Direct costs of dementia in nursing homes

Dementia represents an economical burden to societies nowadays. Total dementia expenses are calculated by the sum of direct and indirect costs. Through the stages of the diseases, as the patients may require institutionalization or a formal caregiver, the direct costs tend to increase. This study aims to analyze the direct costs of dementia in Portuguese nursing homes in 2012, compare the spending between seniors with and without dementia, and propose a predictive costs model. The expenses analysis was based on (1) the use of emergency rooms and doctor’s appointments, either in public or private institutions; (2) days of hospitalization; (3) medication; (4) social services use; (5) the need for technical support; and (6) the utilization of rehabilitation services. The sample was composed of 72 people, half with dementia and half without. The average annual expense of a patient with dementia was e15,287 thousand, while the cost of a patient without dementia was about e12,289 thousand. The variables “ability to make yourself understood,” “self-performance: getting dressed” and “thyroid disorders” were found to be statistically significant in predicting the expenses’ increase. In nursing homes, in 2012, the costs per patient with dementia were 1, 2 times higher than per patient without dementia

“To be or not to be retained… Thats' the question!” Retention, self-esteem, self-concept, achievement goals, and grades

This Document is Protected by copyright and was first published by Frontiers. All rights reserved. It is reproduced with permission.Keeping students back in the same grade – retention – has always been a controversial issue in Education, with some defending it as a beneficial remedial practice and others arguing against its detrimental effects. This paper undertakes an analysis of this issue, focusing on the differences in student motivation and self-related variables according to their retention related status, and the interrelationship between retention and these variables. The participants were 695 students selected from two cohorts (5th and 7th graders) of a larger group of students followed over a 3-year project. The students were assigned to four groups according to their retention-related status over time: (1) students with past and recent retention; (2) students with past but no recent retention; (3) students with no past but recent retention; (4) students with no past or recent retention. Measures of achievement goal orientations, self-concept, self-esteem, importance given to school subjects and Grade Point Average (GPA) were collected for all students. Repeated measures MANCOVA analyses were carried out showing group differences in selfesteem, academic self-concept, importance attributed to academic competencies, task and avoidance orientation and academic achievement. To attain a deeper understanding of these results and to identify profiles across variables, a cluster analysis based on achievement goals was conducted and four clusters were identified. Students who were retained at the end of the school year are mainly represented in clusters with less adaptive motivational profiles and almost absent from clusters exhibiting more adaptive ones. Findings highlight that retention leaves a significant mark that remains even when students recover academic achievement and retention is in the distant past. This is reflected in the low academic self-concept as well as in the devaluation of academic competencies and in the avoidance orientation which, taken together, can undermine students’ academic adjustment and turn retention into a risk factor.Fundação para a Ciência e a Tecnologia (FCT