bluuebunny/crossref_metadata_2025_split huggingface dataset:
State dementia registries: Diverse methodologic approaches to a common public health goal
Authors: Sayetta Rona Beth , Hackleman Karen T. , Howard James T. 
Published: June 2007

A common goal of state dementia registries is public health disease surveillance for program planning service delivery, and research. Despite this similarity in perspective, methodologic differences involving coverage, diagnostic, and data coding issues distinguish the various registries. Some of these differences include the illnesses, geographic area(s), and population groups covered by dementia registries. Diagnostic differences center on the development and application of case definitions specific to the different types of dementing illness, the thoroughness of accessible sources of medical data, and the standardization of disease staging for the dementias. Competing coding systems for diagnoses exist, but fortunately the coding of procedures is already uniform. A critical step toward facilitating the production of regional or national aggregate statistics and engaging in multisite research studies would be the achievement of enhanced standardization of the data elements and coding systems of public health and other dementia registries. This article promotes such methodologic compatibility.
The first year operating experience of the Florida Dementia Registry
Authors: Pfeiffer Eric , Keller Donald M. , Doblas-Shaw Raquel , McCarthy Edwin 
Published: June 2007

In January of 1987, Suncoast Gerontology Center at the University of South Florida in Tampa, signed a contract with the Department of Health and Rehabilitative Services (HRS) to establish and develop a statewide Registry for patients with Alzheimer's disease and other memory disorders. The realization of the Registry's goals depends on the support and cooperation of all the participating programs. Suncoast Gerontology Center has the responsibility to demonstrate the utility of the data collection by stimulating new research and by enhancing communication and collaboration with service and research institutions throughout Florida. Preliminary results will be presented in this article regarding the sociodemographic characteristics of Registry patients. Also, an attempt will be made to identify risk factors associated with Alzheimer's disease for this group.
Death of the personality: The grief response of the Alzheimer's disease family caregiver
Authors: Austrom Mary Guerriero , Hendrie Hugh C. 
Published: June 2007

The grief that follows death is understood and accepted by society. However, the grief associated with certain chronic illness is often misunderstood by family, friends and acquaintances. Unlike a terminal case of cancer where physical deterioration is quite evident, it is difficult to under-stand the grief associated with irreversible dementia because the patient is physically well for most of its duration. What has died in victims of Alzheimer's disease (AD) is the personality that quality or assemblage of qualities that makes a person what he or she is. This paper describes family care-giver responses to providing chronic care for a demented relative and compares and contrasts it with the responses of coping with a non-dementing terminal illness. Based upon our clinical work and empirical research with AD patients and their families, it seems that while many of the AD family caregiver responses are similar to bereavement reactions and anticipatory grieving of other terminal illnesses, the intensity and duration of their responses make them qualitatively different. I nplications for intervention with family caregivers and directions for further research are discussed.
Availability of special nursing home programs for Alzheimer's disease patients
Authors: Leon Joel , Potter D. E.B. , Cunningham Peter J. 
Published: June 2007

While still controversial, there is a growing belief that Alzheimer's disease patients require special programs across the service continuum. There is also a growing concern that nursing home facilities are not providing the programming required. Using data from the 1987 National Medical Expenditure Survey, national estimates are presented on the number of nursing facilities that have special units or programs directed towards the specific needs of the cognitively impaired elderly-primarily patients with Alzheimer's disease. The findings represent the first national estimates on special nursing home programs and units for Alzheimer's disease patients based on a nationally representative sample of nursing facilities. The survey included 759 facilities, and is weighted to be representative of all nursing facilities serving the elderly in 1987. Examined are the numbers of facilities with Alzheimer's disease programs, the patient capacities of these programs, the characteristics of the facilities, the future plans of facilities to either expand present programs or develop new ones, the availability of specialized training received by the staff of these programs, and the respite care these programs offer to non residents. The discussion centers on the implications these analyses hold for the further development of LTC policies and program provisions regarding Alzheimer's disease patients.
The subjective experience of Alzheimer's disease: A sociocultural perspective
Authors: Disman Milada 
Published: June 2007

Although the North American population is multicultural, little is known of sociocultural variations in the subjective experience of Alzheimer's disease. In Canada, data on important health indicators from sociocultural minority groups are not readily available. The reasons for unavailability include problems with defining and measuring ethnicity - in particular, concern that the sociocultural background of a person is private information, linked to concerns about potential violation of the Canadian Charter of Rights. The current commitment to reducing inequalities in health is starting to stimulate more interest in research on health-related sociocultural issues. This focus on links between sociopsychological factors and health suggests that members of sociocultural minority groups, and especially seniors, may be neurologically vulnerable to the stresses associated with older age, particularly when compounded by stressesfrom immigration and from aging in an acquired culture. Cross-cultural psychiatry distinguishes between disease as malfunctioning biologic and psychophysiologic process in the individuals, and illness as a subjective experience of being ill. Consequently, Alzheimer's disease will appear universally across cultures, but may vary in the realm of subjective experience. A strategy for building support groups for family caregivers from the targetedpopulation is presented as one example of effective intervention. The urgent needfor research to inform professional caregivers about sociocultural variations in the subjective experience of Alzheimer's disease is noted. In order to provide responsible and supportive care for patients and their caregivers in sociocultural minority groups, there is the urgent need for research to inform professional caregivers about sociocultural variations in the subjective experience of Alzheimer's disease.
Film Review: The subjective experience of Alzheimer's disease
Authors: Dastoor D. P. 
Published: June 2007

This article reviews five films dealing with Alzheimer's disease as experienced both by the victim and the caregiver. Each of thesefilms looks at the fragility of human existence, the course of the disease, the mental and emotional anguish of those suffering from this disease as well as the courage, love and compassion experienced by those close to the afflicted person - qualities which enable them to endure extremes of pain and agony. Visual image is effective in conveying messages. It has been used effectively by professionals to sensitize the public about the impact this disease can have on the life of others - the moral and ethical issues in ongoing caregiving and management techniques.
Memory training in early Alzheimer's disease: An optimistic look at the field
Authors: Arkin Sharon M. 
Published: June 2007

The purpose of this article is to encourage caregivers and treatment providers of early Alzheimer patients to try various memory stimulation strategies since, as this article will show, some patients do benefit cognitively, while most-caregivers and patients-benefit emotionally and psychologically from the cooperative effort. This article will review three published studies with encouraging results or elements, five with negative results, and three studies involving work with other populations that would seem to have applicability to early stage Alzheimer patients. This author will also describe two unpublished memory training interventions for early Alzheimer patients that have had promising results, but are not yet published. Related research and encouraging trends will be summarized, and treatment and rehabilitation strategies suggested by these and other published literature will be presented.
Behavioral dimensions of dementia: A comparison of three program groups in adult day care
Authors: Taft Lois B. , Seman Dorothy , Stansell Jane , Farran Carol J. 
Published: June 2007

The purpose of the retrospective, descriptive study described in this article, was to measure differences in clients in three different program groups in an adult day care center. Recognizing the interaction between the functioning of clients and their physical and social environment, staff at the Alzheimer's Family Care Center developed three differentiated programs to meet the needs and support the abilities of clients. This article describes the setting, client characteristics, and types of programming in each group. Client differences were measured by comparing mental status, agitation, and social accessibility. Significant differences were identified in cognitive and behavioral characteristics among the clients in the different groups. Behavioral differences in the three program groups were characterized by client scores representing: •High sociability/low agitation; •High sociability/high agitation; and •Low sociability/low agitation. The findings support the assumption that clients with dementia are a heterogeneous group responding to unique therapeutic approaches in differentiated programs.
A telephone helpline for Alzheimer 's disease: Information, referral, and support
Authors: Silverstein Nina M. , Kennedy Karen , McCormick Dawn 
Published: June 2007

Alzheimer's disease is a progressive, degenerative terminal disease. It has been the fourth leading cause of death among adults during the past decade, taking more than 100,000 lives annually. Approximately 10 percent of people age 65 and over have probable Alzheimer's disease and 47 percent of those over age 85 suffer from the disease. The National Institute of Aging predicts that there will be 14 million people with Alzheimer's disease by the year 2050. This study examined the helpline of the Alzheimer's Association of Eastern Massachusetts. Its stated mission is to provide access to comprehensive services as well as provide support to callers who are caring for someone with dementia. How information is provided and perceived may impact upon a caller's overall satisfaction with the helpline and their consequent decision tofollow through on referrals. Helpline staff identified callers who sought information regarding a specific family member or patient during November 1991. About 70 percent (100) of the callers consented to afollow-up telephone interview by a social work graduate student in January 1992. Approximately 63 percent of the calls regarded someone who was post diagnosis. Memory loss, confusion, and repetitive questioning were the major problem behaviors noted. The mostfrequent inquiries regarded nursing home placements, family support groups, and diagnostic referrals. Over 75 percent of the callers were not affiliated with the Alzheimer's Association or with a family support group. While overall satisfaction with the helpline was high, callers who received follow-up information through the mail tended to report greater satisfaction. The majority (87 percent) noted they would call the helpline again as concerns arose in the future. The study highlighted the need for professionals to be better informed about Alzheimer's disease and its impact on families. It also emphasized the lack of knowledge concerning available resources. The Alzheimer's Association through its network of helplines can provide valuable information to both informal and professional caregivers regarding the progression of the disease and its management. The Helpline should be recognized as a resource that may provide ongoing support through the duration of the disease.
Family care of Alzheimer victims
Authors: Beach Diane L. 
Published: June 2007

The burden of caregiver stress has been well documented in the literature. While attention has been paid to caregiving spouses and adult children, few studies have examined the impact of family caregiving on adolescents. With the rise in adult child caregivers simultaneously raising children of their own, increasingly greater numbers of young adults will be involved in caring for Alzheimer's type dementia (ATD) victims. This study examined the characteristics and experiences of these young adults. Specifically, 14 adolescents aged 14-18 were interviewed and asked a series of semi-structured questions regarding theirfeelings of burden and satisfaction as they related to caregiving. Employing features of content analysis methodology, all interviews were audiorecorded and transcribed. The results merged intofive primary categories:• Positive caregiving outcomes; • Negative caregiving consequences; • Peer group support; • Teacher support; and • Patient behavior management.These results are discussed within the context of developing support group interventionsforcaregiving adolescents.
Images in the twilight: Alzheimer's disease and palliative care
Authors: Breaden Katrina , Coulson Irene 
Published: June 2007

This paper provides a discussion of some of the issues surrounding the provision of palliative care for Alzheimer's sufferers and their families during the final stages of the disease. Five nurses working in dementia care institutions in Australia were invited to tell their story about the experience of caring for people in a twilight zone, where the sufferer is suspended in a world that is at the edge of existence. This paper explores the virtual silence in the literature regarding palliative care and Alzheimer's disease. However, it is primarily concemed with the images and metaphors surrounding the advancing stages of the disease. The images and the issues raised during the conversations with these nurses are discussed, together with recommendations for future research in this area.
The Alzheimer functional status instrument: An instrument to assess rehabilitation strategies for Alzheimer patients
Authors: Lasch Kathryn Eilene , Burnham Julia , Lee Jennifer 
Published: June 2007

The Alzheimer Functional St atus Inventory (AFSI) was developed to assess a kinesiotherapy program for 22 randomized pairs ofpatients with Senile Dementia of the Alzheimer Type (SDAT) residing in the Dementia Study Unit of the Edith Nourse Rogers Memorial VA Medical Center; Bedford, Massachusetts. The AFSI was developed by an interdisciplinary team to overcome some of the limitations of standard geriatric instruments to detect changes in functional status in SDAT patients following a rehabilitation program. The AFSI, which is performance-based, includes items adapted from Granger's PULSES Profile and activity disturbances itemsfrom the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), items on mood andbehaviorduring assessment, as well as, one on communication status. The AFSI thus includes items which evaluate physical, psychosocial, and cognitive dimensions offunctional status. These dimensions are: • Sensory function; • Range of motion skills including lower limb and upper limbfunction; • Mood state; • Behavioral status; and • Time to complete tasks.
Alzheimer memory training: Positive results replicated
Authors: Arkin Sharon M. 
Published: June 2007

In December, 1992, Clinical Gerontologist published the results of my dissertation research single subject experiments in which two early Alzheimer patients (Folstein MMSE scores of 23) were assisted to relearn two sets of forgotten biographical information by means of informational narratives and interactive quizzes presented via audio cassette recorder1I Subsequent articles in this journal have discussed my memory training work in the context of a multi-modal treatment program,2 and presented findings from a research study that compared quizzing to repetition as a means of reteaching forgotten information.3 Since none of the previously published articles referred to memory training in their titles, it is conceivable that researchers and practitioners might not find these articles in routine literature searches. This article brings together in one place a summary of my memory training work with the 14 Alzheimer's patients and one undiagnosed amnestic patient with whom I have used the tape-recorded intervention. During the next five years, the technique will be tested, among other interventions, with 18 of 28 early stage Alzheimer patients with whom I'll be working under a grant from the National Institute on Aging. So far, the technique has resulted in substantial learning in 13 of the 15 subjects with whom it was tried. MMSE scores of successful learners ranged from 10 to 27. The two who failed to learn had the highest and lowest mental status scores of the Alzheimer subjects: eight and 26, respectively. One or two week follow-up was done in 12 studies. In 11 of the 12 studies, 78 to 100 percent of questions answered correctly at post-test were answered correctly at follow-up.
Outcomes of nighttime physical restraint removal for severely impaired nursing home residents
Authors: Capezuti Elizabeth , Strumpf Neville , Evans Lois , Maislin Greg 
Published: June 2007

There is ample evidence that physical restraint reduction does not lead to increased falls or injuries. This study tests the effect of removing nighttime restraints by comparing two groups: Restrained in bed at pre- but not postintervention (n = 51), or restrained in bed at both pre- and post-intervention (n = 11). No differences in nighttime fall rates between the two groups were detected. Nighttime physical restraint removal does not lead to increases in falls from bed in older nursing home residents. Although markedly reduced in nursing homes, restraint use remains a common practice among hospitalized older adults. We should continue to focus efforts on developing new, individualized approaches to reduce risk of falling from bed among frail elders.
Correction of Coagulation Defect in Thoracoabdominal Aneurysm Repair by Mesenteric Shunting
Authors: Gertler Jonathan P. , Rehring Thomas F. , Davison J. Kenneth , Laposata Michael , Cambria Richard P. 
Published: June 2007

The authors have previously characterized laboratory coagulation abnormalities in patients undergoing thoracoabdominal aneurysm (TAA) repair as a reduction in clotting factor activity and an increase in the fibrinolysis that occurs after supraceliac clamping. A return to normal in these patients did not occur until the time of skin closure and was influenced by fresh frozen plasma (FFP) administration. To test the hypothesis that shortening the mesenteric ischemic time would mitigate the defect earlier in the operative course, the authors developed a technique of mesenteric shunting during TAA repair and studied coagulation response prospectively. Twelve consecutive elective patients had TAA repair carried out in standard fashion. No heparin was used. After completion of the proximal anastomosis, a coronary perfusion catheter was secured inside a previously sewn graft side arm and inserted into either the superior mesenteric artery or the celiac axis; the graft was clamped below the side arm. Blood levels of fibrinogen, F1.2, D-dimer, and Factors II, V, VII, VIII, IX, X, XI, and XII were analyzed at induction, immediately prior to mesenteric shunt insertion, at reimplantation of the visceral button and 30 minutes after visceral button reimplantation. Clamp times, volume and timing of blood products, and clinical outcomes were recorded prospectively. A two-sided, paired t test (pairwise/intersample) was applied for each factor studied. There was no coagulopathic bleeding. Indicators of fibrinolysis (fibrinogen, D-dimer) continued to rise throughout the procedure as had been true in our previous series. However, clotting factors returned to baseline shortly after mesenteric shunting and prior to administration of exogenous clotting factors. The return to baseline of the coagulation factors studied began at the time of the insertion of a mesenteric shunt. Visceral perfusion appears to have an impact on coagulation response. Earlier reperfusion may help extend the window of operative time by limiting coagulopathic bleeding that is occasionally seen during TAA repair.
Outpatient Varicose Vein Surgery with Transilluminated Powered Phlebectomy
Authors: Spitz Gregory A. , Braxton Jeffrey M. , Bergan John J. 
Published: June 2007

The present study was done to determine the feasibility, efficacy, and safety of varicose vein removal using a minimally invasive, powered, vein-extracting device with cutaneous transillumination and tumescent anesthesia techniques and then compare this to a retrospective group of hook phlebectomy operations. After preliminary development of the procedure, a prospective evaluation was done. There were 59 limbs in 56 patients (51 women, five men) treated with use of the vein extractor aided by transcutaneous illumination. Saphenous reflux was confirmed by preoperative duplex ultrasound using reflux technique and was treated by ligation of the saphenofemoral junction and stripping of the greater saphenous vein to the knee with external hooks. Surgery was performed under general anesthesia on an outpatient basis. Complications were documented. The number of incisions made was recorded and analyzed. Operative time was noted and patient satisfaction analog scores were recorded. Patients were asked to describe their pain and cosmetic results on an analog scale ranging from 1 to 10 with 1 representing no pain and 10 the worst imaginable and a similar scale for the best and worst cosmetic results. Data were analyzed by use of appropriate tests of significance and compared to historical controls of 114 hook phlebectomy operations done over a 12-month period. The 51 women ranged in age from 23 to 66 years (mean: 46). The men were 48, 48, 54, 59, and 72 years of age, respectively. There were 58 unilateral procedures (98%) and one bilateral operation. Operative time ranged from 23 to 58 minutes (mean: 41.0 minutes). The number of incisions per limb averaged 5.6. Cellulitis, small hematoma formation, and swelling or bruising beyond that expected occurred in four limbs (6.8%). Mean postoperative pain score at 48 hours was 3.0 with a median of 3.0. Mean postoperative pain score at 7 days was 2.0 with a median of 2.0. Postoperative pain scores at 6 weeks and 3 months were zero. Mean cosmetic score at 6 weeks was 2.5 with a median of 2.0. Mean cosmetic score at 3 months was 1.0 with a median of 1.0. These results compare very favorably to a historical control group of 114 similar patients who underwent stab avulsion hook phlebectomy to remove varicose vein clusters. Varicose vein extraction using transilluminated powered phlebectomy (TIPP) is safe, efficacious, and cosmetically satisfactory. The procedure decreases operating time and number of incisions required to remove varicose clusters.