bluuebunny/crossref_metadata_2025 huggingface dataset:
TIC para cuidadores informales de pacientes paliativos
Authors: De la Cabeza María , Calero María José
Published: January 2018

Durante estos últimos años se ha producido un aumento de los cuidados paliativos en el ámbito familiar. Esto se ha debido principalmente a la falta de recursos en el sistema sanitario. Además, podemos observar que las condiciones de estos cuidados son cada vez más complejas, por el aumento de la duración de las enfermedades terminales, la carencia de información que presentan los cuidadores informales y la dificultad del cuidado. El objetivo de este proyecto es brindar información, mediante instrumentos de apoyo, adaptados a los cuidadores informales de enfermos terminales, para que les proporcionen seguridad y conocimiento ante la prestación de sus cuidados en el domicilio. Se realizaron búsquedas en diversas bases de datos sobre los documentos e instrumentos de cuidados paliativos enfocados a los propios cuidadores informales. Posteriormente se hizo una nueva búsqueda bibliográfica sobre los síntomas (objetivos y subjetivos) más frecuentes que presenta un enfermo terminal. Tras revisar toda la información encontrada, se obtuvo como resultado la elaboración de un manual dirigido a los cuidadores informales, el cual incluye los aspectos básicos de los cuidados paliativos. En segundo lugar, dicho manual se hizo accesible a través de las TIC para lo cual se creó un sitio web: www.cuidadospaliativosweb.com. Finalmente se discuten los hechos conseguidos y se proponen nuevas líneas de investigación con el fin de que los cuidadores puedan ofrecer una atención de calidad y unos cuidados adecuados según las necesidades del enfermo.
Buscando la satisfacción vital en una residencia de mayores. Estrategias de comparación social exitosas
Authors: Arias Orduña Ana V , Iglesias-Parro Sergio
Published: January 2018

La psicología social ha proporcionado múltiples evidencias de cómo, compararse con otras personas puede ser una estrategia de adaptación a los cambios vitales. El objetivo de este trabajo es analizar las estrategias de comparación social que utilizan las personas que viven en residencias de mayores, y su relación con el bienestar. 30 adultos de gran edad que viven en residencias de mayores. cumplimentaron una escala que medía estrategias de comparación social y otra escala de bienestar subjetivo. Resultados. Los residentes recurren en alto grado a la comparación social para juzgar su propio nivel de funcionamiento. Las comparaciones sociales más frecuentes entre los residentes son descendentes, y reflejan tanto una tendencia a la identificación como al contraste. En cualquier caso, las CS descendentes son menos frecuentes que la encontrada en adultos de gran edad no residentes. Por otro lado, se confirma que utilizar comparaciones sociales adaptativas se relaciona con mayores niveles de bienestar entre los adultos que viven en residencias de mayores. En cambio, su nivel de bienestar, no parece relacionarse con la frecuencia de uso de estrategias desadaptativas. Conclusiones. Por un lado, las CS también pueden mejorar el bienestar durante este periodo del ciclo vital. Por otro lado, las CS descendentes adquieren un significado especial en los entornos residenciales.
Consecuencias del Burnout de cuidadores de pacientes con demencia
Authors: Sánchez Gil Justo , Fontalba Navas Montserrat
Published: January 2018

El objetivo de este estudio es conocer la situación de los cuidadores de pacientes con demencia. Material: Se ha realizado una búsqueda sistemática en las bases de datos Pubmed, ScienceDirect-Journals. Resultados: Actualmente, la población sigue un proceso de envejecimiento progresivo que conlleva una mayor incidencia de enfermedades asociadas, como es el caso de las enfermedades neurodegenerativas y en el supuesto que nos ocupa, las demencias. Cada vez se diagnostican con mayor frecuencia estas enfermedades y esto conlleva también que cada vez existen más personas encargadas del cuidado de estos pacientes. En la mayoría de las ocasiones el cuidado de estos enfermos se realiza en el domicilio con la consiguiente sobrecarga del cuidador principal, a lo largo de estos últimos años se ha ido dando cada vez más importancia al conjunto de signos y síntomas que se presentan juntos en estos cuidadores hasta el punto de llamarlos “segundas víctimas” y dar nombre a una enfermedad conocida como “síndrome del cuidador” o “Burnout”. Discusión: El cuidado continuo con sobrecarga, tiene una repercusión física y psicológica en los cuidadores en forma de insomnio, aislamiento, fatiga crónica, falta de concentración, irritabilidad, cambios de humor, alteraciones en el apetito y alteraciones psiquiátricas siendo la más frecuente la depresión.
Competencia socio-emocional y amistad: el comportamiento prosocial y la falta de autorregulación del comportamiento como predictores de cantidad y calidad de las amistades en la infancia media
Authors: Rabaglietti Emanuela , Vacirca Maria Fernanda , Pakalniskiene Wilmante
Published: January 2018

El objetivo general de este estudio es investigar, mediante un diseño longitudinal de dos años, los efectos en el tiempo de determinados componentes de la competencia social y emocional de los niños (por ejemplo, el comportamiento prosocial y la falta de autorregulación del comportamiento) y las características de la amistad en términos de cualidades positivas y negativas, y del tamaño de la red de amigos. En el estudio participaron 177 niños (6-9 años, M=7.10, SD=0.38; 48% mujeres) que, a T1, asisten a segundo curso de dos escuelas primarias en el Noroeste de Italia. Los modelos de ecuaciones estructurales indicaron que el comportamiento prosocial se asocia positivamente, tanto con la calidad positiva de la amistad, como con el tamaño de la red de amistad: los niños que obtuvieron una puntuación superior en conducta prosocial, también obtuvieron mayores puntuaciones en calidad positiva de la amistad y en el número de amigos, con respecto a los otros. Por otra parte, la falta de autorregulación del comportamiento se asoció positivamente con la calidad negativa de la amistad, lo que significa que los niños con mayor puntuación en falta de autorregulación también fueron superiores en la calidad negativa de las amistades, como el conflicto. Estas asociaciones no variaron por géneros.
La prematuridad: el estrés paternal, el temperamento y el desarrollo del niño
Authors: Monti Fiorella , Neri Erica , Trombini Elena , Aureliano Francesca , Biasini Augusto , Agostini Francesca
Published: January 2018

El estudio explora, en el parto prematuro, la relación entre el estrés de los padres, la percepción maternal del temperamento del niño y el nivel de desarrollo del niño. Para la evaluación de una muestra de 78 niños prematuros a los 3 meses exactos de edad, en comparación con 73 nacidos a término, se han usado: Parenting Stress Index-Short Form (PSI-SF), para el estrés parental; cuestionarios italianos para el temperamento (QUIT, 1-12 meses), para el temperamento; las escalas de desarrollo mental de Griffiths (GMDS; 0-2 años), para el desarrollo del niño. Los resultados muestran que las madres de prematuro experimentan un estrés paternal significativamente mayor y sienten una reducción de la actividad motora en sus hijos, que tienen un menor nivel de desarrollo en la escala de Oído-Lenguaje, performance y cociente general. Los predictores significativos de estrés materno son los siguientes: nacimiento pre término, disminución en el desarrollo locomotor y personal-social y la percepción materna de una alta emocionalidad positiva y una baja emocionalidad negativa. El nacimiento prematuro tiene un profundo impacto estresante en las madres, agravado por la percepción de la disparidad entre las exigencias de la atención neonatal y los recursos disponibles
Uso de internet y redes sociales en estudiantes universitarios
Authors: Molero Jurado Mª del Mar , Martos Martínez África , Cardila Fernández Fernando , Barragán Martín Ana Belén , Pérez-Fuentes Mª del Carmen , Gázquez Linares José Jesús , Roales-Nieto Jesús Gil
Published: January 2018

El objetivo de la presente investigación fue analizar diferentes aspectos relacionados con el uso que hacen los universitarios de las redes sociales en internet: frecuencia y finalidad, la percepción de riesgos o consecuencias negativas de su uso, así como la valoración del usuario sobre las relaciones sociales que establece. Para ello se aplicó el Cuestionario de Redes Sociales en la Red a una muestra de 164 alumnos de la Universidad de Almería (España). Los resultados mostraron una frecuencia de uso de las redes sociales en universitarios con una media diaria superior a tres horas, fundamentalmente para contactar con amigos. Las consecuencias negativas del uso de las redes sociales estuvieron relacionadas con malentendidos y celos. Aunque se constata el uso frecuente de las redes sociales como canal de socialización, el porcentaje de sujetos que negó la utilidad de este medio para la mejora de sus relaciones sociales resultó ser elevado.
Entrenamiento en múltiples ejemplos (MET) en la formación de la conducta de oyente generalizada en el Trastorno del Espectro Autista (TEA). Un estudio de caso
Authors: Feder Jonas , Luciano Carmen , Jorge Ruiz Sánchez Luis
Published: January 2018

El presente estudio utiliza un entrenamiento de ejemplares múltiples (MET) para crear la conducta de oyente generalizada en un niño de 4 años y 8 meses diagnosticado con Trastorno del Espectro Autista (TEA). La conducta de oyente generalizada es uno de los primeros repertorios verbales conocidos en niños con desarrollo normalizado, establece la base de conductas verbales más avanzadas y normalmente no se observa en niños con dificultades en el desarrollo como en el TEA. Conociendo como crear uno de los primeros repertorios verbales, en este caso la conducta de oyente generalizada, se podrá dar un paso importante en la mejora de programas terapéuticos para niños con retraso en el desarrollo. El presente estudio se basa en una replicación sistemática de Luciano, Gómez y Rodríguez (2007). Los objetivos del presente estudio fueron entrenar la conducta de oyente usando un entrenamiento con múltiples ejemplos (MET) y medir el impacto de tal entrenamiento en (a) la emergencia de un patrón generalizado de conducta a nivel de oyente y (b) la emergencia de conducta de hablante. Los resultados muestran que se cumplió el primero objetivo, sin embargo, el MET en la conducta de oyente no fue suficiente para generar conducta de hablante. Los resultados y las limitaciones de este estudio son discutidos.
Resiliencia, conducta de salud y conducta de consumo de drogas en estudiantes universitarios
Authors: Teresa Antonio López María , Arrioja Morales Graciela , De León Gómez Ali , Velasco Parra Leticia , Torres Reyes Alejandro , Morales Castillo Francisco Adrían , Coyotl Rodríguez Erika , Xicali Morales Noé , Tenahua Quitl Inés , Villegas Velázquez María del Socorro , Yoselin Torres Zarate Miriam
Published: January 2018

El consumo de alcohol y tabaco afecta a estudiantes universitarios, es el tercer daño a la salud y principal adicción en México. En este trabajo se analizó la interacción entre los factores personales y la resiliencia en las conductas de salud y el consumo de drogas en estudiantes universitarios. Mediante diseño correlacional predictivo y muestreo aleatorio se seleccionó a la Facultad de Comunicación. La muestra se calculó con análisis de potencia (N=145 estudiantes). Se aplicaron cuatro instrumentos de .7000 a .8746 Alfa de Cronbach. Análisis estadístico inferencial. Se encontró que los factores personales seleccionados influyen sobre la conducta de salud (p.050). La resiliencia fue variable predictora de la conducta de salud y el consumo de drogas en el Modelo de Promoción de la Salud de Pender. Los hallazgos encontrados son aportación teórica a la práctica y, eventualmente, en una intervención de enfermería en estilos de vida saludables, como factores protectores en la prevención de adicciones en estudiantes universitarios.
Revisión bibliográfica de los cuidados del paciente anciano con trastorno mental grave desde una perspectiva multidisciplinar
Authors: Mata Sáenz Beatriz , Delgado Torres Pablo , Resa González Juliana , Rodríguez Cano Teresa
Published: January 2018

Los pacientes con trastorno mental grave constituyen un reto en su atención, por las necesidades a nivel social, psiquiátrico, laboral, orgánico y, fundamentalmente, humano. El objetivo de este trabajo es analizar la bibliografía disponible acerca de las intervenciones recomendadas desde diferentes perspectivas: enfermería, psiquiatría, atención primaria e institucional. Se recoge información a partir de bases de datos (Pubmed, NHSEvidence, Cochrane, Tripdatabase, UpToDate, National Guideline Clearinghouse, Guidelines International Network, CMA infobase), entre 2000 y 2016. Se emplean los descriptores “schizophrenia”, “bipolar disorder”, “older people”, “aripiprazole”, “paliperidone”, “elderly”, “severe mental disorder”, “primary care”, “nurs*” y sus equivalentes en español. La evidencia disponible tanto a nivel de los programas de atención como la medicación en este grupo de pacientes es baja. Los estudios encontrados analizan programas con escaso número de participantes y en muchos casos sin comparativos ni grupos control, incluyendo recomendaciones en base a subanálisis de estudios en población general y extrapolaciones en función de las necesidades de este grupo. A pesar de la escasa evidencia disponible y la necesidad de desarrollar estudios de mayor calidad, podemos establecer la recomendación de integrar abordajes de diferentes perspectivas en la atención y el cuidado de estos pacientes.
Adherencia al tratamiento profiláctico en pacientes hemofílicos A severos
Authors: Garre Andreo Raquel Sagrario , Garre Andreo Pedro , Giménez Fernández María , García Serrano José Manuel , García Ruiz Bronte María
Published: January 2018

Una alta adherencia al tratamiento profiláctico, en los pacientes hemofílicos severos, aumenta y mejora su calidad de vida. La falta de adherencia al tratamiento profiláctico aumenta las posibilidades de sufrir hemorragias espontáneas y con ellas hemartrosis y futuras artropatías. Objetivo principal: Analizar la situación actual de adherencia al tratamiento profiláctico en los pacientes hemofílicos A severos. Metodología: Nuestro trabajo consiste en una revisión bibliográfica de la literatura científica existente de los últimos 10 años, sobre la adherencia al tratamiento profiláctico en pacientes hemofílicos A severos. La búsqueda se realizó en diferentes bases de datos electrónicas. Resultados: Los pacientes de 0-12 años presentan la mayor adherencia, mientras que una menor adherencia fue detectada en los pacientes adolescentes (13-18 años) y los jóvenes adultos (19-29 años). Principales barreras: La negación de los pacientes al tratamiento, la incapacidad de entender los beneficios y la interferencia con el estilo de vida. La evidencia indica una mayor calidad de vida en pacientes con alta adherencia al tratamiento profiláctico. Conclusión: La población adolescente y los jóvenes adultos presentan el mayor riesgo de baja adherencia al tratamiento profiláctico, por su situación de transición entre la administración paterna de las dosis a la nueva auto-infusión, por la mayor independencia y libertad de decidir por sí mismos sobre su enfermedad.
Barreras percibidas por los psicólogos profesionales españoles para una Práctica Basada en la Evidencia
Authors: Badenes-Ribera Laura , Bonilla Campos Amparo
Published: January 2018

La Práctica Basada en la Evidencia (PBE) exige a los profesionales de la psicología que puedan acceder, valorar e integrar la literatura científica junto con la experiencia clínica y los valores y preferencias de los pacientes. El objetivo prinicpal de este manuscrito fue analizar las barreras percibidas por los profesionales de la psicología para implementar una PBE. La muestra estuvo formada por 77 participantes (68.8% hombres), con una edad media de 41.44 años (DT=9.42). Los resultados mostraron que las principales barreras percibidas para una PBE fueron la falta de tiempo la falta de habilidades para localizar la mejor evidencia científica disponible y el conocimiento limitado para valorar la calidad de un estudio. Estos resultados destacan la necesidad de formación en las habilidades de búsqueda y valoración crítica de los estudios científicos que exige la PBE.
La autopercepción competencial de los estudiantes del Grado en Trabajo Social.
Authors: Fernández-Martínez María del Mar , Gutiérrez-Cáceres Rafaela , Hernández-Garre Carmen María
Published: January 2018

En este trabajo se presentan y analizan resultados de una investigación llevada a cabo sobre la cuestión de las competencias específicas en las nuevas titulaciones de grado que el Espacio Europeo de Educación Superior ha promovido en el sistema universitario español. En particular, la cuestión planteada es la de estudiar el impacto que en la autopercepción competencial tiene el nuevo modelo de enseñanza aprendizaje propio de este escenario comprometido con la innovación curricular, y más específicamente en estudiantes de la titulación de Trabajo Social. La investigación se ha desarrollado mediante un método descriptivo, apoyado en una encuesta aplicada a una muestra de estudiantes del citado grado. Los resultados han evidenciado que entre estos estudiantes se ha producido una autopercepción de las competencias específicas de la carrera en la que predominan en atribuciones altas. Igualmente se ha encontrado que variables de interés como el devenir a través de los cursos académicos, el compatibilizar los estudios con la actividad laboral o la relación con el voluntariado en esta titulación no producen influencia, en términos generales, a la hora de percibir en sí mismos las competencias específicas que se les están pretendiendo enseñar.
Análisis del uso de estrategias de aprendizaje cognitivas y metacognitivas en Educación Secundaria.
Authors: Campano Fernández Laura , Robledo Ramón Patricia , Algorri Díez Laura
Published: January 2018

El objetivo de este trabajo es conocer el uso que hacen los alumnos de Educación Secundaria Obligatoria de las estrategias de aprendizaje en función del curso y del rendimiento de los mismos. Se aplicaron el Test de Estrategias de Aprendizaje ACRA, el Cuestionario de Estrategias Cognitivas de Aprendizaje y Estudio y el Cuestionario de Estrategias de Control en el Estudio a un total de 70 estudiantes de 1º a 4º ESO, con tres niveles de rendimiento: suspensos, aprobados/bien, notable/sobresaliente, procedentes de un centro concertado de la ciudad de León. Los resultados obtenidos indican que, en función del curso, la mayor diferencia en el uso de las estrategias de aprendizaje se da entre el alumnado de 1º y 2º ESO, habiendo un estancamiento en el uso de las mismas a partir de 2º. En cuanto al rendimiento académico, se ha comprobado que los alumnos con mejor rendimiento hacen un mayor uso de las estrategias de aprendizaje. Desde una perspectiva aplicada se reflexiona acerca de la idoneidad de capacitar y formar a los alumnos en estrategias de aprendizaje, para conseguir con ello un mayor éxito en los resultados académicos.
Informal Street Food Trade: A Source of Income Generation in Urban Nepal
Authors: Adhikari Dipak Bahadur
Published: January 2018

Street food trade is a growing sector in many developing countries, Nepal among them. As a means to provide low-cost food to a growing urban population of poor, unemployed people and low-wageworkers, street food trade –a predominantly self and family-based activity – has become an opportunity to generate income for many among those same urban poor living in Kathmandu Metropolitan City. On the basis of cross-sectional data collected from a sample of 50 street food vendors in two main areas of the city – namely New Bus Park and Ratna Park – this chapter analyzes the determinants affecting street food vendors’ income: whether it is correlated to vendors’ investment rates, education level, and labor supply, thus attempting to find employment and income patterns. Data are analyzed using OLS regression, and STATA- 12 statistical software. Economic Journal of Development Issues Vol. 23 & 24 No. 1-2 (2017) Combined Issue, Page : 1-17
Foreign Aid in Nepal
Authors: Pandey Kiran Bahadur
Published: January 2018

Foreign aid is essential for least developed countries like Nepal because these countries have the shortage of fund to meet their domestic investment for accelerating economic development and also to finance the import of essential capital goods required for the development. Nepal receives foreign aid from bilateral and multilateral sources. Following a descriptive approaches this paper analyses the trend of foreign did flow in Nepal from aggregative perspective. Economic Journal of Development Issues Vol. 23&24 No. 1-2, (2017) Combined Issue, Page : 71-76
Economic Interpretation of Philosophy of Bhagavad Gita: A Descriptive Analysis
Authors: Pandey Yuba Raj
Published: January 2018

Bhagavad Gita has proposed number of economic principles and values. In his recent book, The Idea of Justice, Amartya Sen discusses main massage of the Bhagavat Gita that is ‘duty is important’. In addition to this, the central thesis of the Gita from the philosophical view is found through the concept of yoga. The path of action without motive (or the path of Niskam Karma Yoga) is the most important of those various principles. The path of knowledge (Gyan Yoga) and the path of commitment to work (Bhakti Yoga) are other important principles. Bhagavad Gita analyses in detail the behavioral nature of different individuals and the result of the behavior of the individual. It emphasizes on the good moral character and considers labour as the duty of each and every individual. Similarly it describes about the qualities of life and the happiness of people. Self-reliance of the individual is also emphasized in the Bhagavad Gita. Full commitment to fulfill ones assigned task makes the task successfully accomplished even if people do not care about the fruit (returns from it) before doing the task. Doubts and continuous eye in the fruit work may divert the attention of the actor from the work to the fruit only. Full concentration in the work is necessary to make the work fully successful. The concepts of sustainable development and human development also have their roots in the Bhagavad Gita. Economic Journal of Development Issues Vol. 23&24 No. 1-2, (2017) Combined Issue, Page : 77-101
Cost and Consequences of Integrated Public Health Campaign in Baglung District, Nepal
Authors: Subedi Sudarshan , Sharma Bishnu Prasad , Adhikari Chiranjivi
Published: January 2018

Correction: On 17th May 2020 the third author's name was changed from 'Chiranjibi' to 'Chiranjivi'

Budget allocated, especially for new pilot program should yield better health effects than the regular ones. The government of Nepal launched Integrated Public Health Campaign (IPHC), a new type of intervention to make rural and vulnerable communities more aware about basic level health care services and increase their utilization. This paper examines the cost of the campaign and its outcomes in terms of providing awareness, utilization of maternal health services and improving health indicators. The study followed a comparative quasi experimental design, study unit being the household and the campaign. Case and Control village development committees (VDCs) were selected from the same territory and matched based on the criteria of IPHC and other socio-demographic & health services characteristics. Cost calculation was based on direct method whereas the effectiveness was measured by analyzing the output of campaign between case and control VDC. The total cost of the campaign was NRs. 18, 00,000 with per household cost NRs. 585.93 and per capita cost NRs. 123.11. The awareness level of Free Health Services (FHS), Primary Health Care-Out Reach Centre and Safe Delivery Incentive Program (SDIP) was found to be 3.3, 2.65 and 1.95 times more in people of Case VDC than those of Control VDC. Moreover, there was no significant association between implementation of campaign with different practices of maternal health viz. Antenatal Care visit, delivery, SDIP and post natal care visit. The campaign was found effective in improving the status of OPD visit, measles, TT2+, growth monitoring of children and vitamin A supplementation to postpartum mothers. The campaign was effective in limited aspects. In case of its continuation, revision is necessary with the introduction of newer and better approaches.

 Economic Journal of Development Issues Vol. 23&24 No. 1-2, (2017) Combined Issue, Page : 113-122
Reconfiguring Sociomateriality from a Neurobiological Perspective
Authors: Taxén Lars
Published: January 2018

The aim of this paper is to propose a reconfiguration of sociomateriality (SM) from a neurobiological perspective, which maintains the relational ontology of SM without relapsing into untenable entanglement positions of strong SM (SSM).
Simplifying Sensemaking: Concept, Process, Strengths, Shortcomings, and Ways Forward for Information Systems in Contemporary Business Environments
Authors: Namvar Morteza , Cybulski Jacob L. , Phang Cynthia Su Chen , Ee Yaw Seng , Tan Kevin Tee Liang
Published: January 2018

Sensemaking is a popular and useful organizational behavior concept that is gaining visibility in the field of information systems. However, it remains relatively unknown compared to more established information systems concepts like technology acceptance and resistance. To enhance and propel greater use of sensemaking in information systems, this article offers a systematic explanation of sensemaking, specifically focusing on its concept, process, strengths, and shortcomings, as well as discussing ways forward for information systems in contemporary business environments.
Decreased Invasion of Urothelial Carcinoma of the Bladder by Inhibition of Matrix-Metalloproteinase 7
Authors: Bolenz Christian , Knauf Daniel , John Axel , Erben Philipp , Steidler Annette , Schneider Stefan W. , Günes Cagatay , Gorzelanny Christian
Published: January 2018

Objectives:

To measure and to modulate the invasive potential of urothelial carcinoma of the bladder (UCB) cells in a standardized preclinical setting using broad-spectrum matrix-metalloproteinase (MMPs) inhibitors and specific targeting of MMP7.

Materials and Methods:

MMP expression levels in UCB cells were determined by quantitative real-time PCR (qRT-PCR) and gel zymographies of cell supernatants (MMP9, MMP2 and MMP1) and cell lysates (MMP7). The invasiveness of human UCB cells (HT1197 and T24/83) and human benign urothelial cells (UROtsa) was modulated by a broad-spectrum MMP inhibitor (4-Aminobenzoyl-Gly-Pro-D-Leu-D-Ala hydroxamic acid; AHA) and by MMP7 specific siRNAs. MMP7 knockdown efficiency was assessed by qRT-PCR and western blot. Invasive potential of UCB cells was measured by a standardized trans-epithelial electrical resistance (TEER) assay.

Results:

Different MMP secretion profiles were measured in UCB cells. The active form of MMP7 was exclusively detected in HT1197 cells. Characteristic TEER breakdown patterns were observed in UCB cells when compared to benign cells. Invasive potentials were significantly higher in HT1197 cells than in T24/83 and in UROtsa cells [14.8±5.75 vs. 1.5±0.56 and 1.2±0.15, respectively; p < 0.01]. AHA treatment reduced the invasive potential of HT1197 cells. Also the specific downregulation of MMP7 by siRNA lowered the HT1197 cell invasiveness [20±1.0 vs. 16±2.8; p < 0.05]. Neither AHA nor MMP-7 siRNA transfection altered the invasive potential of T24/83 cells.

Conclusions:

Invasion of UCB is partially dependent on MMPs. Specific targeting of MMP7 by siRNA reduces the invasive potential in a subgroup of UCB cells. Therefore, MMP7 represents a potential therapeutic target which warrants further investigation.
Defining Priorities to Improve Patient Experience in Non-Muscle Invasive Bladder Cancer
Authors: Garg Tullika , Connors Jill Nault , Ladd Ilene G. , Bogaczyk Tyler L. , Larson Sharon L.
Published: January 2018

Background:

Although approximately 75% of bladder cancers are non-muscle invasive (NMIBC) at diagnosis, most research tends to focus on invasive disease (e.g., experiences related to radical cystectomy and urinary diversion). There is a lack of studies on quality of life, and especially qualitative research, in bladder cancer generally. As a result, relatively little is known about the experiences and needs of NMIBC patients.

Objective:

To understand patient experience, define care priorities, and identify targets for care improvement in NMIBC across the cancer continuum.

Methods:

Through focus groups, patients treated for NMIBC (stage <T2) were invited to share their care experiences including diagnosis, treatment, and survivorship. Transcripts were analyzed using conventional content analysis to identify themes and subthemes.

Results:

Twenty patients (16 male, 4 female, all white) participated in three focus groups. Five primary themes emerged: access to care, provider characteristics and communication, quality of life, goals of care/influences on decision-making, and role of social support. Patients with NMIBC desired timely access to care and honest and caring provider communication. They described urinary function and emotional quality of life changes resulting from diagnosis and treatment. Avoiding cystectomy and being alive for family were the major decision influencers.

Conclusion:

In this qualitative study, we identified access to care, provider characteristics and communication, quality of life, values/influences on decision-making, and social support as priority areas to improve patient experience in NMIBC. Care redesign efforts should focus on improving access, enhancing provider communication, reducing side effects, and supporting caregiver roles.
Liquid Biopsy-Analysis of Circulating Tumor DNA (ctDNA) in Bladder Cancer
Authors: Todenhöfer Tilman , Struss Werner J. , Seiler Roland , Wyatt Alexander William , Black Peter C.
Published: January 2018

Recent advances in DNA profiling techniques have enabled sensitive detection of tumor-associated genomic aberrations in peripheral blood. This type of minimally-invasive molecular interrogation has the potential to guide subsequent treatment selection. The potential utility of ctDNA in bladder cancer (BC) is bolstered by the high somatic mutation rate, meaning that very small numbers of genes or target regions can be informative. First reports indicate that analysis of ctDNA may represent a sensitive method for disease surveillance in patients with different stages of BC. Moreover, recent evidence suggests that ctDNA analysis reveals previously unknown genomic alterations in metastatic patients. Since some of these gene alterations represent therapeutic targets, ctDNA analysis provides an attractive tool to guide individualized therapy in BC.
Body Mass Index, Diet-Related Factors, and Bladder Cancer Prognosis: A Systematic Review and Meta-Analysis
Authors: Westhoff Ellen , Witjes J. Alfred , Fleshner Neil E. , Lerner Seth P. , Shariat Shahrokh F. , Steineck Gunnar , Kampman Ellen , Kiemeney Lambertus A. , Vrieling Alina
Published: January 2018

Background:

Urologists are frequently confronted with questions of urinary bladder cancer (UBC) patients about what they can do to improve their prognosis. Unfortunately, it is largely unknown which lifestyle factors can influence prognosis.

Objective:

To systematically review the available evidence on the association between body mass index (BMI), diet, dietary supplements, and physical activity and UBC prognosis.

Methods:

We searched PubMed and Embase up to May 2017. We included thirty-one articles reporting on observational and randomized controlled trials investigating BMI, diet and dietary supplements in relation to recurrence, progression, cancer-specific or all-cause mortality in UBC patients.

Results:

In non-muscle invasive bladder cancer (NMIBC) patients, both overweight (3 studies, pooled hazard ratio (HR) 1.29, 95% CI 1.05–1.58, I2 = 0%) as well as obesity (3 studies, pooled HR 1.82, 95% CI 1.12–2.95, I2 = 79%) were associated with increased risk of recurrence when compared to normal weight. No association of BMI with risk of progression was found. Results for BMI and prognosis in muscle-invasive or in all stages series were inconsistent. Observational studies on diet and randomized controlled trials with dietary supplements showed inconsistent results. No studies on physical activity and UBC prognosis have been published to date.

Conclusions:

Evidence for an association of lifestyle factors with UBC prognosis is limited, with some evidence for an association of BMI with risk of recurrence in NMIBC. Well-designed, prospective studies are needed to develop evidence-based guidelines on this topic.
Drugs for Dementia and Excess of Hospitalization: A Longitudinal French Study
Authors: François Mathilde , Sicsic Jonathan , Pelletier Fleury Nathalie
Published: January 2018

Background:

The impact of adverse effects of drugs for dementia on the risk of hospitalization has not been much studied despite the impact of hospitalizations on cognitive decline.

Objective:

To determine if the main adverse effects of cholinesterase inhibitors and memantine may be associated with excess of hospitalization and to quantify the subsequent impact on healthcare expenditures.

Methods:

A representative sample of the French national health insurance beneficiaries aged 65 and older and suffering from dementia were included and followed from 2007 to 2014. Binary logit models for longitudinal data (GEE estimation technique) were used to estimate the excess of hospitalization events related to the adverse effects of anti-dementia drugs and then to derive the additional costs of hospitalizations for the public health insurance fund.

Results:

In total, 7,668 patients were followed, generating 111,133 individual observations over the 8-year period. Treated patients were hospitalized significantly more than non-treated patients (adjusted Odd Ratio (OR) = 1.08, 95% confidence interval (95% CI) = [1.02 to 1.13], p = 0.004), mainly with cholinesterase inhibitors for cardiac (OR = 1.21, 95% CI = [1.01 to 1.46], p = 0.034) and gastrointestinal events (OR = 1.43, 95% CI = [1.01–2.05], p = 0.045), especially with rivastigmine. When extrapolated to the entire population, this corresponded to an annual additional cost of € 55,000.

Conclusion:

Prescription of antidementia drugs, more specifically rivastigmine, increases the risk of hospitalizations via their cardiac and gastrointestinal adverse effects and lead to additional health care expenditures. Even though these results must be confirmed, they may encourage cautious consideration of the balance between benefits and harms before a prescription is given.
Progression of Alzheimer’s Disease-Related Pathology and Cell Counts in a Patient with Idiopathic Normal Pressure Hydrocephalus
Authors: Libard Sylwia , Laurell Katarina , Cesarini Kristina Giuliana , Alafuzoff Irina
Published: January 2018

We had an opportunity to assess the change observed in the brain regarding Alzheimer’s disease (AD)-related alterations, cell count, and inflammation that took place during a period of 21 months in a subject with a definite diagnosis of AD and idiopathic Normal Pressure Hydrocephalus (iNPH). Four neuronal markers, i.e., synaptophysin, microtubule associated protein 2, non-phosphorylated neurofilament H (SMI32), and embryonic lethal abnormal visual system proteins 3/4 HuC/HuD (HuC/HuD); three microglial markers CD68, Human Leucocytic Antigen DR, ionized calcium-binding adaptor molecule 1, glial fibrillary acidic protein (GFAP); and AD-related markers, hyperphosphorylated τ (HP τ) and amyloid-β (Aβ, Aβ40, Aβ42) were assessed. Morphometrically assessed immunoreactivity of all neuronal and all microglial markers and Aβ42 decreased parallel with an increase in the HP τ in the frontal cortex. The expression of GFAP was stable with time. The first sample was obtained during the therapeutic shunting procedure for iNPH, and the second sample was obtained postmortem. Negligible reactive changes were observed surrounding the shunt channel. In conclusion, in the late stage of AD with time, a neuronal loss, increase in the HP τ, and decrease in Aβ42 and microglia was observed, whereas the expression of GFAP was rather stable. The observations described here suggest that when a brain biopsy has been obtained from an adult subject with iNPH, the assessment of postmortem brain is of major significance.
A Link between Subjective Perceptions of Memory and Physical Function: Implications for Subjective Cognitive Decline
Authors: Cosentino Stephanie , Devanand Davangere , Gurland Barry
Published: January 2018

Subjective impairment in memory is a frequently defining feature of subjective cognitive decline (SCD), a state hypothesized to precede objectively apparent cognitive symptoms of Alzheimer’s disease (AD) and to hold promise as a non-invasive, inexpensive, preclinical indicator of AD. However, a full model of the factors that contribute to subjective memory (SM), and therefore to SCD, has yet to be articulated. While SM impairment is widely known to be associated with negative affect, the extent to which SM functioning may also reflect other factors, particularly subjective beliefs or perceptions about one’s health, is not known. To examine the extent to which SM is associated with subjective perceptions of health more broadly, the current study investigated the link between SM and subjective physical functioning (independent of depressive affect, and objective cognitive and physical function) in an ethnically diverse sample of 471 older adults enrolled in the population-based Northern Manhattan Aging Project. 199 (42%) participants endorsed no difficulty on a 5-point SM index while 272 (58%) endorsed some degree of difficulty. As hypothesized, SM correlated with both depression and subjective physical function, but not with age, education, global cognition, or objective physical function. When objective and subjective physical function were entered in two separate, adjusted linear regressions predicting SM, only subjective physical function and depressive affect independently predicted SM. Subjective perceptions of memory appear to reflect individuals’ broader health perceptions in part. Articulating the various correlates of SM will improve identification of SCD specific to preclinical AD.
Validation of the Delayed Matching-to-Sample Task 48 (DMS48) in Elderly Chinese
Authors: Feng Xueyan , Zhou Aihong , Liu Zhixin , Li Fangyu , Wei Cuibai , Zhang Guili , Jia Jianping
Published: January 2018

Background:

Delayed Matching-to-Sample Task 48 (DMS48), a brief tool measuring visual recognition memory, is valid to identify the early stage of Alzheimer’s disease (AD) in Caucasians. However, little data is available in Chinese.

Objective:

To develop norms and optimal cutoff points for the DMS48 in Chinese elders.

Methods:

A cross-sectional study was conducted in seven memory clinics from five cities across China. DMS48 was applied to 369 Chinese aged 50 or older (138 cognitively normal [CN], 112 mild cognitive impairment due to AD (MCI-A), and 119 mild AD dementia). The demographic factors which influence DMS48 scores were investigated and the norms were established considering those factors. Receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff points.

Results:

Age was shown to influence DMS48 scores ( r = –0.36, p < 0.05), and we presented the age-stratified normative data for the DMS48. The optimal cutoff point is 42/43 for identifying cognitive impairment (MCI-A and AD dementia) against CN (sensitivity 97.80% and specificity 89.13%) and MCI-A against CN (sensitivity 86.60% and specificity 94.20%). A cutoff of 39/40 obtained good sensitivity (100.00%) and specificity (94.90%) in discriminating AD dementia from CN. The age-stratified optimal cutoff points for identifying MCI-A were 43/44 for individuals aged 50 to 59 years old, 42/43 for 60 to 69 years old, 41/42 for 70 to 79 years old, and 40/41 for 80 or older, respectively (sensitivity 84.80% and specificity 95.70%).

Conclusion:

This study proved that DMS48 is of good validation in screening MCI-A in elderly Chinese.
Detection of Dementia Cases in Two Swedish Health Registers: A Validation Study
Authors: Rizzuto Debora , Feldman Adina L. , Karlsson Ida K. , Dahl Aslan Anna K. , Gatz Margaret , Pedersen Nancy L.
Published: January 2018

Background:

Population-based health registers are potential assets in epidemiological research; however, the quality of case ascertainment is crucial.

Objective:

To compare the case ascertainment of dementia, from the National Patient Register (NPR) and the Cause of Death Register (CDR) with dementia diagnoses from six Swedish population based studies.

Methods:

Sensitivity, specificity, and positive predictive value (PPV) of dementia identification in NPR and CDR were estimated by individual record linkage with six Swedish population based studies ( n = 19,035). Time to detection in NPR was estimated using data on dementia incidence from longitudinal studies with more than two decades of follow-up.

Results:

Barely half of the dementia cases were ever detected by NPR or CDR. Using data from longitudinal studies we estimated that a record with a dementia diagnosis appears in the NPR on average 5.5 years after first diagnosis. Although the ability of the registers to detect dementia cases was moderate, the ability to detect non-dementia cases was almost perfect (99%). When registers indicate that there is a dementia diagnosis, there are very few instances in which the clinicians determined the person was not demented. Indeed, PPVs were close to 90%. However, misclassification between dementia subtype diagnoses is quite common, especially in NPR.

Conclusions:

Although the overall sensitivity is low, the specificity and the positive predictive value are very high. This suggests that hospital and death registers can be used to identify dementia cases in the community, but at the cost of missing a large proportion of the cases.
SORL1 Variants in Familial Alzheimer’s Disease
Authors: Gómez-Tortosa Estrella , Ruggiero María , Sainz Ma José , Villarejo-Galende Alberto , Prieto-Jurczynska Cristina , Venegas Pérez Begoña , Ordás Carlos , Agüero Pablo , Guerrero-López Rosa , Pérez-Pérez Julián
Published: January 2018

The SORL1 gene encodes a protein involved in the amyloidogenic process, and its variants have been associated with Alzheimer’s disease (AD) physiopathology. We screened for SORL1 variants in 124 familial (44 early- and 80 late-onset) dementia of Alzheimer type (DAT) cases. Nine potentially pathogenic changes (three not previously reported and six rare variants) were found in nine probands (7%). After screening the control population and siblings (presence in at least 1/200 controls and/or absence of segregation pattern), a causal relationship with the disease was considered unlikely in six variants and uncertain in one. The change Trp848Ter and a splice-site variant remained likely correlated with the disease. SORL1 mutations are present in 7% of our familial DAT cohort, though in most cases cannot be considered the direct cause of the disease.
Exercise Training on Locomotion in Patients with Alzheimer’s Disease: A Feasibility Study
Authors: Pedrinolla Anna , Venturelli Massimo , Fonte Cristina , Munari Daniele , Benetti Maria Vittoria , Rudi Doriana , Tamburin Stefano , Muti Ettore , Zanolla Luisa , Smania Nicola , Schena Federico
Published: January 2018

Background:

Although current literature has shown that patients with Alzheimer’s disease (AD) have worse locomotion compared with healthy counterparts, no studies have focused on the efficacy of exercise training in improving gait abnormalities including biomechanics and metabolic aspects, in this population.

Objective:

To verify the effectiveness of exercise training (ET) on gait parameters (i.e., speed, step and stride length, single and double support, and energy cost of walking (Cw)) in patients with AD with respect to a standard cognitive treatment (CT).

Methods:

In this study, we included a small portion of data belonging to a larger study (ClinicalTrials.gov number, NCT03034746). Patients with AD (Mini-Mental State Examination 22±5) were included in the study. Gait parameters and Cw were assessed at baseline and after 6 months (72 treatment sessions) of treatment. ET included 90 min of aerobic and strength training. CT included 90 min of cognitive stimuli.

Results:

The 16 patients assigned to ET exhibited significant improvement of Cw (–0.9±0.1 J/kg·m-1), while differences in gait parameters were negligible. The effect on gait parameters were undetectable in the 18 patients assigned to CT (–0.2±0.5 J/kg·m-1).

Conclusions:

Data from this study showed that ET program seems effective in improving Cw in patients with AD. Interestingly, the positive effect of ET on Cw was not coupled with ameliorations of patient’s gait parameters, suggesting that the gain of metabolic aspects of locomotion were the main factors responsible for this positive result.
The Progression of Neuropsychiatric Symptoms in Alzheimer’s Disease During a Five-Year Follow-Up: Kuopio ALSOVA Study
Authors: Hallikainen Ilona , Hongisto Kristiina , Välimäki Tarja , Hänninen Tuomo , Martikainen Janne , Koivisto Anne M.
Published: January 2018

Background:

An improved understanding of the role of neuropsychiatric symptoms (NPS) in the course of Alzheimer’s disease (AD) has recently emerged. NPS lead to hospitalization and caregiver stress, but are more variable during the course of the disease than other symptoms. Knowledge about the role of specific NPS in disease progression and prognosis is especially limited.

Objectives:

To examine the relationship between specific NPS and AD severity during a 5-year follow-up period, and to determine which baseline NPS predict AD progression.

Methods:

236 persons with very mild (CDR 0.5) or mild (CDR 1) AD at baseline and their caregivers were followed up for five years as part of the ALSOVA study. The Neuropsychiatric Inventory was used to assess NPS, and AD severity progression was measured with the Clinical Dementia Rating Sum of Boxes. Data was analyzed with Generalized Estimated Equations and Linear Mixed Models.

Results:

The baseline NPS that best predicted AD progression were delusions, agitation, and aberrant motor behavior, while AD severity during follow-up was associated with hallucinations, delusions, agitation, apathy, aberrant motor behavior, and sleep and appetite disturbances.

Conclusions:

Persons with mild AD presenting delusions, agitation, and aberrant motor behavior at the time of diagnosis could have a more rapidly progressing disease, and some NPS are associated with AD severity. These results highlight the importance of evaluating NPS at the time of AD diagnosis, and the need to offer additional support to persons presenting delusions, agitation and aberrant motor behavior, and their caregivers.