Individualized guidelines for the management of aggression in dementia – Part 2: appraisal of current guidelines

2012 ◽  
Vol 24 (7) ◽  
pp. 1125-1132 ◽  
Author(s):  
Victor Vickland ◽  
Natalie Chilko ◽  
Brian Draper ◽  
Lee-Fay Low ◽  
Daniel O'Connor ◽  
...  
Keyword(s):  
Individual Characteristics ◽  
Personal History ◽  
Point Scale ◽  
Pharmacological Interventions ◽  
Restraint Use ◽  
Key Concepts ◽  
History Of ◽  
The Individual ◽  
Current Guidelines ◽  
Improve Health

ABSTRACTBackground: Individualized guidelines have the potential to offer clinicians assistance in decision-making at the point of consultation to improve health outcomes for patients. This project aims to develop individualized guidelines for the management of aggression in dementia. At an earlier stage, we developed a map of concepts to consider when managing aggression. The purpose of the current study is to appraise paper-based guidelines for their representation of these concepts.Methods: Two reviewers used a four-point scale (absent, weak, moderate, strong) to rate the guidelines on their representation of concepts relating to the patient, the aggression and dementia disorder, the treatment, and the guidelines themselves. Consensus was reached on inconsistent scores.Results: Sixteen guidelines published since 2005 were evaluated for their representation of 13 key concepts. Pharmacological and non-pharmacological interventions were strongly represented overall in the guidelines, in conjunction with a consideration of the individual characteristics of the patients and their environment. Recommendations based on the presentation of the aggressive symptoms, goals of treatment, and theory of the cause of the aggression were moderately represented in the guidelines. Recommendations for the principles of restraint use and emergency treatment, as well as a consideration of the personal history of the patient, were poorly represented. Only 6 of 16 guidelines gave details of the expected review.Conclusion: Concepts important to the management of aggression in dementia are missing in the majority of published guidelines on dementia. This limits the ability of these tools to guide clinical practice effectively.

Individualized guidelines for the management of aggression in dementia – Part 1: key concepts

2012 ◽  
Vol 24 (7) ◽  
pp. 1112-1124 ◽  
Author(s):  
Victor Vickland ◽  
Natalie Chilko ◽  
Brian Draper ◽  
Lee-Fay Low ◽  
Daniel O'Connor ◽  
...  
Keyword(s):  
Clinical Guidelines ◽  
Life Story ◽  
Concept Map ◽  
Treatment Options ◽  
Individual Characteristics ◽  
Pharmacological Interventions ◽  
Restraint Use ◽  
Wide Range ◽  
Key Concepts ◽  
Interactive Map

ABSTRACTBackground:Clinical guidelines have the potential to assist in the management of aggression in dementia. This study aims to develop a conceptual framework for the construction of individualized guidelines for this group.Methods:A concept map of the topic “How to manage aggression in dementia” was developed by reviewing research papers, clinical guidelines, and gray literature. Titles and abstracts of papers that met search criteria were manually scanned in an iterative process for the extraction of key ideas and terminology commonly used to describe the field. Essential ideas and concepts were recorded on a concept map and hierarchically arranged. The concept map was converted into an interactive PDF document for easy distribution and sharing.Results:Ten key concepts were found to be important when managing aggression in dementia clustered along three major dimensions: Patient, Disorder and Treatment. The dimensionPatientwas defined by the “Patient's individual characteristics,” the “Personal life story,” and the “Patient's environment.”Disorderwas defined by the “Presentation of symptoms” and “Theory of causation.”Treatmentwas defined by “Goals and expectations,” “Non-pharmacological interventions,” “Pharmacological interventions,” “Ethics and Restraint Use,” and “Emergency treatment.” Concepts relating to clinical guidelines themselves were also included in the interactive map, including “Support from evidence-based medicine,” “Regular updates,” “Disclosures,” and “Usability.”Conclusion:Managing aggression in dementia requires consideration of a wide range of factors relating to the patient, the dementia and behavioral disturbance, and possible treatment options. An interactive and hierarchical concept map provides a framework to develop individualized clinical guidelines.

The Neuropathic Diathesis, or the Diathesis of the Degenerate

1888 ◽  
Vol 34 (146) ◽  
pp. 167-176
Author(s):  
G. T. Revington
Keyword(s):  
Family History ◽  
Normal Development ◽  
Personal History ◽  
Striking Feature ◽  
General Paralysis ◽  
History Of ◽  
The Creation ◽  
The Individual ◽  
The Mind

I think that the foregoing statistics, and those which follow, together with the large number of cases which I quote, and which connect general paralysis with almost every form of neurotic manifestation, will prove conclusively that neurotic inheritance is a striking feature in the causation of general paralysis. I question whether a distinction between “the cerebral and the insane element” in general paralysis can be maintained. If general paralysis is not a degeneration of the mind-tissue, then the pathology of insanity has no existence, and I would say that the subtle influence for evil, which is transmitted from parents, whose brains are deteriorated by neurotic outbursts, or soaked in alcohol, or wrecked by physiological immorality, tends strongly towards such degeneration. If insanity is, as Dr. Savage says, a perversion of the ego, then a general paralytic is the in-sanest of the insane. We know that the children of a melancholic parent, for example, may develop any form of neurosis—in other words, it is not that melancholia or general paralysis, or any other definite disease, is transmitted, but that a certain tendency to deviate from normal development is transmitted. This tendency to deviate is the neurotic diathesis, and the form of its development is determined by collateral circumstances, and a certain series of collateral circumstances determine the development of general paralysis. Perhaps neurotic inheritance may mean in some cases a limited capital of nervous energy, and if this is wasted recklessly the individual breaks down suddenly and pathologically, as we all do slowly and physiologically. I would also point out that considering the number of histories of insanity which owing to ignorance or reticence we, do not receive, and considering that we never receive information as to the existence of the slighter neuroses, it is marvellous that we get so high a percentage as 51. Of the 145 general paralytics with a reliable history, 38 had a family history of insanity, 28 a family history of drink, 8 of both, 43 had a personal history of drink, 8 of a previous attack too remote to be considered, at least, according to our present ideas, as part of the disease, and the vast majority had a history of some physiological irregularity which must be considered as conducive to the creation of an acquired neurosis. We may now pass to some further statistics.

scholarly journals PAVLO HOLUBEV’S VOCAL PEDAGOGY IN MODERN ART EDUCATION

2020 ◽  
pp. 167-171
Author(s):  
Anatolii MARTYNIUK ◽  
Keyword(s):  
Vocal Pedagogy ◽  
Individual Characteristics ◽  
Educational Process ◽  
Scientific Study ◽  
History Of ◽  
Musical Traditions ◽  
Vocal Art ◽  
Methodological Principles ◽  
Creative Talent ◽  
The Individual

Introduction. The modern vocal pedagogy is based on the methodological principles of domestic and foreign vocal pedagogy, thorough study of the musical traditions of the Ukrainian people. The issue of preserving the traditions of Ukrainian vocal art and the use of innovative ideas in further development is extremely important. The comprehensive analysis of P.V.Holubev’s artistic and pedagogical activities allows to significantly expand the idea of the the artist' work an at the same time realize its importance for the Ukrainian musical art. The artist left great achievements in the history of the national vocal school, contributing to the process of its formation and development. The purpose of the article is highlighting of vocal pedagogy of the outstanding Ukrainian artist, Professor P.V. Holubev. The methods of analysis of musical and pedagogical activity of Kharkiv singer, teacher, Professor P. Holubev. Results. Pavlo Holubev’s vocal pedagogy has distinctive features. Under his guidance, students learned not only solo, but also ensemble and choral singing. The individual lessons with students had as their main goal the achievement of equality of voice sound and the detection of unique timbre color of the sound and the gradual expansion of the range of voice in the descending and ascending directions starting from the development of the middle register; formation of a diverse palette of sound filled with overtones; performing interpretation of vocal music. It is revealed that in P. Holubev’s vocal pedagogy the following main content lines are traced: development of vocal skills, abilities; the need to introduce them into the system of teaching vocal methodology, which is based on the scientific study of national and world experience of vocal pedagogy; synthesis and constant updating of vocal methods, which takes into account the student’s individual characteristics of the voice and creative talent. Originality. After analyzing the artistic and pedagogical activity of Professor P. Holubev we can define certain scientific approaches to educational process, namely: 1) axiological approach; 2) personality-oriented approach; 3) creative and activity approach. Conclusions. Thus, analyzing the musical and pedagogical activities of the outstanding singer, teacher, Professor P.V. Holubev, we can conclude that the features of his vocal pedagogy played an important role in the Kharkiv vocal school. Scientific study of the musical and pedagogical experience of P.V. Holubev became the basis of national and world vocal pedagogy.

scholarly journals First-Year Antibiotics Exposure in Relation to Childhood Asthma, Allergies, and Airway Illnesses

2020 ◽  
Vol 17 (16) ◽  
pp. 5700
Author(s):  
Zhijun Zou ◽  
Wei Liu ◽  
Chen Huang ◽  
Chanjuan Sun ◽  
Jialing Zhang
Keyword(s):  
Childhood Asthma ◽  
Cross Sectional Study ◽  
Individual Characteristics ◽  
First Year ◽  
Cross Sectional ◽  
Childhood Health ◽  
History Of ◽  
Household Environment ◽  
One Year ◽  
The Individual

Background: Associations of early antibiotics exposures with childhood asthma, allergies, and airway illnesses are debated. Objectives: We aimed to investigate associations of first-year antibiotics exposure with childhood asthma, allergies, and airway illnesses. Methods: A cross-sectional study was conducted among preschoolers in Shanghai, China during 2011–2012. A questionnaire regarding household environment and lifestyles and childhood health outcomes was reported by the child’s parents. Results: In total, 13,335 questionnaires (response rate: 85.3%) were analyzed and 3049 (24.1%) children had first-year antibiotics exposure. In the multivariate logistic regression analyses, first-year antibiotics exposure had significant associations with the higher odds of lifetime-ever pneumonia (adjusted OR, 95% CI: 2.15, 1.95–2.37), croup (1.46, 1.24–1.73), wheeze (1.44, 1.30–1.60), asthma (1.38, 1.19–1.61), food allergy (1.29, 1.13–1.46), and allergic rhinitis (1.23, 1.07–1.41), and as well as current (one year before the survey) common cold (≥3 times) (1.38, 1.25–1.52), dry cough (1.27, 1.13–1.42), atopic dermatitis (1.25, 1.09–1.43), wheeze (1.23, 1.10–1.38), and rhinitis symptoms (1.15, 1.04–1.26). These associations were different in children with different individual characteristics (age, sex, family history of atopy, and district) and other early exposures (breastfeeding, home decoration, pet-keeping, and environmental tobacco smoke). Conclusions: Our results indicate that first-year antibiotics exposure could be a strong risk factor for childhood pneumonia, asthma, allergies, and their related symptoms. The individual characteristics and other early exposures may modify effects of early antibiotic exposure on childhood allergies and airway illnesses.

scholarly journals Individual vulnerabilities to psychosis after antiepileptic drug administration

2020 ◽  
Vol 2 (2) ◽  
pp. e000036
Author(s):  
Nozomi Akanuma ◽  
Naoto Adachi ◽  
Peter Fenwick ◽  
Masumi Ito ◽  
Mitsutoshi Okazaki ◽  
...  
Keyword(s):  
Family History ◽  
Focal Epilepsy ◽  
Individual Characteristics ◽  
New Drugs ◽  
Individual Vulnerability ◽  
Intellectual Function ◽  
State Dependent ◽  
History Of ◽  
History Of Epilepsy ◽  
The Individual

BackgroundPsychosis often develops after the administration of antiepileptic drugs (AEDs) in patients with epilepsy. However, the individual vulnerability and clinical condition of such patients have been rarely scrutinised. We investigated the effect of individually consistent (trait-dependent) and inconsistent (state-dependent) characteristics.MethodsThe individual characteristics, clinical states and psychotic outcome of patients from eight adult epilepsy clinics were retrospectively reviewed over 6-month periods after a new drug (AED or non-AED) administration between 1981 and 2015.ResultsA total of 5018 new drugs (4402 AEDs and 616 non-AEDs) were used in 2015 patients with focal epilepsy. Subsequently, 105 psychotic episodes (81 interictal and 24 postictal) occurred in 89 patients. Twelve patients exhibited multiple episodes after different AED administrations. Trait-dependent characteristics (early onset of epilepsy, known presumed causes of epilepsy, lower intellectual function and a family history of psychosis) were significantly associated with the patients who exhibited psychosis. Absence of family history of epilepsy was also associated with psychosis but not significantly. Subsequent logistic regression analysis with a model incorporating family history of psychosis and epilepsy, and intellectual function was the most appropriate (p=0.000). State-dependent characteristics, including previous psychotic history and epilepsy-related variables (longer duration of epilepsy, AED administration, higher seizure frequency and concomitant use of AEDs) were significantly associated with psychotic episodes. Subsequent analysis found that a model including AED administration and previous psychotic history was the most appropriate (p=0.000).ConclusionPsychosis occurring after new AED administration was related to the individual vulnerability to psychosis and intractability of epilepsy.

Job Loss: Outplacement Programs

2014 ◽  
Author(s):  
William A. Borgen ◽  
Lee D. Butterfield
Keyword(s):  
Career Counseling ◽  
Job Search ◽  
Job Loss ◽  
Individual Characteristics ◽  
Displaced Workers ◽  
Vulnerable Population ◽  
Best Interests ◽  
Outplacement Counseling ◽  
History Of ◽  
The Individual

Outplacement counseling (OPC) is a form of career counseling that organizations offer to displaced workers to help them deal with job loss, develop job search skills, and successfully transition back into employment. Despite the fact this is a multimillion-dollar business, little is known about its effectiveness, whose best interests are being served (the organization’s or the individual recipient’s), and the measures of success being used. This chapter reviews the history of outplacement; typical services offered by OPC firms; measures of success; individual characteristics that increase participation in and success with OPC; what helps, hinders, or would have helped individual recipients; challenges related to OPC; directions for future outplacement counseling research; where OPC stands today; and what is needed for OPC to help the vulnerable population it is intended to serve.

scholarly journals Concept “Happiness” in the Autobiographical Prose of Vladimir Nabokov

2020 ◽  
Vol 2020 (2) ◽  
pp. 112-121
Author(s):  
Nadezhda S. Stepanova
Keyword(s):  
Cultural Memory ◽  
Vladimir Nabokov ◽  
Point Of View ◽  
Personal History ◽  
Artistic Experience ◽  
The Gift ◽  
History Of ◽  
The Subject ◽  
The Individual ◽  
Artistic Image

«Happiness» is one of the most significant cultural universals, semantically related to the concepts of the spiritual life of a man, the most important element performing meaning-forming and plot-forming role in an artistic work. The study of the reflection of notions about happiness in the autobiographical prose of V. Nabokov in the context of the literary and cultural situation of the first wave of Russian emigration is defined by the specifics of autobiography as a text that is created at the end of life and involves its recognition from the point of view of a person summing up intermediate or final results. The article analyzes the artistic concept «happiness» in the autobiographical prose of V. Nabokov; it determines its individual author’s content that is correlated with the general cultural content of the concept. The article is devoted to the study of the concept «happiness» as a complex emotional and value formation which reflects the universal artistic experience, recorded in the cultural memory, expresses the individual author’s understanding of the essence of objects and phenomena. The conceptual component of the word «happiness» in the creativity of V. Nabokov includes the harmonious fullness of life, freedom, the gift of creativity, the happiness of childhood, family, the hearth, the happiness of love and marriage, the enjoyment of life and its joys, a reflection of the personal history of upbringing and testing. The concept «happiness» implements not only semantic, but also axiological possibilities, reflecting both the own characteristics of the subject of the artistic image and the features of idiostyle of the writer.

scholarly journals Experience Rating Schemes for Fleets of Vehicles

2001 ◽  
Vol 31 (1) ◽  
pp. 81-105 ◽  
Author(s):  
Denise Desjardins ◽  
Georges Dionne ◽  
Jean Pinquet
Keyword(s):  
Road Safety ◽  
Individual Characteristics ◽  
Data Set ◽  
Experience Rating ◽  
The Public ◽  
Empirical Results ◽  
History Of ◽  
The Individual

AbstractThis paper proposes bonus-malus systems for fleets of vehicles, by using the individual characteristics of both the vehicles and the carriers. Bonus-malus coefficients are computed from the history of claims or from the history of safety offences of the carriers and the drivers. The empirical results are derived from a data set obtained from the Société de l'Assurance Automobile du Québec, the public insurer for bodily injuries and the regulator of road safety.

PIXE ANALYSIS OF HILAR GLAND FOR THE EVALUATION OF PERSONAL HISTORY OF EXPOSURE TO ENVIRONMENTAL CONTAMINANTS

1992 ◽  
Vol 02 (04) ◽  
pp. 453-459
Author(s):  
SHUICHI ADACHI ◽  
KAZUO TAKEMOTO ◽  
YOSHIHIKO SASA ◽  
KUNIHIKO MAEDA
Keyword(s):  
Lung Tissue ◽  
Environmental Contaminants ◽  
Lung Parenchyma ◽  
Chemical Form ◽  
Personal History ◽  
Individual Risk ◽  
Occupational History ◽  
Pixe Analysis ◽  
History Of ◽  
The Individual

Seven autopsied cases were studied for the evaluation of individual history of exposure to environmental contaminants based on the elemental profile of hilar gland by PIXE and lung tissue by AAS. The results well characterized their occupational history, especially from Cr, Al, Si and As detection. Moreover, it might be possible that these analyses would provide data to suspect the chemical form of each element in deposited particles of lung parenchyma, since the solubility could reflect the different profile of element between hilar gland and lung parenchyma. In addition to these retrospective analyses using the materials obtained from autopsies, it is possible to assess the individual risk using small quantity of hilar gland or lung tissue obtained by biopsy or surgical resection.

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