups, results show that the dementia group was more detached, had more problems with depression and cognitive dysfunction, and showed less concerns about Informational Fragility. Of the three groups, the combined and dementia groups had the most problems, including more fixed personality features, more psychiatric problems, more stress moderators and more problematic treatment prognostics. We also show profiles of treatment prognostics and stress moderators of each personality type for a dementia, depression and dementia/depression. We highlight the importance of depression at later life whether with or without a dementia.
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Braga, Mariane Marcia Barros, and Paula Cristiane Strina Juliasz. "O ENTORNO DA ESCOLA COMO TERRITÓRIO USADO: UMA ESCALA DE PLANEJAMENTO E AÇÃO." Caminhos de Geografia 23, no. 89 (October 10, 2022): 01–14. http://dx.doi.org/10.14393/rcg238959835.
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O presente artigo tem como objetivo resgatar o conceito de território usado (Santos, 1994; Santos e Silveira, 2001) para analisar a área denominada como entorno construída a partir da escola como centralidade e que possibilita uma nova escala de análise para o planejamento de políticas públicas voltadas aos estudantes adolescentes. Demonstrando assim, a falta de articulação entre o planejamento das políticas públicas e o entorno da escola o que fragiliza a formação cultural, humana e cognitiva dos adolescentes. Desse modo a escala de ação não acontece no nível do território do entorno, onde os agentes se deslocam e constroem relações dentro de suas rotinas, mas parte dos agentes externos retirando dos adolescentes e de toda a comunidade escolar o direito de construir políticas a partir de uma ação participativa e realmente capaz de transformar o território a partir de suas potencialidades.
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Morris, Claire, Maayken Van den Berg, Chris Barr, Stacey George, and Maria Crotty. "Demographic Characteristics and Functional Levels of Patients With Fragility Fractures Who Accept Tele-rehabilitation as an Alternative to Face-to-face Home Rehabilitation." Home Health Care Management & Practice 33, no. 3 (January 19, 2021): 171–76. http://dx.doi.org/10.1177/1084822320983314.
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There is a gap in the evidence on telerehabilitation (TR) for people with fragility fractures. It is unclear whether this group with recent falls who are often frail with cognitive changes will accept tele-rehabilitation and functional gains can be achieved using this approach. Prospective observational study of consecutive patients admitted with femoral or pelvic fracture to a hospital-based home rehabilitation service (HRS) between January and November 2017. Using tablets, multidisciplinary rehabilitation was provided via videoconferencing and use of exercise apps. Patients chose a face-to-face visit or TR. Information on demographic characteristics, functional levels, the total number of therapy sessions, TR episodes, reasons for non-acceptance of TR, and patient-reported experience using TR was collected. Fifty-two patients with hip and pelvic fractures were admitted to the HRS and 35 (67.3%) received TR. Patients who did not accept TR were older, frailer and more likely to be female than those who received TR. Of the 17 who did not receive TR, 6 were deemed unsuitable by staff due to hearing, vision or cognitive problems and 3 refused. The TR group achieved acceptable functional gains. In the TR group on average, participants had 13.63 (± 7.29) home visits however they only elected to have 3.43 (± 2.48) sessions delivered via TR. TR was acceptable to a subset of hip fracture patients but face-to-face was the preferred mode of delivery. More research is needed to understand patients’ preferences and beliefs, and the influence of clinician attitudes on uptake of TR.
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Wong, Tak Man, Frankie K. L. Leung, Tak Wing Lau, Christian Fang, Felix H. W. Chan, and Jun Wu. "Effectiveness of a Day Rehabilitation Program in Improving Functional Outcome and Reducing Mortality and Readmission of Elderly Patients With Fragility Hip Fractures." Geriatric Orthopaedic Surgery & Rehabilitation 9 (January 1, 2018): 215145931875935. http://dx.doi.org/10.1177/2151459318759355.
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Introduction: The incidence of hip fracture is projected to increase in the next 25 years as the world population ages. Hip fracture is often associated with subsequent readmission and mortality. Nevertheless, elderly patients often may not achieve the same level of functional ability as prior to their injury. Several studies have shown that close collaboration between orthopedic surgeons and geriatricians can improve such outcomes and Geriatric Day Hospital (GDH) is one of the examples of collaboration to improve such outcomes. The aim of this descriptive retrospective study is to review the effectiveness of the day rehabilitation program provided by a GDH on functional outcomes, mortality, and readmission rate, among a sample of elderly patients with hip fracture. Methods: The medical records of patients from January 1, 2009, to December 31, 2012, were collected and evaluated. Demographic data of the patients and Charlson Comorbidity Index were collected. The Barthel Index, Elderly Mobility Scale, and Mini-Mental State Examination were measured on admission and at discharge of the patients to evaluate both physical and cognitive functions. Results: The results showed that the majority of patients benefited from rehabilitation in the GDH. The 12-month mortality rate of patients taking full-course rehabilitation in the GDH was improved. The age of patient was the most important factor influencing the rehabilitation outcomes. Gender was the only risk factor for 12-month mortality and 6-month readmission. Discussion: Since patients were selected to attend GDH, there was a bias during the selection of patients. Furthermore, it was difficult to compare patients attended GDH with patients who did not because outcomes of the latter were difficult to be recorded. Conclusions: Our study shows that postoperative geriatric hip fracture patients definitely can benefit from rehabilitation service offered by GDH in terms of functional and cognitive outcomes.
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Liuzzo, M., R. Feo, S. Giuliano, and V. Pampalone. "A COMBINED APPROACH FOR SURVEYING COMPLEX COASTAL SITES." ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences XLII-2/W9 (January 31, 2019): 425–32. http://dx.doi.org/10.5194/isprs-archives-xlii-2-w9-425-2019.
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<p><strong>Abstract.</strong> This study presents an integrated approach for reading coastal sites. A process aimed at protecting and enhancing these sites must be developed alongside a targeted interdisciplinary strategy, closely linked to the fields of archaeology, survey, landscape reading, morphology of the territory and geology. These must no longer be managed as individual cognitive elements, but within a single comprehensive analytical interpretation model.</p><p>The experiment activity carried out along the rocky area of Aci Castello, on the eastern coast of Sicily, was developed using a methodological approach based on the integration of 3D data coming from various survey technologies &ndash; 3D laser scanning, mobile mapping and echo sounder systems. The aim of the experiment was to create a complete three-dimensional model of the studied area, focused on obtaining a dynamic understanding, that is punctual and comprehensive, of the site’s value and fragility.</p>
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Slotvinska, Karolina. "Picture of MOTHER Based on Selected Writings of Vanda Juknaitė." Vilnius University Open Series, no. 2 (July 30, 2021): 308–17. http://dx.doi.org/10.15388/vllp.2021.19.
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The article provides the analysis of the linguistic picture of mother in contemporary Lithuanian literature. The analysis is based on the writings of contemporary Lithuanian writer Vanda Juknaitė, namely on her novella Stiklo šalis (‘Land of Glass’) and novel Šermenys (‘Funeral’). The research is carried out using cognitive linguistics methodology and the description of linguistic worldview in texts. Through multiple aspects and meanings, fragility, the author shows the real view of mother, with all her weaknesses and dark sides. mother is called using a very general word woman , which probably highlights the importance of maternity in each woman’s life. mother takes no care of her appearance: looks tired, dark, and sad. Her psychological world is full of contrasts; she is strong and weak, decisive and reluctant, brave and timid at the same time. However, she features very strong relations (both physical and psychological) with her child. The analysis of Juknaitė’s idiolect has shown that the author provides no idealised picture of mother.