Suchergebnisse

This report aims to illuminate the complex phenomenon of grief and the needs experienced throughout the time course of their impairments by adults with acquired visual impairments. The study applied a phenomenological research strategy using 10 case studies of South African adults, visually impaired within and beyond six years. Qualitative descriptive data were obtained from follow-up depth interviews. An essential insight gained from the study is that the duration of the acquired visual impairment impacts the unrealistic or realistic awareness of the implications and limitations of living with a chronic visual impairment. This factor profoundly influences the experience of grief and concomitant needs. A chronic, recurrent but episodic grief process and a dynamic process of both experienced needs and need satisfaction were emphasized.

ABSTRACT The aging of the population leads to an increase in the prevalence of dementia and mild cognitive impairment (MCI). Alzheimer's disease (AD) is the most common cause of dementia. Recent studies highlight the early non-amnestic deficits in AD and MCI. The European Union report shows the importance of thoroughly assessing cognitive aspects that have been poorly evaluated, such as processing speed (PS), which could represent early indicators of cognitive decline. Objective: To analyze the diagnostic accuracy of PS measures in older adults with MCI, AD, and those who are cognitively-healthy. Methods: A cross-sectional study was conducted by performing an extensive neuropsychological assessment in three samples: 26 control participants, 22 individuals with MCI, and 21 individuals with AD. Analysis of variance (ANOVA) was employed to test the relationship between dependent variables and the clinical group. Post hoc tests (Bonferroni test) were used when a significant ANOVA result was found. Finally, the Receiver Operating Characteristic (ROC) curve for PS measures was performed in older adults with MCI and AD compared with cognitively-healthy older adults. Results: The results showed that deficits in PS measures can be early indicators of cognitive decline in cases of MCI, even when executive functions (EFs) and functionality are preserved. Conversely, AD versus MCI presented differences in PS, EFs, and functionality. Conclusions: The ROC analyses showed that PS measures had discriminative capacities to differentiate individuals with MCI, AD, and cognitively-healthy older adults.

This study investigates the implications of acquiring vision impairment later in life on the effect of social support among adults with acquired vision impairment in Nigeria. It further explores the importance of maintaining social contact after vision loss which serves as the structural aspect of social support needed for adaptation to vision loss. A qualitative study using a phenomenological approach was undertaken. Eight adults (18- 59years) were recruited from disability service organizations in Nigeria. Telephone interviews were recorded and transcribed, and thematic analysis was used to analyse the data gathered in this study. Three broad themes were developed from participants' accounts of their experiences: (1) diminishment in social contact and social support from friends, romantic partners, and others; (2) negative changes in social support at workplace; and (3) increased social support from family members. The findings indicate that participants experienced diminished social contact and negative social support from friends, colleagues, and employers at the workplace. However, participants experienced increased social contact and positive social support from family members in the form of tangible and effective support. As social connectedness are highly valued in Nigeria's diverse society, we suggest that adults with acquired vision impairment would significantly benefit from support services that would assist these individuals to build and maintain their social contact or networks providing a platform for positive social support.

The aging of the population leads to an increase in the prevalence of dementia and mild cognitive impairment (MCI). Alzheimer's disease (AD) is the most common cause of dementia. Recent studies highlight the early non-amnestic deficits in AD and MCI. The European Union report shows the importance of thoroughly assessing cognitive aspects that have been poorly evaluated, such as processing speed (PS), which could represent early indicators of cognitive decline. OBJECTIVE: To analyze the diagnostic accuracy of PS measures in older adults with MCI, AD, and those who are cognitively-healthy. METHODS: A cross-sectional study was conducted by performing an extensive neuropsychological assessment in three samples: 26 control participants, 22 individuals with MCI, and 21 individuals with AD. Analysis of variance (ANOVA) was employed to test the relationship between dependent variables and the clinical group. Post hoc tests (Bonferroni test) were used when a significant ANOVA result was found. Finally, the Receiver Operating Characteristic (ROC) curve for PS measures was performed in older adults with MCI and AD compared with cognitively-healthy older adults. RESULTS: The results showed that deficits in PS measures can be early indicators of cognitive decline in cases of MCI, even when executive functions (EFs) and functionality are preserved. Conversely, AD versus MCI presented differences in PS, EFs, and functionality. CONCLUSIONS: The ROC analyses showed that PS measures had discriminative capacities to differentiate individuals with MCI, AD, and cognitively-healthy older adults.

AbstractImpairments in cognitive functioning, which obstruct psychiatric rehabilitation, are resistant to drugs and conventional psychosocial treatment but can be reduced by specialized training techniques.

Purpose
This literature review identifies instruments for diagnostic assessment of cognitive impairment in prison populations. The purpose of this paper is to promote procedures for early screening and identification of cognitive impairment using instruments appropriate to prisons.


Design/methodology/approach
A targeted literature review identified studies on screening and diagnostic assessment of adults in jails, prisons, police watch-houses (custody suites), rehabilitation facilities and forensic settings or community settings for offenders. Discriminant validity, suitability, reliability and feasibility of instruments in correctional and forensic settings are presented.


Findings
From 135 peer-reviewed articles relating to diagnostic assessment of cognitive impairment, 15 instruments were considered appropriate for use in prison settings.


Research limitations/implications
Selection of instruments for prison use considers suitability of the instrument(s) and clinical workforce capability. Cultural and gender validity of the instrument, its feasibility for use in the prison environment and cost and time to administer are also important. Using appropriate tools as part of a staged and targeted process in the screening and diagnosis of cognitive impairment is demonstrated by two case vignettes presented in this paper. As this was a desk review, the authors did not evaluate the instruments.


Originality/value
Identification of instruments that are suitable for diagnosis of cognitive impairment in forensic populations informs the rehabilitation of offenders with cognitive impairment in prison and upon release to probation and parole.

Purpose
The authors reviewed studies of validated tools to screen for cognitive impairment among prisoners. The purpose of this paper is to assist organisations in identifying cognitive impairment in correctional facilities.


Design/methodology/approach
A targeted literature review identified peer-reviewed articles on screening of adults in jails, prisons, police watch-houses, custody suites, rehabilitation facilities and forensic settings or community settings for offenders. Validation of screening tools in secure settings, psychometric properties and cultural discrimination is included in this review.


Findings
Eight screening tools are considered suitable for use in correctional settings. Two screening tools are recommended for cognitive impairment, one is recommended for adaptive functioning assessment and one is recommended for screening of brain injury. Two screening tools are noted to be subject to piloting and further development for use with First Nations people, and two screening tools for cognitive impairment are noted for positive consideration.


Research limitations/implications
Recommendations for screening tools are based on review only and evaluation was infeasible.


Practical implications
Short, reliable measures of cognitive ability for use in correctional facilities are needed. Such tools must be appropriate with respect to their purpose, feasible within the clinical capability of staff and sufficiently cheap to administer to allow widespread use.


Originality/value
Screening of prisoners for cognitive impairment allows early detection to facilitate rehabilitation and therapy. This research is at the systems level. Therefore, the authors do not purport to provide guidance for individual clinicians.

This paper addresses the handicapping effects of acquired monocular impairment. The author stresses the importance of informing professionals about monocular impairment and encourages them to pursue rehabilitation programs for their clients. The nature of monocular impairment from the standpoint of sensory psychology is also examined. Data are presented fixing the degree of disability in economic, psychological, and social contexts, explicating the group statistics with case reports.

Psychiatrists are increasingly called upon to care for individuals with cognitive, emotional, and behavioral disturbances after TBI, especially in settings serving military service personnel and Veterans. In both the early and late post-injury periods, cognitive impairments contribute to disability among persons with TBI and are potentially substantial sources of suffering for persons with TBI and their families. In this article, the differential diagnosis, evaluation, and management of posttraumatic cognitive complaints is reviewed. The importance of pre-treatment evaluation as well as consideration of non-cognitive contributors to cognitive problems and functional limitations is emphasized first. The course of recovery after TBI, framed as a progression through posttraumatic encephalopathy, is reviewed next and used to anchor the evaluation and treatment of posttraumatic cognitive impairments in relation to injury severity as well as time post-injury. Finally, pharmacologic and rehabilitative interventions that may facilitate cognitive and functional recovery at each stage of posttraumatic encephalopathy are presented.

Jun-Young Lee,1,2 Sooyeon Kho,1,2 Hye Bin Yoo,1,2 Soowon Park,1,2 Jung-Seok Choi,1,2 Jun Soo Kwon,3 Kyung Ryeol Cha,4 Hee-Yeon Jung1,21Department of Psychiatry, Seoul National University, 2Seoul Metropolitan Government – Seoul National University Boramae Medical Center, 3Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea; 4Department of Psychiatry, Osan Mental Hospital, Gyeonggi, South KoreaObjective: This study aims to apply the virtual radial arm maze (VRAM) task to find spatial working memory and reference memory impairments in patients of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD). Spatial memory functions between aMCI converters and nonconverters are also compared using VRAM results.Methods: We assessed the spatial memory in 20 normal controls, 20 aMCI, and 20 mild AD subjects using VRAM. The Mini-Mental State Examination, Clinical Dementia Rating scale, and other neuropsychological tests were given to the subjects in conjunction with the VRAM test. Scores in working memory errors and reference memory errors were compared among the three groups using repeated measures analysis of variance. In addition, aMCI patients were followed-up after 5 years and surveyed for AD conversion rate.Results: In AD patients, both spatial working and reference memory were impaired. However, in aMCI subjects, only spatial reference memory was impaired. Significant spatial reference memory impairment was found in the aMCI converter group when compared to the nonconverter group.Conclusion: Spatial working memory is less impaired in aMCI while reference memory is similarly damaged in AD. In aMCI patients, more severe spatial reference memory deficit is a neuropsychological marker for AD conversion. VRAM may be well utilized in humans to assess spatial memory in normal aging, in aMCI, and in AD.Keywords: spatial behavior, Alzheimer's disease, user computer interface, cognition