De Cognitieve Screening Test (CST) getoetst aan het schaalmodel van Mokken

In 1991 kwam voor klinisch gebruik in de psychogeriatrie de Cognitieve Screening Test (CST) beschikbaar. De CST heeft twintig items en bevat oriëntatievragen, vragen naar bekende publieke personen (zoals de huidige koningin, haar voorgangster, de minister-president) en vragen naar feiten uit voorbije jaren (zoals de jaartallen van de twee wereldoorlogen).1 Voor toepassing in de klinische praktijk is het belangrijk dat de somscore over de items van de CST betekenisvolle uitspraken toelaat over een eigenschap van de respondenten, zoals in dit geval hun niveau van cognitief functioneren. Betekenisvol kan op minstens twee manieren worden opgevat, in de zin van betrouwbaarheid en validiteit. Om betrouwbaar individuele verschillen te kunnen vaststellen, is het van belang dat de testscore respondenten systematisch ordent op de gemeten eigenschap. 2 Validiteit heeft betrekking op het verband tussen de gemeten (latente) eigenschap en de resultaten van andere metingen of observaties in verwante domeinen

Cognitive neuroscience of delusions in aging

Assessments and clinical understanding of late-onset delusions in the elderly are inconsistent and often incomplete. In this review, we consider the prevalence, neurobehavioral features, and neuroanatomic correlations of delusions in elderly persons – those with documented cognitive decline and those with no evidence of cognitive decline. Both groups exhibit a common phenotype: delusions are either of persecution or of misidentification. Late-onset delusions show a nearly complete absence of the grandiose, mystical, or erotomanic content typical of early onset psychoses. Absent also from both elderly populations are formal thought disorders, thought insertions, and delusions of external control. Neuroimaging and behavioral studies suggest a frontotemporal localization of delusions in the elderly, with right hemispheric lateralization in delusional misidentification and left lateralization in delusions of persecution. We propose that delusions in the elderly reflect a common neuroanatomic and functional phenotype, and we discuss applications of our proposal to diagnosis and treatment

Measurement of overall quality of life in nursing homes through self-report: the role of cognitive impairment

Measuring quality of life is a necessity for adequate interventions. This paper concerns the usefulness of six self-report measures for overall quality of life for nursing home residents with various levels of cognitive impairment. It was investigated which proportion of residents from four cognition groups could complete a scale, and internal consistency and construct validity of the scales were studied. Data collection took place in ten Dutch nursing homes (N = 227). The proportion of residents that could complete each scale varied. The Depression List could be administered most often to the cognitively most impaired group (43%; Mini Mental State Examination-scores 0–4). In the three cognition groups with MMSE-score >5, internal consistency of the Depression List, Geriatric Depression Scale and Negative Affect Scale was adequate in all three groups (alpha ≥.68). Intercorrelation was highest for the Philadelphia Geriatric Center Morale Scale, the Depression List, and the Geriatric Depression Scale (rho ≥.65). Nonetheless, self-report scales were not strongly correlated with two observational scales for depression, especially in cognitively severely impaired residents (rho ≤.30). In conclusion, it may not be possible to measure overall quality of life through self-report, and possibly also through observation, in many nursing home residents

Item response theory analysis of cognitive tests in people with dementia:a systematic review

BACKGROUND: Performance on psychometric tests is key to diagnosis and monitoring treatment of dementia. Results are often reported as a total score, but there is additional information in individual items of tests which vary in their difficulty and discriminatory value. Item difficulty refers to an ability level at which the probability of responding correctly is 50%. Discrimination is an index of how well an item can differentiate between patients of varying levels of severity. Item response theory (IRT) analysis can use this information to examine and refine measures of cognitive functioning. This systematic review aimed to identify all published literature which had applied IRT to instruments assessing global cognitive function in people with dementia. METHODS: A systematic review was carried out across Medline, Embase, PsychInfo and CINHAL articles. Search terms relating to IRT and dementia were combined to find all IRT analyses of global functioning scales of dementia. RESULTS: Of 384 articles identified four studies met inclusion criteria including a total of 2,920 people with dementia from six centers in two countries. These studies used three cognitive tests (MMSE, ADAS-Cog, BIMCT) and three IRT methods (Item Characteristic Curve analysis, Samejima’s graded response model, the 2-Parameter Model). Memory items were most difficult. Naming the date in the MMSE and memory items, specifically word recall, of the ADAS-cog were most discriminatory. CONCLUSIONS: Four published studies were identified which used IRT on global cognitive tests in people with dementia. This technique increased the interpretative power of the cognitive scales, and could be used to provide clinicians with key items from a larger test battery which would have high predictive value. There is need for further studies using IRT in a wider range of tests involving people with dementia of different etiology and severity

Onderdrukking van de sinus aritmie tijdens een taak

U ovom su radu u sklopu teorijskog okvira objašnjeni pojmovi obiteljskog poduzetništva i poduzeća, predstavljena je važnost takvih poduzeća kao i njihova klasifikacija, odnosno vrste. Na poslovanje obiteljskih poduzeća utječu vanjska i unutarnja okolina, iz kojih dolaze pozitivni i negativni elementi koje poduzeće mora prepoznati te stoga iskoristiti njihove pozitivne strane ili izbjeći štetne učinke negativnih. U najnovije negativne elemente koji proizlaze iz vanjskog okruženja obiteljskog poduzeća spada pandemija virusa COVID-19 i korona kriza koju je izazvala. Krizne situacije potiču vlasnike poduzeća na propitivanje uspješnosti dugoročnog planiranja poslovanja poduzeća, koje je važno kako bi se izbjegli ili barem umanjili štetni učinci krize na poslovanje obiteljskog poduzeća. Na primjeru igraonice „Šareni balon“ koja je većinski izvor prihoda jednog obiteljskog poduzeća, analiziran je štetni učinak korona krize na poslovanje. Anketa i intervjui istraživačke su metode kojima su prikupljani podaci od dionika igraonice te njezinih klijenata. Analizom dobivenih rezultata utvrđena je kompleksnost poslovanja i organizacije poslovanja obiteljskog poduzeća tijekom krize. Rezultati istraživanja poslužili su kao podloga za donošenje adekvatnih preporuka za unapređenje poslovanja igraonice i poduzeća. Uočena je potreba za promjenom određenih segmenata poslovanja igraonice „Šareni balon“ kako bi se zadržala lojalnost stalnih korisnika igraonice te potaknuo izlazak poduzeća iz nepovoljne situacije uzrokovane korona krizom.The theoretical framework of family entrepreneurship and family businesses is explained in the thesis. In addition, the importance of such companies and their classification and types are presented. Given that the regular business of family owned companies is influenced by external and internal environments, and that both environments provide positive and negative effects, they should be recognized by the company and used for its advantage, at the same time trying to avoid the negative effects. The latest negative effects arising from the family business' external environment include the crisis caused by the COVID-19 virus pandemic. Crisis situations encourage business owners to review the success of long-term business planning. This important activity has to be carried out in order to avoid or at least reduce the harmful effects of the crisis on the businesses. The damaging effect of the corona crisis on a business was analysed using the example of the playroom "Šareni balon", a major source of income for the owners. In order to collect data from stakeholders and clients, the author used surveys and interviews as main research methods. The analysis of the collected results revealed the complexity of the business and the organization of this family-owned company during the crisis. The results of the research served as a basis for making appropriate recommendations and improving the studied business. Certainly, there is a need to change certain segments of this family-owned business – the playroom "Šareni balon", in order to maintain the loyalty of regular clients and to encourage the company to get out of the unfavourable situation caused by the corona crisis

Delusional misidentification and subsequent dementia: a clinical and neuropathological study

An 81-year-old man presented with psychotic episodes involving the delusion that his wife had been replaced by a closely resembling double (the so-called Capgras delusion). A comprehensive neuropsychological investigation revealed no signs of dementia at that time, but in the subsequent course the patient became demented and died 5 years later. Neuropathological and neurochemical examination displayed many diffuse plaques in the cortex that escaped detection by Congo-red but were clearly demonstrated by antibodies raised to beta-amyloid protein. Neurofibrillary tangles were absent in the cortex. Antiubiquitin immunohistochemistry revealed some cortical and subcortical Lewy bodies. The hippocampus and the majority of the nigral cells were intact. However, in the frontal and parietal white-matter many small lacunar infarcts were found due to arteriosclerotic and hypertensive vessel wall changes. Though the etiology of psychotic symptoms in the context of dementia is complex, this study shows the possible significance of white-matter lesions in the pathogenesis of delusions and subsequent dementi