THE COMPLEXITY OF THE CONCEPT OF FRAGILITY IN MEDICAL PRACTICE. CLINICAL IMPLICATIONS OF FRAGILITY SYNDROME IN ELDERLY PATIENTS ASSOCIATING CARDIOVASCULAR DISEASES

Frailty, in association with aging and chronic disorders, is a key predictive factor of the quality of life and accelerating aging, which contributes to disability and, therefore, has important social-economic implications. The frailty nosological specific features outline to elderly people must be emphasized with its correlative specificities. Without considering a gold standard, we consider that it is useful to make a few clear delimitations and correlations of various frailty concepts and of assessment methods and biomarkers that help easy identify fragile patients. Frailty is a result of the decreasing quality of life in the elderly, that could be prevented, postponed or even improved by well-defined multi-factorial interventions

Real-World Experiences in Autistic Adult Diagnostic Services and Post-diagnostic Support and Alignment with Services Guidelines: Results from the ASDEU Study

Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and post-diagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, < 2% of adults or carers, and < 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals

Intervention Services for Autistic Adults: An ASDEU Study of Autistic Adults, Carers, and Professionals' Experiences

The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated local services' use experiences of autistic adults, carers and professionals with interventions for autistic adults. The majority of the 697 participants experienced recommended considerations prior to deciding on intervention and during the intervention plan and implementation. Psychosocial interventions were the most commonly experienced interventions, while pharmacological interventions NOT recommended for core autistic symptoms were reported by fairly large proportions of participants. Family interventions were experienced slightly more commonly by carers than adults or professionals. Less than the 26% of autistic adult responders who had experienced challenging behaviors reported receiving an intervention to change them. These results provide insights for improving gaps in service provision of interventions among autistic adults

COGNITIVE FRAGILITY – PREDICTIVE FACTOR FOR NEUROCOGNITIVE DISORDERS. METHODS OF EVALUATION AND PREVENTION OF COGNITIVE FRAGILITY IN CLINICAL PRACTICE

Frailty is a clinical condition, associated with the pathological aging process, as well as a major risk for the occurrence of chronic non-communicable diseases (NCDs). Cognitive functions of people over 65 years old are influenced by numerous biological, psychological and social factors that contribute to the development of neurodegenerative disorder. Cognitive decline plays a fundamental role and contributes to the frailty syndrome in elderly people, which has led to the emergence of a new concept – cognitive frailty. Unlike most neurodegenerative diseases, frailty can be partially reversible, with the help of influencing factors and specific interventions at the emergence of it

ELEMENTE ESENŢIALE ÎN INVESTIGAREA TULBURĂRII GLOBALE DE DEZVOLTARE ŞI A DIZABILITĂŢII INTELECTUALE LA COPIL

Obiective. Lucrarea subliniază modalităţile de investigare a etiologiei tulburării globale de dezvoltare (TGD), retardului mintal (RM) sau dizabilităţii intelectuale (DI) şi ordinea efectuării acestora. TGD şi RM/DI sunt entităţi cronice cu debut în perioada de dezvoltare, care afectează funcţiile personale, sociale, academice, ocupaţionale. Elucidarea etiologiei este importantă pentru stabilirea managementului, prognosticului, riscului de recurenţă, eventualelor posibilităţi de prevenţie şi pentru scăderea impactului psihoemoţional asupra familiilor. Material şi metodă. Literatura relevantă a fost revizuită, în prezent fi ind publicate recomandări de abordare a pacienţilor cu TGD/RM, pornind de la un istoric complet, o examinare clinică minuţioasă, apoi formulând o suspiciune etiologică şi incluzând teste genetice, metabolice, neuroimagistice. Rezultate şi concluzii. Progresele din domeniul geneticii au modifi cat abordarea copilului cu TGD de etiologie neelucidată, crescând rata de identifi care a anomaliilor cromozomiale patogenice. Hibridizarea genomică comparativă este recomandată de primă linie, cu cariotiparea ca investigaţie complementară. Secvenţierea permite analiza numeroaselor gene implicate în TGD, iar consultul genetic prioritizează investigaţiile. Identifi carea diagnosticului etiologic oferă posibilitatea stabilirii unor planuri de management anticipativ, individualizat, în vederea limitării complicaţiilor şi comorbidităţilor asociate, pentru îmbunătăţirea calităţii vieţii pacienţilor

Autistic Adult Health and Professional Perceptions of It: evidence from the ASDEU Project

The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated the knowledge and health service experiences of users and providers to generate new hypotheses and scientific investigations that would contribute to improvement in health care for autistic adults. An online survey designed for autistic adults, carers of autistic adults, and professionals in adult services was translated into 11 languages and distributed electronically by organizations and in-country adult service facilities in 2017; 522 autistic adults, 442 carers, and 113 professionals provided answers to the health questions. Professionals, the majority in non-medical services, appeared to be poorly informed about whether certain co-occurring conditions were more frequent in autistic adults than typical adults-especially some medical conditions, suicide attempts, accidents, and pain. A minority of autistic adults reported preventive health behaviors such as routine health check-ups. The majority of users and providers expressed the desire to make health care services more user-friendly for autistic adults. Among the three groups, <20% of responders knew an organization or clinician which has developed a way to monitor health, and prevent poor health, that works well for adults on the autism spectrum. The results point to means for better management of co-occurring conditions associated with autism in adulthood in order to reduce hospital admissions and potential areas of improvement in health and social services for autistic adults. Specifically, efforts should be focused on (1) professionals' education on risks for co-occurring conditions in autistic adults; (2) promoting preventive health behaviors; (3) making services user-friendly for autistic adults and their families; and (4) encouraging knowledge of good local services.This study was funded by the European Parliament and managed by the European Union, DGSANTE [Ref.: SANCO/2014/C2/035]. The Italian Ministry of Health projects Osservatorio Italiano per il monitoraggio dei disturbi dello spettro autistico (Fasc. 1S49) and I disturbi dello spettro autistico: attività previste dal decreto ministeriale del 30.12.2016 (Fasc. 2S57) granted the contribution of the Italian data.info:eu-repo/semantics/publishedVersio

Real-World Experiences in Autistic Adult Diagnostic Services and Post-diagnostic Support and Alignment with Services Guidelines: Results from the ASDEU Study

Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and postdiagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, < 2% of adults or carers, and < 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals.g This study was funded by the European Parliament and managed by the European Union, DGSANCO, [Ref.: SANCO/2014/ C2/035]. The Italian Ministry of Health projects ‘Osservatorio Italiano per il monitoraggio dei disturbi dello spettro autistico’ (Fasc. 1S49) and ‘I disturbi dello spettro autistico: attività previste dal decreto ministeriale del 30.12.2016’ (Fasc. 2S57) granted the contribution of the Italian data.info:eu-repo/semantics/publishedVersio

Real-World Experiences in Autistic Adult Diagnostic Services and Post-diagnostic Support and Alignment with Services Guidelines: Results from the ASDEU Study

Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and postdiagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, < 2% of adults or carers, and < 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals.g This study was funded by the European Parliament and managed by the European Union, DGSANCO, [Ref.: SANCO/2014/ C2/035]. The Italian Ministry of Health projects ‘Osservatorio Italiano per il monitoraggio dei disturbi dello spettro autistico’ (Fasc. 1S49) and ‘I disturbi dello spettro autistico: attività previste dal decreto ministeriale del 30.12.2016’ (Fasc. 2S57) granted the contribution of the Italian data.info:eu-repo/semantics/publishedVersio

Autistic adult health and professional perceptions of it:evidence from the ASDEU project

Abstract The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated the knowledge and health service experiences of users and providers to generate new hypotheses and scientific investigations that would contribute to improvement in health care for autistic adults. An online survey designed for autistic adults, carers of autistic adults, and professionals in adult services was translated into 11 languages and distributed electronically by organizations and in-country adult service facilities in 2017; 522 autistic adults, 442 carers, and 113 professionals provided answers to the health questions. Professionals, the majority in non-medical services, appeared to be poorly informed about whether certain co-occurring conditions were more frequent in autistic adults than typical adults—especially some medical conditions, suicide attempts, accidents, and pain. A minority of autistic adults reported preventive health behaviors such as routine health check-ups. The majority of users and providers expressed the desire to make health care services more user-friendly for autistic adults. Among the three groups, &lt;20% of responders knew an organization or clinician which has developed a way to monitor health, and prevent poor health, that works well for adults on the autism spectrum. The results point to means for better management of co-occurring conditions associated with autism in adulthood in order to reduce hospital admissions and potential areas of improvement in health and social services for autistic adults. Specifically, efforts should be focused on (1) professionals' education on risks for co-occurring conditions in autistic adults; (2) promoting preventive health behaviors; (3) making services user-friendly for autistic adults and their families; and (4) encouraging knowledge of good local services

Real-world experiences in autistic adult diagnostic services and post-diagnostic support and alignment with services guidelines:results from the ASDEU study

Abstract Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and post-diagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, &lt; 2% of adults or carers, and &lt; 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals